Leadership

  • A/Prof Stephen Warrillow
  • Associate Professor Jonathan Barrett
  • Dr Con Giannellis
  • Associate Professor Nerina Harley
  • Dr Bryan Lashansky
  • Dr Laven Padayachee
  • Dr Simon Reilly
  • Associate Professor Ron Sultana
  • Dr Matt Ryan
  • Associate Professor Bill Nimorakiotakis
  • Dr Nicole Tan

Highlights

Emergency Department

  • Accredited for advanced trainees in emergency medicine for a 12-month period
  • Actively involved in research
  • Extremely low bypass rate
  • Features a purpose-designed clinical space with the best of medical technology to treat patients with serious conditions and an experienced team of emergency medicine professionals.
  • Higher rate of emergency physician specialists working in Epworth Emergency Department compared to other hospitals’ emergency departments.
  • Most specialties covered with a comprehensive on-call roster
  • Teaching Hospital: Medical students on rotation from Monash and Melbourne Universities

Intensive Care

  • Epworth admits approximately 3,000 patients to our four state-of-the-art intensive care units each year at Epworth Eastern, Epworth Freemasons, Epworth Richmond and Epworth Geelong.
  • Epworth Richmond ICU consists of 26 private rooms, providing patients with privacy and a quiet recovery environment. Each room features the latest medical equipment for monitoring patient conditions, as well as switchable glass that is transparent to enable monitoring but can be switched to opaque when privacy is required
  • Epworth Geelong ICU also has a state-of-the-art facility supporting the activities of our newest major hospital.

Anaesthetics

Anaesthesia

  • Epworth delivers anaesthesia and sedation for over 80,000 patients per year in 54 operating theatres over 5 campuses.
  • Anaesthesia is delivered for a huge range of procedures from small excisions under local anaesthesia and sedation to complex Open Heart, Neurosurgical and Orthopaedic procedures.
  • We are involved in anaesthesia for Robotic Surgery, Cancer Surgery, Obstetric procedures, IVF and many other types of procedures across our campuses.

Epworth Freemasons

 
Procedural specialty Anaesthetics
Gynaecology 5,574
Urology 3,132
General Surgery 2,970
Gastroenterology 2,155
Ophthalmology 1,946
Obstetrics 1,331
Plastic Surgery 1,120
 Orthopaedic Surgery 815
Otolaryngology 416
Oral & Maxillofacial 185

The above table includes more than 2,200 epidurals administered for analgesia in labour

Epworth Eastern

 
Procedural specialty Anaesthetics
General Surgery 6,095
Gastroenterology 2,904
Urology 2,631
Orthopaedic Surgery 2,269
Plastic Surgery 2,115
Cardiology 864
Gynaecology 739
Otolaryngology 646
Vascular Surgery 557
Cardiothoracic Surgery 337

Epworth Richmond

 
Procedural specialty Anaesthetics
Orthopaedic Surgery 10,283
General Surgery 5,018
Gastroenterology 4,719
Cardiology 2,874
Urology 2,872
Neurosurgery 2,063
Vascular Surgery 1,670
Gynaecology 1,663
Plastic Surgery 1,654
Cardiothoracic Surgery 718

Epworth Hawthorn


Procedural Specialty Anaesthetics
Gynaecology (incl IVF) 2,599
Plastic Surgery 510
Orthopaedic Surgery 456
Urology 442
Vascular Surgery 90
Oral & Maxillofacial 69
General Surgery 59
Neurosurgery 15

Acute pain management

Since the establishment of the acute pain service (APS) in September 2015 to October 2016:

  • Over 1000 patients have been reviewed, of whom 40 % had chronic pain
  • The main source of referrals to the service is from anaesthetists (45%), followed by surgeons (7%), ICU/MET calls (5%) and physicians (2%).
  • The main referring specialist group is orthopaedics (52%), followed by neurosurgery (21%) and general (10%).
  • 80% of patients referred to the APS are seen and discharged within three days.

A rotating medical roster was introduced in June 2016, including pain management specialists. The pain specialists are also supported by anaesthetists.

A rotating chronic pain roster was introduced in September 2016. Patients identifying as high risk or needing further management and assistance when discharged can be referred to a chronic pain specialist. The chronic pain specialists will review patients and provide support with their discharge pain management plan.

The APS has reviews and implements pain protocols and practices at Epworth, in consultation with the Anaesthetic Advisory Committee, Clinical Institutes and the Education Department.

Our performance

Emergency Department

Average waiting time to see a doctor*

23 minutes

Proportion staying > 24hrs (%)

0.06%

* In private hospitals this includes triage and provision of financial information.

Comment: We see 100% of critically unwell patients immediately and meet time targets for other categories of urgency

Intensive Care

To measure our performance, our intensive care results are compared with other hospitals participating in the Centre for Outcome and Resource Evaluation (CORE) hosted at the Australian and New Zealand Intensive Care Society.

A key measure of success in intensive care is the proportion of patients who survive. There are a significant amount of factors affecting an individual’s risk of a poor outcome. As a result, risk adjustment is used to take into account factors affecting potential patient outcome so that a fair comparison between hospitals can be made.

Benchmarking can then be undertaken using a standardised mortality rate (SMR), where an SMR of 1 is the expected outcome for a patient of a particular condition and clinical risk; and less than 1 a better than expected outcome.

ACHS emergency, anaesthetic and ICU

Area Indicator Epworth performance (%) Avg. national performance (%) Result comment
Anaes 3.1 Relief of respiratory distress in the recovery period 0.05 0.04 As per benchmark
Anaes 3.4 Severe pain not responding to pain protocol in the recovery period 0.36 0.37 As per benchmark
Anaes 3.5 Unplanned recovery room stay of longer than 2 hours for medical reasons 0.76 1.01 Performance better than benchmark

All patients presenting to an emergency department are assessed and assigned a triage category, as defined by the Australasian College for Emergency Medicine. The five triage categories range from patients requiring resuscitation (Category 1) to patients whose medical needs are not urgent (Category 5). The Australasian College for Emergency Medicine has identified the maximum time patients should wait until they’re seen by a nurse or medical officer for treatment for each of these categories.

Triage systems are fundamental to effective emergency department management, as they ensure consistency and fairness for the patient requiring medical attention and provide an effective tool for departmental organisation, monitoring and evaluation. Waiting time relative to triage category is the critical performance indicator for an emergency department.

Area Indicator Epworth performance (%) Avg. national performance (%) Result comment
ED 1.1 Australasian Triage Scale Category 1 patients attended to immediately 100.00 99.65 Performance better than benchmark
ED 1.2 Australasian Triage Scale Category 2 patients attended to within 10 minutes 94.81 76.84 Performance better than benchmark
ED 1.3 Australasian Triage Scale Category 3 patients attended to within 30 minutes 77.39* 65.23 Performance better than benchmark
ED 1.4 Australasian Triage Scale Category 4 patients attended to within 60 minutes 86.18 74.47 Performance better than benchmark
ED 1.5 Australasian Triage Scale Category 5 patients attended to within 120 minutes 97.97 91.30 Performance better than benchmark
ICU 1.5 Patients discharged from the ICU between 6pm and 6am 5.29 13.67 Performance better than benchmark

* The old Epworth emergency department was a small facility, which is reflected in this number. On 1 February 2016, Epworth opened a new, larger emergency department, with increased capacity and state of the art technology and facilities. In the first month of operation, 75% of our Cat 3 patients were seen within 30 minutes, and all were seen in an average of 23 minutes. 

# The Epworth patient flow differs from that of many other hospitals. As part of our aim to provide optimal patient care and comfort, we aim to minimise the number of times a patient is transferred between departments. For example, a patient may stay in the emergency department and then be transferred directly to theatre or to the relevant ward.

Activity

FY 2018

 


Services Admissions Bed days

Anaesthetics

98,794

N/A

Emergency Medicine

38,139

N/A

Intensive Care

3,059

8,847

Services

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