ANNUAL REPORT for the Year Ending 30 June 2014 © 2014 Queensland Emergency Medicine Research Foundation ABN 37 814 620 674

QEMRF acknowledges the support and funding received from the Queensland Government through Queensland Health. Inside Cover Image © The State of Queensland 2014, Townsville Hospital CONTENTS

About 2 Queensland Emergency Medicine Research Foundation 2 Our Collaborators 3 From the Chair 4 From the Chief Executive Officer 6 Return on Investment 8 Profiling our Research 10 Media Clips 10 Media Coverage 12 Research Manager’s Report 14 Researcher Profile 16 Dr Kylie Baker 16 Breakthroughs 17 Grants Awarded 20 Distribution of Grants Awarded 20 Grants Awarded 22 - Project Grants Scheme 22 - Staff Specialist Grant Scheme 26 - Capacity Building Grants 29 - Education and Promotion Grant 31 Governance 32 Board of Directors 33 Committees 35 Financial 38 Financial Controller’s Report 38 Statement of Total Equity 39 Reserves to Cover Financial Commitment 39 Audited Statement of Financial Position 40 Audited Statement 41 Publications 42 List of Acronyms 47 ABOUT

Queensland Emergency Medicine Research Foundation

Improving Queensland’s Emergency Medicine Performance

Queensland Emergency Medicine Research ■■ developed extensive national and international Foundation (QEMRF) was established in 2007 research networks connecting Queensland to allocate research grants to individuals and researchers with the best in the world. project groups’ intent on improving the care of QEMRF has demonstrated the ability to take patients in Queensland public hospital Emergency advantage of the opportunity provided through Departments (EDs). strategic funding from Queensland Government. Queensland Health provided an initial $5 million in This is highlighted by: seed funding to establish the Foundation as well as ■■ best practice governance through a skills based $2 million per annum to meet the objectives of Board of Directors the Foundation. ■■ a highly competitive grant process with expert The Queensland Government has shown great national and international reviewers vision in its commitment to funding emergency ■■ demonstrated quantifiable Return on Investment medicine research through QEMRF. ■■ demonstrated focus on translation of outcomes Of the $12 million granted to QEMRF over six into practice years, 97% has been awarded to research and ■■ building capacity across the entire state capacity building programs. QEMRF has a proven including a commitment to rural and regional track record of delivering significant health and Queensland. economic benefits to Queenslanders. QEMRF has demonstrated a superior understanding QEMRF has come a long way in a short time. of quality emergency medicine research by: We have successfully built a unique funding ■■ developing and mentoring best practice model fostering innovative research, and research researchers capability demonstrating outcomes that translate ■■ identifying clinical research projects that into real benefits for the health system and translate into improved health outcomes health economy. ■■ supporting research projects that have QEMRF has a proven track record and has: national impact.

■■ successfully awarded 82 applications to date Queensland is now highly regarded as a national ■■ invested $11.7 million in emergency medicine leader in emergency medicine research and is research grants becoming the location of choice for the brightest ■■ published over 100 peer reviewed journal articles minds in emergency medicine. ■■ generated a highly competitive grants environment, attracting high quality research submissions

Thank you for supporting the Queensland Emergency Medicine Research Foundation. QEMRF acknowledges founding member organisations:

Together is a counterpart organisation of the ASU

Represented by Department of Health Queensland

2 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION OUR COLLABORATORS

GOVERNMENT – QUEENSLAND HEALTH Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) Queensland Emergency Department Strategic Advisory Panel Emergency Management Unit, Disaster Management Retrieval Services Queensland (Northern and Southern Operations)

HOSPITALS Andrews War Memorial Hospital John Flynn Private Hospital Princess Alexandra Hospital Sunshine Coast Hospital Bundaberg Hospital John Hunter Hospital, Newcastle Princess Margaret Hospital, Perth Sunshine Hospital, Melbourne Caboolture Hospital Kingaroy Hospital Queen Elizabeth II Jubilee Hospital The Alfred Hospital Cairns Hospital Lady Cilento Children’s Hospital Randwick Children’s Hospital The Austin Hospital Capricorn Coast Hospital Liverpool Hospital, NSW Redcliffe Hospital The Prince Charles Hospital The Royal Brisbane & Women’s Hospital Children’s Hospital, Westmead Logan Hospital Redland Hospital The Royal Children’s Hospital Dandenong Hospital Mackay Base Hospital Robina Hospital The Royal Children’s Hospital, Melbourne Maryborough Hospital Rockhampton Hospital Emergency Department Clinical Network, QLD The Townsville Hospital Gladstone Hospital Mater Children’s Hospital Royal Hobart Hospital The Tweed Hospital Gold Coast University Hospital Mater Health Services Royal Melbourne Hospital The Wesley Hospital Greenslopes Private Hospital Mater Hospital, Brisbane Royal Perth Hospital Toowoomba Hospital Gympie Hospital Mount Isa Hospital Southern Health - Paediatric Warwick Hospital Hervey Bay Hospital Nambour Hospital Emergency Medicine Western Health, Melbourne Ipswich Hospital Pindarra Private Hospital St Andrew’s War Memorial Hospital Women and Children’s Hospital, Adelaide

INTERNATIONAL RESEARCH / INSTITUTES / UNIVERSITIES / CENTRES DEPARTMENTS Canada Human Effectiveness Experimentation Centre, CSIRO Australian Catholic University Defence Research Development Canada The Australian e-Health Research Centre School of Nursing, Midwifery and Paramedicine Germany Griffith University School of Physiotherapy The Nuremberg Hospital Griffith Health Institute Bond University New Zealand - Centre for Health Practice Innovation Faculty of Health Sciences and Medicine Christchurch Public Hospital NHMRC Centre of Research Excellence in Nursing Centre for Rural and Remote Area Health Kidz First Children’s Hospital, Auckland Research Centre for Clinical and Community A jointly badged centre of Southern Queensland Starship Children’s Hospital, Auckland Practice Innovation - Griffith Health Institute and the University of Queensland University of Auckland James Cook University - Department of Paediatrics Flinders University, South Australia Anton Breinl Centre for Public Health and Spain Tropical Medicine Griffith University School of Medicine Hospital del Mar, Barcelona Mater Medical Research Institute School of Nursing and Midwifery Sweden Mater Pharmacy Services James Cook University Lund University Australian Centre for Paediatric Pharmacokinetics Faculty of Medicine, Health and Molecular Sciences Switzerland QIMR Berghofer Medical Research Institute School of Engineering and Physical Sciences Kantonsspital Liesta School of Marine and Tropical Biology Spital Lachen Queensland University of Technology Australian Centre for Health Services Innovation (AusHSI) School of Medicine and Dentistry University Hospital Basel Centre for Emergency and Disaster Management School of Public Health, Tropical Medicine and University Hospital Zurich Institute of Health and Biomedical Innovation (IHBI) Rehabilitation Sciences Taiwan Joseph Epstein Centre for Emergency Medicine Research Monash Medical Centre China Medical University Medical Engineering Research Facility (MERF) Monash University National Centre for Classification in Health United Kingdom Faculty of Health The Royal Liverpool University Hospital Sunshine Hospital Queensland University of Technology - Department of Emergency Medicine School of Public Health Epidemiology and Preventive Medicine USA The Royal Children’s Hospital, - School of Nursing Baylor College of Medicine Harvard University Melbourne - School of Public Health and Social Work - Harvard Medical School Murdoch Childrens Research Institute Faculty of Science and Engineering Beth Israel Deaconess Medical Centre - Department of Medicine, The Royal Children’s Hospital The University of Melbourne Queensland Children’s Medical Research Institute Division of Gerontology Department of Mathematics Education University of California The University of Queensland The University of Queensland University of Pittsburgh Australian Centre for Prehospital Care Research Critical Care and Anaesthesia - Infectious Diseases Division - Burns, Trauma and Critical Care Research Centre - School of Population Health - School of Medicine Centre for Clinical Research Critical Care Research Group - Centre for Online Health Department of Paediatric and Child Health - Centre for Research in Geriatric Medicine Division of Anaesthesiology and Critical Care FOUNDATIONS Centre for Educational Innovation and Technology Faculty of Health and Behavioural Sciences Centre for Geriatric Medicine Ipswich Hospital Foundation - School of Health and Rehabilitation Sciences - Queensland Trauma Registry National Heart Foundation of Australia - School of Human Movement Studies Centre of National Research on Disability and Royal Brisbane and Women’s Hospital Foundation Faculty of Medicine and Biomedical Sciences Rehabilitation Medicine (CONROD) The Prince Charles Hospital Foundation - School of Medicine University of Western Australia Faculty of Science Centre for Clinical Research in Emergency Medicine - School of Veterinary Science AMBULANCE SERVICES Western Australian Institute The University of Western Australia Queensland Ambulance Service for Medical Research University of South Australia Department of Community Safety University of Sunshine Coast School of Health and Sport Sciences OTHER COLLABORATORS Australian Red Cross Blood Service Charterhouse Medical Royal Australian Air Force Careflight Medical Services Pathology Queensland Royal Flying Doctor Service CaSS Pathology Queensland

ANNUAL REPORT 2013/14 3 FROM THE CHAIR

Over the last five years I have had the extraordinary ■■ hospital avoidance for elderly patients and those privilege of contributing to QEMRF’s evolution with chronic disease into a credible and invaluable contributor to ■■ ability to treat rural and regional Queenslanders innovation and excellence in emergency medicine closer to home through the delivery of high quality collaborative ■■ improved patient flow and cost effectiveness of frontline research. emergency medicine care ■ the development of new National Standards. It is essential to acknowledge up front that the ■ success of QEMRF is the success of its researchers. The strength of QEMRF is the ability to incorporate The quality, breadth and impact of research research methodologies into the normal business outcomes are testament to the quality of our practice of our emergency departments. emergency medicine researchers and their ability This ensures research outcomes translate into to forge collaborative relationships with changes in clinical practice in real time. key stakeholders. Over the past 12 months, the Board has focused on Over the last six years $11.7 million has been continuing to strengthen governance around the awarded in grant funding to support research research grants process and demonstrating the projects that improve quality health outcomes and excellence in outcomes from the investment by the patient experiences, whilst also contributing to Queensland Government through the Department significant cost savings across the state. The return of Health. The Board has also implemented a solid on this investment can be measured in a multitude strategic plan to leverage off the local success of of positive outputs. In addition to the raw outcome QEMRF with the recent successful launch of the of saving lives of critically unwell and injured national Emergency Medicine Foundation (EMF). Queenslanders, QEMRF’s achievements include: There have been a number of Board movements over the last year. ■■ $2.2m in QEMRF research projects have successfully leveraged a further $13m for ■■ Dr Michael Sinnot and Dr Stephen Priestley ongoing National and International projects retired from the Board at the AGM last year after ■■ estimated annual potential cost saving of $86m completing maximum terms as Board Directors. from research into chest pain assessment Their contribution has been exceptional over the and management across Queensland Health past six years.

The Hon Lawrence Springborg MP, Minister for Health (right) with recipients at 2013 Grants Award Ceremony

4 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION ■■ Mr Jason Currie has retired from the Board as I would like to thank the entire QEMRF operational the Queensland Health representative. Jason has team led by Karen Murphy. Their efforts in remained as interim Chair of the Finance Risk supporting the agenda to make Queensland the and Audit Committee and continues to be an national leader in emergency medicine research invaluable asset to the Foundation. have been exceptional. Congratulations to Carla ■■ Dr Sally McCarthy (November 2013) and Ms Baldwin on the very successful introduction to Susanne Le Boutillier (June 2014) have joined motherhood and welcome to all of the new staff the Board and their willing and enthusiastic members working across QEMRF. contributions demonstrate the future strength The Queensland Government has continued to of governance for the Foundation. demonstrate commitment to the vision of making I would also like to acknowledge Prof David Taylor Queensland a world leader in emergency medicine and Prof Tony Brown who will retire from the research and home to the brightest minds in Board in November this year. Their contribution emergency medicine. The Minister for Health has to the strategic direction and governance of been a strong and interested advocate of high the Foundation has been exceptional and I trust quality research that translates into timely quality that we will continue to find ways to tap into the outcomes. Over recent months the Board has opportunities their experience and passion for worked extensively on a business case for ongoing emergency medicine research can provide. and expanded funding for QEMRF over the next five years. Negotiations with the Minister and Department have been very positive and I hope that It is essential to we will be in a position to announce an expanded acknowledge up front future funding program for QEMRF. My tenure as Board Chair concludes in November. that the success of It has been a privilege. There is a very strong future QEMRF is the success for QEMRF moving forward. The governance of the Foundation is in very safe hands. There are very of its researchers exciting times ahead.

Dr David Rosengren Chair

ANNUAL REPORT 2013/14 5 FROM THE CEO

With an ever changing economic environment in who departed the organisation after providing Queensland there have been increasing budgetary invaluable operational support. pressures on the Queensland Health system. It has I must also thank all the staff at QEMRF for their become more important to constantly seek to tremendous efforts under high pressure this year improve the way we do things so that we can help to and all our supporters for their crucial contribution deliver economic benefits to the health system and to improving the health care system through find better ways to save lives in Medical Emergency. emergency medicine research. My first year at the helm of the Queensland I would also like to acknowledge the contribution Emergency Medicine Research Foundation has of Dr Baldwin in her role of Research Manager been filled with growth and change. I am proud of the Foundation. Dr Baldwin has been largely of the work the QEMRF team have undertaken in responsible for the establishment and success of the supporting an increase in research capacity and Foundation’s grants administration program capability across Queensland that has contributed to and has provided invaluable support to QEMRF the delivery of impressive research outcomes. funded researchers. This report outlines the substantial number of grants Our successes would not have been possible without we have made this year and highlights a selection the support of our peer reviewers and subject of breakthrough stories from our grant recipients. matter experts whom I thank for the many hours of We have seen an impressive amount of media work they have volunteered in the past year. coverage both across Queensland and nationally, in recognition of the achievements and outcomes of Finally, I would like to extend my gratitude to the QEMRF funded researchers and research teams. QEMRF Board of Directors who have tirelessly shown considerable support and leadership to QEMRF’s allocation of Queensland Health funding the Foundation. to public hospital emergency medicine research has reached $11.7 million and through our research We hope you enjoy the 2013/14 Annual Report and projects this investment is driving real and valuable we are excited about the opportunities for QEMRF improvements in patient care. moving forward. In this reporting period we have made a number of operational changes and the introduction of a new team to support the Foundation’s efforts. We have also embarked on the establishment of a Research Support Network (RSN) that will sustain the growth phase of research capacity in Queensland for the next three years. The RSN will advance QEMRF’s mission of investing in high quality, ethical research directed at improving patient care and fostering Ms Karen Murphy Queensland’s world class emergency medicine Chief Executive Officer research community. I would like to acknowledge Lisa van den Berg who as the Manager, Research Support Network, is driving this new initiative with consultation across the sector. I would like to also acknowledge the contribution of former Executive Officer, Wayne Patterson, who has been responsible for overseeing QEMRF’s operational success for a number of years. Wayne provided an enormous contribution to key stakeholder relationships integral to QEMRF’s success. Thank you also to Monique Belousoff

6 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Queensland Health Princess Alexandra Hospital Brisbane Emergency Department Nurses Station. Photo by Michael Marston © The State of Queensland Queensland Health Princess Alexandra Hospital Brisbane Emergency Department Nurses Station. Photo

“I would like to thank all our supporters for their crucial contribution to improving the health care system through emergency medicine research.”

Karen Murphy, Chief Executive Officer RETURN ON INVESTMENT

Return on Investment in Emergency Medicine research is manifest in a diverse range of positive outcomes

Queensland Government investment of $12m over 6 years

SAVING LIVES FINANCIAL ■ QEMRF $800k Chest Pain Research ■■ QEMRF $32k – QAS trauma ultrasound allowing pre- ■  hospital triage direct to theatre for lifesaving surgery ■■ $86m estimated annual saving to QH ■■ QEMRF $300k – Resuscitation in trauma – better use of scarce blood resources and other fluid resuscitation with more lives saved and better outcomes PATIENT FLOW

■■ QEMRF $100k – ED Admission prediction NATIONAL STANDARDS tool – optimise distribution of elective and emergency activity – improved NEAT ■■ QEMRF $17k – Hand washing – NEW National Standard led by QEMRF ■■ QEMRF $40k – Evaluation of ED ambulance offload nurse ■■ QEMRF $11k Pathology reporting – REVISED National Standard ■■ QEMRF $60k – Robina ED Impact study Both with international interest LEVERAGED FUNDING CARE CLOSE TO HOME QEMRF $2.28m Leveraged funds $13.05m ■■ QEMRF $100k – Nasal Flow Oxygen – Can treat common QEMRF has childhood viral illness in granted $11.7m community hospitals avoiding INTERNATIONAL need for retrieval in clinical ■■ QEMRF $100k – ■■ QEMRF $300k – Child Head Injury research High Flow Nasal Oxygen – Change in CT protocols and capacity  £4.3m Wellcome Trust reducing need for retrieval building projects ■■ QEMRF $150k – Child Epilepsy  $1m NZ Health Research Council QUALITY AND SAFETY

■■ Quality management system for elderly in EDs NATIONAL ■■ Reduced childhood CT radiation HOSPITAL ■■ QEMRF $300k – Improved ■■ Improved safety for procedural AVOIDANCE Trauma Outcomes  $1.1m sedation (anaesthetics) in the ED Commonwealth funding ■■ QEMRF $300k ■■ Better hand hygiene leads to – Hospital in the ■■ QEMRF $50k – reduced hospital acquired infections Nursing Home Superglue IV Lines  $1.1m - 50% less ED NHMRC attendances ■ QEMRF $300k – Child Head RESEARCH CAPACITY ■ - 50% less hospital Injury  $850k NHMRC ■■ QEMRF has achieved the founding admissions objective to build research capacity within Emergency Medicine STATE - First Professor of Emergency WORKFORCE ■■ QEMRF $280k – Quality Medicine in QLD ■■ QEMRF has achieved founding Care for Elderly  $3.7m - Multiple Assoc Professorships and objective to promote recruitment Health Innovation Fund Director of Emergency Medicine and retention of quality senior ED ■■ QEMRF $1.1m – Chest Pain Research appointments clinical staff Research  $1.3m Health - Multiple PhD and Masters of Clinical ■■ QEMRF $190k – Linking Innovation Fund and Trials candidates workforce models to funding – Industry optimisation of human resources ■■ Australian first Capacity Building Grant program within hospital EDs Detailed Health Economic Assessment available on request.

8 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Return on investment is best demonstrated by translating research outcomes into change in practice, delivering better health system outcomes

CHILD INJURY CHEST PAIN RESEARCH PRO FORMA

QEMRF investment $800k QEMRF investment $25k

■ Improved risk assessment Quality child trauma data informs injury ■ Accelerated assessment regime reduced prevention strategies need for cardiac investigations ■ early detection of non-accidental injury ■ Reduced time in the ED Improvement in ■ evidence that better value by linking to NEAT performance electronic record ■ Currently being implemented across Implemented in all EDs in QLD multiple EDs in QLD ■ Promises saving of $86m yearly in QLD hospitals

CONTROLLING LAB PREHOSPITAL TRAUMA PROCEDURAL TEST ORDERING ULTRASOUND SEDATION STUDY

■ Limiting access to ■■ Diagnosis of life QEMRF investment $25k costly investigations threatening bleeding ■■ Patient controlled by junior medical staff by paramedics in anaesthesia for ED significantly reduces the pre-hospital procedures unnecessary tests with environment ■■ Significant change in ■ Early triage for dramatic cost savings ■ traditional practice Validating this has life saving surgical ■ resulting in greatly allowed multiple treatment reduced risk of adverse EDs to implement ■ ■ Being performed by outcomes programs with all Intensive Care ■■ Results so dramatic significant health Paramedics in SE QLD that change in practice economic value occurred as study unfolded

ANNUAL REPORT 2013/14 9 PROFILING OUR RESEARCH

MEDIA COVERAGE

Across Queensland

July 2013 September 2013 KIDNEY STONE TRIAL MEDICAL GLUE BREAKTHROUGH Townsville Hospital emergency physician Dr Jeremy Furyk to discuss QEMRF-funded research into treatments for Developments in the QEMRF- kidney stones. funded IVL Superglue story to Channel Nine and set up filming Media coverage: Townsville Bulletin at The Prince Charles Hospital April 2014 involving the Health Minister Lawrence Springborg, Professor BOX JELLYFISH VENOM John Fraser, and QEMRF Chair Research undertaken by the Australian Institute of Tropical Dr David Rosengren. Health and Medicine (AITHM) researchers from James Cook Media coverage: University and Cairns Hospital. Nine News statewide The study, funded by the QEMRF, had found vinegar may increase the amount of box jellyfish venom released into October 2013 its victim. ED IMPROVEMENTS Cairns Hospital doctor Mark Little and venom expert, James QEMRF Chair Dr David Rosengren Cook University Associate Professor Jamie Seymour and discussing statistical improvements QEMRF Chair, Dr David Rosengren made the announcement. in Queensland’s public emergency Media coverage: 4BC, North Queensland Register, departments. Torres News and Business Insider. Media coverage: Brisbane Times, Fairfax online, ABC radio news, 4BC news

August 2013 December PUBLIC SAFETY BABY OXYGEN THERAPY TORRES & QEMRF-funded research into a CAPE QEMRF Chair Dr David Rosengren radio interview new oxygen therapy for treating about rise in number of babies with bronchiolitis which is young people being injured being trialled at Ipswich and Gold CAIRNS & by home-made bombs. Coast Hospitals. This included HINTERLAND interviews with lead researcher Media coverage: ABC Radio Dr Andreas Schibler, QEMRF North Queensland Drive Chair Dr David Rosengren and and Morning programs. a mother. NORTH WEST TOWNSVILLE Media coverage: Seven News, 7TWO National News.

MACKAY

CENTRAL WEST SUNSHINE CENTRAL COAST QUEENSLAND February 2014 WIDE IMPROVING BAY DIAGNOSIS TIME FOR HEART FAILURE DARLING Queensland Times story SOUTH WEST DOWNS METRO NORTH METRO SOUTH on QEMRF-funded WEST MORETON research into heart failure GOLD diagnosis being conducted COAST at Ipswich Hospital. Media coverage: Queensland Times.

12 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Across Australia

2013 2014

July January CHILD HEAD INJURY VARIOUS PUBLIC HEALTH RESEARCH ISSUES Media conference at Herston QEMRF Chair Dr David involving the Health Minister Rosengren’s in various current Lawrence Springborg, Director of stories e.g. Queensland heatwave, Paediatric Emergency Medicine steroid abuse figures, Bali fish for Children’s Health Queensland poisoning, road trauma, holiday Dr Jason Acworth, QEMRF Chair QEMRF Funded overindulgence, heat waves, Dr David Rosengren, patient Miah research Safe Night Out Strategy. Sleight and her mother Nicola. Media Coverage: Seven News, This highlighted QEMRF-funded continues Ten News. research aiming to reduce radiation exposure for children to attract May with head injuries. GENERAL MEDIA Media Coverage: strong media Statewide and national. attention across QEMRF’s Chair Dr David Ten News, Seven News, Rosengren commented on Nine News (Queensland and Australia various emergency medicine national), Seven’s Sunrise, issues including the potential The Courier-Mail, ABC radio introduction of fees for visiting news and programs across emergency departments. December Queensland, Northern Territory, Media Coverage: ABC radio, South Australia and ACT; Fairfax SAFE HOLIDAY PLEDGE The Courier-Mail, news.com.au and APN publications statewide Seasonal media conference and Herald Sun and nationally; 4BC Brisbane and; outside Greenslopes Private various healthcare publications Hospital with QEMRF Chair June Dr David Rosengren calling CORPORATE PROFILE November on Queenslanders to take a A major two-page spread in TOP 20 MINDS safe holiday pledge and keep The Courier-Mail’s QB Monthly out of the state’s Emergency QEMRF Chair Dr David featured QEMRF. The story Departments over the silly season. Rosengren feature on focused on those Queensland Queensland’s Top 20 Minds. Media Coverage: Seven News not-for-profits in which the Media Coverage: The Courier- (Queensland and National), investment return “is often truly Mail’s Qweekend magazine Nine News, Ten News, Sky News, priceless”. QEMRF enjoyed a Driven by Achievement ABC radio programs and news, starring role in the feature piece. News Ltd publications statewide, Media Coverage: The Courier- APN online news statewide, 4KQ, Mail’s QB Monthly 4BC, Hot FM Sunshine Coast, River 94.9fm and various family/ children websites

Public Relations Over the past 12 months alone, QEMRF has generated positive publicity for Queensland Health supported research outcomes to the value of $2.1 million with over 100 media clips. QEMRF acknowledges Sequel Communications for the tremendous public relations support provided to the organisation.

ANNUAL REPORT 2013/14 13 RESEARCH MANAGER’S REPORT

Dr Carla Baldwin Research Manager

QEMRF remains committed to supporting ■■ QEMRF funded a Cochrane Review into nausea. emergency medicine research capability and ■■ The second phase of the lung ultrasound study capacity across the state. This reporting period into improving recognition of heart failure in has seen a very competitive grant round which has elderly patients was funded by QEMRF and has been QEMRF’s most constructive to date, with 15 progressed to a multi-site study. applications received and seven recommendations ■■ QEMRF successfully implemented a new online made. Two applications will be supported by application, review and grant management system. voluntary committee members from QEMRF’s ■■ QEMRF conducted an audit of all grants allocated Review Committees and five supported by new to date, allowing for continued improvement and research teams. further optimisation of grants administration. ■■ QEMRF is well-positioned to translate research Achievements outcomes into changes in patient experience and ■■ The QEMRF Board agreed to establish a state- clinical practice. wide Research Support Network which aims to The outcomes achieved through QEMRF funded sustain the exponential growth phase of research research continue to be impressive and we capacity in Queensland over the next three years. congratulate all Queensland emergency medicine ■■ The High Flow Nasal Canula (HFNC) study researchers on their significant accomplishments. team, led by Dr Christa Bell at Gold Coast, and the team’s United Kingdom counterparts, used Finally I would like to extend a special QEMRF seed funding to leverage £4.3M Medical acknowledgement to QEMRF committee members Research Council funding. and expert reviewers who have volunteered their time to the Foundation. The continued success of QEMRF ■■ The Australian Standard on hand washing review has progressed to public comment phase. would not be possible without their support. ■■ Funding for a snapshot methodology on subarachnoid haemorrhage was progressed with QEMRF’s second state-wide initiative.

QEMRF FUNDED RESEARCH OUTCOMES FROM DR LOUISE CULLEN'S CARDIAC RESEARCH Based on the QEMRF supported research at the Royal Brisbane & Women’s Hospital and the published ADAPT study – 20% of ED patients with chest pain who do not require lengthy assessment processes and admission can now be safely identified. The translation of this research via the Accelerated Chest pain Risk Evaluation (ARCE) project was piloted at Nambour Hospital with great success. It has now become a state-wide initiative with implementation of the strategy at the Gold Coast, Logan, QEII, Ipswich, Toowoomba, Redcliffe and Townsville hospitals. Start dates for change of practice have been confirmed for The Prince Charles Hospital, Princess Alexandra Hospital, Rockhampton and Gladstone hospitals.

14 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION THE QUEENSLAND EMERGENCY RESEARCH COLLABORATIVE The Queensland Emergency Research involved in the delivery and advancement of Collaborative (QERC), is a group of Queensland emergency health care. emergency medicine researchers meeting on Attendance at meetings and submission of a bi-monthly basis. This group evolved from agenda discussion items is encouraged and the the former research-subcommittee of the wider emergency care research community is Queensland State-wide Network, and is now invited to participate. functioning independently, and is supported by QEMRF. These meetings promote well-structured emergency care projects with potential for QERC aims to improve the quality and impact statewide, national, or international relevance. of emergency health research activities by It is a collaborative environment where supporting multi-centre research and facilitating interest or participation in proposed projects is collaboration between institutions, health care often initiated. providers, researchers and industry partners www.qemrf.org.au/about/qerc-qemrf

INSIGHT SERIES In October 2013, QEMRF presented an Insight Departments. The vision of PREDICT is to improve Series titled Paediatric Head Trauma: Translating emergency care for children and adolescents practice from an evidence based paradigm. through rigorous multi-centre research. Keynote speakers included Prof Franz Babl, The event was delivered to an audience paediatric emergency physician at the Royal of academic, hospital administrators/staff, Children’s Hospital in Melbourne and Dr Ed researchers, clinicians, specialist and ICU staff. Oakley, Director of Emergency Medicine at Royal Children’s Hospital Melbourne and Chair QEMRF gratefully acknowledges the support of the PREDICT Research Network. received from Charterhouse Medical for the Insight Series in collaboration with the The evening highlighted paediatric head trauma Paediatric Research in Emergency Medicine research conducted by the Paediatric Research Departments International Collaborative in in Emergency Departments International October 2013. Collaborative - the PREDICT group. Established in 2004, PREDICT consists of all major tertiary Thank you to presenters, attendees and children’s hospital Emergency Departments supporters. in Australia and New Zealand as well as some larger mixed (adult and paediatric) Emergency Photo by Michael Marston © The State of Queensland RESEARCHER PROFILE

Dr Kylie Baker Senior Medical Officer Ipswich Emergency Department, West Moreton Health Service District

A two-year $200,000 QEMRF funded study, led by This project introduces good ultrasound technique to Dr Baker, is investigating the usefulness of bedside a large number of trainee doctors. Skills learnt in this ultrasound in breathlessness as an indicator of project are directly transferable to all other bedside cardiac failure. ultrasound techniques. Lung ultrasound is like Elderly people often present to the Emergency 'training wheels', a safe way to get people started. Department short of breath. The two most Dr Baker has found that bedside ultrasound has common causes – heart failure and chronic lung made a huge difference to her decision making disease- appear much the same but require very and treatment in her own clinical practice, both in different treatments. terms of time and uncertainty. She hopes to be able In 2011, the pilot study showed that bedside lung to share these skills with the next generation of ultrasound was safe, feasible, objective, and relatively clinicians and to overcome the traditional lengthy accurate in the hands of novice practitioners looking period of time it can take for new evidence to for heart failure. Dr Baker said this is because the become incorporated into standard practice. current practice of history, examination, blood tests Dr Baker is interested in pragmatic, preventative and chest x-ray is suboptimal - it was not hard to research, with findings that are easily transferred make an improvement. The research team are now into real world practice and have the potential to exploring whether research findings are robust make a big difference. enough to spread over more centres, and more Dr Baker acknowledges the tremendous support novice practitioners. This research has now extended provided by the countless number of people that to a multicentre trial including the Royal Womens’ have helped and encouraged her and the system and Brisbane Hospital, The Prince Charles Hospital that recognises the value of progress by research. and Princess Alexandra Hospital. The team also tend to investigate whether there are any improvements in length of stay, or costs of care between those patients correctly diagnosed, and those patients incorrectly diagnosed with heart failure in the Emergency Department. The first grant received from QEMRF funded training workshops and a research assistant. The second grant essentially funded the same on a much larger scale. The research team refer to themselves as the BLUE Team. This is a large group, with at least four people at each hospital including a principal investigator, and assistant, a research manager and a research assistant. It is a long list to include them all. Having research assistants to extract data, and now a trial coordinator to supervise data collation, has Image courtesy of Kylie Baker meant that Dr Baker has more time to do the work she enjoys the most - teaching, literature surveys, Emergency Department senior doctor Kylie Baker demonstrates the ultrasound equipment on her father and learning about methodology. Clive Pope.

16 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION BREAKTHROUGHS

Predictors for Paediatric Presentations to the Emergency Department

THE PROBLEM Do socio-economic factors predict Emergency Department Emergency Department presentations are disproportionately greater in young children (zero – presentations? five years) than all other age-groups. Young children are a vulnerable population and are at risk for injury Principal Investigator and serious medical illness. In Australia, 13 per cent of all ED presentations are from children less than Dr Gerben Keizjers, Gold Coast Hospital five years of age. Factors leading to greater ED Collaborating Institutions presentation rates in young children are incompletely understood and need further investigation. ■■ Griffith University ■■ Logan Hospital THE SOLUTION ■ The Tweed Hospital ■ This study describes health care use in a cohort of children zero - five years in South East Queensland. It considers socio-economic factors associated with Emergency Department presentations, hospital admissions and medication use. This project uses data from the Environments for Healthy Living study (EFHL), run by the School of Medicine, Griffith University. EFHL has collected data since 2006 on more than 3000 children from birth with follow-up at one, three and five years in the Logan, Tweed and Gold Coast regions. The study will link EFHL data with routinely collected data by Queensland and NSW Health (ED, inpatient and cost data) and Medicare Australia data (GP visits, medications prescribed and vaccination status data).

THE SAVING Research outcomes aim to: ■■ improve health care access and health care quality for this vulnerable group ■■ describe health care costs and better inform health care policy and education ■■ reconfigure ED models of care that will enable more appropriate and efficient use of the ED, to better meet the needs of the populations they serve ■■ inform future research, health care policy and health care planning directed towards ways to improve the quality and access to health care in young children ■■ inform care quality as identified by the Institute of Medicine (IOM, 2006): safety, timeliness, patient-centeredness, efficiency, effectiveness, and equity.

ANNUAL REPORT 2013/14 17 Helicopter Transport for People with Decompression Illness

Will bubbles actually be increased by the vibration associated with helicopter flight?

Principal Investigator Dr Denise Faye Blake, Townsville Hospital Collaborating Institutions ■■ Hyperbaric Medicine Unit, Townsville Hospital ■■ School of Engineering and Physical Sciences, James Cook University ■■ Royal Hobart Hospital

Simulating Helicopter Transport in Decompression divers in the recompression chamber will be Illness: The Effect of Vibration on Intravascular assessed with an ultrasound to detect bubbles Bubble Formation Following Hyperbaric Treatment following the ‘dive’ and then placed in the vibrating basket. The number of bubbles present after this THE PROBLEM will be measured again. Diving is a common recreational activity around the world. In Australia the Great Barrier Reef hosts THE SAVING thousands of local, national and international divers, The outcome of this study will provide conclusive and underpins a significant portion of tourism evidence about the safe transport of DCI within the state. Unfortunately diving has risks patients which can be translated in Australia and which include decompression illness (DCI). DCI is internationally. With international collaborative the formation of gas bubbles in the body which can representation on the research team, from the be fatal. Treatment can involve re-pressurisation Human Effectiveness Experimentation Centre, in oxygenated chambers designed to ‘squash’ the Research Development in Canada, the outcomes bubbles and reduce symptoms. Affected divers can from this study will be of benefit around the world. only receive this treatment in certain hospitals and QEMRF awarded $46,310 for this study. may require transportation by helicopter. However, it is believed that the vibration of the helicopter The findings have the ability to inform and influence itself may have a detrimental effect increasing the international practice related to transport of patients number of bubbles making symptoms worse. affected by DCI. If helicopter transport increases bubble formation and potentially makes DCI worse, THE SOLUTION the need for alternative transportation methods This study will determine whether bubbles will will be proven. Suggested alternatives include actually be increased by the vibration associated substitutional transport modes, or modification with helicopter flight. If vibration does increase of helicopters and helicopter stretchers to reduce bubble formation, then alternative strategies for the vibration. The most practical of these options is transportation of DCI patients can be implemented. the latter. If results of this study offer conclusive To determine this the vibration rate of helicopter evidence the research team will look to use this flight will be tested and simulated using a vibrating study as the basis to trial a variety of stretcher basket model. Healthy volunteers accompanying modifications designed to reduce vibration.

18 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION High Flow Nasal Cannula Therapy in infants with Bronchiolitis – Randomised Controlled Trial in Regional Emergency Departments

Which patients benefit using High Flow Nasal Cannula Therapy?

Principal Investigator THE SOLUTION Dr Christa Bell, Gold Coast Hospital High flow nasal cannula therapy has been used Collaborating Institutions over the last few years in paediatrics with reports showing a reduction in the need for non-invasive ■■ Ipswich Hospital and invasive respiratory support. ■■ Mater Children’s Hospital ■■ Mater Medical Research Institute HFNC is easy to use and more effective than standard oxygen therapy, which can permanently ■■ University of Queensland damage a baby’s lungs. HFNC reduces the work of breathing, improves the gas exchange and can be This study investigates whether early High Flow applied very early in the disease process as there is Nasal Cannula Therapy (HFNC) treatment in infants little inference with the patient’s comfort. with bronchiolitis reduces the number of patients However, there is no “best practice” and many transported from regional hospitals to specialist centres do not use the HFNC for bronchiolitis as paediatric centres and reduces overall hospital there are opposing reports about its benefits and a length of stay. lack of consensus on how to use it. THE PROBLEM Gold Coast medical officer Dr Christa Bell has Bronchiolitis is the leading cause of paediatric received a $69,924 grant to lead a multi-centre hospitalisation in Australia accounting for trial in regional hospitals, assessing which young approximately 8000 admissions annually, of which patients with bronchiolitis benefit using HFNC. 500-600 are admitted to a paediatric intensive care This study investigates whether early HFNC unit (PICU) requiring respiratory support. treatment in infants with bronchiolitis reduces Decades of trials using steroids, salbutamol, the number of patients transported from regional adrenalin, and hypertonic saline have not improved hospitals to specialist paediatric centres and the treatment of infants with bronchiolitis or the reduces overall hospital length of stay. burden on health care systems. This study follows a £4.3million investment of the Medical Research Council (UK) to roll out a study in Africa. QEMRF is the initial investor in Australian studies.

THE SAVING A pilot study at Mater Children’s Hospital showed a significant drop in the number of infants with bronchiolitis being admitted to intensive care, and reduced their length of stay. The HFNC technique should also allow sick infants in regional Queensland to stay close to home for hospital care, rather than be transported to tertiary centres in Brisbane. The pilot data will be used to underpin a National Health & Medical Research Council submission for a $1.2 million national study to inform World Health Organization guidelines on the treatment of paediatrics with bronchitis.

ANNUAL REPORT 2013/14 19 GRANTS AWARDED

Establishment to 30 June 2014

QEMRF Grants Awarded

TORRES & CAPE

$495,000 CAIRNS & $11,698,709 HINTERLAND of QEMRF grants awarded $244,000 (as at 30 June 2014) NORTH WEST TOWNSVILLE $1,421,000 $244,000 MACKAY

$244,000 CENTRAL WEST CENTRAL QUEENSLAND $244,000

WIDE BAY $288,000 SUNSHINE COAST $4,218,000 DARLING SOUTH WEST DOWNS METRO NORTH $244,000 METRO SOUTH $1,599,000 MATER HEALTH SERVICE WEST MORETON GOLD COAST $506,000 $485,000 $1,224,000 CHILDREN’S HEALTH QUEENSLAND $244,000 Grants Awarded by Hospital From 1 July 2013 - 30 June 2014 Hospital Grant % No. % Gold Coast ▪ $216,063 26% 3 38% University ▪ Townsville $253,102 31% 2 25% Royal Brisbane ▪ $32,100 4% 1 13% & Women’s The Royal ▪ $69,930 9% 1 13% Children’s Princess ▪ $250,000 30% 1 13% Alexandra Totals $821,195 8 100%

20 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Grants Awarded by Hospital & Health Service From 1 July 2013 - 30 June 2014

Hospital & Health Grant % No. % Services Gold Coast ▪ $216,063 26% 3 38% University ▪ Townsville $253,102 31% 2 25%

▪ Metro North $69,930 9% 1 13%

▪ Metro South $250,000 30% 1 13% Totals $821,195 8 100%

Grants Awarded by Grant Type From 1 July 2013 - 30 June 2014

Grant Type Grant % No. %

▪ Program $250,000 30% 1 13%

▪ Project $69,902 49% 4 50%

▪ Staff Specialist $171,293 21% 3 38% Totals $821,195 8 100%

Grants Awarded by Administering Institution From 1 July 2013 - 30 June 2014

Administering Grant % No. % Institutions ▪ James Cook University $253,102 31% 2 33% University of ▪ $370,730 45% 2 33% Queensland Royal Brisbane ▪ Women’s Hospital $32,1400 4% 1 17% Foundation Gold Coast University ▪ $165,263 20% 1 17% Hospital Totals $821,195 6 100%

ANNUAL REPORT 2013/14 21 GRANTS AWARDED

Project Grants Scheme The Project Grants Scheme supports research projects in whole, or partial funding to larger projects seeking funding from alternative sources (potentially elsewhere in Australia) such as the National Health and Medical Research Council, or the Australian Research Council. Funding of up to $100,000 per year is available for a maximum of three years.

Australia, Asia and New Zealand Dyspnoea in Emergency Departments Study

What’s the prevalence, causes, treatment and outcome of patients with shortness of breath?

Shortness of breath (Dyspnoea) is a terrifying AMOUNT AWARDED $96,000 symptom experienced by patients and is a common PRINCIPAL INVESTIGATOR reason for presentation to Emergency Departments. There are a wide range of causes including flair up Dr Gerben Keijzers due to chronic conditions such as asthma, heart failure, chronic lung disease or liver or kidney COLLABORATING INVESTIGATORS failure. Acute conditions such as a collapsed lung, Prof Anne-Maree Kelly, Dr Fran Kinnear, chest infection (including pneumonia), trauma Dr Chris May, Dr Jeremy Furyk, (including fractured ribs), airway blockage or an Dr Ogilvie Thom, Dr Shane Martin, allergic reaction can also be the cause. Dr Ulrich Orda, Dr Richard Stone There is significant knowledge about patients who are PRINCIPAL INSTITUTIONS / HOSPITALS admitted to hospital with common causes, however Emergency Departments of Prince Charles there is little conclusive information about Dyspnoea as Hospital, Redlands Hospital, Redcliffe Hospital, a symptom, the distribution of causes, the proportion Cairns Hospital, Ipswich Hospital, Mount Isa of patients requiring admission and whether treatment Hospital, Princess Alexandra Hospital, complies with evidence-based guidelines. Nambour Hospital, Queen Elizabeth II Hospital, Townsville Hospital, Greenslopes Private A recent pilot study in Europe found that 53 Hospital, Western Health Melbourne, per cent of patients had a respiratory cause for Joseph Epstein Centre for Emergency symptoms, 22 per cent had a cardiac cause, and Medicine Research 15 per cent had both cardiac and respiratory components. Almost two-thirds were admitted to hospital with over one-third discharged from ED. In many ways, the study raised more questions than it answered. The study was also too small to comment on adherence to evidence-based guidelines. For that reason, a larger EuroDEM (digital elevation model) study is planned for 2014. The study will be complemented by the Australia, Asia and New Zealand Dyspnoea Departments of Emergency Medicine (AANZDEM) which will collect data from a different region with different systems of care. It will focus on the range of causes, variation over seasons and geographical areas, and compliance with recommended treatments.

22 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Multicentre randomised controlled trial incorporating bedside lung ultrasound into the diagnosis of congestive cardiac failure in breathless older patients

Improving diagnosis of cardiac failure in breathless older patients

conditions. In most cases, several bedside tests are AMOUNT AWARDED $195,000 carried out to identify those patients with heart PRINCIPAL INVESTIGATOR failure. Despite these investigations, which include Dr Kylie Baker blood tests, electrocardiograph and chest x-ray, heart failure is initially misdiagnosed in up to one quarter of patients in the emergency department. COLLABORATING INVESTIGATORS This project focuses on secondary prevention of Prof Geoffrey Mitchell, Dr Geoffrey Stieler, the complications of the disease caused by missed Dr Katherine Isoardi, Dr Ogilvie Thom diagnosis. ASSOCIATE INVESTIGATORS Dr Stephen Brierley, A/Prof Kevin Chu, Some European hospitals use bedside lung Dr Frances Kinnear ultrasound as an adjunct to the above tests, PRINCIPAL INSTITUTIONS / HOSPITALS claiming it improves recognition of heart failure, Ipswich General Hospital, and should decrease the time to appropriate Ipswich Hospital Foundation treatment. The European model of ultrasound practice is significantly different from the Australian COLLABORATING INSTITUTIONS / model, and there is limited evidence supporting HOSPITALS either model provided in the literature. Royal Brisbane and Women’s Hospital, Princess Alexandra Hospital, The Prince This is a multicentre study following on from a Charles Hospital, University of Queensland successful pilot project. A safe, simple protocol has been tested in an Australian Emergency Department, in parallel to normal diagnostic Many older persons present to the Emergency strategies. To prove the protocol actually improves Department complaining of shortness of breath patient care, it now has to be tested as part of the (Dyspnoea). This can be an important forewarning diagnostic workup for breathlessness compared of heart failure, but is also present in many other with the conventional diagnostic procedure.

Image courtesy of Dr Kylie Baker

ANNUAL REPORT 2013/14 23 High Flow Nasal Cannula treatment for viral Bronchiolitis, a randomised controlled trial

point of their illness and are transferred to intensive AMOUNT AWARDED $50,757 care units at children’s hospitals. This is expensive PRINCIPAL INVESTIGATOR inflicting a burden on health care costs and very Dr Crista Bell stressful for children and families involved who are presented with unfamiliar clinical environments.

COLLABORATING INVESTIGATORS Recent research suggests early optimal respiratory A/Prof Andreas Schibler support can reduce the need for transfer significantly allowing patients to receive care in PRINCIPAL INSTITUTIONS / HOSPITALS local regional hospitals where families remain the Gold Coast Hospital, Mater Research Institute, main support. Keeping patients in their regional University of Queensland centre is advantageous psychosocially and has a COLLABORATING INSTITUTIONS / considerable impact on health care costs. HOSPITALS Emergency Departments and Paediatric This research group recently investigated the role of Wards of Caboolture Hospital, Ipswich High Flow Nasal Cannula (HFNC) therapy in infants Hospital, Redcliffe Hospital, Redlands Hospital with bronchiolitis and were able to demonstrate a 40 per cent reduction in intensive care admission. Early respiratory intervention is a fundamentally Acute respiratory disease is the leading cause for new approach, which has the potential to prevent infants and children requiring hospital admission. progression and deterioration of respiratory illness. Hospital treatment focuses on oxygen therapy and The aim of this study is to investigate the role of besides disease specific treatments like inhalers for HFNC therapy in infants with bronchiolitis. Future asthma, or antibiotics for pneumonia. Ten to 20 per research and trials will also include other conditions cent of children require higher levels of care at some such as asthma and pneumonia.

ConSEPT: Convulsive Status Epilepticus Paediatric Trial

CSE is managed with anticonvulsant medications AMOUNT AWARDED $147,820 in a step-wise approach until seizures stop. While PRINCIPAL INVESTIGATOR some management strategies for CSE are well Dr Jeremy Furyk supported by evidence (e.g. initial administration of benzodiazepines), subsequent strategies are based on expert consensus and not evidence. COLLABORATING INVESTIGATORS Dr Natalie Phillips, Dr Shane George Phenytoin, the traditional second line agent for ASSOCIATE INVESTIGATOR CSE has a high failure rate, causes adverse events Dr Stuart Dalziel, Dr Franz Babl, and must be administered slowly. Levetiracetam, A/Prof Ed Oakley, Ms Jenine Lawlor a newer anticonvulsant, has a favourable adverse events profile, can be administered quickly and has PRINCIPAL INSTITUTIONS / HOSPITALS good efficacy for various seizure types. James Cook University, Townsville Hospital COLLABORATING INSTITUTIONS / This research project proposes to undertake a HOSPITALS randomised controlled trial of the second line Emergency Departments of Royal Children’s anticonvulsants phenytoin and levetiracetam for Hospital and Gold Coast University Hospital CSE in children. This multi-centre study will be a world first and have a profound impact on the management of CSE in children in New Zealand, Convulsive Status Epilepticus (CSE) is the most Australia and worldwide, in either confirming common childhood neurological emergency, the current second line medication used or sometimes resulting in death or serious disability. recommending a newer second line medication.

24 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Program Grant Scheme The Large Program Grants Scheme will provide funding for significant bodies of work in which a number of separate but related projects could be funded as a cohesive program of work. Funding of up to $250,000 per year is available for a maximum of three years.

Diagnostic Workup for Suspected Subarachnoid Haemorrhage

Subarachnoid haemorrhage (SAH) is a type of stroke, AMOUNT AWARDED $268,600 which affects about 10 in 100,000 Queenslanders. PRINCIPAL INVESTIGATOR A patient with SAH usually complains of a sudden Dr Kevin Chu onset severe headache. About one in three of these patients die and another one in three survive with a disability. Early diagnosis and treatment is essential. COLLABORATING INVESTIGATORS The diagnosis involves a Computed Tomography Dr Jeremy Furyk, A/Prof Gerben Keijzers, Dr Carol Windsor, Dr Rob Eley, Dr Frances (CT) scan and a spinal puncture to look for blood in Kinnear, Dr Andrew Staib the spinal fluid surrounding the brain. However, these tests are not 100 per cent accurate. PRINCIPAL INSTITUTIONS / HOSPITALS Doctors and patients are also concerned about Royal Brisbane Women’s Hospital, complications from these tests. These include Royal Brisbane Women’s Hospital Foundation radiation from CT scans and discomfort from spinal COLLABORATING INSTITUTIONS / punctures. As a result, there is variability in what HOSPITALS tests are ordered and why they are ordered. Emergency Departments of Townsville An understanding of this variability can assist Hospital, Gold Coast University Hospital, doctors to develop guidelines and streamline the Princess Alexandra Hospital and Prince Charles diagnosis of patients with suspected SAH. Hospital and the Faculty of Health, Queensland University of Technology This project consists of a series of three studies including a one month snapshot of patients presenting to the Emergency Department (ED) across Queensland complaining of a headache, a series of one-on-one interviews with a group of ED specialists at the Royal Brisbane Women’s Hospital and an examination of the accuracy of tests to look for blood in the spinal fluid obtained from a spinal puncture. The results of these studies will help plan the diagnostic workup of patients with suspected SAH.

ANNUAL REPORT 2013/14 25 Staff Specialist Grant Scheme The Emergency Medicine Staff Specialist Research Grants Scheme provides seed funding to develop a plan for project grant funding (from QEMRF or other national sources), or leverage additional funding from other sources (e.g. Australian Research Council linkage grant). Funding of up to $70,000 is available.

Basel Syncope Evaluation Study - BASEL IX Study

Management of patients with syncope (loss of AMOUNT AWARDED $32,009 consciousness) is a serious problem concerning PRINCIPAL INVESTIGATOR 1 - 2 per cent of Emergency Department A/Prof. Louise Cullen presentations. Of these, it is known that between six and 20 per cent of patients will have a problem with their heart. The rapid and accurate identification of COLLABORATING INVESTIGATOR Prof. William Parsonage patients with cardiac related syncope is an important clinical need which until this time has not been met. PRINCIPAL INSTITUTIONS / HOSPITALS Royal Brisbane Women’s Hospital, This observational study will evaluate the diagnostic Royal Brisbane Women’s Hospital Foundation value of patients’ history, clinical judgement and COLLABORATING INSTITUTIONS / new blood tests (biomarkers) for cardiac syncope. HOSPITALS The study will recruit 720 adult patients across University Hospital Basel, Switzerland; multiple sites internationally. Eligibility will be aged Kantonsspital Liestal, Switzerland; Spital based, for those 40 years and older, and presenting Lachen Switzerland; University Hospital Zurich, to the ED with syncope. Switzerland; Hospital del Mar, Barcelona, Spain; Nurenberg Hospital, Germany; Sant’Andrea Hospital, Italy; Baylor College of Medicine, Houston US

Critical Evaluation of a Targeted Point of Care ROTEM and Multiplate Guided Coagulation and Haemostasis Management Programme in Severe Trauma and Critical Bleeding

haemorrhage and the complications that may be AMOUNT AWARDED $69,263 associated with large volume blood transfusion. PRINCIPAL INVESTIGATOR The ability of the patient to form a blood clot will be Dr Donald Campbell assessed by a technology called viscoelastometry and aggregometry using a ROTEM/multiplate device. COLLABORATING INVESTIGATORS This device gives an in-depth assessment of the Dr James Winearls, A/Prof Gerben Keijzers, patient’s clotting and allows specific treatment to Dr Andrew Bulmer, Dr David Pearson, be targeted at specific clotting defects. Using this Dr Gregory Comadira, Dr Alexandra Douglas technology, the investigators hope to reduce the ASSOCIATE INVESTIGATORS amount of bleeding in these cases and also reduce Dr Michelle Bryson, Mrs Fiona Clark, the amount of blood transfused to these patients. Dr Indu Singh, Miss Megan Shuttleworth, The project will implement a blood product transfusion Dr Vivien Wurm programme guided by the ROTEM/multiplate device. PRINCIPAL INSTITUTION / HOSPITAL This research will provide a prospective evaluation Gold Coast University Hospital of the outcomes associated with the initiation of COLLABORATING INSTITUTIONS / Point of Care (POC) coagulation and haemostasis HOSPITALS management in trauma and critical bleeding. Data School of Medical Science, Griffith University collected regarding blood product transfusion rates, bleeding complications, and adverse transfusion related outcomes will be compared to historical data collected prior to the implementation of this program. This project investigates how to assess and treat patients with clotting disorders as a result of trauma This research will further provide an in-depth and severe bleeding. Patients with severe trauma analysis of the coagulation disturbances induced by and critical bleeding have a high risk of death from severe trauma and critical bleeding.

26 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Basel Syncope Assessment of children presenting with possible cervical spine injury in an Australian context

A prospective pilot validation study for clinical decision rules in paediatric cervical spine imaging - CRIC: Children’s Rules for Imaging the Cervical Spine Evaluation Study

Children rarely break their necks but if they do, they AMOUNT AWARDED $69,930 can risk spinal injury or death. Many more children PRINCIPAL INVESTIGATOR present for assessment of possible cervical spine Dr Natalie Phillips (neck) injuries than are subsequently diagnosed with cervical spine injury. The challenge for the emergency doctor is to identify the rare cases without subjecting COLLABORATING INVESTIGATORS too many children to unnecessary tests. Dr Robyn Brady, A/Prof Jason Acworth, A/Prof Geoffrey Askin, Dr Mark Walsh These tests, x-rays and scans, have risks including PRINCIPAL INSTITUTIONS / HOSPITALS exposure to radiation and associated danger of long Royal Children’s Hospital, University of term cancer development, as well as the possible need Queensland for sedation to perform the scan in young children. COLLABORATING INSTITUTIONS / Awaiting these tests is often a time of prolonged HOSPITALS distress for the patient and family as the child needs to Department of Emergency Medicine Lady be kept lying flat and still without moving their neck. Cilento Children’s Hospital, Department of Considerable staff time and Emergency Department Emergency Medicine Mater Children’s Hospital, costs are associated with these tests. Queensland Children’s Medical Research Rules have been proposed to assist doctors in Institute, University of Queensland deciding whether tests are needed. This study seeks to look at all children presenting to the ED over a 12 month period for the assessment of possible cervical spine injury to better understand how children are treated in hospital and how further investigation into the use of these rules can be undertaken.

ANNUAL REPORT 2013/14 27 Partnership Funding for the NHMRC Partnership program: Integrating management strategies for patients with acute chest pain

Safer and faster chest pain services

Up to 10 per cent of all Emergency Department AMOUNT AWARDED $32,000 presentations and 25 per cent of all acute medical PRINCIPAL INVESTIGATOR admissions are due to acute chest pain. The most Dr Louise Cullen common serious cause of chest pain is Acute Coronary Syndrome (ACS) but the majority of patients (approximately 80 per cent) will ultimately COLLABORATING INVESTIGATORS have a cardiac diagnosis excluded. Dr William Parsonage, A/Prof Jaimi Greenslade, Prof Nicholas Graves, A/Prof Adrian Barnett Current management guidelines are based upon ASSOCIATE INVESTIGATORS clinical assessment and serial investigations Prof. Derek Chew, Dr Richard Stone over a minimum of eight hours. EDs are under growing pressure due to increased presentation PRINCIPAL INSTITUTION / HOSPITAL rates, ageing populations, access block, as well as Royal Brisbane and Women’s Hospital political and community imperatives to maintain Foundation, Royal Brisbane and Women’s Hospital patient flow. For this reason, significant research efforts have been undertaken to improve chest COLLABORATING INSTITUTIONS / pain assessment. Advancements to date include HOSPITALS improved understanding of rapid risk stratification, Emergency Departments of Cairns Base Hospital and Nambour General Hospital, evolution of biomarkers of cardiac damage and Australian Centre for Health Services novel methods of non-invasive imaging of coronary Innovation (AusHSI), Queensland University artery disease (e.g. Coronary Angiography [CTCA]). of Technology and the Heart Foundation Research themes have become fragmented with of Australia little success at integration of complementary accelerated advances at a population level. Some favour has been shown toward more widespread application of novel, effective but more expensive technologies, while others suggest routine use of such methods represents an example of ‘over-diagnosis’ and potentially harmful or wasteful use of resources. The overarching aim of this research is to define the optimum method of an integrated process of assessment for all ED patients with possible ACS. The research encompasses randomised comparisons of three strategies in ED patients presenting with chest pain; namely accelerated risk stratification with early (two hour) biomarker testing, utilisation of rapid access chest pain clinics and the role of CT coronary angiography.

28 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Capacity Building Grants Facilities can apply for a grant to build research capacity within their organisation. Funding up to $70,000 per year is available for a maximum of three years.

Princess Alexandra Hospital Department of Emergency Medicine

disease, multi-system disease associated with the AMOUNT AWARDED $90,000 elderly population, cardiovascular disease, sepsis and (Term of extention: 18 months) septic shock, infectious diseases and critical care. PRINCIPAL INVESTIGATOR The PAH ED is a tertiary referral hospital for Dr Michael Sinnott trainees of the Australasian College for Emergency Medicine and excels in service delivery and education; areas in which it has a national PRINCIPAL INSTITUTION / HOSPITAL reputation for excellence. Princess Alexandra Hospital Emergency The outcome from Phase 1 of the QEMRF funded Department three-year plan to increase research capacity COLLABORATING INSTITUTION within the PAH ED was successful with all key University of Queensland performance indicators being exceeded. Phase 2 will build on the platform created in Phase 1 focusing on research promoting prevention or The Princess Alexandra Hospital (PAH) Emergency control of diseases. Department is a designated Level 6 Trauma Centre. The vision for research within the PAH ED is that In 2012, in excess of 50,000 patients presented the ED will be regarded as a leader in emergency to the PAH ED, of which more than 35 per cent medicine research attracting clinical and research were admitted. staff and producing outcomes which will change Clinical expertise within the PAH ED is wide, with clinical practice and improve the health and well- specific disease emphasis in toxicology, chronic being of patients.

ANNUAL REPORT 2013/14 29 Research Support Network

THE RESEARCH SUPPORT NETWORK AMOUNT AWARDED $2,992,500 million over three years ■■ Builds collaboration capacity and coordinates data collection for multi-site, state-wide and MANAGER F national research projects. Mrs Lisa van den Berg, Manager, ■■ Develops meaningful partnerships between Research Support Network, QEMRF research, industry and end users, including research foundations, universities, emergency PRINCIPAL INSTITUTION departments, Queensland Ambulance Service Queensland Emergency Medicine Research and retrieval services. Foundation ■■ Enables reduced duplication of research RESEARCH COORDINATORS effort and impact on project deliverables and Based at six Queensland Hospital Emergency timeframes, allowing project completion and Departments and Queensland Health Services translation of outcomes. COLLABORATING INSTITUTIONS / OBJECTIVES HOSPITALS ■■ Provide an infrastructure supporting state- Queensland Public Hospital Emergency wide capacity building for emergency Departments, Queensland Ambulance Service, medicine research. Queensland Retrival Services, Universities and Research Institutes ■■ Reduce impact on project deliverables and timeframes, allowing project completion and translation of outcomes. ■■ Provide opportunity for audit of research support needs across Queensland. Queensland Emergency Medicine Research ■■ Allow improved engagement with associated Foundation is investing $3 million in a state-wide research foundations and universities with Research Support Network (RSN) to support QEMRF emergency departments, ambulance and researchers and build capacity across the state. retrieval services. Managed via a full-time position within QEMRF, ■■ Provide avenues for direct collection of data six research coordinators will be placed across enabling improved research capabilities. Queensland public hospitals, ambulance and retrieval ■■ Increase and promote Queensland Emergency services to support emergency medicine researchers. Medicine research collaboration and excellence.

The proposed Research Support Network, supporting research across Queensland, with the aim of improving Emergency Medicine research capacity

Princess Alexandra

QEII Caboolture Mater Adult Rockhampton Royal Gold Coast Brisbane & Women’s Coordinator Bundaberg

Redcliffe Logan Coordinator Coordinator Redland Bay

Ipswich QEMRF Mount Isa Manager, Research Support Cairns Network Hervey Bay

Caloundra Coordinator Coordinator

Townsville Sunshine Mackay Coordinator Coast

Robina

Lady Cilento The Prince Children’s Toowoomba Charles Queensland Ambulance Service Retrieval Services

30 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Lisa van den Berg Manager, Research Support Network

Lisa has joined QEMRF as the Manager of the Research Support Network. Lisa brings over seven years experience from the Innovation and Knowledge Transfer of University-based research outcomes in Australia and New Zealand. She worked closely with researchers to identify and develop ways to translate their ideas into practice, focusing on relationship building and translation of multi-disciplinary projects. Prior to QEMRF Lisa was a Commercial Manager at bluebox, the Innovation and Knowledge Transfer company for Queensland University of Technology (QUT). She was responsible for providing commercialisation support and managing Intellectual Property of researchers throughout QUT, including Faculty of Health and the Institute of Health and Biomedical Innovation (IHBI). She is passionate about innovation and enhancing the impact of research outcomes through developing strategies, collaborations and partnerships.

Education and Promotion Grant

Collaborative Knowledge Communities of practice are self-organised and self-directed groups of people, informally Network and Crowdfunding bound together by a common mission and Platform passion for a join enterprise. Collaborative Knowledge Networks (CKNs) link communities of practice together, providing AMOUNT AWARDED a technical and social infrastructure for $500,000 collaboration and knowledge management. MANAGER F When linked electronically into CKNs, communities of practice help organisations Mrs Belinda von Bibra, to drive innovation and accelerate key National Research Director, business practices. Emergency Medicine Foundation Crowdfunding is the act of funding a project by raising small amounts of money from a large The Emergency Medicine Foundation will deliver number of people. It has the potential to raise a Collaborative Knowledge Network (CKN) and funds beyond traditional means by expanding crowdfunding platform to support the QEMRF’s the pool of potential donors through an online, Research Support Network. The CKN is supported publicly accessible medium. by expert advice through an Advisory Panel. Crowd funding uses web technologies and online payment systems to facilitate transactions between researchers (people who request funds) and supporters (people who give money).

ANNUAL REPORT 2013/14 31 GOVERNANCE

In 2013/14, QEMRF Ltd was renamed the This change of company name has the support Emergency Medicine Foundation Ltd, as part of of our Foundation Members (ACEM, AMAQ, a broad strategic initiative to expand the impact Queensland Health, Together Queensland and activities of the foundation at a national level. and ASMOFQ). The Emergency Medicine Foundation Ltd The Emergency Medicine Foundation will be (the Company) as it is now called, continues to act positioned to attract additional sources of as Trustee for the Queensland Emergency Medicine philanthropic funding to expand our ability to Research Foundation (QEMRF), the Trust. offer research grants within the broader emergency The $2 million annual grant from the Queensland medicine clinical community. Government is held within and administered by There remains a strong focus to the vision and the QEMRF (the Foundation and Trust). mission of QEMRF and an absolute commitment to The establishment of the Emergency Medicine demonstrating value to the Queensland research Foundation has been enabled through a loan from community and the Queensland Government for QEMRF of $500,000, with interest paid on the loan. their ongoing investment.

BOARD MEETING ATTENDANCE TABLE 2013/2014 Financial Year

Name 16/7/13 14/8/13 17/9/13 12/11/13 18/2/14 2/4/14 4/6/14 Total

Dr David Rosengren Y Y Y Y Y Y Y 7/7

Dr Stephen Priestley Y Y A Y 3/4

Dr Michael Sinnott Y Y Y Y 4/4

Mr Jason Currie Y Y Y Y Y Y 6/6

Ms Jane Schmitt Y Y Y Y Y Y Y 7/7

Prof David Taylor Y Y Y Y Y Y Y 7/7

Prof Anthony Brown A Y Y Y A A Y 4/7

Mr Cameron Smith Y Y Y Y Y Y Y 7/7

Dr Sally McCarthy Y Y Y Y 4/4

Ms Susanne Le Boutillier A 0/1

Ms Karen Murphy* Y 0/0

Y In attendance N Not in attendance A Apology received prior to meeting

* Represents attendance whilst acting as Director, Ms Murphy attended all meetings in her capacity as CEO.

32 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION PROFILES

Board of Directors

Dr David Rosengren MBBS, FACEM Director and Chair from April 2009 Dr David Rosengren’s current roles include Chair of the Queensland Clinical Senate, Chair of Queensland Faculty of the Australasian College for Emergency Medicine, Director of the Emergency Centre at Greenslopes Private Hospital and Senior Staff Specialist Department of Emergency Medicine Royal Brisbane and Women’s Hospital (RBWH). Dr Rosengren is a Member of ACEM Private Practice and Accreditation Committees, and Queensland Emergency Department Strategic Advisory Panel. Dr Rosengren has a strong interest in wilderness and adventure medicine and is a Fellow of the Academy of Wilderness Medicine.

Dr Michael Sinnott MBBS, FRACP, FACEM Director from establishment (2007) to November 2013 Dr Michael Sinnott’s current roles include Clinical Senior Lecturer at the University of Queensland (UQ) and Senior Staff Specialist at the Princess Alexandra Hospital (PAH) Emergency Department. Dr Sinnott is also the Director the UQ-PAH Emergency Department Research Programme. Previously Dr Sinnott was the Director of Emergency Medicine Training and Chair of the General Clinical Training Committee. Throughout his career, Dr Sinnott has been awarded $2 million in research grants, including being a co-investigator on two ARC linkage grants, $2 million in commercial grants and loans, produced 31 publications, 40 presentations and posters, successfully lobbied for Resolutions on Staff Safety by the Michigan House and Michigan Senate. He is the Managing Director of Qlicksmart Pty Ltd.

Dr Stephen Priestley MBBS, FACEM Director from establishment (2007) to November 2013 Dr Stephen Priestley is a Specialist Emergency Physician. Currently, he is the Director of Emergency Medicine, Sunshine Coast Hospital and Health Service Queensland. Dr Priestley is a Member of the Australasian College of Emergency Medicine’s Quality Management Sub Committee, Chair of the Australasian College of Emergency Medicine Patient Safety Group and a current member of the Queensland Emergency Department Strategic Advisory Panel. Previously, Dr Priestley received the ACEM Morson Taylor Research Prize in 2000 and the ACEM John Gilroy Potts Research Prize in 2004. Dr Priestley continues as a Member of the Senior Court of Examiners, Australasian College for Emergency Medicine.

Mr Jason Currie BSc, LLB, MIP, GCPA Director from September 2010 to March 2014 Mr Jason Currie has worked in the healthcare improvement and innovation space for more than a decade and is currently a Program Manager in Vanguard Health. Jason has delivered statewide improvement programs, established support programs for medical research, provided policy advice to various government departments, and worked as a Patent Examiner in IP Australia. Jason has a passion challenging the status quo, for fostering innovation and reducing the time delay between research creation and practice change.

Ms Jane Schmitt LLB, LLM, GAICD Director from February 2012 Ms Jane Schmitt is a Lawyer by profession, having worked in private and corporate arenas. Ms Schmitt’s move into executive management has seen her in roles at Australia’s largest medical indemnity insurer and Master Builders Australia, before taking on the role of Chief Executive Officer at Australian Medical Association Queensland. Her expertise lies in initiating innovative operational and strategic changes to enhance the influence and profile of communities and businesses. Ms Schmitt is a strategic thinker, a straight talker and contributes vision and enthusiasm, strong leadership skills and business acumen. Ms Schmitt is a graduate of the Australian Institute of Company Directors (AICD) Course.

ANNUAL REPORT 2013/14 33 Prof David Taylor MBBS, FACEM Director from February 2012 Professor Taylor is Director of Emergency and General Medicine Research and Chair of the Human Research Ethics Committee at Austin Health, Melbourne. He is also Chair of the Australian College of Emergency Medicine Clinical Trials Group, the International Federation for Emergency Medicine (IFEM) Research Committee and the Consultative Council for Clinical Trials Research (an advisory council to the Victorian Government). He also serves on the Board of the ACEM Foundation. A Melbourne University graduate, he undertook postgraduate training in the UK, worked as a volunteer in Papua New Guinea, as a medical officer in Antarctica and as a Research Fellow and Attending Physician in the USA. Prof Taylor now undertakes clinical research full-time and supervisors a range of junior researchers from undergraduates to PhD candidates.

Prof Anthony Brown MBChB, FRCP, FRCSEd, FACEM, FCEM Director from March 2012 Professor Anthony Brown is currently a Senior Staff Specialist in Emergency Medicine at Royal Brisbane and Women’s Hospital (RBWH), Professor Discipline of Anaesthesiology and Critical Care, School of Medicine, University of Queensland and former Editor-in-Chief of the Emergency Medicine Australasia. Prof Brown is also a Senior Examiner for ACEM and a recent Member and Senior Adjudicator for the ACEM Trainee Research Committee. His particular interests include medical editing and writing, anaphylaxis, medical education, and medicolegal medicine. As an accomplished author, Prof Brown has published widely in numerous peer reviewed journals and written many medical textbooks from large multi- author to small handbooks.

Mr Cameron Smith MBA Director from 13 November 2012 Mr Cameron Smith is the Managing Director of Enterprise Brokers, a strategy and performance improvement consultancy that services the finance, construction and manufacturing industries. Prior to heading up Enterprise Brokers, Mr Smith was a consultant with McKinsey and Company where he was involved with a variety of clients in the airline, petroleum, steel and beverage industries. He has also held senior management roles in Boral and Origin Energy and was a Captain in the Australian Army. He holds a Royal Commission from the Portsea Military College and an MBA from the University of Virginia, Darden Graduate School of Business Administration.

Dr Sally McCarthy MBBS, FACEM, MBA Director from 12 November 2013. Dr Sally McCarthy is the inaugural Medical Director of the Emergency Care Institute of NSW, established in 2011 as part of the NSW Agency for Clinical Innovation. The Institute exists to network emergency services, spread best practice emergency care, promote research, and advocate on emergency care issues. Currently Dr McCarthy is working clinically as a Senior Emergency Physician at the Prince of Wales Hospital in Sydney, and is an experienced Director of Emergency Medicine Departments across Australia. As the immediate past president of the Board of the Australasian College for Emergency Medicine and former member of the Board of the International Federation for Emergency Medicine, Sally brings a wealth of experience and knowledge to QEMRF. Dr McCarthy has a Masters of Business Administration from the Australian Graduate School of Management.

Ms Susanne Le Boutillier BA, GDIR, GradCert Bus, GAICD Director from 4 June 2014. Ms Susanne Le Boutillier is a health executive focused on building strong leadership, improving systems and delivering outcomes. Her achievements were recognised when she was awarded QUT Business School’s Fostering Executive Women International Scholarship to the Harvard Business School Women’s Leadership Forum in 2012. During Ms Le Boutillier’s more than 25 years in Queensland Health she has worked in corporate level human resources and industrial relations, led Medical Workforce Advice and Coordination (MWAC), Clinical Education and Training Queensland (ClinEdQ), and the Queensland Health Reform Transition Office (QHRTO) from 1 July 2012. Ms Le Boutillier has broad experience in achieving change, stakeholder engagement, negotiation, managing programs, mitigating risk and developing and implementing strategy. She is currently the Senior Director, System Governance Support in the Office of the Director-General and is a graduate of the AICD Company Director’s Course.

34 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION COMMITTEES

Our thanks go to our committees who give tirelessly to the foundation. Our continued success would not be possible without their support.

Ms Maree Blake GAICD, FGIA, FCPA Finance Risk and Audit Ms Blake brings board experience including non- Committee executive directorships, chairing/member of board The Finance, Risk and Audit Committee (FRAC) committees (risk, governance, strategy, finance advises the Board on financial reporting, audit and and audit), state councils/committees of peak risk management matters. The Chair is appointed by professional bodies, and independent member on the Board. governance and audit/risk committees. She is an experienced former senior executive with strong Mr Jason Currie BSc, LLB, MIP, GCPA; Chair skills in governance, strategy, risk and business Member since establishment (January 2013). management, corporate reconstruction, and Mr Jason Currie has worked in the healthcare regulatory environments. Her experience covers improvement and innovation space for more both the private and public sectors, most recently than a decade and is currently a Program Manager as ASIC’s Queensland Regional Commissioner, and in Vanguard Health. Jason has delivered state- previously as partner of national accounting firm. wide improvement programs, established support programs for medical research, provided policy advice to various government departments, Scientific Advisory and worked as a Patent Examiner in IP Australia. Committee Jason has a passion challenging the status The role of the Scientific Advisory Committee quo, for fostering innovation and reducing the (SAC) is to provide strategic advice to the Board time delay between research creation and of Directors on the scientific direction for the practice change. Foundation. The Chair is appointed by the Board.

Mr Paul Monaghan FCPA Member since establishment (January 2013). Grants Review Panel An experienced financial management and The Grants Review Panel (GRP) has responsibility corporate services executive, having worked for peer review of the Staff Specialist and Trainee initially in auditing and accounting, then moving Grant Schemes and is accountable to the GAC. into increasingly more diverse senior management Members of the GRP may vary with each round, positions of health care and non-government depending on the expertise required. The Chair is organisations. Paul currently is the Director appointed by the Board. Corporate Services, Greenslopes Private Hospital. Paul holds Fellow status of CPA Australia and Grants Advisory ACHSM and has had long term interest in the education and development of managers and Committee has held leadership roles in these professional The Grants Advisory Committee (GAC) oversees bodies. In recognition for his contribution to the entire peer review process for QEMRF and university teaching, he is also an Adjunct is accountable directly to the Trustees of the Professor of the Queensland University of Foundation. The GAC has responsibility for peer Technology’s School of Public Health. Paul’s review of the Project Grants, Program Grants, teaching topics included financial administration Fellowship Schemes and Capacity Building Grants. and risk management. The Committee members are composed in relation to a grant round and the expertise they bring to the Committee for the applications received. The Chair is appointed by the Board.

ANNUAL REPORT 2013/14 35 Committee Members and Expert Reviewers

Dr Jason Acworth MBBS, FACEM, FRACP Dr Louise Cullen MBBS, FACEM Paediatric Emergency Physician; Director, Senior Staff Specialist, Department of Emergency Royal Children’s Hospital Emergency Department, Medicine, Royal Brisbane and Women’s Hospital, Queensland; Founding member of PREDICT; Queensland. A/Prof School of Medicine, University of Mr Jason Currie BSc, LLB, MIP, GCPA Queensland; Children’s Health Queensland, Program Manager, Vanguard Health, Queensland. Hospital and Health Service. Prof Ron Dieckmann MD, MPH A/Prof Peter Aitken MBBS, FACEM, EMDM Professor Emeritus of Paediatrics Medicine, Eminent Senior Staff Specialist Emergency University of California (USA). Department, The Townsville Hospital; Associate Professor, Anton Breinl Centre for Public Health, James Cook University; Senior Medical Coordinator – Disaster Management, Emergency Management Unit, Office of the Chief Health Officer.

Dr Maree Boyle BA (Hons), PhD Senior Lecturer, Griffith Business School, Griffith University.

Prof Anthony Brown MBChB, FRCP, FRCSEd, FACEM, FCEM Senior Staff Specialist, Department of Emergency Medicine, Royal Brisbane and Women’s Hospital, Queensland; Professor, Discipline of Anaesthesiology and Critical Care, School of Medicine, University of Queensland, Queensland.

Prof Simon Brown BMedSci, MBBS, PhD, DA, FACEM Professor in Emergency Medicine, University of Western Australia, Royal Perth Hospital, Western Australia; Head, Centre for Clinical Research in Emergency Medicine, Western Australian Institute for Medical Research; Editor-in-Chief, Journal of Emergency Medicine Australasia.

Dr Ellen Burkett MBBS (Hons), FACEM Staff Specialist, Department of Emergency Medicine, Princess Alexandra Hospital, Queensland.

Prof Peter Cameron MBBS, ECFMG (US), FRACS, FACEM Professor Emergency Medicine, Monash University, Victoria; Academic Director Emergency and Trauma Centre, The Alfred Hospital, Victoria.

Dr Kevin Chu MBBS, MSc, FACEM Clinical Research Design and Statistical Analysis; Director of Research and Senior Staff Specialist, Department of Emergency Medicine, Royal Brisbane and Women’s Hospital, Queensland.

A/Prof Julia Crilly RN, MN (Emerg) Hons, PhD Nurse Researcher, Emergency Department Clinical Network; RCCCPI, Griffith University Queensland.

36 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION A/Prof Suhail Doi A/Prof Jonathon Knott A/Prof Clinical Epidemiology, School of Population Deputy Director Emergency Services, Health, University of Queensland, Queensland. Royal Melbourne Hospital.

Dr Mieke Van Driel MD, Dip Tropical Medicine MSc, Prof Peter A Leggat JP, MD, PhD, DrPH, FAFPHM, PhD, FRACGP FACTM, FFTM (ACTM), FFTM RCPS (Glasg), Professor and Chair in General Practice, FACRRM, FAICD, FSIA, FACE, FRGS, ACPHM The University of Queensland, Queensland; (CMSA), WSO-CSE, MRO (AUS & USA) Head, Academic Discipline of General Practice, Professor/Head, School of Public Health, Tropical Medicine and Rehabilitation Sciences, The University of Queensland, Queensland. James Cook University, Douglas Campus Townsville, Dr Rob Eley BSc, MSc, PhD, FSB, CBiol Queensland; Associate Dean for Faculty Affairs Academic Research Manager, Emergency Medicine and Academic Advisor-Public Health and Tropical Research Program, University of Queensland – Medicine, Faculty of Medicine, Health and Princess Alexandra Hospital, Queensland; Molecular Sciences. Adj A /Prof, Centre for Rural and Remote Area Mr Paul Monaghan FCPA Health, a jointly badged centre of The University Director Corporate Services, Greenslopes Private of Southern Queensland and The University of Hospital, Queensland. Queensland, Queensland. A/Prof Ed Oakley MBBS, FACEM Prof Gerry Fitzgerald MBBS, MD, BHA, FACEM, Adjunct Associate Professor, Southern Clinical FRACMA, FCHS School, Monash University, Victoria; Director of Professor of Public Health (Emergency and Disaster Southern Health Paediatric Emergency Medicine. Management), Faculty of Health, Queensland Prof Paul Scuffham RPN, BA, PGDip Econ, PhD University of Technology, Queensland. Professor, Health Economics, School of Medicine, Prof John Fraser MBChB, PhD, DA, MRCP (UK), Griffith University, Queensland. FFARCSI, FRCA, FCICM A/Prof Jamie Seymour BSc (Hons), PhD Eminent Staff Specialist in Intensive Care Medicine, Lecturer, School of Marine and Tropical Biology, The Prince Charles Hospital, Queensland; James Cook University, Queensland. Director, Critical Care Research Group, Dr Ogilvie Thom MBBS, FACEM Grad Cert Clin University of Queensland, Queensland; Res Methods Director, Intensive Care Unit, St Andrews War Senior Staff Specialist and Director of Emergency Memorial Hospital, Queenslan d. Medicine Research, Redcliffe Hospital, Queensland; Dr Jeremy Furyk MBBS, FACEM, MPH&TM, MSc Principal Investigator Emergency Medicine Clinical Trials Staff Specialist, The Townsville Research Critical Care Research Group, The Prince Hospital, Queensland. Charles Hospital, Queensland.

A/Prof Jaimi Greenslade Dr Joseph Ting MBBS, FACEM, BMedSci, Grad Dip Principal Research Fellow, Royal Brisbane and Epi, PG Dip Clin Women’s Hospital, Queensland; Senior Lecturer Trials Staff Specialist Emergency Physician, Mater Public Hospital, Queensland. (Adjunct) at School of Medicine, University of Queensland, Queensland; Adj A/Prof at School Dr Greg Treston BMedSci, MBBS, DTMH (Lon), of Public Health and Social Work, Queensland DIMCRCS (Ed), FACEM, FACRRM University of Technology, Queensland. Staff Specialist in Emergency Medicine, Redcliffe Hospital, Queensland. Dr Gerben Keijzers MBBS, MEpi, FACEM Staff Specialist, Gold Coast Hospital Emergency A/Prof Kerrianne Watt BSc(Hons), PhD Department, Queensland; A/Prof Faculty of Health (Epidemiology) Associate Professor in Research Sciences and Medicine, Bond University, Queensland. Methodology / Injury Epidemiology at the School of Public Health, Tropical Medicine and Rehabilitation Prof Anne-Maree Kelly MBBS, MD, MClinEd, FACEM Sciences at James Cook University, and the Director Professor of Emergency Medicine, Western Health of Research Training. Kerrianne has a background and The University of Melbourne, Victoria; Director, in epidemiology, research methods; evidence- Joseph Epstein Centre for Emergency Medicine based practice and experience in data collection in Research, Victoria. Emergency Departments.

ANNUAL REPORT 2013/14 37 FINANCIAL CONTROLLER’S REPORT

Beth Chapman Financial Controller

QEMRF introduced an internal financial policies and procedures for QEMRF relating to management capacity in August 2013, with administration, Human Resources, Industrial the commencement of Mrs Beth Chapman as Relations, Finance and Grant Management. Financial Controller. This position has responsibility The FRAC meet bi-monthly, prior to QEMRF Board for all of the Foundation’s financial management meetings and is responsible for organisational and statutory reporting obligations. financial reporting, scrutiny, audit and risk Mrs Chapman has worked with the QEMRF management. Board and the Finance, Risk and Audit Committee Thank you to all the members of the FRAC (FRAC) on providing periodic management and Committee for their invaluable contribution during financial reports. the 2013/14 financial year: Mr Jason Currie (Chair), Another key focus has been on overseeing the Mr Paul Monaghan and Ms Maree Blake who finished implementation and adoption of a number of her term in April 2014.

FINANCIAL HIGHLIGHTS

■■ Following legal advice and in line with legal requirements The Board approved a loan to underwrite the establishment of a national Foundation, the Emergency Medicine Foundation. This loan will be repaid over time.

■■ Increased investment in grants program.

■■ In 2013/14 QEMRF provided $821,195 in grants to Hospitals, Health Services and collaborating Institutes.

Refer pages 20-21 for further detail in relation to grants distribution.

38 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION FINANCIAL HIGHLIGHTS

Statement of Total Equity as at 30 June 2014

Please also note that $2 million funding for the 2014-15 financial year was paid early by Queensland Health, and it is noted as an asset in the 2013-14 financial year resulting in an inflated total equity figure of $11,497,761.

Total Equity as indicated by Auditor for the 2013-2014 financial year $11,497,761

Minus amount paid by Queensland Health for 2014-2015 financial year $2,000,000

Minus committed funds for awarded grants $4,994,775

Minus corpus $4,500,000

ACTUAL UNCOMMITTED TOTAL EQUITY $2,986

Reserves to Cover Financial Commitment

The Corpus is an amount set aside by the Board so as to provide adequate reserves to meet existing commitments Year Amount should current funding be withdrawn. The Corpus would allow 2010 $5,000,000 the Foundation to continue its valuable work for several years whilst securing additional funding. 2011 $5,300,000 The corpus declined in 2013/14 as a result of an increased 2012 $5,800,000 investment in the grants programs as well as the Foundation’s commitment to the establishment of the Emergency 2013 $6,000,000 Medicine Foundation. 2014 $4,500,000

ANNUAL REPORT 2013/14 39 Audited Statement of Financial Position as at 30 June 2014

2014 2013 $ $ ASSETS Current Assets Cash and cash equivalents 10,640,126 1,358,066 Trade and other receivables 89,444 181,063 Other assets 18,557 14,835 Financial assets 790,901 10,290,901 Total Current Assets 11,539,028 11,844,865

Non-Current Assets Trade and other receivables 355,621 - Property, plant and equipment 37,712 3,924 Total Non-Current Assets 393,333 3,924

TOTAL ASSETS 11,932,361 11,848,789

LIABILITIES Current Liabilities Trade and other payables 430,873 254,067 Total Current Liabilities 430,873 254,067

Provision 3,727 - Total Non-Current Liabilities 3,727 -

TOTAL LIABILITIES 434,600 254,067

NET ASSETS 11,497,761 11,594,722

EQUITY Settlement sum 10 10 Retained surplus 11,497,751 11,594,712 TOTAL EQUITY 11,497,761 11,594,722

Full set of the Foundation’s financial statements are available on request.

40 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION Audited Statement

INDEPENDENT AUDITOR’S REPORT TO THE TRUSTEES OF QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION

Report on the Financial Statements We have audited the accompanying financial statements of Queensland Emergency Medicine Research Foundation (the Foundation), which comprises the statement of financial position as at 30 June 2014 and the statement of comprehensive income, statement of changes in equity, statement of cash flows for the year ended on that date, a summary of significant accounting policies and other explanatory notes and the Directors of the Trustee Company’s (the trustee’s) declaration.

Trustee’s responsibility for the financial statements The trustee of the Foundation is responsible for the preparation and fair presentation of the financial statements in accordance with Australian Accounting Standards (including the Australian Accounting Interpretations) and the trust deed 2001 and for such internal control as the directors determine is necessary to enable the preparation of the financial statements that are free from material misstatement, whether due to fraud or error.

Auditor’s responsibility Our responsibility is to express an opinion on the financial statements based on our audit. We conducted our audit in accordance with Australian Auditing Standards. These Auditing Standards require that we comply with relevant ethical requirements relating to audit engagements and plan and perform the audit to obtain reasonable assurance whether the financial statements are free from material misstatement. An audit involves performing procedures to obtain audit evidence about the amounts and disclosures in the financial statements. The procedures selected depend on the auditor’s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the auditor considers internal control relevant to the entity’s preparation and fair presentation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose of expressing an opinion on the effectiveness of the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by the trustee, as well as evaluating the overall presentation of the financial statements. We believe that the audit evidence we have obtained is sufficient and appropriate to provide a basis for our audit opinion.

Independence In conducting our audit, we have complied with the independence requirements of Australian professional ethical pronouncements.

Auditor’s Opinion In our opinion the financial statements present fairly, in all material respects, the financial position of Queensland Emergency Medicine Research Foundation as of 30 June 2014, and its financial performance and cash flows for the year then ended in accordance with Australian Accounting Standards – Reduced Disclosure Requirements and the trust deed.

PRIESTLEYS B G HILEY Chartered Accountants Partner

Liability limited by a scheme approved under Professional Standards Legislation Signed at Brisbane this 22 day of September 2014.

QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION ANNUAL REPORT 2013/14 41 PUBLICATIONS

Baker K, Mitchell G, Thompson GG, Stieler G. 2013 outcomes: Analyses based on linking Ambulance, ‘Comparison of a basic lung scanning protocol Emergency and Hospital databases’. Internal Med against formally reported chest x-ray in the Journal. 43 (12): pp 1293-1303. diagnosis of pulmonary oedema.’ Australasian Cullen L, Aldous S, Than M, Greenslade J, Tate J, Journal of Ultrasound in Medicine. November 16 (4), George PM, Hammett CJ, Richards AM, Ungerer JPJ, 183–189. Troughton RW, Brown AFT, Flaws DF, Lamanna Baker K, Mitchell G, Thompson A.G, Stieler G. A, Pemberton CJ, Florkowski C, Pretorius CJ, 2013 ‘Diagnostic accuracy of basic lung ultrasound Chu K, Parsonage WA. 2013. ‘Comparison of high in breathless patients over 60 years of age; sensitivity troponin T and I assays in the diagnosis stressing the protocol.’ Australasian Journal of of non-ST elevation acute myocardial infarction Ultrasound in Medicine. November 16 (4), 176-182. in emergency patients with chest pain’. Clinical Biscak T, Eley R, Manoharan S, Sinnott M, Soyer H. Biochemistry. Dec 5. 2013. ‘Audit of a State-wide store and forward Cullen L, Greenslade J, Than M, Brown A, Hammett C, teledermatology service in Australia.’ Journal of Lamanna A, Flaws D, Chu K, Fowles L, Parsonage telemedicine and telecare. 19 (7), pp 362-366. W. 2014. ‘The new Vancouver Chest Pain Rule Burkett E, Marwick T, Thom O, Kelly AM. 2014. using troponin as the only biomarker: an external ‘A comparative analysis of risk stratification tools for validation study.’ The American journal of emergency department patients with chest pain.’ emergency medicine. 32 (2), pp 129-134. International Journal of Emergency Medicine. 7:10. Cullen L, Greenslade J, Than M, Tate J, Ungerer JPJ, Chu K, Hann A, Greenslade J, Williams J, Brown A. Pretorius C, Hammett CJ, Lamanna A, Chu K, 2014. ‘Spectrophotometry or Visual Inspection to Brown AFT, Parsonage WA. 2013. ‘Performance of Most Reliably Detect Xanthochromia in Subarachnoid risk stratification for acute coronary syndrome with 2 hour sensitive troponin assay results’. Hemorrhage: Systematic Review’. Annals of Heart, Lung Nov 19, doi:10.1016/j.hlc.2013.11.003. emergency medicine. and Circulation. Chu K, Wagholikar A, Greenslade J, O'Dwyer J, Cullen L, Greenslade J, Hammett CJ, Brown AF, Brown A. 2013. ‘Sustained reductions in emergency Chew DP, Bilesky J, Than M, Lamanna A, Ryan K, department laboratory test orders: impact of a Chu K, Parsonage WA. 2013. ‘Comparison of three risk stratification rules for predicting patients simple intervention’. Postgraduate medical journal. 89 (1056), pp 566-571. with acute coronary syndrome presenting to an Australian emergency department’. Heart, Lung and Crilly J, Keijzers G, Tippett V, O'Dwyer J, Wallis M, Circulation, 22 (10), pp 844-851. Lind J, Bost N, O'Dwyer M, Shiels S. 2014. ‘Expanding emergency department capacity: Cullen L, Mueller C, Parsonage WA, Wildi K, Greenslade JH, Twerenbold R, Aldous S, Meller B, a multisite study’. Australian Health Review. 38 (3), pp 278-287. Tate JR, Reichlin T, Hammett CJ, Zellweger C, Ungerer JP, Rubini Gimenez M, Troughton R, Crilly J, Keijzers G, Tippett V, O’Dwyer J, Lind Murray K, Brown AF, Mueller M, George P, J, Wallis M, Bost N, O’Dwyer M, Shiels S. 2013. Mosimann T, Flaws DF, Reiter M, Lamanna A, ‘Expanding Emergency Department capacity: Haaf P, Pemberton CJ, Richards AM, Chu K, a multisite study.’ Australian Health Review. Reid CM, Peacock WF, Jaffe AS, Florkowski C, ePub ahead of print May 2014. Deely JM, Than M. 2013. ‘Validation of high- Crilly J, Keijzers G, Lind J, O’Dwyer J, Thalib L, sensitivity troponin I in a 2-hour diagnostic Wallis M, O’Dwyer M, Bost N, Shiels S, Tippett V. strategy to assess 30-day outcomes in emergency 2013. ‘The impact of opening a new emergency department patients with possible acute coronary department on health care service and patient syndrome.’ Journal of the American College of outcomes: Analyses based on linking Ambulance, Cardiology. 62 (14), pp 1242-1249. Emergency and Hospital databases’. Internal Med Cullen L, Parsonage WA, Greenslade J, Lamanna A, . 43 (12): 1293-1303. Journal Hammett CJ, Than M, Tate J, Kalinowski L, Ungerer JP, Crilly J, Keijzers G, Lind J, O’Dwyer J, Thalib, L, Chu K, Brown A. 2013. ‘Delta troponin for the early Wallis M, O’Dwyer M, Bost N, Shiels S, Tippett V. diagnosis of AMI in emergency patients with chest 2013. ‘The impact of opening a new emergency pain.’ International Journal of Cardiology. 168: department on health care service and patient 2602-2608.

42 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION ANNUAL REPORT | 2013 Eley R, Sinnott M, Steinle V, Trenning L, Boyde M, ‘A prospective evaluation of missed injuries in Dimeski G. 2014. ‘The need to address poor trauma patients, before and after formalising the numeracy skills in the ED environment.’ Emergency trauma tertiary survey.’ World Journal of Surgery. Medicine Australasia 26, 300-302. 38 (1): 222-232. Eley R, Spencer L, Starmer K, Sinnot S. 2014. McDonald C, Fraser J, Shekar K, Dunster K, Thom O, ‘Prescribing knowledge revisited – time for action Fung Y. 2013. ‘Transfusion of packed red blood and awareness.’ Emergency Medicine Australasia. cells reduces selenium levels and increases lipid 26, 211-212. peroxidation in an in vivo ovine model.’ Transfusion Fung Y, Tung J, Foley S, Simonova G, Thom O, Medicine. Vol. 24, No. 1, pp 50-54 Staib A, Collier J, Dunster K, Solano C, Shekar K, Khan M, Burkett E, Schnitker L, Jones RN, Gray LC. Chew M, Fraser J. 2013. ‘Stored blood transfusion 2013. ‘Methodology for developing quality induces transient pulmonary arterial hypertension indicators for the care of older people in the without impairing coagulation in an ovine model Emergency Department.’ BMC Emergency Medicine. of non-traumatic haemorrhage.’ Vox Sanguinis. 13: 23-23. 105: 150-158. Khan M, Burkett E, Schnitker L, Jones R, Gray L. George T, Ashover S, Cullen L, Larsen P, Gibson J, 2013 ‘Methodology for developing quality indicators Bilesky J, Coverdale S, Parsonage W. 2013. for the care of older people in the Emergency ‘Introduction of an accelerated diagnostic protocol Department.’ BMC Emergency Medicine. 13. in the assessment of emergency department Mahmoud I, Hou XY, Clark M, Chu K, Eley R. 2014. patients with possible acute coronary syndrome: ‘Satisfaction with Emergency Department Service the Nambour Short Low-Intermediate Chest pain among non-English-speaking background patients.’ project.’ Emergency Medicine Australasia. 26, 256-261. 25: 340-344. Emergency Medicine Australasia Greenslade JH, Cullen L, Than M, Aldous S, Chu K, Parsonage W, Greenslade JH, Hammett CJ, Brown AF, Richards AM, Pemberton CJ, George P, Lamanna A, Tate JR, Ungerer JP, Chu K, Than M, Parsonage WA. 2013. ‘Validation of the Vancouver Briwn AFT, Cullen L. 2014. ‘Validation of an Chest Pain Rule using troponin as the only accelerated high-sensitivity troponin T assay biomarker: a prospective cohort study’. American protocol in an Australian cohort with chest pain.’ Journal of Emergency Medicine. 31: 1103-1107. Medical Journal of Australia. 200 (3), 161-5. Greenslade JH, Cullen L, Kalinowski L, Parsonage W, Parsonage WA, Greenslade JH, Hammett CJ, Palmer S, Aldous S, Richards M, Chu K, Brown AF, Lamanna A, Tate J, Ungerer JPJ, Chu K, Than M, Troughton R, Pemberton C, Than M. 2013. Brown AFT, Cullen L. 2013. ‘Validation of an ‘Examining renal impairment as a risk factor for accelerated high sensitivity troponin T assay acute coronary syndrome: A prospective protocol in an Australian cohort with chest pain.’ observational study.’ Annals of Emergency Medical Journal of Australia. Jul 8; 199 (1): 30-4. Medicine. 62: 38-46. Perez S, Keijzers G, Steele M, Byrnes J, Scuffham P. Greenslade J, Cullen L, Parsonage W, Reid CM, 2013. ‘Intravenous 0.9% Sodium Chloride Therapy Body R, Richards M, Hawkins T, Lim S H, Than M. Does Not Reduce Length of Stay of Alcohol 2013. ‘Examining the signs and symptoms Intoxicated Patients in the Emergency Department: experienced by individuals with suspected Acute A Randomized Controlled Trial.’ Emergency Coronary Syndrome in the Asia-Pacific region: Medicine Australasia. Dec; 25 (6): 527-34. A prospective observational study.’ Annals of Pereira P, Seymour JE. 2013. ‘Box jellyfish Venoms Emergency Medicine. 60: 777-785. and Human Heart Cells In vitro effects on human Isoardi J, Spencer L, Sinnott M, Nicholls K, heart and skeletal cells of the venom from two O'Connor A, Jones F. 2013. ‘Exploration of the cubozoans, Chironex fleckeri and Carukia barnesi.’ perceptions of emergency physicians and interns Toxicon. 76, 310–315. regarding the medical documentation practices of Pretorius CJ, Cullen L, Parsonage WA, Greenslade, interns.’ Emergency Medicine Australasia. 25 (4), JH, Tate JR, Wilgen U, Ungerer JPJ. 2014. ‘Towards 302-30. a consistent definition of a significant delta troponin Keijzers GB, Campbell D, Hooper J, Bost N, Crilly J, with Z-scores: A way out of chaos?’ European Heart Steele MC, Del Mar C, Geeraedts LMG. 2014. Journal: Acute Cardiovascular Care. 32 (2): 149-157.

ANNUAL REPORT 2013/14 43 Schnitker L, Martin-Khan M, Burkett E, Beattie White J, Seymour JE, Little M. 2013. ‘A Clinicians E, Gray L. 2013. ‘Appraisal of the quality of care Guide to Australian Venomous Bites and Stings’. of older adults with cognitive impairment in the Incorporating the updated CSL Antivenom emergency department.’ Journal of Gerontological Handbook. ISBN: 9780646579986. Nursing. 39 (3), 34-40. Articles Submitted Simonova G, Tung J, Fraser J, Do H, Staib A, Chew M, Dunster K, Glenister K, Jackson Dn Fung Y. 2013 Camillieri et al. ‘The effect of heat on venom ‘A comprehensive ovine model of blood transfusion’ induced consumptive coagulopathy secondary Transfusion. First published online 2 September to Eastern Brown Snake (Pseudonaja textilis) or 2013 doi/10.1111/vox.12076 Coastal Taipan Snake (Oxyuranus scutellatus) envenomation.’ Sinnott M, Eley R, Boyde M, Steinle V, Trenning L. 2014. ‘Decimal numbers and safe interpretation Butson B et al, ‘Emergent diagnosis of malaria in of clinical pathology results.’ Journal of Clinical febrile patients in the Solomon Islands.’ Submitted Pathology. 67, 179-181. to Malaria online. Sinnott M, Eley R, Winch S. 2014. ‘Introducing the Davison M, Kinnear F, Fulbrook P, 2014. ‘Simulation Safety Score Audit – for staff and patient safety.’ improves staff confidence and orientation to a new AORN Journal. 100, 91-95. children’s emergency service.’ Submitted to Medical Education. Six AJ, Cullen L, Backus BE, Greenslade J, Parsonage W, Aldous S, Doevandans PA, Than M. Isoardi J, Spencer L, Sinnott M, Eley R. 2014. ‘Impact 2013. ‘The HEART score for the assessment of formal teaching on medical documentation by interns in Emergency Departments.’ Submitted to of patients with chest pain in the emergency Academic Emergency Medicine. department.’ Critical Pathways in Cardiology. 12, 121-126. Mahmoud I, Eley R, Hou XY. 2014. ‘Subjective reasons why patients from non-English speaking Spencer L, Eley R, Wong A, Kozan E, Sinnott M. backgrounds attend the emergency department.’ 2014. ‘An alternative methodology for Bed Submitted to BMC Emergency Medicine. Occupancy data collection.’ Asia Pacific Journal of Health Management. Neumann M, Eley R, Vallmuur K, Schuetz M. 2014. ‘Current profile and challenges of cycling injuries Starmer K, Sinnott M, Shaban R, Donegan E, – a retrospective analysis of a Trauma Centre Kapitzke D. 2013. ‘Blind prescribing: A mixed- Level I in Queensland.’ Submitted to Australian, methods study of junior doctors’ prescribing New Zealand Journal of Surgery. preparedness in an Australian emergency department.’ Medical Journal of Australia. 25, Wong A, Kozan E, Sinnott M, Spencer L, Eley R. 147-153. 2014. ‘Tracking the patient journey by combining multiple hospital database systems.’ Submitted to Than M, Flaws D, Sanders S, Doust J, Glasziou P, Australian Health Review. Kline J, Aldous S, Troughton R, Reid C, Parsonage WA, Frampton C, Greenslade JH, Deely JM, Hess Published Abstract E, Bin Sadiq A, Singleton R, Shopland R, Vercoe L, Woolhouse-Williams M, Ardagh M, Bossuyt P, Parsonage W, Cullen L, Greenslade J, Tate J, Cullen L. 2014. ‘Development and validation of the Ungerer J, Hammett C, Pretorius C, Chu K, Brown AFT. 2013. ‘Comparison of highly sensitive Emergency-Department Assessment Chest-pain Troponin I and T results in the diagnosis of acute Score and 2-hour Accelerated Diagnostic Protocol.’ myocardial infarction.’ Journal of the American Emergency Medicine Australasia. 26 (1): 34-44. College of Cardiology. 61: E228. Epub 2014 Jan 15. Welfare P, Little M, Pereira P, Seymour J. 2014. Presentations ‘Reply to Vinegar and Chironex fleckeri stings.’ Blake D. ‘Shaken, not stirred! A Prospective Diving and Hyperbaric Medicine Volume 44 (1): Simulation Study Evaluating Intravascular Bubble 33-34. Formation in Healthy Volunteers Exposed to Welfare P, Little M, Pereira P and Seymour J. 2014. Vibration versus Stillness following a Table 14 ‘An in-vitro examination of the effect of vinegar on (241.3 kPa) Hyperbaric Treatment. Preliminary discharged nematocysts of Chironex fleckeri.’ Diving results on helicopter vibration measurement and and Hyperbaric Medicine Volume 44 (1) 33-34. vibration simulator development.’ Research session

44 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION at SMACC. Gold Coast, Queensland, Australia. Schnitker L, Martin-Khan M, Burkett E, Beattie E, Jones R, Gray L. 2013. ‘Appraisal of the quality of Baker K. 2013. ‘Limited lung ultrasound protocol in elderly patients with breathlessness; agreement care of older adults with cognitive impairment in between bedside interpretation and stored images, the emergency department.’ ICEM, 11th International as acquired by experienced and inexperienced Conference for Emergency Nurses, Melbourne. sonologists.’ West Moreton Hospital and Health Digital Media Service Research Day. Facebook. 2014. Blue Team. [online] Chu K, Hann A, Yee J, Greenslade J, Brown A. 2014. ‘Final lumber puncture and absolute percentage Available at: https://www.facebook.com/ change in red blood cell count in the diagnosis BrisbaneLungUltrasound?ref=hl of aneurysmal subarachnoid haemorrhage.’ Baker K, Young S, Isoardi K, Williamson F, International Conference on Emergency Medicine Jarugula R, Mitchell G and Senior H, Steiler G. 2014. http://www.icem2014.org/main.php. BLUE Team LUS+2014 Project. 2014. BLUE Team Davison M, Kinnear F, Watson M. 2014. ‘Paediatric LUS+2014 Project. [online] Available at: http:// High Flow Nasal Cannula therapy to reduce Work ipswichultrasound.wordpress.com. of Breathing in children with bronchiolitis: A retrospective safety and efficacy study.’ Posters Queensland Emergency Medicine ACEM Chung K, Greenslade J, Parsonage W, Than M, Autumn Symposium. Brown A, Cullen L. 2014. ‘Modification of the Grabau P. 2013. ‘The Simulation of Vibrations TIMI risk score to improve risk stratification for Experienced by Patients During Helicopter Acute Coronary Syndrome in patients presenting Winching and Retrieval.’ Pre-completion PhD with chest pain to the emergency department.’ seminar presented James Cook University, International Conference on Emergency Medicine, School of Engineering. Townsville, Queensland. Hong Kong. Hann A, Chu K, Greenslade J, Brown A. 2014. Cullen L, Parsonage W, Greenslade J, Aldous S, ‘Does CSF spectrophotometry provide benefit George P, Hammett C, Lamanna A, Ungerer J, in the assessment of CT negative suspected Richards AM, Pemberton C, Than M. 2013. ‘Diagnosis subarachnoid haemorrhage?’ International of AMI using sex-specific cut-off values of a highly Conference on Emergency Medicine 2014. sensitive troponin I assay in emergency department http://www.icem2014.org/main.php patients with chest pain.’ RBWH Healthcare Symposium, Brisbane. Kinnear F. 2013. ‘Intramuscular Droperidol for sedation of patients with acute behavioural Cullen L, Parsonage W, Greeenslade J, Aldous disturbance in the Emergency Department.’ S, George P, Hammett C, Lamanna A, Ungerer TPCH Research Symposium. J, Richards M, Pemberton CJ, Martin Than. 2013. Kinnear F. 2014. ‘Intramuscular Droperidol for ‘Diagnosis of acute myocardial infarction in sedation of patients with acute behavioural emergency patients with chest pain using a two disturbance in the Emergency Department.’ hour algorithm with highly sensitive troponin I assay Queensland Emergency Medicine ACEM Autumn results.’ RBWH Healthcare Symposium, Brisbane. Symposium. Cullen L, Parsonage W, Greenslade J, Aldous S, Little M. ‘Latest of venoms and antivenoms.’ George P, Lamanna A, Ungerer J, Richards M, Toxinology Update ACEM Winter Symposium. Pemberton CJ, Than M. 2013. ‘Diagnostic accuracy of highly sensitive troponin I versus highly sensitive Little M. ‘Dangerous things in the air.’ Toxinology troponin T assays for acute myocardial infarction Update ACEM Winter Symposium. within two hours of Emergency Department Seymour J. ‘Dangerous things in the sea.’ presentation.’ RBWH Healthcare Symposium, Brisbane. ACEM Winter Symposium. Cullen L, Greenslade J, Than M, Aldous S, George P, Seymour J. ‘Resuscitating a box jelly fish sting Hawkins T, Brown A, Richards M, Pemberton C.J, – can you survive?’ ACEM Winter Symposium. Hammett C, Parsonage W. 2013. ‘Identification Sinnott M, Eley R, Shaban R, London M, Penny J. of low risk emergency patients with symptoms 2013. ‘Staff Safety – Why Do We Ignore It At of possible acute coronary syndrome: External Our Own Peril?’ In Association for PeriOperative validation of the Vancouver Chest Pain Rule.’ Registered Nurses 60th Congress, San Diego. RBWH Healthcare Symposium, Brisbane.

ANNUAL REPORT 2013/14 45 Cullen L, Parsonage W, Greenslade J, Aldous S, Society of Australia and New Zealand Conference, George P, Lamanna A, Ungerer J, Richards M, Gold Coast, Queensland. Pemberton CJ, Than M. 2013. ‘Diagnostic accuracy Cullen L, George T, Parsonage W, Larsen P, of highly sensitive troponin I versus highly sensitive Coverdale S, Ashover S, Bilesky S, Bailey K, troponin T assays for acute myocardial infarction Boulton B, Gibson J, Currie J. 2013. ‘Use of an within two hours of Emergency department accelerated diagnostic protocol in the assessment presentation.’ European Society of Cardiology of Emergency Department patients with possible Congress, Amsterdam. acute coronary syndrome.’ RBWH Healthcare Cullen L, Parsonage W, Greenslade J, Aldous S, Symposium, Brisbane. George P, Hammett C, Lamanna A, Ungerer J, Cullen L, George T, Parsonage W, Larsen P, Richards AM, Pemberton C, Than M. 2013. ‘Use of Coverdale S, Ashover S, Bilesky J, Bailey K, Sex specific cut-offs with highly sensitive troponin Boulton B, Gibson J, Currie J. 2013. ‘Use of an I assay values for the diagnosis of acute myocardial accelerated diagnostic protocol in the assessment infarction in emergency patients with chest of Emergency Department patient with possible pain.’ European Society of Cardiology Congress, acute coronary syndrome.’ Cardiac Society of Amsterdam. Australia and New Zealand Conference, Gold Coast, Cullen L, Greenslade J, Than M, Aldous S, George P, Queensland. Hawkins T, Brown AFT, Richards AM, Pemberton CJ, Eley R, Sinnott M, Trenning L, Steinle V. 2013. Ha,mmett C, Parsonage WA. 2013. ‘Identification ‘Whole numbers please!’ Poster at Princess of low risk emergency patients with symptoms Alexandra Hospital Health Research Week. of possible acute coronary syndrome: External validation of the Vancouver Chest Pain Rule.’ Parsonage W, Greenslade J, Ungerer J, Tate J, Cardiac Society of Australia and New Zealand Pretorius C, Hammett C, Lamanna A, Chu K, Conference, Gold Coast, Queensland. Brown A, Cullen L. 2013. ‘A study of the effect of the manufacturers advised recalculation of the high Cullen L, Parsonage W, Greenslade J, Aldous S, sensitivity troponin T assay on the early detection George P, Hammett C, Lamanna A, Ungerer J, of acute myocardial infarction in patients presenting Richards AM, Pemberton CJ & Than M. 2013. to the emergency department.’ Royal Brisbane ‘Diagnosis of acute myocardial infarction in Women’s Hospital Healthcare Symposium, Brisbane. emergency patients with chest pain using a two hour algorithm with highly sensitive troponin I Parsonage W, Greenslade J, Ungerer J, Tate J, assay results.’ Cardiac Society of Australia and Pretorius C, Hammett C, Lamanna A, Chu K, New Zealand Conference, Gold Coast, Queensland. Brown A, Cullen L. 2013. ‘A study of the effect of the manufacturers advised recalculation of the high Cullen L, Parsonage W, Greenslade J, Aldous sensitivity troponin T assay on the early detection S, George P, Hammett C, Lamanna A, Ungerer of acute myocardial infarction in patients presenting J, Richards AM, Pemberton CJ, Than M. 2013. to the emergency department.’ Cardiac Society of Diagnosis of AMI using sex-specific cut-off values Australia and New Zealand conference, Gold Coast, of a highly sensitive troponin I assay in emergency Queensland. department patients with chest pain.’ Cardiac

46 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION LIST OF ACRONYMS

A A/Prof Associate Professor AANZDEM Australia, Asia and New Zealand Dyspnoea Departments of Emergency Medicine ACEM Australasian College of Emergency Medicine ACHSM Australasian College of Health Service Management ACPM American College of Preventative Medicine ACS Acute Coronary Syndrome ACTM Australian College of Tropical Medicine Adj Adjunct AICD Australian Institute of Company Directors AMAQ Australian Medical Association (Queensland) ARCE Accelerated Chest Pain Risk Evaluation ASIC Australian Securities & Investments Commission ASMOFQ Australian Salaried Medical Officers' Federation (Queensland) AusHSI Australian Centre for Health Services Innovation B B MedSci Bachelor of Medical Science BA Bachelor of Arts BSc Bachelor of Science C CBiol Chartered Biologist CEO Chief Executive Officer CKN Collaborative Knowledge Network ClinEdQ Clinical Education and Training Queensland CMSA Case Management Society of Australia & New Zealand CMSA Combinatorial Mathematics Society of Australasia CPA Certified Practicing Accountant CRIC Children’s Rules for Imaging the Cervical Spine CSE Convulsive Status Epileptics CSIRO Commonwealth Scientific and Industrial Research Organisation CT Computed Tomography D DCI Decompression Illness Dip Diploma Dr Doctor DrPH Doctor of Public Health DTMH Diploma in Tropical Medicine and Hygiene E ECFMG Educational Commission for Foreign Medical Graduates ECG Electrocardiogram ED Emergency Department EFHL Environments for Healthy Living EM Emergency Medicine EMDM European Master in Disease Medicine EMF Emergency Medicine Foundation F FACE Fellow of the Australian College of Education FACEM Fellow of the Australasian College of Emergency Medicine FACRRM Fellow of the Australian College of Rural and Remote Medicine FACTM Fellow of the Australasian College of Tropical Medicine FAFPHM Fellow of Australian Faculty of Public Health Medicine FAICD Fellow of the Australian Institute of Company Directors FCEM Fellow of the College of Emergency Medicine FCICM Fellow of the College of Intensive Care Medicine FCPA Fellow of CPA Australia FFARCSI Fellow of Faculty of Anaesthesia Royal College of Surgeons Ireland FFTM Fellow of the Faculty of Travel Medicine of the Australasian College of Tropical Medicine FGIA Fellow of the Governance Institute of Australia FRAC Finance, Risk and Audit Committee FRACGP Fellow of the Royal Austratlian College of General Practitioners FRACMA Fellow of the Royal Australasian College of Medical Administrators FRACP Fellow of the Royal Australasian College of Physicians FRACS Fellow of the Royal Australasian College of Surgeons FRCA Fellow of the Royal College of Anaesthetists FRCP Fellow of the Royal College of Physicians FRCSEd Fellow of the Royal College of Surgeons Edinburgh FRGS Fellow of the Royal Geographical Society

ANNUAL REPORT 2013/14 47 G GAC Grants Advisory Committee GAICD Graduate of the Australian Institute of Company Directors GCPA Graduate of CPA Australia GCUH Gold Coast University Hospital GDIR Graduate Diploma of Business in Industrial Relations GP General Practitioner Grad Cert Clin. Graduate Certificate in Clinical Research Methods Res Methods GradCert Bus Graduate Certificate Business GradDipEpi Graduate Diploma in Epidemiology GRP Grants Review Panel H HFNC High Flow Nasal Canula Hons Honours I ICU Intensive Care Unit IFEM International Federation for Emergency Medicine IHBI Institute of Health and Biomedical Innovation IOM Institute of Medicine IV Intravenous J JP Justice of the Peace L LLB Bachelor of Laws LLM Master of Laws M MBA Master of Business Administration MBBS Bachelor of Medicine, Bachelor of Surgery MBChB Bachelor of Medicine, Bachelor of Surgery MClinEd Master of Clinical Education MD Doctor of Medicine MEpi Master of Medicine (Clinical Epidemiology) MIP Maste of Intellectual Property Law MN (Emerg) Master of Nursing (Emergency) MPH Master of Public Health MRCP (US) Member of the Royal College of Physicians MRO Medical Review Officer MSc Master of Science MWAC Medical Workforce Advice and Coordination N NHMRC National Health & Medical Research Council NSW New South Wales NZ New Zealand P PAH Princess Alexandra Hospital PECARN Paediatric Emergency Care Applied Research Network PGDipClin Post Graduate Diploma Clinical PGDipEcon Post Graduate Diploma Economics PhD Doctor of Philosophy PICU Paediatric Intensive Care Unit POC Point of Care PREDICT Paediatric Research in Emergency Departments International Collaborative Q QAS Queensland Ambulance Service QCOSS Queensland Council of Social Services QEMRF Queensland Emergency Medicine Research Foundation QERC Queensland Emergency Research Collaborative QHRTO Queensland Health Reform Transition Office QLD Queensland QUT Queensland University of Technology R RCCPI Royal College of Physicians Ireland RBWH Royal Brisbane and Women’s Hospital RN Registered Nurse RPN Registered Practical Nurse RSN Research Support Network S SAC Scientific Advisory Committee SAH Subarachnoid Haemorrhage SE South East T TM Tropical Medicine U UQ The University of Queensland UK United Kingdom USA United States of America W WSO-CSE World Safety Organisation - Certified Safety Executive

48 QUEENSLAND EMERGENCY MEDICINE RESEARCH FOUNDATION

2/15 Lang Parade Milton QLD 4064 T +617 3720 5700 E [email protected] qemrf.org.au /qemrf @QEMRF1 /qemrf ABN 37 814 620 674

The Queensland Emergency Medicine Research Foundation (QEMRF) was established in 2007 with the support of the Queensland Government to allocate grants to individuals and groups working to improve patient care in Queensland hospital emergency departments. The QEMRF vision is for Queensland to be regarded as a world leader in Emergency Medicine research and be the location of choice for the brightest minds in Emergency Medicine. QEMRF is a company registered as a charitable institution.

ANNUAL REPORT for the Year Ending 30 June 2014 © 2014 Queensland Emergency Medicine Research Foundation ABN 37 814 620 674

ANNUAL REPORT for the Year Ending 30 June 2014 © 2014 Queensland Emergency Medicine Research Foundation ABN 37 814 620 674