Collaboration between researchers, policy makers, service users, health managers and clinicians in research is critical and can lead to findings that are more likely to be innovative and positively inform health decisions. This includes innovative future focused infrastructure and digital health initiatives.
Awardees may have demonstrated outstanding and innovative achievements by establishing:
Transcript - Winner - Safer, better emergency nursing care
Transcript - The COVID-19 Critical Intelligence Unit
The Agency for Clinical Innovation is leading the COVID-19 Critical Intelligence Unit (CIU) providing rapid, evidence-based advice during the COVID-19 pandemic. It brings together insights from evidence synthesis and research, data analysis and modelling, and clinical and policy expertise.
The CIU was formed by the Secretary of NSW Health in March 2020 and swiftly established itself as a valuable source of integrated evidence, and support for decision-makers across the NSW health system and beyond.
The unit has produced:
Transcript - Management of rural acute coronary syndrome
Contrary to evidence and guidelines, one third of patients presenting to Australian hospitals with ST elevation myocardial infarction (STEMI) do not receive primary reperfusion treatment. This is more common in hospitals in rural NSW predominantly due to failure to correctly interpret ECG and biomarkers.
Management of Rural Acute Coronary Syndromes (MORACS), a cluster randomised control trial, tested a diagnostic support service to improve management of rural patients presenting with suspected acute coronary syndrome (ACS).
MORACS achieved the primary endpoint demonstrating a statistically significant reduction of missed STEMI (0% vs 35%, p=0.001). It also improved rates of reperfusion therapy (100% vs 64%). Accurate early diagnosis of STEMI was associated with lower mortality in hospital (2.2% vs 7.7%), and at 12 months (6.5% vs 10.3%).
MORACS meets the strategic aims of this category through collaboration of clinicians, researchers, policy makers, and health managers in developing and evaluating an innovative model of care that complements current clinical pathways, integrating existing patient management systems, and research capacity building.
MORACS aligns with the NSW State Health Plan: Towards 2021, the NSW Rural Health Plan: Towards 2021, the HNELHD Strategic Plan 2021, the National Heart Foundation strategy, and the Agency for Clinical Innovation Strategic Plan 2015-2018.
Transcript - Safer, better emergency nursing care
To reduce patient deterioration related to ED care by implementing our new, validated emergency nursing framework HIRAID.
HIRAID was developed with experts, tested, then implemented in ISLHD EDs (302 nurses) using a multi-pronged behaviour change strategy. Causal factors to all 920 deterioration events within 72-hours of ED departure were analysed. Cost savings were calculated via OLS regression.
Results showed that ED related deterioration halved (27% to 13%) as did treatment delays (28% to 15%) and failure to escalate when abnormal vital signs were identified (20.2% to 6.9%). Documentation significantly improved. Savings were $1,914,252 with a payback period of 75 days.
The NSW goal Providing World-Class Clinical Care is clearly achieved through immediate, measurable improved emergency nursing care for 150,000+ ISLHD emergency patients each year.
This multi-disciplinary collaboration changed policy and practice. The ACSQHC, NSW ACI, NHMRC and the NSW and Commonwealth Chief Nurses have partnered with us to upscale HIRAID in another 32 EDs (1500+ nurses) across Australia.
This multi-centre study provides the reliable and necessary evidence and pathway for system-wide change.
