The Victorian emergency department collaboration.

OBJECTIVES: The aim of the project was to bring together 17 major emergency departments across Victoria, Australia, and the Australian Capital Territory to work together over an 8-month period to reduce both clinical and operational waits and delays, and to improve patient satisfaction.
DESIGN: The collaborative was based on the Institute for Healthcare Improvement's Breakthrough Series, and utlilized their intellectual property and methodology adapted for the Australian setting.
SETTING: The largest (by annual attendances) 17 emergency departments in the State of Victoria and one hospital in the Australian Capital Territory participated. STUDY PARTICIPANTS: Each hospital sent a team of three to five persons, which included the Emergency Department Medical Director and Nurse in Charge, and an Executive Sponsor to each learning session.
INTERVENTIONS: The teams were required to attend four learning sessions, to participate during the action period in both clinical and operational improvement activities, and to report regularly in the form of data reports and conference calls. MAIN OUTCOME MEASURES: Each team selected at least one or two clinical topics for improvement and at least one operational project to undertake during the life of the collaborative. A patient satisfaction survey was commenced towards the end of the project.
RESULTS: Forty-seven clinical projects were nominated during the life of the collaborative and 32 of these were completed, with 31 resulting in significant improvement or achieving target. Thirty-nine operational projects were nominated, 30 of which were completed, with 24 of these achieving improvement or target. Numerous additional achievements occurred, which evolved from the framework of supported collaboration.
CONCLUSION: The spread of knowledge and innovation can be best facilitated rapidly by teams working together using a structured program in a supported environment.