A randomised controlled trial pilot study assessing use of clinical digital photography for specialist referral process: can its use reduce length of stay of patients with minor burns within an Emergency Department

Abstract

Emergency departments around Australia are facing increasing demands. Significant contributing factors for growing emergency department (ED) attendances are an aging population, increased occurrence of chronic disease and insufficient hospital, aged care and rehabilitation beds. Other factors include a lack of access to community services and low socio-economic conditions. The increasing demand on ED resources primarily because of increasing presentations increases patient length of stay and leads to overcrowding, this has a negative effect on patient outcomes and decrease in the quality of care. Despite a national focus on improving all Australian EDs, there continues to be limited interventional research that highlights successful strategies to reduce length of stay and thereby reduce overcrowding. There is a wealth of literature on the positive outcomes resulting from clinical photography being utilised within healthcare settings and in remote specialist referrals. Limited research exists on referral practices of ED practitioners and the use of clinical photography within an ED setting. By identifying the research gaps, reviewing findings and analysing current health care demands, the aim of this study was to trial an alternative referral method - clinical photography. The study was conducted by an emergency nurse practitioner candidate, who used clinical photographs of bum injuries as part of the referral process to the bums specialist. This study hoped to assist with decreasing length of stay in ED and therefore adds a plausible way to reduce overcrowding. Additionally, it piloted a study in preparation for a randomised control trial. To the researcher's knowledge, there has been no study to date trialling the effectiveness of this intervention.