Emergency and acute medical admissions: insights from US and UK visits by a Melbourne tertiary health service

Harvey H Newnham, Pieter De Villiers Smit, Martin J Keogh, Andrew M Stripp and Peter A Cameron
Med J Aust 2012; 196 (2): . || doi: 10.5694/mja11.10619
Published online: 6 February 2012

International innovations in health care may take considerable time to become widely disseminated into local Australian practice

Health systems throughout developed countries are being challenged to meet higher demand for access to hospital medical and emergency services. Patients of increasing medical and social complexity are presenting in ever greater numbers at a time of rising community expectations for safety, quality, value and timeliness of health care. While it is agreed that a “whole of system” approach to these issues is required,1 individual national health systems, health services and hospitals are approaching these problems with a broad spectrum of innovations designed around historical, political, workforce and financial imperatives. Unfortunately, evaluation of new health service initiatives is often undertaken only at a local level and is either never published or only published after a long delay. This means that like-minded organisations may waste time reinventing the wheel or, worse, remain ignorant of the impact of innovative approaches.

  • 1 Department of Medicine, Alfred Health and Monash University, Melbourne, VIC.
  • 2 Alfred Health, Melbourne, VIC.



We acknowledge the following institutions and their personnel who contributed generously of their time and expertise to our site visits: USA — San Francisco General Hospital, Rush University Medical Center, John H Stroger Jr Hospital, Beth Israel Deaconess Medical Center, Brigham and Women’s Hospital, Massachusetts General Hospital, Mount Sinai Hospital, Bellevue Hospital Center and North Shore Long Island Jewish Medical Center; UK — St Mary’s Paddington, Kings College, Royal London and John Radcliffe Hospitals.

Competing interests:

No relevant disclosures.

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