Evaluating transitional care - When a stoke patient goes home
2013 Project Grant
My main research interest is in the care of older people in the hospital Emergency Department (ED). More recently this has focused on people who live in Residential Aged Care Facilities. These people are vulnerable in hospital with high rates of cognitive impairment and disability. Hospital is not always the best place for them as they are at risk of falling, developing pressure injuries, delirium, medication and generally becoming more frail.
The Aged Care Emergency (ACE) Program has developed since 2009. It uses evidence-based algorithms to standardise care and nurse-led telephone support, 24 hours a day, to avoid hospital transfer. We have published several papers on this translational research. Currently, we are working on a telehealth intervention to support the ACE program for hospital avoidance.
I spent many years as an Emergency Physician and director of a very busy ED with a keen interest in quality improvement. As ED Director, I realised very early that I needed numbers and data to be able to understand how our health system worked. By now focusing on research, I believe that I have excellent experience for translational research. With a wider audience, models of care can be developed that are consistent with older people’s goals of care.
For me, I see a future where older people receive respectful and thoughtful care that will improve their quality of life when they come to the ED. The clinical team is interdisciplinary and is integrated across boundaries from home to inpatient wards. Telehealth will be an everyday method of communication. It will assist with medical emergencies at home.
I also see better coordination of care with good medication management, chronic disease plans that focuses on the things that are important to them and assists when they deteriorate. It involves families and carers whenever they want. Slowly we are building this picture.
Dr Carolyn Hullick, B.Med., FACEM, Staff Specialist in Emergency Medicine and Clinical Governance for Hunter New England Health. In 2008–09 Carolyn was a Commonwealth Fund Harkness Fellow in Health Care Policy and Practice based at Weill Cornell Medical School in New York City, investigating improving care for older people in Emergency Departments.
She is the former director of emergency medicine at John Hunter Hospital (JHH) and Greater Newcastle Acute Care Hospitals. In these roles, Dr Hullick developed and implemented an emergency services model to improve access, patient flow, patient experiences, and patient safety.
Under her leadership, JHH ED was a recipient of the NSW Premier's Public Sector Award Gold Medal for Delivering Better Services (2007).
Since returning from the US she has been working on improving emergency care for people living in Residential Aged Care Facilities, a collaboration between Hunter Primary Care and HNE Health. She is now working in clinical governance with the portfolio of patient safety, clinical audit and eHealth.
By improving care for older people that is more centred on their own life priorities, rather than a subspecialty medical model, we will deliver care that is safer, more respectful and thoughtful, particularly when they are acutely unwell