New ED artist exhibition

Topias I is a solo exhibition by Georgie Mattingley that examines contemporary Heterotopias.

Through a new series of hand-tinted photographic prints and video works, she documents human-made spaces designed to promote privacy, sterility, surveillance and production. This spans a hospital emergency department, a morgue, an oil refinery, a coalmine, a power station and a prison.

Within society’s most sterile spaces that harness functionality, only the most basic requirements for human life remain, such as our need for food, cleanliness, the simulation of nature and above all, beauty.

Topias I is proudly supported by Creative Victoria and the University of Melbourne, through a Graduate Mentorship Scholarship, the Yarra City Council, the NAVA, through an Australian Artists’ Grant, made possible through the generous sponsorship of Mrs. Janet Holmes à Court and the support of the Visual Arts Board, Australia Council for the Arts.

Strange Neighbour Gallery
395-397 Gore St, Fitzroy
29 April – 21 May 2016
Gallery hours: Wednesday – Saturday 12 – 6pm


Centre for Rural Emergency Medicine Part of NHMRC Grant for Alcohol Research

A 2015 alcohol screening pilot project undertaken at South West Healthcare Emergency Department has contributed to the awarding of a $1.5M research grant.

The Federal Government’s National Health and Medical Research Council (NHMRC) has announced South West Healthcare is part of a winning consortium to deliver the Driving Change: Using Emergency Department Data To Reduce Alcohol-related Harm pilot to emergency departments throughout Australia. SWH’s share of the funding will be approximately $100,000 over five years.

The NMHRC is Australia’s leading expert body for supporting health and medical research; developing health advice for the Australian community, health professionals and governments; and providing advice on ethical behaviour on health care and in the conduct of health and medical research. Becoming the recipient of an NMHRC grant is incredibly prestigious.

Joining SWH, the winning consortium includes Deakin’s Centre for Social and Early Emotional Development (SEED), Vincent’s Hospital Australia (Melbourne and Sydney), the Australasian College for Emergency Medicine, Australian National University, Barwon Health, Calvary Health Care ACT, Monash Health, University of New South Wales, and Cardiff University.

SEED’S Professor Peter Miller will lead the five-year project based on an international model that has shown to substantially reduce violent crimes, street assaults and hospital admissions related to alcohol. Building on the international evidence and pilot data gathered from Warrnambool and other Australian emergency department sites last year, he will oversee and evaluate an intervention that aims to reduce alcohol-related injury in the community through a randomised trial in eight emergency departments in Victoria, NSW and the ACT. A key aspect will be the introduction of mandatory ’last-drinks’ data collection within existing hospital IT systems that identifies areas of problem drinking.

‘Driving Change: Using Emergency Department Data to Reduce Alcohol-related Harm has the potential to improve the wellbeing of Australians,’ says the Director of the Centre for Rural Emergency Medicine’s Dr Tim Baker, who was heavily involved in last year’s pilot.

‘We are keen to continue to be involved so that the needs of rural patients and their families are considered, as well. Reducing the impact of alcohol and other drugs is our emergency department’s number one public health priority. Our share of the grant will allow a researcher to gather the information we need to find out what approach works best.’

According to the Australian Institute of Health and Welfare, over the past decade the number (from 40,000 – 60,000+) and rate (from about 200 – 270 hospitalisations per 100,000) of alcohol-related hospitalisations have risen annually.

SWH’s 2015 research highlighted the growing problem of ‘pre-loading’ – drinkers consuming vast amounts of (cheaper) alcohol at home before heading out to a licensed venue. The eight-month study asked people presenting with injuries at the Emergency Department whether they’d consumed alcohol in the 12 hour lead-up to their injury, and where they’d bought the alcohol they had at home before heading out for a night on the town.

The research also revealed Warrnambool’s May Racing Carnival is the peak time for alcohol-related injuries.

Extra alcohol and drug support for Warrnambool Emergency Department

Warrnambool Base Hospital will receive a $500,000 boost to help its emergency department better respond to patients affected by alcohol and drugs, such as ice,Premier and Member for South West Coast Dr Denis Napthine announced today.

“Drug and alcohol-affected patients can be challenging for emergency departments, in particular patients who are under the influence of new and emerging drugs such as ‘ice’,” Dr Napthine said.“This funding will ensure the hospital has the resources it needs to deal with these challenges.”

Dr Napthine said the local emergency department would now decide which new resources will best suit the needs of the local Warrnambool community, which could include hiring a new specialised alcohol and drug specialist or additional training for existing staff.

The initiative builds on the successful initiative announced in the 2012-13 Budget that provided 21 health services, including six regional health services, with additional resources to respond to alcohol and drug-affected patients.

The funding will also complement new laws introduced into Parliament this year that will better protect doctors, nurses and emergency personnel.“In June, the Government introduced legislation that increases the sentence for seriously assaulting an emergency department doctor or nurse to a minimum of six months,” Dr Napthine said.“These reforms were also expanded this week to create a minimum six-month sentence for serious assaults against staff anywhere in a hospital.”

The additional funding announced today follows the $5.7 million, 5.4 per cent increase to the 2014-15 South West Healthcare budget announced earlier this month. “Since coming to Government, the Coalition has been proud to deliver a $26.7 million, 31.4 per cent boost to the South West Healthcare Budget,” Dr Napthine said.


South West Healthcare Upskilling Emergency Department Doctors Under the Emergency Medicine Programme

South West Healthcare has employed three trainee doctors undertaking their specialist emergency medicine training thanks to funding under the Emergency Medicine Programme (EMP) from the Commonwealth Government.

EMP funds Specialist Training Posts to enable trainee emergency doctors to experience the lifestyle and work environment of rural and regional settings.

Director of South West Healthcare Emergency Department and the Centre for Rural Emergency Medicine, Dr Tim Baker said ‘our aim is to help recruit rural medical students, train them locally at Deakin University and provide as much of their specialist training as possible, here in the country. This is the best way to have doctors build country lives and, therefore, stay in the country.’

In addition, the Emergency Education and Training (EMET) program provides surrounding small hospitals, including Portland, Camperdown, Terang and Hamilton with visits, assistance, and training from the emergency specialist doctors based at Warrnambool.

South West Healthcare is one of 43 EMET hubs across Australia. In the past 30 months, the EMET program has been responsible for delivering more than 3,000 training sessions to 25,000+ doctors and nurses in more than 200 regional, rural and remote hospitals.

The EMET programme seeks to improve care for patients requiring urgent and emergency medical services in rural and remote areas by providing education, training and support to the large number of doctors and nurses working in the smaller hospitals and emergency care services who are not specifically trained in emergency medical care.

Dan Tehan, Member for Wannon said “that programs such as the EMP and EMET help to encourage health professionals who are committed to rural and regional areas at the completion of their training.”


Last drinks: mapping alcohol harm in the country

Packaged liquor sales are acting as a major contributor to alcohol-related harm in rural areas, according to a new study published in Emergency Medicine Australasia, the journal for the Australasian College for Emergency Medicine (ACEM).

In the eight-month study, people presenting with injuries at an emergency department in rural South West Victoria were asked a series of questions including whether they had consumed alcohol in the 12 hours prior to injury, how much they had drunk and where they had bought most of the alcohol.

60% of respondents had bought most of their alcohol at packaged liquor outlets like bottle shops or supermarkets, the study found.

Approximately a quarter of these had gone on to have further drinks – including their ‘last drink’ prior to injury – at a licensed venue or public event.

“This is the first study of its kind to effectively map the source of alcohol-related ED attendances in a rural community,” said Associate Professor Peter Miller, lead researcher on the study, “It allows for the identification of problematic licensed venues and public areas and opens up great opportunity for further intervention; it’s a powerful tool to help communities tackle the problem of alcohol harm.”

Over half of the respondents who had bought most of their alcohol at packaged liquor outlets had consumed their last drink before injury at home, adding to the body of evidence that indicates many problem drinkers ‘pre-load’ at home with alcohol bought at a bottle shop or supermarket.

“The permissive culture that exists around the advertising, regulation and taxation of alcohol needs to be urgently addressed if we want to diminish the amount of harm it causes,” said Associate Professor Diana Egerton-Warburton, Chair of the ACEM Public Health Committee and Clinical Lead on the ACEM Alcohol Harm in Emergency Departments (AHED) Project.

There was also scope to introduce further measures to help reduce the harm caused by alcohol, Associate Professor Egerton-Warburton said.

“An effective brief intervention program – whereby drunks coming into the ED are screened and possibly referred for further treatment – could reduce the number of bloody idiots that we end up having to deal with,” she said, “Our research suggests that these drunks are often violent to staff, adversely affect other patient care and use a huge amount of resources.”

Dr Miller worked with Researchers from the Centre for Rural Emergency Medicine to add questions to a computerised triage system. “These data were generated with minimal cost, great cooperation among staff and no impact to the quality of patient care,” added Associate Professor Miller, “We’re already refining this model and hope to be engaging in a much larger trial very soon.”


CREM Art Project Reveals Workings of Hospital Emergency

Deakin University Media Release

A unique art project that looks at the inner workings of a hospital emergency department has opened in Warrnambool.

Artists Karen Richards, Gareth Colliton and Andrea Radley joined the South West Healthcare Emergency Department in Warrnambool for three months to observe staff and patients then make art in response to what they experienced.


The `embedED’ exhibition starting on 15 November at Scope Galleries was conceived by Centre for Rural
Emergency Medicine (CREM) Director Dr Tim Baker who wanted to make the community better informed and less fearful of a hospital emergency department.

CREM is a partnership between Deakin University’s School of Medicine, Portland District Health and South West Healthcare (Warrnambool).

Dr Baker said he was inspired by artists being embedded in the military to chronicle life on the battlefield.

“We wanted to find a new way to engage and educate the community about what happens in an emergency department,” he said.

“It’s routine for us but for lots of patients it’s the worst day of their year or even the worst day of their lives but they sometimes don’t know what to expect or how to use the emergency department,” he said.
“We’d like people to be more informed and less fearful.”

Dr Baker said it was helpful for the community and emergency department staff to have the perspective of an artist.

“We wanted artists to give their impression of what goes on in an emergency department and do it in a way that would be interesting for other people,” he said.

Dr Baker said he was unaware of any other projects using artists to show people what happens in an emergency department.

It was also a way for emergency department staff to get a different perspective on what they do. “We can be devoted to the technical things, so it’s fantastic to have people look at what we do and what we say in a different way. “We’ve received pretty honest feedback about some of the things that were great and some situations that they thought were surprising.”

Between November 2013 and March 2014, Mr Colliton, a painter working in oils, Ms Radley, a print maker, and Ms Richards, a textile artist working in embroidery, were based in the department.

They were signed on as artist volunteers and assigned to follow a doctor or nurse for two hours of their normal emergency department shift.

Ms Richards said the doctor or nurse had to introduce the artist to every patient and ask for permission for them to be present, which was nearly always forthcoming.

“It is quite nerve wracking to be working publicly, let alone worrying about being in the way in an emergency,” she said. “I had not seen much blood, guts or dead bodies and knowing that I could be exposed to any of these at any moment was unsettling,” she added.

Ms Richards discovered that as an artist people expected her to draw, giving her the opportunity to quickly record what was happening.

However, she admits the subject matter was sometimes overwhelming, with everything from car crashes to mental illness.

“I didn’t want to just illustrate these events; I wanted to capture something bigger about the nature of emergency, medicine and the body,” she said.

She had noticed a lot of black humour amongst the staff so began by making some cross stitch samplers with thoughts and quotations she had heard.

“They struck a chord with the staff and helped to break the ice,” she said.

“I became interested in the idea of the body as a meeting place for art and medicine – or the decorative and the functional.”

The CREM program includes research, education and community engagement to explain what happens at an emergency department.

The program has been funded since 2007 from Alcoa of Australia and the Department of Health. The funding has been recently renewed for a further three years.

The exhibition opened at Scope Galleries by Guy Ben-Ary at 6pm on Saturday 15 November.

Farmers with acute chest pain are uncertain how and when to seek help

April 2011

A pilot study of the prevalence of cardiac risk factors in a group of agricultural workers and of their decision-making abilities with regard to when and how they would seek help when experiencing chest pain has found that most put themselves at risk of dying.

Dr Tim Baker, from the Centre for Rural Emergency Medicine at Deakin University School of Medicine, and Scott McCombe, Cate Mercer-Grant, and Susan Brumby, from the National Centre for Farmer Health at Deakin University School of Medicine and Western District Health Service, studied almost 200 farm men and women recruited from 20 rural Victorian sites.

Their study is published as an Early View article in Emergency Medicine Australasia, the journal of the Australasian College for Emergency Medicine.

The farmers underwent health assessments for total cholesterol, blood glucose, weight, height and blood pressure, and they completed a survey to determine their knowledge of chest pain treatment, local emergency services, and likely response to chest pain.

Each year in regional Australia approximately 9000 people die of coronary artery disease, with acute myocardial infarction accounting for approximately half of these deaths.

Nine hundred of these lives would be saved if mortality rates in regional areas were the same as those in metropolitan areas.

Delays in initiating treatment for acute cardiac events in rural areas might also contribute.

Treatment in the first two hours following a myocardial infarction can decrease mortality by half. Also, one in four people who experience a myocardial infarction die from cardiac arrest within one hour of their first chest pain.

Farmers and non-town dwellers are often thought to be the slowest rural Australians to seek emergency medical treatment.

Reasons given include the poorly defined and stereotypical concept of stoicism and an apparent fatalistic acceptance of supposed outcomes.

In this study, the researchers found 61% of the farmers had cardiac risk factors, with 61% of men and 74% of women either overweight or obese.

When asked to name their nearest ED, 10% of participants nominated health services or towns where no ED exists.

And 67% of respondents believed it was safe to travel to hospital by car while potentially having a myocardial infarction.

“This group of agricultural workers were at considerable risk of experiencing acute coronary events, but many would make decisions about when and how to seek medical help for chest pain that are at odds with published community guidelines,” the researchers concluded.

The researchers said a close relationship with a general practitioner remains the cornerstone of good rural health care, but contacting or visiting a local doctor at their clinic is not recommended when a patient has chest pain.

“Despite this group’s beliefs to the contrary, acute coronary syndrome can seldom be excluded in a clinic setting, and it has been shown to delay hospital presentation by at least one hour.

“In the present study, it appears that many farmers saw being driven to hospital as an acceptable alternative to calling the ambulance. Many reasons have been suggested for the reluctance of rural people to use ambulance services.

“Most rural people can recall an anecdote, from word of mouth or the media, where the use of an ambulance service was said to result in a poor health outcome.

“ There is a widespread belief that travelling by car is quicker and thus safer.

“One participant wrote on their questionnaire that it was ‘sometimes quicker to drive to hospital rather than get an ambulance’. Although the wait at home might be shorter in this scenario, the time to care, which is the most important factor, has been shown to be longer on average.

“Calling the ambulance also provides immediate telephone advice and activates the emergency medical system.

“Paramedics also have the ability to defibrillate once on the scene. From our group, it is not difficult to foresee a tragedy when someone travels by car for 30 minues to an ED where the doctor is unavailable or, even worse, to a town without an ED.”

Improving health literacy among farm men and women is of the utmost importance as they have higher rates of clinical risk factors and appear to be lagging in emergency knowledge and services when compared with their urban and regional counterparts, the researchers maintain.

“Farmers are generally the most remotely located within a population and would achieve greater benefit from acting rapidly in response to acute myocardial events and other medical emergencies.

“Programmes addressing behavioural barriers to accessing care and improving emergency decision making within the farming cohort might be readily translatable into rural lives saved.”


Dr Tim Baker, phone 03 55633500, 0400 902 758

Australasian College for Emergency Medicine, phone 03 9320 0444

Issued for the Australasian College for Emergency Medicine by Marilyn Bitomsky, Impact Promotions & Publications, phone 07 3371 3057 or 0412 884 114. Media please note: I am overseas for a couple of weeks so if you need assistance, please contact Kerry Reeves, 07 3882 1068, 0407 036 791,

Major partnership for Deakin Medical School in rural emergency medicine

November 2010

The Victorian Government, Alcoa of Australia and Deakin University’s Medical School have joined forces to create a Centre for Rural Emergency Medicine.

The Centre, to be launched in Portland on Tuesday 27 November, will operate through Deakin’s School of Medicine, hospitals at Portland District Health and South West Healthcare Warrnambool and through a network of regional doctors.

The Director of the Centre will hold a position in the Deakin Medical School.


Deakin researcher and paramedic hopes to improve paediatric policies

September 2010

Warrnambool paramedic and PhD student with Deakin University’s Centre for Rural Emergency Medicine Kate Cleverley hopes a study she is conducting will lead to improved procedures for transferring paediatric patients to hospitals.

Ms Cleverley said the study could lead to new guidelines that could be used across rural Victoria for the best procedures for taking paediatric patients to the most appropriate facility.

A paramedic with 10 years experience, Ms Cleverley said there were no current guidelines to direct paramedics.

“The intention of the study is to look at paramedic decision-making and to develop protocols and guidelines to make sure paediatric patients who need to go to a higher level of facility are transported there as rapidly as possible,” she said.

“It is not only about the timely nature of the transportation but determining the most appropriate facility to take patients to depending on the level of care required.”

Ms Cleverley said that anecdotally there had been some reports over time of cases where young patients had not been taken to the most appropriate facility.

“It isn’t a common problem but I think having guidelines for paramedics to follow would make the situation less likely to arise.”

She is conducting her research across the Barwon South West region and will include paramedic focus groups, interviews and information from the ambulance service databases. However, she said the planned guidelines could apply to any rural region.

Ms Cleverley completed her Master’s thesis in paediatric weight calculations used by paramedics and was keen to continue her studies in a similar field. She started her PhD studies this year and expects it will take several years to complete. “I am studying part-time at Deakin University in Warrnambool and working at the same time. It’s still in the early stages.”

Ms Cleverley has worked from Warrnambool for the past 18 months and for the six years prior to that was based at Hamilton.

Deakin’s Centre for Rural Emergency Medicine (CREM) is a joint initiative between the Department of Human Services, Portland District Health, South West Healthcare (Warrnambool), Alcoa of Australia and the Deakin Medical School.

Innovative link to medical specialists

May 2010

An innovative online program is bringing specialist medical support directly into the emergency department of Portland District Health.

The new monitor system connects patients in Portland to a network of skilled specialists around Victoria.

The new Datascope Panorama Central Monitor and Web Viewer allow doctors in Portland to consult specialists who will be able see and monitor their patients via on-screen images.

Centre for Rural Emergency Medicine Director and Portland Emergency Department Director, Dr Tim Baker, said the system would ensure patients get the very best care available.

Alcoa Australia has funded the new hardware and software through its Partnering Stronger Communities program.

Dr Baker said the equipment would collect a patient’s pulse, blood pressure, heart rhythm and breathing patterns and monitor trends such as falling blood pressure or increasing pulse rate. The web viewer makes the information available on a secure internet site.

Dr Baker said Portland hospital staff already consulted specialists from larger centres on a regular basis and transferred information such as X-rays and photographs.

“The Panorama weblink is the most important aspect of this telemedicine capability in that it provides direct access to the vital signs that are so important in assessing a critically ill patient,” he said.

Dr Baker said that doctors in rural hospitals such as Portland were often isolated from specialist support.

“Rural hospitals simple cannot employ every type of medical specialist and it is not uncommon to seek specialist support a few times per week. With the new monitor an emergency physician can now call for advice to and the specialist can see the patient and monitor their vital signs. As they say, a picture tells a thousand stories.”

“The specialist can log in and view streaming patient data remotely from virtually anywhere.”

It is expected the system will be used by the emergency physician on call for the Portland and Warrnambool hospitals, the Cardiology Unit at Geelong Hospital, the Alfred Hospital and the Adult Retrieval Service in Melbourne.

Dr Baker said it would be used for the safe care of patients with a variety of critical conditions or injuries and would be used to monitor patients waiting for transfer by air services to other hospitals.

Dr Baker said Alcoa’s support for the project was fantastic. “This equipment will save lives,” he said.

The Centre for Rural Emergency Medicine, which is based at Deakin University in Warrnambool, is also funded by Alcoa Australia in conjunction with the Department of Health.