Small Hospitals Emergency Database (SHED)

The Small Hospitals Emergency Database (SHED) is an collection of episode level data from small rural emergency departments in South West Victoria, the kind of department that are too small to be mandated to collect this data and so seldom do. This project has progressed through several phases and is still a research focus of the Centre for Rural Emergency Medicine.

Initially,  Tim Baker and Samantha Dawson conducted a study that collected 12-months worth of episode-level data from 6 small rural emergency departments in Victoria’s south-west. The findings were published in two articles.

Baker T, Dawson SL. Small rural emergency services still manage acutely unwell patients: a cross-sectional study. Emerg Med Australas. 2014;26(2):131-8.

This article found that a wide range of problems presented and that most of the common procedures were performed. Most importantly, almost 6% of 14318 emergency patients were in the two most urgent triage categories.

Dawson SL, Baker T, Salzman S. Small rural emergency services can electronically collect accurate episode-level data: A cross-sectional study. Aust J Rural Health. 2015;23(2):107-11.

This study found that the SRES were able to collect accurate and mostly complete electronic episode-level data for 12-months with four hours per week of support. This study provides starting data accuracy benchmarks for specific fields collected in SRES and could be used to inform decisions about widespread electronic data collection across these services.

The next part of the study combined what we had learnt about small rural emergency departments with data collected with the same research queries from every other emergency department in Victoria. This study found that rural emergency departments, and even the smallest of rural hospital base emergency facilities, see a significant percentage of Victoria’s emergency presentations

Victorian emergency presentations

It also found that the presenting problems were quite similar. This is displayed below where the size of the diagnostic title denotes the frequency of its presentation. The diagnoses for small rural emergency facilities is on the top right, and for all emergency departments is on the bottom left.

Rural Diagnosis woordle

This study aims to collect activity and performance data from the emergency departments at the Local Hospitals (Rural Category Three Public Health Services) in the Southwest region of Victoria over a 12-month period. The information collected will remain the property of the individual health services, and be available for their audit and review processes. The Centre for Rural Emergency medicine will publish the data in a series of peer reviewed articles. The articles will describe the type and manner of patient presentations, the procedures carried out, patient waiting times and patient transfers. Hospital performance will be described as a group, rather than identifying activity at individual hospitals. The results will be compared with larger hospital emergency departments in Victoria, and published data from rural emergency departments in other regions.

The next stage of the project is to look at available data collected for all Australia’s hospital based emergency facilities.