Literature Review of emergency department Staffing Redesign Frameworks

Deborah Schofield, Emily Callander

Research output: Book/ReportCommissioned ReportResearchpeer-review


Purpose: This study presents an overview of the existing Australian and international literature which looks at the staffing of emergency departments models. It is recognised that in response to changing and increasing demand upon emergency departments, there is a need to consider new staffing profiles. These profiles must not only meet the changing needs of patients, but must also be safe, cost effective and satisfactory to both patients and staff. In order to determine the most appropriate staffing profiles for New South Wales emergency departments, it is necessary to determine what lessons have been learned for existing emergency department staffing profiles. This study looks at what the literature can tell us about existing examples of emergency department staffing. Summary of findings: A number of key principles have been indentified from the success of emergency departments both within Australia and internationally. This includes matching peak staffing levels to peak patient periods, utilising senior staff, having appropriate staff and skills, and tailoring emergency department staffing profiles to the unique needs of individual hospitals. These underlying principles are evident when looking at what staffing profiles have been successfully implemented. There is little literature available which looks at the entire staffing profile of an emergency department and assesses its effectiveness. The few papers that do exist conclude that senior staffing produces the most effective outcomes. Other studies have looked at the appropriate staff combinations of triage, fast track, minor injuries units, care coordination teams, aged care coordination teams and ALERT programs, all of which have been introduced to respond to changing demands upon the emergency department. With changing staffing profiles of emergency departments, a number of new positions and roles have been identified and their success assessed. These roles include emergency care practitioners, accident and emergency physicians, emergency physicians, emergency nurse practitioners, clinical initiatives nurses, advanced clinical nurses, stat nurse, non-medical technicians, communications clerks, emergency department support officers, and equipment coordinators. The roles which these staff provide within the emergency department have been determined by the demand of patients, and the role the hospital requires them to fill. While there are some lessons to be learnt from the success of the staffing of various teams, and the introduction of new roles in emergency departments, there are still significant gaps within the literature. There is a need for assessment of the effectiveness of various emergency department-wide staffing profiles (rather than just individual teams within an emergency department).
Original languageEnglish
Place of PublicationLismore NSW Australia
PublisherUniversity of Sydney
Commissioning bodyMinistry of Health (trading as NSW Health) (New South Wales)
Number of pages38
Publication statusPublished - Dec 2009
Externally publishedYes

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