Public health in Australasian emergency departments: Attitudes, barriers and current practices

Objective: To understand the attitudes of consultant emergency medicine physicians and advanced trainees and the perceived barriers to public health interventions in Australasian EDs. Methods: This was a voluntary cross-sectional, mixed-methods online survey of consultant emergency physicians and advanced trainees of the ACEM, conducted between December 2011 and March 2012. Results: Eight hundred and fifty-six ACEM members responded to the survey - a response rate of 33%. A similar number of consultants (70%) and trainees (75%) believed public health initiatives should be provided in the ED. Barriers identified by a similar majority of consultants and trainees to the implementation of public health interventions in EDs included dedicated time available for staff to be involved; available public health resources; available funding; clinical staff skills and expertise in public health; and the availability of staff training. Conclusions: Public health and health promotion are perceived by the majority of emergency medicine physicians as important in emergency medicine; however, substantial barriers exists to their implementation. Development of an evidence-based approach to public health interventions, which are effective and feasible in the ED environment, will facilitate a more comprehensive approach to public health initiatives in emergency medicine.