834 resultados para ambulance personnel


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This document shows fees that the Veterans Administration charges for copies of military records.

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Par une revue de la littérature et une enquête socio-démographique auprès des membres d’un syndicat, la recherche analyse l’impact de la diversité des identités professionnelles à l’égard de la représentation syndicale. En contexte de crise du syndicalisme et de renouveau syndical, émanent deux hypothèses : les catégories professionnelles ont une influence différenciée sur les besoins et attentes de représentation syndicale et les différents rapports au travail influencent les besoins et attentes de représentation syndicale. Il appert que la diversité des identités professionnelles a une influence sur la représentation syndicale. Également, la diversité des identités professionnelles commande qu’on ne peut opposer une représentation syndicale liée directement aux conditions de travail à une représentation syndicale élargie aux conditions de vie. La multitude d’intérêts des membres freine une classification des travailleurs selon leur identité professionnelle, qui s’avère multiple.

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Cet essai s’intéresse à l’autonomie des jeunes adultes ayant un handicap moteur, physique, sensoriel ou intellectuel et qui ont participé à la démarche de la transition de l’école à la vie active (TÉVA). L’objectif de l’essai est de répertorier les manifestations d’autodétermination dans leur vie professionnelle, scolaire et personnelle. Le contenu des 23 entrevues conduites auprès d’élèves ayant participé à la TÉVA ou de leurs proches dans le cadre d’une étude de Bourdon et Lessard (2015) portant sur la modélisation de la démarche TÉVA en Estrie a été analysé afin d’en extraire les manifestations d’autodétermination. L’analyse thématique des entrevues a permis d’identifier des manifestations d’autodétermination issues d’une régulation externe, d’une régulation introjectée et d’une régulation identifiée. Les résultats obtenus révèlent que les jeunes adultes ayant participé à la TÉVA semblent avoir une bonne connaissance d’eux-mêmes, de leurs intérêts scolaires et professionnels. En contrepartie, le sentiment de compétence, la fierté personnelle et la connaissance des actions à poser pour atteindre leurs objectifs semblent se présenter moins fréquemment en termes de manifestation d’autodétermination chez les jeunes adultes de l’échantillon. Dans peu de cas, les élèves ont rapporté avoir entamé de leur propre chef des démarches pour obtenir un milieu de stage pour lequel ils entretenaient de l’intérêt. L'analyse des entrevues a également révélé que la conseillère ou le conseiller d'orientation ne semble pas être une professionnelle ou un professionnel particulièrement sollicité pour soutenir les élèves en difficulté dans l'élaboration d'un projet professionnel. Bien que l’implication de la famille et du milieu scolaire des jeunes à propos de la transition à la vie adulte et de l’élaboration de projets soit sans aucun doute essentielle, les compétences du conseiller d’orientation en matière d’accompagnement des élèves dans l’élaboration et la mise en œuvre d’un projet scolaire ou professionnel pourraient être également mises à profit pour mieux préparer et accompagner les jeunes adultes dans leur transition. Ainsi, les données analysées dans le cadre de cet essai indiquent qu’il y a une place à prendre pour les conseillers d’orientation dans le soutien des élèves vivant avec un handicap.

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Le renouvellement du corps professoral dans le programme de soins infirmiers pose au moins deux défis. D'une part, la pénurie du personnel infirmier dans les hôpitaux rend difficile le recrutement du personnel enseignant en soins infirmiers; d'autre part, l'arrivée d'enseignantes et d'enseignants inexpérimentés dilue l'expertise du corps professoral d'expérience. En conséquence, cette situation demande qu'on y porte attention de façon particulière. On observe que le nouveau personnel enseignant réalise bien souvent la tâche d'enseignement par essais et erreurs, mais que certaines personnes reçoivent parfois de l'aide d'une personne-ressource, tel un mentor, qui les guide. Ainsi, les collèges mettent en place divers programmes d'insertion professionnelle qui visent à permettre à ces novices de mieux intégrer le marcher du travail et de diminuer leur stress. Parmi ceux-ci, le mentorat s'avère être une solution intéressante. Ce nouveau personnel a de nombreux besoins lors de son insertion professionnelle. Lorsqu'un mentor guide un novice, il n'a pas toujours de libération de tâches pour accomplir cet accompagnement. Il le fait alors de façon informelle, du meiux qu'il peut, sans nécessairement être bien préparé. De plus, les outils pour aider les mentors sont peu développés. Ainsi, un guide qui permettrait aux mentors d'aider les novices dans leur cheminement pourraît être la solution à ce problème.

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L'objectif général de cette recherche est de cerner comment, dans un contexte de renouveau pédagogique, une directrice, un directeur d'école primaire peut favoriser une collaboration optimale entre le personnel enseignant composé de diverses générations. Plus particulièrement, cette recherche vise à aider les directrices et les directeurs d'école primaire à 1) cerner les valeurs propres à chaque génération d'enseignantes et d'enseignants dans les écoles primaires québécoises 2) identifier des manifestations des différences de génération entre les enseignantes et les enseignants au regard du travail en collaboration et 3) nommer des pratiques de gestion visant à faire émerger les forces d'une équipe composée de générations multiples et à favoriser le partage de l'expertise de chacun. Ce projet de recherche est pertinent puisqu'il trace un portrait des manifestations de la cohabitation d'enseignantes et d'enseignants de diverses générations dans des écoles primaire du Québec. À notre connaissance, il existe peu d'écrits qui fournissent aux directions d'établissement scolaire des pistes pour les aider à mieux connaître leur personnel sur le plan intergénérationnel et favoriser leur collaboration.

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L'idée de développer des ateliers destinés aux enseignants sur le sujet des devoirs et des leçons est le résultat de multiples facteurs tant personnels que professionnels qui influencèrent l'orientation de cette recherche. Il en est presque une vérité de La Palice que d'affirmer que les devoirs et leçons sont à l'origine de bien des conflits entre parents et enfants. Dans les hautes sphères intellectuelles, ce sujet de recherche grandement répertorié n'a jamais réussi à faire un consensus. L'intérêt pour le sujet a pris des dimensions importantes dans ma pratique pédagogique lorsque j'ai été initiée à la théorie des Intelligences multiples durant un travail de rédaction pour une maison d'édition. Je fus à même de constater que cette théorie de l'intelligence au pluriel combinée à une approche ludique pouvait devenir un outil innovateur dans la façon de traiter les devoirs et les leçons à la maison. Prendre le temps de s'arrêter sur le sujet des devoirs et leçons a permis une infiltration discrète au coeur d'une problématique qui demeure d'actualité, et ce, depuis plusieurs années. J'ai été à même de constater rapidement que la controverse entourant le sujet des devoirs et leçons impliquait l'ensemble du milieu de l'éducation. Parents, enfants, enseignants, dirigeants et penseurs se retrouvent au coeur de cette tourmente. Il était primordial de cibler l'entité qui rejoignait l'ensemble des différents paliers concernés par le sujet, afin de pouvoir créer un outil de travail pouvant agir le plus largement sur le milieu. Les enseignants, par leur fonction, se situent au carrefour de la problématique découlant des devoirs et des leçons. C'est donc pour eux que j'ai consacré cette recherche.

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As editors of the recently published Vocational psychological and organisational perspectives on career: Towards a multidisciplinary dialogue (Collin & Patton, 2009), we have considerable interest in this particular issue of the Australian Journal of Career Development. This short piece will first present the purpose and thesis of that book and, in the light of them, will then comment on the four papers. The book suggests that to understand the multidimensional and multilayered nature of career, “it has to be studied in a similarly multilayered and multi-perspectival way, and, indeed, it has been” (p. 3). Scholars have pointed out that there is a wide array of disciplines including economics, sociology, anthropology, geography, political science, various branches of psychology (e.g. industrial/organisational (I/O), vocational, counselling), psychiatry, education, organisation studies, organisational behaviour, personnel/human resource management, industrial relations, and more, all of which have something to say about career. Of these, the most influential, according to Peiperl and Arthur (2000), have been psychology, sociology, education and management. These many disciplinary perspectives on career constitute the rich field of career studies.

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• Introduction: Concern and action for rural road safety is relatively new in Australia in comparison to the field of traffic safety as a whole. In 2003, a program of research was begun by the Centre for Accident Research and Road Safety - Queensland (CARRS-Q) and the Rural Health Research Unit (RHRU) at James Cook University to investigate factors contributing to serious rural road crashes in the North Queensland region. This project was funded by the Premier’s Department, Main Roads Department, Queensland Transport, QFleet, Queensland Rail, Queensland Ambulance Service, Department of Natural Resources and Queensland Police Service. Additional funding was provided by NRMA Insurance for a PhD scholarship. In-kind support was provided through the four hospitals used for data collection, namely Cairns Base Hospital, The Townsville Hospital, Mount Isa Hospital and Atherton Hospital.----- The primary aim of the project was to: Identify human factors related to the occurrence of serious traffic incidents in rural and remote areas of Australia, and to the trauma suffered by persons as a result of these incidents, using a sample drawn from a rural and remote area in North Queensland.----- The data and analyses presented in this report are the core findings from two broad studies: a general examination of fatalities and casualties from rural and remote crashes for the period 1 March 2004 until 30 June 2007, and a further linked case-comparison study of hospitalised patients compared with a sample of non-crash-involved drivers.----- • Method: The study was undertaken in rural North Queensland, as defined by the Australian Bureau of Statistics (ABS) statistical divisions of North Queensland, Far North Queensland and North-West Queensland. Urban areas surrounding Townsville, Thuringowa and Cairns were not included. The study methodology was centred on serious crashes, as defined by a resulting hospitalisation for 24 hours or more and/or a fatality. Crashes meeting this criteria within the North Queensland region between 1 March 2004 and 30 June 2007 were identified through hospital records and interviewed where possible. Additional data was sourced from coroner’s reports, the Queensland Transport road crash database, the Queensland Ambulance Service and the study hospitals in the region.----- This report is divided into chapters corresponding to analyses conducted on the collected crash and casualty data.----- Chapter 3 presents an overview of all crashes and casualties identified during the study period. Details are presented in regard to the demographics and road user types of casualties; the locations, times, types, and circumstances of crashes; along with the contributing circumstances of crashes.----- Chapter 4 presents the results of summary statistics for all casualties for which an interview was able to be conducted. Statistics are presented separately for drivers and riders, passengers, pedestrians and cyclists. Details are also presented separately for drivers and riders crashing in off-road and on-road settings. Results from questionnaire data are presented in relation to demographics; the experience of the crash in narrative form; vehicle characteristics and maintenance; trip characteristics (e.g. purpose and length of journey; periods of fatigue and monotony; distractions from driving task); driving history; alcohol and drug use; medical history; driving attitudes, intentions and behaviour; attitudes to enforcement; and experience of road safety advertising.----- Chapter 5 compares the above-listed questionnaire results between on-road crash-involved casualties and interviews conducted in the region with non-crash-involved persons. Direct comparisons as well as age and sex adjusted comparisons are presented.----- Chapter 6 presents information on those casualties who were admitted to one of the study hospitals during the study period. Brief information is given regarding the demographic characteristics of these casualties. Emergency services’ data is used to highlight the characteristics of patient retrieval and transport to and between hospitals. The major injuries resulting from the crashes are presented for each region of the body and analysed by vehicle type, occupant type, seatbelt status, helmet status, alcohol involvement and nature of crash. Estimates are provided of the costs associated with in-hospital treatment and retrieval.----- Chapter 7 describes the characteristics of the fatal casualties and the nature and circumstances of the crashes. Demographics, road user types, licence status, crash type and contributing factors for crashes are presented. Coronial data is provided in regard to contributing circumstances (including alcohol, drugs and medical conditions), cause of death, resulting injuries, and restraint and helmet use.----- Chapter 8 presents the results of a comparison between casualties’ crash descriptions and police-attributed crash circumstances. The relative frequency of contributing circumstances are compared both broadly within the categories of behavioural, environmental, vehicle related, medical and other groupings and specifically for circumstances within these groups.----- Chapter 9 reports on the associated research projects which have been undertaken on specific topics related to rural road safety.----- Finally, Chapter 10 reports on the conclusions and recommendations made from the program of research.---- • Major Recommendations : From the findings of these analyses, a number of major recommendations were made: + Male drivers and riders - Male drivers and riders should continue to be the focus of interventions, given their very high representation among rural and remote road crash fatalities and serious injuries.----- - The group of males aged between 30 and 50 years comprised the largest number of casualties and must also be targeted for change if there is to be a meaningful improvement in rural and remote road safety.----- + Motorcyclists - Single vehicle motorcycle crashes constitute over 80% of serious, on-road rural motorcycle crashes and need particular attention in development of policy and infrastructure.----- - The motorcycle safety consultation process currently being undertaken by Queensland Transport (via the "Motorbike Safety in Queensland - Consultation Paper") is strongly endorsed. As part of this process, particular attention needs to be given to initiatives designed to reduce rural and single vehicle motorcycle crashes.----- - The safety of off-road riders is a serious problem that falls outside the direct responsibility of either Transport or Health departments. Responsibility for this issue needs to be attributed to develop appropriate policy, regulations and countermeasures.----- + Road safety for Indigenous people - Continued resourcing and expansion of The Queensland Aboriginal Peoples and Torres Strait Islander Peoples Driver Licensing Program to meet the needs of remote and Indigenous communities with significantly lower licence ownership levels.----- - Increased attention needs to focus on the contribution of geographic disadvantage (remoteness) factors to remote and Indigenous road trauma.----- + Road environment - Speed is the ‘final common pathway’ in determining the severity of rural and remote crashes and rural speed limits should be reduced to 90km/hr for sealed off-highway roads and 80km/hr for all unsealed roads as recommended in the Austroads review and in line with the current Tasmanian government trial.----- - The Department of Main Roads should monitor rural crash clusters and where appropriate work with local authorities to conduct relevant audits and take mitigating action. - The international experts at the workshop reviewed the data and identified the need to focus particular attention on road design management for dangerous curves. They also indicated the need to maximise the use of audio-tactile linemarking (audible lines) and rumble strips to alert drivers to dangerous conditions and behaviours.----- + Trauma costs - In accordance with Queensland Health priorities, recognition should be given to the substantial financial costs associated with acute management of trauma resulting from serious rural and remote crashes.----- - Efforts should be made to develop a comprehensive, regionally specific costing formula for road trauma that incorporates the pre-hospital, hospital and post-hospital phases of care. This would inform health resource allocation and facilitate the evaluation of interventions.----- - The commitment of funds to the development of preventive strategies to reduce rural and remote crashes should take into account the potential cost savings associated with trauma.----- - A dedicated study of the rehabilitation needs and associated personal and healthcare costs arising from rural and remote road crashes should be undertaken.----- + Emergency services - While the study has demonstrated considerable efficiency in the response and retrieval systems of rural and remote North Queensland, relevant Intelligent Transport Systems technologies (such as vehicle alarm systems) to improve crash notification should be both developed and evaluated.----- + Enforcement - Alcohol and speed enforcement programs should target the period between 2 and 6pm because of the high numbers of crashes in the afternoon period throughout the rural region.----- + Drink driving - Courtesy buses should be advocated and schemes such as the Skipper project promoted as local drink driving countermeasures in line with the very high levels of community support for these measures identified in the hospital study.------ - Programs should be developed to target the high levels of alcohol consumption identified in rural and remote areas and related involvement in crashes.----- - Referrals to drink driving rehabilitation programs should be mandated for recidivist offenders.----- + Data requirements - Rural and remote road crashes should receive the same quality of attention as urban crashes. As such, it is strongly recommended that increased resources be committed to enable dedicated Forensic Crash Units to investigate rural and remote fatal and serious injury crashes.----- - Transport department records of rural and remote crashes should record the crash location using the national ARIA area classifications used by health departments as a means to better identifying rural crashes.----- - Rural and remote crashes tend to be unnoticed except in relatively infrequent rural reviews. They should receive the same level of attention and this could be achieved if fatalities and fatal crashes were coded by the ARIA classification system and included in regular crash reporting.----- - Health, Transport and Police agencies should collect a common, minimal set of data relating to road crashes and injuries, including presentations to small rural and remote health facilities.----- + Media and community education programmes - Interventions seeking to highlight the human contribution to crashes should be prioritised. Driver distraction, alcohol and inappropriate speed for the road conditions are key examples of such behaviours.----- - Promotion of basic safety behaviours such as the use of seatbelts and helmets should be given a renewed focus.----- - Knowledge, attitude and behavioural factors that have been identified for the hospital Brief Intervention Trial should be considered in developing safety campaigns for rural and remote people. For example challenging the myth of the dangerous ‘other’ or ‘non-local’ driver.----- - Special educational initiatives on the issues involved in rural and remote driving should be undertaken. For example the material used by Main Roads, the Australian Defence Force and local initiatives.

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Introduction: Paramedics and other emergency health workers are exposed to infectious disease particularly when undertaking exposure-prone procedures as a component of their everyday practice. This study examined paramedic knowledge of infectious disease aetiology and transmission in the pre-hospital care environment.--------- Methods: A mail survey of paramedics from an Australian ambulance service (n=2274) was conducted.--------- Results: With a response rate of 55.3% (1258/2274), the study demonstrated that paramedic knowledge of infectious disease aetiology and modes of transmission was poor. Of the 25 infectious diseases included in the survey, only three aetiological agents were correctly identified by at least 80% of respondents. The most accurate responses for aetiology of individual infectious diseases were for HIV/AIDS (91.4%), influenza (87.4%), and hepatitis B (85.7%). Poorest results were observed for pertussis, infectious mononucleosis, leprosy, dengue fever, Japanese B encephalitis and vancomycin resistant enterococcus (VRE), all with less than half the sample providing a correct response. Modes of transmission of significant infectious diseases were also assessed. Most accurate responses were found for HIV/AIDS (85.8%), salmonella (81.9%) and influenza (80.1%). Poorest results were observed for infectious mononucleosis, diphtheria, shigella, Japanese B encephalitis, vancomycin resistant enterococcus, meningococcal meningitis, rubella and infectious mononucleosis, with less than a third of the sample providing a correct response.--------- Conclusions: Results suggest that knowledge of aetiology and transmission of infectious disease is generally poor amongst paramedics. A comprehensive in-service education infection control programs for paramedics with emphasis on infectious disease aetiology and transmission is recommended.

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Objective-To establish the demographic, health status and insurance determinants of pre-hospital ambulance non-usage for patients with emergency medical needs. Methods-Triage category, date of birth, sex, marital status, country of origin, method and time of arrival, ambulance insurance status, diagnosis, and disposal were collected for all patients who presented over a four month period (n=10 229) to the emergency department of a major provincial hospital. Data for patients with urgent (n=678) or critical care needs (n=332) who did not use pre-hospital care were analysed using Poisson regression. Results-Only a small percentage (6.6%) of the total sample were triaged as having urgent medical needs or critical care needs (3.2%). Predictors of usage for those with urgent care needs included age greater than 65 years (prevalence ratio (PR)=0.54; 95% confidence interval (CI)= 0.35 to 0.83), being admitted to intensive care or transferred to another hospital (PR=0.62; 95% CI=0.44 to 0.89) or ward (PR=0.72; 95% CI=0.56 to 0.93) and ambulance insurance status (PR=0.67; 95% CI=052 to 0.86). Sex, marital status, time of day and country of origin were not predictive of usage and non-usage. Predictors of usage for those with critical care needs included age 65 years or greater (PR=0.45; 95% CI=0.25 to 0.81) and a diagnosis of trauma (PR=0.49; 95% CI=0.26 to 0.92). A non-English speaking background was predictive of non-usage (PR=1.98; 95% CI=1.06 to 3.70). Sex, marital status, time of day, triage and ambulance insurance status were not predictive of non-usage. Conclusions-Socioeconomic and medical factors variously influence ambulance usage depending on the severity or urgency of the medical condition. Ambulance insurance status was less of an influence as severity of condition increased suggesting that, at a critical level of urgency, patients without insurance are willing to pay for a pre-hospital ambulance service.

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Since China’s Economic Reform and its Open Door Policy, China has entered a new era of education (Adamson, 2002; Hu, 2005a). English has gained status as a language for international relations (Graddol, 1997) and international trade (Qu, 2007). Hence, in 2001, China’s Ministry of Education (MOE) required universities to offer 5-10% of their course units in English, particularly in the fields of information technology, biotechnology, finance and law (Jen, 2001; MOE, 2001). However, “the upgrading of national English proficiency, then, is predicted largely on the professional competence of the teaching force” (Hu, 2005b, p. 655). For TEFL academics, one component of this competence is the capacity to conduct research (Day, 1991; Shu, 2002). Indeed, research productivity has become essential for university success, and academics’ employment and promotional prospects. This study aims to investigate 182 Chinese TEFL academics’ research outputs across three Chinese higher education institutions through the research question: What are the research productivity levels of Chinese TEFL academics? A survey instrument was devised to gather TEFL academics’ calculations of research productivity and, in particular, the quality and quantity of research outputs over a five-year period (2004-2008). Descriptive statistics through SPSS were used to analyse data across research output fields (e.g., journal articles, conference papers). Academic status varied (n=182; teaching assistants 23.6%, lecturers 47.3%, associate professors 22.5%, and professors 6.6%) as did years of teaching (1-5 years 27.4%, 6-10 years 24.7%, 11-15 18.1%, 16-20 years 13.7%, > 21 years 15.9%). Results (n=182, male=27%, females=73%) indicated 18% had not produced any research in the five-year period. Indeed, more than 70% had produced no research in all categories except non-core journal articles and provincial projects. An overwhelming majority of TEFL academics had zero productivity in 10 of the 12 categories. Nevertheless, there were highly-productive TEFL academics, who had produced five or more pieces of research across the 12 categories. In addition, there was not much difference between sole and co-authored research outputs, except non-core journal articles where sole authored work was 20% higher than co-authored work. China’s desire for international competitiveness in education will require measures that facilitate higher levels of research productivity. These measures must include professional development, support and mentoring programs, and employment of personnel who can guide these processes. Research performance is an outcome, hence there is a need to understand Chinese TEFL academics’ perceptions about research, and experiences that may hinder and facilitate higher research productivity.

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Increasingly it has been argued that senior management teams (SMTs), comprising principals, deputy heads and other personnel, play a critical role in the governance of schools. In recent years, many researchers have drawn upon the tools of micropolitics to illuminate the relationships, dynamics and power plays between and amongst members of SMTs. The paper has two foci. Firstly, it overviews some of the seminal literature in the field of SMTs and micropolitics in an attempt to identify the working practices of and challenges facing members of SMTs. Secondly, it discusses an instrument, the TEAM Development Questionnaire, that emerged from a synthesis of this writing and research. The questionnaire presented here was especially devised to use with members of SMTs to help them (i) identify the dynamics amongst team members; and (ii) identify areas for the team to improve. A set of procedures for implementing the TEAM Development Questionnaire is provided to demonstrate its application to the field.

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This publication is the culmination of a 2 year Australian Learning and Teaching Council's Project Priority Programs Research Grant which investigates key issues and challenges in developing flexible guidelines lines for best practice in Australian Doctoral and Masters by Research Examination, encompassing the two modes of investigation, written and multi-modal (practice-led/based) theses, their distinctiveness and their potential interplay. The aims of the project were to address issues of assessment legitimacy raised by the entry of practice-orientated dance studies into Australian higher degrees; examine literal embodiment and presence, as opposed to cultural studies about states of embodiment; foreground the validity of questions around subjectivity and corporeal intelligence/s and the reliability of artistic/aesthetic communications, and finally to celebrate ‘performance mastery’(Melrose 2003) as a rigorous and legitimate mode of higher research. The project began with questions which centred around: the functions of higher degree dance research; concepts of 'master-ness’ and ‘doctorateness’; the kinds of languages, structures and processes which may guide candidates, supervisors, examiners and research personnel; the purpose of evaluation/examination; addressing positive and negative attributes of examination. Finally the study examined ways in which academic/professional, writing/dancing, tradition/creation and diversity/consistency relationships might be fostered to embrace change. Over two years, the authors undertook a qualitative national study encompassing a triangulation of semi-structured face to face interviews and industry forums to gather views from the profession, together with an analysis of existing guidelines, and recent literature in the field. The most significant primary data emerged from 74 qualitative interviews with supervisors, examiners, research deans and administrators, and candidates in dance and more broadly across the creative arts. Qualitative data gathered from the two primary sources, was coded and analysed using the NVivo software program. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as publications in the field, and initial feedback from a draft document circulated at the World Dance Alliance Global Summit in July 2008 in Brisbane. Refinement of data occurred in a continual sifting process until the final publication was produced. This process resulted in a set of guidelines in the form of a complex dynamic system for both product and process oriented outcomes of multi-modal theses, along with short position papers on issues which arose from the research such as contested definitions, embodiment and ephemerality, ‘liveness’ in performance research higher degrees, dissolving theory/practice binaries, the relationship between academe and industry, documenting practices and a re-consideration of the viva voce.

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Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.