Discussion
The role requires a balanced approach to managing competing priorities encompassing Queensland Ambulance Service (QAS) asset allocation and resourcing, emergency department patient flow dynamics and clinical service delivery, as well as inpatient admission access pathways and avoidance strategies. The Medical Commander uses his or her high level of interdisciplinary skills in communication, complex decision and clinical experience to perform this role.
Although evaluation of the effectiveness of this role is difficult to quantify objectively, subjective feedback from senior nursing and medical, QAS and executive staff has been positive.
Lessons learnt
Maintaining up-to-date information regarding all elements of COVID-19 response was quite overwhelming in a very dynamic space as new information emerged, definitions and risk changed, pathways and procedures were modified and updated and vaccinations and treatments were developed – robust and collegiate communication was required across executive leads, infectious diseases, respiratory and emergency teams to ensure accurate and up-to-date information was disseminated efficiently and effectively.
A clinician that can offload phone calls, non-essential tasks, organisational queries and requests and jobs that distract dedicated on floor clinicians from providing clinical care to the patients in their clinical area may improve focused care in high acuity spaces.
A clinician with medical experience and oversight of the workload and staffing of the whole of department may improve the ability for patients to be offloaded more efficiently through early review and division of workload.
