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The Quarterly 2012

Welcome to 2012. As we move into the New Year, we are promised an unsettled one as Federal and various State governments move towards elections, the European economy spirals downwards and the Mayan calendar comes to an end on 21 December 2012, with various dire consequences proposed. As a medical administrator with an interest in rational decision making, I am reminded that the track records of various political, financial and other experts in predicting the future have been less than stellar, with at least one writer noting that a monkey throwing darts at possible options on a dart board would generally do better.1 Given that, I will not add to the multitude of predictions excepting that I, and most Mayanist scholars, are fairly confident that the world will be around in 2013.

More predictably, it has been heartening to see increasing evidence-based research into the delivery of health services. In 2006, Sprivulis et al. highlighted how hospital and emergency department overcrowding was associated with increased mortality in Western Australian (WA) hospitals.2 In 2008, the WA Government announced the introduction of a 4-hour rule in emergency departments (ED), with the rule to be in place in three tertiary hospitals by October 2009 and three additional general hospitals by October 2010. The introduction of the rule was not without its serious challenges, as highlighted by Stokes' review of the program in 2011.3 The key question, however, is – was all this effort worthwhile? The evidence, as it now starts to flow in, would suggest it was. Geelhoed and de Klerk, in their review of the impacts of the program on three WA tertiary hospitals, have demonstrated that there were fewer deaths and a significant fall in mortality for those patients admitted through a tertiary ED that had substantially implemented this program.4 While further research is required, it is promising to see an evolving evidence base for such programs.

Moving to The Quarterly journal, we have now completed our first year of the revised format with a mix of online issues and an annual print version of the key articles. From our surveys, this appears to have been well-received and we will continue with this model, although we are keen to broaden it out to address the needs of our readers. Is there anything further that Fellows, Associate Fellows, Affiliates and Candidates want from The Quarterly? Should we be providing podcasts and vodcasts, acknowledging the enormous success of the webinar series? Should we be moving to shorter articles? We would welcome your feedback on how we should develop The Quarterly over the coming years so please help us to improve your College publication.

Dr Andy Robertson

1. Lehrer J. How we decide. Boston: Houghton Mifflin Harcourt; 2009.
2. Sprivulis PC, Da Silva JA, Jacobs IG, Frazer AR, Jelinek GA. The association between hospital overcrowding and mortality among patients admitted via Western Australian emergency departments. Med J Aust. 2006 Mar 6;184(5):208-12.
3. Stokes B. Four hour rule program progress and issues review. Perth: Department of Health: 2011. http://www.health.wa.gov.au/publications/documents/FourHourRule_Review_Stokes.pdf
4. Geelhoed GC, de Klerk NH. Emergency department overcrowding, mortality and the 4-hour rule in Western Australia. Med J Aust. 2012 Feb 6;196: 122-6.

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Last Updated on Friday, 17 July 2015 14:14