Dr Kim Hansen shares her story of life as an emergency medicine physician in Australia

Dr Kim Hansen is an experienced Emergency Physician with a passion for Safety and Quality in healthcare.  Kim graduated from the University of Queensland with first class honours and a University Medal, completed her Emergency Medicine training in Melbourne, Australia. She has recently completed an MBA with a Vice Chancellor’s Award and additional training in Medical Administration. She works as Director of St Andrew’s War Memorial Hospital Emergency Department as well as a Senior Staff Specialist at The Prince Charles Hospital in Brisbane, Australia.  Kim holds a number of senior roles with the Australasian College for Emergency Medicine (ACEM), including inaugural Chair of Advancing Women in Emergency. She was the inaugural Chair of IFEM’s Quality and Safety Special Interest Group and is currently Co-Chair of the IFEM Emergency Department Crowding and Access Block Taskforce. Kim supports clinician-led research through her role as Chair of the Board of the Emergency Medicine Foundation, a not-for-profit organisation supporting clinical led research. In her time off, Kim loves hiking and playing basketball.

What are the main emergency medicine challenges in Australia?
I believe Access Block is our biggest challenge, there are so many obstacles moving patients through the system from an emergency ward into a hospital ward in a timely manner. This leads to overcrowded Emergency Departments, where patients who arrive, either by ambulance or on foot, are unable to get into a bed, and so we end up seeing patients ramped on ambulances, stuck on trolleys or put on a corridor bed or corridor chair, or even left unseen in the waiting room for hours and hours.

If we think about what’s related to this issue, there’s been huge growth in the use of Emergency Departments partly due to population increase and an aging population. On top of that people are using Emergency Departments increasingly as there’s more chronic disease in the community, so the complexity is definitely increasing. We also have more mental health presentations now than ever before and it’s partly good that people can seek help, but an Emergency Department is usually not the best place to seek help if you’re struggling with mental health. It’s a chaotic environment, not at all soothing or comforting, but it’s the only place to seek help after hours.

There’s also ongoing alcohol and drug use, and in particular the increasing use of methamphetamines cause problems in Emergency Departments, and the patients can be volatile and physically aggressive.

Are there different challenges in regional Australia compared to metropolitan areas?
Yes, the work is different in regional areas and Queensland is a very decentralised state. Workforce is a big issue with attracting and retaining staff to regional areas an ongoing concern for decades, particularly attracting trainees and specialists to work in regional areas. Specialists in regional areas deal with complex patients without the same level of support available in big centres. There are a range of different subspecialties that simply are not available. Referral channels may not be as well established so patients can get stuck in Emergency Departments or the hospital for long periods.

What has been your greatest emergency medicine achievement?
The clinical work is incredibly rewarding, so for me it’s really seeing the people you’ve worked on get better and go home. A couple of times I’ve been able to see patients who we’ve worked on during their cardiac arrest and they’ve recovered completely, and I’ve been able to meet them and their families. I think that is the most rewarding thing to know, that if that emergency care wasn’t available at that time, they wouldn’t have survived.

Recognition for hard work is always gratefully appreciated and winning the ACEM Distinguished Service Award this year has been heartening. Everything I have achieved has been a team effort so I want to acknowledge friends from around Australia and across the globe I have worked with. Those connections are what inspires me to continue.

What are you hoping to achieve over the next few years?
I’d like to continue my advocacy work with ACEM and IFEM. I feel that together, as a collective, we have a very strong voice to change and improve how emergency care is provided across Australia, New Zealand, as well as across the world. While emergency medicine is well established here, a big  risk is getting overworked and not being able to do the job that we’re here to do, which is to treat the acutely unwell and injured in a timely and expert manner. When we’re looking after patients who have been in the ED for 24 – 72 hours, then we’re no longer doing this. When you look at the rest of the world, emergency medicine is well developed in some areas but not others, so we have an opportunity to share what we’ve learnt so far and support those who are working in different countries to develop their systems to fit local requirements.

Why did you become an emergency medicine physician?
I loved it from the first time I did it as an intern, I loved the teamwork, I loved the excitement of new patients every hour or minute, the variety, and that we’re working with the full age spectrum, from babies to the elderly. I love that we get to do challenging and rewarding procedures, but still need to use our brains and our hearts to improve the lives of patients.

What role can IFEM play in supporting you and emergency medicine in Australia?
I think IFEM is great for bringing us all together in terms of the conferences, committees and events. IFEM enables us to share what we’ve been doing and share what our ideas and passions are for improving emergency medicine. Because we’re so well developed in Australia, we have an opportunity to share and spread our knowledge with other countries. Not that they should follow our exact model, but so our colleagues internationally can take what’s relevant for them in their context. Likewise, we can learn from others, no matter what stage EM is at in their country. IFEM’s Quality and Safety Special Interest Group is a great example of developing a framework which is applicable to whatever size emergency department you have. I know emergency physicians in India are using the framework. With a country the size of India that’s a huge opportunity to touch many people’s lives.

 

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