A sense of shared purpose
October 2020
Agency for Clinical Innovation | Agency for Clinical Innovation (nsw.gov.au)
Dr Clare Skinner shares her experience as the Clinical Lead of the Emergency Department COVID Community of Practice (ED CoP).
It began on a Sunday in March with a phone call. There was a brief meeting on Monday afternoon, and by Wednesday morning a long list of issues and tasks had been compiled. Thursday afternoon was spent with the media team making information videos for social media. On Friday, the NSW Emergency Department Community of Practice was officially born.
It’s tricky to remember the sense of urgency and chaos of the early pandemic. Emergency Department clinicians had started to share information early, mostly via social media platforms.
A sense of shared purpose had triggered an unprecedented level of collaboration – transcending professional, specialty and geographic boundaries.
Early planning for the ED CoP aimed to build on and enhance the sharing that was already taking place.
We agreed on key principles. The CoP was to be inclusive, collaborative, and multidisciplinary. It had to serve the needs of large teaching hospitals and small rural departments. The choice of name – ‘Emergency Department’ (instead of ‘Emergency Medicine’) was deliberate.
We seeded the group by inviting four or five senior ED clinicians in each local health district to attend the first meeting. Then we asked those people to bring along anyone else in their network who might be interested. It was important from the outset that everyone involved in providing ED care across NSW was welcome to join – including students, trainees and consumers.
The first meeting was improvised. I dialled in from my laundry, where I had set up a desk to work from home – thanks to a sore throat I was in strict isolation waiting for results from my first COVID swab. The agenda was simple – introductions, orientation to the various structures that had formed within NSW Health to manage the COVID response, and issues from the frontline requiring escalation and action.
Structure started to emerge. We developed a standing agenda that included updates from key agencies and individuals, and allocated time for focused discussion, where we invited speakers to present on a topic of interest – for example, health care worker infections, or use of non-invasive ventilation. Relationships with other COVID CoPs were building, with attendance at other CoP meetings, participation in cross-disciplinary working groups, and invitations to present to other groups emerging as part of the clinical lead role.
Working with the team from the ACI’s Emergency Care Institute (ECI), the ED CoP established a repository of informal resources on SharePoint – the material was broad, ranging from academic articles and clinical protocols, to posters, fact sheets and educational videos. We developed ED Quick Reference Guides and contributed ED perspective and advice to policies and protocols which were developed by other agencies and CoPs.
The ED CoP currently meets fortnightly and has more than 400 members. A recent survey demonstrated that members find the CoP constructive and positive. For me, the ED CoP has served two equally important roles: sharing information, resources and working through service challenges collaboratively has been enormously helpful; and connection with colleagues, including regular communication, sharing our concerns, and checking in on each other, has been invaluable for health care worker wellbeing during stressful and uncertain times.
It has been a privilege and adventure to lead the ED CoP for the last six months. I would like to thank the ECI team for their hard work and imagination – Natalie Wright, Hatem Alkhouri, Jo Goodenough, Michael Golding, James Miers, Laura George, Deb Moss and Tim Cooper. I would also like to thank Anthea Temple, Linda Soars, Tracey Tay and Jean-Frédéric Levesque from ACI for their advice and support. Health care is a team sport – especially in a pandemic.
About Dr Skinner
Dr Clare Skinner is the Director of Emergency Medicine at Hornsby Kuring-Gai Hospital and Chair of the Emergency Medicine Network for Northern Sydney Local Health District. She was recently appointed President elect of the Australian College for Emergency Medicine (ACEM).
