Different patients have different needs
Emergency departments are stressful places. Attending an emergency department can be particularly stressful for vulnerable people, such as children and people living with dementia.
Michael Daley and Labor will improve the way emergency departments care for vulnerable people by introducing world-leading innovations to improve emergency departments – starting at Nepean Hospital.
Patients with dementia require special care
Dementia is an umbrella term used to describe a number of degenerative brain disorders which primarily affect older people. 
Dementia is one of the most important health issues our society faces:
- Around 400,000 people in Australia have dementia;
- 10 per cent of people over the age of 65 have a dementia diagnosis; and
- The prevalence of dementia is three times higher for Indigenous Australians. 
Patients with dementia are twice as likely to experience harm while they are in hospital.  The sources of harm can include falls, pressure injuries or infections. Because of this increased risk of harm, patients with dementia are twice as likely to die in hospital. 
Labor’s plan to provide specialised care for people with dementia
Labor will introduce a new model of care for people with dementia in emergency departments – starting at Nepean Hospital.
This new model will be based on the world-leading Geriatric Emergency Department which has operated at the Mount Sinai Hospital in New York since 2012. 
The new model will aim to minimise the noise and confusion which is common-place in emergency departments. This will help to reduce anxiety and disorientation for people with dementia.
Under the new model:
- Patients will continue to present to the emergency department for triage as they do now.
- Nursing staff will be trained to identify patients displaying signs of dementia as part of the triage process.
- Patients with a life-threatening, emergency or urgent condition will receive treatment immediately or in accordance with timeframes allowed by the Australasian Triage Scale. 
- Patients who show signs of dementia and have a semi-urgent or non-urgent condition will be placed in a dedicated geriatric emergency room.
- Staff at the geriatric emergency room will have specialist training to provide geriatric and dementia care.
- All patients arriving at the geriatric emergency room will undergo a screening test for dementia and cognitive impairment.
- The geriatric emergency room will be specifically designed to reduce confusion, chaos, distress and poor outcomes for patients and their families.
Labor will establish an expert planning committee to develop specific guidelines for the design and operation of the geriatric emergency room. Features may include:
- Decreased ambient noise and the use of sound absorbing materials;
- Modified lighting, including a “skylight” to simulate sunlight during the day and minimise disorientation;
- Dim lighting at night to promote sleep;
- Reduced fall-risk adaptations through non-slip flooring and handrails;
- Large clocks, large signage and large print on any documents;
- Thicker mattresses;
- An iPad – if appropriate – attached to each bed which allows the patient to communicate with the nurse through touching images;
- Calming music; and
- Specific protocols for discharge, including follow-up procedures to reduce unscheduled return visits.
Labor’s plan to provide specialised care for children
Labor will also deliver better emergency department care for children by creating a paediatric room at Nepean Hospital’s emergency department.
The paediatric room will implement best-practice principles recommended by medical experts, including:
- The Standards for the Care of Children and Adolescents in Health Services published by the Royal Australasian College of Physicians; and
- The Australasian College for Emergency Medicine’s Statement on Hospital Emergency Department Services for Children. 
In accordance with these principles, children will be kept separate from other emergency department patients in a dedicated paediatric room.
The paediatric room will be decorated and furnished for children. It will include play equipment and entertainment facilities.
The design of the paediatric room will allow parents to remain with their child as much as possible.
The paediatric room will include specialist staff and equipment suitable for treating children and young people.
1 ED Dementia Care Training, Queensland University of Technology and the Alzheimer’s Australia Dementia Research Foundation, 2017, p. 4
2 ED Dementia Care Training, Queensland University of Technology and the Alzheimer’s Australia Dementia Research Foundation, 2017, p. 4
3 ED Dementia Care Training, Queensland University of Technology and the Alzheimer’s Australia Dementia Research Foundation, 2017, p. 16
4 ED Dementia Care Training, Queensland University of Technology and the Alzheimer’s Australia Dementia Research Foundation, 2017, p. 16
5 Geriatric Emergency Department, The Mount Sinai Hospital
6 Triage, Australasian College for Emergency Medicine
7 Standards for the Care of Children and Adolescents in Health Services, Royal Australasian College of Physicians, 18 November 2008
8 Statement on Hospital Emergency Department Services for Children, Australasian College for Emergency Medicine, July 2012