Simpson Centre for Health Services Research

About the Centre

image - Simpson Centre for Health Services ResearchThe Simpson Centre For Health Services Research (SCHSR) was established and funded in 1994 by the New South Wales Health Department to promote research into Health Systems.

The Centre’s fundamental goal is to innovate, develop, implement and evaluate health care systems. In addition, we conduct research to generate new knowledge about existing services and to influence policy and practice.

The Centre consists of researchers and clinicians committed to improving the health and safety of patients. Close co-operation with health care deliverers is a fundamental part of the multi-disciplinary research team. The research is to inform managers and policy makers about more efficient and better ways of conducting business and to enhance health care practices.

Our focus is on programmes and projects that aim to facilitate change and innovation in order to improve health service delivery and patient and staff satisfaction.

We are committed to achieving world class, clinically driven research.

The Centre is affiliated with the Faculty Of Medicine within the University of New South Wales, (Australia) and South West Sydney Local Health District.

Please click here to watch Professor Ken Hillman discuss the research of the Centre.

History

The Centre was established by a special grant from NSW Health in 1994 and was opened by the Hon. Andrew Refshauge, the Minister of Health in the same year.

The Centre was named after John Simpson Kirkpatrick who served in the Australian army in the first world war and was amongst the first to land on the shores of Gallipoli, Turkey, in the early hours of the 25th April 1915 and who was probably better known as “the man with the donkey”. Simpson threw away the health care manual which was totally inappropriate for the conditions at Gallipoli and simply got on with the job, devising new ways of caring for the wounded, including using a donkey named Murphy. His innovations inspired his comrades and created a legend. The Centre is named after Simpson as he was a front line health care worker who challenged the existing ways of treating the ill and injured.

The Foundation and current Director, Professor Ken Hillman, together with other clinicians saw a critical need for research to be undertaken to deliver better and safer patient care. In parallel to developing new systems would be research to evaluate these systems.

The Centre was established within the Liverpool Hospital Campus and is affiliated with the University of New South Wales, Faculty of Medicine and is part of the South Western Sydney Clinical School, located at Liverpool Hospital. The Simpson Centre is one of four Centres who now form the Australian Institute of Health Information (AIHI). The other three Centres are the Centre for Clinical Governance Research in Health, the Centre for Health Informatics and the Centre for Health Systems and Safety Research.

Projects undertaken by the Centre include:

  • The Perioperative System – introduced to improve the procedures for managing elective surgery and succeeded in providing enhanced patient care at a reduced cost.
  • Emergency Medicine Research – looking at new models of care to provide a better quality of care and greater safety for patients presenting to the Emergency Department.
  • Discharge Programmes – evaluating systems to improve the patient’s hospital journey and discharge process.
  • Early Intervention for at-risk Hospitalised Patients - the concept of the Medical Emergency Team (MET) was first established in 1989 at Liverpool Hospital. It replaced the cardiac arrest team and has been shown to reduce mortality, cardiac arrests and other serious adverse patient events. The system has now been introduced in many countries around the world. The Simpson Centre has led much of the ground-breaking research conducted around this concept.

Future Directions

The Centre will continue to have an increasing role in areas of health services research including:

  • Increased national and international reputation in the area of research around patient safety.
  • Increase in multicentre research.
  • Increased engagement of health services research and government policy.
  • Increase in collaborative research programmes.
Our Research Areas
Emergency Medicine

This program conducts research in close collaboration between ED clinicians and Health Services Researchers to align Emergency Departments (ED) with the reality of the 21st Century. Seeking care at the ED is an attractive option, reflecting a vote of confidence in the quality and accessibility of care received. The ED services match the needs of the community. Emergency Physicians are skilled in assessing, stabilising and disposition of patients. Emergency Medicine requires more support at a systems level to better match supply and demand. New models of care are required.

Discharge Planning

The discharge of patients is still one of the great unknown in Health. The transition from the acute services back into the community is “a rite of passage”, involving an ever-larger number of ageing patients with complex medical problems. Policy development has been substantial within this area. On this basis the expectations and assumptions of planners and managers are, that an efficient discharge plan will commence with a decision to admit a patient.

Medical Emergency Response Intervention and Therapy (MERIT)

The MERIT Study is a cluster randomised control trial, which incorporated 23 hospitals across Australia.

  1. It is one of the largest studies of its kind undertaken anywhere in the world. The purposes of the study were to test the hypotheses that the implementation of a hospital-wide Medical Emergency Team (MET) System can reduce the aggregate and individual incidence rate of:
  2. Unplanned admission to the Intensive Care Units (ICU's);
  3. Cardiopulmonary arrests;
  4. In-hospital deaths.
Medical Emergency Team (MET)

The role of the acute hospital is changing, patients are no longer seen convalescing and rehabilitating on the wards as in the past. The explosion of knowledge and technology within health has meant that the hospital population is becoming more acute. Patients who would normally have died because of their illness are now surviving as a result of this new era in health.

Some hospitals have adapted to cope with this increasing severity of illness by investing in expensive monitoring systems and specialised units of care such as Intensive Care Units. But what happens to patients that are not in these highly monitored environments, or those who have been transferred to the general ward from these units? The unfortunate reality is, these patients are at risk of serious complications, cardiac arrest and death.

Research has shown that morbidity and mortality rates for in-hospital cardiac arrests have not changed since the invention of cardio-pulmonary resuscitation in the 1960’s, with 90% of all in-hospital cardiac arrest patients dying. Other studies have shown that up to 60–80% of these patients have a slow and well-documented deterioration prior to their arrest. A 30-year review of in-hospital cardiac arrests found that the initial 70% survival to discharge rate post CPR has never been repeated since despite the introduction of cardiac arrest teams.

The clinical effectiveness of cardiac arrest teams has become questionable. The utilisation of a cardiac specific team means that the patient has to arrest before activation occurs. The clinical management of a patient that has life supporting functions is quite different to one that has already died. An acute hospital requires a team that provides EARLY INTERVENTION, TIMELY MANAGEMENT AND APPROPRIATE TREATMENT to ALL IN HOSPITAL EMERGENCIES 24 HOURS A DAY.

This team is The Medical Emergency Team (MET) and has been functioning at Liverpool Hospital since 1990. Any staff member can summon the MET to any hospital emergency, at any time of the day. A patient who requires a MET call is defined by the validated calling criteria. Nursing clinicians become "Physiological Police", and activate the Medical Emergency Team when a patient’s vital signs breach the calling criteria.

People related to this Centre

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Research Fellow
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Senior Research Fellow
image - 1337032404 Jack Chen
Senior Research Fellow (UNSW)
image - 1335858922 Roberto Forero
Senior Research Fellow (UNSW)
image - 1326972516 Ken Hillman
Professor and Director
image - 1340682319 Hollis
Research Fellow
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Post-Doc Res Fellow (UNSW)
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Research Fellow
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Executive Assistant

PhD candidates related to this Centre

Resources related to this Centre

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