iIMPROVE e-NEWSLETTER

iIMPROVE: Implementation research in health services to improve care 

Welcome to the second edition of the iIMPROVE Newsletter for 2026. It has been another exciting and productive few months for the iIMPROVE team, with significant progress across several of our implementation research initiatives. Since our last newsletter, we are pleased to share a number of key milestones:

• iIMPROVE PIVC Project: We are making excellent progress with our data analysis and the development of a national implementation roadmap.

• iIMPROVE Digital Hub: We are in the final stages of preparing to launch our Digital Hub - a one-stop destination for practical tools, resources and implementation support material for organisations during their implementation science journeys.

• iIMPROVE PSP Project: We have successfully completed site recruitment and obtained ethical approval, marking an important milestone as we prepare for implementation across participating sites.

• iIMPROVE Diagnostic Excellence: Our co-designed EMR Dot Phrase has received strong early adoption and positive clinician feedback, particularly among junior doctors, supporting diagnostic reasoning and patient safety. Future short-term efforts will be focused on training, optimisation and wider uptake across Monash Health EDs.

This quarter, we also had the pleasure of meeting with our Consumer Advisory Group in person over lunch. We are incredibly grateful to this growing group of passionate consumer partners, whose insights and commitment ensure that the voices and experiences of Australian consumers remain central to the work we do. As our portfolio continues to grow, we are steadily bringing these initiatives together under the iIMPROVE Program umbrella creating a connected ecosystem that supports evidence-based implementation and sustainable improvements in Emergency Care.

A sincere thank you to all our participating health services, collaborators, clinicians, researchers, consumer partners and our wider Community of Practice. Your enthusiasm, expertise and ongoing partnership makes this work possible, and we look forward to continuing this journey together.

Primary Spontaneous Pneumothorax (PSP) Care 

The iIMPROVE Primary Spontaneous Pneumothorax (PSP) project has progressed well since our last newsletter. We have now successfully recruited all 18 participating health services and received ethical approval to commence our stepped-wedge randomised controlled trial. We will commence working closely with each site to complete local governance requirements in preparation for implementation.

Our first modified Delphi survey-round, aimed at developing a national consensus pathway for PSP care, has now concluded. The responses have been analysed, and we are looking forward to convening a Nominal Group Technique workshop later this year. This workshop will bring together key stakeholders to establish the core principles of a consensus pathway, which will then be used to co-design site-specific implementation pathways with each participating health service.

We also held our inaugural Trial Steering Committee meeting this quarter, bringing together all 18 sites to guide the project through its next phase. With recruitment complete and implementation preparations well underway, we are excited to see the project move from planning into action over the coming months.

iIMPROVE Diagnostic Excellence 

A key component of the initiative has been the implementation of a co-designed Electronic Medical Record (EMR) Dot Phrase. Developed with input from both clinicians and consumers, the EMR aims to prompt consideration of differential diagnosis, red flags and patient vulnerabilities during initial assessment, supporting more deliberate clinical reasoning and decision-making.

Analysis of EMR utilisation data from June 2025 to May 2026, alongside clinician survey feedback, demonstrated encouraging early results. Findings showed broad agreement across clinician groups that a diagnostic pause is a valuable clinical practice. More than 70% of junior clinicians reported the Dot Phrase encourages consideration of differential diagnoses, red flags and patient vulnerabilities, while 76% agreed it is a helpful tool in their clinical practice.

These findings align with EMR usage data, showing the highest levels of Dot Phrase utilisation is among interns and HMOs, suggesting the tool is providing meaningful support during early clinical training and assessment.

Positive growth in adoption has been observed across Monash Health sites. Most notably, Dandenong Hospital recorded an increase from 25% in April 2026 to 41% in May 2026, bringing usage closer to levels seen across other Monash Health EDs.

The next phase will focus on increasing awareness through orientation programs, improving access to training resources, engaging clinician champions, refining the Dot Phrase based on user feedback, and continuing to monitor utilisation and outcomes to support continuous improvement in diagnostic excellence.

iIMPROVE PIVC Care

The Just Say 'No' to the Just-in-Case Cannula study (2023–2028) has completed the implementation phase on 30 April 2026, with more than 1 million patient records collected across nine EDs making it one of the largest implementation studies of PIVC practice undertaken in Australia. Biostatistical and health economic analyses are now underway, while participating sites have entered the sustainability phase, ensuring best-practice PIVC care becomes part of routine clinical practice.

Late 2026 marks an exciting new chapter for the program with the launch of the co-designed Best Practice for PIVC Use Toolkit through the iIMPROVE digital hub and the International Point-Prevalence Survey of PIVC Use Study, extending the program’s impact on evidence-based PIVC care nationally and internationally.

Point-Prevalence Survey of PIVC Use Study

Be part of an exciting international collaboration to advance evidence-based peripheral intravenous cannula care!

In Q4 2026 and Q1 2027, the Point-Prevalence Survey of PIVC Use Study will bring together emergency departments to benchmark PIVC practices.

Findings will provide:
• Valuable insights in your current practice
• Identify opportunities to reduce low-value care
• Guide future quality improvements initiatives

Expressions of Interest are now open until 5:00pm AEST, 23 October 2026.

Scan or click the link here to find out more 

iIMPROVE Digital Hub 

Mark your calendars: the iIMPROVE Digital Hub will be launching late 2026, providing healthcare organisations with:

• A suite of implementation toolkits
• Resources to support the design and implementation of implementation science trials at health services
• Designed to help emergency departments translate research into real world change

Scan or click the link here to find out more 

Consumer Engagement 

In June, we hosted our quarterly consumer meeting. The discussion focused on the Digital Hub and Consumer Perspectives of the PIVC study and was presented by Sarah Wiggs, ED Research Nurse & Educator at Monash Health.

It was wonderful to connect in person and warmly welcome some of the newest members of the Emergency Adult Care Consumer Group at a lunch gathering in July.

Conferences and Publications 

Exploring new ways to improve patient care, Professor Diana Egerton-Warburton recently highlighted the value of a Learning Health System approach in the publication Implementation Research to Reduce Unhelpful ED Care: iIMPROVE ED. This collaborative model brings together stakeholder perspectives, research findings and healthcare data to support ongoing improvements in care quality and patient outcomes Read here. 

In June, Diana attended the 2026 International Conference on Emergency Medicine in Hamburg, Germany. She delivered an oral presentation, Diagnostic Excellence in the Emergency Department: Structured Clinical Impressions Following Implementation of an EMR Nudge—A Stepped-Wedge Trial, and presented two posters highlighting both the iIMPROVE PIVC and PSP projects.

If you would like a copy of the posters presented, please feel free to reach out at iIMPROVE@monash.edu. 

We are proud to celebrate the achievements of our talented research nurses; Alice Holten and Kristina Mae Sabado. Alice was recognised with a Highly Commended Award in Excellence in Nursing/Midwifery Research and Evidence-Based Practice category at the 2026 Nursing and Midwifery Awards and Scholarships. Kristina was awarded a 2026 Emerging Researcher Fellowship for her study, Early Recognition of Acute Coronary Syndrome in Monash Health Emergency Departments: Co-Design and Pilot of a Consumer-Driven Digital Screening Tool.

Farewell Sundy!

Please join us as we say thank you and farewell to Dr Sundy Yang on 30 July. While we're sad to see Sundy go, we're excited to see where her next adventure takes her. Sundy has played a pivotal role in the Just Say 'No' to the Just-in-Case Cannula study. Although we will miss her immensely, we are excited for her to embark on her new role as Research Manager at the Monash Institute of Pharmaceutical Sciences, Monash University.

We are grateful to Sundy for all she has contributed and wish her every success in this next chapter.

Stay Informed. Stay Connected with iIMPROVE.

Stay connected with the latest iIMPROVE projects; subscribe to our e-newsletter and express your interest to become a stakeholder in one or more initiatives. Link here 

If you would like to get in touch, please contact us at iIMPROVE@monash.edu.