Amith Shetty
Dr Amith Shetty MBBS, FACEM, PhD
Mob: +61402453061 email: amith.shetty@health.nsw.gov.au Goals The creation of an effective learning healthcare system through collaboration, sound leadership and integration of knowledge streams capable of delivering safe and high-quality better value care with improved patient experiences and outcomes.
Employment
Current position
_ _ Clinical Director, Patient Experience and System Performance Support division, NSW Ministry of health (Since July 2019 to now)
Current role and projects
Clinical Lead, COVID-19 Care in the community NSW health and Clinical lead, SIA COVID-19 Capacity Collaborative NSW health modelling group, Member Critical Intelligence Unit and Clinical Council for NSW COVID-19 response teams Chair, COVID-19 care in the home Community of practice NSW Health Clinical lead, COVID-19 community risk of deterioration live patient tracker
Immediate past appointments
_ _ **Director, **Hospital in the Home service, Western Sydney Local Health District since September 2016-19 **Clinical Director, **eHealth NSW 2017-19, Electronic Transitions of care project (Medication Safety), Clinical analytics and Shared learning programs, Real-time risk trigger monitoring program Staff Specialist, Westmead Hospital Emergency department, Western Sydney Local health district since February 2012 Honorary Research Fellow, NHMRC centre for research excellence in critical infection, Westmead Institute for Medical Research (WIMR) since June 2014 Director, Westmead Emergency Medical Research unit, Westmead Hospital, Emergency department since January 2014 Clinical Senior Lecturer, Sydney Medical School, University of Sydney, Westmead Campus since February 2012
Key Achievements (last 5 years)
· NSW Ministry of Health
o Clinical director for division comprising of System performance support, System purchasing, performance management and system information and analytics o Clinical guidance and leadership on key interventions/ programs/ models of care at NSW health
· eHealth NSW
o Clinically led the proof of concept of the first electronic medications interoperability project to aid transitions of care and information sharing between disparate ward and ICU clinical information systems o Clinically leading the first of it’s kind Internet of Things (IoT) project for device integration in NSW with eHealth NSW, NSW pathology and WSLHD o Clinically leading and implemented the first of its kind algorithm-based risk-harm prediction and reporting system pilot in NSW hospitals
· NSW health
o Currently coordinating and designing system level changes needed to deliver on the recent NSW Premier’s priorities for health o Developing and co-designing novel models of care for care of acute non- emergent patients in NSW hospitals in current role o State-wide emergency medicine clinical lead for the Sepsis Kills program including designing and implementing a clinical alert system for identifying and predicting sepsis earlier, review member and lead for several root-cause analyses teams, systems review post-safety incidents across NSW. o State-wide NSW Emergency care institute Research unit medical chair and member of national emergency research committee
· WSLHD
o Designed, developed and implemented the direct admission at home model of care for hospital in the home services in Western Sydney o Designed and implemented Westmead hospital emergency department novel models of care o Currently leading research initiatives and funding grants in WSLHD themed on use of information technology in healthcare
Education
Fellow of Australasian College for Emergency Medicine (FACEM) (2012). AHPRA Medical practitioner with general and specialist registration
Bachelor of Medicine, Bachelor of Surgery (MBBS) University of Mumbai (1998)
International program for Physician Leadership development at Institute for Healthcare Improvement (IHI, Boston) and Harvard School for Public Health, May 2016.
Doctor of Philosophy (PhD) University of Sydney (2020) Sepsis screening pathways in Emergency departments.
Certificate in Managing Health Care Delivery from Harvard Business School (2020-2021)
Certificates in Leadership strategies in Information Technology in Healthcare (2014), Healthcare Project Management (2012), from Harvard School for Public Health.
Certificates in Authentic Leadership from London Business School and Leading Innovation at Harvard Business School (part I/III of certificate in management excellence at HBS).
Research and publications Key research themes: Models of care, Point of care testing, work-flows and algorithms, risk stratification and patient outcomes and experience measures _Publications: top cited _ Authors Title Publication Volume Number Pages Year Citations Shetty, Amith; Gunja, Naren; Byth, Karen; Vukasovic, Matthew; Senior streaming assessment further evaluation after triage zone: a novel model of care encompassing various emergency department throughput measures Emergency Medicine Australasia 24 4 374-382 2012 36 Perveen, Shuhana; Unwin, Danielle; Shetty, Amith Loknath; Point of care D-dimer testing in the emergency department: a bioequivalence study Annals of laboratory medicine 33 1 34-38 2013 19 Grewal, Harjeet; Varshney, Kavita; Thomas, Lee C; Kok, Jen; Shetty, Amith; Blood pressure cuffs as a vector for transmission of multi‐resistant organisms: Colonisation rates and effects of disinfection Emergency Medicine Australasia 25 3 222-226 2013 9 Vaghasiya, Milan R; Murphy, Margaret; O’Flynn, Daniel; Shetty, Amith; The emergency department prediction of disposition (EPOD) study Australasian Emergency Nursing Journal 17 4 161-166 2014 13 Denver, Dominique; Shetty, Amith; Unwin, Danielle; Falls and implementation of NEXUS in the elderly (The FINE Study) The Journal of emergency medicine 49 3 294-300 2015 17 Shetty, Amith L; Brown, Tristam; Booth, Tarra; Van, Kim Linh; Dor‐Shiffer, Daphna E; Vaghasiya, Milan R; Eccleston, Cassanne E; Iredell, Jonathan; Systemic inflammatory response syndrome‐based severe sepsis screening algorithms in emergency department patients with suspected sepsis Emergency Medicine Australasia 28 3 287-294 2016 8 Macdonald, Stephen PJ; Williams, Julian M; Shetty, Amith; Bellomo, Rinaldo; Finfer, Simon; Shapiro, Nathan; Keijzers, Gerben; Sepsis in the emergency department–Part 1: Definitions and outcomes Emergency Medicine Australasia 29 6 619-625 2017 14 Shetty, Amith; MacDonald, Stephen PJ; Williams, Julian M; van Bockxmeer, John; de Groot, Bas; Esteve Cuevas, Laura M; Ansems, Annemieke; Green, Malcolm; Thompson, Kelly; Lander, Harvey; Lactate≥ 2 mmol/L plus qSOFA improves utility over qSOFA alone in emergency department patients presenting with suspected sepsis Emergency Medicine Australasia 29 6 626-634 2017 16 Shetty, Amith L; Thompson, Kelly; Byth, Karen; Macaskill, Petra; Green, Malcolm; Fullick, Mary; Lander, Harvey; Iredell, Jonathan; Serum lactate cut-offs as a risk stratification tool for in-hospital adverse outcomes in emergency department patients screened for suspected sepsis BMJ open 8 1 e015492 2018 11 Shetty, Amith; Macdonald, Stephen PJ; Keijzers, Gerben; Williams, Julian M; Tang, Benjamin; De Groot, Bas; Thompson, Kelly; Fraser, John F; Finfer, Simon; Bellomo, Rinaldo; Sepsis in the emergency department–Part 2: Investigations and monitoring Emergency Medicine Australasia 30 1 4-Dec 2018 11 ** ** Publications for Amith Shetty 2019 Herwanto, V., Shetty, A., Nalos, M., Chakraborty, M., McLean, A., Eslick, G., Tang, B. (2019). Accuracy of Quick Sequential Organ Failure Assessment Score to Predict Sepsis Mortality in 121 Studies Including 1,716,017 Individuals: A Systematic Review and Meta-Analysis. Critical Care Explorations, 1(9), 1-9. [More Information] Shaw, T., Janssen, A., Crampton, R., O'Leary, F., Hoyle, P., Jones, A., Shetty, A., Gunja, N., Ritchie, A., Spallek, H., Solman, A., Kay, J., Makeham, M., et al (2019). Attitudes of health professionals to using routinely collected clinical data for performance feedback and personalised professional development. Medical Journal of Australia, 210(S6), S17-S21. [More Information] Li, L., Rathnayake, K., Green, M., Fullick, M., Shetty, A., Walter, S., Braithwaite, J., Lander, H., Westbrook, J. (2019). Improving the Performance of Clinical Decision Support for Early Detection of Sepsis: A Retrospective Observational Cohort Study. Studies in Health Technology and Informatics, 264, 679-683. [More Information] Nguyen, H., Rebbeck, T., Kifley, A., Jagnoor, J., Dinh, M., Shetty, A., Nicholas, M., Cameron, I. (2019). Positive recovery for low-risk injuries screened by the short form-Orebro musculoskeletal pain screening questionnaire following road traffic injury: Evidence from an inception cohort study in New South Wales, Australia. BMC Musculoskeletal Disorders, 20(1), 1-10. [More Information] Coggins, A., Nottingham, C., Byth, K., Ho, K., Aulia, F., Murphy, M., Shetty, A., Todd, A., Moore, N. (2019). Randomised controlled trial of simulation-based education for mechanical cardiopulmonary resuscitation training. Emergency Medicine Journal, 36(5), 266-272. [More Information] Chow, M., Nikolic, S., Shetty, A., Lai, K. (2019). Structured Interdisciplinary Bedside Rounds in an Australian tertiary hospital emergency department: Patient satisfaction and staff perspectives. EMA - Emergency Medicine Australasia, 31(3), 347-354. [More Information] Noori, O., Jackson, M., Shetty, A., Medlow, S., Steinbeck, K. (2019). Transition care and the emergency department. EMA - Emergency Medicine Australasia, 31(6), 1125-1127. [More Information] 2018 Pavic, K., Pandya, J., Sebak, S., Shetty, A., Manolios, N. (2018). Acute arthritis: predictive factors and current practice in the approach to diagnosis and management across two hospitals in Sydney. Internal Medicine Journal, 48(9), 1087-1095. [More Information] Shetty, A., Sparenberg, S., Adams, K., Selvedran, S., Tang, B., Hanna, K., Iredell, J. (2018). Arterial to end-tidal carbon dioxide tension difference (CO2 gap) as a prognostic marker for adverse outcomes in emergency department patients presenting with suspected sepsis. EMA - Emergency Medicine Australasia, 30(6), 794-801. [More Information] Brown, T., Shetty, A., Zhao, D., Harvey, N., Yu, T., Murphy, M. (2018). Association between pain control and patient satisfaction outcomes in the emergency department setting. EMA - Emergency Medicine Australasia, 30(4), 523-529. [More Information] Shetty, A., MACDONALD, S., Keijzers, G., Williams, J., Tang, B., De Groot, B., Thompson, K., Fraser, J., Finfer, S., Bellomo, R., Iredell, J. (2018). Review article: Sepsis in the emergency department - Part 2: Investigations and monitoring. EMA - Emergency Medicine Australasia, 30(1), 4-12. [More Information] Williams, J., Keijzers, G., MacDonald, S., Shetty, A., Fraser, J. (2018). Review article: Sepsis in the emergency department - Part 3: Treatment. EMA - Emergency Medicine Australasia, 30(2), 144-151. [More Information] Shetty, A., Thompson, K., Byth Wilson, K., Macaskill, P., Green, M., Fullick, M., Lander, H., Iredell, J. (2018). Serum lactate cut-offs as a risk stratification tool for in-hospital adverse outcomes in emergency department patients screened for suspected sepsis. BMJ Open, 8(1), 1-8. [More Information] Warmerdam, M., Baris, L., Liebergen, M., Ansems, A., Exteve Cuevas, L., Willeboer, M., Rijpsma, D., Shetty, A., De Groot, B. (2018). The association between systolic blood pressure and in-hospital mortality in older emergency department patients who are hospitalised with a suspected infection. Emergency Medicine Journal, 35(10), 619-622. [More Information] 2017 Noori, O., Batra, S., Shetty, A., Steinbeck, K. (2017). Adolescent presentations to an adult hospital emergency department. EMA - Emergency Medicine Australasia, 29(5), 539-544. [More Information] Shetty, A., Teh, C., Vukasovic, M., Joyce, S., Vaghasiya, M., Forero, R. (2017). Impact of emergency department discharge stream short stay unit performance and hospital bed occupancy rates on access and patient flow measures: A single site study. EMA - Emergency Medicine Australasia, 29(4), 407-414. [More Information] Shetty, A., MACDONALD, S., Williams, J., Van Bockxmeer, J., De Groot, B., Exteve Cuevas, L., Ansems, A., Green, M., Thompson, K., Lander, H., et al (2017). Lactate (>=)2 mmol/L plus qSOFA improves utility over qSOFA alone in emergency department patients presenting with suspected sepsis. EMA - Emergency Medicine Australasia, 29(6), 626-634. [More Information] Fullerton, J., Thompson, K., Shetty, A., Iredell, J., Lander, H., Myburgh, J., Finfer, S. (2017). New sepsis definition changes incidence of sepsis in the intensive care unit. Critical Care and Resuscitation, 19(1), 9-13. Fullerton, J., Thompson, K., Shetty, A., Iredell, J., Lander, H., Myburgh, J., Finfer, S. (2017). New sepsis definition changes incidence of sepsis in the intensive care unit. Critical Care and Resuscitation, 19(1), 9-13. MACDONALD, S., Williams, J., Shetty, A., Bellomo, R., Finfer, S., Shapiro, N., Keijzers, G. (2017). Review article: Sepsis in the emergency department � Part 1: Definitions and outcomes. EMA - Emergency Medicine Australasia, 29(6), 619-625. [More Information] 2016 Noori, O., Shetty, A., Steinbeck, K. (2016). Adolescent presentations to adult hospital emergency departments: systematic review. Jacobs Journal of Emergency Medicine, 3(4), 1-7. Tse, R., Thompson, N., Moscova, M., Sindhusake, D., Shetty, A., Young, N. (2016). Do delays in radiology lead to breaches in the 4-hour rule? Clinical Radiology, 71(6), 523-531. [More Information] Shetty, A., Vaghasiya, M., Boddy, R., Byth Wilson, K., Unwin, D. (2016). Perceived incivility during emergency department phone consultations. EMA - Emergency Medicine Australasia, 28(3), 256-261. [More Information] Shetty, A., Brown, T., Booth, T., Van, K., Dor-Shiffer, D., Vaghasiya, M., Eccleston, C., Iredell, J. (2016). Systemic inflammatory response syndrome-based severe sepsis screening algorithms in emergency department patients with suspected sepsis. EMA - Emergency Medicine Australasia, 28(3), 287-294. [More Information] 2015 Yee, K., Shetty, A., Lai, K. (2015). ABG needle study: a randomised control study comparing 23G versus 25G needle success and pain scores. Emergency Medicine Journal, 32(5), 343-347. [More Information] Shetty, A., Shankar Raju, S., Hermiz, A., Vaghasiya, M., Vukasovic, M. (2015). Age and admission times as predictive factors for failure of admissions to discharge-stream short-stay units. EMA - Emergency Medicine Australasia, 27(1), 42-46. [More Information] Denver, D., Shetty, A., Unwin, D. (2015). Falls and Implementation of NEXUS in the Elderly (The FINE Study). The Journal of Emergency Medicine, 49(3), 294-300. [More Information] 2014 Perveen, S., Unwin, D., Shetty, A., Byth Wilson, K. (2014). Response to the comments on 'point of care D-dimer testing in the emergency department-A bioequivalence study' and erratum to the results. Annals of Laboratory Medicine, 34(1), 66-67. [More Information] Vaghasiya, M., Murphy, M., O'Flynn, D., Shetty, A. (2014). The emergency department prediction of disposition (EPOD) study. Australasian Emergency Nursing Journal, 17(4), 161-166. [More Information] 2013 Rafi, M., Shetty, A., Gunja, N. (2013). Accuracy of computed tomography of the kidneys, ureters and bladder interpretation by emergency physicians. EMA - Emergency Medicine Australasia, 25(5), 422-426. [More Information] Grewal, H., Varshney, K., Thomas, L., Kok, J., Shetty, A. (2013). Blood pressure cuffs as a vector for transmission of multi-resistant organisms: colonisation rates and effects of disinfection. EMA - Emergency Medicine Australasia, 25(3), 222-226. [More Information] Perveen, S., Unwin, D., Shetty, A. (2013). Point of Care D-Dimer Testing in the Emergency Department: A Bioequivalence Study. Annals of Laboratory Medicine, 33(1), 34-38. [More Information] 2012 Shetty, A., Gunja, N., Byth Wilson, K., Vukasovic, M. (2012). Senior Streaming Assessment Further Evaluation after Triage zone: A novel model of care encompassing various emergency department throughput measures. EMA - Emergency Medicine Australasia, 24(4), 374-382. [More Information] 2010 Shetty, A., Lai, K., Byth, K. (2010). The CO2 GAP Project-CO2 GAP as a prognostic tool in emergency departments. EMA - Emergency Medicine Australasia, 22(6), 524-531. [More Information] ** ** ** ** Current ongoing research projects · **BLISS 2 trial **– Bacterial load in severe sepsis trial – site lead for this multicentre trial · **SMEDSA **(Sydney Multicentre Emergency Department Sepsis Archive) – Project lead/ Chief investigator for development and analysis of patients presenting to ED – multicentre trial – multiple studies • Key big data project evaluations in Sepsis • Algorithms for screening • Performance of existing algorithms for screening, severity scores • Evaluations of bundles of sepsis care and interventions – time to antibiotics. IV fluids • Age-based cut-off of thresholds • Sex-based sepsis epidemiology • Cost of Sepsis in NSW · **Manual CPR, Manual CPR with feedback and Mechanical CPR in simulation **– randomised trial · **Alcohol Harm in Emergency Department Study **– Research lead for Westmead hospital for multicentre trial (Australia and New Zealand) · **ED/ Hospital in the home costing costing study **– Independent Hospital Pricing Authority led ED level patient care costing study · **Motor Traffic Authority **– clinical lead for Westmead hospital – sociodemographic factors in chronic head injury outcomes · **Domestic violence in Emergency department **– current practice and future policy impacts · **Adolescent presentations to co-located adults and paediatrics hospitals **– qualitative analysis of transitional care. · ED ETP correlation to sepsis, hospital outcomes · ED ETP correlation to hospital occupancy, access block and ESSU performance · Impact of SAFE-t zone and trauma pathways on radiology test ordering. · Developing an retrospective data-based algorithm to predict impacts of different staffing patterns on emergency department waiting times