Transplanting emergency nursing: Can lessons from Australian emergency nursing make a difference in Indonesia?

Putu Budiarsana1

1 Rumah Sakit Umum Pusat Sanglah, Jalan Diponogoro Denpasar, Bali, Indonesia,

Emergency departments around the world face similar challenges in such as increasing acuity and overcrowding due to bed block. Emergency departments in developing countries face additional challenges such as limited resources and problems associated with professional status and the development of collaborative working relationships.

Indonesia has recently introduced universal health coverage which has resulted in unprecedented pressure on public hospitals. As a major teaching and referral hospital Sanglah Hospital in Bali has been particularly affected by these changes, with up to sixty admitted patients at one time waiting in the emergency department for transfer to wards.

This paper describes a collaborative improvement project conducted jointly between nurses from Darwin and nurses in Bali to assist in improving patient flow. Using the Practice Change Framework for International Development (Brown, 2011) this paper describes the process for designing and implementing patient flow ideas from Australia to improve the quality of emergency care at Sanglah Hospital. The challenges and results of implementing reforms in such a challenging environment are explored.


Pak Budi is the Nurse Coordinator for the Emergency Department at Sanlgah Hospital, Bali, Indonesia. He has also nursed in Australia and completed postgraduate studies in Adelaide.