EMERGENCY DEPARTMENT - WAITING TIMES
Mrs ARMITAGE asked a question of the Leader of Government Business in the Legislative Council -
In relation to Emergency Department patients requiring hospitalisation at the Royal Hobart Hospital, the Launceston General Hospital and the North West Regional Hospital -
(1) In the 2011-12 and 2012-13 financial years, how many patients have -
(a) spent greater than 24 hours in the Emergency Department before being transferred to a ward or (b) spent greater than 48 hours in the Emergency Department before being transferred to a ward? (2) How did Tasmania rate in the 2011-12 and 2012-13 financial years against the other states in relation to the transfer of patients from the Emergency Department to a ward? The answer read as follows: (1) Please refer to Table 1 below: Table 1: Number of Emergency Department Presentations Ending in Admission with Extended Length of Stay in the Emergency Department.
Tasmanian Health Organisation - North
The issue of long-stay patients in ED requires a whole-of-LGH response, and this is being addressed by the Department of Medicine and the other areas.
While there have been significant improvements in meeting ED key performance indicators - KPIs, it is acknowledged that addressing the long-wait patients in ED is a complex issue and improvements will take longer.
LGH has and uses a short-stay area; this area is currently not a defined short-stay unit as defined in clause C48 of the National Partnership Agreement - NPA - on Improving Public Hospital Services, as well as under METeOR - Australia's repository for national metadata standards for health, housing and community services statistics and information - in the definition of the non-admitted patient emergency department care National Minimum Data Set - NMDS.
Other health services have different admission policies and have short-stay units that do meet the criteria. This, in THO-North's assessment, is the major reason for why the numbers are so significantly different. LGH is considering the establishment of a compliant short-stay unit within ED.
The fundamental issue is to ensure patients are cared for in the most appropriate and clinically safe area.
LGH is undertaking the following:
The LGH has the capacity to flex up and down regarding bed management as required.
The opening of the 20 sub-acute beds at John L Grove in mid-September 2013 will assist.
The LGH proposes to undertake minor capital works, to allow the reopening of eight surgical beds.
The flow of patients from ED across all areas is being reviewed, both clinically and from a patient flow perspective.
Tasmanian Health Organisation - South
Initiatives introduced by the THO-S over the past three months to improve throughput include:
opening of eight extra beds as a 'Winter Bed Strategy' in the Assessment and Planning Unit -APU;
increasing utilisation of the Transit Lounge both for patients being moved from ED to a ward bed and for any ward patients being sent home;
a weekly inter-disciplinary review of long-stay patients in the hospital to facilitate discharge; and
daily inpatient ward rounds by the Community Nursing Nurse Unit Manager to identify patients hospital-wide who can be managed in their own home and facilitate this process.
(2) The Australian Hospital Statistics 2011-12: emergency department care1 presents information on length of stay for all emergency department presentations, by admission status. This information is presented in Table 2.
The National Health Performance Authority inaugural report Hospital Performance: Time patients spent in the emergency departments in 2011-122 provided information on the length of time spent in the Emergency Department by those patients that are subsequently admitted to hospital, with peer group performance comparisons (refer to Table 3). The report for 2012-2013 is not yet available.
1 AIHW 2012, Australian Hospital Statistics 2011-12: Emergency Department Care, accessible at http://www.aihw.gov.au/publication-detail/?id=10737423042 2 National Health Performance Authority 2012, Hospital Performance: Time patients spent in emergency departments in 2011-12, accessible at http://www.myhospitals.gov.au