the health system bleeds.
By impactEDnurse • Aug 4th, 2007 • Category: piss and vinegar
A recent Monday morning snapshot taken of 71 emergency departments around Australia, found 41% of their patients were waiting for a bed ( and 81% of those patients had been waiting more than 8 hrs. ). Responding to the report in the Sydney Morning Herald, the Australasian College for Emergency Medicine (ACEM) stated that this report found a “significant deterioration” in conditions since the last survey in 2004.
damming:
The data showed a 16% increase in patients presenting to emergency departments, a 27% increase in those waiting for beds and a 36% increase in admitted patients who had to wait for more than 8 hours.
The president of the ACEM (and the director of our own emergency department) Andrew Singer, stated that these figures were a “damming indictment of he various governments unwillingness or inability to address one of the most important needs in health care today”
coal mine canary:
Emergency departments are the coal mine canaries of the health system, and if they are falling off their perches, a widespread collapse is surely imminent. Tragically, our health systems resources have been allowed to slowly deteriorate for so long now, that it will require a massive and sustained effort to resuscitate it.
And then there is this: our local branch of the Australian Nursing Federation ( ANF ) had their biennial conference last week, at which they unanimously carried the following resolution:
…..it has become essential to notify the Australian Capital Territory (ACT) community that staffing levels in the public and private health sectors, cannot sustain the work demands on health services and that nurses are concerned that standards of care may be compromised and need to alert the community of this genuine concern….
….We call upon the community to raise concerns directly with service providers, bureaucracy, ACT Governments and the Federal Government, which demonstrates shortfalls in service delivery or standards of care, across all health sectors.
impactEDnurse is also known as Ian Miller, a nurse with over 26 years experience working in a busy emergency department in, Australia. This site in no way reflects the opinions of that hospital.
All stories (although based on actual experiences) have been changed to protect patient confidentiality.
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This was an article in this morning’s Sunday Mail,
“A 43 year old woman has died on a stretcher at Logan Hospital because no beds were available…QLD Ambulance sources said the woman’s life could have been saved but a shortage of beds at the hospital,in Brisbane’s south,meant she had to wait in a hallway for treatment that never came in time…..The woman’s death was similar to that of father of four Greg Hayes,47,who died in June after being turned away from Tweed Heads Hospital and paramedics were forced to transport him another 22km to the Gold Coast Hospital…..A report by consultant Peter Forster in 2005 said QLD Health would require an additional 170 beds each year for 20 years just to meet future demand.”
Kate Carnell come to power in the ACT on a platform of improved efficiencies and cost effectiveness etc etc.
Health care consultants were hired.
Today we are now experiencing the results of the drive for improved efficiencies and cost effectiveness.
In the eyes of the bureacratic jungle the most cost effective patient doesn’t come to a public hospital.
The ACT as with all the other states has fewer available public hospital beds per thousand of population than they did a decade or two ago and around two decades ago the intake numbers for medicine were reduced.
The nett effect is two fold, not enough public hospital beds and not enough staff, even if the federal and state governments were to suddenly find billions of dollars of extra funding for public hospitals it would take years for more beds to made available and even longer to train enough staff to staff the newly available hospital beds.
In the mean time the situation in emergency departments deteriorates even further, with a flow on effect to all the other hospital departments.
In the mean time all the state and territory health departments find more inventive ways of shifting the blame back to the hospitals for not performing according to the benchmarks.
Afterall the decision makers are not responsible for the effects of their decisions.
I forgot to add.
Kate Carnell said that the ACT health system was broken and that she was going to fix it!
The situation in Melbourne is no different sadly . Our days on Monday, Tuesday and Friday (paramedic shifts in melbourne’s north) were spent dealing with alternating hospitals on full bypass (the Austin, Northern and RMH all on full bypass at one point- where else to go in Melbournes nth??) and as one went off Bypass it was swamped and so on. We had 2 x 2hr waits at hospital on monday and tuesday waiting (6 ambulance crews and their patients crowded into the front foyer of the Northern at one point)to get a bed in the ED and resorted to helping the staff take bloods in the corridor (of course those pts in the ed had no where to go- no beds in the units!)! Friday wasnt much better. As to the effect of such delays on ambulance response times and more importantly access to quick prehospital emergency care, well you dont have to be Einstein to work out the negative flow on effects. Demand is far, far stripping supply (MAS emergency responses in 2006 up by 11.6% alone) but nothing seems to be being done to better resource hospital and ambulance services…