Student cases affect emergency department waits

The length of stays in Dunedin Hospital's emergency department is affected "from time to time" by the number of students turning up with alcohol-related conditions, Southern District Health Board chief operations officer Vivian Blake says.

In a weekend during orientation, 46 students had alcohol-related attendances at the department, she told the hospital's advisory committee meeting yesterday.

She was responding to a question from committee chairman Paul Menzies about when some improvement would be seen in the percentage of ED patients meeting the Government's target of a stay no longer than six hours.

She was "very hopeful" that some improvements would be seen next month, but said she had to publicly note that part of the problem from "time to time" had been the student population.

Mrs Blake said as part of a comprehensive "6 Hours - It Matters!" project, staff were "delving into information" about the types of patients attending and whether they could be managed differently.

Yesterday, in its closed session, the committee also considered a preliminary report on a special unit, known as a medical assessment and planning unit, which might shorten stays in the department.

Senior clinicians in the department have been outspoken in recent months about the need for such a unit or something similar to better cater for those patients who might need monitoring and brief treatment before returning home.

In centres which have a medical assessment and planning unit, patients are referred there from their initial arrival in ED if they need to undergo detailed assessment.

A decision is then made with the input of a multidisciplinary team about whether to provide treatment there for a short period or to admit them to a ward.

Such units are seen to be particularly appropriate for elderly patients.

In the open section of yesterday's meeting, Mrs Blake said it was likely that such a unit would increase compliance with the government target by about 10%.

Although information was still being gathered from a variety of groups by her and project clinical champion intensivist Mike Hunter regarding the issues and how they could be dealt with, she felt there was increased awareness that the issue involved the whole of the hospital.

Computer modelling looking at how a range of scenarios might alter the pattern of stays is expected to be released later this month, which would give "a good steer" on what was required.

A recent meeting with general practitioners to discuss issues they had with the service had been fruitful, with 46 doctors attending.

There had also been a meeting with Grey Power members and another was planned, she said.

There was " nothing more powerful" than getting insights from people who had been through the system on how they felt their experience could have been improved.

Mrs Blake said so far the various meetings had identified probably up to six key areas to focus on.

- elspeth.mclean@odt.co.nz