Dunedin Hospital will not meet the Ministry of Health target for emergency department stays without investment in a short-stay unit, Southern District Health Board chief operating officer (Otago) Vivian Blake says.
Space had been identified for a possible eight-bed unit, aligned to the department.
Computer modelling work using hospital data was being used to test hypotheses involving a short-stay unit or an alternative medical assessment and planning unit in the internal medicine area.
The board needed to be "pretty sure" it needed the unit before spending money.
She told this week's board meeting that while the organisation-wide projects to address the issue would result in an increased percentage of patients spending less than six hours in the department, the improvement would not be enough to reach the target.
The requirement is that 95% of patients attending the ED are seen, treated and discharged or admitted to the hospital within six hours.
Mrs Blake said she believed that the hospital could become "as efficient as we like, but without the ability to invest in a short-stay unit I don't believe we will reach the target".
This view has also been publicly shared by senior clinicians in the department in recent months.
In response to questions from chairman Joe Butterfield about whether the performance of departments outside the ED was being studied, Mrs Blake said "every stone is being turned".
A date had not been identified for when the hospital would meet the target.
She agreed with Mr Butterfield when he said "we're miles away from it".
In December, the board was meeting the target time for 69.44% of patients.
Mrs Blake told the meeting there was a group of projects under the 6 Hours It Matters! campaign which would be reported on to the hospitals' advisory committee.
Richard Thomson was to provide strategic steerage to the group involved with this.
Dr Branko Sijnja asked whether it was necessary to have a facility to identify that patients were under assessment.
Whether a patient was in a special assessment room or an ED room they were still being assessed.
"It makes no difference to the function you're doing."
Mrs Blake said it was clear the time being looked at in the ministry target was that during which the patient was physically in the department.
Chief medical officer (Southland) Dr David Tulloch said he considered the time limit alone was meaningless, but addressing issues affecting the flow of patients through the hospital was important to providing good quality care.
Chief executive Brian Rousseau said the target was not about "five hours 59 minutes versus six hours" but the time was an indicator of the hospital's overall efficiency.
Patients' length of stay would be another indicator which could be used.
Mr Butterfield said he wanted to see a timetable for the results of the work being done and asked hospitals' advisory committee chairman Paul Menzies to look at this issue - "that would at least stop me getting antsy". elspeth.mclean@odt.co.nz
