‘Bed block’ hits southern hospitals

Southerners who have already endured more than 21 months’ delay receiving an operation are being placed back on waiting lists due to bed block.

Unless the issue was taken seriously and tackled urgently, the problem would continue unabated, Southern District Health Board chief executive Chris Fleming said in a report to be considered by the board tomorrow.

"The impact of these challenges is added burden of stress on our staff, potential harm for patients, and cancellation of planned patients due to lack of resourced beds.

"This must change, and we need to have a very clear focus on this with urgency."

Mr Fleming said he had already asked six senior staff to spend a week on creating an action plan with "tangible actions that are immediately implementable" to try to address the problem.

Bed block forced the SDHB to postpone elective surgery in the two weeks before Christmas, then limit the number of operations at the start of January.

Every patient is being given a daily senior clinical review to determine if they needed to stay in hospital.

Mr Fleming said long-stay patients were a particular focus, and if they were able to be reduced, about 55 beds could be released.

A recent check found of 271 beds in Dunedin Hospital, 85 (31%) were being used by people who had stayed five nights or longer.

"Of those, 45 had stayed over 10 nights, and of this 18 over 20 nights," Mr Fleming said.

"In Invercargill, the picture was slightly better as there were only 34 of the 157 resourced beds occupied by longer length-of-stay patients.

"However, at 7am there were 12 patients in ED waiting to be admitted to beds in the hospital but only one bed empty."

There were other beds free but they were not able to be staffed, he said.

For several months the SDHB has being try to manage high hospital occupancy, a phenomenon also noted by many other hospitals around the country.

DHBs are still trying to find the cause of the problem, but suspect it may be because patients who would normally have been treated during Covid-19 lockdown were now being admitted to hospital more seriously ill than they were beforehand, and needing longer treatment time for more complex conditions.

The patients who were now missing out on operations were among those who had waited the longest for surgery, Mr Fleming said.

"We had been targeting getting all patients eligible or still in need of surgery who had been waiting over 21 months on to our surgical lists, but many of these bookings have now been deferred or the booking cannot occur," Mr Fleming said.

"One option that we now need to consider is whether we increase our outsourced orthopaedic surgery for those patients who would be suitable."

However, that expenditure was unbudgeted and would need to be worked through carefully to avoid having a negative financial impact, Mr Fleming said.

"From a medium-term perspective, we also need to focus on improving the match between resourced capacity and demand as there are too many staff — particularly but not exclusively nursing — working beyond their FTE due to vacancies and gaps.

"This is placing unreasonable pressure on staff."

The SDHB expects newly hired graduate nurses, due to begin next month, will help ease some of the strain on staff.

mike.houlahan@odt.co.nz