The Southern District Health Board seldom meets the Ministry of Health target for 95% of emergency patients to be admitted, discharged, or transferred from emergency within six hours.
In the past quarter it achieved 79%, and expects to manage 81% this quarter.
An SDHB hospital advisory committee meeting in Invercargill today will be briefed on efforts to improve that.
A report by specialist services executive director Patrick Ng said draft strategic and economic cases for a range of initiatives had been written, following Treasury’s business case template.
Financial and management cases were now being prepared, he said.
"We are awaiting a design from our building and property colleagues (due in two months’ time) and will then pull together the commercial case which is the final case in the overall template."
For Dunedin Hospital, the SDHB wants to create a "Fit To Sit" area in emergency for lower-needs patients; a request for proposal for that work on the Government Electronic Tender website closed on Friday.
The SDHB also wanted to introduce a "generalist" approach to admission to the ED, Mr Ng said.
Decisions on patients would be made more quickly, and they would be discharged more rapidly.
"In our business case we are combining the concept of generalism with the concept of a co-located medical admissions unit, which would be located next to the ED and would take up to 20 patients.
"The overall concept is that patients would be flowed through the ED quicker, and more patients would be admitted for a short stay (circa 24 hours) rather than as a full admission into the inpatient wards."
Two new staff would need to be employed and hours of work extended, which would come at a cost, Mr Ng said.
"However, there would be a strong payback at the other end, in terms of reduced length of stay in the hospital (which would need to be change managed as a reduction in resourced beds), and also a longer-term more notional and less tangible benefit associated with managing the increasing demands for inpatient bed days as the ageing cohort of our population grows."
Southland Hospital’s emergency department was also a concern, and it came under "enormous pressure" over winter, Mr Ng said.
"The problems at Southland are multi-faceted, with very high ED presentations (which must be solved in partnership with Primary Care), facility constraints in terms of capacity to hold patients, and the flow of patients from ED to admission."
Extra resources had been put into formulating a plan to tackle the issue, Mr Ng said.
