The Southern District Health Board is being urged to spend an extra $419,000 to pay for more theatre time to deal with a "crisis" in acute surgery at Dunedin Hospital.
A business case reveals, while the total extra cost of another 35 hours' acute operating time was $864,345 in extra wages, the board should save $445,330 on outsourced elective surgery, making the resulting outlay just over $419,000.
Tomorrow's hospitals' advisory committee will be urged to recommend approval of the annual additional spending to the full board, which meets on Thursday.
The business case, prepared by emergency medicine and surgery general manager Dr Colleen Coop, medical director Jean-Claude Theis, nursing director Sharon Jones and business analyst Michael Turner, recommends the spending be approved immediately, allowing for an extra 35 hours' operating time a week.
At present, the hospital's single acute theatre operates from 8am to 11pm daily. Increasing its hours could happen straight away, depending on recruitment of extra staff.
Changes in surgical techniques, older and sicker patients, and no increase in acute theatre resources for 20 years had "precipitated a crisis for Dunedin Hospital in the appropriate management of the patient acutely presenting for surgery", the business case said.
"The quality of patient care and the ability to complete elective lists are now compromised.
"The downstream effects of the acute theatre bottleneck are that ward beds are occupied by patients waiting for surgery because they are not prioritised sufficiently high for immediate surgery, yet they are not well enough to go home."
In the past year, 192 elective surgery patients were postponed so their slot could be used for acute surgery.
The business case said outsourcing more elective surgery to free up space for acute patients would cost more.
The team also looked to Southland Hospital, but it had no spare capacity for acute or elective surgery.
If successful, the plan would see 95% of acute surgery cases treated within the maximum time frame, and 80% within the optimal time frame. At present, just 50% of acute patients were operated within maximum times.
The business case also recommends the board develop a plan to increase overall theatre capacity at Dunedin Hospital by 2015 to cope with a projected increase in demand.
