ED commitment restated

The Southern District Health Board has restated its commitment to upgrading its beleaguered emergency department in the wake of the Ministry of Health urging it to improve waiting times.

The SDHB has long recognised the issues at the ED, saying they are partly explained by issues with where other essential services are located within the building.

Within the past 12 months it has tried to create more space for the department, and at a recent commissioner’s meeting a continuing drive to improve wait times at the ED was agreed.

That would involve the spending of a significant seven-figure sum on capital work as well as altering some current hospital systems, although the amount to be spent is yet to be determined.

Money that might otherwise be budgeted to reduce the deficit will instead be spent on the emergency department upgrades.

In recent months the SDHB has reprioritised its "Patient Flow/Quality" project to identify short-term improvements which can be made; made up to eight extra beds available for winter illnesses; moved to free up acute areas after an initial patient assessment; given GP vouchers to appropriate patients; attempted to improve discharge rates; and introduced new patient information software.

Future projects include implementing a new national programme designed to streamline care of cardiac patients, work with inpatient teams to improve flow through the department and continue the focus on discharge rates.

The SDHB would also try to improve patient flow throughout the hospital, as it was believed practices elsewhere in the complex were contributing to issues in the ED.

Emergency departments in all hospitals are notorious for delays, especially in winter when there is a seasonal increase in people with flu-like illnesses presenting.The Ministry of Health-set target is that 95% of patients will be admitted, discharged, or transferred from an emergency department  within six hours.

The SDHB failed to meet that target in all four quarters of 2017-18: it started the year at 88.8% and improved to 91.2% in the second quarter, but in the fourth quarter managed 90.5% of patients dealt with in the target timeframe.

That performance ranked the SDHB 16th out of 20 DHBs, and resulted in the ministry writing to the SDHB urging action to improve its performance.

"The data highlights the challenges with the flow to inpatient units and is where the DHB should be directing its energy," the ministry said.

"A letter will be provided to Southern DHB CEO of recommendations."

The Otago Daily Times has written several stories this year about delays at the Dunedin Hospital ED, which at times have resulted in patients waiting in beds in the corridor and the ambulance bay for some hours before finally being seen by a clinician.

Lack of beds in the department severely affected services in April, May and June.

Other issues highlighted by the SDHB included:

High inpatient use of ED beds.

• Delays in accessing radiology.

• A continuing shortage of ED registrars.

• Difficulty accessing specialty services out of hours and at weekends.

mike.houlahan@odt.co.nz

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