ED delays criticised

Dr John Chambers
Dr John Chambers
The Dunedin Hospital emergency department is ''just not up to standard'' and patients are suffering, an ''exhausted'' Dr John Chambers says.

The ED specialist and senior doctors' union representative spoke out after a busy weekend in which patients overflowed into waiting rooms and corridors.

''Ill and injured patients are waiting three to four hours to be seen and the place is packed.

''Our target is to get patients out of ED within six hours, but it is very difficult to achieve this when they are not actually seen by a doctor for four hours.

''The peak time [on Monday night] was 10pm, when literally every ED bed was full, as were the waiting rooms and corridors,'' Dr Chambers said.

Of the 145 patients in ED on Monday, 84% were discharged or admitted within six hours. The target is 95%.

The department needed refurbishment and more staff, he said.

''When the ED is busy there are many factors involved, the heat and [excessive] alcohol were certainly factors at the weekend, but there were many people who just became ill or had a fall and there were a few car crashes.

''I was there till 3am Saturday and Sunday and am fairly exhausted,'' he said.

Dr Chambers said the Southern District Health Board was ''preoccupied'' with elective surgery, urology and ophthalmology, and dealt with crises only if public pressure was applied.

''I do not think that the executive have really grasped what is required to resolve the issues of ED overload.

''The best way to get this message across would be with some patient stories, but our patients are reluctant to complain when they see staff working hard and overwhelmed,'' Dr Chambers said.

SDHB chief executive Chris Fleming said the usual seasonal reduction in numbers had not occurred.

''While we might traditionally expect presentations to reduce over summer, we are also aware this is not an exact science.

''Last year saw higher numbers of presentations in July and August followed by a significant drop in September and October. This year, our July and August presentations were lower than last year, but have sustained over September and October.''

Mr Fleming has previously acknowledged the need to seek funding from the Government to refurbish parts of the hospital as the rebuild is still years from completion.

''The space available in ED, and its location in relation to other services, is not ideal, and we acknowledge that staff do an excellent job within the physical constraints of the area.

''We are working on a business case to seek support in improving our facilities as we await our new hospital in Dunedin.''

He said a new medical assessment unit that cared for some older patients to relieve ED pressure was helping.

However Dr Chambers said it was ''still early days'' for the medical assessment unit, which opened in September, and had limited capacity to take patients.



Tired of learning how busy and chaotic is the Dunedin ED,and still the hospital refuse to send those non-urgent visitors away to GP'S ,so stop complaining and take the solution.

All studies internationally and in NZ have shown it’s not “GP” patients causing delays in our ED’s it’s the sheer number of people requiring urgent care. If retrospective analysis of presentations is applied then it looks different to this reality, and then vast money is wasted redirecting a minority of patients to other places without relieving the backlog in EDs. Eg someone elderly with indigestion may be treated at their GP but until they’ve been seen and a heart attack’s been ruled out they don’t know it’s just indigestion. We can’t expect GP’s to be available to assess urgent cases within 10minutes and still do all their actual GP work of looking after long term health needs and non urgent problems.
Studies show people in general are extremely good at selecting where to get the right assessment for their urgent health problems, with roughly equal numbers going to the GP when they should be at ED and vice-versa.
It’s more convenient to blame the public than to sufficiently invest in Emergency Department care.
An exception in Dunedin is likely the small number sent to ED from cruise ships who need a better system for accessing scans and other tests.