Dunedin Hospital’s "rapid-rounds" system is to be overhauled as part of the Southern District Health Board’s efforts to eliminate bed block.
A report from the special task force the board set up to examine patient flow issues said it had found "a high degree of variability" in rapid rounds, a quick-fire meeting in which clinicians meet to discuss the status of people in their care.
The meetings were meant to help with planning discharges and availability of beds but, because different wards were taking different approaches to the meetings, there were significant flow-on effects elsewhere in the hospital.
"Some of the issues include not all clinical groups being represented, house officers and nursing not empowered to make enough decisions, structure of the rapid round not being ideal, and input of information being hamstrung by lack of technology or process."
As a result, the board’s rapid round resource kit was being revised, and executives would attend the meetings to help resolve any problems immediately, a report to be considered by the Southern District Health Board on Thursday said.
Bed block — a lack of beds for incoming patients because the hospital is at or near to capacity — has been a problem in southern hospitals in recent months, and caused elective surgery to be briefly postponed in December and January.
Just over a week ago, Dunedin Hospital was declared to be at "code black", partly due to a lack of discharges over the anniversary weekend holiday, and urgent measures were put in place to alleviate the issue.
The next five weeks loom as challenging ones for Dunedin Hospital, as three short weeks due to public holidays are followed by two weeks of school holidays when leave requests were expected to be higher than usual.
The report also said engagement and willingness of some clinical teams to do some
things differently was an
ongoing risk, and that resident medical officers also had to be willing to help.
"We have also identified we need strengthened support and mentoring wrapped around our charge nurse cohort so they feel empowered to lead and make decisions associated with rapid rounds."
Many operational changes remained to be done, and all staff had to accept patient flow issues were everyone’s responsibility.
