Surgeries restricted as bed demand soars

Southland Hospital. Photo: ODT files
Southland Hospital. Photo: ODT files
Southern hospitals are continuing to restrict elective surgery as high numbers of patients put pressure on bed availability.

Just before Christmas the Southern District Health Board postponed all deferrable elective surgery after unprecedented demand in southern emergency departments.

Some operations continued to be deferred at Dunedin Hospital, although most surgery had resumed, surgical services general manager Janine Cochrane said.

However, staffing pressure at Southland Hospital meant few bookings were being taken for operations, she said.

"The reduction in deferrable elective surgery did reduce pressure on demand for beds.

"However, the wards remained under significant pressure."

Southland Hospital would maintain its low operation numbers for another week and the situation would then be reassessed, Ms Cochrane said.

"Bookings for elective surgery are being closely monitored ... patients for the most part are incredibly understanding about postponements, but we know that the impact of a cancellation is huge, especially when wider family members make arrangements to support their whanau and these are changed, sometimes multiple times.

"Telling patients that they are being postponed is also very difficult for our staff to do, particularly when this becomes a regular occurrence."

Help was on its way for beleaguered wards, Ms Cochrane said, as new graduate nurses would be starting work in both hospitals early next month.

"Staffing is expected to improve on both sites in March."

Dunedin Hospital emergency department clinical director Richard Stephenson said there had been a slight dip in numbers of patients during the holiday week, but demand at both Dunedin and Southland had quickly returned to the high pre-Christmas level.

"In particular, we have noticed a significant increase in our high acuity patients compared to 2019," Dr Stephenson said.

"High volumes of serious road trauma have been a major contributing factor ... the situation at Southland Hospital Emergency Department has been similar — however, without the high volume of serious road trauma."

The SDHB has emphasised that anyone who needed emergency care would receive it.

The board has long recognised issues with management of patient flow in its hospitals, and in recent times has instituted initiatives to try to ensure as many beds as possible are available each day.

Late last year it released draft details of an "escalation plan" to address delays in emergency departments, and involve all departments with recognising potential delays.

"Dunedin Hospital emergency department has frequent episodes of overcrowding that create practical obstructions to care, risk and distress to patients and families," a report to the board said.

"An overcrowded ED does not necessarily mean that the problem lies within that service, it is just that this is the point in the system where a flow problem becomes visible."

Comments

The bed shortage explains but does not excuse suddenly discharging an elderly Maori man with 15% heart function who was sent home with no care plan. None, nothing! His wife is not physically fit enough to care for him though she wants to, showering for instance. The family had previously been given assurance they would take her health into consideration. After stirring up they were visited by a nurse but now the plan is to phone check, not taking into account that she is very hard of hearing and being of a generation that doesn't like making a fuss nods and says yes so as not to cause problems for the other person.
This is not good enough. Our older people deserve respectful care, and so do their families. Not everyone has a large number of young, strong, capable and willing family members living near enough to rally round and take care of a very ill person.

 

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