RHH in dire need of ‘culture shift’

A ZERO tolerance for 24-hour stays in the emergency department and an end to ambulance ramping were two of the top priorities identified during a health crisis meeting held yesterday.

The meeting of more than 50 key stakeholders, influencers, staff and consumer representatives discussed the importance of developing sustainable solutions to improve patient flow at the Royal Hobart Hospital immediately — and following the completion of the K-Block.

Australasian College for Emergency Medicine president Simon Judkins yesterday said when compared with other hospitals nationwide, the RHH and Launceston General Hospital were “really struggling” with access block and overcrowding.

Dr Judkins said most of the feedback he had received about emergency medical care and patient outcomes before the meeting involved flaws in “culture, leadership and accountability”.

“The common goal really has to be that every person who turns up to the Royal Hobart is a patient of the hospital, not a patient of one unit or another unit,” he said.

“Everybody needs to look at what they can do to make the system as effective and efficient as possible, because if we don’t look at our processes, more beds aren’t going to solve the problem.”

The meeting agreed to a number of initiatives to improve patient flow and maximise emergency department efficiency, including work to streamline collaboration between hospital departments, improving culture and empowering staff to implement change on the ground.

RHH acute services medical director Paul MacIntyre said a recently implemented integrated operation centre which acted as “the hub of information required for discharge planning and patients being admitted through the ED” had already led to a downturn in demand escalation.

“We have no more physical capacity to build beds at this point in time, but we have to make changes to improve the risk in ED to patients,” Dr MacIntyre said.

“Access solutions start with good discharge planning and streamlined discharges, to keep the beds for those patients that are coming through the system.”

Health Minister Michael Ferguson last night said the Health Department and ACEM would work together over the coming days to finalise an action plan for the strategies agreed to.

“Significant financial resourcing has been invested to meet growing demand, with increasing numbers of inpatient beds around Tasmania, and growth in the medical specialist and nursing staff numbers in our emergency departments and across our hospital system,” Mr Ferguson said. “However, growth in the demand and complexity of patients has outstripped these investments, and we must find new, smarter ways to address this.”

Labor health spokeswoman Sarah Lovell said despite some positive solutions being put forward, staff would still be expected to operate within an “under-resourced” system.

“The actions that will come out of today are largely being driven by the staff, so I have every confidence that those actions will be implemented,” Ms Lovell said.

“What I don’t have confidence in is any significant action from the Government or from the minister to support the staff by adequately funding the health system.”