New ways to help the homeless and drunk
A project to improve the effectiveness of Wellington Hospital’s emergency department has succeeded so spectacularly that other health boards are adopting it.
Whenever an injured person turns up at Wellington’s emergency department staff screen them for alcohol-use and find out whether they are homeless.
If they appear too frequently a multi-agency team intervenes, and those interventions have sharply reduced the burden that homeless alcoholics and ‘‘frequent flyers’’ place on emergency departments.
Paul Quigley is an emergency medicine specialist who divides his time between Wellington and Hutt hospitals.
He said the project focused on injuries because they offer the best return for staff time.
Injuries that occur in the presence of alcohol are more costly to treat and more likely to recur, he said.
‘‘Patients who present with injuries are being asked whether, firstly, the patient themselves feels that the injury is related to alcohol, staff make their own judgement and, thirdly, the patient is screened for alcohol,’’ he said.
‘‘Asking patients directly whether the injury was related to alcohol has been very eye-opening in terms of finding out what the day-to-day cost to the country is of alcohol.’’
Staff also find out whether the patient is homeless, he said.
The aim is to find out why they are frequently returning.
‘‘More than often it is the non-medical reasons,’’ Dr Quigley said.
If a patient has more than three presentations within one month, and is either homeless or alcohol is involved, they get the first flag, he said.
At the subsequent presentation staff carry out an intervention.
If they are homeless they are referred to Te Aro Health centre, to give them an alternative to the emergency department, and to a social worker to deal with accommodation issues.
Over-achiever: Emergency medicine specialist Paul Quigley is leading a project investigating the role of alcohol in the injuries of patients treated in hospital emergency departments.