Roster gaps behind SDHB bed blocks

An increased focus on safe staffing seems to be the reason behind recent bed blocks at Southland and Dunedin hospitals.

Speaking at the Southern District Health Board meeting on Tuesday, chief executive Chris Fleming said beds were closed when there were roster gaps or high-needs patients, to make sure staff members weren’t facing clinically unsafe workloads.

It was one of the causes the board was considering as part of its research into why it began running out of beds at the end of last year, which meant elective surgeries had to be postponed.

Another contributing factor was delays that kept patients in hospital longer than necessary.

Fleming presented data to the board showing that despite the extra workloads staff were reporting, on average, patient numbers had dropped while staff numbers had increased.

Southland Hospital offers 80 beds in its surgical and medical wards, with a further 88 in its maternity, neonatal, children’s ward, critical care unit, assessment treatment and rehabilitation and mental health wards.

In the past year, the surgical and medical wards had an average occupancy of 73 patients a day and a maximum occupancy of 84 patients – which is up from the maximum of 81 in 2019-20.

Nine more full-time specialist nurses were employed at Southland Hospital in the past year, bringing the total to 336.

But average daily discharges dropped slightly from 20 in 2019-20 to 18 in 2020-21.

Three fewer discharges a day – referring to the total decrease for Southland and Dunedin hospitals – added up to 985 case weights during the year, representing a cost of $5.5 million, Fleming said.

‘‘Unfortunately, bed closures have not been recorded in an easily retrievable manner; however, steps have been taken to capture this data moving forward.’’

Staffing needs are calculated using a tool called ‘‘care capacity and demand management’’, and Fleming said this would be used during future budget discussions to ensure safe staffing remained a priority.