‘A disaster waiting to happen’ in EDs: Nats
Hundreds of people are spending 24 hours or longer in emergency departments each month, suggesting a staggering level of dysfunction across the health system which poses a serious risk to patients.
Figures obtained by National’s health spokesman Dr Shane Reti shows 594 people waited 24 hours in an emergency department in August, up from 160 last August – a number getting progressively worse each month.
Clinicians have for more than a year warned of an ED crisis fuelled by staffing shortages, increased demand and too-small departments, leading to worse outcomes for patients.
College of Emergency Nurses spokeswoman Sue Stebbeings said the situation was only worsening.
‘‘We are speaking out because we are aware the risk is increasing,’’ she said.
Dr Kate Allan, Australasian College of Emergency Medicine Aotearoa faculty chairperson, said the figures were ‘‘worrying’’ and reflecting of system-wide issues which are decades in the making.
‘‘These significant pressures being experienced across the country’s healthcare system are making it increasingly challenging for emergency department staff to admit patients requiring further care into hospital inpatient beds, leading to longer ED waits following initial treatment and assessment.’’
The stark warning follows a spate of high-profile deaths including a pregnant woman who died after a delayed admission to ICU in Palmerston North, a 4-year-old who died from a throat infection in Wellington, a woman who died after leaving Middlemore Hospital emergency department because of long waits, and a patient who presented to a
busy Christchurch ED, left and later died in ICU. It also comes as hospitals clear a backlog of more than 30,000 surgical procedures.
The scarcity of beds delays people being admitted to wards from the emergency department, slowing assessments and treatments and increasing the likelihood of an error, clinicians say. It also lengthens the patient’s overall stay in hospital and is tied to worse health outcomes – including death.
Reti, who has worked as a GP, said the figures were a sign of a system under immense stress, and undermined Health Minister Andrew Little’s pledges to end the postcode lottery of care through centralising health bureaucracy and abolishing district health boards.
‘‘EDs are a snapshot of the system,’’ he explained. ‘‘It is a disaster waiting to happen.’’
Reti has called for emergency department wait times targets, set up under National but replaced with health system indicators, to be publicly reported again.
Dr John Bonning, in his former role as president of the Australasian College for Emergency Medicine, had also said the target – to admit, discharge or transfer 95% of ED patients within six hours – should be publicly reported.
Little on Saturday said there was an 11% vacancy rate across the health sector – a figure which would total 9000 doctors, nurses and other workers, and is about double where it usually sits. However, there had been an overall increase in nurses, he said.
The Government was sent a letter by all district health boards more than a year ago, warning of ‘‘considerable pressures’’ and outlining ‘‘critical workforce issues’’ which were being exacerbated by the immigration settings at that time, and warned of an inability for the health system to provide a ‘‘surge response’’ to an uptick in communicable diseases once the borders opened.