AustraliaTreatment times blow out at overcrowded emergency departments

02:50  12 june  2019
02:50  12 june  2019 Source:   brisbanetimes.com.au

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Record numbers of patients are swamping emergency departments across NSW, with critically ill patients needing treatment within 10 minutes waiting over an hour at a major Sydney hospital.

The rising numbers – above population growth – show no sign of slowing as the state enters the winter flu season. Even if patient numbers stabilise, more than 3 million people will present at NSW emergency departments this year.

The latest Bureau of Health Information quarterly report shows that, for the first time, ED attendances tipped over three quarters of a million (756,259) in just three months, according to the figures for the January-March period.

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The flood of sick and injured people severely affected wait times across NSW.

More than one in three (37 per cent) of 'emergency' Triage 2 patients with imminently life-threatening conditions - including severe pain and breathing problems - waited longer than the clinically recommended 10-minutes for their treatment to start; 5.4 percentage points higher than for the 2018 summer.

Westmead Hospital reported the worst treatment times for the third quarter in a row, with more than half of patients waiting too long for treatment.

One in 10 'emergency' patients (563 people) waited at least an hour for their medical care to start at the western Sydney hospital; 50 minutes longer than clinically recommended.

Westmead's head of emergency medicine, Dr Matthew Vukasovic, said: ''The high rates of admissions and small size of our ED are sabotaging all our efforts to improve those treatment times.

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''Our staff are really working very hard in an increasingly challenging environment.''

The report released a week before the state budget will put pressure on the Berejiklian government to safeguard its "hospitals building boom" with enough staffing and resources at the most overstretched EDs.

It's also the first to include the Northern Beaches Hospital's treatment times, after Sydney's newest hospital failing to provide good-quality data last year.

Statewide, 28 per cent of ED patients (205,477 people) waited too long for treatment, up 4.3 percentage points compared to summer last year.

The unprecedented high rate of "summer flu" was partly responsible, with the summer figures surpassing the ED rates recorded during the 2017 horror winter flu season.

There was a significant rise in the most critically ill or injured, with Triage 1 (resuscitation) Triage 2, and Triage 3 (urgent) patients between 8 and 9 per cent higher than in the same quarter last year.

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While some hospitals were able to keep their treatment times stable amid the rise in patient numbers, others struggled under the pressure.

At Westmead, 52.5 per cent of patients (10,464 people) waited longer than clinically recommended; a 14.6 percentage point jump compared to summer last year.

The results confirm interim measures to ease the pressure until Westmead's $1 billion redevelopment is completed have failed.

Dr Vukasovic said Westmead ED's patient profile was more complex than most.

More than 40 per cent of patients need to be admitted, and the majority are non-English speakers, whose first contact with a medical service was the ED when their condition has deteriorated, he said.

"We've been at capacity for the past few years," Dr Vukasovic said.

The hospital's new and bigger emergency department is expected to open in July 2020.

At the Northern Beaches Hospital, more than 40 per cent of patients in its ED waited longer than clinically recommended for treatment, the fifth-worst result of all major NSW hospitals.

Opposition health spokesperson Walt Secord said the data vindicated the decision to launch a parliamentary inquiry into the privately-run, publicly funded $600 million hospital.

The 2018-2019 budget included funding for an additional 40,000 ED attendances, which will be enough only if patient numbers stop rising.

In February the government announced an extra 8300 staff.

AMA NSW President Kean-Seng Lim said the federal government also needed step up investment in the health system overall to keep people healthy and manage chronic conditions out of hospitals.

"This problem will not be solved by simply focusing resources and putting more staff into one area," Dr Lim said.

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Flu kills 50, infects almost 27,000 in NSW this year.
Among the deaths so far this year, eight have been of adults under 65 and 48 were aged 65 and over. The death toll and true flu prevalence are most likely far higher, the report says. Every sixth person presenting to hospital emergency departments last week had respiratory or flu-like symptoms, including suspected flu in 75 children under five, and 126 children aged between five and 16.

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