Waikato emergency department waits a week of work as DHB adds staff

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The target turnaround time is six hours, but at least a third of Waikato ED patients have waited longer to be discharged from the ward (file photo).

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The target turnaround time is six hours, but at least a third of Waikato ED patients have waited longer to be discharged from the ward (file photo).

A patient waited the equivalent of a work week to be treated in the emergency room at Waikato Hospital in February, the data showed.

Long wait times have grabbed the headlines lately, but even before that nearly a third of patients who came forward for help were in the ward longer than the expected turnaround time.

And while an increase in staff brings an extra senior doctor and more nurses to each shift, DHB bosses are reluctant to say when people might be seen – and sent home or admitted – within the six-month deadline. hours fixed in the objectives of the government.

This has been a long standing challenge for Waikato DHB and other health boards.

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An increase in staff will add a senior doctor and more nurses to each shift, said Graham Guy, Waikato DHB's director of medical, elderly and rehabilitation operations.

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An increase in staff will add a senior doctor and more nurses to each shift, said Graham Guy, Waikato DHB’s director of medical, elderly and rehabilitation operations.

Around New Zealand, some patients are waiting more than eight hours just to be seen and frontline staff report treating older patients in hallways and acute patients in waiting rooms, according to the Australasian College of Emergency Medicine NZ.

The government’s target is for 95% of people to be treated within six hours.

In 2021, about a third of Waikato ED patients spent more than six hours on the ward, according to data released under the Official Information Act.

At the start of 2022, with the return of Covid to the community, it was almost 40%.

Additional staffing for the department has been funded and research is ongoing, but the DHB does not say when it aims to meet the six-hour target.

“To … foresee it, we would need a full squad and the [Covid] yellow zone gone,” said director of operations for medicine, seniors and rehabilitation, Graham Guy.

There is a five-year vision for improvement with milestones along the way, he said.

Data shows one person spent 40 hours in the Waikato emergency department in February 2022, and another waited 34 hours.

Those would be exceptions, Guy said, and they wouldn’t have been seated without anything happening.

“They may be fully stable, everything has been sorted out from an emergency care perspective, but they require an inpatient bed which is not yet available.”

Patients can also remain under observation.

Guy could not yet say when patients can expect to be seen within six hours.  “To have certainty and foresee it, you would have to have a full complement and have the [Covid] yellow area disappeared.

Christel Yardley / Stuff

Guy could not yet say when patients can expect to be seen within six hours. “To have certainty and foresee it, you would have to have a full complement and have the [Covid] yellow area disappeared.

A staffing increase for the ED was approved after review for an accreditation process.

Registered nurses numbered about 70 to 72 at this time last year, Guy said. The department is targeting 102 people and has hired additional health aides.

The increase in the number of doctors will add an additional chief medical officer to each shift, “for faster decision-making”.

Other factors reducing wait times include diverting “low-needs” patients, using hospital beds as soon as they become available, and admission avoidance programs such as respite care. .

The postdoctoral research includes a 10-year review of presentations, and the Department of Health funded physical changes such as a larger triage area and a separate lobby.

The long waits in the ER are due to “deep-rooted systemic issues” and under-investment, Australasian College of Emergency Medicine NZ president Dr Kate Allan said in a statement.

It’s “even more of a stretch” at weekends and some patients have to wait in their ambulance until there’s space, she said.

Others spend more than 24 hours waiting to be admitted, sometimes in a bed in a hallway. Major factors include a shortage of hospital beds and nursing staff.

Covid added to staff shortages, Allan said, but really exposed the growing problems for years before the pandemic.

“Our staff are exhausted and often cannot take time off when they need to recuperate, due to insufficient staff to cover their shifts, and patients are suffering.

“A colleague told me, we don’t have time to give patients the care and attention they need.

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