Fast track order to doctors to clear RAH, QEH beds dumped

An order to doctors to fast track their rounds to free up hospital beds and ease ramping has been dumped after it failed dismally.

A senior SA Health executive has been forced into an embarrassing backflip after issuing an order to fast track patient discharges, which left doctors furious amid warnings it would mean just a three-minute check before sending some patients home.

Central Adelaide Local Health Network (CALHN) chief executive Lesley Dwyer issued the direction last October that consultants finish their rounds by 10.30am, seven days a week – rounds normally last well into the afternoon.

The order demanded a 95 per cent compliance rate within three months for CALHN, which covers the Royal Adelaide Hospital and the Queen Elizabeth Hospital.

Central Adelaide Local Health Network chief executive Lesley Dwyer outside the RAH. Picture: Roy VanDerVegt

However, it failed dismally and as of this week just 10 per cent of eligible patients were being discharged by 10am in these hospitals. The order has now been dumped.

Ms Dwyer’s original order noted that across CALHN, there were often between 20-30 patients waiting to be admitted and this puts pressure on EDs.

She said most patients were discharged from midafternoon to the early evening but doing it earlier in the day “would create the capacity of at least another ward”.

An ambulance at the Royal Adelaide Hospital. Picture: NCA NewsWire

Doctors said the fast track edict would put patients at risk and leave no time for training, while their union took it to the SA Employment Tribunal saying it was illegal and that the union was not consulted.

Ms Dwyer on Thursday issued a new message to staff rescinding the order.

In it, she repeated that the direction was “based on evidence that showed us that discharges earlier in the day, even by two hours will create the capacity of at least another ward”.

“Our clinical programs were asked to lead the work to implement the Direction, and while there has certainly been a focus on early discharge, I know that for some clinical areas, due to the nature of their work and patient complexities, it has not been possible to meet the technical requirements of the Direction,” the new message to staff says.

Ambulances at the Queen Elizabeth Hospital. Picture: NCA NewsWire

“Having considered this feedback, and the various ways Programs are trying to achieve early discharge (for example, by criteria led discharge, afternoon rounds the day before or earlier rounds in the mornings), I want to change the approach and provide for more flexibility in the achievement of the objective.

“To this end, I see the withdrawal of the Direction as a necessary step in this process and confirm I have officially withdrawn it today.”

SA Health recently held a “Focus Week” aiming to improve efficiency which set a target for each Local Health Network of 30 per cent of discharges before 10am and 50 per cent by noon.

“As evident during Focus Week, improvement in this area remains a challenge for CALHN, notwithstanding the effort put in by everyone to date,” Ms Dwyer said.

“Currently only 10 per cent of patients are discharged before 10am despite this effort.”

Ms Dwyer said CALHN will use information from Focus Week to “improve our early discharge performance”.