Doctors wanted ‘disaster’ status for RAH to cope with number of patients clogging emergencys

DESPERATE medics sought to have the Royal Adelaide Hospital declared a “disaster” status as 91 patients jammed the 65-bed capacity emergency department earlier this month, as a new report reveals a health system at crisis point.

• Code White: Public hospitals treating more patients than capacity
• 90 days to reach accreditation or RAH closes
• Risk of huge bill to rebuild resuscitation rooms

DESPERATE medics sought to have the Royal Adelaide Hospital declared in “disaster” status as 91 patients jammed the 65-bed capacity emergency department.

As ambulances ramped and half of the ED was effectively “shut down” to patients already treated and waiting for a ward bed, some doctors wanted disaster status so they could divert new arrivals to GPs.

The stunning stand-off is revealed in a report by the doctors’ union after an inspection on March 8, which is now being investigated by Safework SA for alleged breaches of health and safety regulations.

The SA Salaried Medical Officers Association’s (SASMOA) report alleges multiple breaches in the ED and in the mental health ward, where duress alarms are still not working more than six months after the hospital opened.

The clogging of the ED is ongoing — at 9.30am on Wednesday the 65-capacity ED had 41 of its beds taken up by patients who had been treated and admitted but who had not been moved to ward beds.

Eleven of these had been waiting between 12 and 24 hours for a ward bed and the gridlock meant new arrivals faced an average 103-minute wait to be treated.

On Tuesday night, demand overwhelmed the system with more patients being treated than available capacity across the city.

The Australasian College for Emergency Medicine (ACEM) warns winter will be a “disaster” when flu and respiratory illnesses are rampant unless there are major changes.

Health Minister Stephen Wade said ACEM and SASMOA raised serious concerns.

“I need to take seriously their very clear statements that we are in crisis mode,” he said.

“SA Health already has taken some action, but these issues are deep and they are wide, (former health minister) Peter Malinauskas has left a health system in crisis.”

Mr Wade said management and clinicians agreed there were serious patient flow issues in the ED and it was worse in the new building than the old RAH.

He also noted some mental health patients were spending up to two weeks in general wards because there were no beds available in mental health wards.

Options to deal with the logjam include “reinvigorating” outer suburban hospitals, but Mr Wade said simply opening more beds in the supposedly 800-bed RAH was not an instant answer.

It now appears the new hospital is functioning with less inpatient beds than the old RAH, and Mr Wade conceded he does not know how many inpatient beds it has.

“It may not be a short-term option to open more beds,” he said.

“The former Labor government so badly mismanaged the outpatient clinics that some inpatient beds are now housing outpatient clinics.

“One option would be to decant outpatient clinics and return them to inpatient services.”

The report also found that the official hospital statistics for the ED on March 8 were misleading.