RAH’s emergency department hits ‘worst’ patient logjam on record, with people stuck in the ED and no available beds

The patient logjam at the RAH’s emergency department was the worst on record last Monday, the doctor’s union says – until yesterday, when it was even worse.

The $2.4bn Royal Adelaide Hospital continues to lurch from crisis to crisis in managing its emergency department with doctors saying Monday of last week was the worst on record – until it was even worse Monday this week.

The department has been jammed with patients who have been treated but have nowhere to go, leading to long delays for new arrivals, ramping, and people warehoused in the ED for more than 24 hours.

On Tuesday morning at 8am there were 69 people being treated in the 69-capacity ED but 53 of these had finished treatment, had been admitted to hospital, but were waiting for a bed. Three had been waiting for more than 24 hours and 17 patients for between 12 and 24 hours.

People arriving at the ED faced an average 106 minutes to be seen, putting enormous pressure on staff.

SASMOA Chief Industrial Officer, Bernadette Mulholland. Picture: Matt Loxton

SA Salaried Medical Officers Association senior industrial officer Bernadette Mulholland previously told The Advertiser that Monday of last week was the “worst on record” at the RAH with 53 treated patients stuck in the ED waiting to be moved.

However, Monday of this week has surpassed it with SASMOA noting there was “a record 58 admitted patients in the RAH ED. Leaves 11 beds for the expected average (daily) attendance of 240 to the ED.”

SASMOA paid a site visit to the RAH ED on Monday last week in response to calls by members fearing for the safety of staff and patients due to overcrowding and workload.

Well tough day again at RAH - just advised record 58 admitted patients in the RAH ED. Leaves 11 beds for the expected average attendance of 240
to the ED. #weneedspacetokeepyousafepic.twitter.com/uDlzqyfZEJ

— SASMOA (@sasmoa4doctors) June 27, 2022

Its report is expected to go to SafeWork SA this week.

It follows similar sanctioned union inspection visits to the RAH and Flinders Medical Centre’s EDs in the past three months, which found multiple alleged breaches of health and safety laws which have been reported to SafeWorkSA.

Ms Mulholland has called for a Royal Commission into ramping, which successive state government have failed to fix and is a nationwide challenge.

The state government came to office with a pledge to “fix ramping” with plans for 350 more paramedics and ambulance officers, 300 more nurses and 100 more doctors but concedes it may take years to resolve the issue.

The entry to the RAH’s emergency department. Picture: AAP / David Mariuz

Health Minister Chris Picton blamed the previous Liberal government for the problems – despite their record spend on upgrading EDs – and noted Covid, flu, delayed treatment during the pandemic plus a surge in strokes added to logjams.

“The key problem across the health system is there simply is not enough capacity to cater for the large number of very sick patients, with every possible bed being used,” Mr Picton said.

“Advice from the Royal Adelaide is there has been a high number of very sick people including a higher-than-usual number of people with strokes.”

An extra 28 private hospital beds have been purchased and the RAH has opened a “discharge lounge” to help flow in the hospital.