Ambulance ramping reveals a health system in crisis: Labor
Tasmania’s failing health system is unable to deal with daily demand, let alone a serious event, Labor says, with patients waiting up to four hours in emergency. LATEST >>
Emergency Services
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CONTINUED ambulance ramping at the state’s major hospitals showed a health system “one serious incident away from a catastrophe,” Labor says.
Opposition health spokeswoman Sarah Lovell said so many ambulances were delayed at hospital that people were waiting up to four hours for help in emergencies.
It was a signal the health system was in no way prepared to deal with daily demand, let alone a major incident or a COVID-19 outbreak and paramedics were overloaded and suffering stress, she said.
“We’ve had a health system that’s been in crisis for years now,” Ms Lovell said.
“They’ve then had on top of that a global pandemic, they’ve come out of the end of the pandemic back into a system that’s at crisis and what we’re hearing from doctors and nurses that it’s the worst it’s ever been.
“I am very concerned about the lack of support that is being provided to our health workforce, and the risk that we will lose very, very good people — who are holding the system together — to other states.
“The underlying cause really comes down to the fact that there are not enough beds in the hospitals. That creates a backlog.”
Ms Lovell said the Liberals had failed to deliver lasting improvements to the health system.
“These are patients who need to be admitted to hospital, there’s no room to admit them.
“So they’re waiting in the emergency department, which means then there’s no room in the emergency department for new presentations in ambulances.
“The government promised 250 new beds through the Royal Hobart hospital redevelopment, and yet we’ve heard from the minister that they’ve only delivered 50.
“They’ve been in power now, for almost seven years. It’s not good enough, we’ve seen years of chronic underfunding and we are left with a system that is not getting any better.
Health Minister Sarah Courtney said she was focused on supporting staff and making things better.
“I don’t want to see ambulances ramped at any time across the state,” she said.
“We know that we do have challenges in our EDs across the state.
“It’s an area that we’re very focused on, I know that for those that are working in those circumstances, as well as visitors to our hospitals, having bed block can add to stress and anxiety so it’s my priority to make sure that we’re taking action.
“We have done that already through some of the Access Solutions initiatives that have already been rolled out.”
‘Organised chaos’: Damning report reveals ED crisis
January 7, 2021
Cameron Whiteley
THE emergency department at the state’s second largest hospital was one of “organised chaos” plagued by ambulance ramping and access block and where makeshift spaces were used during times of crowding, a new research report has found.
The report, whose authors include two Launceston General Hospital emergency department workers Alex Pryce and Maria Unwin, also revealed “hidden” wait times leading up to patients being triaged which are not officially measured.
The study, published this month in the International Emergency Nursing journal, analysed almost 90,000 presentations to the ED in 2016 and 2017 and included researchers conducting real-time observations to map the patient journeys of 382 people.
They described an environment of extreme crowding, highlighting the design of the waiting room and triage area, ramping, staff and patient safety and limitations in mental healthcare as the most problematic issues.
Staff were also observed performing makeshift roles, including support staff acting as “sitters” for involuntary mental health or confused patients.
The lack of available space in the ED led to patients being treated in makeshift spaces, many of which did not have call bells, duress alarms or examination equipment, with concerns raised about compromised patient safety.
But the report said despite the environment, staff demonstrated a high level of professionalism efficiency and ability to cope under pressure.
Australian Institute of Health and Welfare data shows patient wait times in the ED had deteriorated since the time of the study.
The percentage of emergency patients who commenced treatment within the recommended time fell from 72 per cent in 2016-17 to 69 per cent in 2019-20, while treatment of urgent patients reduced eight per cent.
“The key issues such as structural design of the LGH ED, ramping, crowding, staff safety, patient safety, access block, severe limits on mental health care, privacy and inappropriate use of space still exist,’’ Health and Community Services Union state secretary Tim Jacobson said.
Australian Nursing and Midwifery Federation Tasmanian branch secretary Emily Shepherd commended the staff at the LGH for their “professionalism and dedication in extremely challenging circumstances day in and day out”.
“The report does date back a few years, but the issues largely remain the same,’’ she said.
“Access block continues to cause challenges for the staff in ED as well as the patients who continue to wait longer to access the department also in-patient beds.
“The data also shows that ambulance ramping times is also increasing.”
Ms Shepherd said the ANMF had negotiated with the Tasmanian Health Service for a business case to be put to implement staffing levels the same as those at the Royal Hobart Hospital.
Health Minister Sarah Courtney thanked staff at the LGH who she said had experienced greater demand, particularly in the emergency department.
Ms Courtney said the government had boosted staffing levels at the hospital, including more than 100 full-time equivalent roles last financial year.
She said a patient flow team had been implemented 24 hours a day, while a transit lounge was established in 2018 to assist with managing patients awaiting discharge.
Ms Courtney said the recent state budget also included funding to improve ambulance access to the hospital’s ED.
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