Royal Hobart Hospital escalates to level 4 in a ‘potentially catastrophic overload’

For some patients presenting to the Royal Hobart Hospital tonight, there will be an “increased risk of dying” during admission, as the hospital activates its highest escalation plan.

The Royal Hobart Hospital emergency department has moved to a level 4 escalation, with 10 ambulances ramped. Picture: NIKKI DAVIS-JONES

THE Royal Hobart Hospital has increased its escalation plan to its highest level as it grapples with a “potentially catastrophic overload”.

Late on Monday afternoon, 76 patients had arrived in the emergency department with 29 waiting for a bed in a ward, with no “rescue bed” capacity and 10 ambulances already ramped. In a message sent to staff abut 5pm, the hospital management predicted at least another 20 patients were expected to present to the ED in the following eight hours, leading them to call the situation “the most severe state of overload” seen for that stage of the day.

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AMA spokesman Frank Nicklason said the consequences of the level 4 escalation meant for some patients there was an increased risk of dying.

AMA spokesman Dr Frank Nicklason. Picture: LUKE BOWDEN

“Unfortunately, too long a stay in the emergency department means for certain groups of patients, such as the frail and complex older patients, there is an increased risk of dying during that hospital admission. And similarly for patients with mental illness it creates a worse situation,” said Dr Nicklason.

“It’s more of the same unfortunately and it just really underlines what we’ve been saying previously that there is a need for increased capacity at the Royal in terms of staff and in terms of flexible bed capacity for situations just like this.

“We just don’t have the capacity to get patients out of the emergency department quickly enough and that’s the problem. And of course there are consquences for those patients.”

In the internal hospital message, which conveyed a very real sense of urgency, staff were encouraged to reconsider all patients for potential discharge.

“Every ward bed you can make available that is suitable for an adult patient will count tonight,” it read.

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Dr Nicklason said Tasmania’s demographic meant the state had higher numbers of older, sicker patients who were less able to navigate the health system and as a result don’t receive treatment at the right time.

The RHH’s Relative Stay Index, which measures how the hospital compares with other like hospitals, found that 38 per cent of patients in the emergency department require admission. In large metropolitan hospitals interstate, those figures are closer to 20 per cent.

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A statement released by the hospital’s executive director of operations, Susan Gannon, reminds the public that during periods of high demand normal triage protocols will be used, which ensures those with life-threatening and severe conditions will be seen first.

“Patients who present with non-urgent conditions may have to wait for longer than they believe is necessary, but the community can be assured that we are doing everything we can to ensure they are seen as quickly as possible.”

The escalation is expected to be in place until Tuesday.

The situation comes two days after the State Government called for tenders to manage the refurbishment of the hospital’s emergency department.

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