First published Feb 6
Patients spending more than 24 hours in the Royal Hobart Hospital’s emergency department have more than doubled in the past year, according to figures leaked to the Tasmanian Times.
The data, prepared within the hospital and circulated to key staff, cover the past six years and show how the emergency department has increasingly struggled under budget cuts by the past two state governments.
The leaked document presents a picture that is even worse than previously thought.
Lives are being lost.
The rolling crises created by the bungling of the hospital’s decanting process during the present rebuilding program are more starkly revealed than ever in these figures.
The number of ambulances ramped for longer than 30 minutes has tripled in the past year, from an average of 6% in 2016 to 18% in 2017.
The figures show how staff are struggling to cope with the massive increases in workload and overcrowding, as patients needing treatment on a specialist ward have to wait on trolley-beds in emergency.
The number of patients needing admission who have to spend less than four hours in emergency – a key national target – has fallen from 19% to 16% in the past year. In 2012, it was 23%.
This is known as bed block.
A key measure of bed block is the time waited by patients needing admission at the 90th percentile mark: if 100 people are waiting, the 90 percentile time refers to the time waited by patient number 90.
In 2017, this went up to 18 hours from 15 the year before. Earlier figures, from the Australian Institute of Health and Welfare, showed that bed block at the Royal Hobart Hospital was the third worst among the 30 major hospitals in Australia.
Research in Australia and overseas, some commissioned by the Australasian College of Emergency Medicine, found patients affected by bed block – defined as needing admission being kept in emergency for four hours or more – had an increased risk of death of between 20% and 30%.
Nationally, the Australian researchers found, bed block accounted for more deaths than the road toll.
In Hobart, the new figures reveal that the death toll is likely to be substantially greater at the Royal Hobart Hospital because of the inability of staff and services to cope.
The number of emergency presentations to the hospital has risen from 49,955 in 2012 to 62,806 last year. Until 2017, presentations increased by about 4.5% a year. But over the past year that increase has dropped to only 2.7%.
Staff believe this is because significant numbers of people needing care avoid coming to the hospital because they believe the system will not be able to cope with them adequately, and because they do not want to add to the workload of emergency personnel or to the ongoing chaos in the system.
The figures explained …
EARLIER on Tasmanian Times …
*Martyn Goddard is a public policy analyst based in Hobart.