Demands Placed on Emergency Departments (21st Jan 2020)

CENA notes that there is significant media attention and public concern raised around the capacity demands placed on Emergency Departments across Australia.

CENA appreciates that this is a difficult and sensitive issue that highlights some of the very real challenges that emergency departments, hospitals and the health care system are facing.

CENA acknowledges the ongoing efforts of emergency staff from all disciplines who, while trying to provide safe, high-quality care, are overburdened by system inadequacies, which places them under significant additional stress and puts patients at risk. These factors are outside of the control of the emergency department and require a co-ordinated and considered response from government and key healthcare stakeholders.

CENA expresses concern that there are instances where patient safety is compromised due to inadequate facilities and resources. In these instances, despite efforts to improve timely access to emergency care, patients continue to be put at risk through policies that fail to address emergency department demand leading to overcrowding and challenges meeting patient needs.

Practices such as “ramping”, “double-bunking”, “care-in-the-chair”, “hallway-care”, the use of make-shift spaces and modified staff roles are short-term responses that are less than ideal now and certainly not acceptable as longer-term solutions. It has been demonstrated that these practices have done little to alleviate extended wait times as emergency departments are placed under increasing pressure.

CENA supports a system wide review and actions that address the root cause of the problem – there are many patients presenting at emergency departments, for issues such as mental health, general health care and long-term illness, simply because they do not have access to alternatives.

In addition to increasing acute care capacity, CENA suggests that it is imperative that stakeholders take positive actions to address the causes of presentations, examine appropriate pathways and provide appropriate alternative care models for those that are over-represented in Emergency Departments.

Taking this action has been demonstrated to provide the community with improved patient-centred care while effectively reducing demand for Emergency Department services.

CENA maintains its stance that our growing communities require additional health care capacity across a range of facilities and treatment options including acute care – reducing Emergency Department overcrowding is not a simple matter and requires a multifaceted system-wide response.

Response to patient death after ramping outside of Adelaide hospital

The tragic deterioration and subsequent death of a patient ramped outside Flinders Medical Centre unfortunately reflects another avoidable failure of the health care system in South Australia.

The College of Emergency Nursing Australasia (CENA) expresses our sincere condolences to the patient’s family.  CENA is deeply concerned that patient safety at Flinders Medical Centre has been severely compromised, and that despite promises by SA Health to improve timely access to emergency care, patients continue to be put at risk through policies that create overcrowded emergency departments that are unable to meet patient needs.

Emergency staff, while trying to provide safe, high-quality care, are overburdened by system inadequacies, which places staff under significant additional stress and puts patients at risk.  CENA maintains its stance that the growing community requires additional acute care capacity.

Link: https://www.abc.net.au/news/2019-11-18/adelaide-hospital-ramping-third-patient-dies/11712776

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