The peak body for emergency medicine in Australia and New Zealand says Tasmanian emergency departments at extreme levels of overcrowding require solutions based on evidence, and community and health resources needs to be expanded.
“The argument around urgent care centres as a way to address the perceived impact of GP patient presentations to emergency departments is unlikely to provide much benefit to Tasmanian patients,” Australasian College for Emergency Medicine (ACEM) Tasmania Faculty Chair Dr Marielle Ruigrok said. “The fact is, there’s little evidence any of these approaches have any meaningful effect on the level of overcrowding that we’re seeing in our hospitals and emergency departments.”
The real issue, Dr Ruigrok said, remains access block.
“Last week we heard the return of a common mythology – that emergency departments are clogged with GP-type patients. The workload of GP-type patients in emergency departments is trivial and is not the main reason for overcrowding,” Dr Ruigrok said.
“The main cause of overcrowded emergency departments is the issue of bed capacity, basically patients having to stay longer in the emergency department because there aren’t beds in wards of the hospital.
“We don’t need more of the short-sighted, ineffective and unproven measures, none of which have led to lasting improvement. What we need is real action around the core issues of staffing levels and increased bed capacity, because it’s unacceptable to run a healthcare system that puts patient’s lives at risk.”
In order to significantly reduce demand for after-hours medical care, evidence-based demand-reduction strategies need to be implemented. Importantly, a whole-of-community response where everyone plays their part is necessary.
Examples include:
- Community-based admission avoidance programs targeting patients who present frequently to emergency departments or with conditions requiring recurrent admission.
- Better management of chronic disease, with increased investment in medical care support in nursing homes and/or aged care residential facilities, as well as Hospital-in-the-Home programs.
- Increase in funding for inpatient services and resources (for example, more beds and more staff on more shifts across the whole week).
ACEM President Dr Simon Judkins said: “Our research shows that the true workload of GP-type patients is less than 5% in most major emergency departments. Furthermore, various research has demonstrated that the vast majority of attendances at the ED are appropriate for the patients’ medical condition(s).
“Of course, ACEM supports the development of a viable alternative system of after-hours, affordable GP-type care that can be accessed in a timely manner, targeting those whose needs cannot be met through standard-hours services and who do not require hospital–based care. However, this will not solve the issues of patients spending days in emergency departments waiting for beds on the wards and this ongoing problem needs to be addressed urgently.”
Background
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
Contact
Andre Khoury
ACEM Public Affairs Manager
03 8679 8813
0498 068 023
[email protected]