Australasian College for Emergency Medicine (ACEM) Tasmania Branch Chair Dr Juan Carlos Ascencio-Lane said that bed block is not caused by people presenting to the ED but when patients needing hospital admission cannot move through the system quickly enough.
"If there's one thing emergency physicians want you to know about bed block and ED overcrowding, it's this: it's not caused by people coming into the ED seeking care,” Dr Ascencio-Lane said.
“The problem is the lack of hospital beds for patients needing to be admitted but with nowhere for them to go, and the lack of aged care, disability, and community care places for patients once they're ready to leave.”
“Patients who come to the ED with a minor injury or illness are usually treated quickly. They don't need the beds, the specialist teams or the equipment that our sickest patients rely on to survive," Dr Ascencio-Lane said.
“However, when there aren’t enough beds available in the hospital, the emergency department backs up, waiting rooms fill up, and ambulances ramp outside because there’s simply nowhere to put our patients. Care slows down for everyone.
“EDs are always open for people needing emergency care. They have been designed to absorb short-term surges in demand. However, the pressure no longer comes in waves. For many EDs, it is constant.”
Dr Ascencio-Lane said that bed block is caused by under-investment across the whole health system, meaning EDs are being forced to function as overflow hospital wards while still trying to respond to medical emergencies at the front door. In addition, pressure on aged care, disability care, mental health and community services also flows directly into EDs.
He said that while alternate care options such as urgent care clinics and GP access were a valuable piece of the puzzle, greater capacity across the whole health system was needed to ease the key pressure points on EDs.
“Patients requiring ED expertise but not needing admission are not the source of bed block,” Dr Ascencio-Lane said.
“Emergency departments cannot solve bed block on their own. This requires whole-of- health system leadership and accountability,” he said. “Governments need to work together to increase hospital bed capacity and ensure those beds are properly staffed so admitted patients can move through the hospital in a timely way.”
“We also need more investment into residential aged care and post-hospital care options for patients awaiting aged care or NDIS accommodation, in order to reduce delays to care for people who have completed their hospital admission but need extra care in the community to allow their safe discharge.”
“ACEM will continue to work with the Government to address these issues and improve healthcare for everyone in Tasmania.”
Background:
ACEM is the peak body for emergency medicine in Australia and Aotearoa New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
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