The Australasian College for Emergency Medicine (ACEM; the College) is distressed by tragic media reports from Queensland that continue to highlight the state and nation’s acute hospital access crisis.
Emergency clinicians in Queensland share the concerns of colleagues across the country about whole of healthcare system issues leading to dangerous bottlenecks in emergency departments that are putting patient safety at risk. For the safety of the entire Queensland community, these issues need to be addressed.
ACEM President Dr John Bonning said, ‘This latest report is incredibly distressing, and sincerest condolences extend to the family involved’, said Dr Bonning. “We hope that every available support is afforded to them at this incredibly difficult time.”
Addressing the immense pressure currently being faced by emergency departments across the country, Dr Bonning said it had become far too common for patients to spend upwards of eight, 12, or even 24 hours waiting in emergency departments for admission to inpatient beds or other care following their initial assessment and treatment in emergency departments.
“This indicates system failure,” said Dr Bonning. “Problems occurring in emergency departments across the state and country are because of whole-of-healthcare system issues. These issues are leading to delays in admitting sick and seriously injured patients from EDs into more definitive care.”
Recent research has shown that a person arriving at an emergency department experiencing access block for admission to inpatient beds is 10% more at risk of dying over the next seven days, compared to a person who arrives at an emergency department which is not experiencing such bottlenecks.
“The massive demand for emergency care happening across Queensland and the country represents a continuation of trends we have been seeing for years,” said Dr Bonning. “More patients, and particularly more sick patients, are continuing to present in greater numbers to emergency departments, while systems have failed to keep up with demand.”
The College recently called for greater state/federal cooperation to address what is now a national crisis. Better data will also be key to understanding where resources need to be targeted to make this happen. The College has developed Hospital Access Targets, based on the best available evidence, which will support governments to do this.
ACEM Queensland Faculty Chair Dr Kim Hansen said, “Emergency clinicians will always do their best to provide the highest possible standard of care, but emergency departments are not set up to provide that care for long periods. EDs need systemic support to allow patients to transition from emergency departments to the next stage of their care.
“These are complex systemic problems requiring complex solutions. More staffed inpatient beds are part of the answer, but systemic issues like workforce sustainability, extending out-of-office hours access to other hospital services and specialties, including advanced diagnostics must also be addressed.
“While recent announcements we have seen from the Queensland government may have some impact, greater vision and commitment in the longer term, as well as immediate measures are needed.
“The current situations is unsustainable. Patients are being put at risk and the immense pressure is taking a toll on emergency department staff. This is a matter of life and death, and the situation must improve.”
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