Among the many issues raised by the program was the increasing pressure facing hospital Emergency Departments (EDs) and staff around the country, as they struggle to keep up with increasing demand.
 
New hospital access block survey data obtained by ACEM shows Australian EDs are more crowded than ever before, with the figures representing the worst overcrowding ever reported in these biannual snapshots that have been undertaken since 2007.
 
Caring for patients waiting for hospital beds represented one third of the ED workload, and in large hospitals this figure was over 40%, the survey of hospital EDs taken at 10am local time on 2 September 2019 revealed. Additionally, 132 patients were identified in 40 hospitals with dangerously long wait times of more than 24 hours.
 
Although there has been little change in demand for admission to wards over the past four surveys, the number of patients waiting in the ED for inpatient beds was 25% higher than in September 2018. The resultant overcrowding meant 21% more patients chose to leave the ED rather than face excessively long wait time to be seen.
 
Insufficient inpatient beds, resourcing in EDs and systems to improve patient flows through the hospital can all contribute to preventing patients from leaving the ED for more suitable, longer-term care environments.
 
All of this leads to access block – where people are waiting in the ED for longer than eight hours for an inpatient bed. The consequences of this can include ambulances ramping in front of the hospital unable to unload patients and respond to further calls for help; and worse patient outcomes, including the heightened risk of medical errors and delays to treatment.
 
ACEM President Dr Simon Judkins said patients and staff in EDs will continue facing increased risks unless major improvements are implemented across the board.
 
“We are seeing Australian hospital EDs under more pressure than ever before, and urgent action is needed to address the issues and ensure patients are receiving the care and treatment they require,” said Dr Judkins.
 
“The gridlock in EDs means staff struggle to do their jobs in hallways and waiting rooms, and the risks to patients are heightened.
 
“In some jurisdictions, we have seen deficits in managerial and medical leadership, and failures to engage in solutions. We need buy-in from all levels of hospital management and inpatient teams, to get admitted patients out of EDs via whole-of-hospital solutions that not only address bed and staffing levels, but also look at how hospital patient flows and transfers are managed.
 
“We also need greater accountability from hospital management, and repeat our call for all states and territories to embrace a national standard which ensures that no patient is left waiting for 24 hours or more in an ED to receive the treatment they need. ACEM supports mandatory reporting of 12 and 24 hour ED waits to the CEO and the relevant Health Minister respectively.
 
“The tragic and harrowing cases covered by the Four Corners program are unacceptable, and highlight many shortcomings in Australia’s healthcare systems. It is crucially important that all with responsibility for the care of patients learn the important lessons and work towards improvements to minimise the risk of similar cases happening in the future.”

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
 
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