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The Australasian College for Emergency Medicine (ACEM: the College) says a state-wide plan is urgently needed to address dangerous capacity and patient flow issues leading to hospital bed block, emergency department (ED) crowding and ambulance ramping in South Australian hospitals.
 
The recent cancellation of elective surgeries in some Adelaide hospitals in an effort to address a backlog of patients awaiting admission to hospital from EDs is the latest escalation of dangerous issues the College has been raising for years.
 
ACEM President Dr John Bonning said:
 
“Cancelling elective surgeries is a short-term measure which, while potentially providing some short-term capacity, can result in further negative impacts on system performance and patient safety down the track.
 
Cancelling surgeries is a reactive, stop-gap measure and should not be seen as the normal way to address the chronic system and capacity issues which have beset South Australian hospitals for some time now. The number of presentations to emergency departments, and increased demand over weekends, are predictable, and it is unacceptable to allow dangerous situations where crowded EDs and ramped ambulances are viewed as normal.
 
It is pressing on hospital managements and the State Government to find plans and solutions in the short and long-term, to address what are increasingly risky situations for patients and staff. For managements and the government to treat this as a surprise, or something to simply be accepted, represents a significant failure of the system and their duty of care to the people of South Australia.
 
Importantly, any response must include finding whole-of-system solutions to ensure timely and appropriate care can be provided to mental health patients, who are disproportionately affected by ED crowding, and dangerously long waits for definitive psychiatric care."
 
ACEM South Australia Faculty Chair Dr Mark Morphett said:
 
“In the current COVID-19 pandemic, crowded emergency departments pose additional risks to patients and staff. With the risk of COVID-19 still so present, it is unethical to allow situations where patients and staff may be forced to wait or gather in dangerously close quarters to occur. Given the overcrowded state of essentially all the emergency departments in metropolitan Adelaide, this state’s acute health system is clearly not prepared for a second wave of COVID-19. We need to learn the lessons of interstate where health care facilities have become epicentres for infection - we simply can’t afford that to occur here.
 
ACEM has repeatedly raised these capacity and system issues for some time but, frustratingly, there seems to have been little, if any lasting improvement. We implore the State Government to genuinely commit to addressing these dangerous and longstanding issues with a comprehensive, state-wide plan. This is particularly urgent as we continue to contend with the COVID-19 threat.”
 
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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