Please don’t wander into the Emergency Department pleads the Chief Minister

By 20 May 2012 35

Chief Minister Gallagher is asking Canberrans to stop making her emergency department numbers even worse by coming in for non-emergencies.

Instead she suggests these alternatives:

– Community Pharmacist – your local pharmacist is qualified to give you expert advice on many health issues;

– healthdirect – call 24 hours a day seven days a week on 1800 022 222 for free expert advice and reassurance;

– Walk-in-Centre – for one-off treatment of minor illness and injuries for those over the age of two, see a specialist nurse seven days a week from 7am until 11pm, at Canberra Hospital;

– GP surgery – for ongoing comprehensive health care for everyone, including those with acute problems, children under two years and those who have complex medical problems, your GP is your best option; and

– CALMS – 1300 422 567, the call centre is open weeknights from 6pm and all day weekends and public holidays, with CALMS clinics open from 8pm.

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35 Responses to
Please don’t wander into the Emergency Department pleads the Chief Minister
Mr Evil 10:51 pm
21 May 12

For God’s sake, people – Katy just wants all you selfish, whinging, ungrateful bastards to stop getting sick and injured: is that really too much to ask in this day and age????

And while we’re at it – isn’t it time you all got back to the salt mines, you bloody lazy bludgers!

miz 7:46 am
22 May 12

It would really help Emergency if the Walk in Centre could treat a broader range of ailments. Eg, it can treat a UTI, but if you have any back pain whatsoever, that ‘could’ be a kidney infection, and up you must go to Emergency. This sort of thing is just plain silly.

BimboGeek 8:23 am
22 May 12

Just to point out that there is a bit of culture gap at work here. Some of you are trying not to cause a nuisance and staying away from EDs even when quite sick or injured.

They are more concerned with grannie drops, princesses with grazed knees, panicked hypochondriacs and other genuinely minor problems that can seem major to the helpless idiot suffering them.

In Britain the “don’t come in unless you are dying” culture was so ingrained in some people that they had to run ads going “actually these things are emergencies, come in please!”

supamum 1:23 pm
22 May 12

katkat said :

Every time I’ve called Health Direct they’ve told me to go to the ER, and most of my friends (who have called) have had the same experience. That line seems to be driving up numbers at the ER rather than reducing them.

Same for me, with my children. They alway say we recommend you see a doctor in the next 4 hours…. Ok so its 10pm guess we’ll have to go to the hospital.

snoopydoc 8:52 pm
22 May 12

Health Direct (the phone advice line) is necessarily risk-averse. It is exceptionally difficult to adequately assess the nature, extent, and potential risks of a patient’s condition over the phone. Despite the wonders of the information technology age, actually laying eyes and hands on a patient is still far and away the best, most accurate and safest way to figure out what the hell is going on with you and make a sensible and safe decision about what needs to be done about it.

The Walk-In Clinic is _very_ good at sorting out minor/simple problems, however there are two things worth keeping in mind. Firstly, it is staffed by nurses. They are very experienced, senior nurses, with specialised extra skills and training in a wide range of practice, however they are still limited by very specific and rigid operating guidelines. Secondly, these guidelines are there for a reason, predominantly that what _you_ might consider minor and/or simple and what health care practitioners consider minor and/or simple can be (and often are) two _very_ different things.

Patients presenting with minor complaints that are not really appropriate for the Emergency Department do, indeed, clog up the works a little bit. However, it’s worth keeping in mind that in fact this group of patients doesn’t actually inhibit the provision of acute/critical care to those patients who _do_ have “proper” emergency conditions to any significant extent. It makes the waiting room a hell of a lot more full, and it results in a higher number of people giving up after a long wait and leaving (interestingly, this is one of the statistics that excites and frightens politicians the most, but which is of minimal importance in terms of actual bad outcomes for the public, or the functioning of an emergency department).

Clinics aimed at relieving the demand created by minor ailments do not reduce the number of presentations to, or workload of, emergency departments, but they _are_ a very good way for politicians to be seen to be doing something active to address the problem without actually addressing the underlying more relevant causes of emergency department overloading and dysfunction. Providing more acute inpatient hospital beds (what we actually need) just isn’t as publicly noticeable or sexy as building a shiny new clinic. Such clinics _are_ very useful, however, and almost certainly reduce the demand for “regular” GP appointments for minor injuries and ailments.

The CALMS after-hours GP service is excellent, and information about them can be found here:

One previous commentator complained that there is a broken path to the fee structure. The website above clearly indicates that the maximum out of pocket expense will be $35. If the CALMS doctor thinks you need ED assessment or treatment, they will send you to ED, with a detailed referral letter and they will also have discussed your case with a senior ED doctor before you get there. Unfortunately, this does not mean you get to “jump the queue”, and you will still be triaged, just like everybody else. (Incidentally, arriving by ambulance is also not a ticket to bypass triage).

The causes of long ED waits, overcrowding and inefficiencies are many… but too many people presenting with minor “non-emergency” problems is not a major player.

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