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Canberra Hospital Ranked 15th Busiest Australian Public Hospital

By Grumpy Smurf - 5 July 2008 18

Driving to work this morning I heard the whiney one (aka Katy) telling me that Canberra Hospital raked 15th busiest of Australian Public Hospitals…. And that this was a good thing?

Ok, is it just me, or is Canberra small (population wise) in comparison with other major cities in Australia – wouldn’t this then lead you to think that if our largest public hospital is ranking highly as one of the busiest in the nation, then there’s something wrong with healthcare in the ACT? (Nothing against the staff, they’re doing the best they can, but the policy, administration and funding.)

My reading of this claim is that we don’t have enough health care facilities, that people wait until they’re very sick, then present to the hospital.

I was recently directed by an after hours GP to attend casualty. I sat there for seven hours before deciding I’d rather die in my own bed. During this time I watched a waiting room of over 35 patients (not including carers) dwindle to five – not through these patients being treated or admitted, but through walking out due to sheer frustration with the system.

If Canberra Hospital is 15th busiest now – where would it rank if they included all the patients that DON’T get seen?

One would hope that those patients who left either didn’t require emergency care, or were able to seek treatment elsewhere. Either way this leaves me to thinking that there is something wrong with our healthcare system.

Our illustrious Health Minister also went on to quote stats on how our hospital beds per 1000 had increased by 0.1 of a percent (while still being 0.3% below the national average). Maybe if we invested some of the $1 billion allotted to Health on preventative care and additional public health centres, we wouldn’t need the extra beds to begin with.

When will we have a minister focused on a Health Care system not a sick care one?

What’s Your opinion?


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18 Responses to
Canberra Hospital Ranked 15th Busiest Australian Public Hospital
gun street girl 9:17 am 06 Jul 08

Apologies for the triple post, but the following is a great insight into what’s going on at present – highly recommended:

http://www.impactednurse.com/?p=517

gun street girl 9:10 am 06 Jul 08

…And it’s official – I suck at HTML tags.

gun street girl 9:08 am 06 Jul 08

imhotep said :

Wrong. YOU try sitting in a cold, uncomfortable waiting room with a sick child for hours on end. Have we reached a situation where staff regard anyone who will ‘survive’ until morning as non-urgent?

When the acute area of the ED is full of people who [i]won’t[/i] survive if they don’t get attention – then yes, the people with discomfort and misery, but no life-threatening problems will be left until later. It sounds harsh, but essentially, there’s a difference between what the public (and health care professionals) perceives as appropriate triage, and how the system must triage according to the whittled down resources currently afforded to it. Let’s get one thing straight: nobody goes into nursing or medicine with the intent to ignore somebody in distress. The opposite is true – most people pursue this path with the desire to help people in times of need. We don’t take delight in not being able to deliver top-notch care – the fact that we [i]can’t[/i] is much of the reason for staff morale being as crappy as it is. We don’t like the fact that people have to wait – both to be seen, and to get a bed on the wards. And before you try telling me to sit in an ED waiting room – save your breath. I’ve been on both sides of the fence – as a health care consumer, and as one of the people working in the ED. I know what you’re talking about.

The idea of opening more emergency departments is a little short sighted. The health care crisis is NOT limited to the emergency departments. Opening more departments won’t affect patient care in the end. Staff shortages are across the board, not just the ED. The reason we hear so much about the ED is because a) it’s the public face of the hospital – it’s the first point of contact for the public, but merely reflects what’s going on in a bigger sense and b) waiting times and bed block are a quantifiable measure by which political parties are judged, therefore, we hear a lot about them in the media. If we moved more of our medical and nursing staff down to ED, or opened a whole new department, and ensured [i]every[/i] patient who presented to the ED was seen immediately, where do you think the admitted patients would go? The problem is lack of flow – access block is the real problem. It’s our ability to find them a bed on the ward, to get timely access to investigations and treatments for inpatients, to find theatre time to operate on them, and to move patients through and out of beds after treatment – that’s where the issue lies. If there’s no room inside a house, it’s only natural that you see a bunch of visitors hanging around at the front door, because they can’t move any further. That is essentially what you see in our ED.

imhotep 9:24 pm 05 Jul 08

gun street girl said :

The people who come to the ED, wait for a few hours, then go home rarely come back. Why? They aren’t that sick to begin with.

Wrong. YOU try sitting in a cold, uncomfortable waiting room with a sick child for hours on end. Have we reached a situation where staff regard anyone who will ‘survive’ until morning as non-urgent?

I was an emergency admission myself at TCH 2 years ago (road accident). I I remember being parked in a corridor waiting for XRAY next to an old woman who was calling softly for help from the time I was parked there until the time I left, about an hour later. NO-ONE stopped to see how she was.

I remember being in the ward at night, listening to the ‘overworked’ staff at the nurse’s station doing bugger-all for most of their shift. I left vowing never to return.

Morale at TCH is bad, and I believe it reflects on patient care. If I’m sick, send me to St Vincent’s in Sydney. I don’t care if I die on the way.

bundahgirl 9:14 pm 05 Jul 08

Ummm, nice idea peter@home. However, you need doctors on site 24 hrs to have an Emergency Dept, CJJMH, as a private hospital, doesn’t have doctors on site after hours.
They always have to be called in. Thats why we all go to TCH or Calvary if we need medical care after hours.

How about some of the GP’s in this town bulk bill? Now there’s a novel idea, so those of us that dutifully pay our medicare levy every year can access a GP and not have to pay $60 up front. Thats why ED’s are busy, as half the people there should be in their GP’s waiting room but can’t or wont cough up the cash up front. Then those who need emergency care wouldn’t be crowded out by those with sniffly noses etc. I remember hearing a story at a party of a person who called an ambulance and went to ED @ because she hadn’t had a shit for 5 days. I’m serious. One giant turd later she was sent home again.
Just to cheer you all up!

peter@home 8:57 pm 05 Jul 08

Look, the one thing that would help us all out would be for the JJMH to open an emergency section. I am fairly certain that it has been considered, and would alleviate some of the load on TCH. another option would be to build a hospital down south – this would enable cooma patients to come to a closer location, and allow the ANU to have more expansion for their medical school.

If I am paying for more beds / doctors etc, I want them to provide them.

JC 5:36 pm 05 Jul 08

It is neither a good nor a bad thing. It all depends upon how good the care is, not how busy the place is. The hospital is quite large compared to many in the country, so it is no surprise it is so busy.

gun street girl 1:54 pm 05 Jul 08

The road tranfers from the mountains may well go to Cooma first, but it’s not uncommon for the Cooma Hospital to take a primary look at the patient, decide they are too complicated or sick to be dealt with there, and then send them onto us via road.

ant 1:47 pm 05 Jul 08

That’s interesting, I was told the roads went to Cooma. Sounds like they’re then trucked up the road!

It’s an intriguing question though, that the ski fields contribute such a load during winter. Someone who lives near Woden Valley Hospital reckoned that in peak season, the helicopter is going over head “constantly”. We had a few visits from it at Charlotte Pass, one such was at night, we all had to stand in a circle with flares to give it landing guidance.

Who’s paying for all this?

gun street girl 12:01 pm 05 Jul 08

I seem to recall a study suggesting that the ACT was getting the rough end of the deal regarding NSW/ACT funding deals (though cannot remember details – so may well be incorrect in my recollections). For the adult population, TCH can cater for everything except organ transplants. The same cannot be said for the NSW regional districts that we service.

We get an awful lot of road *and* air transports from Cooma this time of year. Again, they are limited in what they can cover there – there are heaps of “non-urgent” tranfers by road that come to us from Cooma during the ski season – Cooma certainly doesn’t keep all that don’t need to be choppered out urgently. Same goes for other regional centres – it’s not just the Southcare transfers that we have to deal with – it’s the road transfers as well.

ant 11:55 am 05 Jul 08

I believe that there is a reasonable funding agreement in place to compensate for all the NSW patients taken to Canberra. We have to send quite a few of our people to Sydney hospitals and treatment centres too.

I would be interested to know how they cost out and re-coup the costs of the emergency skifields injuries though. The road evacs usually go to Cooma, but the heli-vacs come to Canberra (via our Southcare helicopter).

bundahgirl 11:20 am 05 Jul 08

Re: % of NSW clients:
I cant locate the original media release by Katy Gallagher, it may have been deleted, but here is a link to the information it contained http://www.maryporter.net/node/1590

gun street girl 9:26 am 05 Jul 08

bundahgirl said :

I agree.
TCH is the only tertiary care hospital between Sydney and Melbourne. In 2007 it discharged 10% of patients to NSW addresses.
However, many problems are evident at TCH, and many other large public institutions too, which are unrelated to cross border care levels. These include
High management turnover
a long history of direct interference at all levels of service delivery by politicians and senior management
insufficient funding for basic equipment
High levels of ‘personality’ issues leading to horizontal violence and workplace harrasment
a general feeling of powerlessness on the part of the patient care staff
Despite this TCH does a great job, and has a great health care team and is trying constantly to improve quality of client care despite the factors listed above.

Amen, amen, amen to the list of problems (and could add to them too!).

Anecdotally, I would have thought we were admitting more than 10% of patients from NSW addresses.

bundahgirl 9:21 am 05 Jul 08

I agree.
TCH is the only tertiary care hospital between Sydney and Melbourne. In 2007 it discharged 10% of patients to NSW addresses.
However, many problems are evident at TCH, and many other large public institutions too, which are unrelated to cross border care levels. These include
High management turnover
a long history of direct interference at all levels of service delivery by politicians and senior management
insufficient funding for basic equipment
High levels of ‘personality’ issues leading to horizontal violence and workplace harrasment
a general feeling of powerlessness on the part of the patient care staff
Despite this TCH does a great job, and has a great health care team and is trying constantly to improve quality of client care despite the factors listed above.

gun street girl 9:15 am 05 Jul 08

TCH has a larger feeder population. It services approximately half a million people when you count the south-eastern NSW districts that are covered by our service. That kind of helps put things into a little more perspective.

The people who come to the ED, wait for a few hours, then go home rarely come back. Why? They aren’t that sick to begin with. The “Did Not Wait For Treatment” coded patients (which, incidentally, are a minority) rarely re-present to the ED – and it’s not because they went home and died! The people you see in the waiting room are really only the tip of the iceberg. That’s really not the sole reason why the ED is so busy – it’s the really sick people – in the acute area of the ED, and in the wards upstairs – that really suck the resource pool dry.

Preventative medicine is a good idea, but it won’t solve the problem of increasing age and frailty. Patients are coming in sicker and older, and they take longer to get better. No amount of preventative medicine will stop them getting old. At the moment, what TCH desperately needs is more beds. Patient flow is impossible when you can’t move them.

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