Health system coping despite hospital bypass

Canberra Health Services say that despite last night’s emergency bypass at Canberra Hospital, Canberra’s health system is coping with the current periods of heightened demand.

An incident at the Bimberi Youth Justice Centre triggered the emergency bypass at 8:30 pm last night. Seven Bimberi Youth Justice Centre staff members were taken to hospital on Monday night (26 August) after a riot took place at the centre.

A code brown was triggered at Canberra Hospital and lasted for about two hours. This is an emergency management plan that is activated for external disasters.

“Canberra Hospital was already experiencing high demand yesterday,” Minister for Health Rachel Stephen-Smith said while addressing the media this afternoon.

“When the incident occurred the hospital determined that they should call a code brown and made the decision to put the hospital on ambulance bypass as a risk management measure.

“No ambulances were diverted to Calvary Hospital but it was an important risk management measure,” Ms Stephen-Smith said, while assuring that such measures are rarely taken and only under special circumstances.

The emergency bypass was the fourth one put in place this year. There have been three other occasions on 20 May (for 2 hours), 1 July (for 30 minutes) and 14-15 August 2019 (for 4 hours).

Canberra Health Services said that only stable patients that meet appropriate criteria are diverted. Paediatrics patients, those with life-threatening emergencies, and trauma patients are always taken directly to Canberra Hospital.

Canberra Health Services CEO Bernadette McDonald told Region Media that the demand on emergency departments has been very high since the end of June.

“The flu season peaked earlier than last year and demand is higher. We’ve had to have extra beds open, and extra staff on. We got to the point (on 14 August) where just about all our beds, with the exception of some in the ICU, were full,” Ms McDonald said.

“In order to keep everybody safe and make sure that patients get treated in the right place at the right time, we asked Calvary to work with us and for ambulances to be diverted there for a number of hours.

Ms McDonald said such a decision is not made lightly and is made in consultation with senior hospital staff.

“I think it worked extremely well. It gave us a little time to breathe so that we could manage that demand.

“It’s pretty phenomenal to be honest, and they [hospital staff] do this every day. They are under pressure and demand every day, and they always lift and they do it extremely well, providing excellent care to our community.”

A Canberra Health Services spokesperson said it is implementing changes as part of its Timely Care Strategy, a whole-of-hospital approach to access and patient flow.

“We would like to remind the community to only attend emergency departments in a genuine emergency.

“Our free walk-in centres are open every day until 10 pm and many GPs offer after-hours appointments. They are perfect for one-off treatment of minor injury and illness, such as colds and flu, cuts and sprains and bites and stings.

“The public can also see their GP for treatment of non-life-threatening conditions and symptoms such as headaches/migraines, vomiting, diarrhoea, colds and flu, backache, earache and mental health,” the spokesperson said.

The executive director of the ACT’s peak health consumer advocacy body, the Health Care Consumers Association, Darlene Cox, said part of the issue is safely discharging patients once they have been treated.

“We’ve got a system that’s under incredible pressure and when it’s winter, it’s under even more pressure,” Ms Cox said.

“Yes, we’ve had unprecedented demand with the number of people being admitted, but at the same time, we have to have a process where people can be discharged safely back to their homes or other facilities, whether that’s a nursing home or public hospital or back to their own homes.

“At the moment there are some delays around discharge. I think we have to recognise that we have a system where there are peaks and troughs and there has to be the flexibility to ramp up and down to accommodate that.”

Ms Cox reinforced that people first consider Canberra’s walk-in centres and described them as one of the hidden jewels in the system. Consumers can also use the ACT Health Directorate app that has the emergency walk-in centre wait times for all three walk-in centres at Belconnen, Gungahlin and Tuggeranong.

She said that while they are also very busy, the app can help make a decision on which walk-in centre is best placed to offer treatment. There is also the home doctor service and community pharmacies that can assist with minor issues.

“This is not a simple issue and it really shows the complications of humans and the way we view our health and the understanding of the system,” Ms Cox said.

“When it’s a major issue like a two-year-old with a temperature of 39 degrees, you go straight to the emergency department, as there are times when you don’t muck around and you will be triaged appropriately.”