17 July 2009

Pig sniffles to excuse elective surgery failures?

| johnboy
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The ABC reports that the eminently predictable flu season has once again taken the ACT health bureaucracy by surprise:

    More than 9,500 people presented to ACT public hospital emergency departments in June, making it the busiest month on record.

    Health Minister Katy Gallagher says most of the increase can be attributed to swine flu and there have been 383 confirmed cases in the ACT.

    She says if demand does not drop off, then patients will face longer waits in emergency departments, and some elective surgery may have to be postponed to free up beds and operating theatres.

With a growing population we can pretty much expect any given winter month to be a record.

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Yes.

The selection criteria for the administrators should include coal-face experience. It’s completely illogical to do otherwise. And there should be regular meetings with all the stakeholders involved or their representatives. The people on the ground would probably have very sensible suggestions if they knew exactly what problems were facing administrators, and the administrators should never lose touch with the human face of the system, the staff and patients they are there to provide services to.

Everything shouldn’t have to be such a battle for everyone all the time.

gun street girl8:27 pm 18 Jul 09

Actually, I’m not really the exception, rather than the rule. Most people in the public system are there because they care – nobody wants to see bad outcomes for their patients. It’s easy to assume that hospital workers are there for glory and prestige, rather than a genuine desire to help. Those of us who work in the hospital itself do so with patient positive outcome, rather than statistics and economics, as our foremost goal. As such, there’s invariably a divide between those who are working on the ground (ie healthcare providers at the coalface) and the administrators who only have a theoretical grasp on how the hospital works (who rarely even step foot in the place). The latter group send out directives that are frequently ignored by the former – unfortunately, we don’t often see eye-to-eye.

Good on you, gun street girl! I really admire people who stand up to pressure to do the expedient thing, and do the right thing anyway. It takes a lot of courage and personal integrity, and sometimes means getting passed over in favour of people who are willing to ‘play the game’. But lives are too precious to be played with like that. Thank goodness there are so many people in the health system that genuinely care.

gun street girl7:00 pm 18 Jul 09

Access block affects everyone – it’s not just an ED problem (a shame that the “fix” to the problem always involves more attention/funding to that particular department, which ignores where the real problem is). Personally, I don’t have any qualms about telling management to get stuffed if they try applying the thumb screws to discharge early. I once sent them an invitation to visit my unit in order for them to personally identify the patients who were admitted unnecessarily, as clearly I was keeping people in who would have been better off at home, and obviously needed instruction as to how to do my job properly. Suffice to say, they didn’t accept my kind offer.

Access block is horrible and demoralising to the wards too- the pressure to discharge patients that you feel really need to stay another day or two is immense.

The sydney hospitals are scaling down surgery, as people needing intensive care due to Swine Flu are increasing. It is attacking lungs and people need their blood oxygenated while the lungs are non compis mentis.

gun street girl9:41 am 18 Jul 09

miz said :

On one of my to and fro errands from hosp, I couldn’t help but notice that there were trolleys in corridors and the cas waiting area was ‘chockers’ (no seats left). An emergency staff member mentioned in passing that the lady in the emergency bed next to my son had been waiting for a bed in a ward for THREE DAYS!

This is not uncommon – both the length of wait for a ward bed, and the fact that ambulance trolleys are often banked up (five or six to a corridor), unable to offload. Access block is a horrible, demoralising problem which is not well understood in the media.

Word at the TCH is they ‘stopped’ elective surgery for the last two weeks of the financial year as the hosp was `in deficit’. I think this is unbelievably callous. Because, NOW, there is a HUGE backlog.

Not sure where you got your information from, but my girlfriend went in for an elective procedure 2 days before end of financial year. There were at least another half-dozen patients there at the same time. Maybe theres a difference between elective and emergency elective. It seems emergency elective is getting pushed off while normal elective surgery isnt waiting too long. This seems opposite to how it should be.

Word at the TCH is they ‘stopped’ elective surgery for the last two weeks of the financial year as the hosp was ‘in deficit’. I think this is unbelievably callous. Because, NOW, there is a HUGE backlog.

My son injured one of his limbs and went to hosp by ambo yesterday (Fri). On one of my to and fro errands from hosp, I couldn’t help but notice that there were trolleys in corridors and the cas waiting area was ‘chockers’ (no seats left). An emergency staff member mentioned in passing that the lady in the emergency bed next to my son had been waiting for a bed in a ward for THREE DAYS!

My son was moved to a ward in the arvo thank goodness. But there’s more – one of the patients nearby told us he had smashed his ankle in a motor cycle crash on Monday, and the operating theatres were so behind they could not operate on him until Thursday.

The Doc told us my son should have been operated on yesterday . . . but it was going to be impossible. We are HOPING it will happen today, but I am not holding out much hope as we were advised last night (in the early evening, before the usual Friday night accidents and incidents) there were at least 40 people already on the operation list and they were trying to ‘catch up’ by running four operating theatres from 7am today (Sat). If my son loses the use of his ‘limb’ (can’t be more specific as I don’t want any repercussions) I will bl**dy sue the Health Department.

I also want to add that staff have been absolutely top notch and wonderful throughout, my fury is aimed squarely at Ms Gallagher.

farnarkler said
why doesn’t the government draft in a few military medical staff. I bet the ratio of doctors to patients is a lot lower in the military than the public health system.

because they ae terrible, myartner isin the army and would prefer to payto see a doctorthan use the sub-standard ones provided. Once he needed stitches and was sent home with a bandaid becauseit was almost 4 when the doctor was finishing… its notall like that guy off greys anatomy 😀

gun street girl10:30 pm 17 Jul 09

Ian said :

Katy was quite evasive on the radio this afternoon when asked how these numbers compared with normal months …the June number was around 320 a day. Katy ummed and ahhed but eventually came out with the average per day being something like 140-170 at Canberra and 110-140 at Calvary, ie 250-300. While there is an increase it is not remarkably large.

Depends on the acuity of the cases. If you have 320 presentations of man cold (for instance), you can send them all home – admissions don’t factor into the burden. However, if more of your presentations are significantly ill, then the age-old problem of bed shortage and access block comes to the fore. Judging by the pile up of ambulance trolleys littering the corridors this week, I would say that the latter problem has made itself known – yet again.

According to a mate who was at school with Katy, she’s pretty vague about most things.

Katy was quite evasive on the radio this afternoon when asked how these numbers compared with normal months …the June number was around 320 a day. Katy ummed and ahhed but eventually came out with the average per day being something like 140-170 at Canberra and 110-140 at Calvary, ie 250-300. While there is an increase it is not remarkably large.

They should set up a MASH unit on the grass area over Yamba Dr from the Canberra Hospital.

gun street girl10:12 pm 17 Jul 09

farnarkler said :

I bet the ratio of doctors to patients is a lot lower in the military than the public health system.

Particularly when the medics at Duntroon send in their complex patients to the public hospitals for diagnosis and management. 😉

Anecodotally, the swine flu thing has seen a bigger than usual swell of patient presentations this year.

Just as long as it doesn’t affect the waiting times for those naughty boys in the 5 star jail. If it’s really that bad in the emergency dept, why doesn’t the government draft in a few military medical staff. I bet the ratio of doctors to patients is a lot lower in the military than the public health system.

Do people know there’s a really good place called CALMS at Calvary? Last Sunday morning my son broke a bone in his foot (don’t ask – silly teenager) and I booked him into CALMS. It took a ½ hour to see the doc , get an x-ray and get home. Cost about $80 and was truly worth it. Meanwhile, there would have been at least 50 people in the emergency dept. half with masks over their faces waiting to see someone and looking decidedly ill. I know it costs, but hey – you get it back on Medicare and it’s better than sitting there for hours in pain or feeling sick.

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