Palmerston North Hospital's emergency department is the worst in the country for making patients wait more than six hours for treatment, discharge or admission to a ward.
MidCentral District Health Board's poor performance has prompted the Ministry of Health to implement weekly monitoring of its attempts to do better.
But the goal of getting more than 95 per cent of patients in and out of the department within six hours, to comply with national targets imposed by Health Minister Tony Ryall, remains elusive.
MidCentral saw its figures for waits of less than six hours slump from 86.3 per cent last quarter to 84.6 per cent in the three months to the end of September.
The figures comparing the performance of the 20 district health boards against the targets were released yesterday.
"We have tried everything," said hospital advisory committee chairman Jack Drummond.
"I just don't think we have buy-in from clinical staff.
"Most doctors don't even know who Tony Ryall is, or care about the six-hour rule. They care about their patients."
He said doctors were anxious to ensure they had done enough tests to avoid missing a serious illness, and waiting for results could take time.
The operations director for hospital services, Lyn Horgan, said long stays in the department were undesirable. They were linked to overcrowding, and less privacy and dignity for patients. Patients who moved thorough the department more quickly were more likely to get better sooner.
The main reasons put to the board committees for the delays were hospital beds being already full, especially in isolation rooms, nighttime staffing shortages, and patients arriving in surges rather than as a steady flow.
An increase in the number of people coming to the department through the winter months had compounded problems in the last quarter. An extra 475 patients came in compared with the previous quarter, with a total of 10,347 people seen, including an influx of children aged 14 and under.
A new project was launched in August to speed the process through the department, with a patient flow co-ordinator appointed.
Ms Horgan said the efforts had seen the figure for October improve to 89 per cent of patients leaving the department within six hours.
Of the five other targets, MidCentral Health continues to exceed goals for infant immunisation, timely access to cancer treatment and the number of elective operations carried out.
It still falls below targets for more heart and diabetes checks, and providing better help for smokers to quit, but is in the top half of the league table for both and making progress.
HEADED FOR FINE
MidCentral Health has gone halfway towards copping a $1.4 million penalty because some people have been waiting more than five months for operations they were promised.
At the end of September, 17 people were in that situation, and at the end of October, the number had risen to 30.
The elective services performance indicator will have been sitting on red for two months.
If the waits continue for four months, a monetary penalty can be imposed.
But hospital services operations director Lyn Horgan said efforts to clear the backlog should improve performance by the end of November, turning the status down from red to yellow.
Already, 15 of the 30 patients waiting had a date for surgery, she told yesterday's meeting.
She said most of the problem had been related to orthopaedics due to staff shortages.
Palmerston North Hospital had trouble recruiting enough orthopaedic surgeons, and one it did have had significant other commitments with training and examining younger doctors.
- © Fairfax NZ News
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