Patients are still waiting too long for emergency medical treatment at Wellington Hospital, prompting a call for extra beds.
Capital and Coast District Health Board is also looking at creating an observation area for people who have been treated in the emergency department but cannot leave.
"We are one of the few DHBs that don't have this," chief executive Mary Bonner told a board meeting yesterday.
She also said an additional doctor would work a night shift at the department from next month.
The measures follow more than three years of failing to meet the nationwide target of 95 per cent of emergency department patients being admitted, discharged or transferred within six hours.
The board aims to reach the target by June.
It achieved 82 per cent in the latest results published by the Ministry of Health - the worst out of all 20 district health boards, but better than 67 per cent when it was first measured in 2009.
Approval was being sought to put more beds into the hospital in time for the winter influx of patients, Mrs Bonner said.
However, board member Keith Hindle said it was not "just a seasonal thing" because demand was constantly increasing.
Mrs Bonner said an additional medical registrar would be working nights from early March.
However, not being able to shift patients from ED to full wards was a "whole of hospital" problem.
"If we get to 92 per cent occupancy, we get into trouble."
The hospital was running at 94 to 100 per cent occupancy last week, she said. A report by a PricewaterhouseCoopers health consulting team on work completed so far to address the clogging of the emergency department was due later this month.
It would also evaluate patient flow and include a list of suggested improvements.
Steps have already been taken to improve the department, including an $800,000 refurbishment in 2010, when a space was created for treating minor injuries, as well as a private area to assess people when they arrive.
Deputy chief medical officer Grant Pidgeon said reviewing the triage process and improving the transition of patients from ED to the wards had also helped cut wait times. Last year, the majority of patients were either discharged or admitted within seven hours and 42 minutes, shaving just over two hours off the 2011 time.
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