Hospital crowding major killer

THE PATIENT PATIENT: Gordon Power had to wait 20 hours for a bed at Wellington Hospital. Growing pressure on the emergency department - partly driven by an influx of people with influenza symptoms - has forced the hospital to consider a 'risk-sharing' plan that could send patients to other departments for supervision within six hours of being assessed.
THE PATIENT PATIENT: Gordon Power had to wait 20 hours for a bed at Wellington Hospital. Growing pressure on the emergency department - partly driven by an influx of people with influenza symptoms - has forced the hospital to consider a 'risk-sharing' plan that could send patients to other departments for supervision within six hours of being assessed.

Emergency department overcrowding and delays for hospital beds kill the same number of people as road accidents, researchers say.

The Australasian College for Emergency Medicine review concluded that overcrowding and delays in hospitals were the most serious issues confronting emergency departments.

In Australia, the problem is estimated to cause 1500 deaths a year, rivalling the country's road toll.

New Zealand's road toll stands at 389 for the past 12 months but emergency department specialists say it is impossible to measure the impact of overcrowding in New Zealand hospitals.

Christchurch Hospital emergency medicine specialist Professor Mike Ardagh said a shortage of hospital beds was a significant problem in New Zealand but it was difficult to quantify how many deaths it caused.

"Emergency department overcrowding is bad and certainly leads to adverse outcomes for some patients probably deaths, based on the Australian data, and certainly delayed treatment and prolonged suffering."

The Australasian review said those with unplanned hospital admissions, including the elderly, mental health patients and those with undiagnosed critical illnesses, were most vulnerable.

They could face communication and medication errors, and delays in receiving antibiotics, pain relief, and care for heart attacks and other serious conditions.

"They don't actually die in the emergency department," Ardagh said. "They often die some days later in the wards, probably due to delayed antibiotics and so on which makes them a little bit sicker than they would have otherwise got."

The college, which is hosting an international summit on the issue this week, recommends an increase in beds.

Reports of patients waiting for treatment in corridors have plagued many New Zealand hospitals, with Christchurch emergency department specialists attributing the problem to their inability to move people to beds elsewhere.

Ardagh said a 15 per cent increase in beds would help address the problem, as would better use of the beds available.

Hospital general manager Mark Leggett said the hospital was only at full capacity two or three times a year.

"To say that simply increasing the number of beds is the answer to improving patient flow and outcomes would be to seriously underestimate the complexity of the issues involved."

 

The Press