Emergency numbers up but waiting time down

LIB WILSON
Last updated 05:00 18/01/2014

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Thousands of people have spent part of their summer at Waikato's emergency departments - but their time in the waiting room was shorter than usual.

Fewer people are facing long waits as Waikato District Health Board inches closer and closer to meeting the government set target of having 95 per cent of patients admitted, discharged, or transferred from the ED within six hours.

The Waikato's five EDs saw 102,598 patients in 2013, an increase of 1.3 per cent on the previous year.

Yet in the October-December quarter for 2013, 94 per cent of patients got through within six hours - just 1 per cent shy of the Ministry of Health target.

That's a 88 per cent improvement in the same period for 2012.

However, it looks like Waikato's emergency emergency departments may still have a busy year.

In the first 15 days of January, Waikato Hospital saw 2732 patients, or approximately 182 a day.

The daily average for January 2013 was 175.

Thames also experienced a slight increase, with around 50 presentations per day so far in 2014, compared with an average of 48 per day last January.

Waikato Hospital assistant group manager Jo-Anne Deane said new approaches to dealing with emergency patients had helped reduce wait time.

"We asked ourselves, is it appropriate for someone to wait more than six hours in an emergency department? The answer of course is no," she said.

There were three main elements behind the improvement, Ms Deane said - work within the emergency department, smooth transitions to inpatient admissions, and a primary care partnership.

The primary partnership involved Midlands Health Network, accident and medical centres, and St John, and helped make sure patients were treated in the most appropriate place, she said.

"ED is good at doing acute and urgent. Unfortunately people who don't fulfil that category can end up with delays, and that's not necessarily a helpful thing for them. So we need . . . a partnership approach between primary and secondary care."

More emphasis was also put on front of the house in the emergency department, with patients assessed from the outset and streamed to appropriate destinations.

Options included primary care such as a family doctor or accident and medical centre, or Midlands Health Network programme Primary Options, which provides for treatment in the community for certain patients with acute illnesses.

And those with ongoing health needs were encouraged to reduce the load on emergency departments over holiday periods by visiting their doctor beforehand for routine tests or to organise prescriptions.

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The partnership model was the start of a fundamental shift and ongoing discussion with all parties involved would ensure it continued to produce results, Ms Deane said.

And Midlands Health Network chief executive John Macaskill-Smith agreed a different approach was paying dividends.

"It seems that we have kept the lower end of stuff that can be treated in primary care out of there [emergency departments] which is great."

He said subsidised care at select accident and medical centres on the non-statutory days between Christmas and New Year seemed to have stopping many people heading to the emergency department to avoid the expense.

The district health board was looking at replicating this around upcoming holidays.

Another improvement was the after- hours response service launched in September 2013, Mr Macaskill-Smith said.

Patients could call a single number and speak to a trained operator who could give them advice or assistance, and some patients could be helped without leaving home, he said.

Also, the Primary Options programme looked at which services traditionally accessed in emergency departments could be managed in primary care.

This freed up space in emergency departments and was more cost-efficient, he said. 

- Waikato Times

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