ACEM President Dr Simon Judkins, who will visit the hospital with AMA Queensland representatives, said the two bodies will be seeking the intervention of the Queensland Health Minister if the meetings do not result in satisfactory solutions.
Dr Judkins said the meetings and site visit were necessary because hospital management’s response to concerns repeatedly raised by Emergency Department (ED) staff over capacity and access block issues has so far been a case of ‘too little, too late’.
“For some time now we have been raising concerns that patient and staff safety at Cairns Hospital is being seriously compromised due to the failure to manage demand,” said Dr Judkins.
“We’ve raised concerns that Code Yellow – which the health service is placed under during disaster situations when it struggles to meet public demand for health services – has become a normalised way for the Cairns Hospital to operate.
“When a hospital runs at full demand, the ED bears the brunt. Ambulances are forced to ramp up in front, unable to respond to more people in the community who need help, and staff are placed under incredible pressure.
“Threats to patient safety increase, including through a heightened risk of medical errors, delays to treatment, and the tying up of ambulance resources.
“Not enough has been done. Management must address this unacceptable situation with a whole-of-hospital response that extends beyond just small investments in beds and staff. They need to address how the inpatient units operate and how they manage flow through the wards to help free up ED capacity.”
AMA Queensland President Dr Dilip Dhupelia said people living in the Cairns region deserved access to good quality health services and patient care.
“Cairns Hospital and Health Services and the State Government need to immediately implement solutions to ensure patients are treated and admitted in a timely manner,” he said.
“Any problems with hospital access that could affect patient safety must be addressed immediately,” said Dr Dhupelia.
ACEM and AMA Queensland again urge Cairns Hospital to immediately adopt the following actions to provide some short term relief:
- Open 10 beds in Cairns Hospital that are staffed and equipped to manage acute admissions, not just low acuity patients. These must be distinct from the beds being purchased at Cairns Private Hospital.
- Intervention from the Director General to support the hospital’s executive in complying with and implementing current hospital systems – particularly around managing Code Yellow, enforcing discharge arrangements and inter-hospital transfer policy.
- Enforcement of the existing inter-hospital transfer policy to enable stable patients who are being transferred from another hospital to be assigned directly to the appropriate ward, without going through the Emergency Department.
To address the underlying systemic issues, ACEM and AMA Queensland also urge Cairns Hospital to adopt the following actions:
- Strengthen accountability of the hospital executive and the medical leadership for effective management of inpatient capacity through the current ‘Access to Care’ project. This should include mandatory reporting of 12 and 24 hour ED waits to the CEO and the Queensland Health Minister respectively.
- Ensure that the hospital has capacity to admit patients from the ED as part of a proactive plan for each forward 72 hour period.
“People in far north Queensland deserve a hospital system which ensures the sick and unstable patients who turn up on a daily basis get the treatment they need, and that the pressure on staff is relieved. If tomorrow’s meeting does not yield satisfactory outcomes, we will be left with little choice but to seek the urgent intervention of the Queensland Health Minister,” said Dr Judkins.
ACEM is the peak body for emergency medicine in Australia and New Zealand, responsible for training emergency physicians and advancement of professional standards. www.acem.org.au
AMA Queensland is the peak body representing all Queensland doctors and medical students. AMA Queensland exists to promote and protect the professional interests of doctors and the health care needs of patients and communities. www.amaq.com.au