The External Review of Hospital Performance and Ambulance Ramping by Dr Mark Monaghan, Dr Helen Bell and an expert panel is an indictment on 10 years of Labor’s failure to deliver effective emergency department services at SA Hospitals.
“This Report is the second within a month into failures at Emergency Departments in the Adelaide Health system which identify systemic failures. The report says;
‘The fundamental issue has been the decision to not allow patients arriving by ambulance entry into the department if there is no capacity to accept them’. (p.7)
‘The review team gained the strong impression that the systemic issues identified were representative of broader issues that could be found at any of the SA tertiary sites'. (p. 4)
‘The review team came away from these discussions convinced that the challenges faced at FMC are consistent across the spine hospitals'. (p.5)
‘Lyell McEwin Hospital stands out as being most challenged from a capacity perspective, with a disproportionately small bed stock for their ED presentations 245 multiday beds (excluding mental health), for approximately 60,000 presentations'. (p. 5)
‘It also appears that there was little in the way of key performance indicators (KPIs) or accountability for performance'. (p.5)
‘Inefficiencies in discharge practice, delayed referrals, investigations and access to sub-acute beds’. (p.6)
‘The FMC commonly runs at greater than 100% capacity. This is incompatible with efficient patient flow from the ED to the wards'. (p.9)
'With regard to (ambulance) diversion practice, the current practice of one hospital calling another to instigate diversion is an unsustainable and inefficient model'. (p.10)
‘There is a significant ongoing need to invest in and improve the strained relationship between hospital management and the ED. A poignant example of this is the installing of CCTV cameras in the ramp area by the management without any consultation with the department'. (p.19)
‘The Review Team formed the view that the ED seemed to be quite culturally segregated from the inpatient units'. (p.23)
“The report confirms the pressure upon EDs for mental health patients with no dedicated mental health triage area at the hospital. (p.17)
“The report outlines a litany of ED process issues which Labor should have fixed over the last 10 years. Criticisms were also made between the interface between FMC and the Noarlunga Hospital, bed management practices and systems, patient flow pathways and discharge planning.
“This is a very poor report card indeed on Labor’s management of the health system,” Mr Hamilton-Smith said.
The Monaghan report can be found at the following link: http://bit.ly/NgDSgT