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Waikato Hospital works to improve patient flow through its busy Emergency Department

Huge demands on Waikato Hospital’s busy Emergency Department has led the Waikato DHB to introduce an overflow bed policy to help move patients out of ED and improve patient safety.

The number of people turning up to Waikato Hospital ED has increased 20 percent over the last five years. Over the last year alone there have been 3,500 more people turning up at the Waikato Hospital ED than the year before.

Marc ter Beek, Executive Director of Operations and Performance said: “Not only have we seen our population in the Waikato district increase but we’ve also seen an increase in the proportion of the population coming to ED. In addition, patients are spending longer in the hospital, which is putting additional pressure on the available hospital beds.

The new policy identified additional beds on 24 wards, in family rooms or treatment rooms, throughout the hospital. These can be used in times of high bed occupancy, when inpatients in the Emergency Department experience delays moving into a specialty ward bed.

Mr ter Beek said: “During last winter we experienced very high patient numbers in our Emergency Department, particularly in the early morning hours of 6-7am when people who are due to be discharged haven’t left the ward yet, and we have many patients in ED waiting for a bed.

“It’s much safer for people to be on a ward with specialist nursing care than lying in ED. Under the new protocol, when there is acute pressure in the morning, patients who are ready for discharge home would go into an overflow bed on the ward, which have electronic call bells and privacy curtains, and new patients coming in from ED would be given the standard hospital bed.

“On busy days we may need to use ten or sometimes more of these beds in a day.  The decision to use the overflow beds is taken by on call nurse management in the morning of each weekday, based on clear criteria assessed by our bed capacity manager before making a decision to trigger the protocol.”

The Full Capacity Procedure, as part of the updated bed management policy, was accepted by all clinical leaders as part of the patient flow package of changes on 14 November.

Mr ter Beek said: “The final policy had changed from the draft policy that we consulted with staff on, in particular around the clarification of the process for enacting the policy and the definition of overflow beds, and we took on board staff feedback during a trial period. In early drafts staff had suggested equipping the overflow beds with hand bells (colloquially called cow bells) which are used in hospitals when there are outages of the electronic call bells, but this was not adopted and all the overflow beds now have electronic call bells and privacy curtains.”

As facility updates were required to ensure all overflow beds were suitable to be used, the policy has not been enacted yet. It is due to be re-enacted on 13 February.

He also encouraged people to keep the Emergency Department for emergencies and if people were feeling ill to first think about whether they could see their GP or contact Healthline.

People can also sign up online for the DHB’s new SmartHealth service which provides a free out of hours online doctor and access to doctor-approved health information. It can prevent people coming to ED and having a long wait when they don’t need to. Visit SmartHealth.org.nz to sign up.

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