It took five hours for Kathryn Harradine’s six-month-old son Andy to be treated for a lung infection at Canberra Hospital’s emergency department.
- The ACT Health Minister wants 70 per cent of ED patients to be seen on time by October
- Doctors are now stationed at ED triage points in a bid to improve patient flow
- Elective surgery waiting times are still too long, with more than 1,000 people overdue for treatment
The excruciating wait for the Canberra mum was difficult to endure, but not an uncommon tale.
Fewer than half of Canberra’s emergency department (ED) patients are seen within clinically recommended times — they should be discharged or admitted within four hours of presenting.
But when Andy, who spent time in neonatal intensive care for serious bowel obstructions when he was younger, started “becoming more and more unwell,” Ms Harradine took no chances and went straight to the ED.
He was diagnosed with bronchiolitis and, while it is common in babies, Ms Harradine said she had no choice but to present at the ED for the diagnosis because it was outside general practitioner hours and her son was too young to be seen at Canberra’s walk-in centres.
“You can’t go anywhere else. That’s the whole thing,” Ms Harradine said.
“There’s one place you can take your kids and that’s the paediatrics emergency department at Canberra Hospital.
“We were actually taken into the adult area of the hospital because the paediatrics area was just overflowing. There’s just not enough space.”
Fed up with the poor performance, Rachel Stephen-Smith wants to be the ACT health minister to finally turn around these blown out emergency department waiting times — and she says she’ll do it in nine months.
“The emergency department is really challenging and it has been a challenge for a long time, both at Canberra Hospital and Calvary Public Hospital,” Ms Stephen-Smith acknowledged.
She has set a goal of having 70 per cent of ED patients seen within clinically acceptable times by October this year.
And while no-one would argue against her intentions, many would be sceptical of the system’s ability to achieve the goal in only a matter of months — after all, the most recent national scorecard again placed the ACT worst in Australia.
Doctor to triage ED patients, reduce ‘distressing’ waits
But Ms Stephen-Smith said Canberrans would not have to wait years until the much-anticipated Canberra Hospital expansion was completed before improvements would be seen.
She said Canberra Health Services was trialling having a doctor at the triage point of the ED with the aim of improving patient flow.
Based on her recent experience, Ms Harradine has urged Ms Stephen-Smith to improve the triage process so people who can be diagnosed and discharged are not left with a “distressing” wait.
Ms Stephen-Smith said she had heard anecdotes similar to Ms Harradine’s and hoped that the trial to embed a doctor earlier in the process would be a solution.
“It’s about triaging people appropriately and making sure they’re in the right stream [and] also determining whether a nurse or a doctor can start a treatment process straight away,” she said.
“For example, ordering diagnostics and blood work that they know is going to be required for that patient.”
Ms Stephen-Smith’s nine-month goal also hinges on the establishment of a discharge lounge for patients who require some level of care up until being released despite no longer needing a bed, such as people returning to aged care residences.
A further change being trialled to reduce bed block was “ward huddles” which Ms Stephen-Smith said would help staff prioritise discharging patients in a timely way.
Ms Stephen-Smith said she was meeting with Canberra Health Services weekly to discuss the changes — which have been trialled over the past 18 months — and the same questions were being asked.
“How are we going? How are these processes becoming embedded? And when are we going to start to see change?” she said.
Nonetheless, she expressed confidence change would be evident within nine months.
More than 1,000 patients overdue for elective surgery
The emergency departments are not the only facet of Canberra’s public health system plagued by long waiting times.
A quarter of all patients who needed elective surgery like hip or knee replacements in the ACT waited too long in the 2019-20 financial year.
Data from November 2020 showed there were 5,127 people on the elective surgery waitlist, more than 1,000 of which were overdue for treatment.
Canberra orthopaedic surgeon Paul Smith recently told ABC Canberra he decided to work through the Christmas break to conduct 65 surgeries in just over a fortnight, to improve the quality of life of people who had been languishing on a waitlist.
In response to Professor Smith’s interview, hundreds of people contacted the ABC to share their experiences of waiting too long for surgeries in the ACT.
One of those Canberrans was occupational therapist and former nurse Ruth Palavestra, who spoke out over her father’s treatment.
Ruth said her elderly father had waited so long for scans and an appointment with an orthopaedic surgeon, that by the time he was seen, his injury was inoperable.
“Dad’s gone from being completely independent, completely fit, to needing to use a walking stick and a wheelie walker,” Ruth said.
“The surgeon told him he’ll be on the wheelie walker permanently now.”
Despite approaching his 90th birthday, Ruth’s father had been active before the injury, driving himself around Canberra and living independently.
“The aim of aged care these days is to keep people in their own homes as long as they can.
“If you can’t keep them independent and you can’t provide wrap-around services, then they need to move into supported accommodation, and that’s catastrophic.”
Ms Stephen-Smith insisted the system was powering through elective surgeries, pointing to data showing the ACT had removed more people from the elective surgery waitlist than had been added in the year to June 30, 2020.
She also reiterated a target of completing 16,000 elective surgeries this financial year.
“Am I pleased that there are 1,000 people overdue waiting for elective surgery? Absolutely not,” she said.
“I would like to see that number be zero.”