Box Hill Hospital again. Doctors fear hospital ‘holding areas’ will make overcrowding worse August 18, 2022
Doctors have warned patients have been deteriorating in new “holding areas” for ambulance patients queued outside Victoria’s hospitals, as an account of a woman in her eighties being treated in a tent outside Box Hill Hospital overnight puts a spotlight on extreme emergency department overcrowding.
The Age has seen memo reportedly sent to emergency department directors across the state describing a plan to set up spaces, in some cases outside, for up to 10 patients for whom there is no emergency cubicle available.
The aim of the extra offload areas is to prevent paramedic crews getting stuck at hospitals waiting to hand over their patients for hours or, in some cases, for their entire shift. The growing problem has contributed to flagging ambulance response times, now more than 20 per cent below target for the most urgent cases.
The memo said the holding areas would be for patients who require treatment within a timeframe of 30 minutes to two hours, categorised from urgent to non-urgent. They would be patients who could be looked after by a range of different staff, from registered nurses to student paramedics.
The offload areas should be equipped with “adequate heating and cooling”, a duress system connected to the main ED, resuscitation equipment and space for an additional five ambulance stretchers, the document said.
However, an account of a woman in her 80s, who was in a large white tent at Box Hill Hospital when her daughter contacted the media on Thursday morning, has highlighted what many patients are likely to make of the arrangements.
“The staff came to me and said ‘what’s wrong’ and I said ‘I can’t believe we are in a tent,’” the daughter, who did not want to be named, told Nine.
“The staff have been amazing. Paramedics have been fantastic, I can’t fault them, but I would have expected post-COVID, we’re not in the height of COVID, we wouldn’t have been in a tent now still.
“There’s no privacy, it is heated … there’s no water ... there are limited supplies, there’s a computer, there’s sort of a makeshift office.”
She said the 83-year-old had a suspected stroke on Wednesday morning at her aged care facility, spending time in a crowded corridor at Box Hill Hospital before being moved outside into a tent, where she stayed for more than 16 hours.
A Victorian government spokeswoman said the “Ambulance Victoria Offload” model was now operating at 14 Victorian public hospitals, allowing patients to be monitored and submit for tests while waiting for admission to the emergency department or a ward. Some hospitals already have similar arrangements in place.
The number of patients spending more than 24 hours languishing in EDs has exploded recently, rising to 1844 patients in the last quarter to June, a more than four-fold increase in a year.
On Thursday morning Premier Daniel Andrews said he hadn’t been briefed on the situation at Box Hill Hospital.
Victorian Health Minister Mary-Anne Thomas said the “other additional challenges that our emergency departments have been facing…. is as a consequence of deferred care during the pandemic”.
Australian Medical Association Victoria board member Simon Judkins said the marquees and temporary structures used outside EDs last year for COVID-19 patients were only meant to be a temporary, crisis measure. Now, some of those had become offload areas.
Although he acknowledged it was essential to get ambulances back on the road, Judkins said it needed to be recognised that emergency departments were not the root of the problem. For example, some of the ambulances left waiting, queued outside hospitals recently were occupied by people who could easily have received care from their GP, or in the community with disability support.
Victorian Ambulance Union secretary Danny Hill said offload areas could be the best of a number of the bad options for the time being.
