The Hodgman Liberal Government will implement a range of actions to ensure patients can get more timely care in emergency departments at the Royal Hobart Hospital and the Launceston General Hospital.
While we have the long term One Health System reforms, which includes making the Mersey a dedicated elective surgery centre from July 1, it is clear that more needs to be done in the interim to manage a spike in demand in our busiest emergency departments.
Cabinet has endorsed, in full, a range of recommendations made by the CEO of the Tasmanian Health Service, Dr David Alcorn and Department of Health and Human Services Secretary Mr Michael Pervan, which will form a new initiative known as Patients First.
Key actions in Patients First include:
Clinical Initiative Nurses. We will recruit and train Clinical Initiative Nurses, where needed, to actively monitor and provide advice to patients and their families whilst they are in the Emergency Department waiting room, including developing plans of care for patients in consultation with our ED doctors.
More efficient discharge. We will trial enabling senior nursing and allied health staff to safely discharge patients earlier in the day, based on medical criteria set earlier by the treating doctor, often on admission. This already occurs in other states and internationally, and has been requested by clinicians. The trial will commence by July this year.
Psychiatric Emergency Nurses at the Royal. We recognise the role played by these positions and will work on how these roles might continue beyond this financial year, subject to discussions with the Australian Government.
Enhanced role of Paramedics. We will examine enhancing the scope of practice for paramedics to enable them to manage pre-hospital and potential emergency department demand including reviewing the potential for secondary triage and referral to alternative services.
A list of unacceptable ‘red flag’ events in our Emergency Departments. These are events where hospital leadership must take immediate action to address the situation. The THS CEO will consult with ED staff on the final list, but unacceptable events are likely to include cases where any patient is admitted to the ED for longer than a set period of time, with shorter limits for the elderly and for children.
Better utilisation of rural hospital beds. We will continue the work to see more patients moving to receive their safe care at lower acuity facilities near where they live, such as rural hospitals, wherever it is clinically appropriate to do so and in the patient's best interests.
Evidence based escalation policies. These will be triggered at times when our services are experiencing high levels of demand and will give our staff avenues to call for more senior support when needed. They are action plans and procedures which provide for a whole‑of-hospital response to ensure patient flow is maximised. They will be in place by May this year.
Working better with the private and not-for-profit hospitals. We will ensure our escalation policy includes improved liaison with private healthcare providers, as part of our Escalation Policy, so we can better use both the public and private sectors to meet demand.
Winter illness strategies. We will ensure that these strategies are in place across all THS sites, before the coming winter, and will consider temporary flexing of beds where required in sensitive clinical areas.
The full list of the 19 actions listed in the Patients First report is available here and more information about the One Health System reforms is available here .
We are investing more money than ever before in Health in Tasmania, with funding in excess of $6 billion, and we have a strong reform plan which is being implemented during 2016 and 2017. However, recent events have shown we must also look at more immediate ways to ensure patients get seen sooner, and that is what these actions are aimed at.
As I have repeatedly said, I believe the dedicated people at the frontline of our hospital system - the doctors, nurses and allied health professionals are committed to and do provide exceptional care - it is our system's flaws which are letting them down, and patients who are waiting too long. This is what we are addressing through Patients First.
These actions, including those to open more flex beds and recruit additional staff, are able to be achieved using resources already available to the THS.
Last week in COAG the Premier secured an additional $54m in health funding to flow from 2017-20. There will be further updates in the budget about how this money will be invested and the rollout of our One Health System reforms.