Today, I am pleased to announce we are taking steps to ease pressure in the Launceston General Hospital’s Emergency Department. These steps have been designed to support whole-of-hospital solutions and are in line with Patients First.
While we have the long-term One Health System reforms, the Government believes that more needed to be done in the interim to manage demand at the LGH Emergency Department.
While patient numbers presenting to the LGH have remained consistent with previous years, the number of patients requiring admission have increased. As a result, this has put pressure on the ED. The Patients First strategy for Tasmanian EDs was released in April and funded in the recent budget. A number of these 19 actions are being specifically brought forward.
This includes the reopening of 12 beds in Ward 4D for as long as required, particularly over winter and spring, to allow the hospital to address patient flow issues and seasonal demand. This is the ward that was closed by the former Labor-Green Government.
Because of the large number of additional beds already opened under the Liberal Government together with redevelopment works which has necessitated use of 4D for the allied health team, the LGH is physically constrained. To allow 4D to be reopened to inpatient medical care, some allied health staff will be asked to relocate to other facilities in the LGH.
The extra beds will be appropriately staffed, and are expected to be ready for patients within the next two weeks.
I am pleased to announce that I am advised that one resignation of a senior Emergency Department doctor has been withdrawn, and that specialist will continue as part of the team to meet the needs of our patients at the LGH and the training requirements of our emergency department specialist trainees.
We are continuing to work to retain and recruit emergency department doctors. Repeated claims that nine doctors out of eleven had resigned is incorrect, with the proportion of staff resigning from the THS actually now the equivalent of two full-time staff.
In any case, the Government has sought to proactively engage with clinicians with a view to overcoming any barriers to those valued staff staying on.
The government is also working to recruit to address other workforce turnover issues including reduced hours, retirement and transfers to other Tasmanian hospitals.
In addition to reopening Ward 4D, and working to recruit and retain ED doctors, we will accelerate implementation of key Patients First initiatives at the LGH.
This includes a full escalation plan for the LGH such as has been implemented at the Royal Hobart Hospital, triggered at times when our services are experiencing high levels of demand and where patient flow issues require a whole-of-hospital response. The escalation plan’s protocols and actions will give our staff real-time triggers to call for more senior hospital staff support, including doctors.
The overall plan will better ensure that patients are moved from the Emergency Department into the next available ward bed, if they require it. This plan will give our staff avenues to call for more senior support when needed. LGH emergency physicians and emergency department nurses will be key members of a working group to align this policy with the one successfully implemented in Hobart.
This working group will commence by the end of next week, and conclude its work within three weeks.
We will also fully review the role of nurses in the Emergency Department, to ensure that we are best supporting our skilled nursing staff to get better patient outcomes, examining broader scope of practice and reviewing nurse initiated procedures in the ED, and moving to criterion-led discharge where clinically appropriate.
As part of this, the emergency department nursing staff have requested a Clinical Initiative Nurse Educator for the ED, with recruitment to commence in July. This will allow us to better provide professional development to our nursing staff to provide care and assistance in the waiting room. We will also consult with staff on how we can improve Allied Health support in the ED, including consideration of new positions.
I have also asked the CEO of the THS, Dr David Alcorn, to meet with the ANMF and discuss other suggestions its membership has raised.
The past few weeks have been challenging for the LGH, and I wish to thank management and staff for the excellent and professional way they have handled the additional pressure. While they have continued to provide care during a challenging time, the CEO and I have spent considerable time working through the range of possible solutions, encouraging staff to see a better future through Patients First and taking on feedback from all those who will be affected by this more rapid implementation.
It is important that we continue to support those who provide the care and don’t overlook the progress that is being made as we implement our longer term reforms to address the broken health system we inherited. This includes significant service upgrades at the LGH in the future, across a wide range of specialties.
The Government has just commenced the $3 million Community Rapid Response Service for the Launceston area that will see less emergency department presentations, which will roll out to 33 GP practices over the coming 12 months. Additionally, the Government is funding an additional three paramedic positions based at Launceston from 1 July.
We have also made significant gains for our long-waiting elective surgery at the LGH. In the 12 months to the end of May 2016, the LGH performed over 5,300 elective surgeries – over 1,030 more than the previous 12 month period. This is surgery provided at the LGH itself – the number is even higher when private sector surgeries are included.
I want to thank all of the medical, nursing, allied health practitioners and team members for this remarkable achievement.
