Lismore Base Hospital.
Lismore Base Hospital. Marc Stapelberg

52,000 people in emergency departments in just three months

MORE than 52,000 people presented to emergency departments at hospitals across the Northern Rivers in a three-month period, a new report has revealed.

The latest Bureau of Health Information Quarterly Report shows that between April and June, there was a 7.3 per cent increase in ED presentations at hospitals in the Northern NSW Local Health District area.

Director of clinical operations, Lynne Weir, said despite this significant increase in activity, emergency treatment performance remained strong.

"We're seeing near record activity in our emergency departments, yet our hospitals are still performing at very high levels when it comes to providing patients with quality and timely care," she said.

"The median time for patients leaving our EDs this quarter was just under two hours, well below the state average of two hours and 53 minutes."

There was also an 8.3 per cent increase in the number of ambulance arrivals.

Ballina, Byron, Casino, Lismore and Maclean hospitals all recorded increases of close to or more than 10 per cent in emergency department presentations compared to the same quarter in 2018.

Ms Weir said despite rising demand, the average length of stay in hospital remained stable at 2.5 days.

Seclusion and restraint

Ms Weir said the health district was committed to reducing and, where possible, eliminating seclusion and restraint.

These methods are used to maintain safety for a patient, staff or others, after less restrictive alternatives have been trialled or considered.

Both Lismore and Tweed mental health units were below the performance indicator for seclusion rates in the April-June quarter.

The state-based KPI for rate of seclusion in 2018-19 is less than 5.1 per 1000 bed days.

"I'd like to acknowledge the significant work our teams have been doing to reduce seclusion rates for patients in their care, which is leading to better experiences for our patients," Ms Weir said.

Lismore recorded a halving of the total number of seclusion events compared to the same quarter in 2018, with an overall rate of 4 per 1000 bed days.

The average seclusion time for patients in Lismore also decreased significantly, down 28 minutes for an average duration of two hours and 13 minutes, well below the NSW Health target of less than four hours.

Tweed recorded a seclusion rate of 4.6 per 1000 bed days, and a reduction of 29 minutes in the average duration of seclusion events, down to two hours and 42 minutes.

Some initiatives implemented over the past 18 months to improve patient care include:

  • Supporting nurses to spend more time engaging therapeutically with mental health patients.
  • Significant uptake among staff completing therapeutic relationship training, developed by Nurse Educators and Allied Health staff
  • Trauma informed care training for mental health staff, assisted by a dedicated trauma informed care coordinator. This training is also provided to staff in Emergency Departments, Maternity and a number of other services across the LHD
  • The Mental Health service has reviewed the transfer of care process from Mental Health Emergency Care (MHEC) teams and mental health inpatient teams to the community team
  • Enhancing the Mental Health patient flow unit to provide seven-day cover. Recruitment is underway to strengthen this further with extended hours into the evening
  • Improved psychiatry cover in the Emergency Department, providing more timely access to assessment and planning for patients presenting with a mental illness in the ED.