The death of a woman in her 70s who was hit and waited in the emergency department of a Tasmanian hospital for more than nine hours is “totally unacceptable” and shows the state’s health system is collapsing, according to a union.
Key points:
- Ambulance congestion occurs when hospital emergency departments are full and cannot admit new patients
- In June this year, 52% of patients were treated on time at the LGH ED, according to the Tasmanian Department of Health.
- Tasmanian Department of Health Secretary Kathrine Morgan-Wicks says a formal review of the case is underway
The union representing paramedics in Tasmania said the woman was taken to Launceston General Hospital about midnight on Friday night and died about 9am on Saturday.
“At the time he died the patient had been on the ramp for nine hours and was still in an unsuitable environment and had not been allocated a bed at the time,” said Robbie Moore from the Community Services Union and Health (HACSU).
“This is a very sad situation which just shows how bad our healthcare system is, that we could not have a bed available for a patient who clearly needed medical assistance and it shows that the expansion of ambulances is out of control and the patients’ lives are getting out of control. put at risk”.
Ambulance ramping occurs when hospital emergency departments are full and cannot admit new patients.
Paramedics attend to patients who have been transported to an area of the hospital outside the emergency department.
Moore said the patient received care from emergency department staff while they waited for an ED bed to become available, and was also treated by ambulance paramedics.
“It’s totally unacceptable for a patient to be run over for nine hours and it shows we’re letting the Tasmanian community down,” he said.
“Unfortunately, this is not an isolated incident … unfortunately we are aware of several other incidents where patients have not been able to get a bed and have died on the ramp.”
Nursing staff “distressed” by conditions in LGH’s emergency department
Australian Nursing and Midwifery Federation Tasmanian secretary Emily Shepherd said on the night the woman was taken to hospital, LGH’s emergency department was full, with 20 patients waiting be admitted to beds in other parts of the hospital, about 50 people in the hospital. ED waiting room and seven ambulances went up.
“It’s incredibly worrying [to have a patient die after being ramped],” she said.
“Our members have been absolutely baffled for many years by the situation in the emergency department at LGH and indeed across the state.”
Ms. Shepherd said nurses, doctors and paramedics did their best to care for patients waiting to be admitted to the ED.
“We have patients receiving care not only on the ramp, but also in waiting rooms surrounded by dozens of other people.
“It is clear that the environment and circumstances in which this care is provided are not optimal, of course our members would like to see all patients presenting to the emergency department moved into a cubicle and treated properly in the right environment and space.
“But we’ve known for many years that, unfortunately, that’s not the case.”
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Patients spend twice as much time in LGH EDs as in comparable hospitals
Access block, also known as bed block, is the leading cause of ambulance ramping.
It occurs when acute beds in hospitals are full, so patients in the emergency department cannot be admitted to the hospital, meaning that new patients cannot be admitted to the emergency department.
In 2019, the Australasian College of Emergency Medicine determined that the ED at Launceston General Hospital suffered from the worst access blockage in Australia.
According to the Australian Institute of Health and Welfare, up to 10 per cent of patients spent more than 16 hours in the LGH ED, compared with more than eight hours in comparable hospitals across the country in 2020-21.
While the number of patients presenting to the LGH ED has barely changed over a decade, the number of emergency presentations has almost doubled, from 3,228 in 2011-12 to 6,117 in 2020-21.
In June this year, 52% of patients were treated on time at the LGH ED, according to the Tasmanian Department of Health.
The federal government urged to do more
Premier Jeremy Rockliff said he could “look Tasmanians in the eye and say we can and must do better when it comes to our healthcare”, which is why “I have retained the health portfolio”.
But he added that he believed the federal government needed to do more.
“Many of our challenges in the acute care system relate to people’s lack of access to GPs and primary health care services. This is a responsibility of the federal government.
“We’re happy to play our role as a state government, and we’ve been. We’ve been moving into that primary care space, providing access to GPs, we’re moving into that role.
“I was critical of the previous one [federal] government when it comes to access to GPs, and I will work with our new government to make sure they up their game on improving access to GPs and primary care.”
Mr Rockliff said he had called on the federal government to “address the sub-acute challenges we have in terms of looking after older people and NDIS participants, who spend too much time in our hospitals”.
“They have to be provided with their care in the right environment, and that’s a responsibility of the federal government. Again, we’ll work with them collaboratively, but all governments, state and federal, have to one step”.
A formal review of the rampage death is underway
Tasmanian Department of Health secretary Kathrine Morgan-Wicks said the patient was receiving care in a transition area while waiting for a hospital bed.
“While waiting for an Emergency Department (ED) bed to become available, the patient was receiving care from ED staff and paramedics in a transition area within the ED,” he said in a statement.
The health chief said a formal review of the case is underway.
“As always when a patient dies in our care, we take this matter very seriously and offer our sincere condolences to the family and friends of this patient,” Ms Morgan-Wicks said.
“Launceston General Hospital and Ambulance Tasmania will conduct a root cause analysis to review and fully understand the circumstances surrounding this patient’s death.”
Ms Morgan-Wicks said she could not comment further due to patient confidentiality.
Asked on Tuesday what the state government was doing to reduce the ambulance backlog, Premier and Health Minister Jeremy Rockliff said his government had employed 870 extra frontline health workers over the past 12 months and was working on system improvements.
“It’s about making sure we get access and flow from triple zero to discharge of the patient through our hospital system and our emergency department,” he said.
“And it’s the system improvements that are so crucial, as well as, of course, the investment in staff and infrastructure resources.”
According to the Australian Institute of Health and Welfare, up to 10 percent of patients spent more than 16 hours in the LGH ED. (ABC News: Luke Bowden)