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Near record activity in Northern NSW hospitals

Near record activity in Northern NSW hospitals

More than 52,000 people presented to Northern NSW Local Health District Emergency Departments in the April to June quarter, according to figures in the latest Bureau of Health Information Quarterly Report.

NNSWLHD Director 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,” Ms Weir said.

“I’d like to congratulate the whole Northern NSW team for their hard work and dedication.”

This April-June quarter saw a 7.3 per cent increase in ED presentations, up by 3,576 people on the same quarter last year, as well as an 8.3 per cent increase in the number of ambulance arrivals.

“The median time for patients leaving our EDs this quarter was just under 2 hours, well below the state average of 2 hours and 53 minutes,” Ms Weir said.

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, while Grafton and Tweed saw increases of 6.2 per cent and 4.9 per cent respectively.
Ms Weir said despite rising demand, the average length of stay in hospital remained stable at 2.5 days.

“Thanks to the excellent, efficient care provided by our staff, patients are being discharged back to their own homes or into community care to continue their recovery where they’re most comfortable,” Ms Weir said.

Elective Surgery Performance

Despite the continuing high activity, the number of elective surgeries performed remained stable.

“I am proud to say that 100 per cent of urgent elective surgery procedures were performed on time, as were 92 per cent of semi-urgent procedures,” Ms Weir said.

“However, we also recognise elective surgery is affected by our high activity in the system and we’re working with clinicians and management to improve waiting times.”

SECLUSION AND RESTRAINT

NNSWLHD is committed to reducing and where possible, eliminating seclusion and restraint, and providing the best possible mental health care and treatment in the least restrictive environment.

Seclusion and restraint are used to maintain safety for a patient, staff or others, after less restrictive alternatives have been trialled or considered.
The District is continuing to implement actions from the NSW Health Mental Health Safety and Quality in NSW: A plan to implement the recommendations of the Review of seclusion, restraint and observation of consumers with a mental illness in NSW Health facilities.

The introduction of new strategies have already shown positive results in this quarterly report.

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 1,000 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 1,000 bed days.

The average seclusion time for patients in Lismore also decreased significantly, down 28 minutes for an average duration of 2hr13m, well below the NSW Health target of less than four hours.

Tweed recorded a seclusion rate of 4.6 per 1,000 bed days, and a reduction of 29 minutes in the average duration of seclusion events, down to 2hr42m.
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 our 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.

The 2019-20 budget for Northern NSW Local Health District is over $875 million, this is an increase of more than $37 million on the 2018-19 budget.
Between mid 2012 and mid 2019 the Northern NSW Local Health District increased its workforce by an additional 843 full time equivalent staff – an increase of 22.4% including 115 more doctors, 280 more nurses and midwives, and 53 more allied health staff.

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