North Shore Hospital report - New Zealand Doctor

Health and Disability CommissionerHospital‘s needs and has expressed a commitment to fulfilling them. Increased capacityis coming, with some short-stay beds on line in June [2008], and others in November,with plans for the new Lakeview wing in two years‘ time.2. Bed management processes which include:(i) Capacity and demand forecasting.(ii) Daily active bed management according to actual demand.(iii) Days/weeks-out bed management based on forecasted demand.(iv) Crisis (Gridlock) bed management plans when access to beds is threatened by ahigh rate of hospital bed occupancy.(v) Control of all admissions, and integration of acute and elective admissionprocesses so that movement of acute patients into ward beds is prioritised.Comment: Capacity planning tools are in use and I understand that daily bedmanagement meetings (―Balancing Meeting‖) and weekly planning meetings areoccurring. It is understood that the ―Balancing Meeting‖ will be based more on qualitycapacity/demand predictions in the future.3. Appointment of a Clinical Director of ECC who (with the nursing and managerialleadership of ECC), has authority over all the activities within the ECC whether theybe Emergency Medicine or other specialty activities, and who contributes clinicalleadership to all of the above.Comment: I understand an appointment is pending, 101 although the authority of theposition may need to be ensured.4. Development of an explicit, serious and meaningful commitment in the Ministry ofHealth, with the support of the Minister and government policy, to address the issueof overwhelmed acute care services in New Zealand.Comment: The Ministry recently co-hosted a workshop on this issue and has shown aninterest in patient flow through the work of the Quality Improvement Committee. It isuncertain if the Ministry or the Minister will commit to the recommended future stepsfrom the Workshop, which included the establishment of a well constituted workinggroup to develop recommendations for enhancing quality in Emergency Departmentservices. 102References1. Ardagh M, Richardson S. Emergency Department Overcrowding — can we fix it? NZMed J. 2004; 117 (1189).2. Ardagh M. The case for a New Zealand Acute Care Strategy. NZ Med J. 2006; 119(1247).3. Asplin BR, Magid DJ, Rhodes KV, et al. A conceptual model of Emergency Departmentcrowding. Ann Emerg Med 2003; 42: 173–80.101 The new Clinical Director of Emergency Medicine was appointed in September 2008.102 As noted in footnote 101 above, the Working Group has produced recommendations that are beingdeveloped into a formal work programme by the Ministry of Health.130April 2009