‘Brutal’: Lyell McEwin ED at nearly double capacity overnight

The Lyell McEwin Hospital emergency department was last night crammed with nearly double the number of patients than it has beds for, the doctors’ union says, leaving clinicians “broken” and “traumatised”.

Aug 15, 2022, updated Aug 15, 2022
Artwork: Tom Aldahn/InDaily

Artwork: Tom Aldahn/InDaily

The SA Salaried Medical Officers Association said the ED was inundated with dozens of “walk-ins” at the same time as ambulances were ramped outside, unable to offload sick patients into a swamped ED.

SASMOA chief industrial officer Bernadette Mulholland told InDaily this morning that doctors were texting her throughout the evening, expressing their frustration and concern.

“It’s just so hard and brutal out there at the moment,” she said.

“Words like ‘broken’, ‘traumatised’ were being used – these are the people trying to provide the care.”

Mulholland said the last update she received last night was about 9.30pm with doctors telling her there were 92 patients waiting in the ED which has 52 beds.

Many of these were still waiting to be seen and hadn’t even progressed in the queue.

The union had tweeted earlier in the evening that there were 87 patients in the 52-bed ED, with 40 waiting to be seen.

87 patients in the LMH ED which has 52 beds – 40 of these patients waiting to be seen. 10 patients now at triage so will soon be 93 patients in ED – these situations are created by poor bureaucracy who are not funding beds and workforce needed 4 current health demand @SAHealth

— SASMOA (@sasmoa4doctors) August 14, 2022

“These situations are created by poor bureaucracy who are not funding beds and workforce needed (for) current health demand,” the tweet read.

The union also tweeted a photo of ambulances apparently ramped outside the ED.

Lyell McEwin Hospital ED – Congo line of ambulances- ?

— SASMOA (@sasmoa4doctors) August 14, 2022

“They were getting very high numbers of presentations, particularly walk-ins,” Mulholland told InDaily.

“Then we started to see the ambulances start to ramp.”

Mulholland said the problem was exacerbated because the ED is in the midst of an upgrade of its electronic patient record system, further slowing things down.

“We’re in a real winter crisis at the moment – we’ve got a new (patient) electronic system going in there, they’re already down on staff… and we don’t have enough staff on a daily basis,” she said.

“The doctors are saying that they’re starting to lose ‘situational awareness’ of the patients – that is where are we at, what patient is where, what safety provisions have we got in place, can’t see them all?

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“That raises the anxiety levels.

“They found it really distressing to be in that environment.”

Doctors had accused hospital management of blocking attempts to recruit staff but Mulholland said $3.9 million had now been released in part for that purpose.

“But the problem is this – there’s already difficulty in recruiting medical staff, there’s competition for staff within the Local Health Networks, interstate and overseas,” she said.

“We already know that GPs – advertised as alternatives (to EDs) – are difficult to get into.”

She said it could take up to three months to recruit a doctor.

The SA Health online public dashboard showing real-time ED activity was unavailable for the Lyell McEwin Hospital this morning due to a “system upgrade”.

A spokesperson for the Northern Adelaide Local Health Network said “the health system and all metropolitan hospitals experienced significant emergency department demand last night in line with recent ongoing pressure due to COVID-19, flu and winter demand”.

“Presentations to Lyell McEwin Hospital’s ED last night were consistent with usual activity experienced at the end of a busy weekend, with a significant number of walk-ins as well as patients arriving through SA Ambulance Service,” the spokesperson said in a statement.

“We continue to respond to the ongoing pressure with measures including prioritising discharges for patients where appropriate, reviewing elective surgery on a daily basis and the cancellation of non-essential meetings for clinicians.

“We thank the community for their patience and remind them to call HealthDirect for assistance if you are unsure if your condition requires emergency medical treatment.

“We recognise the hard work undertaken by our staff every day while we navigate through this period of high demand, and thank them for their commitment to our patients.”

A State Government spokesperson said the government was working to address a long-standing lack of beds and workforce at the Lyell McEwin.

“This government is doubling our election commitment from 24 to 48 extra beds to help fix access block, giving patients in the ED somewhere to go while easing pressure on frontline staff,” the spokesperson said in a statement.

“We are taking immediate steps to increase capacity in our public health network, including adding an extra 107 private hospital beds across the system.

“We are opening sites like Regency Green to get NDIS patients out of hospital and into community-based care, freeing up beds for patients who would otherwise be stuck in the emergency department, as well as finding hundreds of places for aged care patients to be safely discharged to aged care facilities.

“The major LMH emergency department redevelopment, planned and funded under Labor in 2017… will increase capacity to 72 treatment places when the complete new ED opens early next year.”

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