KEY POINTS:
The Health and Disability Commissioner has criticised hospitals for putting patients at risk by running their emergency departments with too few staff.
Ron Paterson released his findings yesterday on five cases involving the deaths of three patients. Some were reported by the Government-appointed Quality Improvement Committee in February when it tallied up the scale of errors in the public health system but in far less detail than Mr Paterson's analyses.
The major, preventable events reported by the committee for the 2006/7 financial year potentially or actually harmed 182 patients and included 40 deaths.
In some of the five cases reported by Mr Paterson, he found doctors had breached the code of patient rights but he reserves his strongest criticisms for the five district health boards involved.
Three cases involved overcrowded emergency departments, an issue the new Government intends to address with revised health targets.
"A key theme in relation to the emergency department cases is the threat that overcrowding poses to patient safety," Mr Paterson told the Herald. "It is going to need a concerted national effort ... because a number of the cases, in particular the Hutt Valley, Wanganui and Canterbury cases, illustrate the risk of harm to patients when the departments are overcrowded and short-staffed.
"All five of the cases raise issues about the importance of good discharge information. Partly it's making sure good information goes back to the GP, if there is a GP."
But despite his criticisms, Mr Paterson maintained the public health system was making progress on patient safety.
"There's a much greater consciousness that these are real problems that need to be fixed."
The five reports generally contain commitments from the DHBs to make improvements, such as hiring more ED staff and developing electronic patient information systems.
In his Nelson Marlborough report, Mr Paterson is sharply critical over a physician's admission that he did not order a CT scan on a Saturday night - one of the factors that compromised the patient's care - partly because after-hours scans required calling out two radiology staff.
"Reduced services and staffing after hours across all sections of a hospital, although a very common practice, is of concern," Mr Paterson wrote.
"Patients get sick 24 hours a day. Patients who present after-hours with demanding or undifferentiated symptoms need access to definitive investigations."
Health Minister Tony Ryall intends to impose maximum patient waiting times on emergency departments.
A Health Ministry taskforce is considering a six-hour maximum from emergency department arrival to ward admission, transfer or discharge - and a ban on leaving patients waiting in ED corridors.
