Emergency department wait still too long in most hospitals

Only four out of 20 district health boards met all three benchmarks for waiting times for the most seriously ill patients in emergency departments, according to a report released today.

However, the latest quarterly DHB Hospital Benchmark Information report (for the period April to June 2005) noted that despite an increase in the number of more serious cases over the last two years, emergency department staff had "managed to maintain the same level of performance".

Under the triage targets set by the Australasian College for Emergency Medicine, 100 per cent of category 1 emergency patients (in immediate danger of losing "life or limb") should be treated immediately; 80 per cent of category 2 patients (in potential threat of losing life or limb) should be treated within 10 minutes, while 75 per cent of category 3 patients (suffering urgent medical needs such as fractured limbs, chest pain or bleeding) should be treated within 30 minutes.

While only four emergency departments (Tairawhiti, Wairarapa, Nelson-Marlborough and South Canterbury) met all three triage targets, three others (Lakes, Whanganui and Otago) met the benchmarks for triage codes 1 and 2.

Accurate data was not available for Waitemata.

For the entire June 2005 quarter across all DHBs, only two code 1 patients were recorded as not having treatment commenced by a doctor on arrival.

Deputy director-general of DHB funding and performance, Anthony Hill, said the Health Ministry had been working with DHBs and clinicians throughout 2004/05 to improve emergency triage times.

"It is hoped that the results for code 2 and 3 will improve in 2005/06," he said.

"Some of the required improvements are not related to clinical practice, but rather to recording mechanisms, including computer systems."

The total number of hospital-acquired bloodstream infections (which are associated with the highest rates of illness and death) reported in the June 2005 quarter was 394 for all DHBs combined, which was "fairly stable" for the whole of the 2004/05 period.

In New Zealand - in common with other developed countries - around 10 per cent of hospital patients pick up new infections in hospitals.

The benchmark study is divided into four sections: organisational health, quality and patient satisfaction, process and efficiency and financial.

DHB summaries of significant results:

* Northland DHB recorded the lowest rate of staff turnover of all DHBs
* Auckland DHB recorded the lowest rate of staff on sick leave
* Counties Manukau settled the most complaints within a satisfactory time-frame
* West Coast had the highest patient satisfaction rate out of all DHBs


- NZPA