Emergency patients wait longer

Hospital emergency departments in New Zealand are getting worse, medical specialists say.

A Health Ministry report for the quarter ending September 2003 shows emergency patients are waiting too long for treatment in 17 of the country's 21 health boards.

Just two boards, Wairarapa and South Canterbury, measured up. West Coast's waits were satisfactory, and Waitemata did not submit data.

The sector continues to perform poorly and would benefit from an independent audit, the report says.

Health boards use Australasian College of Emergency Management guidelines that recommend patients be prioritised, or triaged, by urgency.

Throughout New Zealand, performance in triage one (patients in need of resuscitation) improved, but remained poor overall, with only 13 health boards seeing all patients immediately.

But triage two and three performance dropped by more than 3 per cent. Just over half (56.4 per cent) of all triage two patients were seen within 10 minutes, and 48.8 per cent of triage three patients were seen within half an hour, compared with targets of 85 per cent and 80 per cent.

Triage two includes patients with possible heart attacks or significant injuries. Triage three patients tend to have undefined but potentially serious problems.

Health and Disability commissioner Ron Paterson said the figures were a wake-up call and a "significant concern" in the lead-up to winter.

Christchurch Medical School professor of emergency medicine Michael Ardagh said the situation was worse than last year, when departments were reported to be in crisis.

Emergency departments were overcrowded and overstretched, due to increasing demand, staff shortages and poor facilities, he said.

Triage standards were high and most hospitals struggled to meet them, but the long waits were worrying.

Though health boards and the Health Ministry were sympathetic, no one seemed prepared to take responsibility for improving the situation, Professor Ardagh said.

College of Emergency Nurses chairwoman Jane Lawless agreed the situation was getting worse.

Nurse morale was low and turnover was high in a traditionally popular department. Waits were having a worrying effect on patient safety, she said.

"We are in big trouble. Every winter brings us closer to disaster."

Health Ministry acting deputy director-general of clinical services Pat Tuohy said triage one patients were the main priority for emergency departments and the ministry was "reasonably comfortable" with those waits.

- NZPA