Health board wants faster discharges from new hospital

By MARTIN JOHNSTON, health reporter

Patients are under pressure to spend less time in Auckland City Hospital beds, in a bid to cut financial losses.

The deficit at the 7-month-old super-hospital - which was planned to improve efficiency - is running 85 per cent over budget.

Health chiefs are focusing on the last half day of patients' stay, once their hospital-based treatment is completed.

"I'm not asking doctors to discharge patients earlier than is clinically appropriate," said general manager, Nigel Murray.

"I'm talking about discharging those who are ready to go, clinically. It's really important that when they are ready to go, they go promptly."

The $450 million Grafton hospital, attached to Starship, and the Greenlane Clinical Centre are replacing Auckland, Green Lane and National Women's Hospitals by mid-October.

The new hospital is failing on several of its targets, such as staff cuts, the deficit, staff productivity, average occupancy (at least 95 per cent, well over the target 85 per cent), number of operations performed without a pre-operative overnight stay, and surgery delays caused by the centralised instrument-sterilising room.

The hospital is treating slightly fewer patients, although some have been sent to other health boards as planned, and many non-urgent cases are facing long delays for surgery or first assessments by specialists.

Nurses Organisation organiser Mark Lennox laments how constantly overloaded the hospital is. "Nurses are struggling to provide safe care," he said.

The union believes the hospital - like the whole state health sector - has too few nurses.

But the board's managers, while acknowledging this, are adamant the organisation can function safely with fewer staff overall - by losing some out-of-district patients and making its new, more-efficient systems work.

Dr Murray said the hospital could save several million dollars a year with measures such as discharging patients faster, deploying nurses more efficiently, making greater use of its transition and discharge lounge, and adding another high-dependency unit for some of the worse-off patients.

The aim was to discharge patients by midday, but often they languished until the afternoon, waiting for a doctor's final approval.