Hospital A&E struggles with record influx of patients

Auckland City Hospital has been inundated with record numbers of patients at its adults emergency department.

Winter is usually the busiest time for hospitals, but this year the heavy load extended into spring and significantly worsened.

"In September there were 10,548 people through the emergency system in Auckland [District Health Board], which is off the scale," said the clinical director of the adults emergency department, Dr Tim Parke.

Of them, 4053 were managed by his own department, 540 more than in the same month last year. The rest were in the assessment and planning unit next door, the children's emergency department at the Starship, and acute clinics like the eye unit at Greenlane.

The day-by-day flood reduced slightly in October, although the monthly tally was higher because October has one more day than September.

The occupancy of inpatient wards correspondingly "went through the roof" in September, Dr Parke said.

Average nightly adult occupancy, excluding National Women's, hit 685 - 25 more than in September last year.

The reasons for the continuing flood were unknown, but it involved all kinds of illness and injury.

Dr Parke said the hospital was working towards compliance with the Government's new six-hour target for emergency department patients, but might take up to two years to get there.

The target is that 95 per cent of emergency patients are admitted to a ward, transferred or discharged within six hours. Middlemore Hospital reached this level last month after more than a year of concerted effort.

Dr Parke said his department was meeting the six-hour target for 65 per cent of patients overall. The figure was higher for those it treated and discharged, but lower for those sent to a ward from the emergency department because of congestion in the hospital.

The congestion was due to many factors, like difficulty finding a resthome bed to discharge ward patients to once their hospital care ended, and limitations on discharging patients at weekends because medical ward rounds tended not to be run then.

The hospital is, however, trying to address its shortage of beds, developing plans to add around 300 in its adult health services. This would bring the total, including children's facilities, to more than 1300.

Patient load

Number of patients seen at Auckland City Hospital's adults emergency department:

* September 2008 - 3513

2009:

* July - 3853
* August - 3907
* September - 4053
* October - 4085