KEY POINTS:
Middlemore Hospital says it has got on top of an overcrowding problem which has pushed patient beds into emergency department corridors for most of this year.
The changes are likely to be copied at North Shore Hospital, where the emergency department is even more overstretched.
Middlemore staff have spent this year plotting how to remove the need for five corridor beds. They reached that goal last week with a symbolic victory when the signs marking the beds' positions were removed by staff, as the beds were no longer being used.
The beds' place in the hospital's computer system is also being removed.
Beds were still present in the Middlemore emergency department's relatively private corridor alcoves, as during extremely busy periods the old corridor spaces could still be called on, Counties Manukau District Health Board quality improvement general manager Allan Cumming told the Herald.
But that meant the old corridor beds being used about once every 10 days - a marked reduction from the beginning of the year when the beds were occupied every day, he said.
The achievement was even greater with patient numbers reaching a record 240 per day.
The bed removal had been made possible in part by the "releasing time to care" programme - a hospital-wide push to get staff to come up with ideas for making their jobs and departments more efficient.
The other big change was an acceptance that emergency department's bed-block usually stemmed from blocked ward beds, not under-resourced emergency departments, Mr Cumming said.
Patients who had received emergency care and were ready to be admitted to a hospital ward bed often had none to go to, as the wards needed time to free up space. That left the patients in their ED beds - beds meant for new patients coming in to the department.
The hospital had used modelling of previous ward admissions to predict when the emergency department would be calling for ward beds. Those beds were now being freed up in anticipation, Mr Cumming said.
Next month the same programme will be rolled out at Otago District Health Board and Waitemata District Health Board.
North Shore Hospital emergency department clinical director Dr Bhavani Peddinti told the Herald patients were put in corridor beds every day at the hospital.
Staff were "extremely enthusiastic" about adopting Middlemore's model, and it was expected the number of corridor beds would decrease. However, he said it was unlikely the hospital could record the same level of success as it was too constrained by space.
Every single space in the hospital was being utilised, he said, and until Waitakere Hospital's next redevelopment stage was completed in early 2010, that would continue to be a problem.
THE PROBLEM
Emergency department patients have been forced into corridors because there are no free beds.
THE SOLUTION
Staff plan ahead to move patients out of ward beds when the recovering emergency patients are due to move in.
