❓ The Minister for Health outlines initiatives to address ambulance ramping and ED pressures, focusing on virtual emergency departments and improved care pathways for older adults, aiming to reduce ED reliance and improve patient experience.
AnsweredQoN 229Legislative Assembly
QuestionView source ↗
EMERGENCY DEPARTMENTS — REFORM
229. Mr M. HUGHES to the Minister for Health:
I
refer to the McGowan Labor government's emergency department reform
program providing long-term emergency care reforms.
(1) Can the
minister outline to the house how these reforms are addressing the systemic
causes of ambulance ramping, including through new initiatives such as virtual
emergency departments?
(2) Can the minister advise the house how this
initiative builds on our actions to reform emergency departments and put
patients first?
229. Mr M. HUGHES to the Minister for Health:
I
refer to the McGowan Labor government's emergency department reform
program providing long-term emergency care reforms.
(1) Can the
minister outline to the house how these reforms are addressing the systemic
causes of ambulance ramping, including through new initiatives such as virtual
emergency departments?
(2) Can the minister advise the house how this
initiative builds on our actions to reform emergency departments and put
patients first?
AnswerView source ↗
I
thank the member for Kalamunda for his question and for his interest in older
adults, aged care and ageing in place.
(1)–(2) This strategy supports our older Western Australians.
Last year when I delivered my first major speech as Minister for Health to Business
News, I said that we cannot afford to keep turning to emergency departments
to solve all our problems; the rest of the system needed to be fully
functioning. Currently our system is based on a ''all roads lead
to the emergency department'' philosophy, which just has to change.
Other states have had great success with virtual emergency departments.
Victoria's Northern Health virtual ED recently got funding to double
its capacity from the Victorian state government.
I am pleased to say that health
service providers have begun this journey over the last couple of years supported by funding from the government. Virtual
emergency medicine at Fiona Stanley Hospital, initially funded in the
2021–22 budget and expanded in last year's budget, enables
paramedics to videoconference with physicians and divert patients from ED to go
directly to a ward, imaging or timely outpatient care. The Co-HIVE—community health in a virtual environment—at
the East Metropolitan Health Service uses the world-leading HIVE program to deliver remote monitoring, virtual
geriatric care and a multidisciplinary in-reach into aged-care
facilities. The emergency care navigation centres at the North Metropolitan
Health Service funded in the midyear review supports patients to reach the most
appropriate care as quickly as they can, such as quick access to specialists
through the rapid access clinic program.
What is new is that through the
ministerial task force on ramping, we have pulled these programs together as a system-wide
strategy that works as a system. We will then evaluate all those programs and
essentially scale-up the most successful or
best parts to become a system-wide approach and allow people to get the right
care at the right time in the right place. The vision of WAVED—WA
virtual emergency departments—is to get away from ''all roads
lead to emergency departments''. This will allow, particularly this
winter, aged-care facilities to have a safe optional alternative to calling an
ambulance, in which they get a consultant on the phone straightaway to talk to
a nurse on site or to talk to a facility on site and give immediate medical
advice on how to manage their patient, and joint decision-making on the best
thing for that patient. This is a great way forward.
The first stage is that hospital
service providers and St John Ambulance will trial new models of virtual
emergency care focused on frail and older adults in the South Metropolitan
Health Service. East will build on its Co-HIVE model, north will deliver its
emergency care navigation centre, and we are also piloting the My Emergency
Visit app and the emergency care navigation centre to support patients more
generally to expedite their care through the emergency department. It may be
that the advice is to come later in the day
when it is not at peak demand, and that patient can be seen more quickly if
that is clinically appropriate and is decided by the doctor at the time
he sees the patient.
We know that older adults are an
important cohort. They are also one of our biggest cohorts in hospitals.
Currently, given the challenges in aged care in attracting the right skills
mix, the only option is to call an ambulance.
Many families and residents do not want to end up in an ambulance and going
through an ED . This is a more comfortable journey for them; most
appropriately, it is a more comfortable and appropriate journey for them. It will avoid potential hospital-based decline, which
is common in older people in hospital ; it will improve bed block; and,
significantly, we hope and anticipate that it will have some impact on ramping,
given that over 50 per cent of ramping hours are ambulances with older adults
in them. Many of them just need access to a specialist or care as quickly as
possible, but they do not necessarily need emergency medicine.
These are some of the many ideas and
solutions that have come from clinicians on the floor—those who are passionate about making our system functional
and supporting people as best we can. This government is committed to funding those ideas, putting them
in place and backing in the staff on the ground to support our
community.
thank the member for Kalamunda for his question and for his interest in older
adults, aged care and ageing in place.
(1)–(2) This strategy supports our older Western Australians.
Last year when I delivered my first major speech as Minister for Health to Business
News, I said that we cannot afford to keep turning to emergency departments
to solve all our problems; the rest of the system needed to be fully
functioning. Currently our system is based on a ''all roads lead
to the emergency department'' philosophy, which just has to change.
Other states have had great success with virtual emergency departments.
Victoria's Northern Health virtual ED recently got funding to double
its capacity from the Victorian state government.
I am pleased to say that health
service providers have begun this journey over the last couple of years supported by funding from the government. Virtual
emergency medicine at Fiona Stanley Hospital, initially funded in the
2021–22 budget and expanded in last year's budget, enables
paramedics to videoconference with physicians and divert patients from ED to go
directly to a ward, imaging or timely outpatient care. The Co-HIVE—community health in a virtual environment—at
the East Metropolitan Health Service uses the world-leading HIVE program to deliver remote monitoring, virtual
geriatric care and a multidisciplinary in-reach into aged-care
facilities. The emergency care navigation centres at the North Metropolitan
Health Service funded in the midyear review supports patients to reach the most
appropriate care as quickly as they can, such as quick access to specialists
through the rapid access clinic program.
What is new is that through the
ministerial task force on ramping, we have pulled these programs together as a system-wide
strategy that works as a system. We will then evaluate all those programs and
essentially scale-up the most successful or
best parts to become a system-wide approach and allow people to get the right
care at the right time in the right place. The vision of WAVED—WA
virtual emergency departments—is to get away from ''all roads
lead to emergency departments''. This will allow, particularly this
winter, aged-care facilities to have a safe optional alternative to calling an
ambulance, in which they get a consultant on the phone straightaway to talk to
a nurse on site or to talk to a facility on site and give immediate medical
advice on how to manage their patient, and joint decision-making on the best
thing for that patient. This is a great way forward.
The first stage is that hospital
service providers and St John Ambulance will trial new models of virtual
emergency care focused on frail and older adults in the South Metropolitan
Health Service. East will build on its Co-HIVE model, north will deliver its
emergency care navigation centre, and we are also piloting the My Emergency
Visit app and the emergency care navigation centre to support patients more
generally to expedite their care through the emergency department. It may be
that the advice is to come later in the day
when it is not at peak demand, and that patient can be seen more quickly if
that is clinically appropriate and is decided by the doctor at the time
he sees the patient.
We know that older adults are an
important cohort. They are also one of our biggest cohorts in hospitals.
Currently, given the challenges in aged care in attracting the right skills
mix, the only option is to call an ambulance.
Many families and residents do not want to end up in an ambulance and going
through an ED . This is a more comfortable journey for them; most
appropriately, it is a more comfortable and appropriate journey for them. It will avoid potential hospital-based decline, which
is common in older people in hospital ; it will improve bed block; and,
significantly, we hope and anticipate that it will have some impact on ramping,
given that over 50 per cent of ramping hours are ambulances with older adults
in them. Many of them just need access to a specialist or care as quickly as
possible, but they do not necessarily need emergency medicine.
These are some of the many ideas and
solutions that have come from clinicians on the floor—those who are passionate about making our system functional
and supporting people as best we can. This government is committed to funding those ideas, putting them
in place and backing in the staff on the ground to support our
community.
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