❓ Minister responds to a question about ambulance ramping, outlining government investments and strategies to address hospital congestion, highlighting initiatives like seven-day hospitals and emergency care navigation centres.
AnsweredQoN 151Legislative Assembly
QuestionView source ↗
HEALTH — AMBULANCE RAMPING
151. Dr J. KRISHNAN to the Minister for Health:
I refer to the Cook Labor government's
record investment to address the underlying causes of ambulance ramping.
(1) Can the
minister outline to the house how this investment will see reductions in
ambulance ramping at hospitals across the state?
(2) Can the minister advise the house what these
improvements will mean for patients across Western Australia?
151. Dr J. KRISHNAN to the Minister for Health:
I refer to the Cook Labor government's
record investment to address the underlying causes of ambulance ramping.
(1) Can the
minister outline to the house how this investment will see reductions in
ambulance ramping at hospitals across the state?
(2) Can the minister advise the house what these
improvements will mean for patients across Western Australia?
AnswerView source ↗
(1)–(2) I
thank the member for Riverton for the question. As we know, COVID-19 has
unleashed huge disruption across health
systems around the world, and many jurisdictions are still grappling with
record bed block and ramping numbers, particularly the eastern states.
There is certainly no silver bullet. There is no one solution to managing
congestion in our hospitals and emergency departments. We had a recent
suggestion from the Tasmanian Liberals at their state election. They are just
going to ban ramping. That is like saying that we are going to ban patients
from coming to hospital or ban people from calling an ambulance! It is the most
ridiculous proposition I have ever heard.
We
know that congestion in our emergency department is not about the emergency
department as such. It is actually a symptom of congestion in a range of areas,
whether it is the inability to get access to pre-hospital care before people get really sick; processes
inside the hospital or, of course, at the other end; having suitable accommodation to discharge people to; or aged-care, disability or appropriate
mental health supports. Of course, beds are
part of that. They are part of the mix, which is why we have put 570 beds in
the system in the last two years.
That is the size of a tertiary hospital across our whole system. That is one
part of the mix.
In a number of those strategies, I have
to give credit to the North Metropolitan Health Service, which has been a first mover on many of the reforms that we
have been working through. Our approach has been to fund innovative solutions
through the half-billion-dollar ramping fund and to work with clinicians and health
services on how we can get solutions to these issues. North Metro has really
led the way in a number of those reforms. One of those reforms is the seven-day
hospital. For people who think hospitals work seven days a week, they do not.
Anyone who goes on a weekend will see that the car parks are often empty. We
are working to resolve that and get staff in on the weekends to continue
episodes of care and make sure that people get tests and get discharged if
required, so they are not sitting in hospital waiting for tests on the Monday, for example, and they can get these things
moving through. This was so successful that we invested another $19 million
to extend radiology and allied health services across all three adult tertiary
sites.
North Metro also expanded the
residential care line, which is a nurse practitioner–led service that
supports clinicians through the WA virtual emergency department by providing
hands-on care in nursing homes. An emergency clinician receives a call from the
nursing home, which does not necessarily want to put the elderly resident into an ambulance and send them to hospital. The
nurse practitioner is called, and they diagnose , treat and do the care
that is required if it is safe to do so. That is receiving huge support from
aged-care facilities and from residents and their families, who really
appreciate having that alternative.
Last week, we also launched what is
called the emergency care navigation centre at Sir Charles Gairdner Hospital,
which is $7 million funded in the 2022 midyear review. This is an example of
where technology can assist with helping patients through a faster and more
seamless process. It will never replace people; we will always need more and more healthcare workers, but technology can
absolutely support the journey . The emergency care navigation centre
essentially addresses the issue of directing every single patient through one
door, which is the emergency department door. Before they even present,
patients can put in the details of why they are attending the emergency
department. It is very simple. It is very easy. People do not have to download
an app. There is an app, but people can do it online. All that information goes
through to an emergency consultant, a St John Ambulance senior paramedic and a registered
nurse, who can see the person even before they are in the waiting room or have
been triaged from the nursing service desk.
They can start to order tests for the person. They can start to provide an
alternative pathway for an older person or a neurological pathway. This
is a genuine reform of how we manage that process of everyone coming to an
emergency department. It is on top of the triage process with the nurse. It is
not instead of; it is on top of. It is safe.
When
I went there, the former head of the Australasian College for Emergency
Medicine, who helped to develop this, said that he loves working in the shift
as the consultant because he genuinely gets to do emergency medicine. He is not
teaching or supervising; he genuinely gets to do emergency medicine. This is a really
exciting trial. I want to thank the staff, particularly at Charlies, for their
commitment. We are looking at rolling this out at Fiona Stanley Hospital, and
we are working with other tertiaries on how we can scale it up throughout the
whole system to provide people with a faster, more seamless trip to the
emergency department.
thank the member for Riverton for the question. As we know, COVID-19 has
unleashed huge disruption across health
systems around the world, and many jurisdictions are still grappling with
record bed block and ramping numbers, particularly the eastern states.
There is certainly no silver bullet. There is no one solution to managing
congestion in our hospitals and emergency departments. We had a recent
suggestion from the Tasmanian Liberals at their state election. They are just
going to ban ramping. That is like saying that we are going to ban patients
from coming to hospital or ban people from calling an ambulance! It is the most
ridiculous proposition I have ever heard.
We
know that congestion in our emergency department is not about the emergency
department as such. It is actually a symptom of congestion in a range of areas,
whether it is the inability to get access to pre-hospital care before people get really sick; processes
inside the hospital or, of course, at the other end; having suitable accommodation to discharge people to; or aged-care, disability or appropriate
mental health supports. Of course, beds are
part of that. They are part of the mix, which is why we have put 570 beds in
the system in the last two years.
That is the size of a tertiary hospital across our whole system. That is one
part of the mix.
In a number of those strategies, I have
to give credit to the North Metropolitan Health Service, which has been a first mover on many of the reforms that we
have been working through. Our approach has been to fund innovative solutions
through the half-billion-dollar ramping fund and to work with clinicians and health
services on how we can get solutions to these issues. North Metro has really
led the way in a number of those reforms. One of those reforms is the seven-day
hospital. For people who think hospitals work seven days a week, they do not.
Anyone who goes on a weekend will see that the car parks are often empty. We
are working to resolve that and get staff in on the weekends to continue
episodes of care and make sure that people get tests and get discharged if
required, so they are not sitting in hospital waiting for tests on the Monday, for example, and they can get these things
moving through. This was so successful that we invested another $19 million
to extend radiology and allied health services across all three adult tertiary
sites.
North Metro also expanded the
residential care line, which is a nurse practitioner–led service that
supports clinicians through the WA virtual emergency department by providing
hands-on care in nursing homes. An emergency clinician receives a call from the
nursing home, which does not necessarily want to put the elderly resident into an ambulance and send them to hospital. The
nurse practitioner is called, and they diagnose , treat and do the care
that is required if it is safe to do so. That is receiving huge support from
aged-care facilities and from residents and their families, who really
appreciate having that alternative.
Last week, we also launched what is
called the emergency care navigation centre at Sir Charles Gairdner Hospital,
which is $7 million funded in the 2022 midyear review. This is an example of
where technology can assist with helping patients through a faster and more
seamless process. It will never replace people; we will always need more and more healthcare workers, but technology can
absolutely support the journey . The emergency care navigation centre
essentially addresses the issue of directing every single patient through one
door, which is the emergency department door. Before they even present,
patients can put in the details of why they are attending the emergency
department. It is very simple. It is very easy. People do not have to download
an app. There is an app, but people can do it online. All that information goes
through to an emergency consultant, a St John Ambulance senior paramedic and a registered
nurse, who can see the person even before they are in the waiting room or have
been triaged from the nursing service desk.
They can start to order tests for the person. They can start to provide an
alternative pathway for an older person or a neurological pathway. This
is a genuine reform of how we manage that process of everyone coming to an
emergency department. It is on top of the triage process with the nurse. It is
not instead of; it is on top of. It is safe.
When
I went there, the former head of the Australasian College for Emergency
Medicine, who helped to develop this, said that he loves working in the shift
as the consultant because he genuinely gets to do emergency medicine. He is not
teaching or supervising; he genuinely gets to do emergency medicine. This is a really
exciting trial. I want to thank the staff, particularly at Charlies, for their
commitment. We are looking at rolling this out at Fiona Stanley Hospital, and
we are working with other tertiaries on how we can scale it up throughout the
whole system to provide people with a faster, more seamless trip to the
emergency department.
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