Page 313 - Week 01 - Thursday, 15 February 2018

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Winter inpatient bed management strategies.

Nine more Emergency Department (ED) beds opened as the final stage of ED expansion in July.

Additional nurses recruited in paediatrics, as well as permanent and casual positions in the nurse/midwifery relief pool.

Adjusted wards person rosters to meet afternoon/evening demand through ED and Medical Imaging.

More Hospital Assistants to clean beds and maintain medical stock levels.

Increased afternoon and evening availability of the central equipment courier for transporting items including medication to and from pharmacy and pathology.

Winter testing regime in Pathology, increasing instrument capacity, staff availability over the weekend, and prioritising ED and inpatient samples.

Daily operational focus on managing patient movement through the hospital.

Organisational targets focusing on discharging patients who are safe to go home earlier in the day; ensuring continued safe discharges across the weekend and reducing length of stay where clinically appropriate.

Aim to keep long length of stay patients below 250 (days).

Communications strategies throughout Canberra Hospital to ensure staff were cognisant of demand pressures.

3. As outlined in the Capacity Escalation Procedure, there are three levels of alert and the criteria that determine each escalation level are:

Alert Level 1 - beds available for new admissions and patient flow being achieved.

Trigger: two or more of the following:

Hospital 90-94 per cent occupancy across all Divisions

Five or below bed booked patients in the Emergency Department (ED)

Intensive Care Unit (ICU) at capacity (funded beds)

Alert Level 2 - limited availability of beds, patient flow is compromised

Trigger: two or more of the following:

Hospital 95-99 per cent occupancy across all Divisions

Between six or 10 bed booked patients in the ED

ED resuscitation room full

ICU over capacity (funded beds)

Isolation beds unavailable

Ambulance off loads in ED corridor

Alert Level 3 - bed availability critical services disrupted

Trigger: two or more of the following:

Hospital > 100 per cent occupancy

More than 11 bed booked patients in ED

All surge beds open

Unable to decant resuscitation room

Unable to admit patients from other hospitals

Isolation beds unavailable and cohorting unable to be implemented

ICU over capacity (funded beds)

Considering cancellation of surgery.


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