Page 1419 - Week 04 - Thursday, 12 April 2018

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(e) what was the average occupancy rate for the Emergency Department for each month during 2017 and (f) on what dates in each month during 2017 did the peak occupancy rate for the emergency department exceed 90 percent and what was the actual occupancy rate in each case.

Ms Fitzharris: The answer to the member’s question is as follows:

a) Bed occupancy is calculated on funded beds at the Canberra Hospital and Calvary Public Hospital Bruce that are available to receive admissions from the Emergency Departments.

b) The hospital’s response to capacity requirements at times of high demand is managed under the Capacity Escalation Procedure. This states that the Chief of Clinical Operations or the Executive On Call can authorise the opening of additional hospital beds and rostering of additional staff at times of high demand.

c) The Capacity Escalation Procedure outlines three alert levels. If two or more criteria for each level are met, the Chief of Clinical Operations can activate that alert level. The alert levels are:

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

i. Hospital 90-94 per cent occupancy across all Divisions

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

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

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

i. Hospital 95-99 per cent occupancy across all Divisions

ii. Between six or 10 bed booked patients in the ED

iii. ED resuscitation room full

iv. ICU over capacity (funded beds)

v. Isolation beds unavailable

vi. Ambulance off loads in ED corridor

Alert Level 3 - bed availability critical services disrupted.

i. Hospital ≥ 100 per cent occupancy

ii. More than 11 bed booked patients in ED

iii. All surge beds open

iv. Unable to decant resuscitation room

v. Unable to admit patients from other hospitals

vi. Isolation beds unavailable and cohorting unable to be implemented

vii. ICU over capacity (funded beds)

viii. Considering cancellation of surgery.

d) Canberra Hospital employs a number of strategies to ensure bed availability each day including 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. The hospital discharges between 600 and 650 patients each week.

In the winter season of 2017, additional strategies were employed such as:

• 34 additional inpatient beds provided under the winter bed management plan;

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

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