A suite of initiatives is helping to speed up patient flow and discharges at the Lyell McEwin Hospital, and bring down ramping.

The measures include clinicians working to discharge patients on weekends, additional staffed beds in emergency for ambulance patient offload, emergency streaming for patient needs and geriatric care in emergency.

Ramping at Lyell McEwin Hospital has decreased by 45 per cent since October last year, recording its fifth straight month in a row of ramping reductions at the hospital.

A new team of doctors, nurses and allied health professionals, known as SWIFT, has been established to improve the rate of patient discharges on weekends, where backlogs have traditionally occurred.

The clinical team uses Artificial Intelligence software to identify patients to be reviewed for discharge, saving clinicians valuable time from having to unnecessarily trawl through large lists of patient records and notes.

Staff can then focus their time on ensuring ready patients have everything they need such as medication and test results to go home, reducing preventable delays to discharge.

SWIFT – funded in last year’s State Budget as part of a raft of measures aimed at reducing bed-block – has been operating at the Lyell McEwin Hospital since December with promising results.

There has been a 34 per cent increase in weekend discharges since the program began, from an average of 70 discharges each weekend in 2023, to 94 in March 2024.

Within the emergency department, the ambulance patient offload zone has also been expanded, more than doubling the number of offload beds now available 24/7, supported by an increase in staffing.

A total of 10 beds, up from four previously, allows patients arriving by ambulance to be assessed and triaged by nursing staff within the ambulance offload zone. The six new beds are in addition to those already available within the ED.

The hospital has also strengthened the streaming process used within the emergency department for all patients presenting for care.

On arrival, patients are streamed, aligned with their anticipated care needs – those expected to be seen, treated and sent home; those with more serious conditions expected to require admission; and paediatrics.

This approach minimises multiple patient moves, and ensures patients are co-located in the part of the emergency department where their care will be delivered.

Specialised older person services are also being delivered for the first time within the hospital’s emergency department through the new Geriatric Emergency Department Inreach (GEDI) program.

Focused on people aged 80 and over, as well as those from residential aged care, GEDI offers greater support to older patients with multiple chronic conditions and fast-tracks them to appropriate care.

The team, which includes a geriatrician, junior medical officer, nurse consultant and clinical nurse, performs specialist assessment and screening of the patient’s needs and helps identify if they require admission to hospital or can be supported with community-based services.

More than 190 people have been supported since the program began in January, with 50 per cent avoiding a hospital admission.

The hospital’s newly-expanded emergency department – increasing capacity with up to 76 treatment spaces – has also helped improve flow.

These initiatives by the Northern Adelaide Local Health Network are improving patient care while helping to bring down ramping at the Lyell McEwin Hospital.

The Lyell McEwin saw a significant improvement in ramping for the second month in a row despite sustained pressure across the system, with 479 ramped hours at the hospital in March, compared to 544 in February – a 12 per cent improvement, and down from 868 hours in October 2023, a 45 per cent improvement.

In March, ambulances spent 4,095 hours on the ramp. The system was under extreme pressure with a 17 per cent increase in Category 1 patients – the sickest level – compared to the previous month and the same time last year.

There was also a five per cent increase in ambulance arrivals at emergency departments compared to February 2024 and March 2023.

Full ramping data, including a hospital by hospital breakdown, can be found here.

Quotes

Attributable to Chris Picton

Clinicians at Lyell McEwin Hospital are using clever strategies to help improve patient flow, reduce delays to patient discharge and bring down ramping.

Doctors, nurses and allied health staff are working together to achieve some great results for safe and accessible care. I congratulate all the hard-working staff at the Lyell McEwin Hospital for their excellent work and commitment to their patients.

We know our health system is under intense pressure at the moment, as the primary health care crisis and aged care blockages continue to push patients into our hospitals and make it hard for them to get timely discharge.

We know we need more beds in our system and we are working tirelessly to build and open every bed that we can.

This year alone we will open 150 new beds across our hospitals, with a further 130 beds next year – that’s the equivalent of a new Queen Elizabeth Hospital.

Attributable to Northern Adelaide Local Health Network Interim Chief Executive Officer Karen Puvogel

These initiatives are a great example of how our exceptional leaders, clinicians and support staff collaborate to design, trial and embed new initiatives that improve patient care.

It demonstrates NALHN’s commitment to improving care for our patients while creating capacity for new patients entering the healthcare system.

The improvements in NALHN’s February and March ED ramping and patient flow data is encouraging and demonstrates we are on the right track with these initiatives. We will continue working with our teams to review, refine and optimise how we deliver care.

NALHN is committed to supporting our community to have the best possible health and wellbeing outcomes throughout their life.