A key strategic initiative of the Statewide Surgical and Perioperative Care Clinical Network (SSPCCN), is to examine emergency surgery wait times to determine if there is a mismatch between demand and capacity, or evidence of people waiting longer for emergency surgery than clinically planned.
Additionally, the size and magnitude of the problem and its impacts on patient outcomes, was to be reviewed.
Although analyses have been occurring at the Local Health Networks (LHN) level, there had been no visibility previously across metropolitan Adelaide, where the majority of emergency surgery occurs, of the demand versus capacity challenges or any standardised method for assessing.
The CEIH worked with the LHNs to produce, for the first time, a standardised data set to enable benchmarking and consistent metrics across metropolitan public hospitals. Surgical and Anaesthetic Heads of Unit from each metropolitan LHN joined to form an Emergency Surgery Group to undertake this work.
Data provided by The CEIH Clinical Informatics team showed for the period that emergency theatres are used, nearly 35% of the time is the turnaround time between patients (effective utilisation 65%).
Based on this analysis, it appears that approximately 35 beds per day are occupied by patients who have waited more than 24 hours, in excess of the clinically recommended time, for their emergency surgery. There is a direct link to Emergency Department (ED) congestion and potentially impacting those patients waiting, on the ‘ramp’, in ambulances, to be able to access a bed in the ED.
Following initial analysis, it was proposed that a Statewide Emergency Surgery sub-committee be formed, under the auspices of the SSPCCN. This sub-committee will review and implement recommendations to improve emergency surgery capacity and provision, based on the findings within the ‘Metropolitan Operating Theatre Emergency Surgery, Demand versus Capacity’ analysis report.
The committee will also be charged with researching and formulating further recommendations to address the current mismatch between the capacity and demand for emergency.