In a sign that the Illawarra's hospitals are at breaking point, the health district has imposed a "circuit breaker" period, as COVID, flu and staff shortages threaten to send the system into overload.
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According to the region's health boss, hospitals have been inundated with "sicker and more complex patients" in recent months and have been forced to try out new strategies to move patients through the overburdened wards amid rising winter illnesses.
In a staff memo, Illawarra Shoalhaven Local Health District chief Margot Mains outlined a "persistent and at times unprecedented cycle of events" that has meant patients are staying longer in hospital, keeping beds full and causing long wait times in the emergency department and ambulance bays.
Announcing an "organisation wide circuit breaker" period, which started on May 23, Ms Mains said there had been a "decline in the effectiveness of the patient flow journey".
"Each of you is very aware of the significant demand right now for services across the LHD, in particular our Emergency Departments, which flows through to the rest of our services," she told staff.
"The teams are seeing sicker and more complex patients, who are needing longer lengths of stay.
"Plus, we have more people than ever whose discharge is delayed for one reason or another; all of which combined has contributed to our ability to effectively flow patients through our hospitals and free up access."
"This, together with the ongoing impact of staff furlough and the hangover of the past two years of living with COVID-19, fire and floods, means the challenges keep coming and testing all areas of the organisation, and most importantly, our colleagues."
Ms Mains said the circuit breaker period was aimed at "addressing once and for all, causes of blockages in our patient flow approach and not just reacting to the symptoms as they arise".
During the two-to-six week circuit breaker period, staff have been asked to "pause non-clinical activities that are not critical to improving patient flow".
This includes reducing emails, limiting meetings and putting non-clinical work on hold, and having management staff on the floor of the hospital to support frontline staff.
The district has also created a Medical Advisory Panel which will make fast decisions on complex matters, and has set up a command centre where live information about patients is fed to a patient flow team.
This command centre - located inside the soon to be closed Mass Vaccination Hub - will be holding twice daily bed capacity meetings, and doctors across the hospital will need to increase their daily patient rounds.
Issues which will not be a focus of the circuit breaker period included "conversations about the number of ED accessible beds, access to residential aged care facility beds, work with ambulance about virtual care opportunities and service redesign opportunities".
Nurses say the main issue is 'severe staffing shortage'
The week has received a mixed response from staff, with some saying they are sceptical the administration's focus will improve the situation in the hospital long term.
One staff member, who asked to remain anonymous, said she was concerned that the push to move patients quickly out of hospital could affect patient experience and outcomes, potentially creating a bigger issue down the track when patients needed to return to hospital.
Wollongong's Nurses and Midwives Association delegate Genevieve Stone said nurses did not want to comment on the week.
Instead, she said they wanted to draw attention to the "elephant in the room and the main issue, which is the severe staffing shortage".
"The only way the health system will improve is if the NSW Government steps up and introduces safe staffing through mandated patient ratios," she said.
"The current system is unsafe for patients and staff, and that's where we need to start.
"From a nursing perspective, I don't think we are going to see any changes to our workload or patient care unless we get better staffing."
NSW opposition health spokesman Ryan Park said that more funding was the solution to the region's hospital woes.
"We can't keep asking staff to perform miracles. They are worn out and inevitably it leads to burn out," he said
"The Government needs to boost resources to the Emergency Department so that capacity can be increased and it's certainly an issue that I will be talking to the Minister about when Parliament resumes next week."
"Everyone understands that from time to time Emergency Departments are under pressure, but this is happening all the time and it's simply not right on patients, their families or our hardworking staff to ignore it."
How the hospital will cope as winter continues
Ms Mains told the Mercury it was expected that the current high demand would continue to increase, which is why the circuit breaker period was important.
"This is an opportunity to focus specifically, for a two-week period, on improving patient flow," she said.
"It will enable us to better identify what is working well and what we might do differently to ensure the patient journey begins with timely care in our EDs, right through to appropriate admission and a safe and efficient discharge from the ED and hospital wards."
"This circuit breaker period will give us the opportunity to achieve improvements in key areas, including more timely discharges from our ED to hospital beds across the District, a better success rate in aged care placement and transfer to residential aged care facilities, and better use of use of technology and real-time solutions."
Also this week, Ms Mains took to social media to reassure people that the hospital would be able to cope as winter illnesses rise.
She urged people to take advantage of the free flu shots being offered through out June to help take the pressure off the health system.
"This is the first time in two years we are seeing high rates of influenza, and this coupled with COVID_19 means we all need to do everything we can to reduce our respiratory illness," she said.
"I want to reassure the community that despite this demand on our ED we will always treat the most unwell patients as a priority. So please do not hesitate to call triple-0 or come to the ED if you have chest pains, signs of stroke or another serious health emergency."
Kate McIlwain
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
