New transit units help reduce hospital pressure

Two new transit units at the Royal Adelaide and The Queen Elizabeth hospitals are helping free up beds, reduce hospital pressure and have contributed to ramping reducing by almost 40 per cent since the July winter peak.

The units, which opened five months ago, have already seen more than 4,000 patients, freeing up ward beds for others.

The units are designed to help improve patient flow by caring for patients who are medically stable and ready for discharge or transfer to another facility.

This then enables earlier availability of inpatient beds for patients at the beginning of their hospital stay. Inter-hospital transfer patients who are waiting for a ward bed are also cared for in these units.

The success of these units has saved more than 8,624 hours of acute bed time, an average of four bed days each day at the Royal Adelaide and more than 1,736 hours of acute bed time, an average of two bed days each day at The Queen Elizabeth Hospital.

The transit units have helped contribute to a 38.7 per cent reduction in ramping across the Central Adelaide Local Health Network (RAH and the QEH) to 1,705 hours in October, down from 2,783 hours in July.

The transit units at the RAH and the QEH are based on best practice with Central Adelaide Local Health Network’s frontline clinicians involved in their design.

While in these facilities the patients remain under the supervision of dedicated nursing and allied health staff and still have access to comfort services such as bathrooms, TV and food and beverage services.

The transit unit at the Royal Adelaide Hospital comprises 12 beds and three chairs and operates 7 days from 7am until 10.30pm. At The Queen Elizabeth Hospital there are spaces for the care of six patients and it operates from 8am until 4.30pm on weekdays.

SA Health will explore the potential benefits of expanding the hours of operation of the transit wards, which was among the recommendations from the recent Coronial report into three deaths that occurred in April 2019, September 2021 and March 2022.

The Government will accept all the recommendations from the Coroner’s report, with programs of work underway. SA Health Chief Executive Dr Robyn Lawrence will oversee the implementation.

The Coroner found “SA Health’s response to ramping is extremely comprehensive and well thought through” and that “SA Health’s comprehensive attack on the root causes of ramping is an excellent use of public funds”.

The Coroner noted the efforts taken in relation to ramping to date are “commendable”, “broad and meaningful”, and are contributing to “a stronger more robust health system in South Australia”.

Ramping improved across the state in October, to 3,948 hours – the best result in six months and down 32.7 per cent from July’s peak of 5,866 hours and down 13.4 per cent from September’s 4,557 hours.

In October, ambulances reached 67.1 per cent of Priority 1 cases in the target timeframe of 8 minutes, compared to only 47.1 per cent in January 2022.

Ambulances reached 60.8 per cent of Priority 2 cases in the target 16-minute timeframe in October, compared to only 36.2 per cent in January 2022.

South Australia’s lowest ramping result in six months came despite a 5.9 per cent increase in emergency department presentations in October compared to the July winter peak, with more than 2,000 extra patients presenting at EDs.

Hospitals also have performed 2,118 more elective surgery operations than at the same time last year – a 5.7 per cent increase.

The Malinauskas Government is building a bigger health system to continue to improve patient flow, including 600 extra beds. The Government has also recruited more than 2,700 additional health workers above attrition since the election.

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

Quotes

Attributable to Chris Picton

The Malinauskas Labor Government is building a bigger health system including 600 extra beds and hiring thousands more doctors, nurses and allied health clinicians.

These new transit units are another way we’re creating more capacity in our busy health system and it’s fantastic to see the results they’re delivering.

More than 4,000 patients have used the transit units at the Royal Adelaide and Queen Elizabeth hospitals, which has helped free up beds and while we know there is still much more to do, it is welcome there has been a reduction of ramping by almost 40 per cent at the Central Adelaide Local Health Network since July.

Attributable to Central Adelaide Local Health Network (CALHN) Executive Director Operations and Performance, Rachael Kay

The strength of this implemented Transit Unit model is that it comes directly from our frontline CALHN clinicians and reflects our safe and connected approach to care.

The units provide a comfortable and supportive environment for patients who are beginning their care with CALHN or preparing to move to the next stage of their journey.

By improving patient flow and strengthening the connection between teams the Transit Units help ensure every patient receives safe, timely and appropriate care, no matter where they are in their hospital stay.