by Emmanuel Joseph
In making the announcement this morning during a news conference, Chief Executive Officer, Dr. Dexter James, said the crisis was caused by the increasing number of patients who continued to occupy beds, even though they are deemed eligible for discharge.
“From where we sit, we actually have a mass casualty crisis on our hands. We define a mass casualty as a condition in which the number of patients overwhelm the resources that we can currently provide under normal conditions,” James pointed out.
“As of today, we have seven patients in the Accident and Emergency Department classified as elderly for care, we have 13 patients awaiting admissions and needless to say, if patients present emergency conditions to the Accident and Emergency Department, we would find it very difficult to find beds to examine these patients,” lamented the hospital CEO.
He disclosed that there were more than 40 patients on the wards, deemed and cleared fit for discharge, but cannot find alternative accommodation for one reason or another.
“These patients, by virtue of remaining at the QEH, exposes not only the hospital to unnecessary risks, but expose themselves to the possibility of hospital acquired infections, such as bed sores which can in fact lead to death of these patients,” he reported.
James said the matter was sufficiently grave that it required an urgent response from the agencies responsible for care of the elderly as well as internally, “we are going to be reviewing our processes to make sure that we could discharge patients who are deemed fit for discharge in an efficient and effective manner”.
Clinical Risk Consultant, Dr. Fiona Leacock, told the news conference that the bed blocking had reached such a dire stage, that all elective surgeries had been cancelled from Friday.
“Which means we now have … once we clear some beds, we have to try and get those patients admitted in order to get them through and we would give the ones that were waiting who didn’t have a surgery date this week … have been delayed even further,” explained Leacock.
“And that is the impact that it has when we have this phenomenon of patients being abandoned and left here at the QEH or they come in for a clinical reason and then we cannot get them to return home.”
She revealed that eight of the 38 patients on wards are under 65 years of age who required some form of care, but a lot of them are homeless.
She said many of these patients who were taking up bed space, were either diabetics, just had surgery or had limbs amputated.
Leacock noted that some have been abandoned for more than a year while one had remained in hospital for “all his life”.
Head of the Department of Medicine, Dr. Ann Marie Hassell, who also shares responsibility for surgery, explained that her section could not care for patients needing admission from the emergency room, so they have to care for acutely ill persons in the emergency room itself.
“Secondly, the patients who are already admitted to the wards – those who we would like to keep for a day or two more – we are forced to discharge … a little early just so we can get people up from downstairs,” Hassell asserted.
“Patients are constantly being admitted,” she added, “from the public, through A&E to the general wards. This puts a significant burden on the doctors because sometimes we have to make decisions where we would like to keep another day, but we can’t because of the pressure coming from patients needing to get admitted.”
“So we are now in a very tight bind right now. Getting this group of patients out, is not going to solve the problem because we were able, towards the end of last year to have at least 25 to 30 patients out of the hospital system into the district hospitals, but that number quickly came back from zero to 45 again. So it’s a constant revolving door,” she added.
Hassell was of the view that apart from the family, churches and communities needed to be responsible again, rather than leaving matters of this kind to the Government or the hospital.
The hospital recommendations for creating a permanent solution include families collecting their relatives from the QEH, assistance from the police to return patients home, use of private homes paid for by patients, increase bed space and staffing levels at district hospitals and expanded day-care for elderly persons and the development of a multi-disciplinary team to help with discharge planning. firstname.lastname@example.org†††††