The Ministry of Health and Medical Services (MHMS) would like to inform that it is fully aware of issues of overcrowding and bed shortages at the Accidents and Emergency Department (AED) and it is working hard and closely with the National Referral Hospital (NRH) management to address the issue.
First, the Ministry wish to acknowledge the hardworking doctors and nurses at the ED who have had to attend at times to high numbers of sick patients and sympathize with the patients and their caregivers who in peak times, had to resort to the floors to rest and wait long hours before being attended by the doctors.
While there are several contributing factors internal and external leading to this situation, the ministry is working tirelessly to address the matter from assessing the bottlenecks to development of an action plan to address the matter.
Thus, pleased to inform that the hospital for the first time now has a Bed and Patient Taskforce Committee established with the purpose of managing the bed and patient flow within the hospital to ensure minimal time as much as possible from initial examination at ED, to admittance to the wards and discharge. Their tasks involve obtaining overnight the number of patients that needs to be admitted and check all wards for the beds. They also help various departments within the hospital identify beds and help to ensure smooth and swift discharges from the hospital to allow movement and transfer of patients into the wards.
The NRH medical laboratory is now operating on 24 hours basis to enable the doctors to make the diagnosis early and make a plan for medical management of the patients. In that case, the aptient can be discharged early, if fit to do so.
A customer patient care service is in place and ready for roll out at the AED. There will be additional staff both nursing and non- skilled staff to help coordinate patient and non- patient movements at the department. They will basically direct patients to their appropriate clinics, and ensure they are seen by their doctors in a timely manner and help with their comforts on wheel chairs and beds.
All departments are also requested to develop their inpatient protocol, which involves accepted length of stay at the hospital wards for a particular sickness in lines with the principles of managed care. Reasons for any extended stay at the hospital will be flagged to the doctors and nurses. Patient discharges will be done no later than 10am each day with clear discharge, medication and follow up plan. Reducing the length of stay of the patients will not only ensure bed availability but also ensure that there are less chances of hospital acquired infections which could further prolong the stay of the people.
Stringent measures to control overcrowding at the AED will be implemented to prevent people from just walking in as always is the case, making it difficult for doctors and nurses to manage patients with diligent and care with duress.
With discharged patients, there is also delays due to waiting on beds for take home medication and transport. This will soon change as two areas have been identified and will be secured and cordoned for patients straight after their discharge.
Other internal short term measures include, creation of additional bed spaces at the hospital with plans in place for 71 potential additional beds. In the long -run, a new hospital to be built as per the NRH business case which is also in progress.
With regards to external measures, the ministry will be consulting with the Honiara City Council (HCC) and Guadalcanal Province for HCC and Guadalcanal clinics to be opened at the weekends to prevent influx of people to the NRH emergency during the weekend which cause crowding in the hospital especially during the weekend.
As part of our efforts to restrict the patients coming into the NRH, we have strengthened Good Samaritan Hospital, X-Rays can now be done there, a laboratory will be functional very soon and talks are ongoing with the hospital to provide isolation beds at the GSH.
The patient flow has also increased because of closure of Kukum clinic and talks are ongoing with the HCC to identify alternate health facility to attend the patients after clinic hours. Work on Naha birthing centre is in progress.
With this, the Ministry is urging the public to minimize as much as possible visitors to the hospital including caregivers to care for the sick. Space is vital in the operations of the hospital especially with the discharge of duties of doctors and nurses. Whilst we work on sorting out waiting area for discharged patients, we kindly request that patients prepare well in advance transport after being notified of the time they will be discharged so beds can be freed up as soon as possible. The patients are also advised to seek medical care early to prevent hospitalization, adhere to other good habits to prevent disease and seek hospital care only if they need it. Please access services at the clinics who will guide you whether you need to go to the hospital. The AED is for acute cases needing intervention at the hospital and for routine diseases which do not require hospitalization, one must try to avoid coming there.
While these measures some in place and others still in progress, it may take time before situation improves nevertheless the Ministry and the National Referral Hospital once again assures the public that it is giving all its best to improve the situation.