All 24-hour waits in hospital EDs would be reported directly to Health Minister Michael Ferguson, if requests by Australia's peak body for emergency medicine are met.
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The Australasian College of Emergency Medicine has written to health ministers across the country, calling for urgent action to address the "unacceptable" state of mental health support available to people seeking help through EDs, along with systematic issues it claims is leading to violence against staff.
ACEM president Simon Judkins said a lack of appropriate resourcing was putting frontline emergency department staff, and other patients, at risk of violence.
"We know that many people present to emergency departments in a time of deep health crisis and urgent need, and that many of these health crises are extremely complex," he said.
"When incidents of violence occur, the knee-jerk reaction is to blame the perpetrator, which may be entirely appropriate in some cases.
"However, when patients present in a mental health crisis and are left to wait in unsupported environments and their behaviour escalates, not recognising and addressing the system issues leading to these behaviours will result in inappropriate blame and not result in any sustainable change.
"Emergency departments need to be resourced and supported so that they can respond properly to complex community health needs in an appropriate way."
Tasmanian Government figures show violence or threats of violence to staff and patients at the Launceston General Hospital have been occurring at higher rates, with 842 code blacks called at the LGH between 2016 and September 2018.
ACEM have identified four actions to improve the safety and quality of mental health care.
They include:
- All Australian governments act urgently to engage people with lived experience in reforms that deliver timely access to appropriate mental health care, with an immediate focus on after hours care in the community.
- When psychiatric admission is required, processes need to be timely and streamlined so that acutely unwell people can access an appropriate inpatient bed any time of day or any day of the week.
- States and territory health departments enforce a maximum 12-hour length of stay in the ED, by providing accessible, appropriate and resourced facilities to allow for ongoing care beyond the ED, with mandatory notification and review of all cases embedded in the key performance indicators of public hospital chief executives.
- All 24-hour waits in an ED should be reported to the Health Minister regularly, alongside any CEO interventions and mechanisms for incident review.
Responding to the requests, Health Minister Michael Ferguson said he would always listen and consider the views of key health stakeholders and would be in touch with the college.
"The safety of staff and patients is a top priority for the government, which is why we established a team to challenge violence and aggression across the THS, and a tender has recently been awarded for new special training for aggression management," he said.
"This three-year program will be offered to every one of our THS staff and will provide skills in picking up aggressive behaviour and using deescalating techniques.
"By using these skills, staff will be better equipped to reduce the danger of aggressive incidents.
"This means our staff and patients will have increased protection against aggression, and also ensures our hospitals are able to provide the care people need as efficiently as possible."
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Jessica Willard
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
Being a health reporter to me is about more than just reporting the problems. It's about asking why they are happening in the first place and what needs to change to fix it.
