Launceston General Hospital spent more than 70 per cent of its time between June 2018 and January 2019 in a state of "almost constant gridlock" and at the highest level of escalation, a new report has found.
Tabled in parliament on Tuesday, a Tasmanian Auditor-General report into the state's emergency department services found the health system is not working effectively to meet growing demands, calling for an urgent review into services.
The report looked into the effectiveness of the state's four major hospitals - the Royal Hobart, the Launceston General Hospital, the Mersey Hospital, and the North-West Regional Hospital - in the delivery of emergency department services.
It found ambulance ramping increased by about 149 per cent between 2012-13 and 2017-18, while the RHH was bed blocked for almost 93 per cent of time between June 2018 and January 2019, with patient safety "severely and routinely" compromised almost once every four days.
Patients also waited increasingly longer in EDs for treatment, according to the report, with the rate of ED adverse events increasing by about 60 per cent between 2015 and 2018.
Auditor-General Rod Whitehead said inefficiency across the system was partly due to capacity constraints and longstanding weaknesses within the hospitals around effective discharge planning, bed management and coordination between EDs and inpatient areas.
"These challenges increase the risks for patients and staff and are preventing the EDs of Tasmania's four major hospitals from operating efficiently and effectively," he said.
"Successive reviews over the last decade have highlighted dysfunctional silos, behaviours, process barriers and resistance to change from some clinicians and administrators as the major drivers of these inefficiencies.
"These issues mainly lie outside of EDs but are within the control of hospital leadership teams and are yet to be addressed.
"The patient journey through Tasmania's four major EDs as a result, has become more challenging over the last decade for both patients and ED staff."
The report made 10 recommendations for improving the quality and timeliness of emergency care, including urgent action to strengthen whole-of-hospital and system-wide leadership.
While acknowledging reforms made by the state government in 2018 to improve the performance and governance of the Tasmanian Health Service, Mr Whitehead said the changes were in the early stages of implementation and could not yet be "reliably" assessed.
Health Minister Michael Ferguson said the report's recommendations would be examined closely as part of the upcoming Access Solutions Meeting with the Australasian College for Emergency Medicine.
"The reality is that, despite hiring more than 1000 extra staff in our hospital system over the past five years, opening new beds across the state and increasing services, there is still growing demand, with an increase in complexity of patients presenting to hospitals," he said.
"The government has brought in reforms to clarify and strengthen accountability in Tasmania's health system, with the secretary of the Department of Health now the single point of accountability for the management and delivery of healthcare, and stronger local leadership for our hospitals.
"There are no silver bullets to the issues raised in the report, but the government remains committed to further improving the longstanding cultural and process challenges in our hospitals to improve patient flow and provide the best possible healthcare to all Tasmanians."