The latest Bureau of Health Information (BHI) Healthcare Quarterly report from January to March 2023 was released this week. The report looks at patient numbers in the emergency department as well as the time taken to treat patients.

While most of the statistics were positive for the Northern NSW Local Health District, Lismore Base Hospital (LBH), once again, is consistently at the bottom of the 8 hospitals in the region except for the transfer of patients by paramedics into the emergency department (ED).

Arrival by ambulance was up 4.4% to 2,754 for the January to March quarter for Lismore which is the most in NNSW. The state average for transferring patients to ED staff within 30 minutes is 77.7% with Lismore improving 7% to 77.2% in the last 12 months. In Northern NSW (NNSW) the average was 81.1%.

That is where the good news stops for Lismore Base Hospital.

Attendances at LBH ED were up 3.9% or 367 to 9,848 in the first quarter of 2023.

The time to start treatment in Northern NSW (NNSW) was 74.6% while the NSW result was 67.4%. LBH decreased by 3.1% from 64.3% to 61.2%, 6.2% below the state average and 13.4% below NNSW.

The time from arrival to leaving LBH within 4 hours had a NNSW number of 72.5% and a state average of 58.2%. LBH decreased 2.6% from 57.2% to 54.6%. Again well below the NNSW percentage and under the state average.

There is no doubt that first COVID and now the catastrophic effects of the February 28 megaflood impacted LBH. We have seen in past surveys that the staff rate highly so the solution lies in the system itself.

The Lismore App asked Acting Chief Executive for Northern NSW Local Health District (NNSWLHD) Lynne Weir why this is the case and what is being done to turn the numbers around.

"There are multiple factors which have an impact on the timeliness of emergency department (ED) treatment, and transfer of patients into the hospital, including hospital capacity and patient flow, the acuity (severity) of presentations, and models of care."

"Lismore Base Hospital and Northern NSW Local Health District (NNSWLHD) regularly review models of care, both within the hospital and for services which reduce a patient’s length of stay or the need for hospital admission, such as Hospital In the Home."

"A new Patient Flow Unit was introduced in early 2023 and is now operating right across NNSWLHD, with the aim of improving the transfer of patients within the hospital network, coordinating patient flow for better utilisation of available beds."

"Staff are also working to streamline the transfer process when admitting patients from the ED to the wards, so that available beds are more easily identified, and patient care needs are captured in a standardised way."

"Across the District, we have also been focused on boosting recruitment and improving retention of our existing staff, through measures such as increasing the number of new graduate positions offered, offering all new nursing graduates permanent positions, and pursuing recruitment opportunities for overseas nurses to fill long-term vacant positions."

"The latest Bureau of Health Information (BHI) Healthcare Quarterly report (January – March) shows that of the more than 9,000 presentations to Lismore Base Hospital’s ED in the first quarter of 2023, almost half (47 per cent) were by patients in the semi-urgent (triage 4) and non-urgent (triage 5) categories."

"All patients are seen and triaged on arrival at the ED and, as always, the most seriously unwell patients are treated first. During busy times, those with less urgent conditions can experience longer wait times when there are large numbers of seriously unwell patients being prioritised for emergency care."

"NNSWLHD continues to remind the community to support us by saving emergency departments and ambulances for saving lives. If an illness or injury is not serious or life-threatening, we encourage people to call Healthdirect Australia on 1800 022 222, for 24-hour telephone health advice." 

The 2022-23 budget for Northern NSW Local Health District is more than $985 million, an increase of more than $40 million, or 4.3 per cent more, than the previous year’s budget.  

INDIVIDUAL HOSPITAL RESULTS from NNSWLHD

BALLINA DISTRICT HOSPITAL had 4,514 ED attendances during the quarter. The majority of patients (70.1 per cent) started their treatment on time. More than seven in 10 patients (74.5 per cent) left the ED within 4 hours. More than 8 in 10 patients (84.3 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.  

BYRON CENTRAL HOSPITAL had 5,908 ED attendances and 8 in 10 patients (82.8 per cent) started their treatment on time, which is better than the average for hospitals of a similar size in NSW (78.4 per cent). Nearly all patients (95.5 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, also better than the average for hospitals of a similar size in NSW (93.9 per cent). 

CASINO & DISTRICT MEMORIAL HOSPITAL had 3,463 ED attendances in the quarter. The vast majority of patients (84.5 per cent) left the ED within 4 hours of arriving, which is better than the average for hospitals of a similar size in NSW (79.3 per cent). More than 9 in 10 patients (92.9 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark.  

GRAFTON BASE HOSPITAL had 6,961 ED attendances during this quarter. The majority of patients (68 per cent) started treatment on time, and almost 7 in 10 patients (69.3 per cent) left the ED within 4 hours, which is better than the average for comparable hospitals in NSW (64 per cent). Almost 9 in 10 patients (89.7 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark. 

LISMORE BASE HOSPITAL had 9,848 ED attendances during the quarter. The majority of patients (61.2 per cent) started treatment on time. More than 7 in 10 patients (77.2 per cent) were transferred from ambulance to ED staff within the 30-minute benchmark, which is in line with the average for hospitals of a similar size in NSW (77 per cent ).  

MACLEAN DISTRICT HOSPITAL had 3,957 ED attendances during the quarter. More than 8 in 10 patients (83.8 per cent) started their treatment on time, which is better than the average for hospitals of a similar size in NSW (78.4 per cent). Almost 9 in 10 patients (89.7 per cent) left the ED within 4 hours, which is significantly better than the average for comparable

Northern NSW ED attendance up 6.2% or 3,123 patients to 54,913.