Yes, I couldn't agree more. I'm sure each department has its own list of new
interventions that have increased waits in recent years. Ketamine sedation,
CT/US scanning and interpretation, OT/physio intervention, to name but a
few. Interpreting our poor waiting times as "inefficient" is clearly
oversimplifying the situation.
Adrian Fogarty
----- Original Message -----
From: Jonathan Benger <[log in to unmask]>
To: <[log in to unmask]>
Sent: Sunday, March 31, 2002 7:51 PM
Subject: Re: Initial medical assessment
> I think the other thing that we have to take into account is the amount
that
> we actually do for our patients these days.
>
> It takes much longer and occupies many more resources to thrombolyse a
> patient in the ED rather than "slow-tracking" them to CCU. Likewise we
spend
> much more time investigating, treating and observing than we used to.
Simply
> counting the number of staff and the waiting time doesn't allow for
changing
> acuity, increasing intervention or better standards of patient care.
>
> Jonathan Benger.
> SpR, Bath.
>
> -----Original Message-----
> From: Accident and Emergency Academic List
> [mailto:[log in to unmask]]On Behalf Of Dunn Matthew Dr. (RJC)
> ACCIDENT & EMERGENCY - SwarkHosp-TR
> Sent: 26 March 2002 09:43
> To: [log in to unmask]
> Subject: Re: Initial medical assessment
> >
> > Waiting times have increased because the method of working
> > has been forced to change by
> > reduced bed availability. A&E nurses are being utilised to
> > look after patients who should be on
> > wards. This reduces the number that can be made available to
> > the minors 'stream' so slowing down
> > that stream as well. The acuity of care required is the
> > variable that has changed most rapidly and
> > has caused the slowdown - for reasons beyond A&E's control.
> >
>
> Yes, I think you're right, but I'd like to see the proof (and I'd like
even
> better for the DoH to see the proof). Certainly, my perception of A and E
> departments has been that the waiting time corresponds more closely to how
> long patients referred to inpatient specialities spend in the department
> than to attendance rate: staffing ratios. There's a number of papers
around
> showing that staffing is a poor predictor of waiting times. I haven't seen
> anything looking at referral to admission times against waits to be seen.
> Would be useful, needs a bit of work on how best to do it. Possibly
compare
> departments that have other specialities regularly clerking in patients in
A
> and E with those that don't?
>
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