Medical Admissions Unit Staff Shortage can compromise patient safety – Overcrowding caused by social cases
Press Release 29th August
Medical Admissions Unit
Staff Shortage can compromise patient safety – Overcrowding caused by social cases
Unfortunately the Department of Medicine, like most other areas in the public health sector, is suffering from severe shortages in medical manpower.
• This was confirmed by a recent circular by the Chairman of the Department of Medicine – to the extent that restrictions to vacation leave were threatened and it was intimated that “activities of daily living” are a luxury for doctors.
• The number of doctors on duty in the department of is less than stipulated than the industrial relations act.
• The medical manpower situation is such that there is a problem to find doctors to man the emergency services almost on a daily basis.
The opening of the new unit would result in increased work-load because
• All patients in the casualty need to be assessed whether they qualify to enter into the new admissions ward
• More patient reviews are necessary to affect the increased number of patient transfers.
• Fast tracking implies frequent review by more senior doctors.
• Indeed the health division was planning to deploy additional non-medical staff to run the unit, rather than rely on those already present.
It was not possible to do likewise with doctors because of the serious manpower shortage. One cannot continue to stretch the already over-stretched medical emergency services.
It is therefore not possible to guarantee patient safety in all medical wards should the Medical Admissions Unit start operations with the current staff complement.
Whilst the health authorities may wish to bury their heads in the sand and pretend that everything is well, MAM will not do likewise and it is unwilling to compromise patient safety.
• The proposed operational policy of the unit involved changes in conditions of work, which, unfortunately were not discussed with MAM.
• Doctors were expected to perform many more reviews and assessments in the “fast tracking” system
• Many doctors would have new responsibilities in deciding which patients should be sent to the “admissions unit” and having to discharge patients earlier than usual.
Consultants and other doctors were also not adequately consulted on the matter.
MAM challenges the Heath Division to state how many meetings were held with the medical consultants and other doctors to discuss the Medical Admissions Unit.
The Overcrowding problem is caused by 100 blocked beds . 80 socials cases, and 20 cases awaiting Zammit Clapp cannot be solved by a 14 bed unit.
• There are around 80 “social cases” at St. Luke’s waiting to be transferred to long stay geriatric (old people’s) homes.
• Patient (around 20) haves to wait 3-4 weeks to be transferred to Zammit Clapp for rehabilitation –
• The mean duration of stay at St. Luke’s is 4.5 days, one of the lowest in the world, indicating a high turn over.
• Reducing the stay of a handful of patients from 4 to 3 days will have only a minimal effect on overcrowding in the Medical Wards.
The present unfortunate situation is due to the almost total lack of consultation by the health authorities and their failure to invest in human resources. The health authorities are invited to stop the “blame game” and engage in meaningful discussion with the elected representatives of the Medical Profession.
Once again the attitude of the Health Authorities does not augur well for the opening of the new hospital.
Dr Martin Balzan MD FRCP(Lond) FEFIM