The Far West Local Health District has been successful in reducing the percentage of Aboriginal people who do not wait for emergency department treatment in the Broken Hill Hospital following a project that looked at how people access treatment.
The improvement came about due to a concerted effort by the health service, in collaboration with Aboriginal consumers, Aboriginal staff, the Broken Hill Aboriginal Community Working Party and the Broken Hill University Department of Rural Health, to address what was a very real concern, said Melissa Welsh, Clinical Redesign and Innovation Manager, Far West LHD.
“The Far West LHD wanted to close the gap between Aboriginal and non-Aboriginal people not waiting for treatment in the emergency department at Broken Hill Hospital,” said Ms Welsh.
“There is a real concern when people come to the emergency department for treatment but for whatever reason, do not wait to be seen. Of particular concern was the higher number of Aboriginal people not waiting.”
To address the ‘do not wait’ rates for people accessing the emergency department, the Far West LHD initiated the ‘PleDG-ED: Please don’t go it’s worth the wait’ ED project in August 2014.
“We spent a lot of time working with people who accessed the emergency department to find out what helped them stay and what contributed to them leaving. We were told by our patients that they were willing to wait for the doctor if they knew that they had access to care from the moment they arrived, rather than filling in a form and waiting to be seen. In early 2015, the registration form was the first point of contact with the ED, and there were at times long waits before being seen by the triage nurse. Our patients told us that these were significant barriers to accessing care. Based on this feedback, the registration form was removed. The other key change as part of the PleDG-ED project was that ED staff completed online cultural awareness training, which enhanced the way staff interacted with Aboriginal consumers,” said Ms Welsh.
In August 2014, the rate of Aboriginal DNW (Did Not Wait) was 8.7% compared to 4.2% for non-Aboriginal people. At the completion of the project in December 2015, the Aboriginal DNW rate was averaging below the 4.2% target rate and was closer to 2%, compared to 1.5% for non-Aboriginal DNW resulting in a both an overall reduction in DNW as well as a narrowing of the gap between the two measures.
“This was a very pleasing result,” said Ms Welsh
“The current rate continues to sit between 2% and 4%, and whilst it fluctuates from month to month, it continues as a downward trend between October 2014 and now. What this means is that people are waiting for care, and medical issues can be addressed before things get worse for the patient”.
The data continues to be closely monitored and action is taken to address emerging issues before they get out of hand.
Subsequent improvement projects in the ED have also worked towards improving the flow of people through the ED and ensuring rapid triage occurs as the first point of contact. Work continues on patient flow through the ED and access to triage, and the impact of these projects are continually monitored.