New evidence has raised “considerable doubt” over the viability of Australia’s four-hour emergency department wait target for psychiatric patients after one hospital recorded an average ED wait time of almost 18 hours for psychiatric admissions despite there being beds available.
The average ED wait time for individuals requiring admission to the Queen Elizabeth Hospital psychiatric ward was just under 25 hours when there were no vacant beds, researchers from the University of Adelaide observed.
But even when the ward had one empty bed or more the average ED wait time was still significantly longer than the recommended target, clocking in at 17.9 hours, the authors reported in Australasian Psychiatry.
The results raised “considerable doubt about the target being realistic for psychiatric patients”.
The study involving 2,000 people presenting to the ED with a psychiatric problem also found the wait on weekends was significantly longer than weekdays (28.7 hours compared to 20.3 hours) despite no statistically significant difference in the mean number of people presenting with a psychiatric diagnosis on any given day.
But far fewer discharges from the psychiatric unit were carried out on weekends, and a significant inverse correlation was found between times spent in the ED and the number of discharges per day from the ward, leading the authors to conclude the significantly longer wait times in ED on weekends was due to fewer discharges from the psychiatric ward on these days.
The authors suggested the reluctance to discharge patients on the weekends was most likely due to the patients’ and family preferences, support services not being readily accessed on the weekends and working preferences of the treatment teams.
The authors suggested even modest increases in services provided on weekends could lead to substantial increases in hospital care.
“Careful consideration should be given to developing strategies that enable discharge of patients over the weekend, given the adverse consequences associated with access block and crowding
in the ED,” they recommended.
Australasian Psychiatry March 2012, DOI: 10.1177/1039856211432458
As first apppeared in Psychiatry Update