Tweed Hospital ICU in gridlock
THE intensive care unit (ICU) at the Tweed Hospital is an eight-bed ward in which medical staff work to keep critically ill patients alive.
But a shortage of infrastructure and services means this vital unit at the facility is near gridlock, its director Dr Mike Lindley-Jones has warned.
"We feel that with the rate of (population) growth, and the increasing demands on our services, we are right at the point of not being able to cope," Dr Lindley-Jones said.
The problem is that patients who are ready to be discharged from the ICU have nowhere to go because the hospital's 201 beds are almost always full.
As a result the ICU can't make anymore admissions.
Clinging to life support, many critical patients must wait in the operating theatres or in emergency until an ICU bed becomes available or an ICU team reaches them in their ward.
"We can carry out procedures on a ward but we don't think they (patients) get the best care," Dr Lindley-Jones said.
Some of the critically ill must be transferred to Robina or Gold Coast University hospitals for services such as angiography, to track acute bleeding from the heart.
"Transfer is a big deal, requiring one doctor and one nurse, and can take three to four hours," Dr Lindley-Jones said.
With the Tweed population growing by 2.5% a year, there are fears the bed-lock is on the cusp of turning into bedlam.
The solution, as outlined in the hospital's NSW Redevelopment Plan, is a modest increase of 12 beds to the ICU by 2017.
This proposal was signed off by the Northern NSW Local Health District in December 2013, but shows no sign of being actioned by the NSW Health Minister Jillian Skinner.
Last month the Tweed Daily News, in conjunction with senior medicos, launched a campaign to pressure the government to allocate the funding.
"The major upgrade of Tweed Heads hospital will not happen overnight and it is incumbent on ... staff to determine the models of care needed to treat patients until the redevelopment is complete," was Ms Skinner's response.
The chair of the Tweed Heads Medical Council, Dr Ian McPhee, has labelled the minister's comments "trite, insulting and unwarranted".
"(The comments) clearly made in ignorance of what is actually being done here in Tweed to manage the pressures that this health service is under," Dr McPhee said.
This included inviting the Agency for Clinical Innovation and NSW Health Ministry to explore "Clinical Pathways", a new model of patient care.
"And instead, despite our championing of this, we hear that funding of the implementation of this model is likely to go to Lismore," Dr McPhee said.
Dr Lindley-Jones said it was simply not possible to remodel the hospital any further.
"We are extremely proud of the work we do in the ICU - we are performing at optimal efficiency.
"And in the hospital, we have one of the shortest lengths of stay in NSW, which is 3.6 days versus Lismore's 4.3.
"It is not possible to streamline any further. We need services now."
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ICU increase in patients since 2011: 44%
ICU increase in beds since 2011: one