Yesterday, the Southern District Health Board released an update on Southland Hospital services and capacity and the impact of workers being stood down.
Screening questions strengthened to support protections for staff
Last week a patient attended Southland Hospital and subsequently tested positive for COVID 19. There is no suggestion the individual was aware they had COVID-19 or intentionally put people at risk. However, it led to a number of staff needing to be stood down.
The experience has underscored the importance of patients being adequately screened on entry to hospital, or health care settings, including asking about all symptoms, no matter how minor, as some symptoms may not be recognised as possible COVID-19 symptoms.
Additional questions are now being asked to capture very mild or atypical symptoms. This screening has been introduced at all SDHB hospitals, including Southland Hospital, to ensure patients who could have COVID-19 are identified.
We are continuing to learn more about this illness, and are aware of a number of extremely mild cases in our district, where symptoms have been negligible or not immediately identified as COVID-19.
Our thoughts remain with the patient and we acknowledge this has been a challenging event for all involved.
Impact on workforce
In this instance, despite staff being stood down, because of lower than usual occupancy of the hospital as part of the COVID-19 response, Southland Hospital has been able to manage with existing staff. However, if the hospital occupancy rate increases, any such stand down of staff would have an impact.
We are supporting those staff who were affected by last week’s situation and also working to make sure the wider staff at Southland Hospital are informed and supported.
Southern DHB hospital services and capacity
Southern DHB’s COVID-19 response has seen a significant reprioritisation of services, as is expected at COVID-19 Alert Level 4.
This has included the need to create capacity in our hospitals, so that we are able to accommodate a sudden influx of patients, and avoid our hospitals becoming overwhelmed as has been seen in other parts of the world. We also need capacity to see our sickest patients who need our care at this time, and we want to enable patients and their families to observe the requirements of Alert Level 4. To achieve this, we have deferred a range of non-urgent outpatient and elective services.
In Southern approximately 2,531 face-to-face outpatient appointments have been impacted due to the COVID-19 response. Some of these patients have been contacted by phone or Skype and had their appointment conducted remotely. The remaining appointments will need to be remade when the country moves to a lower alert level.
The COVID-19 response has also resulted in approximately 418 elective operations being postponed.
Southern DHB is putting in place measures for patients who have had their appointments or elective surgery deferred. We are regularly reviewing our patients and all surgery, scans and outpatient appointments that cannot be deferred are being carried out in the appropriate environments. We are contacting patients by phone, using telehealth and Skype. In addition, information on Southern HealthPathways is being constantly updated for GPs.
While these deferrals have been necessary, we know the current pandemic does not make the ongoing health needs in our community go away.
We are already planning and discussing how we might transition back from the Alert Level 4 COVID-19 response to providing increased services and procedures over time. There are many uncertainties facing us as we seek to address this, and we want those in our community whose health care has been impacted by the COVID-19 response to know that we have not forgotten about them. We thank everyone for their understanding and patience, and we want to make sure that our communities receive the health care they require, and that those treatments that have been deferred are caught up with in good time.
TOTAL FREE BEDS RESERVED FOR COVID-19
- Dunedin Hospital current dedicated COVID ward has 24 bed spaces, but can be made up to 28 by using clinical rooms. Southland Hospital has 12 beds reserved for Covid-19 patients.
- Additional capacity has also been created at Lakes District Hospital in Queenstown.
- Beyond this, we have further wards that we would make available as we step up the response across the Southern health system.
Dunedin ICU has contingency plans to enable up to 30 beds for COVID use; Southland has 6 CCU beds.
CURRENT OCCUPANCY RATE
As well as reduced attendance at appointments and elective surgery, we have seen a significant reduction in presentations at the Emergency Departments since Alert Level 4 began.
- Current Dunedin Hospital occupancy on 5 April was 66%. Usual occupancy pre COVID-19 was between 88 to 105% occupied.
- Southland Hospital occupancy on 5 April was 61%. Usual occupancy pre COVID-19 was between 85 to 102% occupied.
From 23 March 2020 to 3 April 2020 a total of 432 high tech scans were postponed or deferred at Southland and Dunedin Hospital Radiology units. High tech imaging refers to Computed Tomography (CT), Magnetic Resonance Imaging (MRI) and Ultrasound (USS)
Southern DHB undertook 1560 elective plain x-ray examinations between 23 March 2019 and 03 April 2019 – compared to the same period in 2020 where 164 elective x-rays were completed.