NSW health department looks like they may be requesting a “please explain” from doctors who admit patients to hospital with a diagnosis that can often be treated in the community such as pneumonia, UTI, DVT, etc.

See The Sydney Morning Herald article Dec 17th 2008.

NSW Health’s Acute Care Taskforce has identified 12 medical conditions, including pneumonia, bronchitis, urinary tract infections, chest pain and gastroenteritis.

Hmmm… chest pain Mx in the community for trial of death?

Sounds like the bureaucrats think we are lazy and irresponsibly unnecessarily adding to bed access block by admitting low risk patients.

Certainly there is a place for encouraging some of these patients to be treated in the community, but I would be surprised if most avenues to community treat appropriate patients are not already being tried.

At the end of the day, the patients we admit are almost always needed to have inpatient care either because they have a more severe form of the illness that warrants close medical or nursing care, or their social situation mandates it, or there is a lack of community support (unavailability of hospital in the home resources or availability of adequate GP follow up), or evening presentations where home care overnight becomes less safe.

Many EDs utilise their Short Stay Observation Unit for lower risk patients as long as hospital administration has not usurped this beds as interim care for patients needing inpatient care.

Creating more paperwork will just make us more frustrated and inefficient – the ED environment is already overloaded with bureaucratic processes that adversely impact ED staff efficiencies without demonstrably improving patient care, please don’t add more!

Sounds like just more political smoke screen to disguise the fact that there just are not enough acute hospital beds for the population and not enough community resources to allow community care.