Waiting times for treatment at Ballarat Base Hospital's emergency department during December were the longest they have been throughout the pandemic, as a COVID surge at the end of the year clogged hospital beds and reduced the number of staff available to work.
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Throughout the October to December quarter, just 37.7 per cent of patients in the ED were treated within the recommended time, well below the state average of 64.73 per cent, according to the Victorian Agency for Health Information's quarterly hospital performance statistics.
Grampians Health hospitals chief operating officer Ben Kelly said November and December were particularly challenging for the hospital as a COVID wave peaked and the number of patients increased.
"We had a really early increase in COVID through November, a bit ahead of the rest of the state, and what ... then transpired was a high number of patients staying in the Base Hospital, and staying longer periods of time ... and from that December was our longest wait times through the whole of the pandemic," he said.
People staying longer meant fewer beds were available to transfer people needing admission to the hospital from the ED, and patients staying longer in the ED meaning those waiting to be seen faced "unacceptably long" waits.
Our focus now is really about how we get the ED back to levels we are comfortable with. It is better than it was in November and December but we need to ensure we keep a strong focus. This is a marathon.
- Ben Kelly
"It was coupled with our own workforce needing to isolate because COVID was so prevalent," Mr Kelly said.
He assured Ballarat residents the hospital was doing all it could to bring waiting times back, while at the same time preparing for an inevitable "next wave" of COVID.
"The COVID demand is easing now though it's still present but nothing like what it was through the November-December period," Mr Kelly said.
Works are under way to transform the former maternity outpatients area near the ED into treatment bays for people, along with other measures.
"Our focus now is really about how we get the ED back to levels we are comfortable with. It is better than it was in November and December but we need to ensure we keep a strong focus. This is a marathon," Mr Kelly said.
Greeters at the hospital entrance have been removed, continuing a trend across the state, with visitors now urged to exercise commonsense when visiting the hospital and stay away if they have been exposed to COVID or test positive.
"A lot of that (greeting) was provided by students, nursing students in particular, and we would like to be able to make use of that workforce in a more productive clinical manner than greeting," Mr Kelly said.
The quarterly health statistics also revealed a slight drop in elective surgery patients treated, from 1163 in the July to September 2022 quarter to 1128 in the last months of the year but despite the pressure on the entire hospital it was still significantly higher than the same time in 2021.
"Through those months we maintained elective surgery, not as high as we would like it to be, but better than the state average and we tried to make sure we kept a good balance there with workforce, demand and bed availability," he said.
But the number of patients on the elective surgery waiting list jumped from 1499 to 1746 from December 31 2021 to the same date last year.
During the October to December quarter the ED also recorded a continuing increase in the number of urgent category one presentations - the sickest patients requiring immediate treatment.
There were 196 category one patients, up from 187 the previous quarter but an increase of 25 per cent over the same period the previous year.
The number of category two cases, which should be seen within 10 minutes, increased from 2721 in the July-September quarter to 2843 from October-December, while category three cases needing treatment within 30 minutes grew by 254 to 6287.
Coinciding with the opening of the UFS-led Priority Primary Care Centre in Windermere Street, designed to treat lower-category patients, the number of category five patients at the ED dropped from 380 to 322.
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Overall, the Ballarat Base Hospital ED treated 11,946 across October, November and December - the equivalent of just over 131 per day, every day.
During that time the number of ambulance arrivals grew significantly, with ambulance response times rising only slightly.
Eighty-six people brought in deemed "life threatening priority code 0" was up from 68 in the previous quarter. The median response time of 8.73 minutes rose from 8.02 the previous quarter.
The number of "code 1 high priority time critical incidents" rose from 2040 to 2097, while the median response time was similar at 11.15 minutes compared to 11.08 in the July-September quarter. "Lights and sirens dispatch" cases grew by 80 to 2188 and by more than 284 from the same time in 2021, while response rates increased just over 30 seconds.
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