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Emergency department fails to meet targets

In the 12 months to February 2022, Wairarapa District Health Board has failed to meet its target of seeing emergency department [ED] patients within six hours.

All district health boards [DHBs] had a target to see 95 per cent of ED patients in six hours or less between admission and discharge.

However, each month between March 2021 and February 2022, Wairarapa DHB failed to meet this goal.

In February, the ED failed to see 26.1 per cent of its patients within six hours of arrival.

The highest rate in the 12-month period was in March 2021, when 91.2 per cent of patients were seen within six hours. However, this rate still fell 3.8 per cent below the DHB’s target.

The rate had declined each month since March 2021. In December, 84.7 per cent of patients were discharged within six hours, 78 per cent in January, and 73.9 per cent in February – the worst result since the target was set in 2016.

Wairarapa DHB chief executive Dale Oliff said several factors contributed to the time patients spent in ED, including covid and staffing issues.

“The requirements for patient screening and use of personal protective equipment and isolation processes all slow down care delivery within the department.

“We have seen high rates of staff and whanau sickness and the need to self-isolate. This, alongside existing vacancies, has resulted in the department operating on less-than-optimal staffing levels at times.

“These same factors also extend to other critical services that support our ED team, such as imaging, which can contribute to delays in the emergency department for patients.”

Oliff said external factors also determined the time spent in ED.

“A high number of current acute ward inpatients constrains our overall capacity to maintain the flow of patients in our hospital system. This has increased recently, given the impact of covid on our aged residential care facilities in the district.

“We regularly transfer patients based on clinical considerations to other DHBs who will face similar pressures in their own communities.

“All these aspects can contribute to delays for patients in the department.”

However, the DHB had also failed to meet the target before the pandemic.

In 2020, the Times-Age found that the DHB had not met the target for 19 out of the 22 months between July 2018 and May 2020.

Between July 2018 and May 2020, the DHB’s lowest rate was failing to see 10.7 per cent of patients within six hours.

Oliff said there was a high level of vacancies across the department.


“There are currently 5.4 vacant nursing FTE [full-time equivalent] and one medical FTE in our acute services team.”

She hoped to mitigate the issue by increasing resources and targeting overseas recruitment.

“We are also reviewing the use of our AAU [Acute Assessment Unit], a five-bed area within the acute services department where patients can be admitted that are awaiting transfer to another DHB or area of the hospital. This will improve flow through the emergency department.”

Oliff encouraged the community to use primary care and alternative services to avoid longer waits from presenting to the emergency department.

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