Hospital Bypass and Hospital Early Warning System
July to December 2010
Department of Health
Hospital Bypass and Hospital Early Warning System
July to December 2010
Page 1 Hospital Bypass and HEWS (July – December 2010)
If you would like to receive this publication in an accessible format, please phone (03) 9096 7392 using the National Relay service 13 36 77 if required.
© Copyright, State of Victoria, Department of Health, 2011 Published by the Hospital and Health Service Performance Division, Victorian Government, Department of Health, Melbourne, Victoria. This publication is copyright, no part may be reproduced by any process except in accordance with the provisions of the Copyright Act 1968. This document is also available in PDF format on the internet at: www.health.vic.gov.au/performance Authorised by the State Government of Victoria, 50 Lonsdale Street, Melbourne.
Page 2
Contents
Hospital Bypass and Hospital Early Warning System (HEWS) 4 Introduction 4
Hospital Bypass 5
Hospital Early Warning System 8
Definitions 11 Hospital Bypass Specifications 11
Page 3 Hospital Bypass and HEWS (July – December 2010)
Hospital Bypass and Hospital Early Warning System (HEWS)
July to December 2010
Introduction This is an interim report containing summary information relating to the Emergency Department activity of Victoria's public hospitals. In future months, a wider range of information will be reported and made available through a new and dedicated website designed to provide information about hospital activity and performance in Victoria.
March 2011
Page 4
Hospital Bypass
Hospital bypass is a period of time when a public hospital emergency department can request that ambulances bypass it and take patients to other hospitals. However, even when a hospital is on bypass, urgent patients will be accepted.
The Government has set a target for the thirteen major metropolitan hospitals which requires them to spend no more than 3 per cent of operating time on bypass.
Table 1: Percentage of time spent on hospital bypass (Year to Date)
13 Major Metropolitan Hospitals July – December 2010 December 2010 Angliss Hospital 0.2% 0.0% Austin Hospital 3.8% 1.3% Box Hill Hospital 3.5% 1.4% Dandenong Hospital 2.9% 1.7% Frankston Hospital 3.8% 1.9% Maroondah Hospital 0.6% 0.0% Monash Medical Centre 3.0% 2.3% St Vincent’s Hospital 1.4% 0.8% Sunshine Hospital 0.9% 0.4% The Alfred 1.5% 0.3% The Northern Hospital 3.8% 1.8% The Royal Melbourne Hospital 1.9% 0.5% Western Hospital 2.7% 0.3% Statewide average 2.3% 1.0% Source: Hospital Bypass Data Collection
Page 5 Hospital Bypass and HEWS (July – December 2010)
Figure 1: Percentage of time spent on hospital bypass (Year to Date - July to December 2010)
Angliss Hospital
Austin Hospital
Box Hill Hospital
Dandenong Hospital
Frankston Hospital
Maroondah Hospital
Monash Medical Centre
St Vincent's Hospital Statewide target: 3.0%
Sunshine Hospital
The Alfred
The Northern Hospital
The Royal Melbourne Hospital
Western Hospital
Statewide average
0.0% 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% 3.5% 4.0% Hospital Bypass
Figure 2: Percentage of time spent on hospital bypass – December 2010
Angliss Hospital
Austin Hospital
Box Hill Hospital
Dandenong Hospital
Frankston Hospital
Maroondah Hospital
Monash Medical Centre
St Vincent’s Hospital Statewide target: 3.0% Sunshine Hospital
The Alfred
The Northern Hospital
The Royal Melbourne Hospital
Western Hospital
Statewide average
0.0% 0.5% 1.0% 1.5% 2.0% 2.5% 3.0% 3.5% 4.0%
Hospital Bypass
Page 6
Figure 3: Percentage of time spent on hospital bypass for Victoria’s 13 major metropolitan hospitals (six monthly periods – July 2008 to December 2010)
3.2% Statewide target: 3%
2.3% 2.2% 1.9%
HospitalBypass (%) 1.7%
July - Dec 2008 Jan - June 2009 July - Dec 2009 Jan - June 2010 July - Dec 2010
Page 7 Hospital Bypass and HEWS (July – December 2010)
Hospital Early Warning System
The Hospital Early Warning System (HEWS) is a standardised internal hospital response to increased pressure in an emergency department (ED). It is instigated where occupancy and workload within the emergency department is at a level that there is a likelihood that bypass criteria will be reached within the next hour.
The goal of HEWS is to better manage access for emergency patients by improving communication across and within both the hospital and the emergency system. The benefit of HEWS is derived from the internal escalation processes within hospitals that create additional capacity to deal with demand pressure.
On receiving advice that an ED is on HEWS, Ambulance Victoria advises relevant crews of the change in status and seek an alternative destination for non urgent patients, patients without a significant past history and patients not already in transit.
The average duration of a HEWS escalation between July and December 2010 was 1 hour.
Table 2: Number of Hospital Early Warning System Incidences
July – December 2010 December 2010 (Monthly average) (Total number) Angliss Hospital 7 4 Austin Hospital 55 52 Box Hill Hospital 45 26 Dandenong Hospital 61 46 Frankston Hospital 51 44 Maroondah Hospital 24 9 Monash Medical Centre 96 82 St Vincent's Hospital 27 18 Sunshine Hospital 15 8 The Alfred Hospital 42 35 The Northern Hospital 29 41 The Royal Melbourne Hospital 36 20 Western Hospital 23 2 Source: As provided by Ambulance Victoria- may be subject to revision
Page 8
Figure 4: Average number of HEWS incidents per month (July to December 2010)
Angliss Hospital
Austin Hospital
Box Hill Hospital
Dandenong Hospital
Frankston Hospital
Maroondah Hospital
Monash Medical Centre
St Vincent's Hospital
Sunshine Hospital
The Alfred
The Northern Hospital
The Royal Melbourne Hospital
Western Hospital
0 20 40 60 80 100
Average number of incidences per month
Page 9 Hospital Bypass and HEWS (July – December 2010)
Figure 5: Total number of HEWS incidents (December 2010)
Angliss Hospital
Austin Hospital
Box Hill Hospital
Dandenong Hospital
Frankston Hospital
Maroondah Hospital
Monash Medical Centre
St Vincent's Hospital
Sunshine Hospital
The Alfred
The Northern Hospital
The Royal Melbourne Hospital
Western Hospital
0 20 40 60 80 100 Total number of incidences
Page 10
Definitions
Hospital Bypass Specifications Hospitals reporting: 13 major metropolitan hospitals. Source: Hospital Bypass Data Collection. Latest edition/update of the data: December 2010.
Definition: Hospital bypass occurs after a request is placed with the metropolitan ambulance service to divert all but time critical ambulance patients for a specified period of up to two hours. A hospital may request a period of bypass when: • the emergency department is full and it cannot safely accommodate and treat more patients • there are unexpected factors (for example, power failure) that would compromise the treatment of existing patients in the ED. For the purpose of this report, bypass is reported as occasions of bypass that exceed 30 minutes where the ED is full.
Calculated as: Hospital bypass (Hours) % time on hospital bypass = Hours in time period for system
Time on bypass is calculated as the end time less start time.
Page 11