Winter Demand Management Plan 2019

Print version

Introduction

Every winter our hospitals and ambulance services experience a surge in demand right around the state.

At the same time, we face inevitable absences among our frontline staff due to illness.

To deal with this, the Department of Health, in collaboration with the Tasmanian Health Service, releases a Winter Demand Management Plan.

This is designed to help manage and, where possible, prevent the impact of winter illnesses and ensure our services manage winter demand surges well.

Previous winter plans have helped the health system respond well to the additional demands of seasonal surges and we’ve applied what we’ve learned to this plan.

We are committed to take every action we can to ensure patients have access to timely healthcare and ambulance services this winter.

Having said this, it’s good to remember that prevention is better than cure.

I urge you all to make sure you and your family have your flu immunisation this year and take care to stay well over winter.

Yours sincerely

Michael Pervan

Secretary Department of Health


Winter 2018

  • 54% of patients who presented to an ED were classified as triage category4 (semi urgent) or5 (non urgent)
  • 70% of people presenting to ED were treated and then sent home
  • 29% of people presenting to ED were admitted to hospital
  • 1% of people were sent to another hospital
  • 40 404people presented to our EDs
  • 11 453 people transported to our EDs by ambulance
  • 771 cases of flu or flu-like illness presented at our EDs

2019 Winter Approach

1. Tackling flu

Immunisation strategy and investment

Flu is much more than a bad cold; it’s a highly contagious and serious disease that makes many people very ill and puts added pressure on the health system.

Tasmanians should be immunised, particularly those at risk of severe flu.

The best protection we have from flu is immunisation. This means getting as many Tasmanians immunised as possible.

Tasmanians vulnerable to severe flu are advised to get their free flu vaccine under the National Immunisation Program.

Flu vaccine is free to protect those at highest risk of severe disease:

  • People aged 65 years and over.
  • All Aboriginal and Torres Strait people aged over six months.
  • Pregnant women.
  • People aged six months and over with medical conditions such as lung or heart disease, severe asthma, impaired immunity or diabetes. All these conditions increase the risk of flu complications.
  • The State-funded free flu immunisation program for all Tasmanian children aged from six months to less than five years introduced in 2018 will be continued.

This year, the Government is extending the availability of flu vaccinations in pharmacy to ages 10 years and over.

Free flu immunisation for all Department of Health, Ambulance Tasmania and Tasmanian Health Service staff is provided to help reduce the overall impact of flu.

We have worked with the aged care sector to get their clients and staff immunised, and to develop their flu outbreak management plans.

Ongoing flu testing

Extended hours for the pathology service and increased on-call resources to support timely patient care will be provided.

Regular reporting via FluTAS

Laboratory-confirmed flu cases and other measures of flu are reported.

Flu surveillance snapshots are provided weekly, with monthly FluTAS reports published at www.flu.tas.gov.au

2. Bed utilisation

Maximising bed capacity

Health agencies are working together to build winter capacity at each major public hospital including improving patient flow and discharge, and managing demand for beds and inter-facility transfers.

Private inpatients are identified early to assist their timely transfer to private health facilities.

Royal Hobart Hospital

  • Start of the Community Rapid Response Service hospital diversion initiative.
  • Use of 12 Hospital in the Home mental health beds to support consumers who would otherwise need a mental health inpatient bed.
  • Working more closely across the system to manage demand.

Launceston General Hospital

  • Continued flex capacity in day stay beds.
  • Continued use of Community Rapid Response Service hospital diversion service.
  • District Hospitals will accept direct admissions from local communities and transfers from the acute hospitals.

North West Regional Hospital and North West

  • Use of eight-bed acute medical unit at NWRH.
  • Start of Community Rapid Response Service hospital diversion initiative.
  • Flu-like illness pathology testing being done locally for improved decision making around isolation needs.

Mersey Community Hospital

  • Opening of 12 additional beds.
  • Use of flexible surgical beds to support interim care between the emergency department and medical ward.

3. Patient flow optimisation

Ensuring effective planning for patients

Hospitals are improving timeliness of discharge especially in the high turnover areas where small increases in efficiency will significantly improve patient flow.

The process identifies and reduces causes of avoidable delays such as discharge medications, diagnostic testing and/or treatment services needed before patient discharge.

Hospitals will continue to facilitate the flow of patients from acute services to subacute and community services transit lounges in the major hospitals. They are effective and will be monitored and refined.

Discharge planning on day-of-arrival including patient pathway for length of stays likely to be over 10 days will be implemented.

Discharge strategies for key wards, such as respiratory units, will be improved.

All public hospitals will maintain and deliver post-discharge support.

Patient flow meetings at all hospitals

Our hospitals will improve coordination of parties involved in patient flow and patient care.

Hospitals will manage patients with flu-like illness in line with the Winter Plan, including allocating wards as flu wards as and when needed.

All public hospitals are working to more quickly discharge long stay and potential long stay patients where safe to do so.

Use of rural and regional hospitals

Statewide district and private hospitals will be used for additional capacity as needed.

Strong coordination between Ambulance Tasmania and hospitals

Ambulance Tasmania will implement an ambulance offload delay procedure in conjunction with Royal Hobart Hospital and Launceston General Hospital. It includes the Ambulance Tasmania Surge Escalation Plan.

Staff will identify frequent callers under an Ambulance Tasmania secondary triage function.

Extended care paramedics will get up-to-date information on alternative service providers statewide. This will include information on after-hours GP clinics and pharmacies.

Ambulance Tasmania will work with Department of Health, Tasmanian Health Service and the aged care sector to manage demand throughout winter.

4. Collaboration

Ongoing consultation with staff and hospital management

These winter planning initiatives will be communicated to all staff and key stakeholders.

Public Health Services enabling aged care providers

Public Health Services has provided education and advice to Tasmanian aged care providers to help them protect their residents and staff from the flu.

Statewide workshops for aged care facility representatives were held to help them prepare and plan for the flu season.

These included staff and resident immunisation, recognising flu-like illness and outbreaks and the importance of infection, prevention and control measures.

Public Health Services has provided education and advice to general practitioners who play a central role in the planning, preparation and management of flu outbreaks in aged care.

Ongoing coordination with community and primary healthcare providers

Primary Health Tasmania will work closely with government in planning for the winter season and strongly supports this whole-of-system approach.

Primary Health Tasmania and Public Health Services will work together to ensure community and primary healthcare providers are informed about the planned approach to managing common winter conditions and protecting vulnerable Tasmanians.

They will work to support the important role of GPs and other community-based healthcare providers to share information and resources on winter strategies.

They will also maximise awareness of all of the care options available to providers and their patients in and outside normal operating hours.

These options include use of theTas After Hours website, healthdirect Australia and GP Assist services in the out of hours period.

After hours medical services

Dedicated non-emergency afterhours services are available for use by Tasmanians when their usual GP or healthcare provider is unavailable.

People can use Primary HealthTasmania’s Tas After Hours website www.tasafterhours.com to find information about a range of medical services available at night time, weekends and public holidays. The site can be downloaded as an app.

Consumers can also access free after hours medical advice all day, every day through the national healthdirect Australia telephone helpline: 1800 022 222.

Registered nurses at healthdirect Australia provide information and advice. If a nurse decides a Tasmanian caller needs more care, the caller is transferred to a doctor at GP Assist in Tasmania.


How you can help

Emergency Departments are for emergencies

Emergency Departments at hospitals can get extremely busy, especially in winter. It’s a place where life and death situations are dealt with every day. For this reason, people are encouraged to remember that Emergency Departments are for emergencies only.

Medical advice around the clock

If you’ve got a cough or a cold speak to your GP or usual healthcare provider first.

Alternatively, call healthdirect on 1800 022 222 to speak to a registered nurse about your symptoms. This service is free and available 24 hours a day, seven days a week.

If the situation is urgent or life-threatening, you should call 000 immediately or go directly to an Emergency Department for help.

Save Triple-zero (000) for saving lives

Ambulances are for getting people with urgent or life-threatening conditions to hospital quickly. They are not taxis.

Calling an ambulance for a non-urgent condition might delay someone else with an urgent condition getting to hospital quickly.

Arriving at an Emergency Department by ambulance with a non-urgent condition will not get you seen sooner.


Winter wellness advice

Winter is when many of us will be exposed to increased risks of illness. Here are some tips for staying healthy this winter and during the colder months.

With the shorter days and colder weather we often stay indoors where it is warm, becoming less active and eating unhealthy foods.

Avoid getting and spreading flu

The best way to prevent flu is by getting your yearly flu vaccine.

If you do get sick with a cold or flu:

1. When you cough or sneeze, cover your mouth with your elbow (rather than your hand).

2. Wash your hands often to get rid of germs on them. Use soap and water, or an alcohol-based hand rub.

3. Stay at home from work. If your child is unwell keep them at home from childcare or school.

4. Avoid visiting people likely to get really unwell from flu, including infants and young children, pregnant women, those with medical problems and the elderly.

5. Stay at least one metre away from other people especially when coughing.

6. If you do need to see a doctor, call ahead and let them know you have a cold or flu. This will allow the medical service to plan your visit to prevent your infection spreading to others.

Visit fluTAS for more information www.flu.tas.gov.au


Tips to stay healthy

To stay healthy during the colder months:

  • choose nutritious food and drinks that meet your energy needs
  • enjoy a wide variety of nutritious foods from the five major food groups and aim to eat two serves of fruit and five serves of vegetable each day
  • limit intake of alcohol and foods containing saturated fat, added salt and added sugars
  • keep hydrated – drink plenty of water
  • be active every day in as many ways you can
  • reduce sitting time in front of the television or computer
  • get a flu vaccine each year
  • quit smoking.

Quit smoking

Quitting smoking will significantly improve your health and reduce your risk of disease and premature death.

If you’re thinking of quitting smoking call the Quitline on 13 7848 (13 QUIT) or access the Quitline via Quit Tasmania www.quittas.org.au

Cover your cough

When you cough or sneeze, cover your mouth with your elbow (rather than your hand) or use a tissue to cover your nose and mouth. Make sure you dispose of the tissue afterward in the nearest waste bin and wash your hands. This helps avoid the spread of germs that cause colds and flu.

Wash your hands

Hand washing helps to reduce the spread of germs that cause colds and flu. Wash your hands often to get rid of the germs on them. Use soap and water, or an alcohol-based hand rub.

May 2019