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Waiting time benchmarks planned for Emergency Department

The administration at Mater Dei Hospital is to set benchmarks of waiting time at the Emergency Department according to European levels, Parliamentary Secretary Joseph Cassar announced today.

He was speaking at a press conference with Social Policy Minister John Dalli at the launching of a campaign to discourage people from making use of the E&A Department except for genuine emergencies.

Dr Cassar said the benchmarks would depend on the nature of the emergency, and he pointed out that in the UK, a patient has to be either admitted to hospital or released from the Emergency and Admissions Department within four hours.

Mr Dalli said a culture change was needed because only 20 percent of those calling at the department were genuine emergencies. These people, he said were not receiving the best possible treatment because of the pressures caused by the other 80 percent.

The minister said the government was concentrating on plans to reform and strengthen health centres and to make them a realistic alternative to the hospital Emergency Department. The health centres, he admitted, had a serious shortage of staff. Several health centres also needed additional equipment to serve as alternatives to the hospital.

A suggestion that had been made was for particular health centres to be dedicated for particular emergencies – such as fractures or ophthalmology.

Mr Dalli and Dr Cassar underlined the importance of family doctors and expressed concern that some people viewed them as second class doctors when many of them were actually specialists on general practice.

Dr Cassar said professors Mario Vassallo and Godfrey Laferla have been appointed co-chairman of the E&A Department to look into how the management of the department could be improved, especially from their respective fields of medicine and surgery.

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Comments

Noel Enriquez (on 9/7/08)
Although I fully agree that this is a problem that needs to be addressed and hopefully for the benefit of all solved, i wonder, are we trying to solve it in the correct way? Are we addressing it in the proper manner? Can't the doctors and more importantly nurses working in the A&E department have a say in suggesting reforms? The nurse is the only person/s that sees to a patient from the moment of admission to the department, to the exit of the patient either through discharge or a transfer to another ward.
albert leone ganado (on 8/7/08)
A step in the right direction.

May I suggest that there should also be a trained person in attendance to explain clearly the working procedures of the emergency department , keep patients and their relatives informed, offer them support and calm them down. Children and old people even suffering minor injuries or pain are often in a state of shock and great stress. This often rubs on to their relatives who in a state of perceived helplessness resort to rash actions which result in confrontation with staff or leads them to seek unnecessary private hospital remedies which they financially regret later.

There should also be separate queues for major emergencies and minor cases. Minor cases can often be dealt with by junior staff
cynthia busuttil (on 8/7/08)
The source of the problem is unreliable service from polyclinics. Offer a good, professional service and that includes the nurses. Every time (which is rare) that I need one, I feel the Dr is happy to see my back. Even when the waiting room was empty, and no one being treated, I waited and waited. Once when I took my young child for nebuliser, the Dr on call did not even bother to check him afterwards. Few show a genuine vocation to assist. Gzira PC is without XRay service. C Busuttil Sliema
Julian Boffa (on 8/7/08)
Sometimes I wonder why we complain in this country when a solution is very simple. First of all one should make the premise that someone who is in pain is not necessarily in a position to assess how serious his condition might be. So people will never stop going to the ED for trivial conditions because we all want to put our mind at rest that we are getting the best of attention. If these same people are ready to travel themselves to MDH all the better. The solution is to set up a health centre at MDH to treat the trivial cases. In this way, a patient which has just been admitted would be redirected either to the ED or the health centre according to his condition. What is the difference if a health centre is in Paola, Mosta or wherever, or within MDH (or next to it)? This way one would ensure to keep everyone satisified.
M. Borg (on 8/7/08)
Want to solve the Emergency abuse? Follow the Swedish system. In Sweden, healthcare - like us - is free. However if someone goes to an Emergency Dept and is found to have a trivial compliant, then he or she will have to pay around 50 euros for the consultation (based on private fee estimates). I can assureyou that there are no unnecessary cases lying around Casualty over there!!
Maria Attard (on 8/7/08)
First and Foremost we need to have good medical staff before they could advise which is urgent and what can wait !!! My boyfriend had to go to MDH three times before a brilliant doctor could realise how serious his injury was. For others (nurses and doctors), he had absolutely NOTHING even though he was in agony !!! I do not mind wait - but wait six hours because he had nothing -according to Triage personnel- was insane when infact he thought he was dying after spending five days in bed!! He was immediately operated and I complained to the customer care were we were treated very well and this was treated with attention since Medical Staff have to be of certain standard too!! Once in hospital, i cant complain - MDH is like a 5 star hotel but all the way before was a night mare !! Are the staff in Triage professional enough to see what the case really is about before deciding the importance of the patient's case?
J. Tonna (on 8/7/08)
I agree with this initative, especially after I had to wait for hours without being, at least, told what they were doing about my case. However, first they should increase the number of doctors in Health Centres, because even there one had to wait for long hours to be seen to. The same Doctor that examin patients in the Health Centre has to go out for emergency calls, leaving others waiting.
Ramon Zammit (on 8/7/08)
I fully agree with this initiative. Most of those who go to the ED at MDH are not emergency cases and these are causing the department to operate inefficiently to those really in need. However on the other hand I hope that the benchmarks should reflect the case in a realistic matter. Some years ago I had sustained multiple fractures and was not admitted by ambulance but some friends brought me to SLH's ED....I had to wait for over an hour before being seen to!! I was already feeling numb where the injuries where suffered and the skin was becoming dark too, due to internal bleeding! ED should be for URGENT cases ONLY and for the rest there is the family doctor. Lets keep MDH efficient as possible for those really in need! I really don't wish to be in a situation where I have to wait and I am in dire need of medication again...it felt really painful....and I am everyone agrees with me.
J. Stivala (on 8/7/08)
I think a possible solution to alleviate the pressure off Mater Dei is community care. Govt needs to beef up the localities' health centres

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