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ED’s (Emergency Department) in Australia are Overrun & No Longer Safe, ED Physician Says! How INTENSIVE CARE AT HOME Helps!
Hi, it’s Patrik Hutzel from intensivecareathome.com where we provide tailor-made solutions for long-term ventilated adults and children with tracheostomies and where we also provide tailor-made solutions for hospitals and intensive care units whilst providing quality service for long-term ventilated adults and children with tracheostomies also otherwise medically complex adults and children at home including home BIPAP (bilevel positive airway pressure), home CPAP (continuous positive airway pressure), home tracheostomy care when adults and children are not ventilated, also Home TPN (total parenteral nutrition). We also provide IV potassium, IV magnesium infusions at home, as well as IV antibiotic infusions at home. We also provide port management, central line management, PICC (Peripherally Inserted Central Catheter) line management, Hickman’s line management, as well as palliative care services at home and that also includes ventilation weaning at home.
We have also provided an emergency department bypass service for the Western Sydney Local Area Health District because today actually, I want to talk about emergency departments and I actually want to read out a really great LinkedIn post from an Australian Emergency Physician, Christopher Edwards.
Let me read out his blog posts or his LinkedIn post from this week because it’s really relevant for the work that it is out doing. It’s also relevant for the work that we are doing and let me read it out.
So, the LinkedIn posts from Dr. Edwards comes after the ABC here in Australia published a news article where it says, “Patients treated in Emergency Department corridors at Adelaide Hospital operating over capacity, the union says”.
So, this is in response to that ABC article that Dr. Edwards writes. He says, “This is happening all across Australia. Talk to any clinician in a moderate to large Emergency Department on a Monday morning. When you can pretty much set your watch to the familiar ‘Access Alert’ or ‘Code Yellow’ announced over the tannoy, usually between 10 am to 12 pm.
This is when the influx of new patients to ED is greeted by a department with no available beds – having largely been occupied by ward admissions who have been forced to linger for hours or days due to a hospital operating at capacity, with minimal staffing to facilitate discharges over the weekend.
This overflow is centered on the Emergency Department. Why?
Because hospital wards operate at strict staff ratios. Because for some reason, whilst the ED cannot and will not say ‘No’ – inpatient teams can and will. Because whilst the ED operates 24 hours / 7 days a week, the hospital doesn’t. Because discharges to NDIS supported accommodation or nursing homes is complicated by a lack of availability and complex procedures.
There are many reasons for access block, but the impacts are seen in the area of the hospital with the highest risk of things to be missed – the Emergency Department. Where finding that needle becomes that much more difficult as the haystack grows and grows.
Ambulance ramping? Again, that’s just a symptom of overflow of the overflow. It just happens to be the most visible where the media can go and take pictures of queues of ambulances, but don’t be deceived. The real chaos lies inside, hidden from view and governments insisting on compulsory offload times or building a bigger ED is not a ‘fix’. It is just a clever way to hide the issue from the media.
Our ED clinicians are working harder than ever behind those doors but without access block relief, those needles are going to get more and more difficult to identify in the growing field of haystacks.
It is likely all of us will need to attend an Emergency Department at one time or another.
Do you want to be one of the needles waiting to be found?”
Well, Dr. Edwards, what a great article and it describes the state of health care very well, especially in hospitals. While we at Intensive Care at Home, we certainly provide two things that tie right in with Dr. Edwards article here.
Well, number one, we provide NDIS (National Disability Insurance Scheme) services in the community, especially for long-term ventilated adults and children who are at super high risk of going to ED if they don’t have intensive care, 24 hours a day, at home.
The next risk is if they can’t go home, and they’re stuck in ICU. Well, that’s also blocking bed flow from ED to ICU. So, we’re eliminating that as well.
Number three, we are aware of that there sometimes can be delays with NDIS funding or other funding, but we are in the midst of helping our clients with that. We have NDIS support coordinators, but also support coordinators for the TAC (Transport Accident Commission) for example, or for iCare, and so forth.
Now, lastly, another thing that I mentioned in the beginning is we have also provided ED bypass services where we send our critical care nurses into people’s homes to avoid an ED presentation.
So, we also have sent our critical care nurses into residential aged care facilities to avoid ED readmissions, and that could be procedures such as catheter changes, unblocking catheters, nasogastric tube changes, unblocking nasogastric tubes, PEG (Percutaneous Endoscopic Gastrostomy) tube changes, unblocking PEG tubes, tracheostomy changes, or changing inner cannulas. Again, clients with the tracheostomy at home are at high risk of dying if they don’t have the intensive care nurse, 24 hours a day.
You don’t believe me? Well, we have evidence that clients have died in the community because they did not have the intensive care nurses, 24 hours a day, as is evidence-based, and you can find that on the Mechanical Home Ventilation Guidelines on our website.
But coming back to Dr. Edwards, thank you so much for sharing this on LinkedIn and for raising awareness of what’s happening in hospitals. I know you are at the forefront in getting better care for patients and their families. So are we and I think we all want the same, we want our patients to be safe and to be in the right environment which in some instances is the Emergency Department.
We don’t want the Emergency Department to be blocked by low acuity patients who could be looked after at home, for example. Then, there’s no space and no resources to look after patients that really need ED. So, thanks again for sharing this with your followers and connections on LinkedIn.
So, if you have a loved one in intensive care, long-term on a ventilator with a tracheostomy or not ventilated with a tracheostomy on BIPAP, CPAP with a central line, home TPN, or if you need TPN, you’ve come to the right place, please contact us. We can help you going home as quickly as possible.
We are also providing Level 2 and Level 3 NDIS Support Coordination and that will help you to get on the NDIS if that is what you need and if that is what you qualify for.
If you are at home already on a ventilator with a tracheostomy, seizure management, and you don’t get the support that you need, you have insufficient support, your rosters are not working, or you don’t have funding for nursing care, and you’re going back to hospital all the time, your rosters are unstable, please reach out to us as well. We can help you with funding and with nursing staff and we keep our clients home predictably.
If you need help, go to intensivecareathome.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected]. Like I said, if you have insufficient support at home, please reach out to us. If you have support workers instead of registered nurses for basically intensive care treatment, which is for the ventilator and the tracheostomies, you need to reach out to us urgently before it’s too late.
Our clients do not go back to hospital unless it’s something elective because we can keep them at home predictably because we have the critical care nurses at home, 24 hours a day, for adults and for children that are on ventilation with tracheostomies like I mentioned.
Now, we are currently operating all around Australia, in all major capital cities as well as in regional and rural areas. We are an NDIS (National Disability Insurance Scheme) approved service provider all around Australia, we are TAC (Transport Accident Commission) approved service provider and WorkSafe approved service provider in Victoria, iCare in New South Wales, NIISQ (National Injury Insurance Scheme in Queensland), as well as DVA (Department of Veteran Affairs) approved service provider all around Australia. We have also received funding through public hospitals, departments of health, as well as private health funds. So, reach out to us if you need help.
Like I mentioned, we are also sending our critical care nurses into the home to keep emergency departments empty. We have done that successfully for the Western Sydney Local Area Health District and we have kept their ED empty.
If you are a hospital executive or an ED physician and you’re watching this, we want to hear from you because we can help you keep your ED empty, so you can focus on the people that really need ED.
Now, if you are an NDIS Support Coordinator and you’re looking for nursing care for your participants or for more funding because you don’t know how to advocate for nursing care, please reach out to us as well. We can help you also with a specialist NDIS nursing assessment.
If you are a critical care nurse and you’re looking for a career change, we want to hear from you as well. If you have worked for a minimum of 2 years in critical care ICU or ED, and if you ideally have completed the postgraduate critical care qualification, we currently have jobs in Melbourne, Sydney, Brisbane, Albury Wodonga, in Bendigo, in Country Victoria, as well as in Warragul in Country Victoria. We want to hear from you.
We are looking for intensive care nurses or critical care nurses that want to complement our team, people who are team players, and people who are looking for regular work. We are a service provider and not an agency. We do pride ourselves on providing a tailor-made solution to our clients. So, if you’re looking for agency work and you want to sort of come and go, please don’t apply. Only apply if you’re serious and if you want to make a difference to our client’s life and if you want regular work and that includes our clients on a regular basis.
If you are an intensive care specialist, we are currently expanding our medical team. We want to hear from you. If you are an intensive care specialist and you have bed blocks in your ICU, which I know you do, I encourage you to reach out to us as well. We can help you eliminate your bed blocks, but more importantly, we can improve the quality of life and sometimes quality of end of life for your patients and their families and you won’t pay for it.
If you are a hospital executive watching this, we also want to hear from you because again, we can help you eliminate bed blocks in ICU, ED.
Once again, our website is intensivecareathome.com. Call us on one of the numbers on the top of our website or send us an email to [email protected]. If you are in the U.K. or in the U.S., we can help you there privately. Please reach out to us as well.
If you like my videos, subscribe to my YouTube channel for regular updates for Intensive Care at Home, but also for families in intensive care. Click the like button, click the notification bell, share the video with your friends and families, and comment below what you want to see next or what questions and insights you have.
Thank you so much for watching.
This is Patrik Hutzel from intensivecareathome.com and I will talk to you in a few days.
Take care for now.