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Queensland’s target is to have 90 per cent of patients transferred from ambulances into the care of an emergency department within 30 minutes.Credit:ninevms

A Queensland Audit Office report can reveal the overall POST performance for the top 26 reporting hospitals decreased from 85.9 per cent in 2014-15 to 68.5 per cent from July 2020 to February 2021.

Demand for emergency departments was growing at a faster rate than population growth and more people were arriving with complex issues,increasing pressure on the system,including ambulances.

Between 2014 and 2020,walk-in emergency department presentations increased by 20.5 per cent and ambulance arrivals by 45.8 per cent,while population growth was 9.5 per cent.

While emergency departments were treating more people within recommended timeframes each year,as a percentage of the entire patient population,their performances were declining,the Audit Office report said.

Since 2014-15,Queensland Health consistently outperformed its targets for the least urgent cases and mostly hit its targets for immediate life-threatening cases,but did not meet its targets for categories two and three.

Only one of the top 26 reporting hospitals,Mount Isa Hospital,met its targets for both the time people stayed in the emergency department (known as ELOS) – four hours for 80 per cent of patients – and its patient off-stretcher time target between July 2020 and February 2021.

The accuracy of the four-hour performance data was also at risk due to data-entry issues with the internal system,called FirstNet,in which it was possible to enter a physical departure time that occurred before the patient arrived,resulting in a negative length of stay.

Queensland Health director-general John Wakefield.Credit:Jocelyn Garcia

That meant staff were forced to manually review data to ensure it was correct.

In 2019-20,more than 1.6 million people presented to public hospital emergency departments,with more than one-third arriving by ambulance.

The Audit Office made five recommendations,including the need to improve the accuracy of emergency department data,to improve how off-stretcher times were reported,and to monitor the use of short-term treatment areas with emergency departments,such as short-stay units,which “stop the clock” on ELOS times.

Health department director-general Dr John Wakefield said that over the past few years,there was significant growth in demand for unplanned care – even before the COVID-19 pandemic.

“Since the commencement of the pandemic,our EDs have been placed under additional pressure,with further demands for services in addition to managing the lasting operational impacts of COVID-19 precautions,” he said.

Dr Wakefield said emergency departments had adopted new infection control measures,such as social distancing and PPE requirements,which increased treatment times and emergency length-of-stay performances.

He said Queensland Health had expanded options to provide care outside hospitals,improve the flow from ambulances,and increase bed capacity.

LNP leader David Crisafulli said the report was a “horror story” and he called for data to be available in real time.

“I’ve read some reports from the Auditor-General but few have belled the cat as loudly as this one,” he said.

Opposition leader David Crisafulli says the audit report shows a “culture of failure”.Credit:Matt Dennien

“This government can blame all sorts of things – COVID,the Commonwealth,clinicians – but in the end,the report shows a culture of failure,of what happens when you don’t plan ahead.”

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