Ms ROSOL – I’d like to ask some questions about bed block. I know that you’ve spoken about the federal government being responsible for a lot of what’s happening in health, due to the lack of funding and suggested that bed block is because of that lack of funding. I think we all agree that the federal government has an important role to play and should be doing more, but that doesn’t mean that there isn’t more that we could be doing here in Tasmania.
The Department of Health’s annual report shows the number of patients being discharged from hospital on the weekend is below KPI targets, and discharge numbers prior to 10.00 a.m. are also below KPI targets. Would it be true to say that it’s lack of staffing that’s having a negative impact on the ability to plan and deliver discharges for patients?
Mrs ARCHER – I suspect that there is a range of reasons, but I will ask the Secretary to provide some context.
Mr WEBSTER – Through you, minister. The pattern of doctors being on our wards affects the two KPIs that you just said. As part of addressing some of this, we’re introducing programs called Criteria Led Discharges. In other words, specialist medical practitioners, instead of them being present before the discharge, they actually create a criteria for the registrars and for the nursing staff that says if the patient reaches these levels of criteria, then they’re able to be discharged rather than be on presence to monitor that. That’s had a large degree of success in our surgical wards, for instance, and we’re trying to now put that across all wards across our system. It won’t be applicable to every patient, but it’s really important that we acknowledge that we don’t have 24/7, seven days a week specialist medical practitioners in our hospitals. We do have registrars and junior doctors present over those times. It’s important that we actually create the criteria to allow for that.
Do we have enough staff? We actually have introduced, over the last few years, a number of staff, such as discharge planners, et cetera, to increase the ability to do this. We continue to push for criterion-led discharge as a primary method. Secondly, working with our discharge planners to actually work with our allied health professionals in terms of getting the person and their family ready for discharge, because that becomes an issue. You’ve already mentioned aged care and NDIS. Again, they’re very complex discharges that we have to negotiate well in advance.
One of the things that we’ve introduced as part of the suite of things, for instance, is we now on admission, we ask our doctors to actually set an expected date of discharge so that it gives our allied health professionals, our nursing staff, the ability to say, ‘Okay, if the expected discharge is 1 December, here’s what needs to be achieved in terms of socio‑supports or medical supports outside of the hospital,’ and that helps as well. All of these things are a work in progress, I have to say. As it says in the annual report, we haven’t achieved the measures in the last financial year, but we continue to do that.
Ms ROSOL – Follow up question then to that would be around the transit lounges, which I understand have been created. I can remember them when I was nursing. The transit lounge is a way of helping to decant people off the ward before they leave. According to the annual report, the occupancy is supposed to be at 80 per cent, but the actual results are that the transit lounge occupancy is sitting at only 20 per cent. Why is the transit lounge occupancy so low? It’s created to help discharges happen and it’s not being used, are there staffing issues there or what are the issues that are preventing the transit lounges from being used to their capacity?
Mr WEBSTER – Again, through you, minister. What I would say – and I’ve asked for the hospitals and primary care space to review transit lounges. As a model, we’ve tried it over a number of years, and when you get that type of result, it starts to question: is it worth investing in them? I’ve also asked for a review of that data because I don’t believe it’s right for the LGH. I think you worked at the LGH. You can tell it’s actually a really busy space. The 20 per cent figure for there just doesn’t fit with what’s occurring at the LGH. It may be it’s because of the number of hours that you’re expected to be to get to the 80 per cent and those sorts of things. I think there is a problem with the data.
Having said that, I think there’s also an issue with the idea of the transit lounge is that’s where you go when you’re almost ready to go home and there might be a bit of monitoring left and a bit, ‑ you know, you got to get your pharmaceutical and things like that. There is a reluctance to do that in case the person has to come back and things like that. There’s a number of factors that’s working against our transit lounges. Having said that, I don’t believe the data. I think it is still too low, particularly, say, at the Royal, and we need to work to either improve it as a model or come up with a new model – is what I would say. I’m admitting to you that we’re not very successful with transit lounges in their current format, but they are very well staffed.
Ms ROSOL – Okay, because I was going to say I’ve heard reports that they’re often closed or or unused because of staffing. You’re saying no, that’s not the case, by the sound of it?
Mr WEBSTER – Again, through the minister. I wouldn’t say to you that they’re never closed because of staffing issues. If we don’t have the safe staffing level, we won’t ‑ there are periods where they’re not open. But what I would say is that is not contributing to the low usage of the transit lounges. There are a number of other factors. As I said, in terms of the LGH, I just don’t believe the data because I’ve never visited the transit lounge at the LGH and it hasn’t been busy. Whereas I can tell you if you visit the Transit Lounge at the Royal, it doesn’t look that busy. Again, that just might be when the times of the day you’re visiting, things like that. I’ve asked for a look at the data, but a look at the model as well.
CHAIR – I remind everybody to please speak into the microphones. Over to you, Prof Razay.
Mrs ARCHER – Maybe just before Prof Razay, I think the Secretary’s team has an update for Ms Rosol on the statewide Health Environmental Sustainability Committee meetings.
Mr WEBSTER – Yes, through you, minister, the committee has met three times this year with a fourth meeting scheduled for 5 December. They’re all of the scheduled meetings.
Ms ROSOL – Is that 2025‑26.
Mr WEBSTER – No, it’s 2025, sorry.
Ms ROSOL – So it’s a calendar year not overall?
Mr WEBSTER – That’s in the calendar year. Yes.
Ms ROSOL – So there’s still some data missing.
Mr WEBSTER – Yeah.
