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The College of Emergency Nurses are “outraged” at the Health Minister “claiming the emergency department health targets are a great success”.

The NZNO College of Emergency Nurses NZ (CENNZ) was responding to a press release yesterday from Health Minister Jonathan Coleman stating that the nationwide health targets – including the ‘shorter stays in ED target – were making a real difference to the quality of care and saving lives. The latest target data shows that 93 per cent of patients were admitted, discharged or transferred from emergency departments (EDs) around the country within six hours. Coleman said that recent New Zealand research indicated that the ‘shorter stay’ target was saving lives, with an estimated “700 fewer deaths than predicted in 2012 if pre-target trends had continued”.

The College said their outrage at the minister claiming the target as a success was because nurses knew that meeting the ED target in “an underfunded health system” could “cost lives and careers”.

Hilary Graham-Smith, NZNO’s associate professional services manager, also pointed to the recent Health & Disability Commissioner’s report into the death of a Northland man who was moved out of ED specifically to meet the national target when he had a heart condition needing further assessment. She said “trumpeting the targets” just days after that news was “inappropriate”.

Chairperson of CENNZ, Rick Forster said members told him that ED occupancy rates were often well over 100 per cent and ED staff faced additional difficulties trying to admit patients to the wards because hospital beds were full.

“When ED’s full we can’t close the doors, so more patients are ending up in corridors,” said Forster. “There comes a tipping point where care is rationed and risk of harm increases.”

Graham-Smith said the ED targets needed to be re-examined and nurses consulted. She said the combined effect of a high-needs and ageing population, patients with complex needs and several particularly bad winters had resulted in ED staff feeling they were compromising the quality of care and patient safety. EDs were also facing a staff shortage crisis.

She backed Forster’s comments and said New Zealanders did not deserve to be left waiting for extended periods in ED waiting rooms, in ambulances or on trolleys in corridors.

“Nurses need to be able to provide safe and effective care that is of a high standard, and the time to do that should not be constrained by a national target,” said Graham-Smith. “The stress of care rationing on nurses is unacceptable to the nursing profession and NZNO.”

Coleman acknowledges ED nurses work

Coleman responded on August 24 to the College and NZNO comments saying he acknowledged the work of nurses across the health system “particularly among the pressures which do arise in any busy ED, especially in the middle of winter”.

He said the shorter stays target helped to address “formally unsafe and long ED waiting times which were known to put lives (and potentially careers) at risk”.

The minister said the Emergency specialist Mike Ardagh’s research cited in his initial press release indicated the target had lead to an overall reduction in hospital stays by an average of about seven hours, created capacity for more acute admissions and equated to 700 fewer deaths than expected if pre-target trends continued.

He said the health system wasn’t underfunded with health funding having kept ahead of demographic pressure and inflation over the past eight years. “Health has remained the Government’s number one funding priority,” said Coleman.  “Budget 2017 delivers on that by investing an extra $3.9 billion in health over four years for new initiatives and to meet cost pressures and population growth.” He said the health budget would reach an record $16.8 billion in 2017/18.

Article updated 10am August 24

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