Canberra Hospital is struggling with demand so much it has had to roster on dedicated “corridor nurses”, with beds frequently lining the emergency department’s walkways.
Australasian College for Emergency Medicine president Dr Simon Judkins singled out Canberra Hospital as one of three emergency departments in the country where deteriorating conditions were putting the health and safety of patients at risk.
He visited the hospital's ED about four weeks ago and was shocked by some practices.
He said admitted patients were being treated in corridors - a very public thoroughfare - and cared for by a dedicated, rostered on “corridor nurse”.
“We were quite shocked, we haven't seen that in a while,” he said.
"This sort of practice is a sign of a system under stress and a system not working."
He said feedback from concerned doctors indicated it was happening more and more often.
“I’m not sure exactly how long that’s been going on but I got the impression it has been there for at least a couple of weeks, with no long-term solution in sight," Dr Judkins said.
Dr Judkins said local doctors were deeply concerned about access block, with rapidly rising numbers of patients staying in the emergency department for more than 24 hours because of a lack of beds at other wards.
He said in the past five weeks there were more than 100 patients who stayed in Canberra Hospital's emergency department for more than 24 hours.
In Victoria, just one patient staying longer than 24 hours generates a notification to the state's health minister, a policy he urged the ACT Government to adopt.
Dr Judkins said long periods in the ED could lead to increased adverse events in patients, increased morbidity and longer stays in hospital.
He said long stays in emergency were due to flow issues within the hospital.
“The doctors are working in a situation where they know they're unable to provide the level of care their patient deserves," Dr Judkins said.
"We don't think it's acceptable for anyone to stay for 24 hours, let alone 100 in a matter of weeks," Dr Judkins said.
"We can't point the blame at the emergency department for this, it's a symptom of a bigger disease."
He said the care offered at the ED was completely different from ward care.
"We don't do regular medication rounds, the lights are always on, there is a lot of noise," he said.
"If you spend 24 hours in there you probably won't get sleep, you'll be dealing with delirium and you'll end up spending more time in hospital in the long run."
Dr Judkins said Canberra Hospital had previously been doing excellent work in managing patient flow, but in recent years and months conditions had deteriorated.
“From what we understand there were key drivers in the department promoting efficient use of hospital beds - some of those people have moved on.
“It may also be simply a matter of resources and lack of capacity."
He said governments needed to stop seeing flu season as contributing "unforseeable demand".
“From the 52 years I’ve been alive winter happens every year,” he said.
“It’s not unprecedented demand - it's winter.”
Dr Judkins singled out Canberra Hospital - as well as Royal Adelaide Hospital and the Royal Hobart Hospital - as a hospital with deteriorating conditions putting patients' lives at risk.
An ACT Health spokesman said bed block was commonly faced by all hospitals providing emergency health care services.
He highlighted the extra demand Canberra Hospital faces as the major tertiary hospital for the surrounding NSW region.
The ACT received tens of millions each year in cross border payments as compensation for treating interstate patients.
"The decision to place patients in the corridors of the ED does occur on occasions during periods of high demand," he said.
"Any patient who may be placed in a corridor is prioritised to move to either a treatment space or an in-patient bed at the earliest possible moment.
"When patients are placed in the corridors of the ED during periods of high demand, an additional nurse is allocated to care for these patients. This is a critical intervention to ensure patient safety.
"Patients who wait for more than 24 hours in the ED for an in-patient bed are cared for with safe staffing levels.
"These patients have received treatment from the ED team, and have been accepted and reviewed by the in-patient team responsible for their admission. Action is always taken to move these patients to an in-patient bed as soon as it is available."
The spokesman highlighted measures in the recent budget for extra beds at the hospital.