Thursday 9 January 2014

Hospitals facing severe bed crunch take unusual steps

Patients being housed in tent and corridors, or sent to other hospitals
By Salma Khalik, The Straits Times, 8 Jan 2014

A SEVERE bed crunch at Singapore's public hospitals has forced several of them into taking some extraordinary measures.

Changi General Hospital (CGH), which has 800 beds, started housing patients waiting for beds in a large air-conditioned tent this week.

The 1,200-bed Tan Tock Seng Hospital (TTSH), meanwhile, has been forced to set up 49 beds along the corridors of its wards to cope with the demand.

Together with Khoo Teck Puat Hospital (KTPH), they have also resorted to sending patients to Alexandra Hospital, one of the few public hospitals here with spare beds.

Having taken in more than 900 patients from other hospitals between last September and December, it continues to admit around 11 such patients each day.

Dr Lee Chien Earn, CGH's chief executive officer, told The Straits Times: "Our bed occupancy rate has crossed 100 per cent for certain periods over the past month and some patients have waited more than 24 hours for an inpatient bed."

This is despite CGH already renting a ward from Parkway East Hospital and the next-door St Andrew's Community Hospital (SACH).

Mr Liak Teng Lit, head of Alexandra Health which runs KTPH, said: "Every day, we have to make decisions regarding our 500 patients. Those who are not so sick are discharged to make way for the 50 to 60 patients waiting for a bed."

He described the current bed crunch as "abnormal", since public hospitals usually experience a dip in patients during this period. But numbers went up instead.

Dr Chia Shi-Lu, a member of the Government Parliamentary Committee for Health, suggested that the crunch might be due to the holiday season rather than a spike in illnesses.

Mr Liak said this was possible. He explained how 20 KTPH patients at any one time refuse to be discharged. Some say their families are on holiday, and there is no one at home to take care of them.

Health Minister Gan Kim Yong said last night that he was aware of the problem - hence, the push to add 1,900 more acute hospital beds and 2,600 community hospital beds by 2020.

He added: "The hospitals have also implemented various measures to alleviate the bed crunch.

"CGH has set up a nine-bed Short Stay Unit and expanded its observation ward from 12 to 20 beds at the Emergency Department and also set up an Admission Transit Area for patients who are waiting for a bed in the ward."

Madam Fatimah Beevi, 60, has experienced the crunch at both KTPH and CGH over the past fortnight.

She spent Christmas night on a trolley bed in the packed KTPH's emergency department, where she said the beds were so close she could touch the next patient by stretching out her arm. She was discharged after a day.

When her problems persisted, she went to CGH on Sunday. She was placed in the Admission Transit Area for 48 hours while waiting for a B2 bed.

"There was no shower room and I couldn't bathe for two days," said Madam Fatimah, who was discharged yesterday evening after her condition stabilised.

MOH spells out efforts to tackle bed crunch
Gan: Patients' comfort also important amid bed shortage in public hospitals
By Salma Khalik, The Straits Times, 9 Jan 2014

HEALTH Minister Gan Kim Yong has instructed public hospitals to "do everything possible" to make patients comfortable and "ensure their safety" even as they face a severe shortage of beds.

Having seen the growing demand for hospital care some years ago, he stressed yesterday that the Government has begun building more hospitals, with 1,200 beds to be added later this year.

In the meantime, "we are actively working to tackle the current crunch in a few public hospitals" he said, by sending patients to other public hospitals with available beds, and discharging them to community hospitals when possible.

Yesterday, Mount Elizabeth Novena offered to lend 60 beds to public hospitals to help relieve the space crunch. Alternatively, it said, it could take in that many patients to be cared for by its own medical team.

Explaining how the new upmarket private hospital has spare capacity as it is not fully opened yet, chief executive Kelvin Loh said: "We're always open to private-public cooperation."

He added that fees will be reasonable as"the intention is to help meet the high demand".

The offer comes after a Straits Times report yesterday highlighting the severe shortage of beds at several public hospitals.

Tan Tock Seng Hospital (TTSH), Changi General Hospital (CGH) and Khoo Teck Puat Hospital (KTPH) experienced more than 92 per cent bed occupancy last week, on the back of very high rates in the past year.

That means there were days when occupancy crossed the 100 per cent mark, forcing CGH, for instance, to start housing some patients in a tent this week.

Dr Loh said private hospitals usually aim for occupancy rates of 70 per cent to 75 per cent, as special beds in intensive care and isolation units, for instance, must always be kept available for emergencies.

If occupancy rates cross 80 per cent, "it means that on peak days we could cross 100 per cent and our responsiveness will be affected". "That's not acceptable in a private hospital."

Two other hospitals in the Parkway Pantai group, to which Mount Elizabeth Novena belongs, already have link-ups with the public sector. CGH rents a ward from Parkway East, while also sending some of its dengue patients to Gleneagles Hospital.

"I think the Ministry of Health should be open to all options which can help alleviate the current situation," said the chairman of the Government Parliamentary Committee for Health, Dr Lam Pin Min, when told about Mount Elizabeth Novena's offer. He added that he will raise the subject when Parliament next sits on Jan 20.

The hospital most likely to benefit is TTSH as it is just across the road from Mount Elizabeth Novena. It has already set up temporary beds, complete with privacy curtains, along the corridors of its wards to deal with its bed crunch.

Nearly 30 patients are using these "corridor beds".

The bed crunch is also affecting the National University Hospital (NUH), with 89 per cent occupancy last week.

* CNY brings relief to hospitals' bed woes
Occupancy drops to an average 66% on first day; fewer people seen at A&E
By Salma Khalik, The Straits Times, 14 Feb 2014

THE Chinese New Year brought welcome relief to public hospitals here, with bed occupancy falling to an average of 66.3 per cent on Jan 31.

This is in marked contrast to earlier last month, when the hospitals faced a severe bed crunch.

Some were seeing more than 100 per cent occupancy on some days, with patients waiting for a ward bed having to be placed in a tent, along emergency department corridors and even in an area meant for mass decontamination.

Several hospitals needed to transfer some of their more stable patients to Alexandra Hospital, which had beds available.

Since the festive period respite, occupancy rates have climbed to 84.2 per cent last week, said the Ministry of Health (MOH).

This is close to the weekly average in January, which ranged from 86.2 per cent to 88.7 per cent.

For the whole of the Chinese New Year week from Jan 26 to Feb 1, the average was 76 per cent.

A spokesman added: "Traditionally, bed occupancy rates during Chinese New Year will dip as patients may request to return to celebrate with their families. Doctors will try their best to facilitate the request if it is clinically appropriate.

"In addition, people tend not to opt for non-major surgery during the festive period."

Last year, the average bed occupancy rate on the first day of Chinese New Year was 69.9 per cent - or 5.4 per cent higher than this time.

There were also fewer people turning up at the emergency departments of the six public hospitals on the first day of the Chinese New Year on Jan 31 this year.

In all, 1,802 people sought emergency medical help that Friday, compared to the 2,394 who turned up on Monday that week.

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