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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2012-05-30 Daily Xml
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Ministerial Statement

EMERGENCY DEPARTMENTS

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (15:05): I seek leave to make a ministerial statement.

Leave granted.

The Hon. J.D. HILL: Today in question time the member for Waite asked me a question about a Coroner's report dated June 2010. That report was into the death of a patient, a Ms Promnitz, who died in the QEH on 5 March 2006, so now over six years ago. I have further information which I would like to provide to the house.

I am advised that the lady in question was a resident at the time at the St Hilarion Nursing Home at Lockleys. On the evening of 5 March 2006 she was taken by ambulance to the Queen Elizabeth because of dehydration resulting from deterioration in her health. She was placed in the corner of the waiting room at the QEH and was triaged as a category 4, which is a relatively low level, which according to the Australian triage scale means that she should have been seen by a doctor within one hour.

She was not seen by a doctor; however, a nurse did take observations on two occasions and her vital signs were normal. She was found deceased around 2 o'clock in the morning, as the member had said. The Coroner handed down his investigation in 2010. I am advised that he found that she died as a result of sepsis due to a urinary tract infection with group B streptococci. I am also advised that the Coroner did not make any recommendations in relation to the Queen Elizabeth Hospital; however, he expressed concerns regarding the remarks made by Dr Sally Tideman, who was then the director of medical services, who made these remarks during the inquest. I quote Dr Tideman:

It's deplorable, in my view; absolutely deplorable that we are not in this state able to provide good general practitioner services that don't rely on locum services to our residential aged care. And therefore the acute setting—the acute hospitals, like my hospital—then become the first line for sick elderly patients who do not need to be in a hospital and, in fact, care can become compromised by them coming into hospital.

That was what Dr Tideman said to the Coroner, and the Coroner's only recommendation was in relation to that remark. He directed that the remark be referred to the commonwealth Minister for Health and Ageing. I subsequently wrote to minister Roxon in relation to that remark. The remark essentially makes a very good point that a lot of people end up coming into our hospitals who should not be there, who should be looked after, and this is a particular issue in relation to nursing homes. One of the reasons I asked for the ageing portfolio to be added to my responsibilities of health was so that I could build a better relationship between the health services and nursing homes.

On 3 June the then chief executive of the Central Northern Adelaide Health Service, Martin Turner, put out a press release, a media statement, about the Coroner's report. He expressed his condolences and he made a detailed statement about what actions the Queen Elizabeth Hospital had taken in relation to the events which had happened some four years earlier, now six years ago.

The hospital had gone through what is called a root cause analysis, as they do when any incident like this occurs. As a result of that analysis, he reported on 3 June 2010 that a number of significant improvements to patient monitoring procedures has occurred since that incident. They include the introduction of a dedicated triage nurse assigned solely to observe and maintain contact with patients in the ED waiting room at all times. Also, they have introduced to the hospital a rapid assessment team which can be called upon if a nurses is concerned about the condition of the patient in a waiting room.

A policy has been implemented whereby medical staff are alerted if there is an urgent need to transfer patients from the ED to medical wards, and a new diagnostic planning unit has been included in the hospital where patients can be seen quickly by a consultant. Improvements have been made to the call bell system throughout the ED waiting areas, and an extended care unit designed to cater for patients that may require a longer period of observation is also planned. So, in brief, I could not recall the particular case. It is now six years ago that the matter happened but the hospital has responded, and that was issued in a press release at the time of the Coroner's report. The one request that the Coroner made, which was for us to notify the commonwealth government in relation to this matter, has been complied with.

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