What we are doing now - Hospital Demand Management Plan

COVID-19 response

In South Australia, a range of measures have been implemented on the advice of our medical and public health experts, to protect the health and wellbeing of all South Australians and prevent the spread of COVID-19 in our community.

Detailed planning has been undertaken to ensure adequate capacity and resourcing across our health system as part of our COVID-19 response.

The response is tailored to our local conditions and may change over time as the situation in our state changes.

My Home Hospital

We are implementing

The My Home Hospital (PDF 140KB) program is the next step in delivering more appropriate patient care throughout the health system, which will help free up hospital beds and enhance the experience of patients who can be better managed in a home setting.

Currently, only 1.3 per cent of all acute hospitals deliver health services at home, and the My Home Hospital program will aim to increase this number to almost five per cent.

In its first year of operation, the conditions that will be eligible include those with respiratory infections or inflammations, kidney, and urinary tract infections.

This type of service has shown its worth during the COVID-19 response with around 163 COVID-19 patients treated under the current Hospital-in-the-Home (HITH) programs - receiving care at home rather than being admitted to a public hospital.

Southern Health Expansion Plan

We are implementing

The Southern Health Expansion Plan has been brought forward as part of South Australia’s COVID-19 response. The Plan will boost health services in Southern Adelaide through a series of service moves by:

  • increasing emergency treatment by 30 more spaces at Flinders Medical Centre
  • creating state-of-the-art 12-bed facility at the Repat for patients with dementia and complex care needs
  • enhancing acute capacity in Noarlunga Hospital and increasing medical cover in the Emergency Department.

Flu vaccination

The public awareness campaign Stop the Flu Before it Stops You was launched in April to educate the community about the risks associated with flu, how easily it spreads, and practical measures to reduce the spread.

Free flu vaccinations are available for everyone aged over 65, pregnant women, all children aged six months to less than five years of age, all Aboriginal and Torres Strait Islander people aged over six months, the homeless, and people with medical conditions that predispose them to complications from the flu.

Priority Care Centres

We are implementing

We have opened Priority Care Centres across metropolitan Adelaide following a successful pilot program to ease pressure on our hospital Emergency Departments (EDs). As of 31 May 2020, a total of 1,826 patients have attended the Priority Care Centres.

Our SA Ambulance Service and our hospital ED staff offer this option to patients who could be cared for and treated in the community in a Priority Care Centre, rather than waiting at an ED, resulting in the patient receiving the care they need sooner.

Additional access pathways to access services at a Priority Care Centre have also been established to enable general practitioners and also SAPOL to utilise this service option as an alternative to sending people to an ED.

Mental Health

In response to COVID-19, SA Health in collaboration with Ramsey has opened 20 beds at the Adelaide Clinic for patients in the metropolitan area. The beds will be open from March through to June 2020 to assist with anticipated higher demand in the acute system.

SA Health is working closely with the private sector to establish an urgent mental health care centre in close proximity to the Royal Adelaide Hospital, as an alternative for mental health patients who would otherwise present to its Emergency Department.

We are also implementing:

  • Increased mental health bed capacity at the Royal Adelaide Hospital and Lyell McEwin Hospital
  • Direct mental health admission pathways, and rural and remote rapid review processes for hospital transfers, in CALHN.
  • A statewide Borderline Personality Disorder Collaborative has been established.
  • Construction has commenced on a specialised 18 bed Neurobehavioural Unit (NBU) at the reactivated Repat site.
  • SA Ambulance Service and Central Adelaide Local Health Network (CALHN) have partnered to commence a second phase of the Mental Health Co-Responder program. This program brings paramedics and mental health clinicians together to support consumers in the community where suitable, rather than transport them to an ED.
  • Planning has commenced for a Statewide Paediatric Eating Disorder Service and a Tier 7 Dementia Unit for Older Persons, both based at the reactivated Repat Health Precinct.

Transferring patients to free up beds

We are implementing

By transferring metropolitan inpatients to peri-urban hospitals, patients can receive ongoing care in an appropriate setting at times of peak demand, and help free up beds for acute and urgent care in metropolitan Adelaide.

Elective surgery

We are implementing

To ensure that beds are available for patients requiring acute or urgent care during times of peak demand, some patients scheduled for same day or overnight elective surgery may have their procedure temporarily postponed and rescheduled for a later date.

NDIS Patients Transitioning from Hospital to Home

We have implemented

As part of a project to assist in transferring long stay patients in acute beds to alternative non-acute care options. SA Health continues to work with the National Disability Insurance Agency (NDIA) and the Department for Human Services on safely discharging NDIS patients to home and community care and improving the timeliness of National Disability Insurance Scheme (NDIS) supports being available.

A new Transition to Home: Step Down program has been established in partnership with the Department for Human Services with an additional 48 beds being available for NDIS eligible patients while awaiting their longer term supports being put in place.

As at 22 May 2020, 312 patients have been discharged from hospital through these projects. These 312 patients had a combined stay of 34,963 days since being medically cleared for discharge.

Private partnerships

We have implemented

In July 2019, a new Patient Services Panel was established, which allows public hospitals to access services at private facilities. This more streamlined coordination of services will result in reduced waiting times for elective procedures and increased capacity in our public hospitals.

The 13 private providers include day and overnight hospitals which will primarily assist with providing hospital services, such as elective surgery and rehabilitation, but also support during emergencies or major incidents.

Opening more beds

We have implemented

We’ve opened more hospital beds throughout the hospital networks, including:

  • 50 beds on the Repat site.
  • 12 beds at the Noarlunga Hospital Medical Short Stay Unit.
  • 8 bed Emergency Extended Care Unit (EECU) at Modbury Hospital.
  • 10 new forensic mental health beds at Glenside.
  • 10 new Psychiatric Intensive Care Unit (PICU) beds at the Royal Adelaide Hospital.
  • 5 bed Short Stay Mental Health Unit at Lyell McEwin Hospital.

Mobile Radiology Service

We have implemented

South Australia Medical Imaging (SAMI) has rolled out a mobile radiology service, bringing x-ray equipment direct to nursing home residents. This mobile imaging service trial will support older patients in the southern suburbs who would otherwise require transport to a nearby hospital for an x-ray.

Hospital discharges

We have implemented

We’ve introduced a new Statewide Hospital Criteria-Led Discharge plan to help patients return to their home as soon as possible, and reduce the pressure on our hospitals and EDs.

Home Hospital Pilot Programs

We have implemented

Several Home Hospital Pilot programs were introduced across metropolitan Adelaide, to enable suitable patients to be treated at home and save patients from unnecessary visits to hospital.

  • Central Adelaide LHN partnered with Calvary Private Hospital to trial a Modified Geriatric Rapid Acute Care Evaluation Service (GRACE), which aims to provide the best care for acutely unwell residents in Retirement and Aged Care facilities (RACF), in the most appropriate and familiar setting, and avoid an unnecessary transfer and/or admission to hospital.
  • The Northern Adelaide LHN and Pop-Up Community Care co-designed program which aimed to reduce ED presentations by linking certain patients with ongoing community supports is now complete. NALHN have transitioned to a modified model of care that continues to deliver services to patients in their homes to support hospital avoidance.

SA Ambulance Service (SAAS)

We have implemented

  • SAAS has undertaken a Scheduled Transport Development Program to improve the efficiency of the Patient Transport Service. This work, collaborating with the metropolitan LHNs, supports patient flow by assisting with timely discharges and assists in creating capacity within our hospitals.
  • SAAS has established Hospital Ambulance Liaison Officers (HALO) in each metropolitan LHN. These officers coordinate the SAAS support of patient flow, hospital discharges, and SAAS/LHN improvement projects. They provide timely liaison between the hospital and ambulance operations.
  • The SAAS Emergency Operations Centre has Health Network Coordinators (HNCs) who assist in the coordination of ambulance distribution among our hospitals. They actively manage any delays and support the sharing of capacity across the state’s health system.
  • Extended Care Paramedics provide the highest paramedic level clinical treatment, advice and support to assist people to remain in the community rather than attend hospital. ECPs focus in areas such as residential care, palliative care, community referral and support of out of hospital care programs. Within SAAS, they also provide clinical advice to ensure safe and effective ambulance care and referral across the state.
  • On 6 February 2020, a ‘Ramping Revisited’ workshop was held to identify common barriers to patient flow across metropolitan Adelaide. SA Ambulance Service will introduce a clinical telephone assessment in mid-2020 to ensure that patients receive the very best care and are able to access the most appropriate pathway for their needs. The initiative will also free up capacity to ensure ambulances are available to respond to emergencies and ease pressure on emergency departments.
  • Bringing forward two intern groups (approximately 35 FTE) recruited for the June and September 2020 intakes to commence in April 2020. Bringing these two internship groups forward will not only assist immediate COVID-19 related surges in demand, but will also benefit winter workload due to new recruits being ready to work on-road during winter who would have otherwise received training in June and September.
  • The rapid engagement of extra resources in country South Australia which encourage existing SAAS volunteers to be engaged on casual contracts to fill roster shortfall and enlist State Emergency Service (SES) volunteers to act as Ambulance Assist officers to support Ambulance Officers.

Direct admissions to EDs

We have implemented

An increased number of direct admissions means that more patients are being admitted directly to a ward and by-passing hospital EDs, which means less waiting for patients and reduced pressure on our EDs.