Victorian hospitals reopen coronavirus wards amid record demand

The Alfred hospital is examining ways to house a rising wave of acute patients outside Melbourne’s major trauma centre, amid record demand in the emergency department and severe staffing constraints.

As Victorian hospitals begin reopening coronavirus wards this week, The Age can reveal a review is under way to determine if it is clinically possible to admit more patients to Alfred Health’s Caulfield Hospital to free up beds at the main hospital site on Commercial Road.

An internal memo sent to staff at The Alfred hospital on Friday from chief executive Andrew Way detailed that the health service was “facing record presentations in our emergency departments, an increase in COVID admissions, increasing challenges responding to deferred and delayed care and a growing number of us affected by furlough and transmission.”

In the memo, seen by The Age, Professor Way said the opening of a second coronavirus ward at The Alfred, which is home to the state’s 24-hour emergency and trauma centre, was imminent. That follows projections that the spread of the Omicron BA.2 sub-variant could soon lead to several hundred extra hospitalisations in Victoria each day.

Professor Way also told staff a review was being undertaken to determine whether it was clinically feasible for more acutely unwell patients to be admitted to, or transferred to, Caulfield Hospital.

“This [review] will include looking to see what, if any, services might be offered away from their traditional hospital site,” Professor Way wrote.

“In particular I wish to review the potential for creating a suitable clinical environment for more of our acute patients at Caulfield Hospital.”

Alfred Health’s Caulfield site is an eight-ward hospital that specialises in rehabilitation, aged care and aged mental health.

The Caulfield hospital plays a statewide role in rehabilitation services. It includes an Acquired Brain Injury Rehabilitation Centre, neurological and spinal rehabilitation, as well as specialised care for amputee patients.

Doctors and nurses from across the state told The Age last week overcrowding in Victoria’s emergency departments was the worst it had been in years, leading to waits of up to 12 hours just to be seen.

Transferring patients outside of major hospitals, including those who are nearing the end of their hospital stay but are too sick to go home, is not unheard of in Victoria. The state’s quarantine hotels have been used for recovering COVID-19 patients to free up beds in the state’s struggling hospitals.

Professor Way said Alfred Health was grappling with balancing “the many different demands” of the pandemic, including a higher acuity of patients. As reported by The Age last week, these patients are arriving seriously unwell and need urgent admission and treatment at the hospital.

A review is being undertaken to determine whether it is clinically safe and possible for some acutely unwell patients to be admitted to the health service’s smaller Caulfield hospital in a bid to free up hospital beds at The Alfred.Credit:Justin McManus

A second coronavirus ward, with 20 beds, is expected to open at The Alfred hospital by the end of the week. Meanwhile, the Royal Melbourne Hospital opened another eight coronavirus beds on Friday, as its 16 bed COVID-19 ward approached capacity.

A Royal Melbourne Hospital spokeswoman said there were plans to immediately open more coronavirus wards, if required, in coming weeks.

On Monday there were 305 COVID-19 cases in hospitals in Victoria, up from 252 at the same time last week. New modelling suggests case numbers for the latest outbreak will peak later this month.

Professor Way also flagged in the memo that senior management was reviewing how Alfred Health could increase support for hospital-at-home programs and further formalise telehealth appointments, as the health system continues to battle severe workforce constraints.

“I wanted to bring you into this conversation as early as I could, knowing that for some of you this will create some anxiety, and for others raise concerns about where staff will come from. Both issues we need to tackle openly,” Professor Way said in the memo.

Emergency department workers have reported seeing a flood of extremely ill patients at a level that hasn’t been witnessed since during the pandemic, or for some, in their entire career.

Pressures include mental health conditions, such as eating disorders and anxiety; cancer and other serious conditions being diagnosed late; COVID-related chest pain; and injuries sustained on the road, at work and through violence.

A spokesman for Alfred Health said the organisation continually reviews how to best use its resources.

“No decisions have been made at this point,” he said.

“Ongoing patient and staff safety as well as the provision of quality care to all patients is fundamental to any operational change.”

Paramedics also warned that critically ill people, including those who had heart attacks, were waiting longer than they should for a bed. A stroke patient was reportedly ferried across town in recent days, after paramedics were told to bypass one particular hospital because it already had seven stroke patients waiting.

The state’s ambulance service was forced to declare a code red for two hours last Tuesday when 99 per cent of its fleet was occupied by high demand or hospital overcrowding.

Emergency health workers have called for widespread system reforms to address chronic hospital bed shortages, a key cause of ambulance ramping.

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