General News
19 January, 2022
More to come: Code Brown could bring more changes to hospital management
Grampians Health chief medical officer Matthew Hadfield addresses some questions regarding the local impacts of the Code Brown.
Update, Wednesday January 19, 1.30pm:
A PANDEMIC Code Brown has begun across various health services in Victoria and Grampians Health incident commander and chief medical officer Matthew Hadfield addressed some questions regarding the local impacts of the code.
Mr Hadfield said the Code Brown response would be coordinated with representatives from all campuses, including Wimmera Base Hospital, on the senior management team.
“As an organisation we have been dealing with the COVID surges and this time with the serious increase of hospital admissions and staff shortages for a number of weeks now,” he said.
“We’ve already been making significant adjustments to our hospitals in terms of dealing with the influx of COVID patients and with the staff shortages that the COVID pandemic is forcing us to address.
“There’s going to be no sudden changes in how we are already managing things.”
Mr Hadfield said it was unlikely the Dimboola campus would see any effects of the code.
“Horsham as the sub regional service is the most likely to feel the impact should the demand for COVID positive patients spread and increase rapidly,” he said.
“In terms of size we would expect Ballarat, then Horsham, then Stawell, then Edenhope to be affected.”
Mr Hadfield said that as it was difficult to predict how long the current COVID increase would continue for it was highly probable further actions would have to be implemented to maintain levels of staffing.
“We’ve had a number of staff offer to cancel or postpone taking their leave; however our approach is, where possible, that we are declining these offers,” he said.
“Our current focus is that we have an exhausted staff that need as much rest and recuperation time as possible and we don’t believe that cancelling staff leave would be our first approach.
“We are aware of one or two staff members who have returned to support in areas where staffing had been particularly hard to maintain and that may happen on an individual basis but the policy should be that we maintain our staff leave wherever possible.”
Currently, Ballarat Base Hospital is receiving all positive COVID-19 patients across the Grampians region.
“We have a dedicated COVID ward and intensive care facilities dedicated to be able to do that,” Mr Hadfeild said.
“Hospitals tend to run near capacity at all times and it's a question of prioritising clinical care to use that capacity in the best way.
“At the moment the number of COVID patients presenting is well within the capacity of our COVID ward.”
Mr Hadfield said the announcement did not change arrangements to elective surgeries statewide.
“We’re restricted to emergency and category one surgery only,” he said.
“The term elective surgery can sometimes diminish the importance of surgery to individuals
“Behind every cancelled operation is a patient who is desperately waiting for necessary surgery and it's heartbreaking.
“The Code Brown may result at some point in more less-urgent services being cancelled and that will add delays to get inpatient or outpatient treatment.
“Our aim is to minimise that as much as possible because it merely pushes the problem down the road, we have to deal with the longer waitlists in both inpatient and outpatient treatment.”
Mr Hadfield said a worst-case scenario would be asymptomatic COVID positive staff going back to work.
“When you get to this stage of the pandemic, all options are on the table and there is a sequence of relaxation of restrictions that you have to consider as the pandemic gets worse and staff shortages increase,” he said.
“But in terms of relaxed isolation requirements for close contacts, we as an organisation rely very heavily on excellent PPE.
“We have adequate supply and that is a protection for both staff and patients.”
Earlier:
THE Wimmera Base Hospital, as part of Grampians Health, is one of several regional and metropolitan hospitals where a Pandemic Code Brown will be implemented due to the Omicron outbreak.
The code puts in place a formal emergency management structure to make the best use of hospital resources to combat COVID-19.
Victoria’s health system is juggling workforce shortages because of staff in isolation, a vast number of coronavirus patients requiring hospitalisation, and ongoing treatment for patients with urgent and emergency needs.
As health services are asking for further assistance to manage the situation, the Department of Health has declared that affected public hospitals will activate their Code Brown plans by midday on Wednesday, January 19.
Acting Minister for Health James Merlino said hardworking health workers on the front-line were caring for record numbers of coronavirus patients every day.
“This is the best way to ensure our hospitals can continue to safely care for those that need it most,” he said.
“Our health services will have to make some hard decisions over the next few weeks to manage increasing demand and I thank every single one of them for making the tough calls necessary to help as many Victorians as they can.”
Under the code, health services can configure services to free up more staff, including the delivery of outpatient services outside the hospital, and the rapid offload of ambulance patients at emergency departments to get paramedics back on the road as soon as possible.
Hospitals may also choose to redeploy staff to work in areas of highest clinical priority.
In addition to hospitals in metropolitan Melbourne, the code will be implemented at Barwon Health, Grampians Health, Bendigo Health, Goulburn Valley Health, Albury Wodonga Health and Latrobe Regional Hospital.
Australian Nursing and Midwifery Federation Victorian branch acting secretary Paul Gilbert said nurses and midwives had a “week from hell” leading up to the Code Brown announcement.
“These coming weeks will only be worse,” he said.
“The Andrews Government has acknowledged nurses’ and midwives’ serious concerns and is sending an honest, crystal-clear message to the community that our health system is facing challenges not seen in more than a century.
Mr Gilbert said staffing a 24-hour, seven-day-a-week roster was impossible when up to 7000 members were missing from a workforce.
“Nurses and midwives are working short staffed under emergency surge team models that include students and allied health,” he said.
“They’re exhausted and making incredibly stressful decisions about how they prioritise and ration patient care to maintain safety.”
A coordinated approach was deemed necessary to help health services including Ambulance Victoria work together rather than in isolation, in the face of overwhelming demand.
Read more: Wimmera COVID numbers rise again
Health services and the health workforce will continue to have responsibility for decisions around how to manage internal patient flow within a health service as well as the assessment, treatment and referral of patients.
There is set to be an expansion of COVID streaming sites to increase the number of hospitals caring for coronavirus patients to help ease the pressure at hospitals currently handling the most patients.
The Department of Health will also establish a new Health Service Response Centre which will help hospitals coordinate patient flow, distribute activity and support decisions around service reconfiguration including suspending some activity or moving to home-based care.
The Pandemic Code Brown is expected to last four to six weeks and health officials will monitor the situation to determine when it’s safe to begin winding down arrangements.
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