During the last few weeks, hospitals in the Western Cape have seen consistent and continued increases in patients requiring to be admitted with COVID-19. Hospitals have been under extreme pressure and at times near capacity. Drastic interventions were required to support these hospitals in quicker admission, transfer and discharge procedures.
The Western Cape Department of Health’s Emergency Medical Services (EMS) recognised the need and identified a “gap they could fill” to support the overall health platform response to the relentless impact the pandemic had.
Traditionally, an allocated vehicle fleet and human resources were allocated to geographical areas to assist with emergency medical care and transport of patients amongst facilities in that specific area.
EMS identified they could intervene and assist in alleviating pressure on certain hospitals by fast tracking patients at a hospital which was under severe pressure. Stewart Taylor, Acting Director for EMS explains, “We basically prioritized the health platform and re-organized the workflow to create fluidity in patient movement with the emphasis on creating bed space for those patients whose health condition required escalation.”
To reduce the turn-around times in the Metro, EMS’s strategy involves keeping resources within the City’s two main referral pathways, North East and South West. This strategy prevents across City patient movement thus reducing turnaround times. At any given time, there is an ambulance available to support a particular hospital which was under pressure. The results could be seen and felt almost immediately as patients could be transported between hospitals in these areas much quicker than previously (when an ambulance would have to travel from a certain part of the Metro to the hospital).
The challenge of rapid increase in admissions was also felt in the Rural areas, specifically Garden Route and Cape Winelands. Because the distance to travel between rural areas are much bigger, the team decided to pool resources in a specific area to support under pressure facilities in freeing up space. By ambulance being pooled, results in more being available in a specific area to transfer patients between hospitals.
The EMS teams excelled as these transfers at times were very complex as it involved transporting patients who were connected to oxygen and the team needed to be vigilant of the patient’s condition and the connection of the equipment throughout the journey.
Stewart explains “the lockdown level also assisted in providing some relief from the amount of calls associated with trauma and violence”, meaning they were freed-up and could attend to COVID-transfers”.
Stewart says the Metro strategy has been under discussion for a while and Covid-19 provided the opportunity to implement and develop the strategy moving forward. “We moved away from the traditional way of providing our service with various innovations which resulted in positive outcomes and defined the way we will work in the future,” he adds.
The quick-thinking and application of innovative solutions by EMS resulted in many hospitals being able to have patients transferred quickly ensuring the best health outcomes for them.
“The selfless act of our EMS staff members is another example of the unsung heroes. They often went beyond the call of duty, working longer hours to ensure they support the hospitals. Their innovative thinking is yet another example of how our Department pulls together in challenging times, which enables us to respond to a pandemic of this nature united. I thank all our Health Heroes for all that they sacrifice to ensure our Department continues to save lives,” said Dr Keith Cloete, Head of Department.
Deanna Bessick
Emergency Medical Services & Forensic Pathology Services
Cell: 073 620 4694