Bed crunch in Singapore forces hospitals to put patients in corridors

January 26, 2010
Singapore Democrats

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The Malaysian Insider

Along a corridor in a Class C ward in Tan Tock Seng Hospital (TTSH) on Tuesday, a patient lay on a moveable trolley bed. A green folding screen did little to shield him from hospital visitors and other patients and staff passing by.

Admitted after a severe bout of diarrhoea, he was given that bed and told to stay there till a new bed was freed up. He stayed for 12 hours.

The patient, who did not want to be named, said he was told there was no bed for him in the six-bedded room within the ward.

Public hospitals are reporting occupancy rates averaging 90 per cent or more in the past few weeks, indicating a bed crunch.

January is traditionally a busy time of the year as doctors return from leave and patients schedule elective surgery they postponed from the December holidays.

At TTSH, such a peak started occurring after the new year, said the hospital’s chief executive officer, Dr Lim Suet Wun.

He said in an e-mail reply to The Straits Times that having patients in temporary beds in the wards would allow the ward doctors and nurses to tend to the patients quickly.

“While it’s not ideal (mainly, there’s less privacy), most of our patients have been understanding and appreciate that it is better than waiting at the emergency department,” he said.

He did not say how many patients have been given such temporary beds or for how long this would go on, but added that a new ward will be opening in the middle of next month.

Patients and their family members, however, are none too pleased about the situation.

Programming assistant Nur Diana Kamaruzaman was upset that her grandmother was initially left along the corridor on a temporary bed in a B2 ward last year. She was warded for a total of nine days for a burst vein in her brain.

“My grandma felt so alone because she was left outside and not given a proper place… she felt abandoned outside the room,” she said.

Nur Diana, 22, added that the family would have transferred her to another ward class if told about the bed crunch earlier.

Perimal Suppaya Munasamy, 55, who was warded for surgery to remove a perineal abscess three weeks ago, was also given a bed outside a room in a B2 class ward at TTSH. He stayed put for 12 hours overnight before his operation.

His wife, Suppiah Saroswani, 54, a telephone operator, said: “My husband had to go through the night with on-off sleep because people were walking by all the time.”

Dr Lim said these patients were usually moved to proper beds in wards within a day. “I do apologise for the inconvenience the patients in temporary beds have to go through,” he said.

A Health Ministry spokesman said the temporary beds are among the measures that hospitals are taking to cope with the sudden surges in patient numbers. She asked that patients who are fit for discharge cooperate and leave beds before noon so that beds can be released for new admissions.

At Singapore General Hospital (SGH), another busy hospital, patients from its accident and emergency department waiting for a bed are placed in a transition ward.

This ward does not have facilities like a television or telephone. Patients have to use the toilet and bathroom along the corridor, instead of inside the room.

Dr Wong Yue Sie, SGH’s chief operating officer, said these patients will be treated as though they have already been admitted in the normal wards.

“Notwithstanding any delays in getting a bed, our patients’ care and safety are always our priority,” he said.

At Changi General Hospital, where occupancy is at 99 per cent, patients in the past few days usually had to wait about five to seven hours for a bed at an observation ward within the accident and emergency department, said a spokesman.

The squeeze on public hospital beds seems set to continue at least until Khoo Teck Puat Hospital opens its wards in September.

To better manage the situation, TTSH and SGH have tried to improve their discharge planning process by giving patients advance notice of their discharge dates and plans.

Since last month, TTSH has also transferred 80 patients whose conditions have stabilised to the newly opened Ren Ci Community Hospital.

National University Hospital, which is operating at over 90 per cent capacity, offers outpatient services like intravenous antibiotic treatment and parenteral therapy for patients suffering from inflammatory diseases, instead of getting them to be admitted for these procedures.

Its heart patients who go to the emergency department with chest pains will also be asked to go directly for treadmill tests ordered by doctors, instead of being admitted and waiting for the next specialist visit before ordering the tests.

Halimah Yacob, the former head of the Government Parliamentary Committee for Health, estimated that Singapore needs to create 600 new beds a year in order to cater to a growing and ageing population.

Singapore has more than 8,000 acute-care hospital beds, of which over 6,000 are in the public sector. Over 100 beds have been added in the public hospitals in the past three years.

Halimah suggested hospitals expand the number of procedures which can be done through day surgery; and better subsidies to get more to stay at community hospitals instead of crowding the acute hospitals.

Dr Lam Pin Min, current head of the committee, recommended that the Health Ministry give real-time updates, perhaps in a text-messaging format, on waiting times at various emergency departments and also on bed occupancy, similar to the ones done for parking spaces in the city.

“This will give patients and relatives a better idea on which hospital they should visit to minimise crowding and long waiting times,” he said.

As for the temporary beds along ward corridors, he said such patients should be given a pro-rated discount on bed charges.

“This is only fair,” he said.

http://www.themalaysianinsider.com/index.php/world/50662-bed-crunch-in-singapore-forces-hospitals-to-put-patients-in-corridors