Bed crunch at Singapore hospitals: Some patients are stuck in emergency departments

SINGAPORE – The bed crunch in public hospitals is so severe that it has spilled over to their emergency departments, many of which stay packed with patients because there is no room to move them elsewhere.

Emergency department (ED) doctors say there are days when the situation is so bad that an ambulance arriving is unable to discharge the patient for lack of space. Instead, the medical team has to assess the patients while they are on the ambulance trolley.

Those who are in critical condition are treated immediately. Others might have to wait 15 to 30 minutes for space to be found so that they can be offloaded and the ambulance can leave.

This also holds up the ambulance, which might be urgently needed by another critically ill patient.

The Singapore Civil Defense Force, which runs the emergency ambulance service, said there has been a 32 per cent increase in calls in the first half of 2022 over the previous year, of which 93 per cent were real emergencies.

The Ministry of Health (MOH) says hospitals will mitigate the situation during peak congestion periods through measures such as adding more beds to wards and creating holding spaces in EDs. At least one hospital has converted a consultation room to hold such patients in recliner chairs when it is short of beds.

The Straits Times spoke to several ED doctors and nurses who asked that they and their hospitals not be identified. They say the problem has been around for years, but has become worse this year, partly on account of the surge in Covid-19 cases.

They say they are no longer surprised that a patient they had admitted was still around when they return to hospital for their next shift. On some occasions, the patient might still be in the ED for up to four days after being admitted.

“Patients remaining in the ED for days on end is now the norm,” said an emergency medicine specialist.

Another said: “I am no longer as surprised as before but, yes, still surprised when I see the same patient and next of kin a few days later in the ED.”

Mr Anthony Pragasam, 91, was one such patient. He was taken to a public hospital ED at 3pm on Sept 20, and was officially warded at 8pm. But he remained in the ED for two days before he was sent to a ward at 6pm on Sept 22.

As he was in the ED, no visitors were allowed. Said his son: “I am quite certain he did not get a shower, but there is just no way to know, as we were not allowed inside.

“There needs to be a rethink about holding patients in the ED without easy access to family members, especially elderly ones like my dad who have dementia, are unable to communicate clearly and cannot ask for what they need. And to keep family members away from the patient for two days without any of us to see how he is doing, I think that cannot be allowed to happen.”

According to MOH’s published data, for the last two weeks of September, the median wait time for a bed at Ng Teng Fong General Hospital on six of the 14 days was 22 hours, 22.3 hours, 22.7 hours, 23.1 hours and 23.7 hours and 24.2 hours . Weekends were generally less crowded and the shortest wait time was 7.6 hours on a Saturday.

In August, the longest median wait time for this hospital was 25.4 hours.

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