Recently a family member was transferred by ambulance to a Sydney public hospital. During my visit to the hospital, I found myself contrasting the expectations for residential aged care homes versus the practices I observed during my two-hour visit to this hospital.
Firstly, I would like to note that the care delivered to my family member was excellent, and the staff were very helpful.
I was surprised when I arrived at the main hospital entrance at around 6:30 pm on a weekday to find no one attending to visitor entry screening. When I eventually found my way to the ED, the very helpful clerical staff asked me to complete some forms on behalf of my family member. At no time was I asked for evidence of my COVID-19 vaccination status or screened on the other four criteria for hospital visitor access listed in the NSW Health guide to hospital visitation. My name and contact details were not recorded in a visitor register as required for visitors to residential aged care facilities.
IPC practices were inconsistent, and while all clinical and administrative staff wore masks, I didn't see any staff in the ED wearing eye protection, although some had safety glasses pushed back onto the top of their heads. An RN touched the front of their mask then treated a patient for a cut. There seemed to be a shortage of treatment rooms, with a couple of patients treated in the waiting room, so this infection control breach was in plain view for all to see. Social distancing in the waiting room was not possible.
Some patients, including my family member, had their post-discharge treatment plans discussed with a doctor while in the waiting room, breaching patient confidentiality.
Over the last few days, I have reflected on my observations and considered the disparity between the standards expected of residential aged care providers versus hospitals. As we know, staffing levels in aged care homes are much lower than hospital staffing levels, yet hospitals treating vulnerable patients aren't required to meet the rigorous standards applied to aged care. Why not? I have no doubt there would be significant consequences if any of the breaches I observed were found in an aged care home by the ACQSC.
Sadly, there are many more examples of disparity between the two systems, including the significant gap in public funding for the care of high acuity aged care residents compared to funding received for patients of the same acuity treated in public hospitals.
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