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SASMOA Members were recently surveyed about pressure to discharge patients from hospital.


The survey was conducted in response to the Minister for Health and Wellbeing querying concerns raised by SASMOA about premature discharge being directed by non-clinicians. 


The survey received 250 responses. As a voluntary, self-selecting survey, the results should not be interpreted to be statistically representative of the entire SASMOA membership; they do however indicate that the issue of pressure to discharge is real and of concern



Key findings of the survey are: 

•    Of respondents, 84% agreed or strongly agreed they feel pressure to hurry patient care because of the number of people waiting.
•    Of respondents,
80% agreed or strongly agreed that the pressure to hurry patient care negatively impacts on patient care.
•    Of respondents,
62% agreed or strongly agreed that the culture in the workplace made them feel pressured to discharge patients before they are medically ready.
•    Of respondents,
28% indicated they have been directed by someone other than a clinician to discharge patients. Non-clinicians included: administrators (27% had experienced this), executives (38% had experienced this) and program leads/business managers (19% had experienced this).
•    The most common way to receive a direction to discharge a patient is verbal instruction (71% had experienced this). 
•    Of respondents who answered yes to whether they have been directed by someone other than a clinician to discharge patients,
49% indicated that direction had been against their clinical judgement. 
•    Disturbingly,
56% of respondents reported that in their view a direction to discharge patients had negatively impacted on patient care.
SASMOA Members are reminded that the Health Care Act 2008, makes it clear that the administration “cannot give a direction concerning the medical treatment of a particular person”.


If this occurs the risk is borne by the doctor and their patient. 


If anyone in administration directs a doctor to discharge or send a patient home you should request the direction in writing and contact SASMOA and/or your medical indemnity insurer. This is a particular concern for junior medical officers, who may feel intimidated by administrators.


If there are insufficient beds for sick patients who you are of the view should be admitted to the hospital, then email the hospital executive to advise of issue. Advise the patient or the patient’s family also to contact the hospital executive, or the hospital Board chairperson or both. Sick patients should not be sent home due to a lack of resources.


The survey results have been provided to the Minister, along with the full range of comments made by respondents. All responses have been de-identified. 


The survey results can be read here
Bernadette Mulholland
SASMOA, Chief Industrial Officer

7 June 2021

Surgeon in Uniform
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