Warsaw infirmary Rescue Divisions (SOR) reached a critical point, standing on the verge of efficiency. Doctors are alerting that the current situation threatens patient safety and leads to utmost staff exhaustion. Dr. Paweł Szłogosz of the Clinic of Orthopedics and Traumatology WUM states: “We have nowhere to treat people.” The overload is so large that patients with lighter medical conditions wait for hours or even days for a free bed, blocking access to life-threatening emergency care. The problem is not only with the capital itself, but besides with patients from the surrounding areas, who, in the absence of alternatives, go to few, overloaded facilities.
System overload: Numbers talk for themselves
The Warsaw SORs have long crossed their limits. The data is alarming: at the Children's Jesus infirmary in May of that year, the ER passed through 3056 patients, which gives an average of 102 people a day. By comparison, the erstwhile year it was 2,520 people, or 84 patients a day. This drastic increase by almost 20% per year exposes the scale of the problem. Dr. Szłogosz emphasizes that with specified pressure, staff are incapable to devote more than half an hr to the patient, which affects the quality of diagnosis and treatment.
The centralisation of patients in respective facilities is simply a key origin in the situation. After the close of the SOR at Barska Street and the infirmary in Solec, patients from the centre and surrounding districts are forced to commute to overloaded hospitals specified as Stępińska or Bielany. This increases queues and prolongs waiting times, creating dramatic on-calls. For example, on May 2, 164 patients were reported, on May 22, 167, and on May 27, 165. 3 doctors must service at the same time 20 patients lying and more than 150 incoming.
Wrong Circle: Why Do Patients Block SORs?
Hospitals are not made of rubber, and the problem of overloading S.R.S.s is besides due to the fact that there are patients who should not be there. This is the consequence of primary wellness care (POZ) failure and night care. Polish doctors are besides frequently limited to issuing referrals to the SOR alternatively of providing self-help. This affects emergency wards with little urgent conditions, specified as pneumonia or urinary tract infections, which could be treated in another facilities.
The situation is all the more complex that the Baby Jesus infirmary plays a key function in the transplantation system, transplanting pancreas, liver and kidneys. Sites for these critical patients are frequently blocked by people who could be treated in internist wards. Despite being placed in internist wards in region hospitals reaching just 55-60%, another institutions are reluctant to receive diagnosed patients, even after infirmary transport. Patients with an internalist diagnosis who should be in the ward within 12 hours are on the ORs for up to a week, taking valuable seats.
Burning Staff and deficiency of Workers
Lack of space and systemic shortages affect medical personnel dramatically. Doctors and nurses are highly overloaded and burned. Dr. Szłogosz admits that despite announcing the competitions for posts, there are no volunteers to work. Staff do more than they can, but human capabilities are limited. In addition, patients are aggressive, and the hands of medical rescue teams are more and more frequent erstwhile ambulances stand under the SOR for up to 5 hours alternatively of leaving for further calls. The infirmary pays fines for specified downtimes, which is additionally borne by the budget of the facility.
Another serious problem is the deficiency of long-term care facilities. Beds in hospitals are blocked by patients requiring specified care even for many months. Dr. Słogosz indicates that he presently has 12 specified patients who occupy seats, while their condition no longer requires infirmary treatment, but only care. This phenomenon creates a domino effect, reducing the availability of beds for urgent patients and deepening the crisis on the SORs.
Unused Potential: Where to Search for Solutions?
Despite the dramatic situation, Dr. Słogosz does not lose hope and points to possible solutions. He believes that the strategy could be relieved if it included institutes that have contracts with the NFZ and close their doors at 3:00. Their unused possible could be directed towards handling urgent cases, relieving the SORs. In addition, it would be worth encouraging private hospitals to receive patients urgently. Their bed base and human resources could importantly support an overloaded public wellness care system.
The crisis in the Warsaw SORs is an emergency signal for the full wellness system. It requires immediate, systemic solutions, which will cover both improving the operation of POIs, better management of patient flow between institutions and expanding the availability of long-term care. Only comprehensive actions can prevent further deepening of the crisis and supply Warsaw residents with access to effective and safe medical care in emergency situations.
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Warsaw SORs on the verge. Doctors alert: there are no seats and no staff!
