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The potential to further cut hospital waiting lists through improved infection prevention and control

Our hospitals and all health care practitioners are wholeheartedly deserved of our praise for their tireless efforts to navigate and support us through the COVID-19 pandemic. Placing an unprecedented strain on resources, elective surgery saw suspension of some services for a time in 2020. Following that, hospitals continued their focus on boosting elective surgery levels and this has resulted in better on-time performance and reduced waiting lists in many jurisdictions. 

In NSW, 64,599 elective surgeries performed was the highest of any April to June quarter since 2010 and record numbers were seen across all urgency categories, as reported in the Bureau of Health Informations’ latest Healthcare Quarterly report.The percentage of patients who received their surgery on time continued to improve while waiting lists were markedly shorter at the end of June 2021 when compared with the record levels seen a year earlier. 

This is excellent progress and a trend that NSW will no doubt wish to continue. However, challenges still exist both here and overseas. 

The US National Library of Medicine National Institutes of Health report – Waiting time as an Indicator for Health Services Under Strain: A Narrative Review details worsening wait times which have been shown to be associated with patient dissatisfaction, delayed access to treatments, poorer clinical outcomes, increased costs, inequality and patient anxiety. For patients with chronic health conditions, there may be a cumulative burden from increased waiting time. Patients with chronic disease may spend more time out of the workforce, which may contribute to worsening socioeconomic position. It reports further work to better clarify definitions, identify driving factors and understand hidden waiting times and identify opportunities for reducing waiting time or better using waiting time could improve health outcomes of health services.

One driving factor is availability of hospital beds. In the OECD Report, Waiting Time Policies in the Health Sector: What Works? (Australia) it indicates there were a total of 81,826 hospital beds in Australia in 2009 (3.73 per 1000 population). As in most OECD countries, the number of hospital beds per capita in Australia has fallen over time. This decline has coincided with a reduction in the average length of stay in hospitals and an increase in the number of same-day surgical procedures. 

It got us thinking. What if more hospitals employed technology to increase the availability of the beds they already have in place through a reduction in potentially avoidable patient stays?

Australian and New Zealand hospitals already achieve high standards in infection prevention and control but moving the dial even slightly can deliver big improvements in both cost and patient care. Take Indigo-Clean for example. It is proven to reduce Surgical Site Infections (SSI’s) by 73%. 

The Australian Commission of Safety and Quality in Healthcares (ACSQH) report on Healthcare-Associated Infections estimates the impact of SSI’s results in an extra 20 days in hospital at approximately $42,102. Furthermore, HAI’s can be contracted in other areas of a hospital, in ICU, ED’s and in patient rooms and these can all contribute to a significant length of stay and increased costs. 

Based on these numbers, if a hospital with 10 SSI’s per annum at a cost of $421,020 and 203 days was able to reduce this by 73%, or from 10 down to 3, this would potentially represent a cost saving of $295,000 per annum and return 142.1 bed days back into the system. And with the cost of implementing the Indigo-Clean system into an OR less than the associated costs of two surgical site infections, the potential savings are enormous. 

What’s more, if Indigo-Cleans safe and continuous technology, effective at killing SARS-CoV-2 (the virus causing Covid 19), influenza A, MRSA and a list of pathogens that negatively impact health and wellness, was introduced in a variety of hospital settings, then the potential for avoidable stays having a significant positive financial impact to hospitals is enormous. 

With bed availability being a contributing factor to reducing hospital wait times, then surely employing a cost-effective method of continuous infection control has got to be one answer to this challenge?