The Groote Schuur Hospital Emergency Funds for Emergency Surgeries project – which has raised more than half a million rands, and which was launched this week in anticipation of the Easter weekend – will provide surgical teams with resources for additional emergency procedures over peak periods, the facility says.
Through donations from insurance company Metropolitan and private individuals, the Groote Schuur Hospital Trust has raised just more than R300 000 for the first three months of the project.
The goal for the year is to enable an additional 70 emergency theatre lists during surge periods, assisting about 200 patients over and above existing capacity, reports Daily Maverick.
Professor Lydia Cairncross, head of General Surgery at the hospital, said that for every theatre service, there were both planned operations and procedures for emergency patients, but that these were never predictable.
“However, we’ve seen some patterns emerge, particularly with trauma emergencies which tend to surge at particular times of the year,” she said.
“Over long weekends, on public holidays and around the Christmas period – as well as month-end, and usually when there’s a lot more money in circulation – there’s a very distressing correlation between alcohol, drugs and trauma.”
The fixed service capacity in the hospital’s emergency surgical theatres meant that when trauma numbers rose, all patients on the theatre lists would wait longer, she added.
“Our idea with this project was to create a fund where we could have additional theatre lists to provide surge capacity within our emergency system, allowing us to match the surge in trauma at these predictable times of the year.”
Of the 70 additional emergency theatre lists the hospital is aiming to enable, 50 will take place weekly to prepare for weekend trauma, while 20 are planned around high-risk public holiday periods, including the Easter long weekend.
“We run two theatres all the time, and what we want to do is create a third theatre when we need extra capacity,” said Cairncross.
As there are theatre rooms at the hospital going unused, the money raised for the project will fund staffing teams to perform the additional operations.
“That staffing team is primarily anaesthesia and nursing (personnel), and some of the support staff around that. Almost all of the money will go towards theatre staffing.”
High trauma burden
South Africa carries one of the highest trauma burdens in the world, said Dr Deidre McPherson, trauma surgeon at Groote Schuur. However, the effects of trauma on the surgical system were often “under-recognised and vastly under-resourced”.
“Groote Schuur serves not only the people of Cape Town, but also patients referred from across the province and beyond. Every week, our team faces the reality of South Africa’s trauma epidemic – road traffic collisions, stabbings, gunshot wounds, falls and broken bones… What makes it more overwhelming is that they often come not one by one, but in … waves of trauma that flood our emergency departments and theatres, pushing our already stretched system to its limits,” she said.
“Suddenly, our surgical team must make an impossible decision. Who goes to theatre first? Who has to wait? And who might not make it at all? This isn’t due to poor planning, it’s due to impossible constraints. We work with dedication and urgency, but when our system is already stretched thin, the weight of these decisions becomes unbearable.
“A trauma surge is not a hypothetical disaster scenario. It is a routine reality for us, and its consequences reach far beyond the trauma bay.”
Sister Nina Watson, assistant manager of theatre nursing at Groote Schuur, said that while the emergency list sat at around 15 to 20 people on an ordinary day, it could go up to about 50 patients during a trauma surge.
“We get through about four or five (patients) during the day. We get through anywhere between five and seven patients at night… If you’re only getting through 10 to 12 over a 24-hour cycle, and you’re adding patients to that board every day, the list is getting longer and longer.”
Dr Maritz Laubscher, orthopaedic surgeon at Groote Schuur, said orthopaedic surgery patients were often disproportionately disadvantaged as their injuries were seldom life-threatening, meaning they were “pushed to the bottom of the queue”.
“Not only is it inconvenient for the patients, but with a significant delay, it also makes the surgery more complex. It reduces the expected outcome for them. And often, patients block beds, so it’s got a knock-on effect down the chain in the hospital,” he said.
Kristy Evans, executive director of the Groote Schuur Hospital Trust, urged individuals, businesses and philanthropic partners to assist the trust in raising an additional R1.86m that would allow the project to be sustained beyond June.
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