WIMMERA Health Care Group chief executive Catherine Morley hasapologised to people who have experienced poor service atWimmera Base Hospital's emergency department.
She says the organisation is working to change this, and that she would "love to" work with the community as it trials ways to improve its urgent medical care.
Ms Morley said the healthcare group had received negative feedback about the way it discharged emergency patients.
"We've sent people home in the middle of the night who lived at home alone, and that caused them distress," she said.
"We've now got a process in place that we assess them before we discharge them from emergency, and part of that review is what are we sending them home to?
"We won't send elderly people home at night, that's not a safe way to send people home. We are really interested in feedback on how we can make sure when people come to emergency they go home with the treatment that does help them to remain at home and be well.
"I apologise if people haven't got great service."
Victorian Agency for Health Information data showed of all patients admitted to the Wimmera's only emergency department between October and December 2019, 69.84 per cent were seen within the recommended time.
This represents a drop from the 71.5 per cent of patients they saw between October and December 2018.
Horsham's emergency department saw 4003 patients for the December 2019 quarter - up by 188 on the same quarter a year earlier.
The state government target is for 80 per cent of patients to be seen within recommended timeframes. The hospital has not met this value for any of the five most recent quarters.
Ms Morley said the health service was trialling ways to provide the best care to patients with limited resources.
"We thought it had to do with a loss of general practitioners at the start of 2017 and a flu epidemic in 2018, but as the figures show presentations to the emergency department continue to rise," she said.
"There are more people coming in, we are certainly having more triages above 3, which means it is more serious than a GP-level presentation."
Across Australia, patients are triaged - or classified - into one of five categories based on the acuity of their condition. 100 per cent of patients triaged Category 1 - meaning they required immediate treatment or resuscitation - were treated within the recommended timeframe in Horsham.
Ms Morley said the increasing complexity of the cases the emergency department saw could partly be explained by it receiving admissions from a wide geographic area.
"Some of that is relating to what is happening with the West Wimmera Health Service - they didn't have GPs for a significant period of time," she said.
"We've put on some more expertise that is very expensive, but we've said for our community we need to have that expertise. We can't afford to have it on 24/7 like the big Melbourne hospitals, but we are trying to have it available between eight and 12 hours a day. We are managing to do that with the use of permanent employees and some locums.
"The other thing we've done is support a nurse to become a nurse practitioner, which is a higher level of skill, and we'd like to look at more of them in place."
Nurse practitioners are registered nurses with the experience and expertise to diagnose and treat people of all ages with a variety of acute or chronic health conditions.
Ms Morley said there were 14 spaces at the Horsham emergency department.
The data showed between October and December, the hospital transferred 87.5 per cent of the 807 ambulance arrivals to the ED in less than 40 minutes - up by 2.1 percentage points on the previous quarter but below the statewide target of 90 per cent. Patients wait an average of 13 minutes to be transferred.
On Friday, Ambulance Victoria released its quarterly performance data. It showed paramedics received a spike in callouts in both the Ararat and Northern Grampians in the three months to December 2019.
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Over the same time, the average response time in Ararat increased by two and a half minutes, while in Northern Grampians the time increased by 22 seconds. The percentage of responses in under 15 minutes dropped in both municipalities.
In Horsham, the average response time dropped by 36 seconds to 10 minutes and 22 seconds, while the total number of jobs for paramedics also declined.
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