ANMF Media Release: Code Yellow at LGH

August 2024

Code Yellow at LGH

The Australian Nursing & Midwifery Federation Tasmania has had to take the extraordinary action of enforcing a Code Yellow protocol at the Launceston General Hospital Emergency Department.

Code Yellow is an internal emergency escalation code across hospitals, made in the event of an internal emergency.

Members of the ANMF will enforce when the LGH Emergency Department (ED) is overflowing with patients and unable to cope with the demand and similarly, if there are insufficient staffing numbers to cope with demand.

We have previously called on internal management, the Department of Health and the Government to enable a code yellow to be activated.

But our pleas have fallen on deaf ears – with the management claiming there are already escalation avenues in place.

Our members believe that the Code Yellow is now necessary as usual escalation avenues do not trigger a whole of hospital response when the above issues occur.

Ultimately when the ED is overrun or doesn’t have enough staff, patient flow and discharge across the rest of the hospital is what is required to decompress or assist with ED.

Our Code Yellow will see notifications sent to the Minister of Health and the ANMF, who will issue a public alert for members as the Department and Government won’t.

Examples of when this might occur is when there are 45 or over patients on Track ED, there are 2 or more patients left in corridors post transfer of care or there are not baseline minimum staffing levels.

The Code Yellow will also occur around issues including:

• Nurse Staffing: Less than 22 on a morning shift, 25 on an afternoon shift, 21 on a night shift, no capacity for oncall, immediate backfilling and or Overtime and Double shifts being used to fill staffing deficits.
• Ramped Pts: 2 or more patients, ramped for greater than 30 minutes.
• Corridor Pts: Where patients are offloaded to a corridor or non-clinical space without capacity to provide care (Excluding the 3 Ambulance offload spaces)
• Waiting Room Pts: More than 15 patients in the waiting room.
• Total ED Pts: 45 patients or greater are on the screen
• 1:1 Ratio Pts: 2 or more patients requiring a 1:1 ratio (inclusive of Psychiatric, Paediatric ICU and NCCU patients), ANUM informed and was unable to allocate the 1:1 ratio.
• Admission/Admitted Pts; 4 or more patients waiting for admission, or an admitted patient has been waiting more than 12 hours, or an ICU/NCCU/MHS is patient waiting for admission

We believe it is unfortunate that our LGH ED members have had to take this action when their calls for additional resources to support the additional workload of the transfer of care procedure have been ignored.

We have even raised these concerns in the Tasmanian Industrial Commission.

The reality is, we will implement the Code Yellow when the situation is not safe – for patients of the Greater North and our members.