There is a huge patient load on the hospitalization system, which is in need of additional resources, particularly in emergency rooms.
The Ministry of Health holds medical treatment in emergency rooms (Emergency Departments – EDs) to be one of its central objectives for improvement for the coming year.
Preparations have been made in advance for winter morbidity, we are taking steps for the short term, and a professional long-term plan for the hospitalization system (for EDs) is being jointly prepared by the Ministries of Health and Finance, which will be presented to the next government for approval.
In the short term, in preparation for the morbidity burden, as is currently being manifested, the Ministry of Health has acted together with the Ministry of Finance and additional parties as follows:
  1. Allocation of 31.5 physicians’ positions to EDs (from the positions in the physicians’ agreement); 6.5 of these for geriatricians.
  2. Allocation of additional shifts (with ‘golden’ loading to pay rate) for nurses during the winter months.
  3. Issue of professional guidelines – “Preparation for Winter” – including guidelines for the prevention of morbidity (vaccination against influenza) and reinforcement of ED staff at times of overload.
  4. Issue of professional guidelines regarding triage in emergency rooms, as to the need to carry out a process of medical assessment on admission of a patient to the ED.
  5. Issue of a guideline obliging EDs to have a specialist physician present until 23:00 (or 24/7 at the major centers).
  6. A pilot project for ED-internal medicine department synchronization has recently been completed, in which work procedures were changed in order to achieve earlier release of patients from internal medicine departments, enabling patients to be transferred to hospitalization departments shortly after the decision to hospitalize them.
  7. Encouragement of administration of antibiotic treatment and intravenous fluids in institutions in the community, including in nursing homes that are defined as high level nursing care medical institutions.
  8. Development and implementation of a computerized system for providing an up-to-date picture of vacant beds at geriatric centers to which patients can be transferred from the general hospitals.
  9. Provision of a grant for purchase of medical equipment, at an overall sum for all EDs for NIS 10 million (a portion of this has already been transferred to hospitals, and the remainder in the next few months).
  10. In 2013, 10 centers for primary emergency medicine in the community were opened, with Ministry of Health, municipal and HMO funding.
  11. Provision of grants to physicians who choose to work and specialize in EDs (inclusion of emergency medicine in the list of specializations of which there is a shortage).
  12. Definition of a Physician’s Assistant role in EDs.
In the long term, the Ministry of Health is preparing a professional plan that will be presented for the approval of the Minister of Health and the Ministry of Finance, which will include the following elements:
  • A further allocation of physician and nurse positions (including nurse positions for the purpose of triage).
  •  Allocation of addition treatment stations in EDs.
  • Opening of rapid diagnosis units, such as chest pain units.
  • Training of paramedics to serve as Physician’s Assistants in EDs, and allocation of specific positions for employing them.
  • Broadening to additional hospitals of a pilot project for ED-internal medicine department synchronization.
  • ED computerization project, which will include a queue management system (and will effect transparency to the public regarding the load on EDs), and a control and monitoring system at the ED, hospital administration and Ministry of Health levels. This project has already commenced, and installation of the first queue management system was recently successfully completed at the Poriya ED.
  • Development of indicators of quality and service at EDs, which will be measured and monitored by the Ministry of Health and made transparent to the public.
  • Actions to further reduce the load on EDs, e.g. by opening additional primary emergency medicine centers in the community.
  • Establishment of the national digital health council, which is assessing models of telemedicine. Development of alternatives to hospitalization in the community (home hospitalization), a pilot project with the MDA ambulance service to assess alternatives to transportation of patients to EDs.
    Together with the Digital Israel project, lead by the Prime Minister’s Office, advancement of telemedicine models.
  • An incentives program for EDs, in which hospitals will be remunerated for achieving quality-of-treatment targets in EDs.
  • Establishment of a new hospital in the Negev. Consideration of the establishment of a new hospital in the Krayot (Haifa Bay towns).