WA Health Misconduct Handling Procedures - Corruption and Crime ...

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2.3.5 Identifying Misconduct .................................................................... 262.3.6 Recording Misconduct .................................................................... 262.3.7 Managers’ Perspective .................................................................. 262.3.7.1 Do I Know what Misconduct Is? ................................. 272.3.7.2 Are there Misconduct Risks? ...................................... 272.3.7.3 How Would I Know Misconduct is Occurring? ...... 272.3.7.4 How Would I Deal with It? ........................................... 282.3.8 WACHS-Kimberley Recommendations .................................... 302.4 Drugs Management Review ......................................................................... 312.4.1 Background and Purpose of Drugs Review.............................. 312.4.1.1 Legislation ........................................................................ 332.4.2 Management of Schedule 8 and Schedule 4 Drugs ............. 332.4.3 Practices ............................................................................................. 342.4.3.1 Wards/Theatres/Emergency Departments ............. 34Storage .............................................................................. 34Access/Security .............................................................. 35Registers/Checks ........................................................... 36Disposal/Discarding of Drugs ..................................... 37Transport/Transfer of Drugs ....................................... 382.4.3.2 Pharmacy ......................................................................... 39Hospital Pharmacies ..................................................... 39Chief Pharmacist ............................................................ 422.4.4 Management of Drug-Related Misconduct .............................. 442.4.4.1 Executive, Security and Risk Managers ................. 442.4.4.2 Drug-Related Misconduct Concerns ........................ 462.4.4.3 Awareness of a Drug-RelatedMisconduct Focus in WA Health ............................... 472.4.4.4 Awareness of Drug-RelatedMisconduct Occurring ................................................... 482.4.4.5 Managing Drug-Related Misconduct ........................ 492.4.5 Observations ..................................................................................... 492.4.6 Drugs Management Review Recommendations .................... 522.5 Royal Perth Hospital (RPH) Review(January 2009 - July 2009) ........................................................................... 542.5.1 Policy, Guidelines and Codes ...................................................... 542.5.2 Understanding Misconduct at the Executive Level ............... 552.5.3 Is Misconduct Recognised as a Risk Generally? ................... 562.5.4 Is Misconduct Formally Recognised on Risk Registers? .... 562.5.4.1 Risk Register Review .................................................... 572.5.5 Executive View ................................................................................. 592.5.5.1 Misconduct Messages from the Department .......... 592.5.5.2 Confidence in MisconductManagement at RPH .................................................... 612.5.5.3 Perceptions of Staff Awarenessand Understanding of Misconduct ............................ 632.5.6 Other Issues ...................................................................................... 642.5.6.1 A “Culture of Entitlement” ............................................ 64viii
2.5.6.2 A Culture of Protection and Loyalty .......................... 652.5.6.3 A Fear of Reprisal .......................................................... 662.5.6.4 Removal of the RPH General PractitionerClinic and a Lack of Clarity around “Acceptable”Use of Resources .......................................................... 662.5.6.5 Inadequate Management Skills .................................. 672.5.7 Conclusions ....................................................................................... 682.5.8 RPH Recommendation .................................................................. 70CHAPTER THREEISSUES RELEVANT TO THE REVIEW: SENIOR HEALTH EXECUTIVEFORUM AND THE CORPORATE GOVERNANCE DIRECTORATE ......... 713.1 Senior Health Executive Forum ................................................................... 713.2 Corporate Governance Directorate ............................................................ 753.3 Fraud and Corruption Control Committee ................................................ 773.4 Discussion .......................................................................................................... 79CHAPTER FOURCASE STUDIES ........................................................................................................... 814.1 Introduction ........................................................................................................ 814.2 Case Study One ............................................................................................... 814.3 Case Study Two ............................................................................................... 824.4 Case Study Three ........................................................................................... 834.5 Case Study Four .............................................................................................. 854.6 Case Study Five ............................................................................................... 864.7 Case Study Six ................................................................................................. 884.8 Anecdotes .......................................................................................................... 89CHAPTER FIVEINDEPENDENT SURVEY: MISCONDUCTMANAGEMENT AND REPORTING ...................................................................... 915.1 Survey ................................................................................................................. 915.2 Demographics ................................................................................................... 915.3 Survey Results ................................................................................................. 935.4 Scenarios ........................................................................................................... 1025.5 Discussion of Survey Results ...................................................................... 106CHAPTER SIXCONCLUSION .............................................................................................................. 1096.1 Summary ............................................................................................................ 1096.2 Overall Opinion ................................................................................................. 1106.3 What Needs to be Done? .............................................................................. 1106.4 Recommendations ........................................................................................... 111APPENDIX ..................................................................................................................... 113Misconduct Management in WA Health ....................................................... 115WA Health Organisational Integrity Framework ......................................... 127ENDNOTES ................................................................................................................... 137ix
Page 2 and 3: ISBN: 978-0-9805051-8-4© 2010 Copy
Page 6 and 7: RPHRoyal Perth HospitalSchedule 4 D
Page 11 and 12: EXECUTIVE SUMMARY[1] This report pr
Page 13: [11] The Commission examined the Se
Page 16 and 17: (b)(c)a public officer corruptly ta
Page 18 and 19: were three fundamental issues raise
Page 20 and 21: (3) Notwithstanding the work undert
Page 22 and 23: [25] The review shows these workpla
Page 24 and 25: subsequent review at WACHS-Kimberle
Page 26 and 27: Central to this is the need to comm
Page 29 and 30: CHAPTER TWOCOMMISSION REVIEW2.1 Sco
Page 31 and 32: … there is no specific training o
Page 33 and 34: identified misconduct, which it cat
Page 35 and 36: impartially as it should be if I [h
Page 37 and 38: (3) Training and education programs
Page 39 and 40: example, nurses or doctors) their e
Page 41 and 42: misconduct was occurring or not. Pr
Page 43 and 44: compliance, or that they had any gr
Page 45 and 46: • the framework of policies relat
Page 47 and 48: [125] The review focused on actual
Page 49 and 50: … we started counting [Panadeine
Page 51 and 52: checks on the clinical aspect of ad
Page 53 and 54: (2) regional to district hospitals
Page 55 and 56: medication chart … sometimes it d
Page 57 and 58: Pharmacist plus support staff). The
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… I’ve checked our policy and p
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... there probably is scope for abu
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… I have a heightened awareness [
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(b)The notion that the misconduct r
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(2) endeavoured to improve communic
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The available policies, guidelines
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2.5.4.1 Risk Register Review[233] T
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approach is not adopted by SMAHS”
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emails each day … we’re busy cl
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temazepam … I asked the staff mem
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they were entitled to “take” fr
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… the hospital has got rid of the
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[287] Executives had varying views
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CHAPTER THREEISSUES RELEVANT TO THE
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issues raised and recommendations m
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[310] Several SHEF members raised t
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… sure, budget always plays a par
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… I don’t know that it’s [Cor
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• The Schedule 8 cupboard in whic
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esuscitation room. There had been t
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[363] Local level inquiries were ma
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[373] The Commission is not critica
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… a doctor was raiding the ED [em
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• 78.4% of respondents were from
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[384] Question 2: As an employee wi
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• 81% of respondents indicated th
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Management has demonstrated to me a
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The Department of Health is serious
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[408] Question 15: To whom within W
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[414] Scenario 5: A junior doctor i
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Criminal Code; there is also a risk
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constitute misconduct and the syste
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[438] The Commission also conducted
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APPENDIX113
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MISCONDUCT MANAGEMENT IN WA HEALTH:
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YEAR MONTH MISCONDUCT-RELATED ACTIO
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WA Health Organisational Integrity
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Corporate Governance and Public Hea
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Misconduct Resistance: Framework Ov
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Progress: Completed InitiativesMisc
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ENDNOTES1 In its response the Depar
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34 Note in this section some totals
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