North Shore Hospital report - New Zealand Doctor

Health and Disability Commissioner2. Please comment on the standard of care provided to [Mrs B] by North Shore HospitalECC. Explain what standards apply and whether they were complied with. Please includecomment on:a) the appropriateness of the assessment and management of [Mrs B‘s] multiplemedical problems.3. Please comment generally on the systems and policies in place at Waitemata DHBbetween April and October 2007 to ensure patients received appropriate and timely care.In particular:a) contingency planning with respect to bed availability.b) the adequacy of systems in place to facilitate patient flow through the hospital.c) any other factors impacting on patient flow and hospital capacity.d) the predictive models and reporting systems used by the DHB.4. Please comment on Waitemata DHB‘s initiatives designed to improve patient flow andhospital capacity.5. Please provide any recommendations for improvement.6. Are there any aspects of the care provided by Waitemata DHB that you consider warrantadditional comment?Interpretation of instructionsMy instructions are to provide ―emergency medicine‖ advice and specifically regarding thecare in North Shore Hospital‘s Emergency Care Centre (ECC) provided to [Mrs B] and [MsA]. I am aware that advice will be forthcoming from expert nursing and expert generalmedical perspectives about all of the cases subject to this investigation. Consequently I willfocus on the care of [Mrs B] and [Ms A], and on the performance of the ECC. However, Ihave reviewed the documentation of all of the cases. [Mrs E] also had some specific issuesregarding the ECC, so I will give advice regarding her management too. I am aware that thefunctioning of the ECC is significantly influenced by the ability of the whole institution toprovide acute care. The documentation pertaining to the other cases gives useful insights inthis regard, and so I will refer to the other cases as appropriate, although I will not discussaspects of their care not relevant to the ECC nor to ―emergency medicine‖.Information reviewed Complaint letters and complainant interview notes. Notification letters. Relevant medical records. Letter to Waitemata DHB dated 28 March 2008. Responses received to date from Waitemata DHB. Relevant Waitemata DHB policies and procedures. Transcripts of staff interviews on 19 May 2008. Additional Waitemata DHB material arising from the 19 May interviews.112April 2009