North Shore Hospital report - New Zealand Doctor

Opinion 07HDC217422005, ―Scheduling discharges project description‖ authored by [the CommissioningProject Manager].2005, All staff memo re closing of 34 medical beds across four wards for summermonths. [General Manager for Adult Services].2005, ―Impact of Waitakere ECC remaining closed overnight‖ report to Board authoredby [the General Manager for Adult Services].2005, ―Information paper — Expansion of Critical Care‖. Proposal for HDU.2006, Increased overcrowding, with voicing of frustration, and complaints. IncumbentCD of ECC resigned.2006, Media scrutiny and questions in Parliament.2006, ―ECC governance review proposed model draft 2‖ authored by [the DHB ProjectManager].2007, Letter to Ministry re difficulty providing a service due to RMO shortage.2007, ―Business case for PBMA Adult Medical Services Patient Safety and InpatientCapacity‖. Describes high occupancy and very well and strongly worded argument formore beds.2007, ―Strategies for managing a shortage of acute inpatient beds at NSH‖ [GeneralManager for Adult Services], report to Board. Requesting funding to open existing beds,and to build new beds.2007, Information paper, Finance and Audit. Observations and discussion on issuesfacing adult health services. Paper for the Board recommending a number of initiatives toincrease bed capacity.In addition, interviews with staff confirmed unrequited requests for assistance. One example,from the transcript of an interview from a staff member, states this:―Dr X felt that governance was a big issue and it was difficult for him to effect change.In 2004 he presented to the Board that overcrowding was an issue, need to plan for morebeds, he did not feel like anyone was listening. The Board seemed to have otherpriorities.‖Another transcript records these comments:―… at the highest level of management (the Board) they did not listen to what they werebeing told and were obstructionist about establishing more beds. It was suggested thatthe Board did not fully grasp the business cases put to them. The Board was requested bysenior staff to provide more beds but focused more on gaining improvements by otherprocess means. They have now, finally got the message that they need more beds. Staffare now desperately trying to hold situation and ‗catch-up‘ over next two years.‖It is apparent that things have changed, as suggested in another quote, and confirmed in otherdiscussions:―… positive changes have resulted from the crises of last year (referring to the eventssubject to this investigation). The Board understands now that beds are a priority. Boardhas been more proactive about beds in last six months.‖Although it is good to see action since the events subject to this investigation, this does notmitigate a lack of action which may have contributed to the problems noted in 2007.April 2009 127