North Shore Hospital report - New Zealand Doctor

Health and Disability Commissionercarer support booklet before she was discharged at 4.30pm and taken home by hergranddaughter.General concernsDuring her time in ward 10, Mrs E was dismayed by the ―distinct‖ lack of cleanliness.Her concerns were: rubbish was left on the floor under beds and lockers the top of her locker was sticky from spillage bathrooms and toilets had signs instructing patients to use antiseptic wipes beforeusing the toilet, and to spray the toilet seat, basins and taps with disinfectant andwipe dry after use, but the antiseptic wipes ran out and were not replaced rubbish containers were not emptied and blood splatters not cleaned up there were no toilet roll holders, so toilet rolls were left on the floor in the toilets wet towels were left on the bathroom floor when there was no soiled laundry bag.BOARD AND MANAGEMENT RESPONSE TO ECC OVERCROWDINGThe Board and senior management of Waitemata DHB have taken steps over manyyears to address problems and anticipate growing demand in the North Shore HospitalECC.In 2002, the Inpatient Services Manager was asked by the General Manager andSurgical Services Manager to review the operation of North Shore Hospital‘s ECC.The Inpatient Services Manager noted that the ECC was the point of access for allmedical admissions and emergency surgical admissions into North Shore Hospital.From June 2001 to June 2002 North Shore Hospital processed 45,000 ECCattendances, of which 18,456 were medical admissions. The Inpatient ServicesManager concluded her report with key recommendations for the future: that theBoard provide clear Clinical Director leadership and General Manager/ServiceManager direction, develop further ECC business rules, and provide further in-depthanalysis on the benefits of a short-stay ward.The DHB states that, at the time, it was unaware of any ―insurmountable‖ concernsabout the ECC. It understood that managers and clinicians were working onimproving a range of systems and processes. The DHB was confident that with goodprocess redesign, a newly commissioned ECC at Waitakere Hospital (opened in 2003)and an upgrade of information systems, any problems at North Shore Hospital ECCwere ―likely to be short lived‖.In 2003/04, the Ministry of Health reviewed the DHB‘s overall operating performanceto identify improvements that would assist the DHB to meet its financial and serviceperformance targets. The DHB submitted that the review looked only at costs and theMinistry refused to look at funding. A few cost savings were identified and fundingimproved in 2004/05.The Ministry said that the terms of reference for the review were jointly agreedbetween Waitemata DHB and the Ministry. The focus of the review was to considerthe operating performance of Waitemata DHB and to identify improvements that30April 2009