North Shore Hospital report - New Zealand Doctor

Opinion 07HDC21742would enable the DHB to better meet its financial and service performance targets.The draft review report was confidential. However, it indicated that there were―extensive recommendations‖ relevant to improving the DHB‘s financialperformance. The reviewers indicated that the fiscal outlook was not good and statedthat the Board must identify and address options to produce a more sustainable futurefor the DHB. The DHB advised the Ministry that it was ―taking the recommendationsforward‖.In June 2004, Waitemata DHB asked its General Manager for Adult Services to againreview the North Shore Hospital ECC. Her report, ―Dealing with Pressure on NSHECC‖, highlighted problems with staff vacancies and higher than 100% occupancylevels. It was suggested that the recent opening of acute orthopaedic services at NorthShore Hospital and an influenza outbreak that winter had largely contributed to theproblems. The DHB approved measures to ease the situation until extra beds atWaitakere Hospital were available in 2005. These measures were: approval of seven additional nurse positions per day purchase of additional equipment, including beds and reclining chairs, for use ofpatients staying in ECC for longer periods providing additional bed spaces by turning eight large single rooms into doublerooms opening a winter ward providing five additional Assessment, Treatment & Rehabilitation beds commissioning six ortho-geriatric beds.In October 2004, the General Manager for Adult Services presented a further paper tothe Board on an initiative to support Waitakere Hospital ECC by using after-hoursprimary care services, such as Accident & Medical clinics. As a result, the WestAuckland White Cross Accident and Medical Centre was contracted to provide anafter-hours service.Later in October 2004, the General Manager for Adult Services proposed that theNorth Shore Hospital Critical Care Service be expanded, and that a business case forthe development of a High Dependency Unit (HDU) be approved. It was felt thatthese initiatives would reduce pressure on ECC. In July 2005 these proposals wereapproved and the first two HDU beds were in place in 2005/06. The Board alsodiscussed the provision of a full HDU at North Shore Hospital, to commence in April2007, and requested that a full business case be developed. In June 2007, the Boardapproved capital expenditure of $3.684m for an HDU.In December 2004/January 2005 a range of projects were established to review andimprove patient flow and efficiency within North Shore Hospital. One of theseprojects, led by the Commissioning Project Manager, looked at the ECC teamstructures and patient flow. The Waitemata DHB Chief Executive at the time, 48 wasthe project sponsor, and he kept the Board Chair informed of progress on this andother projects to improve hospital efficiency. The Chair advised that ―small gains‖48 The CEO resigned in September 2006. The new CEO took office in November 2006.April 2009 31