North Shore Hospital report - New Zealand Doctor

Opinion 07HDC21742 Since March 2009 North Shore Hospital managers have been implementing aprogramme called ―Hardwiring Excellence‖, which is intended to develop a cultureof accountability, improve leadership, enhance communication, and reward goodwork by staff. Ward 11 is the lead ward in the ―Releasing Time to Care‖ programme, designed toincrease patient satisfaction and safety and improve work satisfaction andefficiency. Ward 11 has a new charge nurse and a full complement of nursing staff.The programme is also being introduced on ward 10 and other wards. There has been a successful drive to recruit nurses to North Shore Hospital fromwithin the region, other parts of New Zealand, and overseas. A dedicatedrecruitment nurse was appointed in 2008. 91 Team nursing has been progressively implemented on the wards, with enrollednurses and additional health care assistants to support the nurses. By October 2008there were almost 21 FTE healthcare assistants compared with 12 FTE in October2007. There has been renewed emphasis on measuring patient satisfaction, co-ordinatingcomplaints, recording incidents, and following up issues identified.RECOMMENDATIONSI recommend that Waitemata District Health Board provide a written apology for itsbreaches of the Code to Mrs E and Mr A (Ms A‘s partner), and to the families of MrsB, Mrs C and Mr D.I recommend that the DHB give urgent consideration to my experts‘ comments andrecommendations about the services provided at North Shore Hospital ECC and onthe medical wards, in particular:1. Implementing a programme to improve management of acute services at NorthShore Hospital, including a bed management programme that takes a whole-ofhospitalapproach.2. Initiatives to reduce non-emergency admissions to ECC by enhancing primarycare options and developing an acute admission ward.3. Initiatives to improve nursing care, in particular to better predict workload andmatch nursing resources, to release nurses‘ time to care, to emphasise theimportance of caring and compassion, and to ensure a more systematic approachto nursing care.I recommend that the DHB advise HDC and the Director-General of Health on itsprogress in responding to these recommendations by 31 October 2009.91 In March 2009 North Shore Hospital ECC and Waitakere Hospital‘s nursing positions were fullystaffed for the first time in many years. The DHB attributed its increased ability to attract and retainnursing staff to the recession.April 2009 69