The report finds the Central Adelaide Local Health Network, which runs the hospital, was yet to meet seven “core” standards and undertake 17 “developmental” actions.
Federal Liberal Health Minister Greg Hunt weighed into the South Australian election campaign in its dying days, accusing the Labor Government of withholding the “essential safety and quality” report for political purposes.
Then-Treasury spokesperson Rob Lucas said at the time that failing to release the report would be considered “an attempt by senior members of the government and/or the public service to protect the political fortunes of the Labor Party at the expense of the public’s right to know, and the best interests of community safety for all South Australians”.
All of the problems identified by the Australian Council on Healthcare Standards’ surveyors are of “low” to “moderate” risk, and none need to be fixed immediately.
SA Health must fix them by early June to avoid losing accreditation for the state’s flagship hospital.
The risks described in the report include the need for a comprehensive assessment of medication management systems and training in patient and carer engagement.
The Weatherill Government had argued the report was “interim” in nature, and was not released as a matter of normal practice until the final report, which it said was coming next month.
Central Adelaide Local Health Network CEO Jenny Richter had told staff in a newsletter that day that: “A copy of the final accreditation report will be published on the intranet when it becomes available in April.”
But newly minted Health Minister Stephen Wade said this afternoon that “the people of South Australia had the right to know that their new $2.3 billion hospital had not met accreditation standards before casting their ballots”.
“Contrary to the assertions of the former Labor Government, there is no indication the report is an interim report,” he said.
Problems labelled “moderate risk” included:
- Variable levels of compliance, and difficulty producing accurate information, regarding mandatory training programs.
- Risks identified by the quality and safety team are often “not accepted as a risk at a directorate level”.
- Clinical leaders, senior managers and the broader workforce needed training in “patient-centred care” to “facilitate consumer engagement”.
- Patients and carers needed to be more thoroughly engaged in analysing safety and quality of healthcare, including the management of quality improvement.
- The last comprehensive review of medication management systems was carried out in 2013. “Without regular assessment, there could be gaps in the system that could impact on patient safety,” the report says.
- The hospital needed to provide evidence that comprehensive lists of medications given to patients during treatment are passed on from doctor to doctor during clinical handover.
- Patients’ medical discharge summaries for general practitioners needed to be completed faster.
“Low risks” included:
- Managers’ expectations “of safe quality service provision and clinical governance” were not widely understood.
- Patients are not specifically asked whether they have questions about the charter of healthcare rights contained in the hospital’s Welcome Pack.
- Hospital management needed to develop strategies to better include people from diverse backgrounds in governance partnerships.
- Plans to include patients and carers in the training of staff need to be implemented.
- Patients and carers needed to be better involved in decision-making concerning safety and quality – however, there were “good examples” of this occurring already.
- Similarly, patients and carers were inconsistently involved in the design of health services – although “clear examples” of such participation were evident.
- Systems to facilitate collaboration with patients and carers during clinical handover – from one doctor to another – were not in place.
- Hospital management needed to provide evidence that patients are given useful and meaningful information about blood or blood products.
- Consent forms for blood transfusions given to patients receiving surgery needed to be more specific.
- Plans to implement a mechanism to allow carers or family members to “initiate an escalation of care response” needed to be implemented.
- Information handed to carers and patients about the risk of falls, and prevention of falls, in the hospital needed to be reviewed to ensure it was meaningful and capable of being understood..
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