Feuding staff put major hospital department’s credentials at risk

Personal conflicts, registrars with wellbeing problems — SA Health now has six hospital units marked as “must do better” by inspectors.

Feuding staff left a key department in a major hospital so dysfunctional it is on notice it risks losing its teaching accreditation unless relations improve.

Tensions have been running so high that inspectors warn it is affecting the teaching of young doctors in the orthopaedics department in the Northern Adelaide Local Health Network (NALHN), which covers Lyell McEwen and Modbury hospitals.

It reached a point NALHN is on notice to improve relations, although SA Health officials say the “interpersonal conflict issue” has been addressed.

An audit of teaching accreditation of all metropolitan public hospital departments requested by The Advertiser reveals there are problems in six units.

It follows revelations by The Advertiser the Women’s and Children’s Hospital’s paediatric intensive care unit had lost its teaching accreditation, while its neonatal intensive care unit and Flinders Medical Centre’s obstetrics and gynaecology unit have only provisional accreditation.

The latest units to join the list needing improvements are NALHN’s orthopaedics and anaesthetics departments, plus radiology at the Royal Adelaide Hospital.

All three are accredited for training for 12 months but must make specific improvements in the coming year after inspections found problems.

In the NALHN cases, its orthopaedics department was embroiled in personnel conflicts to a point it affected training.

Its anaesthetics department faces a review in May and officials say workforce shortages have been addressed though hiring extra staff and measures to “improve registrar training and wellbeing”.

Workload issues are being addressed at the RAH radiology department to improve access to training.

SA Health chief medical officer Dr Michael Cusack stressed: “College accreditation is focused on training and is not an assessment of the quality and safety of the unit or hospital which is undertaken via a different process.”

Chief Medical Officer Dr Michael Cusack. Picture: AAP Image/David Mariuz

He said medical colleges undertake regular, rigorous training accreditation review processes across the clinical services provided by SA Health to ensure the training provided is of high-quality, in line with national and international best practice.

“All units and services across our four metropolitan local health networks, with the exception of the Women’s and Children’s Hospital PICU unit, have college accreditation to train doctors, noting this does not impact existing trainees,” Dr Cusack said.

“Two clinical services currently have provisional training accreditation, while three are training accredited, but need to meet agreed recommendations over the next year.”

NALHN acting chief executive Natalia Hubczenko said action had been taken following the reviews of anaesthetics and orthopaedics.

“Since April we have hired more staff and commissioned an independent review into anaesthesia to make sure we are doing everything we can to provide excellent training for doctors,” she said.

“We are confident the measures we have put in place will be reflected in our next review and will continue working with the college to implement recommendations across our anaesthetics and orthopaedic units.”

SA Medical Imaging clinical director Associate Professor Marc Agzarian said: “We’ll be working closely with our radiology team at the Royal Adelaide Hospital team over the coming months to make sure recommendations are promptly addressed.”