Review finds Central Adelaide Local Health Network staff resisting change
A HUGE review of the Central Adelaide Local Health Network has found medical staff are “retaining a culture which is rooted in a mid-20th Century view of the profession” and are “resisting real change”.
A HUGE review of the state’s Central Adelaide Local Health Network, including the Royal Adelaide Hospital, has found medical staff are “retaining a culture which is rooted in a mid 20th Century view of the profession” and are “resisting real change”.
The clinical governance review, undertaken by an independent team of health professionals and commissioned by the network’s chief executive officer Julia Squire, has also highlighted a clear need for clinicians to lead — and work together — more effectively.
It found “with some exceptions ... little evidence of effective clinical governance at either service level or at whole of organisation level”.
“With some exceptions, the medical profession in both major CALHN sites has to varying degrees resisted real change, instead retaining a culture which is rooted in a mid 20th Century view of the profession, of their relationship with the organisation and of care delivery,” the report said.
The hospitals featured in the review include the Royal Adelaide Hospital, Queen Elizabeth Hospital, Hampstead Rehabilitation Centre and St Margaret’s Rehabilitation Hospital.
The need for the review comes following numerous failures within the health network, including the handling and reporting of the 10 acute myeloid leukaemia patient’s who received only half the recommended dose of the chemotherapy drug Cytarabine between July 2014 and January 2015.
The review found numerous concerns with the health system that include:
CLINICAL staff reported that open disclosure is inconsistently understood and applied across the organisation.
THE medical profession in both major CALHN sites has to varying degrees resisted real change, instead retaining a culture which is rooted in a mid 20th century view of the profession, of their relationship with the organisation and of care delivery.
A HEAVY focus on mortality as “the only outcome that matters” with little formal review of
morbidity or other patient outcomes.
LITTLE sense that people are held to account for quality of care or for their behaviours.
A SIGNIFICANT disconnect between clinicians and the service level representatives of the team which coordinates patient safety, risk, quality and accreditation.
While the review found staff were committed to providing high quality care for patients, it also revealed staff faced challenges, including concerns about the new enterprise patient admission system (EPAS), the planned move to the new RAH and implementation of Transforming Health.
A total of eight recommendations were made and will be implemented across the network.
SA Health interim chief executive Vickie Kaminski said the review aimed to help clinicians lead together.
“What they (the review) found was that individual practitioners were actually individual practitioners — there wasn’t a systematic approach to the care that people were receiving or to resolving issues,” she said.
“(It was) an island unto myself as opposed to a group of physicians who collectively make sure our practices continue to grow and modernise.”
SA Salaried Medical Officers Association president Dr David Pope said there was a “huge disconnect between clinicians on the floor and management”.
“It’s fair to say management have very little understanding of clinical requirements,” he said.
“Frankly, management come along with ideas which are never going to be effective for patients
in fact, they’re inefficient and lead to harm.”
More than 600 staff took part in the review process, which included 60 interviews and focus groups with staff and key stakeholders and more than 560 responses to a staff survey.