PA Hospital staff discontent exposed in report

High levels of burnout and discontent have been exposed at one of the state’s biggest hospitals, as less surgery is being carried out.

A series of reports into one of Queensland’s largest hospitals has revealed that a miscalculation made on the number of staff needed to safely operate has led to less surgery being carried out and high levels of burnout and discontent in its anaesthetics department.

The leaked reports out of the Princess Alexandra Hospital come as new figures show almost 60,000 Queenslanders are stuck on elective surgery waiting lists.

PA chair of surgery Dr Adrian Nowitzke commissioned three independent experts to investigate the issues impacting the under-pressure department of anaesthesia.

He told staff in an email sent late last year that the reports found “the calculations we have been using to determine the level of staffing in the department have not provided for a sustainable and healthy workplace as additional commitments have been requested from the department”.

“This has contributed to a level of discontent, stress, fatigue and burnout,” the email stated.

Three separate reports were produced from the review: a business case to solve long-running rostering issues including an ad hoc leave system and inequitable allocation of on call shifts, a report on the declining workplace culture, and a discussion paper outlining options for the best way to improve the performance of the unit.

The culture review found that: “The link between an increase in workload and a decline in overall morale appeared clear”.

“The majority of those interviewed emphasised to the reviewers that staff shortages were an impediment to normal operating capacity and the current establishment has difficulty meeting the requirements of the post-Covid workload with surgical catch up required for patients experiencing prolonged waiting times,” the authors wrote.

Hospital bosses were warned in the report that although the overall culture of the department was sound it was “increasingly becoming fragmented and insecure” and needed addressing before it became worse.

The investigation comes after surgeries at the hospital were scaled back in October last year due to issues raised by the accreditation body for anaesthetist training – Australian and New Zealand College of Anaesthetists – called for workloads to be reduced to ensure service and training requirements were met.

At capacity the PA should complete 323 surgeries/procedures per week, however the Establishment Discussion paper states “the anaesthesia department is not currently providing support for 323 sessions”.

However, Metro South Hospital and Health Service chief executive Noelle Cridland said two new anaesthetists started at the hospital in February, enabling more theatres to reopen and an average of 371 surgeries were completed per week.

“An additional anaesthetist will commence in March 2023 which is when the hospital expects to resume normal activity,” she said.

“PA Hospital has made significant progress in responding to the recommendations made by ANZCA, including progressing digital rostering and the recruitment of additional specialists to respond to ongoing demand.”

Late last year it was revealed that PA division of medicine chair Judy Flores sent an email to hospital directors saying the hospital had been given a “non-negotiable direction” to reduce expense budgets for this financial year by $9m in December.

However, Health Minister Yvette D’Ath denied there had been any budget cuts.

Ms Cridland said workforce shortages and Covid-19 had severely impacted the level of elective surgical activity able to be performed at the PA Hospital.