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Northern Territory Department of Health Library Services Historical Collection
HISTORICAL COLLECTION
0017
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ROYAL DARWIN HOSP.ITAL MANAGEMENT BOARD
ANNUAL REPORT
1990/91
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ROYAL DARWIN HOSPITAL MANAGEMENT BOARD NORTHERN TERRITORY
All correspondence to:
Chairman
Royal Darwin Hospital Management Board PO Box 41326 CASUARINA NT 0811
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October 19 91The Hon. Daryl Manzie, MLA
Telephone: 228888 Telex: AA85450
In reply quote 90/0119
Minister for Health & Community Services GPO Box 3146
DARWIN NT 0801
Dear Minister
RE: 1990/91 ANNUAL REPORT
Herewith find the 1990/91 Annual Report of the Royal Darwin Hospital Management Board.
~ r e l y
LIND~-::E • Secretary
Hospital Management Board
CENTRAL LIBRARY
2 3 OCT 1998
TERRITORY HEAL TH SERVICES
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ROYAL DARWIN HOSPITAL MANAGEMENT BOARD ANNUAL REPORT 1990/91
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This report has been compiled in accordance with Section 25 of the Hospital Management Boards Act 1980 and is a report on the operations of the Board and of Royal Darwin Hospital during the 1990/91 financial year.
1.
1.1
OPERATION OF THE BOARD Composition
The vacancy created by the resignation of Mr Don Cooper remained vacant through the year. In February 1991 Ms Veronica Elsegood also resigned. Both vacancies were advertised and seven applications were received for consideration. Recommendations for appointment have since been made.
1.2 Areas of Responsibility
Following from the success of the previous year, the concept of subdividing operational areas of the Hospital and allocating them specifically to appointed members was continued. The concept again proved successful despite the short fall in appointed members in the latter half of the year. The allocated areas of responsibility for the 1990/91 financial year were:
Mr Richard Giles (Chairman)
Governing body and Management, Accident and Emergency
Service, Medical staff organisation, Social Work services and Rehabilitation Medicine Services.
Mr Reg Lowry (Member)
Medical Records, Pharmacy service, Physiotherapy, Occupational Therapy and Speech Therapy.
Dr Gerry Goodhand (Member)
Operating Theatre service, Anaesthetic and Laboratory services.
Ms Veronica Elsegood (Member)
Nursing Division, Special care Nursery and Radiology services.
Members of the Management Board in accordance with the Hospital Management Boards Act 1980 Section 7 (2), (3) and (4) are
respectively;
Dr Pauline Wilson Mrs Lois Johnston Mr Graham Symons
Medical Superintendent Director of Nursing Darwin Regional Director 1.3 Information Services
During the year, Board members were kept informed of activities and developments throughout the Hospital on a monthly basis through the receipt of Cammi ttee minutes and functional area reports as detailed below.
i. Committees Ambulatory Care
Drugs and Therapeutics Infection Control Medical Records Operating Theatres ii. Reports Finance
Maintenance Nursing Security iii. Other
Minutes of meetings of Hospital Management Boards of other Northern Territory Hospitals
Royal Darwin Hospital Monthly Statistics
The Board wishes to acknowledge the assistance provided by staff members in the compilation of written reports.
1.4 Board Meetings
Meetings are held on a regular monthly basis with additional meetings scheduled for specific purposes as required. Meetings have been generally well attended. During the year a number of representatives of the Hospital staff and external organisations were invited to attend meetings to assist the Board on specific matters and topics of interest. Such guests included:
Mr Michael Flanagan Mr Allan McEwen
Mr Mike Richards Mrs Lorraine Porter
- Noreen International
- Specialists Private Practice - Trust Fund and Associates - Financial matters
- Cresap Consultant - Accreditation Officer
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1.5 Hospital Inspection
The annual inspection by the Board has not yet been conducted.
The inspection was planned in conjunction with the re-opening of Ward 4A however, delays in this refurbishment project have resulted in postponement of the inspection. It is anticipated that the inspection will now be conducted in October 1991.
1.6 Royal Darwin Hospital Auxiliary
The Auxiliary again provided invaluable support to the Hospital through their fund raising activities. These included the Finniss River Station race weekend, a fashion parade, monthly games days, chocolate sales and raffles. The proceeds from these and other activities enabled the Auxiliary to donate such items a s ;
1. 7
Curtains and prints for Ward 2A Toys for the Paediatric Ward
Carry bags for patients on transfer
4 Television sets for the Orthopaedic Ward, and a cash donation for Leprosy Research to the Menzies School of Health.
Management Board Trust Account
This account is operated by the Board for the purpose of accepting donations and sponsorships and raising funds for such uses within the Hospital as are approved by the Minister.
During the year the Board was active in this area and funds were raised from a wide range of activities and sources. Maj or fundraising items included:
Noonamah Hotel Frog Race Proceeds from Vending Machines Private Practitioners Trust Fund
Profit from Royal Darwin Hospital Lottery Liquor Sales 1990 Christmas Party
Toshiba Donation for Ball expenses
A number of the major fund disbursements made during the year are listed below:
Apnoea Monitor - Special Care Nursery Laryngoscope - Special Care Nursery Paediatric Ventilator - Special Care Nursery
$3920
$1500
$6225
Furnishings for two Surgical Rooms Payment of Lottery Prizes
Public Address System - Public Relations
2. OPERATION OF THE ROYAL DARWIN HOSPITAL 2.1 Major Events and Activities
$ 840
$8645
$1363.50
During 1990/91 reviews of staffing and workload levels and equipment utilisation were undertaken to improve efficiency and cost effectiveness in the areas of Pathology, Nursing and Paediatrics. The support of Hospital management and employee involvement contributed to the achievements of these reviews.
Royal Darwin Hospital was actively involved in negotiations throughout the year with the Commonwealth Medical Officers Association to trial a new overtime allowance scheme as part of an out of award agreement for Medical Officers (a first in Australia).
During the year, introduction of the Hospital Information System was a prominent activity. Modules incorporating Patient Services, Radiology and Infection Control were the first to be introduced, followed by Ward functions, Accident and Emergency, Outpatient bookings and Theatre modules. The system will benefit hospital management and staff to efficiently and effectively schedule patient throughput.
A pilot of an electronic Time Management system commenced in the Pathology Department in April. The pilot site was chosen as i t encompassed a wide range of staff including Medical Officers, Technical Officers, Administrative and Nursing staff. An evaluation of the pilot has yet to be undertaken however i t is expected efficiencies in streamlining payroll calculations will be achieved.
In September 1990 the Hospital held a highly successful 10th Anniversary ball at the Beaufort Hotel and at that time launched its newly acquired Coat of Arms. The Armorial bearings granted to Royal Darwin Hospital by the Kings of Arms in London bear the motto -
"Progress and Service".
Fire Safety Upgrade and associated works and refurbishing of ward areas continued throughout the year.
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Fire upgrade, which included installation of a Sprinkler System, VESDA (Very Early Warning Smoke Detection Apparatus), Smoke Exhaust System and Fire Collars was carried out in Wards 3A, 4A, 5A and Building 2 (Red Cross Kiosk).
Refurbishment was completed in Wards 3A and 4A and included carpeting, painting, alterations to cupboards and shelving. The improvements create a more pleasant atmosphere conducive to quicker recovery, and have been favourably received by staff, patients and visitors alike.
Ward 2A, which was actually completed during 1989/90, was officially opened by the Minister on 17 September 1990.
2.2 Accreditation
During 1990 a study was undertaken to assess the position of Royal Darwin Hospital prior to seeking accreditation. The study identified a considerable amount of work that needed to be done to reach accreditation standards and suggested a time frame of at least two years would be required to prepare for survey.
A full time Accreditation Coordinator has been appointed and considerable progress is being made. Although no firm date has yet been set for survey assessment in the vicinity of September/October 1992 is possible.
2.3 Quality Assurance
In co-ordination with Accreditation preparation, a multi disciplinary Quality Assurance Committee has been established to ensure optimal patient care and service delivery at Royal Darwin Hospital. To provide staff, at all levels, with as much information as possible about Quality Assurance, education sessions have been held in all Departments and will be ongoing to facilitate Quality Assurance education. External consultants have conducted workshops with members of the Management Board, Hospital Executive, Department Heads and a great number of staff.
2.4 Key Staff Recruitment
2.5
During the year Royal Darwin Hospital successfully recruited;
Dr Goh
Dr Arianaygam Dr Carson Dr Burrows Dr Padmanathan Ms Margaret Cook Ms Cynthia Croft Ms Naomi Haensel Medical
Senior Specialist Anaesthetist Specialist Pathology
Senior Specialist Surgeon Staff Specialist Physician Senior Specialist Anaesthetist Assistant Director of
Nursing(Education)
Assistant Director of Nursing (Clinical)
Senior Physiotherapist.
Dr Frank Rhodes retired at the end of the year after providing a long period of teaching and clinical services to the Royal Darwin Hospital.
Dr Jim Burrow, a staff specialist, has taken over from Dr Rhodes.
It was with great regret Royal Darwin Hospital announced the sudden death of Dr Trevor Taylor, Assistant Medical Superintendent, in September 1990.
In recognition of Dr Taylor's Association decided to name the Award "The Trevor Taylor Prize".
work, annual
During the year representing five Colleges.
Royal Darwin Hospital different specialities
the Staff Specialist RMO/Registrar Research
was of
visited by the various
teams Royal
Accreditation for Registrar training means there will be an increase in the numbers of rotating registrars from interstate hospitals in 1992, and there will therefore be a decrease in the number of non-trainee registrars employed.
This accreditation combined with the enthusiasm of specialist staff to develop a more structured training programme for interns and resident medical officers augurs well for clinical teaching next year.
Dr Alan Walker, Senior Specialist in Charge of paediatrics, was recently included on the 1991 Queen's Birthday Honours List. He was awarded "Member of the Order of Australia (AM)", in acknowledgement for his services to Medicine in the Territory particularly in the field of paediatrics.
The Hospital Management Board congratulates Dr Walker on his achievement.
2.6 Nursing
Between August and November 1990 a review of patient dependency and nurse staffing levels was undertaken which identified the staffing required to meet patient needs and enable efficient utilisation of human resources.
A joint Departmental - Australian Nursing Federation review of the nursing service was conducted in December 1990. This review examined many aspects of the nursing service and identified areas of excellence and those requiring review. Recommendations made have been taken up by the Nursing Executive and strategies developed to implement those that are appropriate. A Nursing Consultative Committee was formed to represent the views of nurses at all levels.
The transfer of Nursing Education to the Regional Education Centre has seen a continued focus on professional development for nurses. Transfer has provided ready access to a broad range of educational services.
2.7 Maintenance The Royal
maintained condition respects.
Darwin Hospital campus has over its eleven year life
of the asset is less than
not been adequately span and the general satisfactory in many
Engineers from the Department of Transport & Works have identified major works which are required to prevent deterioration in buildings and -engineering services to a state where satisfactory operation cannot be maintained. It is essential that funding is made available for these works as the problems will escalate rapidly in both scope and cost if not addressed promptly. Such problems include condensation in the ward block and water penetration of the ambulance ramp and below ground areas.
The major maintenance work completed during the year was the air conditioning chiller replacement contract. The progressive installation of Government energy management programs continues.
2.8 Security
The frequency and nature of security incidents occurring on the campus are a matter of some concern. Between 30 and 50 incidents are recorded during most months, the majority involving Accident and Emergency with a high proportion alcohol related. Further consideration of screening procedures for entry to Accident and Emergency may be required.
Petty theft within the Hospital, vandalism and drinking in the grounds is a continuing problem exacerbated by the open access to itinerant pedestrian traffic. It is intended to examine the feasibility of constructing security fencing to reduce this through traffic.
2.9 ROYAL DARWIN HOSPITAL EXPENDITURE Expenditure ($OOO's)
Salaries and Allowances Administrative & Operational Capital Equipment
Other Services Property Management TOTAL
1990/91 41,171 12,147 817 2,323 5,243 61,701
1989/90 38,760 11,494 1,335 1,741 4,554 57,884
The Hospital has an ongoing conuni tment to maximise available funds and continues to operate within its Budget Allocations.
2.10 Patient Care Statistics
Authorised Beds (End of year) Occupied Bed Days
Average Daily occupied Beds
Patients in Hospital at End of Year Total Admissions for the Year
Average Length of stay (days) Live Births
Still births
Deaths On arrival In Hospital Non-Admitted Autopsies
1988/89 1989/90 1990/91 301
100074 274 252 14432 6.9 1201 17
1988/89
177 176 15 260
311 96383 264 250 14610 6.6 1272 22
311 96914 266 256 15281 6.3 1260 26
1989/90 1990/91
152 178 18 288
167 198 20 278
Operations Major Minor Dental
Outpatient Consultations and Treatments
Radiology
Inpatients X-rayed outpatients X-rayed Physiotherapy
Inpatients
Number of Treatments Outpatients
Number of Treatments Occupational Therapy General Inpatients General Outpatients
2288 4390 260 75305
9193 22550
12318 15255 6130 6400
2040 501
2172 4850 301 76880
9191 23769
16150 21800 7361 7919
1746 585
2451 4853 379 78356
10301 24271
17025 22984 7861 8183
1925 523
*
In this report the 'Average length of stay', (days) is calculated by dividing the number of 'occupied bed days' by the number of admissions for the year.2.11 Public Relations
The Royal Darwin Hospital Public Relations Department, in conjunction with the Hospital Executive and Management Board, has undertaken responsibility for special projects and sponsorships together with the general upgrading of community perceptions of the Hospital. Successful projects have included the 10th Anniversary Ball and Coat of Arms launch in September 1990 and the staff Pool Party and Lottery Draw in June 1991 as well as a number of functions to mark ward re-openings and farewells to long serving staff.
The dedication of a specific staff member to the Public Relations function has continued to provide the media and public with a constant point of contact and a consistently reliable source of information. This has improved the Hospital image and is considered an asset in maintaining patient, public and staff morale at a high level. The Public Relations function has served the Hospital well and contributed greatly to the high regard in which i t is now held by the general community.
3 • CHAIRMi.-:\N' S COMMENTS
This last year has been one of considerable and significant activity within the Royal Darwin Hospital. One is tempted to say that change is the only thing that has remained constant.
However i t is pleasing to report that the level of patient care has remained at a high standard with staffing within the medical, nursing and administrative sections of the Hospital remaining remarkably constant. I take this opportunity to thank the various members of the Hospital staff for their tremendous loyalty, dedication and effort over the past year which has seen some disruption, many reviews and in recent times significant financial cutbacks.
A number of reviews of Hospital activities were conducted during the year and are detailed elsewhere in this report.
Many recommendations put forward in the reviews have already been implemented. Hopefully they will improve the efficiencies within the Hospital and the level of patient care and not just be review and change for its own sake.
In addition developments effects on including:
there have been a number of initiatives within the Hospital which will have long the Hospital's operation and delivery of
and term care
the introduction Information System
of the computerized Hospital
the development of a Sister Hospital relationship with the Soe/Kupang hospitals of West Timor
the investigation of a decentralized/ divisional system of management which will hopefully allow Hospital clinical departments to take greater decision making responsibility.
The constitution role and function of the Board has not gone untouched.
The Hospital's committee structure ·has been reviewed, and i t is hoped that Board members will take a greater role within that structure and thus take a more effective management role. The Board's position in the Hospital's policy decision making processes still needs to be improved. Whilst it cannot and should not be involved in the day to day functioning of the Hospital, I believe that the Board has a significant role to play in the management of the Hospital's activities including but not limited to the maintenance and improvement of patient care.
Social activities have also been significant in the life of the Hospital over the last year with the principal event being the Hospital's 10th Anniversary Ball held at the Beaufort ballroom in September. The highlight of the Ball was the presentation and unveiling of the Hospital's Coat of Arms by the Minister. I again use this opportunity to thank the Hospital's public relations officer Laurelie Briggs for her tremendous efforts in organizing these events and for the fortnightly publication throughout the year of the Hospital's Bulletin.
The Board has continued to pursue and encourage the development of Quality Assurance programs throughout the Hospital and the efforts of Lorraine Porter in this regard have been greatly appreciated.
The Hospital's financial performance over the year has been creditable with expenditure being within a budget which had on previous year's budgets been increased by less than the increases in the Consumer Price Index. Notwithstanding this budgetary performance (which has been continued over the past three years) hospital expenditure has still come under review and with the recent Estimates Review Committee and ongoing Cresap reviews, likely to be reduced still further. It is hoped that these reductions in expenditure can be achieved without any significant reduction in the standard of services and care provided by the Hospital.
However, i t is opportune to note that whilst the demand for Hospital services has remained relatively constant its financial resources have over the past three years been significantly reduced. While some reductions can be accommodated by improving the efficiency of various operations a point must come where further reductions will significantly reduce the standard of patient care and the services the Hospital can provide to the public. In addition further expenditure will be required in areas such as the ongoing maintenance of the Hospital buildings.
Finally, I take this opportunity to thank the Hospital's Chief Executive Officer, Lindsay Pyne and his Executive for their hard work and initiative during the year.
Government Printer of the Northern Territory
