Royal Darwin Hospital Management Board

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Northern Territory Department of Health Library Services Historical Collection

Annual Report

Royal Darwin Hospital Management Board

Year Ending 30 June 1997

HISTORICAL COLLECTION

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~oyal Darwin Hospital Management Board

All correspondence: • Chairman PO Box41326 Casuarina NT0811 • Tel: (089) 22 8180 • Fax: (089) 22 8870 Our Ref: hmb-0076

Your Ref:

The Hon Denis Burke, MLA GPO Box 3146

DARWIN NT 0801

Dear Minister

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I have pleasure in presenting you with the 1996-97 Annual Report of the Royal Darwin Hospital Management Board.

The report provides details of the activities and operations of the Board and Hospital, in accordance with section 25 of the Hospital Management Boards Act 1980. The draft report was reviewed by the Board members and will be ratified at the meeting to be held on 20 October 1997.

Yours sincerely

PETER OWEN Chairman

:} c September 1997

CENTRAL ^LIBRARY 2 3 OCT 1998

TERRITORY HEAL TH SERVICES

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ROYAL DARWIN HOSPITAL MANAGEMENT BOARD

1996-97 ANNUAL REPORT

CONTENTS:

1. Chairman's Report

2. Purpose of the Report

3. Profile of the Board

3.1 Overview

3.2 Composition of the Board

3.3 Meetings

3.4 Sub-Committees

4. 1996-97 Activities

4.1 Management Board Trust Account 4.2 Hospital Inspections

4.3 Employee of the Year 4.4 Trevor Taylor Award 4.5 Hospital Auxiliary

5. Operations of the Royal Darwin Hospital 5.1 Activities

5.2 Highlights/ Achievements 5.3 Expenditure

5.4 Statistics

5.5 Management

5.6 Partnership Plan

6. Contact Information

1. CHAIRMAN'S REVIEW

1996-97 saw a year of dynamic change and development which will result in Territory residents enjoying significant improvements in the delivery of health care. Highlights for the year include:

• the establishment of the Northern Territory Clinical School through a partnership with the Flinders University School of Medicine. This is a significant achievement and allows Territorians to complete their medical education in the Territory. The benefits will continue to flow when these graduates join the Hospital as interns.

The appointments of Professors of Surgery and Paediatrics and Senior Lecturers in Medicine and Obstetrics also complements the level of clinical service available within the Hospital and enhances the contribution to clinical research;

• the appointment of a professorial chair in nursing at the Northern Territory University has enhanced the development of nursing staff by providing support for both post graduate training and hospital based research programs directed towards 'continuity if care';

• a sustained recruiting campaign has resulted in attracting many highly credentialled medical and surgical specialists to the Hospital. As a result, the Hospital is now able to provide services which were never before available in the Territory. These include, the recent commencement of cardiac services and endoscopic investigative procedures to analyse disorders of the liver, pancreas and other organs. This will alleviate the need for patients to travel interstate for these services and therefore result in considerable cost savings; and

• during the year the Royal Darwin Hospital appointed the General Manager of the Darwin Private Hospital to its Board, whilst the Darwin Private Hospital reciprocated by appointing the Royal Darwin Hospital General Manager to its Board. These appointments have formalised what is already a close working relationship and recognises that further advances can be made to develop joint services that are mutually beneficial to both organisations.

These initiatives, together with the ongoing relationships with the Menzies School of Health Research, have seen the evolution of what can be described as a 'health precinct' of national standards and credibility. Such developments are not possible without the provision of financial resources, and in this regard the Board is most grateful to the Minister for Health Services for his continuing support.

Finally, I have just received fantastic news that the Royal Darwin Hospital has been given accreditation status by the Australian Council of Healthcare Standards until September 2000. Well done to all staff, and to the staff of the Darwin Private Hospital for also recently achieving accreditation status.

2. PURPOSE OF THE REPORT

The Annual Report provides details of the functions of the Royal Darwin Hospital Management Board, including its activities during the year. It also advises its readers of the services available in the Hospital.

The Report is also prepared in order to meet the requirements of section 25 of the Hospital Management Boards Act 1980 and the Public Sector Employment and Management Act.

3.

3.1

PROFILE OF THE BOARD Overview

The functions of the Hospital Management Board are specified in the Hospital Management Boards Act and are the same for all Hospital Management Boards in the Northern Territory. The main functions of the Board include determining and supervising the standards of service provided by the Hospital, and providing an independent opinion on any matter relating to the operation of the hospital to the Minister for Health and the Hospital Executive Group.

The Royal Darwin Hospital is a section of Territory Health Services and accordingly the Board must comply with the Northern Territory Public Sector Employment and Management Act and the Financial Management Act.

3.2 Composition of the Board

Section 6 of the Hospital Management Boards Act states that the Board shall consist of eight members. The Royal Darwin Hospital Management Board members during 1996-97 are detailed below.

• Mr Peter Owen -Chairman, external appointment by the Minister

• Mr Peter Fisher -Deputy Chairman, external appointment by the Minister

• Mr Michael Martin -General Manager of the Hospital

• Dr Len Notaras -Medical Superintendent

• Ms Sandra Smiles -Director Patient Care and Nursing Services

• Mr Kevin Davis -external appointment by the Minister

• Ms Kathy Byrne -external appointment by the Minister

• Ms Mai Katona -external appointment by the Minister 3.3 Meetings

The Board meets on a monthly basis. Detailed reports are provided at each meeting regarding the Hospital's functions, including medical and nursing activities, and the Board's Trust Account.

The Board is responsible for overseeing the activities of its sub-committees, which are required to address specific service delivery areas. They concentrate predominantly on clinical matters but this in turn encompasses support services. The sub-committees are:

• Patient Care Committee;

• Ambulatory Care Committee;

• Hospital Ethics Committee;

• Aboriginal Health Care in Royal Darwin Hospital; and

• Private Practice Trust Fund Administration Committee.

Membership of the first four committees includes general practitioners, rural health, community health and consumer representatives.

During the year the following matters were reviewed by the sub-committees:

• elective surgery waiting lists;

• development of quality performance indicators;

• processing discharge summaries from the Emergency and Outpatients Divisions;

• patient satisfaction surveys were introduced for the Emergency Division;

• trial undertaken for an Aboriginal Interpreter Service; and

• a reference group established for the Cross Cultural Consultant.

4. 1996-97 ACTIVITIES

4.1 Management Board Trust Account

A Trust Account is operated by the Board for the purpose of accepting donations and sponsorships and raising funds. The Board would like to thank the Royal Darwin Hospital executive for its continued support and the provision of secretarial services during the year. Special thanks is also offered to the following individuals, local charities and Service Clubs for their very generous donations.

• Variety Club of Australia - Northern Territory Division;

• Heart Kids of Northern Territory;

• CFME Union;

• Australian Kidney Foundation;

• Mr Janssen Cilag;

• Cleveland Clinic Foundation;

• Dr SJ Linco;

• Northern Territory Police "Crop-A-Cop";

• Sotheby and Channel 9;

• Finniss River Station;

• Noonamah Hotel;

• Smiths Snackfoods;

• Public Trustee;

• Flinders University;

• Mercantile Mutual;

• Northern Territory University;

• University ofNew South Wales; and

• Royal Darwin Hospital nursing staff.

During 1996-97, the Board receipted over $329,000 and, of this amount, almost

$168,000 was utilised to purchase hospital equipment and comfort items such as televisions, toys and furniture for waiting rooms; and the reimbursement of conference and education expenses for staff.

4.2 Hospital Inspections

Since 1993 the Board has been undertaking a hospital inspection at the commencement of each meeting. During the year, visits were made to the Paediatric Unit; Ward 2A - Surgery; Engineering Services; Laundry; Patient Services; Self Care Centre; and the Pharmacy.

The inspections allow members to familiarise themselves with the hospital environment and procedures, and also offer staff the opportunity to discuss any issue with the Board members.

4.3 Employee of the Year

On 25 September 1996, the inaugural Employee of the Year Award was won by Mr Gavin Pollard, groundsman.

The Royal Darwin Hospital Management Board "Employee of the Year" award is bestowed to recognise and reward individuals for their work productivity, quality of work and contribution to the division, section or work unit. Special consideration is given to those who work 'over and above' the expectation of the job.

A total of twenty-two nominations were received from most areas of the Hospital, with four of these being exceptional. Therefore, three Certificates of Merit were also awarded as follows:

• Mr Kevin Roe - switchboard operator;

• Mr Peter O'Shea -Support Officer, Self Care Centre; and

• Ms Mollie McKeiver - Clinical Nurse Consultant, Division of Medicine.

4.4 Trevor Taylor Prize

In November, Anaesthetic Registrar Dr Peter Howe was awarded the 1996 Trevor Taylor Prize for his presentation on "Anaesthesia for Aborigi.nal Australians".

Dr Trevor Taylor was a medical officer at Royal Darwin Hospital who died of cancer in Darwin in 1990. The following year the Staff Specialist Society produced an academic prize in his honour. All Royal Darwin Hospital registered medical officers and registrars are entitled to submit a paper for consideration of the prize. The Royal Darwin Hospital Management Board sponsors the competition to the value of $1,500.

All presentations were of a very high standard and four equal runners-up were declared. These were:

• Dr Sarah Huffam - The Use of lvermectin for Crusted Scabies in the Top End of the Northern Territory;

• Dr Tom Hurley- Survival of ELBW and VLBW Infants at Royal Darwin Hospital (1976-1995);

• Dr Janine Spencer - Postneonatal Mortality in the Northern Territory (1989- 1994); and

• Dr Nick Wallwork- Slipped Capital Femoral Epiphysis in the Northern Territory.

4.5 Royal Darwin Hospital Auxiliary

The Hospital Auxiliary again provided the Management Board with valuable support in its fundraising activities, purchasing equipment and providing an important service to both patients and hospital staff.

5.

5.1

OPERATION OF THE ROYAL DARWIN HOSPITAL Activities

The Royal Darwin Hospital offers general surgery, medicine, obstetrics and gynaecology, nephrology, rehabilitation medicine, ENT (ear, nose and throat) services, ophthalmology, dermatology, plastic and reconstructive surgery, paediatrics, psychiatry and orthopaedics. Speciality services are delivered on a visiting basis;

interstate consultants spanning cardiology (both adult and paediatric), neurology, neurosurgery, oncology, urology, podiatry and rheumatology.

5.2 Highlights/Achievements

During the year the Royal Darwin Hospital has placed significant emphasis on improving and increasing its services, in order to provide Northern Territory residents with a best practice health care, including the continued recruitment of credentialled specialists. The Board acknowledges the following improvements and performance of the Hospital's services during 1996-97.

• The appointment of senior lecturers in both Obstetrics/Gynaecology and Medicine;

Professor of Surgery and a Rural Surgical Fellow; Professor of Paediatrics and an additional general paediatrician; two eye specialists - one with a particular interest in Aboriginal eye health; an additional anaesthetic specialist, to be followed by the appointment of an intensive care specialist; two orthopaedic surgeons; and three highly credentialled psychiatrists.

• Extension of audiology services.

• Commencement of visits by Dermatologist Dr Rob McDonald.

• The establishment of a twelve bed elective surgery ward will provide the Hospital with the necessary resource to achieve its initiative to further reduce the waiting list for elective surgery. The Hospital is aiming to ensure that all patients who require elective surgery, are treated within the time frame as determined by the Commonwealth Government. The number of patients on the waiting lists have now reduced from 4,200 at the end of 1995 to 1,192 in June 1997.

• The pre-admission clinic became fully functional, which resulted in increased same day procedure activity and reduced operating theatre delays. The number of total operations in the Hospital increased from 5,300 in 1993-94 to 9,225 in 1996-97.

• A contract was signed with NT Imaging for the provision of radiologist services, whilst an accredited radiologist training post has been established at the Hospital.

Radioactive iodine can now be administered on-site for the treatment of thyroid cancer

• A surgical and obstetric/gynaecological outreach program was developed to service Aboriginal communities, whilst a research project into intestinal permeability in hospitalised children, and a supplementary feeding program in four communities, commenced.

• Accreditation status was awarded to the Northern Territory Clinical School from the Australian Medical Council for 'Graduate Entry Medical Program of the School of Medicine of Flinders University', and also to the Emergency Department from the Royal College of Emergency Physicians.

• An immunohistochemistry laboratory which was established in February 1997 following assistance from the Prince of Charles Hospital in Brisbane, will benefit the diagnosis and correct cell typing of neoplastic diseases.

• Cytology reporting has been standardised in line with the Australian Society of Cytology recommendations using a modified 'Bethesda System', which has world- wide acceptance.

• A clinical diabetes service has been established.

• The needs of the elderly are rapidly increasing. Palliative care is a critical element and the Division of Medicine has formed a close relationship with community services to provide optimum resources to those Territorians requiring palliative care.

• Intensive care nursing staff developed-a Cardiac Rehabilitation Group for outpatients.

• A Bums Nurse Specialist position was created resulting in hospital-wide changes to the management of patients with bums.

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• The Division of Maternity and Child Health cared for a monthly average of 118 babies who were born at the Hospital, whilst the occupancy in the Special Care Nursery averaged over 100 per cent.

• The fire upgrade program was completed, which involves the latest in fire detection technology.

• The Adult and Paediatric Self Care Centre has been upgraded and modified to include wheelchair access to two rooms and two common rooms.

5.3 Expenditure

1994-95 1995-96 1996-97

$000 $000 $000

Personnel Expenses 48 197 51 620 56 221

Operational Expenses

( excluding Cross Border Charging) 21 725 23 583 26 339

Capital Equipment 1 339 629 1 051

Total Expenditure 71261 75 832 83 611

5.4 Statistics

1994-95 1995-96 1996-97

Available Beds (as at 30 June) 289 287 297

Occupied Bed Days 96 122 101 382 100 683

Average Daily Occupied Beds

Average Length of Stay (days) 7.31 7.19 7.19

Separations for the year 22 368 23 964 25 362

Surgical Cases 9 670 10 877 12 636

Elective Surgery Waiting List 2 074 1144 1 192 (as at 30 June)

5.5 Management

On 28 October 1996, Mr Michael Martin FCP A BA BComm, was appointed General Manager Royal Darwin Hospital as well as Deputy Secretary, Territory Health

~ervices, and reports directly to the Secretary, Territory Health Services. Mr Martin obtained an accounting degree from the Australian National University, and a Bachelor of Commerce from Queensland University, and is a Fellow of the Australian Society of Certified Practising Accountants and a Graduate member of the Australian Institute of Company Directors.

Mr Martin has been employed by the Territory Government since July 1978. He joined Northern Territory Treasury in 1986 in an accounting system role, and then established the Financial Services Division in 1988. On 1 July 1994, he was appointed as General Manager of the new NT Treasury Corporation, which was followed by a second appointment as Assistant Under Treasurer in July 1995.

In January 1997, Dr Craig Margetts MBBS MBA, was appointed as Director Finance and Administration. Along with obtaining medical and law masters, Dr Margetts also has 14 years experience with casemix concepts. He was previously employed as Director Casemix with the Alfred Group of Hospitals in Melbourne, for five years.

The Board recognises the outstanding services of Drs KC Lee and ABN Rao who retired during the year, after many years with the Hospital.

5.6 Partnership Plan

A Search Conference was held on 9-10 May 1997, with the purpose of establishing a strategic plan for future relationships between the Darwin Private Hospital and the Royal Darwin Hospital. The conference was attended by almost fifty personnel.

A Search Conference is a carefully planned and designed event in which a 'community' plans its own future and takes responsibility for making it happen. The participants have a strong commitment to implement their plans with a great deal of energy and enthusiasm. The responsibility is located with the people who have to live with the consequences of their actions and the plan. Searches follow a simple classical design of exploring the external social environment, the system which is the industry or issue and then integrating these into a set of strategies and detailed action plans to achieve the most desirable future.

A major outcome of the conference was the agreement of four strategic goals and several related objectives, followed by the establishment of individual task forces to ensure that each objective is achieved.

6. CONTACT INFORMATION

Members of the Royal Darwin Hospital Management Board and executive support may be contacted as follows:

Mr Peter Owen Chairman 8981 1199

Mr Peter Fisher Deputy Chairman 8948 2700

Mr Michael Martin General Manager 8922 8102 Dr Len Notaras Medical Superintendent 8922 8156 Ms Sandra Smiles Director Nursing & Patient Care 8922 8158

Mr Kevin Davis Member 8946 6239

Ms Kathy Byrne Member 8920 6014

Ms Mai Katona Member 8939 7111

Ms Mandy Ryan Executive Officer 8922 7992