MINUTES OF THE MEETING OF THE HOSPITAL ADVISORY COMMITTEE NORTHLAND DISTRICT HEALTH BOARD

Transcription

1 MINUTES OF THE MEETING OF THE HOSPITAL ADVISORY COMMITTEE NORTHLAND DISTRICT HEALTH BOARD HELD ON TUESDAY 4 JUNE 2013 AT COMMUNITY SERVICES CONFERENCE ROOM DARGAVILLE HOSPITAL COMMENCING AT 9.05AM PRESENT Bill Sanderson (Chair) John Bain Greg Gent Sally Macauley Win Bennett Tony Norman Mike Roberts IN ATTENDANCE Nick Chamberlain (CEO), Kathryn Leydon, Robert Paine, Andrew Potts, Sue Wyeth, Margareth Broodkoorn, Craig Brown, Libby Jones, Michelle Crayton-Brown Members of the public Opening prayer was said by Bill Sanderson FIRE PROCEDURES The fire exits were noted 1. APOLOGIES Pauline Allan-Downs, Maureen Allan IT WAS MOVED THAT the apologies be received MOVED Greg Gent SECONDED Sally Macauley CARRIED 2. CONFLICTS OF INTEREST The Committee Chair reminded Committee members that in keeping with agreed protocol, conflicts of interest should be declared on a meeting-by-meeting basis as issues arise 3. CONFIRMATION OF THE MINUTES IT WAS MOVED THAT the minutes of the meeting held on 22 April 2013 be approved. MOVED Tony Norman SECONDED Sally Macauley CARRIED

2 4. MATTERS/ACTIONS ARISING Dashboards HAC noted the guide on operational dashboards Pgs Points of discussion: o Pg 12: No benchmark o Number of charts to be cut down to those most relevant to committee o Pg 14 Surgical checklist audit: One specific area around anaesthesia affecting achievement. Target of 90% is external to organisation. GM Clinical Services to report back on this at next meeting o Pg 38 DRG: Discussion on Eating and Obsessive-Compulsive Disorders. Figures high due to increased number of 24/7 watches on eating disorder cases. Research Projects Compared to other DHBs NDHB is participating in a similar number of projects. This amounts to about 12 internal projects a year, plus 12 external larger studies. Caseweights Caseweights are used to measure workload. All service s outputs can be measured in caseweights, but only some services have budgeted caseweights (such as surgery - acute and elective, medicine, and paediatrics). If we are reporting against budget, we will only report the appropriate actual caseweights. Graphs and tables in the future will be clear regarding what is being reported. 5. CHAIR S REPORT The Chair had no items to bring to the Committee s attention 6. GENERAL BUSINESS 6.1 Patient Experience of Health Services Sue Wyeth, General Manager, Mental Health, Addiction & District Hospitals gave a video presentation with consenting patients from the BOI Hospital Outpatients Department. Presentation focussed on: Access to GP Getting to hospital Admission Treatment Specialist and follow-up care Care at home The Hospital Key Issues and Discussion Points Information, communication frequently mentioned Visitors/family and how they can contribute positively to patient care/outcomes. 6.2 Clinical Integration Report Broad range of initiatives and projects in progress o IT projects eg Telehealth, Hospital Discharge Summaries o Hospital Discharge Summaries: - Challenging to put together and often written by junior doctors

3 - Need to support junior medical staff to produce informative discharge summaries, which may require senior medical officer support - Three different audiences patient, GP, hospital doctors (when patients come back to outpatients or are readmitted) - Encouraging SMOs to take more responsibility for discharge summaries, and completing them, for complex patients - Examples of good discharge summaries developed for teaching house surgeons - Audit tool developed to measure performance. SMO will take five discharge summaries, audit them and mark against audit tool, then discuss with house surgeon - Need to look at the patient discharge summary as a transfer of care document - The patient discharge summary will form part of the central patient repository and will eventually be available via the patient portal which patients will be able to access themselves. 7. OPERATIONAL REPORT The GMs Finance, Funding & Commercial Services, and Clinical Services, and Mental Health Addiction & District Hospitals, and Chief Medical Officer spoke to the report for April 2013 Clinical Services o The key focus for clinical services management is achieving year end five-month waiting time target for elective services. Every patient who will have been waiting five months or more at 30 June 2013 will have a date for surgery by the end of this financial year. Currently on course to achieve that. o Next target from 5 months to 4 months comes into effect at the end of December We have 18 months to reach this target, which will reduce the outsourcing required o Discussion on: - cost of procedures in-house compared to outsourced - getting best price as compared to ACC - performing fee for service operations: much more productivity 1/3 more operations compared to theatre time; 3-4 day length of stay as opposed to 5-6 days; Consultant takes care of patients rather than junior doctors; and patients are discharged earlier - number of patients advised by GPs to go private rather than use the public system o Big challenge with ageing population, growth and need is strong, 5% growth each year o ACC cost shift, eg shoulders now come into hospital o Fewer people taking up health insurance so are seen in public hospitals o Pg 32 MRI waiting times under pressure. Maximum wait of least urgent patient running at about eight months due to medical staff capacity issues. We have the capacity to do more scans. Staff recruited and due to start in the near future, which is expected to improve waiting times o CT usage is around capacity. Current CT scanner most intensively used in NZ o Some MRI reports for urgent patients (reads) being outsourced. Health of Older People and Clinical Support

4 o Medicines reconciliation results compromised due to a shortage of pharmacists. Expect to go back up to target shortly. Mental Health & District Hospitals o Continues with high demand on inpatient and sub-acute unit. Admissions up 25% on last year. Some of this is Child & Youth. Service has done well in terms of meeting financial targets. Lot of pressure on inpatient unit. o Suicide contagion: 8 suicides ytd, with two under 25 years o Funding approved by Ministry for a suicide prevention coordination process including a programme for training community people, in terms of first aid; drama programme going into high decile schools workshop talking about issues of coping with stresses related to suicide o Two vacant psychiatrist positions filled o Mid-North fully staffed o Far-North, will be fully staffed by July. Seeing a substantial change in quality and calibre of people interested in rural hospital medicine now that it is a speciality o IFHCs: Ngati Hine presented a conceptual plan for an IFHC at the BOI Hospital, with a combined acute area for people that present. Next step is to look at what this means in terms of getting detail, eg patient flows/access, looking at acute care pathway, what is needed, and logistics. Another workshop to be held in three weeks. Focussing on acute care, and what the model would be for primary care - the concept design put forward has been in consultation with practitioners - NHHT are providing capital for their part of the building - primary care services will be required to be situated in the IFHC - exit/transfer clauses will be in the contract - concept plan also includes other independent GP practitioners ambulatory care GP services - acute care and inpatient care will be separated o Article to be prepared for local newspaper to advise community on what is happening with IFHC o Dargaville Independent midwives have left the district. Patients now either get independent midwife from Whangarei or use DHB midwives. Child, Youth, Maternal & Oral Health: o Paediatric patient watches have had significant increase this year o Supply costs overspent this financial year. healthalliance procurements for next year should contribute to improved performance against budget. Commercial Services: o Patient transport: currently the DHB is finalising contracts and detailed planning has commenced to bring renal transport in-house o All of government HBL procurement continues o Food and laundry services engaging with HBL on food and laundry national projects o Financial procurement and supply chain project to put all systems onto national platform. Oracle based, but run by healthalliance.

5 2. FINANCIAL REPORT The GM Finance, Funding & Commercial Services spoke to the report for April 2013 The financial result for DHB Owned services for the month is unfavourable to budget by $630k and year to date unfavourable to budget by $1,251k Year to date incurred an operating deficit of $13k against a budgeted surplus of $1,238k Affected by increased cost of surgery and outpatient work to bring down wait times; locum in renal services covering sabbatical; budget phasing Still consistent with modest forecast of break-even at year end for the DHB as a whole A cost still to be accounted for is IT depreciation in healthalliance, however this is still manageable within DHB for end of year. IT WAS MOVED THAT the Monthly and Financial Report be received Moved: John Bain Seconded Greg Gent CARRIED 9. NEXT MEETING DETAILS The date of the next meeting is Monday 15 July 2013, 9.00am at the Learning Centre, Maunu House, Whangarei Hospital There being no further business the meeting closed at a.m. Confirmed that these minutes constitute a true and correct record of the proceedings of the meeting. CHAIR DATE