Sunday, October 12, 2008

TWO REPORTS FROM TWO DIFFERENT AUSTRALIAN STATES:

NSW: Hospital statistics are so disastrous that the government disowns its own statistics

They sure are desperate in the NSW government

The NSW Government has an explanation for why some public hospitals are failing to see most of their urgent patients on time -- it does not believe its own health figures. According to the data, in January only 36 per cent of patients with an imminently life-threatening condition were seen within the required 10 minutes of arriving at the emergency department of the Royal Prince Alfred Hospital, in inner Sydney.

But the NSW Health Department says this figure and those for Westmead Hospital are wrong because of problems with collecting data, even though they are included in the performance indicators it publishes to enable people to compare hospitals. Asked by The Weekend Australian why the Government had published incorrect figures, a spokesman for NSW Health Minister John Della Bosca said it was important to publish the information for the sake of transparency. "Although some of the data might reflect poorly on these hospitals, we are prepared to wear that while we try to fix the teething problems," he said.

The revelations add a bizarre twist to the string of claims about fudged figures on hospital performance in NSW and Victoria. Mostly the allegations are that data is being massaged to meet performance benchmarks. But in this case, the NSW Government claims the figures understate the true situation. State governments have responded to dissatisfaction with public hospitals by releasing data on their performances, available on health department websites.

According to former Victorian and NSW premier's department head Ken Baxter, whose consultancy prepared a report on the funding of public hospitals earlier this year, the figures, particularly in NSW, "are not worth the paper they were written on". There were serious doubts about the veracity of the data fed into them from hospitals. Nor were they necessarily the best indicators of performance. "For example, waiting times for elective surgery can be manipulated for what you want out of them," Mr Baxter said.

The report by TFG International, of which Mr Baxter is chairman, found hospital data was "inconsistent, patchy and not readily comparable on a state-by-state basis". Although the states had spent more than $2billion on information technology and data collection systems, this money had "largely been wasted".

Documents obtained by NSW Opposition health spokeswoman Jillian Skinner show that patients are not included on the waiting lists for elective surgery if they cannot be operated on within a certain period.

The problems highlight the challenge the Rudd Government faces in establishing a national system of performance benchmarks on which it will base part of its funding of hospitals under a new agreement with the states due to apply from January 1. Canberra wants to use better and more uniform data to drive improvements in hospital performance. Treasurer Wayne Swan quotes the example of New York state publishing information for hospitals on patients receiving heart bypass surgery. In the three years after the introduction of the system in 1989, mortality rates for cardiac operations fell by more than 40per cent.

The Weekend Australian asked NSW Health why only 36per cent of patients taken to Royal Prince Alfred Hospital in January with an imminently life-threatening condition were seen within the required 10 minutes, compared with the average for all hospitals in NSW of 82per cent.

The figure for the RPA rose in subsequent months and reached 71per cent in June, the latest figures to be published. But it is still below the figures for most other hospitals. The pattern was the same for patients with potentially life-threatening conditions, who are supposed to be seen within 30 minutes, and potentially serious candidates, who should be seen within an hour. The department responded that the explanation involved a "technical issue, related to how data is extracted out of the patient systems into reporting systems ... It is important to notethat clinical care delivered at this hospital remains of the highest quality, although this may not be reflected in the triage benchmarks".

What then of the figures for Westmead hospital, in western Sydney, which showed that just 36per cent of patients with potentially life-threatening conditions were seen within the required 30 minutes in March, compared with the average for all NSW hospitals of 74per cent? Low figures were also reported for Westmead in most other months this year, although they had improved by June.

The department said Westmead and other hospitals were introducing a new emergency department system and that "some initial usability and process issues associated with this new system have been experienced ... This has led to some inaccurate under-reporting against performance benchmarks ... Again, standards of care were not affected". NSW Health said both hospitals had experienced higher-than-average increases in emergency attendances.

The independent and not-for-profit Australian Council on Healthcare Standards, which collects data from hospitals, said last year that only one of the indicators of treatment in emergency departments showed satisfactory results in 2006. This was for the immediately life-threatening cases, required to be seen within two minutes, where the benchmark was met in 99per cent of cases throughout the nation.

Source






QLD: Wire from public hospital surgery left inside EIGHT children

Not just one: EIGHT! Amazing

QUEENSLAND Health has ordered checks on about 200 child hospital patients after wire from a frequently used piece of medical equipment was found inside eight of them. The children have all been treated with what's known as a peripherally inserted central catheter, commonly called a PIC line, used to deliver drugs, including chemotherapy. A PIC line is inserted in a vein in the elbow, and then advanced through increasingly larger veins, toward the heart.

Concerns were raised this week about a particular brand of PIC line after a piece of wire was discovered inside a patient at Townsville Hospital. Australia's medical regulator, the Therapeutic Goods Administration, has been notified of the problem. Queensland Chief Health Officer Jeannette Young said today Queensland Health was in the process of notifying parents of children potentially affected. She urged parents not to panic because there was no evidence of children coming to harm as a result of the wire being left in.

Source

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