MEDICAL SERVICES
Tel: (03) 5320 4278
Fax: (03) 5320 4554
OVERVIEW
FROM EXECUTIVE DIRECTOR, MEDICAL SERVICES
FOR THE MEDICAL STAFF GROUP
CLINICAL DIVISIONS AND HMOs
MARCH 2011
1. BUDGET AND WORKLOAD
The table below shows activity to the end of February 2011. WIES activity at the end of February was 99.65%, within the limits for funding.
Ballarat Health Services Summary of Activity December 2010/11YTD 2010/11 / YTD 2009/10 / Change / % Change
WIES
Acute Separations
Acute Discharged Bed days
Discharged Births
Theatre Cases
Emergency Attendances
Outpatient VACS
Waiting List / 15,712
22,494
52,124
850
6,939
35,009
28,608
1,256 / 15,382
21,773
51,602
878
7,273
33,032
27,717
1,452 / 330
721
522
-28
-334
1,977
891
-196 / 2.14%
3.31%
1.01%
-3.19%
-4.59%
5.99%
3.21%
-13.50%
The YTD figures show an increase of 2.14% in WIES, 3.31% in acute separations, 5.99% in emergency attendances, and a decrease of 13.5% in the total number of patients on the elective surgery waiting list compared to the same period last year.
The financial operating result for February is a surplus of $1.8M, which is $1.2M above budget expectations; this is largely because funding has been received from the Department of Health to cover the additional salary costs incurred as a result of additional public holidays over the Christmas period ($1.2M in December and January). The YTD result shows a surplus of $178,000 which is $657,000 worse than budget. Continued financial concerns include Residential Services ($1.52M over budget), Medical Services ($897,000 over budget), Nursing Services ($489,000 over budget).
The Medical Services overspend is largely in the areas of Radiology and Pathology. Medical staff salaries and wages are $870,000 over budget YTD, an increase partly due to a $500,000 annual ($292,000 YTD) budget reduction in December. It is hoped that expenditure in these areas will decline significantly in the last quarter of the financial year as measures to control these costs take effect.
Although the overall financial position remains tight, some progress is being made on the YTD surplus, and it is estimated that budget expectations may be met by May.
2. MEDICAL STAFF
JUNIOR MEDICAL STAFF:
28 registrars and 18 HMOs completed their rotations at Ballarat Health Services at the beginning of February and we wish them well in their future careers. On the 7 February 2011 we welcomed 36 new registrars and 13 HMOs.
EDMS OVERVIEW - MARCH 2011
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SENIOR MEDICAL STAFF:
Gastroenterology
Dr Mahmod Fahdawi has accepted an appointment as Staff Specialist in Gastroenterology and will join us later in 2011. An offer of appointment as Staff Specialist in Gastroenterology has also been made to Dr Paul Mullins and we await his response.
Oncology
We welcome Dr Heather Francis and Dr Yen Tran who joined the Oncology Unit as VMOs in February.
Internal Medicine
Dr Chris Power has joined the Internal Medicine Service as a VMO in Acute and Geriatric Medicine.
Paediatrics
Dr Mark Nethercote joined the Paediatric Service in late February as a VMO.
Anaesthetics
Dr Deas Brouwer has commenced as a Staff Specialist in Anesthetics. Deas was formerly an Anaesthetist at Geelong Hospital.
On behalf of Ballarat Health Services I would like to offer a warm welcome to our new arrivals.
3. CLINICAL ISSUES
(i) Performance Monitoring Framework
The performance of BHS is monitored by the Department of Health against a number of performance and financial KPIs. These include % of patients transferred from ED to an inpatient bed within 8 hours, numbers of overdue category 2 and 3 patients on the elective surgery waiting list, hospital initiated postponements (HIPs) (ie cancelled surgical operations), and hospital acquired Staphylococcus Aureus Bacteraemia (SAB) rates. At present BHS is close to dropping below the 70/100 point benchmark below which Performance Watch is invoked by the Department of Health, significantly reducing our autonomy and increasing the level of Departmental scrutiny. A number of initiatives are under way to address these issues, in particular to reduce SAB levels by changing IV cannulas more frequently and to minimize HIPs. I would be grateful for your cooperation in these measures.
(ii) Continuing Medical Education Guidelines
BHS has just finished revising its guidelines for reimbursement of CME expenses, and the new guidelines will be circulated shortly.
(iii) Review of Mental Health Services
The clinical review of BHS mental health services by the Office of the Chief Psychiatrist of the Department of Health is taking place at the time of writing.
EDMS OVERVIEW - MARCH 2011
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(iv) Approval for Junior Medical Staff Unrostered Overtime
A new procedure has been introduced for junior medical staff to claim for unrostered overtime worked. Consultant approval at the time or as soon as possible afterwards will still be required, but instead of obtaining the signature of an authorizing consultant, the name of the consultant and the time of authorization will be recorded. Verbal approval by telephone is perfectly adequate and I ask for your cooperation in this process.
4. FACILITIES AND EQUIPMENT
(i) Short Stay Unit
The Short Stay Unit in the Emergency Department commenced operations on the 7 February. In February daily admissions varied between 2 and 11. 13.5% of patients attending ED were transferred to the SSU, and 94% of SSU patients were discharged directly to home. SSU beds are also being used on an occasional basis at weekends to mitigate extreme bed pressures.
(ii) Ballarat Regional Integrated Cancer Centre
Construction of the Ballarat Regional Integrated Cancer Centre by Leighton Contractors Pty Ltd has commenced on the site of the Drummond Street Car Park after a “turning of the sod” ceremony on 14 February. The construction works have necessitated relocating Dental Services and Pathology. Completion is anticipated in mid 2012.
(iii) 128 Slice CT Scanner
The new Siemens Definition AS+128 slice CT Scanner has been installed in the Radiology Department. The new scanner will allow a reduction in radiation dosage, significantly improve temporal and image quality, increase patient comfort and improve capacity for scanning trauma patients.
5. STRATEGIC PLAN
The BHS Strategic Plan for 2010 – 2013 has been adopted by the Board of Management and is available on the BHS Intranet.
PHILIP REASBECK
BChir MA MBA MD MRCP FRCS FRACS
Executive Director of Medical Services
29 March 2011
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