Patient safety and governance issues put Canberra Hospital accreditation at risk

The Canberra Hospital has been given 90 days to turn around dozens of shortcomings, including serious governance and patient safety issues identified in an interim report, so that its accreditation can be renewed.

The Australian Council on Health Care Standards (ACHS) interim accreditation report released by the ACT Government shows that of 208 core criteria, the hospital had met 176 but failed to meet 33, which ACT Health is now acting on.

The report found that the current governance system with its lack of clarity, role confusion and poorly defined accountable structures created a high risk for the organisation, and that there was no strategic plan in place.

“The current system is fragmented, lacks consistency and clear direction across the organisation for the staff and service delivery,” it said.

Patient safety had been put at risk including major delays in rectifying the ligature points in Mental Health after several suicides in the area, the state of the kitchen, and ongoing high counts of Legionella rates.

The report noted serious concern at a number of issues in Mental Health and the number of suicides in the health service – four in the Mental Health Unit and one in the general ward – over the past three years, which have not had a robust review nor strategies implemented to mitigate the risks.

The report recommended an external review of all Mental Health Inpatient Units, Alcohol and Drug, and Justice Health facilities, and the establishment of a Mental Health Review Advisory body to oversee the review and the implementation of subsequent recommendations. Mental Health Minister Shane Rattenbury said this was already being acted on.

It also found issues with reporting of incidents, with compliance fragmented and a number of reports only partially completed. “There is also a need to ensure that all significant incidents are reported to the highest level of governance,” the report said.

Other criteria not met included those related to infection control and cleaning regimes.

Minister for Health and Wellbeing Meegan Fitzharris reassured the community that care at the Canberra Hospital had not been compromised and that ACT Health had accepted all of the report’s recommendations and were acting on them.

“If myself or my kids got sick that is absolutely the first place I would go,” she told ABC radio.

The recently announced splitting of ACT health into two agencies – administrative and clinical – was a response to the poor governance issues and she said the hospital would be able to address all concerns by July when it was due to have its re-accreditation renewed.

She said the findings were disappointing but all jurisdictions were facing similar problems of increasing complexity of health issues and demand for services.

Australian Medical Association ACT president Professor Steve Robson said the findings reflected a system under pressure, with increasing workloads across the hospital.

He said infection and hygiene issues were the result of the ageing building, saying the AMA had been pressing for a rebuild of the main facilities for many years.

He also said there were also systemic issues with ensuring areas were consistently clean.

“It’s usually not the nurses, doctors or allied health, it’s the systems in place to make sure these things happen all the time. They’re are likely to need attention,” he told ABC radio.

Opposition Leader Alistair Coe said the report was a discredit to Ms Fitzharris’ performance and had effectively put her on 90 days’ notice.

“It’s an embarrassment, and demonstrates the Government’s indifference to ensure quality care to patients,” he said.

“Ms Fitzharris and the Chief Minister need to finally demonstrate some leadership and bring order back into our health system.”

Mr Coe was sceptical of Ms Fitzharris’s decision to split the directorate, saying there was already a part of ACT Health that had responsibility for corporate matters.

“I fail to see why just calling it a directorate is going to solve anything,” he said.