Mansfield District Hospital

CEO Update

 

Report from the Board Chair & Chief Executive Officer

 

On behalf of the Mansfield District Hospital Board of Management, we are pleased to present the 140^th Annual Report, including the Quality of Care Report, the audited Balance Sheet and Financial Statements for the year ended 30 June 2011.

 

Governance Report

 

The Board of Management is responsible for determining the strategy of Mansfield District Hospital and for ensuring the organization pursues this strategy with optimum efficiency. Our goal is to provide excellent care for our patients, residents and clients. In monitoring the efficiency with which we are achieving this, the Board requires and receives regular reports on the organization’s operating status. These reports are presented at monthly meetings of the board through our various committees.

 

Gratitude

The Mansfield and District Community are very fortunate to have a group of dedicated and committed people working at the Mansfield District Hospital. This extends to staff and Visiting Medical Officers in all departments who strive to provide a quality service in their area of expertise.

 

The Board and Chief Executive Officer extend their appreciation to all staff for a ‘job well done’ during the past year. The efforts of all our volunteers must also be recognised and thanked; without our volunteers, special patient and resident programs would not be possible. 

 

We also thank our Director of Medical Services, Dr Rick Lowen, and our Visiting Medical Officers from Central General Practice and Mansfield Medical Clinic for their continued support of and service to the Mansfield District Hospital.

 

MDH is particularly appreciative of the continued fundraising efforts of groups in the community that have enabled MDH to improve its facilities and equipment. Special thanks must go to our three Auxiliaries (Mansfield, Bonnie Doon and Bindaree) for their extreme generosity. Our Auxiliaries continue to work tirelessly on behalf of the organization to purchase equipment that enhances patient and resident care. On behalf of the Board of Management and Staff, we extend our sincere thanks to everyone who contributed to all fundraising efforts throughout the year.

 

Special mention must be made of the Bindaree Auxiliary and The Harry & Clare Friday Foundation for their financial support of the recently established ‘Travelling Staff Scholarship’. This scholarship is made available to all staff, not only for national learning opportunities, but for international opportunities.

 

Every year some of our volunteer Board Members depart the Board.  Departing Members this year are, Marie Sellstrom, Malcolm Blair, Julie Walpole and Elizabeth Duncan. We extend our thanks to these Members for their valued contributions and commitment, in particular to Ms Marie Sellstrom, our former Chair.

 

We also extend our thanks other members of the board, Leanne Robson, Jaya Naidu, Julie Syme, Len Foster, Robert Beekman, and Sandy Tod who have worked tirelessly throughout the year in their capacity as non-executive Directors of the organization.

 

The appointment of a Ministerial delegate, Mr Mick Ellis, to the Board during March 2010 has been of significant assistance to the Board in relation to governance issues and financial performance and reporting. We are most grateful to Mick for his invaluable contribution to the board.

 

Dr Graham Slaney continued to represent the medical officers in his capacity as VMO representative to the Board. We thank him for giving so generously of this time to provide expert advice on medical and other clinical issues.

 

We also acknowledge the contribution made by our two independent Audit & Risk Management Committee members, Mark Henry and Craig Willingham. Their expertise and advice has proven to be extremely valuable and important over the past 12 months.

 

Governance

During the 2010-2011 financial year the Board undertook many programs to enhance its modes of operation, interaction with stakeholders and governance of MDH. The programs ranged from Governance Reviews based on individual surveys to complete revision of the Board’s Governance Policy Manual and By-Laws. The result is a much more enhanced and functional board and, again, we thank Mick Ellis for his sage advice and expertise in these areas.

 

Strategic Initiatives

The Board has taken some major steps in 2010-2011 towards further refining the organization’s three key initiatives.

 

The Primary Care Precinct project has seen significant progress this year with various partnership enterprises seeking and obtaining grants to make the primary care precinct a reality.

 

Many elements have been explored to support the consolidation of our residential aged care services of Bindaree and Buckland House.  These range from facility enhancements to the support of services for ongoing aged care.

 

Our Service Plan was revised during the year and reinforced the need to enhance facilities for the acute hospital. A staged approach is envisaged with the planning for stage 1 (the redevelopment of the emergency department, dialysis unit and operating theatres) being addressed in the 2011-2012 financial year.

 

The Board also established a ‘Community Liaison Committee’ to provide a community perspective on how best to engage with the wider community. The aim of this Committee is to increase community participation in MDH’s planning processes and review of services. The Committee has developed a draft ‘Community Engagement Program’ and it is envisaged that this program will be implemented over the next 12 months.

 

 

Operations Report

 

The 2010-2011 year has, again, been a challenging one with everyone working hard to generate revenue, reduce costs and improve our services. The following highlights a number of initiatives taken throughout the year that demonstrate MDH’s commitment to continuous quality improvement.

 

Capital grants

We were fortunate to receive two capital grants from the State Department of Health during the 2010-2011 year.

 

A grant of $69,000 was received for the purchase of a new gastroscope and colonoscope for the operating theatre. These flexible scopes are fitted with mini cameras and a light source and are used to examine the gastrointestinal tract. The gastroscope is used for examinations of the oesophagus (food tube), stomach and upper part of the bowel; the colonoscope is used to examine the lower part of the bowel. Both these pieces of equipment are vital for monitoring and diagnosing certain gastrointestinal conditions and will enable MDH to continue to provide high quality care and treatment to our local community.

 

MDH also secured a State capital grant for the removal of asbestos from the hospital’s boiler room during the upgrade and replacement of the old boilers. To the best of our knowledge, the boiler room was the last area in the organization where asbestos was situated. A specialist asbestos removal company was engaged and the material was removed from the boiler room in July 2010.

 

Annual appeal – Revive Recovery

The 2010-2011 annual appeal funds were used to redevelop and upgrade our recovery room and its equipment. Registered Nurse, Jenny Pollard, undertook a full review of the recovery room requirements and liaised closely with doctors and nurses about the changes required. The recovery room has now been replastered and repainted, new cabinetry has been installed, and new equipment includes 4 new patients trolleys and a ‘state of the art’ patient monitoring system.

 

A huge ‘thank you’ to the Mansfield Community for their continued fundraising efforts and support; the ‘Revive Recovery’ redevelopment will benefit everyone who needs special surgical and/or procedural care at MDH.

 

Appointment of new Director of Finance & Corporate Services

In July 2010, we welcomed our new Director of Finance & Corporate Services, Andrew Nitshcke, to our Executive Team.

 

Andrew brings a wealth of experience to MDH in the area of finance. As well as being a qualified accountant, Andrew also has a Masters of Business Administration and a background in aged care. Andrew’s portfolio extends to the Corporate Services areas with responsibility for environmental and engineering services.

 

Compliance Updates

The hospital, visiting nursing service and outreach community health service underwent its annual ISO accreditation review in September 2010. The annual review was a success and a number of minor suggestions for improvement were raised. MDH has embraced these suggestions and we look forward to them being reviewed as part of our triennial (3 yearly) review in August 2011.

 

Buckland House Nursing Home and Bindaree Hostel are currently accredited through the Commonwealth’s Aged Care Accreditation Agency (ACAA) until May 2012. In between this 3 yearly cycle, ACAA conduct ‘unannounced visits’ to all aged care agencies to undertake mini audits to ensure standards remain high at all times. Both Buckland House and Bindaree Hostel underwent an unannounced visit in June 2011 and passed the audit with no major issues being raised. This result is testament to the wonderful job our Aged Care Manager and Aged Care Team are doing to ensure the needs of our residents are met.

 

Our Catering Team passed their annual Food Safety Audit in May 2011 with no non conformances raised, and our Environmental Services Team continued to produce excellent results for their internal and external cleaning audits.

 

The Finance Team’s compliance requirements were met through internal and external audits including, but not limited to, Prudential Compliance, Financial Management Compliance Framework, Tax Compliance and Simplified Billing audits.

 

Midwifery Model of Care

During the year MDH undertook a major review of its maternity services and looked at different midwifery models of care across the State of Victoria. Given that MDH has an ageing midwife workforce, it was imperative that MDH had a thorough look at what other rural maternity services were doing and how some of these ideas might assist MDH to sustain its maternity services into the future.

 

The result of the review was the development of a new proposed Midwifery Model of Care specifically for MDH. The new MDH model takes ideas from a number of different rural midwifery models and has the support of MDH’s midwifery staff and GP Obstetricians. MDH is currently working with the Department of Health’s regional office to work through the new proposal. We hope that the new model will be implemented during the 2011-2012 year.

 

Risk Management

Health services are regularly exposed to high levels of ‘risk’. During 2010-2011 MDH’s insurers, Victorian Managed Insurance Authority (VMIA), conducted a review of MDH’s risk management systems and processes.

 

The report highlighted some areas where MDH might consider additional processes to improve its overall risk management system. All recommendations from the VMIA report have since been addressed and, under VMIA’s ‘Risk Management Maturity Level Matrix’, MDH’s risk management system is rated as ‘Effective’. This rating should give the Mansfield Community a level of comfort that MDH’s risk controls, programs and systems, particularly in relation to patient care, are working well.

 

Primary Care Precinct

For a number of years, MDH has been working closely with the Mansfield Shire Council, Delatite Community Health Service, the Department of Health and the local general practitioners to establish a precinct on one site for all primary care health services to improve coordination and access to these services.

 

The Primary Care Precinct project took a great leap forward in July 2010 when a detailed ‘Feasibility Building Study and Mini Masterplan’ was commissioned. Whitefield, McQueen, Irwin Alsop won the tender and worked closely for four months with the Primary Care Precinct Project Control Group.

 

Implementation of Rhook Review Recommendations

In May 2010, the final report from the Rhook Review was received which outlined a number of recommendations to assist MDH in reducing its overall costs.

 

These recommendations were implemented during the 2010-2011 year as part of a cost reduction strategy. One of the recommendations included reducing the effective number of full time employees by 1.6 EFT; this reduction in staff hours was achieved in the areas of administration and engineering services throughout the year.

 

Service Plan Review

The organization’s Service Plan was first developed in 2006 and provided a ‘blueprint’ for future MDH services and capital works.

 

In March 2011, Cordyline Consulting were re-appointed to review and update the Service Plan. The scope of the report included acute health services, community health services, ambulatory services and aged care. The review concluded that:

• The Primary Care Precinct Project is consistent with State & Commonwealth objectives, consistent with the role of MDH and will help to address many of the fragmentation issues with Mansfield community health services – it should be a high capital priority for MDH
• A strategic masterplan should be undertaken to review development options on the sites to achieve:

Ø  Redevelopment of the acute facilities including inpatient medical, procedural services and urgent care services

Ø  Redevelopment of theatre suite

Ø  Expansion of community health

Ø  Collocation of residential aged care beds

Ø  Consideration for collocation of ambulance services

 

We look forward to working towards these strategic objectives during the 2011-2012 year.

 

Information Technology

Through the Hume Region Health Alliance (health agency’s information technology provider), MDH and other hospitals in the Hume region secured videoconferencing facilities. This equipment is being well utilised for meeting and conference attendance throughout the state and training has been planned early 2011-2012 to enable educational and training videoconferencing services to commence for all staff.

 

Environmental Sustainability

All health agencies are now required to have an approved environmental sustainability plan. MDH has led the way for a number of years in environmental sustainability initiatives in the health care setting and, given this background, were the first health service to submit the new ‘ResourceSmart’ plan to the Department of Health.

 

Workforce

The workforce has remained relatively stable during the 2010-2011 year compared to previous years. MDH has recruited to it’s establishment EFT (effective full time equivalents) in most areas of the organization.

 

Training & Education

MDH has remained committed to the professional development of staff members in the organization. Some of the educational highlights for the year include:

§  Internally trained Division II registered nurses – two (2) current trainees; one (1) trainee completed the course during 2011-2012 and is currently employed on staff

§  Two (2) School Based New Apprentices commenced their Certificate III in Aged Care – this is a collaboration between MDH and the Mansfield Secondary College

§  New Graduate Nurse program run in collaboration with Benalla Health, NEH Wangaratta, Yarrawonga District Health & Alpine Health - all graduates across all health services now undertake study days together which provides additional collegial support

• Three MDH Graduate Nurses were appointed in 2011 and are rotating through all clinical areas of the organization
• Clinical Support Nurse position has had a major positive impact on all staff, preceptors, students and new staff through practical support and mentorship
• Major education activities in 2010-2011 were:

Ø  Foetal Surveillance for five (5) GP’s and twelve (12) midwives

Ø  First Aid for ten 10 Division II Nurses & Activity Staff

Ø  Change Management workshop for fourteen (14) nursing staff

Ø  Airway Emergency Training for eight (8) registered nurses and five (5) GP’s

Ø  Wound Management for twenty-nine (29) clinical staff

Ø  Midwifery management training for non midwife registered nurses

 

Interdisciplinary education is a highlight of internally run educational programs at MDH.

 

Emergency Department

In 2006-2007 our emergency department presentations numbered ‘2605’. Our emergency department presentations to the end of June 2011 were ‘3428’. This equates to a 74% increase in the number of emergency department presentations over 4-5 years. To the end of March 2011, 46% of ED presentations were patients with postcodes outside of the Mansfield Shire.

 

To cope with the increase in emergency department presentations, Mansfield Hospital has had to roster nursing staff over and above the nurse:patient ratios to deal with the increased impact of tourism. Based on current experience, we will be allocating an additional 27 nursing shifts for the emergency department in 2011-2012 to deal with demand; this equates to an additional cost of around $15,000 per annum.

 

MDH continues to provide specific emergency education and training to nursing staff to meet increased emergency department demand.

 

Fundraising and Donations

We have been fortunate in being able to purchase a number of items of equipment during the year due to the generosity of our Auxiliaries, Philanthropic organizations and community groups.

 

 

On behalf of the Board and Staff of Mansfield District Hospital, we sincerely thank every single person who contributed, either directly or indirectly, to the organization’s fundraising activities during the year.

 

Robert Beekman                                                              Janene Ridley

Chair, Board of Management                                         Chief Executive Officer