Staff raise alarm bells about patient safety at Mildura Base Hospital

This is a disturbing article by Christiane Barro (The New Daily 22 April 2019), which tells of  staff shortages and risks imposed on patients by the cost cutting private operator of the Mildura Base Hospital, Ramsay Health Care.

Pharmacist Dan* worked tirelessly behind the scenes to rectify doctors’ prescribing errors at Victorian state-owned Mildura Base Hospital (MBH).

In one of the most catastrophic mistakes, one patient could have suffered a life-threatening haemorrhage had he not fixed a drug blunder.

Unfortunately for patients, Dan was short-staffed, underpaid and overworked – so he didn’t have time to double-check every prescription. Nor were all oversights reported.

The problems didn’t end there.

Dan, along with other current and former staff, has blasted Ramsay Health Care, the multibillion-dollar health company charged with the operation of this busy hospital.

They claim the company’s focus on cutting costs has resulted in unsafe patient discharges, deadly prescribing errors, elective surgery cancellations, and the temporary shutdown of beds and birthing suites.

Jane MacAllister resigned after realising she “didn’t want to continue devaluing myself in the same way that they obviously did”

An investigation by The New Daily has found that despite receiving millions in taxpayer funds, the privately run hospital doesn’t have the same oversight as others in Victoria. It has consistently evaded mandatory accountability requirements.

The hospital where patients are scared to be treated

Dan, who resigned due to poor working conditions, said the number of patients re-admitted within 48 hours of discharge was “out of control”.

Many were sent home without having their discharge medication reviewed by a hospital pharmacist, Dan said.

And, many were arriving back in emergency as a consequence of being discharged too early.

Triage nurse Natalie* agreed, saying: “It’s a ticking time bomb.”

She said management had rejected her repeated requests for additional staff to help unclog the emergency department.

“They don’t give a reason why. I think it’s about saving money.”

In one extreme case, doctors sent home a patient with kidney failure after forgetting to review his blood test results, Dan said.

Two patients were readmitted after developing blood clots because they were not prescribed anticoagulants, which are meant to prevent clots from forming.

Dan said patients had been receiving a “poor level of care” because many medical officers had only overseas qualifications and lacked knowledge of the “therapeutic guidelines” and “hospital practice protocols”.

One overseas-trained doctor, whom the hospital appointed as its medical officer, made “countless” mistakes with medications, Dan said.

The level of medical knowledge he had with medication management was less than that of a fifth-year medical student.”

MBH doctor Sarah* said staffing levels are low in every department, noting there are more overseas-trained doctors and medical locums (staff on temporary, short-term contracts) than there are permanent workers.

She said junior doctors were also filling roles outside their scope of practice.

“The new term of junior doctors here are floundering and not being well supported because of staff shortages and a lack of consistent senior medical staff,” Sarah added.

A Ramsay Health Care spokesperson said: “Junior doctors are fully supervised and supported by senior medical staff.”

Sarah said that at one stage, the hospital was “so short” on midwives, it was forced to close birthing suits, leaving staffers scrambling to arrange costly, taxpayer-funded transfers for pregnant women by air ambulance.

Elective, emergency, orthopaedic, gynecological and general surgical cases are “moved multiple times” because of recurring staff shortages, namely a lack of anaesthetic doctors and theatre nurses, Sarah said.

“Where’s the investment in improvement and quality control? I can’t see it. My doctor colleagues and nursing staff can’t see it,” she said.

A Ramsay spokesperson said, “Birth suites are always staffed to meet the needs of birthing women in the community”.

The spokesperson said 6500 surgical operations were performed  at MBH in an average year, and fewer than 1.5 per cent in the past 12 months were cancelled on the day of surgery due to insufficient staffing or in-patient bed capacity.

Every month, doctors meet senior clinical staff to run through a list of mortality and morbidity cases, ideally to prevent avoidable problems from recurring – a requirement set out by Victorian government agency Safer Care Victoria.

Sarah was aware of the same avoidable problems and “near misses” raised every month.

Because, as Sarah explains, as long as MBH management can tick off that all the relevant cases in that month had been presented, there is no meaningful effort to find ways to stop issues from recurring.

Because, as Sarah explains, as long as MBH management can tick off that all the relevant cases in that month had been presented, there is no meaningful effort to find ways to stop issues from recurring.

Mildura MP Ali Cupper has led the campaign to end privatisation of the Mildura Base Hospital

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