Caboolture Hospital Surgical Services Review

The independent review into surgical services at Caboolture Hospital conducted by eminent South Australian surgeon Dr Jim Sweeney concluded on 25 October 2021.

Metro North Hospital and Health Service Board Chair Jim McGowan reaffirmed his commitment to consistently high standards of care at Caboolture Hospital, as well as transparency to the public, via the publication of the report and a subsequent action plan (see below).

The purpose of the “independent, external report” was to reassure the Caboolture community and the staff at Caboolture that they can have confidence in the Safety and Quality of surgical services and, where appropriate, to identify areas for improvement.

While the general conclusion must be that Caboolture Hospital performs well on most objective measures, every patient/consumer who suffers from Hospital Acquired Complications or is disappointed with the outcome of their non-clinical experience, is not a statistic but a person and clinicians must engage with them to explain what happened and what are the future options. We need to use their feedback as an opportunity to improve the care or the experience for them and for future patients/consumers. To that end, all individual cases where identification was possible have been reviewed and all cases reported through the hotline or through the media are being, or will be followed up, with those individuals and/or their families. The review recommended that there be a comprehensive review and analysis of each Human Error and Patient Safety (HEAPS) and Root Cause Analysis (RCA) reports on surgical cases at the Caboolture Hospital from 2020 -2021 to identify any outstanding issues and future improvement strategies. This will commence immediately.

The scope of practice for all surgeons has been reviewed against the operations performed at Caboolture Hospital. The review found that there is no evidence that any surgeon has practised outside of their scope of practice for general surgery at Caboolture Hospital.

The clinical review of the practice of general surgery at Caboolture Hospital against the current approved Queensland Health and Metro North Clinical Services Capability Framework (CSCF) for Caboolture Hospital was undertaken and confirmed that Caboolture Hospital performs surgical procedures/operations within that framework.

The report was critical of the quality of Safety and Quality reports and recommended further training around clinical incident management, report writing, open disclosure, consumer complaint management and auditing processes. It also recommended standardised templates across all Metro North hospitals. Clinical governance would be improved by the establishment of a peer review process across the Metro North Health Surgery and Intensive Care Stream of surgical complication cases and document actions for improvement. This will also provide networking opportunities across all four hospitals. Clinicians need to see involvement in key Safety and Quality meetings as a critical part of their role.

Patient and consumer feedback and experiences data and information should be used by the Surgery and Intensive Care department to improve the safety and quality of services and care. Clinicians have a responsibility to respond directly to patients who have had an unsatisfactory experience.

During the review, concerns were raised by staff about inappropriate behaviours and attitudes. Inappropriate behaviours in the workplace can have a direct link to poor surgical outcomes and performance. Metro North Health and Caboolture Hospital will support strategies to improve workplace cultures at the work unit and hospital level. Mr. McGowan stated that “a line in the sand needs to be drawn. Inappropriate behaviours including bullying and harassment cannot be tolerated. Reporting of such incidents is to be encouraged”.

Metro North Health has accepted the recommendations as outlined in the action plan.

During the review period, Metro North Health received 137 calls to its dedicated Caboolture Hospital feedback hotline which formed part of the review.

The dedicated feedback hotline will remain open to support any ongoing communication and ensure patients feel that their concerns have been heard. In addition, feedback is being taken through regular channels, by contacting Caboolture Hospital Consumer Liaison Office directly on (07) 3883 7618.

Mr McGowan and Metro North Health would like to thank everyone who has provided feedback during the review period, with Metro North Health actively working with those who made contact and as outlined in the report.

Metro North Health will work with its key stakeholders, including consumer representatives to implement the recommendations.