Year of the ‘Home’
The year that was has turned out to be a ground-breaking one for the Australian GP Alliance, which represents independent GP practice owners. It was forged in the fires of the pathology rental debacle which became so politicised, it had politicians hopping around like scalded cats. With push from the RACGP and the AMA, the alliance succeeded in getting that legislation overturned. It continues to be driven in WA by a core of WA GPs including Kalamunda GP Dr Sean Stevens and Dr Jags Krishnan, while its membership of about 100 practices, representing about 1200 GPs, is spread across the country. Sean told Medical Forum the alliance was this year gearing up to tackle among other things Health Care Homes (HCC). Sean said owners were concerned by the number of trial sites which have been allocated to the corporates. Apparently IPN and the Government have negotiated a separate agreement, the details of which haven’t been made public. The HHC figures provided to independent GPs were pretty ugly, so many are keen to know if deals have been done.
Pathology rent simmers
And while the pathology rental fire has been subdued it hasn’t been extinguished. In our conversation with Dr Sean Stevens from the Australian GP Alliance he said the group had growing concerns that the issue would flare again with the news that Primary Health Care has joined Pathology Australia. Sean said that both Primary and IPN have indicated that they intend to negotiate more aggressively on rent, which will leave small independent GPs out on a limb. All that the alliance asks for is a fair playing field but it’s hard to be competitive when there is no transparency.
WAMAS now WAKMAS
The melanoma service formerly known as the WAMAS has, after a turbulent six months of uncertainty moved from SJG Subiaco Hospital to its new home at the Perkins Institute where it has joined the Scott Kirkbride Melanoma Advisory Service to become the WA Kirkbride Melanoma Advisory Service. What’s in a name? Well the service is still headed by Dr Mark Hanikeri, who is clinical director and board chair and staff transitioned as well. He explained that patients with advanced or complex malignant melanoma can be referred to the clinic by GPs, skin clinics and dermatologists. He said the new facilities would enable more patients to access the team of specialists including pathologists, medical and radiation oncologists, plastic surgeons and dermatologists.
Audit has an impact
The release of the 2017 Report of the Western Australian Audit of Surgical Mortality (WAASM) contains the good news that while the total number of deaths has plateaued, mortality is still falling after allowing for population growth. WAASM is managed by RACS and funded by the WA Department of Health and clinical reviews are conducted by surgeons who practise in the same specialty but at a different hospital. Clinical reviews into 2897 deaths over five years has shown the number of deaths per 100,000 has decreased from between 30-35 in the first five years (2002-2006) to a record low of 22.1 in 2016. “This suggests the WAASM is achieving its aim of reducing the proportion of deaths associated with clinical management issues in WA,” said the Audit chair, Dr James Aitken. WAASM was the first audit of its kind in Australia in 2001 and now it exists in every Australian state and territory. The introduction of online submissions of surgical case forms and first-line assessments has seen reporting increase to 99.2% compared to 30% when they were first launched in November 2013.
Drunk and in ED
The Australian College of Emergency Medicine (ACEM) produced some sobering figures captured late at night on Saturday 16 December across 100 Australian EDs which showed that one in eight patients who wobbled into emergency departments were affected by alcohol. WA was the worst state with almost one in five patients there in some way because of alcohol. ACEM, which won a recent Victorian Health Award for its work raising awareness of alcohol-related harm, pointed out that as our summer of sport rolls out on our television screens, alcohol advertising remains front and centre. For the record, WA had 19.4% alcohol related presentations followed by the ACT, NT and Tasmania with 17.5%. NSW was the lowest with 9.6%.
Changing scape at Healthscope
We report Dr Michael Stanford’s move to the Healthscope board after 16 years CEO of SJG Health Care. His is not the only new hospital appointment. Claire Byers has been the Mount Hospital’s new general manager since June and last month announced a $15m redevelopment of the hospital. The first stage will focus on upgrading the cardiac facility, including a third Cardiac Catheter Laboratory (Cath Lab) and the state-of-the-art Hybrid Operating Theatre, which will support vascular and structural heart services including the new Transcatheter Aortic Valve Implantation (TAVI) program. Construction is expected to begin in April.
New standards, new pressures
Revisions to the National Safety and Quality Health Care Standards have reduced the number of actions that require surveillance for pressure injuries and Wounds Australia are very concerned about it. The CEO Anne Buck told Medical Forum that the previous edition of the standards listed 22 actions to be managed and that figure had been reduced to three as various components had been absorbed into different categories. Anne is concerned health staff may not being as vigilant of pressure injuries as they should be. She said pressure injuries were a common and costly health care complication. Recent surveys had found about one in 10 patients in hospital had a pressure injury with an estimated cost of almost $1b annually. She said it would take a little time for the new standards to kick in and hopes the ACSQHC reconsiders the emphasis given to pressure injury.
<subhead>The new year brought sad news for the team at Perth Radiological Clinic with the death of one of its senior figures, Dr Paul Yoong, who died on January 5. Paul was also a significant contributor at Royal Perth Hospital’s radiology.
Hazards and commonsense
The TGA has released the ECR (Emergency Care Research) Institute’s top 10 hazards list for 2018, and includes the experts’ opinion on which risks should receive priority now. ECRI engineers, scientists, clinicians, and other patient safety analysts nominated topics for consideration based on these insights:
- Ransomware and other cybersecurity threats to healthcare delivery.
- Endoscope reprocessing failures expose patients to infection risk.
- Mattresses and covers may be infected by body fluids and microbiological contaminants.
- Missed alarms may result from inappropriately configured secondary notification devices and systems.
- Improper cleaning may cause device malfunctions, equipment failures.
- Unholstered electrosurgical active electrodes can lead to patient burns.
- Inadequate use of digital imaging tools may lead to unnecessary radiation exposure.
- Workarounds can negate the safety advantages of barcoded medication administration systems.
- Flaws in medical device networking can lead to delayed or inappropriate care.
- Slow adoption of safer enteral feeding connectors leaves patients at risk.