Submission to. The Independent Review of the Lady Cilento Children s Hospital

Transcription

1 Submission to The Independent Review of the Lady Cilento Children s Hospital May,

2 Introduction The Queensland Nurses Union (QNU) thanks the Queensland government for the opportunity to submit to the Lady Cilento Children s Hospital (LCCH) Review (the review). Nursing and midwifery is the largest occupational group in Queensland Health (QH) and one of the largest across the Queensland government. The QNU is the principal health union in Queensland covering all categories of workers that make up the nursing workforce including registered nurses (RN), registered midwives, enrolled nurses (EN) and assistants in nursing (AIN) who are employed in the public, private and not-for-profit health sectors including aged care. Our more than 50,000 members work across a variety of settings from single person operations to large health and non-health institutions, and in a full range of classifications from entry level trainees to senior management. The vast majority of nurses in Queensland are members of the QNU. The QNU notes that there has already been a clinical review of the opening of the LCCH and we acknowledge the extraordinary dedication and effort of staff involved in those first few weeks of operation. That review addressed many of the issues that arose as a result of bringing forward the opening date of such a large and complex project. The nursing workforce was particularly instrumental in keeping the health system safe during that time, especially the roving clinical nurses. Paediatric nursing is a specialised area of practice that must be adequately staffed and resourced to ensure patient safety. The QNU believes that the opening of the LCCH provides the opportunity to establish robust nursing reporting lines through strong nursing governance. Terms of reference 1. Assess the governance and other matters surrounding the commissioning of the LCCH, by the Children s Health Queensland (CHQ) Hospital and Health Board, Department of Health and other government agencies; 2. Consider system planning, decision-making, resourcing and other related activities that impact on patient safety during the commissioning process; 2

3 3. Assess and benchmark the processes and timeframe for building commissioning (required to achieve practical completion) and operational commissioning (required to properly operate) of the facility, taking into account facilities of a similar size and complexity; 4. Consider the appropriateness of the governance practices, management and oversight employed by the Department of Health and the Board of CHQ Hospital and Health Service in relation to the commissioning of the LCCH. The terms of reference for this inquiry appear to focus on the commissioning of the LCCH, a process that commenced in 2006 under the Beattie government. In light of the fact that the commissioning, planning and building of the LCCH spans governments and the review is concerned with governance, decision-making and resourcing we suggest the Auditor-General of Queensland and the Queensland Audit Office (QAO) may be better placed to carry out an independent assessment of these activities. Information relevant to commissioning, tendering and decisions of the Children s Health Queensland Hospital and Health Services (CHQHHS) board are not readily available to the public. The Auditor-General and staff have unfettered access to all government entities, and can examine and report to Parliament on the efficiency and effectiveness of any aspect of public sector finances and administration. The QNU has always supported the concept of one new children s facility, but we maintain our reservations about the site. In October, 2011 we made a submission to the Health and Disabilities Committee of the Queensland Parliament s Inquiry into the Public Works Project to Construct the Queensland Children s Hospital where we outlined our concerns about the choice of location. Consultation The Queensland Children s Hospital Project established the Queensland Children s Hospital Union Consultative Forum to identify shared solutions to industrial and other matters relating to the development of the transition to the children s hospital. We thank Queensland Health for engaging the QNU in such a comprehensive process of consultation. All parties involved in the nursing consultations benefitted from the discussion and collaboration in this project. Unfortunately Mater Health Services (MHS) did not adopt such an expansive approach and was unwilling to share information with us to a similar degree. As the recipient of government funding, in our view, the Mater should be held responsible for providing the same level of cooperation as Queensland Health and the CHQHHS board. In the absence of such an approach, the QNU facilitated information sessions at our premises as a means of keeping nursing staff informed. As the independent review (CHQHHS, 2015) also noted, MHS gave limited access to orientation, familiarisation, commissioning and socialisation activities, reportedly due to 3

4 giving priority to their commitment to service delivery. We fail to see how service delivery could be effective without staff being familiar with the new facility. Facility Design The QNU has invested considerable resources in researching and reporting on health facility design and we have been very active in advising members of best practices in this area. As the construction of healthcare facilities requires both design professionals and healthcare providers to work collaboratively, it is important they build their knowledge and skills in health service planning. However, healthcare providers, particularly nurses and midwives, generally learn by trial and error since there are few formal educational activities that prepare them to participate in and, more importantly, influence how healthcare facilities are built and furnished. To meet this need, the QNU engaged Annabelle Caramba, an architect with particular expertise in health facility design to research and develop resources on best practices in key areas affecting and involving nursing and midwifery practice. We have attached the following documents prepared by Annabelle for your reference: QNU Guidelines for Nurse Engagement in the Planning and Design of Healthcare Environments (Attachment 1); Facility Design (Health and Safety 2010) (Attachment 2); Best Practice in Healthcare Facility Design: A QNU Evidence-Based Handbook for Nurses and Midwives on Occupational Health and Safety (Attachment 3). These papers are part of a resource kit the QNU distributed to members and have been particularly useful for informing nurses and midwives in the redevelopment of the Mackay base hospital. We also note the recent UK research (Maben, Griffiths, Penfold, Simon, Pizzo, Anderson, et al., 2015) into the workforce implications and impact on patient and staff experiences of single room hospital accommodation. This research found that nursing staff perceived improvements (patient comfort and confidentiality), but thought the new accommodation worse for visibility and surveillance, teamwork, monitoring, safeguarding and remaining close to patients. Giving sufficient time and attention to each patient, locating other staff and discussing care with colleagues also proved difficult. 4

5 Conclusion The QNU welcomes this opportunity to provide feedback on the LCCH. We can give further information to the review panel should they require it. References Maben J., Griffiths P., Penfold C., Simon M., Pizzo E., Anderson J., et al. (2015) Evaluating a major innovation in hospital design: workforce implications and impact on patient and staff experiences of all single room hospital accommodation, Health Service Delivery Research, 3 (3). Children s Health Queensland Hospital and Health Service (2015) Lady Cilento Children s Hospital Clinical Review Final Report, Queensland Government. 5