Quality of Care Report - Ballarat Health Services

Waiting for surgeryBallarat Health Services has sixoperating theatres and two procedurerooms, performed 10,443 operationsduring 2007-2008. Elective cases areperformed between 8am – 6pmMonday to Friday, with emergencycases performed as required, day ornight.As per DHS Elective Surgery GuidelinesBallarat Health Services endeavors totreat patients waiting for electivesurgery in a timely manner, Category 1patients within 30 days, Category 2patients within 90 days and Category 3within 365 days. This may not alwaysbe possible to achieve given thevolume and complexity of patientswaiting for elective surgery, particularlyin the specialties of orthopaedics andophthalmology.The number of complex Category 1elective patients waiting for surgery hasgrown significantly over the last fouryears, often resulting in those patientsin categories 2 or 3 experiencing delaysand sometimes cancellations. BHS hasmaintained the 100 per cent targetthat ensures that the most urgentpatients (Category 1) undergo surgerywithin the 30 days.BHS treats the most urgent emergencypatients first; sometimes this meansthat elective surgery is cancelled, andpeople with less serious conditionspresenting in the EmergencyDepartment must wait. BHS isconstantly reviewing the number andtypes of patients waiting for surgery toensure equitable access for all patientsand to this end conducts 6 monthlyaudits of the elective surgery waitinglist.Ballarat Health Services reported 84.30per cent category 3 patients waiting365 days or less for surgery, thereforenon-achievement of the Department ofHealth Services (DHS) waiting listtarget. The increased emergencypresentations put extreme pressure onelective surgery patients often resultingin cancellation of category 2 or 3surgery and impacting on hospitalresources and the management of thewaiting list. The DHS program, ElectiveSurgery Access Service (ESAS) a statewide program, to assist patients onlong waiting lists saw 28 of ourpatients receive their care earlier thanwould be possible at BHS to the end ofJune 2008. If you are a patientsaccepting treatment through ESAS youmust be willing and able to attendoutpatient, pre-admission and postoperativeappointments at thedesignated hospital. The initial referral2004/05 2005/06 2006/07 2007/08 TargetCategory 1: Urgent Admission 100.00% 100.00% 100.00% 100.00% 100%Within 30 days desirable for a conditionthat has the potential to deterioratequickly to the point it may becomean emergencyCategory 2: Semi-Urgent Admission 87% 78% 96% 88.54% 88%Within 90 days desirable for a conditioncausing some pain, dysfunction ordisability but is not likely to deterioratequickly or become an emergencyCategory 3: Non-Urgent AdmissionAt some stage in the future acceptable N/A 92% 83% 84.30% 93%for a condition causing minimal or nopain, dysfunction or disability that isunlikely to deteriorate quickly, and doesnot have the potential to becomean emergencyNumber of patients on the Elective 1009 1239 1140 1,017 1,046Surgery Waiting Listis arranged by the ESAS Coordinator atBallarat Health Services. The receivinghospital then communicates with bothyou and your General Practitionerregarding the surgery and care. Youwill also have access to a designatednurse at BHS regarding any enquiries orissues.For further information please contactthe elective surgery coordinator on(03) 5320 4775.Outpatient ServicesThe Ballarat Health Services OutpatientService is committed to the delivery ofa coordinated, flexible and high qualityOutpatients Service, responsive to youthe consumer.BHS has been investigating Outpatientwaiting times over the last year tomake sure the most urgentappointments are seen within anacceptable timeframe.The Outpatients Department hasimplemented an electronic waiting listwhich allows a current list of patientswaiting for an appointment.Each clinical specialty has an individualwaiting list with nursing staff assignedto contact long waiting patients bytelephone to provide assurance, clinicaladvice and if necessary anappointment. This phone call allowsthe staff to update demographicsdetails, remove the patient from the listif the appointment is no longerrequired and gives the patient anindication of waiting time.Outpatient visits exceeded 2007-2008target by 977 or 2.46 per cent.Ballarat Health Services had 36,694outpatients visits during the financialyear.Ballarat Health Services has asignificant number of outpatient’sappointments that are not kept – didnot attend (DNA). Significant resourcesare used in the management ofpatients that do not attend. A jointinitiative between BHS and the Ballaratand District Aboriginal Co-operative(BADAC) has been embraced by ourindigenous residents resulting in asubstantial decline in the failure rate ofAboriginals attending outpatientappointments.The proportion who now fail to attendtheir appointments has fallen to 21 percent, compared with a failure rate of40 per cent prior to the introduction ofthe program. Under the program BHSnow notifies BADAC, when makingoutpatient appointments forindigenous clients. BADAC staff arethen responsible for contacting theclient in the lead-up to theappointment and organizing transportand support if required.21Ballarat Health Services Quality of Care Report 2007-08