Women and Newborn Health Service
General
King Edward Memorial Hospital
Improvements
Major improvements at KEMH since 2002 include:
Governance
- Establishment of an internal Douglas Inquiry Audit Committee in 2003 under the chairmanship of the Chief Executive. This committee meets regularly to review results of audits of compliance and make further recommendations for improvements. Membership includes senior clinicians across a range of disciplines and specialty areas.
- The Douglas Inquiry Audit Committee actively promotes the uptake of ongoing audit within clinical areas as part of routine practice. This is facilitated and supported by the comprehensive clinical governance framework established at KEMH including the Obstetric Gynaecology Clinical Care Unit Quality Improvement process and the Medical Advisory Committee review process.
- Review of the terms of reference for the Medical Advisory Committee (MAC) to provide a role as the peak clinical governance body for the hospital.
- Clinical governance activities have been strengthened by establishing a Clinical Governance Reporting System.
- Establishment of a central Quality and Safety team to support clinical areas with governance activities with an executive position to lead and facilitate safety and quality initiatives. This team ensures there is now systematic reporting and review of risk management issues to the MAC and Senior Executive.
- A consultant-led Maternal and Perinatal Mortality Committee has been established that reviews all perinatal and maternal deaths.
Facilities
- Significantly improved facilities for the assessment,
diagnosis and care of women and children at KEMH including:
- Upgrade of the Emergency Department to provide improved facilities for patients and a safer work environment for staff.
- Renovation and upgrade of the Delivery Suite, Adult Special Care Unit, Maternal Fetal Assessment Unit and Neonatal Unit.
- Enhanced diagnostic and assessment services through:
- Establishment of a purpose built, well equipped Maternal Fetal Assessment Unit that provides comprehensive assessment and monitoring for pregnant women.
- Development of procedures and guidelines for the MFAU.
- Implementation of a system for online review of diagnostic images (such as X- rays) that has improved the timeliness and availability of images.
Staffing
- Increased numbers of consultants have been employed at KEMH, which allows enhanced consultant cover in Emergency Centre, Delivery Suite, Neonates and after hours.
- Increased numbers of midwifery staff have been employed.
- Improved arrangements for consultant cover and patient review in the KEMH Adult Special Care unit, with associated transfer to Level 3 Adult Intensive Care Units.
- Improved appointment, credentialling and performance management processes for clinical staff with systems in place for ongoing audit of procedures performed against credentialled status and completion of performance appraisals.
- Improved supervision, orientation and educational programs for junior medical staff. A Director of Post Graduate Medical Education (PGME) has been appointed and a comprehensive education program for clinical staff is in place. A surgical skills training course is also in place.
- Appointment of a Clinical Midwifery Consultant for 'high risk' women under the care of the Maternal Fetal Medicine department.
Client Services
- Establishment of a comprehensive Perinatal Loss Service (PLS) at KEMH that provides continuing and comprehensive multidisciplinary care for women and families experiencing perinatal loss. The PLS coordinator has an educative, consultancy and resource role for all healthcare practitioners throughout the state of WA.
- Establishment of Telehealth services has enhanced the delivery of outpatient clinical services, patient education, and expert advice and support for professionals in country areas.
- Improved complaints management process with formal review of responses by Executive members and monitored response time targets.
- Increased use of interpreters for women from non-English speaking background.
- The Community Advisory Council (CAC) is represented on the Douglas Inquiry Audit Committee. The CAC represents the interests of the people of Western Australia in relation to KEMH, working in partnership with KEMH to monitor and improve the services offered by the Hospital.
Care Planning
- Ongoing development and review of comprehensive clinical guidelines that are available to all clinical staff on the intranet and in some cases the internet for use by other hospitals in Western Australia.
- Improved clinical care planning, coordination and documentation that includes greater involvement of women in decisions.
- Clarification of referral processes both to the hospital and within departments.
- Improved processes for reporting and managing clinical incidents to ensure the causes of incidents are identified and addressed in a way that seeks to prevent further occurrences.
- Implementation of an electronic discharge system at KEMH has improved communication with General Practitioners.
- Development and use of a hand held record for women receiving maternity services and care at KEMH.
