King Edward Memorial Hospital
Major improvements at KEMH since 2002 include:
- 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
- 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
- Renovation and upgrade of the Delivery Suite, Adult
Special Care Unit, Maternal Fetal Assessment Unit and
- 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.
- 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
- 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.
- 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
- 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.