PHYSICIAN- HOSPITAL ECONOMIC ALIGNMENT Becker’s Hospital Review Annual MeetingMay 17, 2014.
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Transcript of Hospital review report
NURSING/HEALTH 1
Hospital Review/Report
September 16, 2012
NURSING/HEALTH 2
Australia belongs to a number of the countries with the developed health care system.
The structure of health care of the state includes a number of all-medical, profile, pre-hospital
and hospital medical, paramedical and other components.
The important place in the structure of the Australian health care is occupied by the
rendering of medical care to the population in hospital establishments. The considerable share
of the means allocated for financing of such medical services from the state budget testifies to
it. In 2010-2011 86.9 billion Australian dollars were allocated for them. At the expense of the
state budget 93 % of the hospital expenses and 7 % of private and other sources are financed.
An average cost of one day of a patient’s stay in the state hospital makes 600-700 Australian
dollars.
St. Vincent’s hospital, Melbourne is the main hospital in Fitzroy, Melbourne,
Australia. It is located at the corner of Nicholson Street and Victoria Street. Its address is:
Ground floor, 41 Victoria Parade, Fitzroy VIC 3065.
Mailing address is: St Vincent’s PO Box 2900, Fitzroy VIC 3065.
“Inspired by the caring tradition of the Sisters of Charity and the healing
ministry of Christ, St. Vincent’s Hospital Melbourne strives to be a leader in
providing high quality and innovative health care to the community. Our
values and concern for all people permeate every aspect of the life and work of
the hospital. Our leadership is achieved through the outstanding contribution
of our people in delivering a range of specialist hospital and community
services, underpinned by excellence in education and research” (St. Vincent’s
Hospital Melbourne: 2012).
St. Vincent’s Hospital was open in 1893 as a Catholic hospital which was managed by
the Sisters of Charity. Originally conceived as a branch of the Sydney St. Vincent’s Hospital,
St. Vincent’s Hospital, Melbourne, was intended to be a charitable establishment which will
NURSING/HEALTH 3
help to support the minimal health care of Melbourne. This idea was supported by the
Catholic archbishop of Melbourne, Doctor Thomas Karr who liked the idea of the hospital to
care for “poor and homeless patients and abandoned children”. These ideals corresponded
directly to the widespread Victorian ideas of favor which especially were pleasant to the
middle classes. The hospital was quite small with a room less than for 100 beds for the first
years. The hospital soon created the communications with the suburbs where the working
class of Fitzroy (in which the hospital was located) lived. The hospital was built owning to
charity. In July 2002, the hospital was officially called St. Vincent’s Hospital.
“St Vincent’s Private Melbourne is part of St Vincent’s Health Australia, and
operates under the direction of the Trustees of Mary Aikenhead Ministries
(TMAM). TMAM was established by the Sisters of Charity of Australia on 1
July 2009 to continue their work in health, education and welfare services. The
name Mary Aikenhead Ministries was adopted in tribute to the foundress of
the Sisters of Charity, Mother Mary Aikenhead. Inspired by her extraordinary
example, we work together with TMAM to continue to bring this great
tradition of service to all in need of care” (St. Vincent’s Private Melbourne:
2012).
A new building has been constructed recently behind the old one. It was highly
appreciated for its innovative design ideas, additional medical and surgical peculiarities such
as neuralgia/neurosurgery. It includes the centralized nursing centers and satellite drugstores.
St. Vincent’s Hospital is placed as a specially constructed hospital. The hospital has a
centrally-blocked system. Such a system provides a clear functional split of several blocks
connected among themselves - multystoried wards, diagnostic and service premises, natural
illumination of all wards, offices of doctors, clinic-diagnostic and service premises. In
hospitals there is a zoning of the territory including the zone of a hospital garden.
NURSING/HEALTH 4
The internal accomplishment of the wards in St. Vincent’s Hospital has a number of
differences from the other Australian hospitals. Some of them are provided with the phones
of city communication, but in case of their absence the patient is given opportunity to
communicate via the landline phone established in the other rooms.
St. Vincent’s Hospital is a bright example of a compact building. The hospital has 450
beds. For a year more than 3000 medical employees render medical aid for about 30 000
hospital patients and 40 000 patients, needing emergency medical aid.
It includes such medical departments as: cardiology, neuralgia, gastroenterology,
oncology, clinical microbiology, endocrinology, nephrology, rheumatology, haemotology,
and therapy. Besides, it has the following surgical departments: microsurgery, plastic surgery,
cardiac surgery, orthopaedic surgery, rectal surgery, urology, neurosurgery, general surgery,
gastrointestinal surgery. Moreover, the hospital has the psychiatric department with a special
Expanded Crisis Assessment and Treatment Team, which manages the psychological state of
the patients.
Pic. 1. St. Vincent’s Hospital Campus Map
NURSING/HEALTH 5
“St Vincent’s works with collaborative partners to deliver high quality
treatment, teaching, education and research. As a tertiary public healthcare
service, St Vincent's provides acute medical and surgical services, emergency
and critical care, aged care, diagnostics, rehabilitation, allied health, mental
health, palliative care and residential care, as well as undertaking research and
educating the next generation of healthcare professionals. In 2009-10 St
Vincent's had 53,212 separations and 257,444 bed days. We provided more
than 500,000 occasions of service to patients through our emergency
department, specialist clinics and other services. We operate across 17
locations in metropolitan Melbourne including St George's health service and
Caritas Christi Hospice in Kew and our main campus in Fitzroy” (Yellow
Pages: 2012).
Pic.2. Organizartional Chart of St. Vincent Hospital.
The key figure in the hospital’s organizational structure is the general practitioner.
The general practioners conduct the primary reception of the patients addressing to them. The
office of any physician in St. Vincent’s Hospital consists of the reception room; the doctor’s
consulting room, and medical treatment room.
NURSING/HEALTH 6
The reception room serves for the waiting patients. They wait in it until the doctor
invites them for consulation. The consulting room usually occupies 14-20 squre meters. It has
all the necessary equipment for the specialist. Medical treatment room serves for some
ambulatory interventions, medical procedures and specialized medical check-ups.
Proceeding from different reasons (including financial), the doctors in St. Vincent’s
Hospital choose the scheme of reception of patients more convenient for them. The majority
prefers the reception by preliminary telephone call for a certain time. Such a way is
convenient also for the patients since in this case it is not necessary for them to wait long.
The duration of a patient’s reception makes on average 12-15 minutes, but it can also
make 30-40 and more minutes at primary reception, a combination of a “simple” survey to
the additional procedures or selection of blood tests, specification of these or those questions
by phone with the other establishments of health care, specialists, etc. There are no standards
which strictly regulate the duration of the working day of VOP in Australia.
The average annual salary of the ordinary intern in St. Vincent’s Hospital makes about
100-150 thousand Australian dollars, specialist - 300-400 thousand (in some cases much
higher); nurse - 65-75 thousand.
As well as in the majority of the other countries, hospitalization of the patients in the
hospital is carried out in two main directions: according to the plan and urgent medical
indications. The patients, delivered by a brigade of an emergency medical service, are
accepted the first.
The organization of nutrition both for patients and medical personnel is presented in a
very high level in the hospital. Every hospital patient is provided with three meals a day.
Moreover, the patients with diabetes are provided with a light diet snack with tea or coffee
during the consultation with endocrinologist.
NURSING/HEALTH 7
Performance management is important for the success of St. Vincent’s Hospital. The
main thing at efficiency increase is to provide the fulfillment of the operations in order to
satisfy the inquiries of buyers. The organization provides the patients with the medical
services they require.
Performance management is the major labor indicator; all main indicators of
production efficiency, and all labor indicators depend on the dynamics level: effectiveness of
medical services, a number of workers, etc. Performance management is closely connected
with the control of its change from the point of view of identification of adverse deviations of
a labor productivity level in definite periods of time.
St. Vincent’s Hospital uses the workforce planning in its performance management
system. Workforce planning can be a very difficult procedure with the use of computer
modeling and difficult mathematical methods for forecasting. The effective manager should
be responsible for the organization and planning of a workforce in his division or department.
Effective workforce planning in St Vincent’s Hospital can be represented as a
sequence of the following actions:
The analysis of the existing
resourses
Future needs forecast Planning of measures for
these needs satisfaction
Table 1. The Process of Effective Workforce Planning in St. Vincent’s Hospital.
Human resource managers in St Vincent’s Hospital are limited in their direct impact
on financial, material and energy aspects of productivity. These are prerogatives of the other
officials and divisions. However, human resource managers can and should have more
influence on a labor component of productivity. A competent human resource manager in St
Vincent’s Hospital can actively influence a level of executive discipline of workers and a
NURSING/HEALTH 8
philosophy of the overall management. Thus, they influence an increase of the hospital’s
effectiveness.
The accurate mechanism of motivation and estimation of the results for workers and
teams will inspire confidence that they will get the award for an effective work, and the
management of St. Vincent’s Hospitals will feel confidence that the goals achievement will
be performed with the greatest diligence and productivity. Such an acceleration of the
processes represents a dilemma for the majority of the organizations. The personnel of St.
Vincent’s Hospital demands the newest knowledge which it is necessary to give more often
and in conditions as much as possible close to occurring changes; however, training should
be conducted within the limits of the time they can spend on it.
Health Information Management (HIM) is a strictly structured service in St. Vincent’s
Hospital. In general, HIM includes diagnostics, treatment, prevention, expertise, and care for
the patients. Health Information Manage in St. Vincent’s Hospital administers all medical
records according to the current legislation and requirements of the hospital. The tasks of the
Health Information Manager include:
- Maintenance of the health information systems;
- Design of the medical records forms;
- Recruitment and training of the medical record staff;
- Organization of the efficient workflow;
- Control of the recorded information;
- Facilitation of the effective communication between the hospital staff and the
patients;
- Evaluation of the health care researches conducted within the hospital.
Medical records storage has a special system in St. Vincent’s Hospital. The exchange
of information is carried out in the NHIN network (Nationwide Health Information Network).
NURSING/HEALTH 9
The construction of this network was conducted under the direction of the Australian
Department of Health and Human Services Office of the National Coordinator. The used
technologies provide accuracy, efficiency and safety. Besides, they allow avoiding
redundancy and additional checks.
Possessing the means of medical information exchange, the patients can instantly
address to the medical records and receive the necessary help in any hospital’s department.
Owning to the implementation of the new program, the procedure of cards transfer occurs
within several seconds. Thus, as a result, the quality of medical services improved, the level
of the patients’ safety increased, and the efficiency of information exchange and rendering of
medical care grew.
Moreover, St. Vincent’s Hospital widely uses the Imaging module, which became
available to physicians in 2005. Its application gives the papers-free technology of work for
doctors and access to all medical images (also to video, photo and audio-materials, and
scanned documents).
St Vincent’s Hospital has a strategic plan for its development. According to the plan
2010-2015, many strategies aimed at the development of the hospital and its services will be
implemented up to 2015.
“St Vincent’s has enunciated a number of key short and long term objectives
in the recently issued St Vincent’s Strategic Plan 2010-2015. Some of the core
objectives are to:
- Build relationships with strategic partners;
- Strengthen surgery, medicine and interventional care;
- Deliver services of significance and value;
- Continue to innovate to grow a smarter business focussed on the future;
NURSING/HEALTH 10
The manner in which these objectives are to be achieved is set in detail in the
Strategic Plan 2010 - 2015. St Vincent’s measures its performance in detailed
monthly Finance and Activity reports that are issued to the Senior Executive,
Board and Department of Health” (St. Vincent’s Hospital: 2009).
NURSING/HEALTH 11
References
Department of Health. (2010-2011). “Statement of Priorities”. Available at:
http://www.health.vic.gov.au/hospitals/sops/st_vincents_signed1011.pdf
General Medical Admissions at St. Vincent’s Hospital Melbourne: Nature of Patients and
Factors Influencing Length of Stay. Available at:
http://imsanzconference.co.nz/september/edit/ftpuploads/1665759958_cimsanz0912ab
stract00075%20Tey%20C.pdf
History of St. Vincent hospital, Melbourbne. (2009). “About St. V’s”. Available at:
http://stvcancercentre.org.au/about-stvincents/history.htm
St. Vincent’s Hospital Melbourne. (2012). St. Vincent’s Hospital Melbourne Campus Map.
Available at:
http://obesityconsortium.unimelb.edu.au/about_us/about_us_extra_files/svhmmap.pdf
St. Vincent’s Private Melbourne. (2012). “Our History”. Available at:
http://www.stvincentsmercy.com.au/about/history/
St. Vincent’s Hospital Melbourne. (2012). “Information and Guidelines for Undergraduate
Nursing Students and Clinical Educators”. Available at: http://library-
macfields.swsi.wikispaces.net/file/view/Information+for+Students+clinical+placemen
ts.pdf
St. Vincent’s Hospital (Melbourne) Limited. (2009). “Report of Operations. Financial
Statements”. Available at:
http://www.svhm.org.au/aboutus/newspublications/Documents/Financial%20Stateme
nts%20and%20Report%20of%20Operations.pdf
Yellow Pages. (2012). “St Vincent’s Hospital Melbourne”. Available at:
http://www.yellowpages.com.au/vic/fitzroy/st-vincents-hospital-melbourne-
12424199-listing.html