Health CEO Department Chris Hosking talks health system, code yellow and ACACIA IT System rollout again

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Episode Transcript

Speaker 1 (00:00):
We know that up to one thousand healthcare support workers

(00:02):
they're expected to take that protected industrial action on Monday.
They say they want to increase pay and what the
union's described as better conditions. Now they're going to be striking.
From what the head of the union, Erina Early, told
us earlier in the week, they're going to be striking
on Monday at eleven am for one hour. What impact
is this going to have on our major hospitals. Well,

(00:25):
joining me on the show is Chris Hosking, the CEO
of MT Health. Good morning to you.

Speaker 2 (00:30):
Chris, Good morning Cody, and good morning to you listeners.

Speaker 1 (00:34):
Chris. What efforts are going to be made on Monday
to ensure that this protected industrial action doesn't impact patients
at our hospitals across the territory.

Speaker 2 (00:45):
Yeah, thanks Cody. In the event that the United Workers'
Union proceeds with that action on Monday, we have a
range of business continuity measures in place to ensure that
patients and the public will be able to continue to
receive services uninterrupted. And in parallel with that, the government

(01:10):
is continuing to negotiate in good faith with the United Workers' Union,
and I know the Commissioner for Public Employment and their
team is actively engaging with unions and there've been negotiation
meetings this week, so I'm actually hopeful that we don't
see that industrial action take place. Obviously, we respect the

(01:31):
rights of the unions to exercise industrial action through the
proper channels if that's the views of their members, but
I'm optimistic that that may not be necessary to move
those negotiations along, and in the event that it does,
Territorians can be well assured we've got measures in place
to deal with that.

Speaker 1 (01:50):
Yeah, I feel the same crise. I hope that it
doesn't go ahead, you know, particularly after last week and
it was lifted earlier this week the Code yellows of
course at Royal Darwin and Palmerston Regional Hospital. I just,
you know, I don't feel like it's the right time.
But as you touched on, I know the unions and
the members certainly have the right to do that. But yeah,

(02:11):
I hope that it doesn't go ahead. As I mentioned,
we know that that Code yellow has only just been
lifted at Royal Dalen and Palmerston Hospitals. It was the
first since July, but workers say the issues at the
facilities haven't changed from your perspective, what prompted that declaration
and how are things tracking?

Speaker 2 (02:32):
Yeah, thanks Cody, And certainly there's a structured process we
go through if we do call a code yellow, and
that comes to me as the chief executive, to sign
off on. In simple terms, it's really about patient numbers,
patients in versus patients out. And we had been seeing

(02:52):
an uptech in not so much just the volume of
presentations at the hospital, but the people who were coming
in to get treatment. We're crooker than usual, and that
led to them staying in hospital for longer in some cases,
you know, weeks not days, and that means that our
discharge rate falls away and we end up with very

(03:14):
large numbers on the wards and large numbers are queued
up in the ed waiting to get a bed. And
when we reach a point and we use a bunch
of metrics to calculate this, and it just reached the
point where we declare the code yellow, which does a
number of things. I guess. It sends a really strong
message to the staff that we're taking we're intervening and

(03:37):
taking action. But more importantly, we activate messaging to the
public to say, hey, look, we're experiencing bed pressures if
you're feeling a bit crook, and maybe think about seeing
your GP or go to the urgent care clinic. If
you're really sick and you need hospital care, you please
turn up at Rhodarwen at the ED and you will

(03:59):
get scene where the public health system and we take
absolutely everybody. But you know, if you've got a cold
or a flu or a minor ailment, we encourage you
perhaps not to use the ED as an alternative to
your GP, which I know is tough. It's I had
a GP appointment earlier this week, Katie, and I waited
two weeks to get it. So sometimes easier said than done.

Speaker 1 (04:21):
Yeah, spot on, It can be really difficult. And probably
that you know, that brings me to the next question
I've got for you. We've been in undated by listeners
over the last week or so, some of them telling
us about some pretty shocking experiences that they've had through
the health system. And I know it can be tough,
you know, in terms of like you touched on, not

(04:42):
being able to get to your GP to begin with
and then sort of you know, getting to the next points.
But one man waiting three years for a rehab follow
up appointment, a parent waiting hours for an X ray
for their child and then having to return another day,
and tragically, a wife who lost her husband after what
she says was a lack of diagnosis, and still waiting

(05:05):
on a final report on what happened. Now, many have
lodged complaints and they say they don't hear from anyone,
or they don't hear from anyone after a very long time.
What assurances, if any, can you provide to residents. Well,
you know that those complaints are being processed and that

(05:25):
there are improvements being made following those complaints.

Speaker 2 (05:32):
Yeah, yeah, thank you, Katie. Look, I would say a
couple of things in response to that. First and foremost,
as a health provider, we absolutely welcome feedback from the public,
whether it's good, bad, or somewhere in between. So if
people have had a negative experience, we strongly encourage them
to report that through the reporting channels, and we've got

(05:56):
established channels for that, which you can find on our
websit or our social media footprint or any of those
places where we have a public presence. And I would
also say we're absolutely committed to providing the best care
we can to patients. I'm very sure. We don't get
it right every single time. And that example you used

(06:18):
of a fellow who'd been waiting a very long time
for a particular procedure. I am having that matter looked
into it at the moment and will certainly be responding to
that family once I've got all the facts in front
of me. But we have a number of established channels
and if people feel that they're not getting listened to
by the Health Department and by the existing complaint handling channels.

(06:42):
I mean, we have a complaints team who works centrally
in the Health Department across all of our health services
and handle this and the interaction with patients every day,
and there is an independent Health Complaints Commission that people
can escalate their concerns too. I'm not necessarily encouraging people
in that direction. That's generally when you can't get your

(07:03):
matter resolved through the proper channels, But there is an
escalation process there. But I do, I guess make the point.
We look into each and every one of those and
we do get back to people. Sometimes it takes a
bit of time, particularly if it's a clinically complex matter.
Now that the three year example sounds dreadful at face value,

(07:27):
and we'll certainly look into that one very carefully. But
I guess the message I would send to Territorians is
we do have a hospital system here in the territory
that is at capacity. It's no secret I've been very
publicly vocal about the fact that we don't get a
fair funding deal from the Commonwealth and we're advocating very

(07:50):
strongly to try and rectify that structural budget deficit and
to improve our infrastructure footprint. Unfortunately, we have of health
infrastructure and facilities here, most of which are were built
pre self government and pre cyclone Tracy, and we've pretty

(08:10):
much outgrown them. And we need a fairer deal in
funding from our Commonwealth partners, and we are going to
need in the next five to ten years a new
tertiary hospital in the top end. Royal Owen's was commissioned
not long after Cyclone Tracy, and it really is an
end of life. It's not an appropriate design for the

(08:33):
tropics and it's an old building.

Speaker 1 (08:35):
Chris, how are we going to get that? Like, how
are we ever going to get the funding for that
when we can't even get the thirty five million that
you guys requested for maternity services. Do you know what
I mean? Like, it's going to be a real stretch.

Speaker 2 (08:47):
It's going to be a battle, Katie, but it's one
we're up for and we have started the work there already.
So we've already done some initial analysis with our Infrastructure
Department and we have opened that discussion with our federal colleagues.
I mean, obviously, a new hospital for the top end
is a five to ten year journey, but it's also

(09:08):
one that would be measured in billions, not millions, and
hence we need a lot of help from the Commonwealth
to be able to get there. But what people may
not realize is Cyclone Tracy was being built. Sorry, Broad
Oarwen was being constructed prior to Cyclone Tracy. The cyclone
obviously derailed that a bit, but the construction was finished

(09:28):
off in the seventies and it's really at the end
of its life and it's time we stopped tacking bits
on the side and took a really measured, strategic approach
to this. And it's on my list of top five
things that I'm working through my Minister to progress and
I'm absolutely committed to providing something better for Territorians over

(09:52):
the longer term.

Speaker 1 (09:52):
Well, look, I think a lot of people would agree.
We know that the infrastructure there at the hospital is
it's old. There is no other way to put it. Chris,
just going back to some of those issues that our
listeners have told us about, I do want to say
that I know that our hospital staff do an incredible
job under really what can be really difficult circumstances. We
know that we've got one of the busiest hospitals I

(10:14):
would imagine in Australia. I guess the thing that I
hear from those listeners though, when we do have them
contact us about these issues, is what they really want
is for nobody else to have to go through the
same thing that they've gone through. So, you know, without
going into specific details on each of those incidents, but
when a complaint is received by the department, are there

(10:36):
different ways that you then look into it to go
how can we make sure that we don't have this
happen again? Or you know that we we don't have
people rocking up for appointments and sending them home to
come back two weeks later. You know, for something that
they should be able to get in there and be
seen for.

Speaker 2 (10:56):
Yeah, Look, we certainly do, Katie. We when we investigate
these matters, we will make a set of findings and
we'll always report that back those to the clinical units
who administer the care, and quite often that might be
you know, generally, when something doesn't go smoothly in an
episode of care, there's not one key mistake you can

(11:19):
point to. It's usually a series of actions, and sometimes
it involves multiple teams. So we'll bring those teams together,
whether it's doctors, nurses, or administrative stuff, and we'll look
at what went wrong, what lessons we can take away
from that, and how we can modify our standard procedures
and protocols to try and do better. Are mindful, you know,

(11:42):
human beings can always make a human error, and we
all understand that. I think we probably all make one
of those every now and then, and that's to be expected.
But where it's an issue in terms of clinical protocols
or procedural practices, we do the work to ensure that
we codify into that. I'm not saying we get it

(12:03):
one hundred percent right one hundred percent of the time,
but I know our teams do a cracking job of
trying to make sure that doesn't happen again. And I
often underquite trying circumstances, as you've mentioned.

Speaker 1 (12:14):
Chris, a couple of quick ones before I let you go.
This morning, we know the Acacia computer system. It's being
rolled out again across facilities after it was suspended. What's changed,
and you know, do you have assurances for those stuff
that it's going to not cause havoc for them when
trying to use it.

Speaker 2 (12:34):
Well, I certainly hope so, Katie, because it went live
in the emergency department at about ten to seven this morning.
So we are working on Acacia in our emergency department
now as for the last couple of hours, and I'm pleased
to report it's all going really smoothly. So we had
a team who worked through the night to do that

(12:54):
and it's been a very smooth transition. And I've been
speaking with people on the floor at the emergency department
throughout the night and this morning, and so far that's
all going really well. And we've done a comprehensive amount
of work to the system to address some of the
concerns that our emergency clinicians raised last year that were

(13:16):
frustrating them. The software we use here is a product
called track Care, which is used in hospitals all over
the world, but we've done a lot of work to
adapt it to the way clinical patient flows happen in
Rhodeen Hospital, and some of the concerns that our senior
doctors had about being able to examine aggregate data of

(13:37):
large cohorts of patients have been addressed through some really
innovative real time patient dashboards which give senior doctors far
more intuitive tools. And we've done all of that work
by our software engineering teams and our software vendor and
our doctors working side by side in what we'd call

(13:59):
a code of process. So we've done the work together
to make sure that those system changes are informed by
clinical practice and what works for doctors and nurses. So
we're really optimistic that that will be the end of it.
And I'm also really pleased to say that that reintroduction
in the emergency departments sees the system fully rolled out

(14:23):
across all of our public hospitals in the territory and
enables us to stop using our old legacy system that
was part of the reason for doing that particular project
in the first place.

Speaker 1 (14:34):
Well, hopefully it all continues to run smoothly, Chris, before
I let you go, where are we at? I touched
on this before with these maternity services, we heard obviously
ten million dollars from the Health Minister as being more
the figure that we're looking at instead of thirty five
to boost maternity services at Royal Darwin Hospital. Is there
another meeting coming up or where's this that from your perspective?

Speaker 2 (14:58):
Yeah, So, look, we've been the active discussions with the
Commonwealth Health Department since the maternity forum that occurred in
Darwin a couple of weeks back, and we've progressed that along.
It's been made quite clear to us that the Commonwealth
is more supportive of the more moderate number or in
the ten million dollar vicinity, and we've just in recent

(15:22):
days provided a whole bunch of detailed information between senior
officials about how that will be deployed within rolled down.
So we don't actually have our hands on the check yet, Katie,
but we've given the Commonwealth the sort of the details
of how that will be used within the hospital and
we're optimistic that we'll be able to get our hands

(15:45):
on the funding very soon.

Speaker 1 (15:46):
I know your press for time, as am I, but
what is that ten million dying to deliver.

Speaker 2 (15:52):
Look, it will deliver a range of refurbishments to the
environment where you come to have your baby. At the
hospital I've mentioned Ardie H is old and it's a
bit run down and it's perhaps not as aesthetic and
pleasing an environment as a private hospital experience, and we
certainly can't compete with the private sector. But had we

(16:13):
been able to secure the thirty five million, we could
have done some internal building works and co located all
maternity services in one spot. We won't be able to
do that for ten but we will be able to
do some really, really nice refurbishment, so for mums and
families who come to Rule Darwen to have their baby,
it'll be a much more pleasant experience and a nicer

(16:35):
environment than it is today.

Speaker 1 (16:36):
Well, Chris Hosking, the CEO of the Department of Health,
we will leave it there. Thanks so much for your
time this morning. Greatly appreciate it.

Speaker 2 (16:44):
Thank you KD and thank you to your listeners.

Speaker 1 (16:46):
Thanks so much.