HEALTH CARE SERVICES IN NEW SOUTH WALES PUBLIC HOSPITALS

QUESTION

The purpose of this assignment is for you to demonstrate your ability to identify the implications of the Final Report of the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals, and the impact that it will have on you as a newly Registered Nurse. To achieve this you will need to consider the impact / implications of the Garling Report on health services in NSW, the services provided for your particular sub-major, and for you as a new Registered Nurse entering the workforce. It is hoped that this assessment will enable you to be suitably informed about the health system that you will be entering in your transition year as a Registered Nurse.

Firstly, you are required to give an overview of the major findings of the Garling Report, with particular emphasis on your sub-major. Secondly, you are required to identify two (2) issues pertaining to your sub-major. Choose two of the following;

• Child and adolescent mental health
• Referrals to specialist children’s hospitals
• Transfer of care of complex paediatric patients to other hospitals
• Transition of complex paediatric patients to adult hospitals

SOLUTION

In this assignment the author outlines the major findings in the health care system in the New South Wales Public hospitals and the impact of such acute care services on a newly registered nurse. Garling Report on health services in NSW undertaken by Commissioner Peter Garling in 2008 was referred, to consider the impact on health services. NSW has many public hospitals known for their enormous and modern infrastructure and health care facilities around the world. Around 27% budget of the NSW state government is spending on health care. The hospitals have well trained doctors, nurses and clerical staff along with the most sophisticated medical care, excellence centers for burns, major trauma and intensive care. Even the organ transplant procedures are carried out for free. Although the hospitals have such state of the art medical care facilities even then there are found alarming reports against the health care system of these hospitals in the media. Therefore the author makes an inquiry into the health care services and its impact on a newly registered nurse in the hospitals of NSW taking into consideration Garling Report.

Overview of the Major findings and recommendation of Garling Report

Commissioner Peter Garling undertook an inquiry into the health care system of the NSW hospitals after getting repeated complaints concerning rising number of deaths in public hospitals, longer waiting periods for surgery, medical staff resigning from public hospitals, delays in emergency wards, claims of bullying, cases of miscarriage etc. The Commissioner formed a Garling Report which enclosed major findings and recommendations to reform the NSW health system. The present assignment focuses on the Major findings and Recommendations of the Garling Report in health sector and as a new registered nurse.

Findings in Health Care System

As the population is increasing, more people are visiting the hospitals. The elderly patients having complex and chronic conditions require utmost care of the specialist and longer duration of stay. With better health care facilities, mortality rate has decreased and almost 45% patients in public hospitals are over 65 years of age. The cost of treatment is rising similar to the number of patients. There is also shortage of skilled workforce. The demographic changes and fewer rewards in kept the skilled persons away from these hospitals. Further a check was made by commonwealth in 1990s for the entry of doctors into the workforce which added to the shortage of doctors. Therefore it was found that NSW hospitals are good by world standards but sometimes incapable to deal with increasing number of patients, rising cost of treatment and shortage of workforce.

Recommendations of Garling Report

Teamwork- In order to solve the issue of shortage of staff, the doctors and nurses should work as a team and they should attend to the patient collectively. Instead of examining the patient individually, doctors should work towards single direction and clear principles that is treating the patient.

Use of information technology- data relating to patient safety and care should be made available in real time. Bureau of health information may be established to interpret and report all data relating to patient care.

Training for new doctors- an institute of clinical education and training should be established to train new doctors, nurses and health professionals for team based treatment of patients

Model of care

Supervision of junior doctors- The junior doctors should be properly supervised even after the regular 9 am to 5 pm routine hours. Inexperienced staff when inadequately supervised can lead to danger to the patient’s life. Junior doctors should never be discouraged to ask for help or advice from seniors and the latter should extend their guidance considering the health of patient as prime motive.

Electronic medical records- sometimes the information and data about a patient are not properly communicated and even notes written by doctors are in poor handwriting. Therefore an electronic medical record should be prepared for the dosage of drugs. To avoid medication errors, a clinical pharmacist should take ward rounds.

Infection from doctors- doctors should practice hand hygiene before and after seeing each patient.

GF08