On 21 December 2015, the Queensland Office of the Health Ombudsman ("OHO") issued its investigation report into the quality and safety of maternity services at Beaudesert Hospital, part of the Metro South Hospital and Health Service (MSHHS).
Background
The Beaudesert Hospital is a rural health facility which provides low-risk birthing and procedural services, categorised as a Level 3 within the Clinical Services Capability Framework ("CSCF"), which means that the facility can provide low to moderate complex inpatient and ambulatory care services.
In July 2014, the OHO and MSHHS both received a complaint from a member of staff at the hospital regarding the clinical communication and managerial skills of a medical practitioner. The OHO commenced its investigation into the allegations against the medical practitioner, while the MSHHS commissioned an independent clinical review of maternity services at the hospital.
Independent Clinical Review
In December 2014, the MSHHS produced the findings of the independent review to the OHO. The reviewers made recommendations including that Queensland state-wide Maternity and Neonatal Clinical Guidelines are used to guide the care of patients, and that those guidelines be incorporated into local procedures or work instructions.
The reviewers also recommended that consideration be given to a review of antenatal care for women who are not suitable to deliver at the hospital, and there be improved communication and documentation between the hospital and the alternative care provider.
Finally, the reviewers noted that the overarching clinical governance was being reviewed and that changes had been implanted including "robust guidelines for the acceptance of obstetric patients and weekly clinical review meetings attended by a consultant obstetrician".
OHO Investigation
On 30 March 2015, the OHO issued MSHHS with a notice pursuant to section 228 of the Health Ombudsman Act 2013 requiring information on:
- How the recommendations of the Independent Clinical Review were distributed to staff;
- What action had been taken since the findings of the Review were released;
- The outcomes as a result of the actions taken; and
- The future actions established as a result of any outcomes.
The MSHHS provided the OHO with the details of the actions taken, including a comprehensive plan which included 21 individual recommended actions with associated timeframes for implementation. All 21 actions had been implemented, and most were subject to ongoing monitoring requirements.
Following consideration, the OHO was of the view that there were no deficiencies in the recommendations, nor any issue with their implementation, and that the MSHHS had taken appropriate action to improve the clinical services within the Beaudesert Hospital maternity unit. The MSHHS had addressed any issues by implementing initiatives and improvements to the local work instructions. Any risk to public health and safety had also been appropriately managed.
