Hawke’s Bay Hospital is in the process of completing and implementing recommendations regarding its radiology service after a damning report noted a “culture of learned helplessness”, with a belief amongst staff that clinical issues and risks were known but no resolutions offered.
The Report on External Review of Te Whatu Ora Te Matau a Māui Hawke’s Bay Radiology Services made 18 recommendations.
As of October 3, 2023, six of those recommendations have been completed, 11 are still in progress and one has been accepted in principle.
According to an Official Information Act (OIA) response to BayBuzz, the first recommendation to be completed by the hospital was recommendation 1 – Establishment of a Te Whatu Ora Report Implementation Oversight Group.
The first priority of this group was to prioritise and establish timelines with appropriate clinical engagement, for addressing each recommendation.
Interim Lead – Hospital and Specialist Services Te Matau a Māui Hawke’s Bay Paula Jones said the oversight group was meeting to progress the remaining recommendations.
Responding to another recommendation, Jones said a regional clinical governance board was now in place with an established risk register.
“Terms of reference have been agreed and a digital clinical subgroup is being set up which will focus on the central region. This will include adopting lessons identified and learned from other parts of the motu.”
Other recommendations regarding improvement and upgrading of digital information systems are being implemented.
Safety1st is the risk reporting tool in use in the region, and per another recommendation, a full review of the system, process and training has occurred with refresher courses ongoing. High trust relationships with the patient safety and quality teams have been developed and there is an ongoing engagement and training curriculum to ensure current staff are upskilled and new staff are inducted appropriately.
A key “urgent” recommendation related to reduction and investigation into patient harm. Response to that is still underway.
Jones said while there was little evidence to support claims of extensive significant patient harm, a review of the Safety 1st and other regional risk reporting tools were underway. The concern here is that test results were at times not seen by referring doctors.
“The target of the review will be in cases where the pattern of the ordering and sign off would indicate a high risk of the report not being sighted by the referring clinician.”
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