Statement of Compliance
To the Hon Bob Kucera MLA
MINISTER FOR HEALTH
In accordance with Section 66 of the Financial Administration and Audit Act 1985, I
hereby submit for your information and presentation to Parliament, the Report of
Metropolitan Health Services for the year ended 30 June 2002.
This report has been prepared in accordance with the provisions of the Financial
Administration and Audit Act 1985.
Mike Daube
DIRECTOR GENERAL OF HEALTH
Accountable Authority for The Minister for Health in his
capacity as the Deemed Board of Metropolitan Public Hospitals
14 March 2003
Annual Report 2001/2002 Metropolitan Health Services
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Contents
ANNUAL REPORT
The past year has seen significant changes in the WA health system, in the context of an
increasing recognition of its place in to our national health system.
The State Government health system does not exist in isolation. We work alongside other
Government and non-Government services in the context of a national health system that
remains fragmented and at times competitive. Much of our work and many of our
challenges are informed by national and international trends, and decisions taken
elsewhere. Nowhere is this clearer than in areas that tend to attract most public attention
and place the greatest stresses for our system, such as workforce issues and the
pressures on our teaching hospitals. These are understandably seen locally as local
problems for local solution, but the reality is that they are significantly influenced by
international trends and national policy and funding decisions.
We in Western Australia face all the challenges of contemporary health systems, together
with high community expectations and often optimistic or disingenuous expectations that
long-standing problems faced by all health systems can be resolved overnight in our
State.
Against this backdrop have been steadily implementing change to ensure that the WA
Government health system is as well placed as possible to face the challenges of the
future. While ever more conscious of the size and complexity of our system and the
challenges we face, remain optimistic that with good support and community
understanding we can move well towards achieving our common objectives.
Our community enjoys outstanding health and health care by any standards. When we
see and hear about problems we face, it is tempting to imagine that our system is failing
us overall or that we are doing badly by national or international standards.
Of course there are areas of deficit, but Western Australians enjoy some of the best
health and health care in the world. We live longer than people in almost all other
countries, and even within Australia some parts of Western Australia are notable for the
longevity of their populations.
Our health professionals are as well trained and qualified as those anywhere around the
world, and we rightly adopt the most stringent standards in relation to their training and
practice.
Those in the system will be more aware than any others of areas in which we can do
better, but above all our community should be aware and rightly proud that we have a
system in which first class professionals deliver high quality health care to a community
with health outcomes that would be envied in almost any other country.
The world of health and health care has changed dramatically in recent years, and
especially in the last decade. Around Australia, Governments and health systems are
faced with identical problems and pressures including increasing costs of labour,
equipment and pharmaceutical products, the changing roles of health professionals, a
Annual Report 2001/2002 Metropolitan Health Services
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Contents
very proper emphasis on quality (and the inevitable costs and changes that this will
impose on us), the needs of ageing populations and more.
The Department of Health is a vast and complex organisation, employing some 30,000
staff operating from more than 650 sites around the State. It is not a simple agency. We
deliver some services ourselves; we work collaboratively with Commonwealth and local
Governments; and we fund several hundred non-Government organisations, ranging in
size from those such as St John Ambulance Association and the Royal Flying Doctor
Service to small groups providing equally important local services.
During 2001/2002 we restructured the Department so that it is now a single unified health
system. We now have a State Health Management Team, which works as a single
Departmental Executive Committee. The four Metropolitan Areas have been established.
Our Country Health Services have been rationalised; and an enormous amount of work
has been carried out to move away from silo mentalities and towards a recognition that
we must indeed work as a unified system.
During the year, the Department has recognised its responsibilities arising out of matters
such as the Douglas Report on King Edward Memorial Hospital, as well as resolving
some important industrial negotiations.
As the work of consolidation, always slower than one would hope, develops, my hope is
that during the coming year we will be able to address further some of the high profile
priorities for both Government and the community – for example coping with winter
pressures, reduce waiting lists and valuing and supporting our workforce; that we will be
able to demonstrate our values as a health system committed to quality, prevention and
remedying disadvantage; that we will be able to focus on the medium and long term
planning that are crucial if the needs of the next generation are to be well serviced; and
that we will be able to engender an understanding in the community of the national and
international context within which our system works. In the latter regard, negotiations on
the next phase of the Australian Health Care Agreements will be of fundamental
importance.
I would like to convey special appreciation to all the staff and volunteers working within
the Department of Health. They know as well as anyone else the pressures we all face,
but also the excellent service they provide and the commitment they display on a daily
basis.
Mike Daube
DIRECTOR GENERAL
Annual Report 2001/2002 Metropolitan Health Services
iii
About Us
Statement of Compliance
Director General's Overview
Report on Operations
About Us
Address and Location
1
Mission Statement
5
Broad Objectives
5
Compliance Reports
Enabling Legislation
6
Ministerial Directives
6
Submission of Annual Report
6
Statement of Compliance with Public Sector Standards
7
Electoral Act 1907 — Advertising and Sponsorship
8
Freedom of Information Act 1992
9
Achievements and Highlights
Armadale Health Service
13
Bentley Health Service
15
Fremantle Hospital and Health Service
17
Graylands Selby–Lemnos and Special Care Health Services
20
Kalamunda Health Service
23
King Edward Memorial Hospital and Princess Margaret Hospital
24
North Metropolitan Health Service
26
Perth Dental Hospital and Community Dental Service
29
Rockingham Kwinana Health Service
31
Royal Perth Hospital
34
Sir Charles Gairdner Hospital
37
Swan Health Service
40
Major Capital Projects
43
Management Structure
Organisational Chart
46
Accountable Authority
47
Senior Officers
47
Pecuniary Interests
48
Annual Report 2001/2002 Metropolitan Health Services
iv
About Us
Our Community
Demography
49
Available Services
51
Disability Services
53
Cultural Diversity and Language Services
55
Youth Services
56
Our Staff
Employee Profile
58
Recruitment Practices
62
Staff Development
63
Industrial Relations Issues
64
Workers’ Compensation and Rehabilitation
65
Equity and Diversity Outcomes
66
Keeping the Public Informed
Marketing
69
Publications
70
Research Projects
Research and Development
71
Evaluations
74
Safety and Standards
Risk Management
75
Internal Audit Controls
76
Waste Paper Recycling
76
Pricing Policy
77
Key Performance Indicators
Auditor General's Opinion
78
Certification Statement
79
Audited Performance Indicators
80
Financial Statements
Auditor General's Opinion
181
Certification Statement
183
Audited Financial Statements
184
Annual Report 2001/2002 Metropolitan Health Services
v
About Us
Address and Location
Metropolitan Health Services
189 Royal St
EAST PERTH WA 6004
PO Box 8172
Perth Business Centre
PERTH WA 6849
( (08) 9222 4222
9 (08) 9222 4046
* PRContact@health.wa.gov.au
ý www.health.wa.gov.au
Legal title
The correct legal title for the Metropolitan Health Services is "The Minister for Health in
his capacity as the Deemed Board of Metropolitan Public Hospitals".
Component health care units
The Metropolitan Health Services are also made up of the following health care units:
Armadale Health Service
3056 Albany Hwy
ARMADALE WA 6112
( (08) 9391 2000
9 (08) 9391 2129
* ahs@health.wa.gov.au
ý www.ahs.health.wa.gov.au
Bentley Health Service
18–56 Mills St
BENTLEY WA 6102
( (08) 9334 3666
9 (08) 9356 1632
* david.owen@health.wa.gov.au
ý www.health.wa.gov.au/bhs/
Annual Report 2001/2002 Metropolitan Health Services
1
About Us
Fremantle Hospital and Health Service
Fremantle Hospital
Alma St
FREMANTLE WA 6160
PO Box 480
FREMANTLE WA 6959
(
9
*
ý
(08) 9431 3333
(08) 9431 2921
firstname.secondname@health.wa.gov.au
www.fhhs.health.wa.gov.au
Rottnest Island Nursing Post
ROTTNEST ISLAND WA 6161
(
9
(08) 9292 5030
(08) 9292 5121
Woodside Maternity Hospital
18 Dalgety St
EAST FREMANTLE WA 6158
(
9
(08) 9339 1788
(08) 9319 1245
Graylands Selby–Lemnos and Special Care Health Services
Graylands Campus
Brockway Rd
MOUNT CLAREMONT WA 6010
(
9
(08) 9347 6600
(08) 9385 2701
Selby–Lemnos Campus
Lemnos St
SHENTON PARK WA 6008
(
9
(08) 9382 0800
(08) 9382 0820
Kalamunda Health Service
Elizabeth St
KALAMUNDA WA 6076
(
9
(08) 9293 2122
(08) 9293 2488
Annual Report 2001/2002 Metropolitan Health Services
2
About Us
King Edward Memorial Hospital and Princess Margaret Hospital
King Edward Memorial Hospital for Women
374 Bagot Rd
SUBIACO WA 6008
(
9
ý
(08) 9340 2222
(08) 9388 1780
www.pmke.wa.gov.au
Princess Margaret Hospital for Children
Roberts Rd
SUBIACO WA 6008
(
9
ý
(08) 9340 8222
(08) 9340 8111
www.pmke.wa.gov.au
North Metropolitan Health Service
Osborne Park Health Campus
Osborne Pl
STIRLING WA 6021
(
9
ý
(08) 9346 8000
(08) 9346 8008
www.health.wa.gov.au/NorthMetro
Perth Dental Hospital and Community Dental Services
43 Mt Henry Rd
COMO WA 6152
( (08) 9313 0555
9 (08) 9313 1302
ý www.dental.wa.gov.au
TTY (08) 9313 2085
Rockingham Kwinana Health Service
Corporate Office
Elanora Dr
COOLOONGUP WA 6168
(
9
(08) 9592 0600
(08) 9592 1621
Kwinana Community Health and Development Centre
Peel Ct
KWINANA WA 6167
(
9
(08) 9419 2266
(08) 9439 1088
Annual Report 2001/2002 Metropolitan Health Services
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About Us
Rockingham Kwinana District Hospital
Elanora Dr
COOLOONGUP WA 6168
(
9
(08) 9592 0600
(08) 9592 1621
Rockingham Kwinana Mental Health Services
Ameer St
ROCKINGHAM WA 6168
(
9
(08) 9528 0999
(08) 9529 1266
Royal Perth Hospital
Wellington St Campus
Wellington St
PERTH WA 6000
(
9
ý
(08) 9224 2244
(08) 9224 3511
www.rph.wa.gov.au
Shenton Park Campus
6 Selby St
SHENTON PARK WA 6008
(
9
ý
(08) 9382 7171
(08) 9382 7351
www.rph.wa.gov.au
Sir Charles Gairdner Hospital
Hospital Ave
NEDLANDS WA 6009
(
9
ý
(08) 9346 3333
(08) 9346 2534
www.scgh.health.wa.gov.au
Swan Health Service
Eveline Rd
MIDDLE SWAN WA 6056
PO Box 195
MIDLAND WA 6396
(
9
(08) 9347 5244
(08) 9347 5255
Annual Report 2001/2002 Metropolitan Health Services
4
About Us
Mission Statement
Our Mission
To improve and coordinate the delivery of public health services and access to public
hospitals in the metro area.
Broad Objectives
The vision of the Metropolitan Health Services is to be recognised as a provider of high
quality, accessible and integrated publicly-funded health services in the metro area.
In particular, the objectives of the MHS are:
•
To establish an integrated Health Service for the metropolitan area based on equity of
access and resource allocation.
•
To provide high quality, patient-focused health services.
•
To promote health service delivery based on the best available scientific evidence and
judgement.
•
To operate according to the principles and practices of good corporate governance.
Annual Report 2001/2002 Metropolitan Health Services
5
Compliance Reports
Enabling Legislation
The Metropolitan Health Services is incorporated under the Hospitals and Health
Services Act 1927, which provides for the establishment, maintenance and management
of public hospitals, and for incidental and other purposes.
The Minister for Health, Hon. R. C. Kucera APM MLA, is incorporated as the board of the
Hospitals formerly comprised in the Metropolitan Health Service Board under Section 7 of
the Hospitals and Health Services Act 1927, and has delegated all the powers and duties
as such to the Director General of Health.
Ministerial Directives
The Minister for Health did not issue any directives on Health Service operations during
2001/2002.
Submission of Annual Report
Approval was sought under the Financial Administration and Audit Act 1985 to extend the
Metropolitan Health Services’ deadline for submission of key performance indicators and
financial statements to the Auditor General to 14 October 2002.
Annual Report 2001/2002 Metropolitan Health Services
6
Compliance Reports
Statement of Compliance with Public Sector Standards
In the administration of the Metropolitan Health Services, I have complied with the Public
Sector Standards in Human Resource Management, the Western Australian Public
Sector Code of Ethics and our Code of Conduct.
I have put in place procedures designed to ensure such compliance and have undertaken
appropriate internal processes to satisfy myself the statement made above is correct.
Such processes include:
• Conducting regular reviews of human resource policies to ensure consistency with
public sector standard requirements, and to promote best practice and quality
assurance.
• Incorporating broad consultation and employee input into policy development, and
ensuring these policies are widely communicated and accessible. This process
provides all employees with an awareness and ownership of human resource policies.
• Providing a comprehensive induction and orientation program that raises staff
awareness of the Code of Ethics, the Code of Conduct and other relevant human
resource policies and practices. The review of our Code of Conduct is a current
priority.
• The provision of relevant, comprehensive training programs to managers and
employees to ensure those in attendance have a knowledge and understanding of
human resource processes and compliance requirements. Reviews and audits are
also conducted on relevant paperwork and processes to ensure continued
compliance.
• Providing human resource staff — through their attendance at appropriate training
workshops and seminars — with skills enabling them to provide accurate advice and
support to managers and employees in all areas of human resource management.
The applications made to report a breach
for the reporting period are:
• Number of applications lodged
• Number of material breaches found
• Applications under review
in standards and the corresponding outcomes
17
None
None
The Metropolitan Health Services has not been investigated or audited by the Office of
the Public Sector Standards Commissioner for the period to 30 June 2002.
Mike Daube
DIRECTOR GENERAL
Accountable Authority for The Minister for Health in his
capacity as the Deemed Board of Metropolitan Public Hospitals
14 March 2003
Annual Report 2001/2002 Metropolitan Health Services
7
Compliance Reports
Electoral Act 1907 — Advertising and Sponsorship
The following table lists the expenditure on advertising and sponsorship made by the
Metropolitan Health Services published in accordance with section 175ZE of the Electoral
Act 1907:
CLASS OF EXPENDITURE
Advertising Agencies
Market Research Organisations
Polling Organisations
Direct Mail Organisations
Media Advertising Organisations
TOTAL
1999/2000
$
2000/2001
$
4,218.00
192.00
–
295.00
8,265.00
17,239.00
8,888.00
–
–
11,070.00
$12,970.00*
$37,197.00*
2001/2002
$
712,558.04
–
–
295.30
3,575.80
$716,429.14
*Advertising and sponsorship data reported for 1999/2000 and 2000/2001 do not include expenditure for
advertising staff vacancies or activities conducted by hospital foundations.
Annual Report 2001/2002 Metropolitan Health Services
8
Compliance Reports
Freedom of Information Act 1992
The Metropolitan Health Services received and dealt with approximately 3320 formal
applications under the Freedom of Information guidelines during 2001/2002.
Formal applications are defined as requests which:
•
Are in writing.
•
Give enough information to enable the requested documents to be identified.
•
Give an address in Australia to which notices under the Freedom of Information Act
1992 can be sent.
•
Give any other information or details required under FOI regulations.
•
Are lodged at an office of the agency with any application fee required under FOI
regulations.
Applications are usually received from existing or former patients wanting to read or have
a copy of their medical record, while others are from lawyers, authorised next of kin or
authorised agencies.
Virtually any information can be the subject of a formal application. There is no charge to
access personal information, but a fee of $30 applies for those wishing to access nonpersonal information.
An application relating to documents the Hospital or Health Service does not hold will be
transferred to the appropriate agency in possession of those documents. The applicant
will be subsequently notified.
Applicants who are unhappy with the Hospital or Health Service’s decision regarding their
FOI request can lodge a further application in writing within 30 days.
The types of documents held by the MHS include:
•
Patient medical and dental records.
•
Patient information brochures and patient discharge instructions.
•
Papers relating to policy development.
•
Information brochures and employment brochures.
•
Annual reports.
•
Department of Health manuals and policies.
Annual Report 2001/2002 Metropolitan Health Services
9
Compliance Reports
In accordance with Part Five of the Freedom of Information Act 1992, an information
statement detailing the nature and types of documents held by the organisation is
available from the following officers:
Armadale Health Service
Tanya Fiamengo
FOI Coordinator
3056 Albany Hwy
ARMADALE WA 6112
(
(08) 9391 2112
Bentley Health Service
Coordinator, FOI
PO Box 158
BENTLEY WA 6982
(
(08) 9334 3666
Fremantle Hospital and Health Service
FOI Coordinator
Alma Street
FREMANTLE WA 6160
(
(08) 9431 2789
Graylands Selby–Lemnos and Special Care Health Services
David Broughton
FOI Officer
Graylands Campus
Brockway Rd
MOUNT CLAREMONT WA 6010
(
(08) 9347 6475
Kalamunda Health Service
Linda Allen
FOI Coordinator/Patient Information Coordinator
PO Box 243
KALAMUNDA WA 6076
(
(08) 9293 2122
Annual Report 2001/2002 Metropolitan Health Services
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Compliance Reports
King Edward Memorial Hospital and Princess Margaret Hospital
Lorraine Sims
FOI Coordinator
Medical Administration
GPO Box D184
PERTH WA 6840
(
9
(08) 9340 8239
(08) 9340 7057
North Metropolitan Health Service
Coordinator Patient Information and Casemix Services
Osborne Park Hospital
Osborne Pl
STIRLING WA 6021
(
(08) 9346 8000
Perth Dental Hospital and Community Dental Service
Claude Minuta
FOI Coordinator
43 Mt Henry Rd
COMO WA 6152
(
(08) 9313 0505
Rockingham Kwinana Health Service
FOI Coordinator
PO Box 2033
ROCKINGHAM WA 6168
( (08) 9592 0600
9 (08) 9592 1621
Royal Perth Hospital
FOI Coordinator
GPO Box X2213
PERTH WA 6847
(
(08) 9224 2316
Annual Report 2001/2002 Metropolitan Health Services
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Compliance Reports
Sir Charles Gairdner Hospital
Jean Addie
FOI Coordinator
Hospital Ave
NEDLANDS WA 6009
(
(
(08) 9346 2427 (direct) or
(08) 9346 3333
Swan Health Service
Gordan Cvetkoski
Patient Information Manager
Eveline Rd
MIDDLE SWAN WA 6056
(
(08) 9347 5244
Annual Report 2001/2002 Metropolitan Health Services
12
Achievements and Highlights
Armadale Health Service
The Armadale Health Service is committed to improving the general health and quality of
life of people living in Armadale and the surrounding areas.
Integrated facilities offered at the Health Service include the:
•
Community and Child Health Service — a population-based health service.
•
Mental Health Service — a community, inpatient and rehabilitation service for
children, adolescents, adults and the elderly.
•
Rehabilitation and Aged Care Service — an inpatient, restorative and ambulatory care
service.
•
Acute Hospital Service.
The Health Service took significant steps during 2001/2002 to ensure the delivery of
these services continues to be at the forefront of integrated health care.
Key Operations and Achievements
Ø Opening a new $60 million private hospital facility.
Ø Developing family and parenting programs through community and primary health
services.
Ø Introducing a performance management strategy.
Ø Opening an Adult Mental Health inpatient unit.
Ø Introducing a medical admission planning unit.
Ø Introducing an Emergency Department fast-track system and observation ward.
Ø Establishing a specialist/GP antenatal clinic.
Ø Participating in the National Demonstration Hospitals’ Program.
Opening a Private Hospital Facility
The Health Service opened a new facility at its main Armadale campus during 2001/2002
as part of a $60 million redevelopment of the Armadale Kelmscott District Memorial
Hospital, which includes a private hospital co-located on the campus. The facility has
significantly increased the Health Service’s operational capacity. It includes a 50-bed
medical and surgical unit, a 24-bed obstetric unit, a 10-bed paediatric unit, a 25-bed day
procedure unit, six operating suites, a specialist centre, a 10-chair renal dialysis unit and
an eight-chair dental clinic. Patients from Armadale and the surrounding areas can now
access a much broader range of health services closer to where they reside, reducing
their need to travel to centrally-located tertiary hospitals.
Developing Family and Parenting Programs
The Armadale Community Health Service has received funding from the Department of
Health’s Office of Mental Health to assist in adapting the Positive Parenting Program for
Aboriginal families. This program, which helps parents to manage challenging childhood
behaviour, has been running successfully for several years. The program will be made
available to families of pre-school aged children across WA.
Annual Report 2001/2002 Metropolitan Health Services
13
Achievements and Highlights
The Primary Health Service has also developed a new multidisciplinary program for
children aged from birth to four years. The program aims to provide education and
support to families and child health centres.
Introducing a Performance Management Strategy
A performance management strategy was introduced at the Health Service to ensure
health indicators and outcomes are recognised at individual, team and service levels. The
strategy was initially piloted in the Rehabilitation and Aged Care Service, and has since
been extended to other areas within the Health Service.
Opening of an Adult Mental Health Unit
The open unit of the Adult Mental Health facility was commissioned in July 2001 followed
by the High Dependency Unit in January 2002. The service provides access to 14 acute
beds. Eleven beds remain closed, but will be opened as service demands increase in the
area.
A recruitment drive was conducted in the United Kingdom which assisted with the
recruitment of staff for the new facility, with seven full-time equivalent staff employed as a
result.
Introducing a Medical Admission Planning Unit
A medical admission planning unit was introduced to assist with the coordination of all
aspects of patient care within the Health Service. All medical admissions have a full multidisciplinary assessment and management plan in place within the first 24 hours.
Introduction of an Emergency Department Fast-Track System
The introduction of a fast-track system on weekends and public holidays in the
Emergency Department has significantly reduced the waiting times for non-urgent cases
from seven hours to four hours.
Establishment of a Specialist/General Practitioner Antenatal Clinic
The introduction of this service has been designed to improve the referral of midwife
antenatal patients to GPs and specialists for immediate management and to improve
access to antenatal care.
Participation in the National Demonstration Hospitals’ Program
The National Demonstration Hospitals’ Program focuses on continuum of care with the
aim of promoting a smooth transition between acute, sub-acute (rehabilitation) and
community services. This will involve:
•
The implementation of risk assessment tools.
•
Improved liaison with the Emergency Department.
•
A review of assessment documentation to reduce duplication.
•
Improved processes for referral between services and disciplines.
Annual Report 2001/2002 Metropolitan Health Services
14
Achievements and Highlights
Bentley Health Service
The Bentley Health Service is dedicated to providing comprehensive, quality health care
to the local community.
The Health Service’s two major driving objectives are:
•
To seek continuous improvement in the health outcomes and quality of life of patients.
•
To develop collaborative partnerships with other health service providers to facilitate
integrated and comprehensive service delivery.
These objectives underpin many of the activities across the Health Service and are
clearly embraced in all major projects undertaken during 2001/2002.
Key Operations and Achievements
Ø Initiating a voluntary transport service for the elderly.
Ø Establishing a single point of entry to the West Australian Youth Centre.
Ø Introducing a clinical risk management framework for all inpatient mental health
services.
Ø Installing a new air-conditioning system at the day hospital within the Elderly Mental
Health Service.
Ø Being awarded with four years’ accreditation by the Australian Council on HealthCare
Standards.
Ø Developing a mentor program to assist in the area of allied health services.
Ø Establishing a falls clinic to assist those at risk in the local community.
Ø Being nominated for a number of health and workplace awards.
Ø Introducing an Outstanding Employee Award.
Initiating a Voluntary Transport Service
The Bentley Health Service and the Royal Perth Hospital initiated a voluntary transport
service to work in conjunction with the Bentley Elderly Mental Health Service day hospital
and the Aged Care Therapy Unit. This transport service replaced a taxi-based system
that had previously been used for the pick-up and drop-off of patients who attended
programs at the day hospital.
Establishing a Single West Australian Youth Centre Entry Point
A dedicated triage position was established to provide a single point of entry to the WAY
Centre operating within the Child and Adolescent Mental Health Service. The WAY
Centre comprises inpatient, transitional, residential, outpatient and outreach services.
Having a single point of entry to child and adolescent mental health services is a
guideline set out in the National Standards for Mental Health Services and a
recommendation of the Office of the Chief Psychiatrist.
Annual Report 2001/2002 Metropolitan Health Services
15
Achievements and Highlights
Introducing a Clinical Risk Management Framework
A clinical risk management framework was introduced to all inpatient mental health
service areas. Every patient now undergoes a standard assessment on admission to any
of the Health Service’s inpatient facilities. Protocols have also been standardised to
ensure that appropriate safety measures are in place to combat clinical risks.
Installing Air Conditioning
Refrigerated air conditioning was installed at the day hospital in the Elderly Mental Health
Service lodge to replace the old and inefficient evaporative system. This has completed
the air-conditioning upgrade of the entire building. Furniture in all inpatient and day
hospital areas within the lodge has also been upgraded.
Four Years’ Accreditation
The Health Service was awarded with four years’ accreditation by the Australian Council
on HealthCare Standards following a comprehensive organisational survey. The Health
Service’s accreditation status will expire in October 2005.
Developing a Mentor Program
A mentor program was developed to assist with the supervision of allied health service
staff in rural areas. The program will be used to develop effective mentor services for
staff, and to assist with rural workforce issues.
Establishing a Falls Clinic
A clinic was established to provide a multidisciplinary assessment and intervention
service for patients in the Health Service’s catchment area who have a history of falls.
The clinic’s assessment procedures follow a protocol already trialed and implemented
across all Perth metro aged care services.
Award Involvement
The Health Service was involved in the following during 2001/2002:
•
The Health Service won the Heart Foundation Health Based Organisation Award for
the implementation of healthy heart activities.
•
The Community Support and Rehabilitation Team was a runner-up for an award
recognising carer support within the community. The award is coordinated by the
Association of Relatives and Friends of the Mentally Ill.
•
The Health Service was presented with a Silver Award by Mr Brian Bradley, the
Commissioner of WorkSafe in recognition of its competent safety and health
management in the workplace, and for its contribution to the reduction of work-related
injury and disease in WA.
•
The Health Service received an Australian Violence Prevention award in recognition
of the work undertaken to reduce the risk of patient-initiated violence towards staff
working in the mental health services area. This award is sponsored by the heads of
Australian governments and is a joint Commonwealth, state and territory initiative.
Introducing an Outstanding Employee Award
The Health Service introduced an Outstanding Employee Award during 2001/2002
sponsored by the Perth Radiological Clinic. The award is presented on a quarterly basis,
and is given to a staff member who is nominated for carrying out their duties in an
exemplary manner.
Annual Report 2001/2002 Metropolitan Health Services
16
Achievements and Highlights
Fremantle Hospital and Health Service
The Fremantle Hospital and Health Service is dedicated to ensuring the best achievable
health status for all Western Australians. The organisation believes in the pursuit of
strong public health and preventative measures to best promote and protect the health of
the community.
The Health Service strives for excellence in addressing the following priority areas:
•
First-class acute and chronic health care for those in need.
•
Appropriate health, rehabilitation and domiciliary care for all stages of life.
•
Cooperative efforts in improving the health status of our Indigenous, rural and remote,
and disadvantaged populations.
Key Operations and Achievements
Ø Opening the Moss Street Centre following the completion of extensive renovations.
Ø Opening the Hampton Road Service.
Ø Commissioning the construction of a new operating theatre and upgrading the cardiac
catheter theatre at the Fremantle Hospital.
Ø Gaining additional nursing staff through a recruitment campaign.
Ø Starting a meal regeneration and delivery system through the Catering Department.
Ø Installing a monoplace hyperbaric chamber.
Ø Establishing a new eight-bed supervised care unit.
Ø Being involved in a falls prevention project in conjunction with a number of eastern
states hospitals.
Ø Establishing an Emergency Department mental health triage and consultant service.
Ø Launching a state-first picture archiving and communications system.
Ø A Health Service librarian being presented with the 2002 WA Special Librarian of the
Year award.
Opening the Moss Street Centre
The Moss Street Rehabilitation Centre was opened in July 2001 following extensive
renovations to the building. The centre provides a comprehensive range of aged care
services to the South Metro region using a multidisciplinary team approach.
Opening the Hampton Road Service
The Hampton Road Service was opened on 12 December 2001 and provides 24-hour
short-term supported accommodation to help reduce pressure on the Hospital and Health
Service’s acute mental health facilities. The service consists of 10 community-based beds
for mental health patients, and operates according to the following three main
components:
•
An acute admission diversion service which avoids the need to admit patients to
hospital.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
•
A facility for patients who need short-term support after discharge from hospital.
•
A respite facility providing short-term accommodation enabling patients to gain the
skills needed to live successfully within the community.
Commissioning and Upgrading of Hospital Theatres
A new operating theatre designed for orthopaedic and general surgery procedures was
commissioned for construction in April 2002.
The Fremantle Hospital also upgraded the cardiac catheter theatre during 2001/2002 to
accommodate new scanning equipment. This involved putting in new walls, air
conditioning, floor and wall vinyl, ceilings, cabinets, as well as upgrading electrical wiring
and repainting the theatre.
Recruiting Additional Nurses
The Fremantle Hospital successfully recruited 14 nurses as part of a campaign designed
to attract former staff back into the Hospital’s work place. Casual call hours, the option of
part-time, casual or full-time work, and professional development were offered as
incentives for nurses to return.
Starting a Meal Regeneration and Delivery System
The Catering Department started a meal regeneration and delivery system during
2001/2002. The system has reduced food preparation times, enhanced food-handling
practices and minimised the potential for cross contamination, while also giving hospital
wards more flexibility with meal distribution times.
Installing a Monoplace Hyperbaric Chamber
The Diving and Hyperbaric Medicine Department installed a monoplace hyperbaric
chamber during 2001/2002 — the first of its kind in Australia. Patients are placed inside
this pressurised chamber and supplied with oxygen as a means of correcting many
serious health problems. This new facility has allowed for greater flexibility in areas of
patient care and staff safety, with nurses no longer needed as attendants inside the
chamber.
Establishing a Supervised Care Unit
An eight-bed supervised care unit was established at the Fremantle Hospital in January
2002 to provide a more secure, safe environment for patients requiring constant
surveillance because of agitation or confusion, and for those who are at high risk of injury
or falls.
Involvement in a Falls Prevention Project
The Fremantle Hospital was selected along with four eastern states hospitals to
participate in a project on falls prevention and the work being undertaken in the Hospital’s
supervised care unit. The Repatriation General Hospital in Adelaide will lead the project.
The hospitals involved in this project have been successful in gaining funding under
phase four of the National Demonstration Hospitals Program.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Establishing an Emergency Department Mental Health Triage Service
A new Emergency Department mental health triage and consultant service was
established during 2001/2002. The service provides a senior mental health nurse who is
employed to ensure patients with potential psychiatric issues are given an appropriate
and timely assessment. A marked decrease in the waiting time for patients requiring
psychiatric input and a decrease in the number of people leaving the department before
being assessed have been recorded since the service started.
Launching a Picture Archiving and Communications System
The Health Service became the first site in WA to install the new digital recording and
image archiving system — otherwise known as the picture archiving and communications
system. This new facility was officially launched in September 2001.
Presentation of the 2002 WA Special Librarian of the Year
A Health Service librarian was presented with the 2002 WA Special Librarian of the Year
award by the WA Knowledge and Information Specialists Group of the Australian Library
and Information Association. The award recognises excellence in technical, professional
and business skills.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Graylands Selby–Lemnos and Special Care Health Services
The management and staff at the Graylands Hospital believe in the provision of
comprehensive quality care in a safe and comfortable environment.
The Graylands Selby–Lemnos and Special Care Health Services place great emphasis
on hospital teams working with patients, families and the community to ensure optimum
care is provided.
Strategies employed to achieve this include:
•
A bio-psycho-social approach to assessment and treatment.
•
Placing emphasis on:
− Treatment rather than custody.
− A multidisciplinary team approach led by a psychiatrist.
− Treatment and management tailored to the individual patient.
− Maintaining patients’ rights to be fully informed and to participate and be
instructed in their care.
Key Operations and Achievements
Ø Trialing a gender separation program at the Graylands Hospital.
Ø Being involved in a number of health service-related agreements.
Ø Trialing a series of Key Performance Indicators.
Ø Receiving a Workright award for the leading mental health role taken up by the Centre
for Clinical Research in Neuropsychiatry.
Ø Advancing pharmacy research and improving the distribution of medication
information.
Ø Improving psychiatric emergency services.
Ø Improving access to computer resources.
Ø Improving accommodation options for people with a long-term mental illness.
Trialing a Gender Separation Program
A separation program that acknowledges gender-specific requirements and incorporates
appropriate occupational therapy activities was trialed in the secure wards of the
Graylands Hospital. The Fitzroy West Ward now cares for female patients, while the
Montgomery and Smith wards have been designated for male patients only. These wards
are being progressively refurbished to accommodate these changes.
Agreements
The following agreements were made during 2001/2002:
•
Management of the Frankland Centre was vested in the Statewide Forensic Mental
Health Service.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
•
A Memorandum of Understanding was agreed with the Department of Justice
regarding the transfer of prisoners from Acacia Prison to the Frankland Centre.
•
A Memorandum of Understanding was agreed with the Inner City Mental Health
Service regarding the provision of services to the Perth Central Law Courts lock-up.
Trialing a Series of Key Performance Indicators
Evaluation of the Health Service during 2001/2002 involved participating in the
development of a Key Performance Indicators pilot project. A series of indicators were
trialed as part of the project including the following:
•
Response time from referral to assessment.
•
Written management plan.
•
Length of stay.
•
Clinical change.
•
Completion of discharge summary.
•
Re-admission rates.
Receiving a Workright Award
The Centre for Clinical Research in Neuropsychiatry received an award from Workright
Australia in recognition of the leading role taken by the centre in employing people with
mental health issues. The CCRN has been chosen by the World Health Organization as
the national reference centre for the training and supervision of WHO schedules for
clinical assessment in neuropsychiatry. The centre also continues to train certain staff in
National Health and Medical Research Council funded research.
Advancements in Pharmacy Research and Medication Information
Pharmacy research projects were established with the University of Western Australia
and the CCRN. Two papers were presented to peer review journals for publication as a
result, with pharmacists also conducting lectures on psychotropic medications for the
benefit of health care professionals, carers and consumers.
The provision of medication information to patients through the Health Service was
improved by:
•
Widely distributing quarterly drug bulletins through mental health service areas.
•
Setting up medication groups at a ward level.
•
Giving consumer medication information and summaries to patients upon their
discharge from hospital.
Improving Psychiatric Emergency Services
Improvements were made to the Psychiatric Emergency Team’s telephone, data
collection and complaints’ management systems during 2001/2002. These improvements
have enhanced general satisfaction levels with psychiatry services and have led to more
accurate clinical care statistical reporting.
A new PET nursing position was also created to develop and facilitate mental health
education and training courses for external agencies, groups and communities in metro
and rural areas.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Improving Access to Computer Resources
The Clinical Information Access Online service was made available to all staff. This move
led to significant cost savings by eliminating the duplication of resources that had been
previously in place across the local network.
Patients now have access to personal computers in the Patients’ Library and in some
wards, with the service running MS Word and games facilities to improve computing skills
and allowing users to print documents. A monthly book club was started for patients
staying at the Frankland Centre.
Community Options 100 Project
The Community Options 100 Project is developing a program for people with serious and
persistent mental illnesses in accordance with government policy, which will allow
patients to live in more normal, home-like accommodation with appropriate support to
meet their needs. Inpatients living in the Murchison Ward, the slow-stream rehabilitation
unit at Graylands Hospital, are the main focus group for this project.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Kalamunda Health Service
The Kalamunda Health Service places great emphasis on ensuring its health services
meet the changing needs of the community. The organisation keeps abreast of health
trends to ensure it can provide effective, efficient and up-to-date services.
Key Operations and Achievements
Ø Receiving four years accreditation from the Australian Council on HealthCare
Standards.
Ø Replacing endoscopic equipment at the Kalamunda District Community Hospital’s
operating theatre.
Ø Running a series of joint ventures with the Swan Health Service.
Ø Being involved in management of the VRE outbreak.
Four Years Accreditation
The Health Service received four years accreditation from the Australian Council on
HealthCare Standards in November 2001. The organisation’s accreditation status will
expire in February 2006.
Replacing Endoscopic Equipment
The Health Service was able to replace $212,000 of endoscopic equipment for the
Kalamunda District Community Hospital’s operating theatre.
Running Joint Ventures with the Swan Health Service
The following ventures were undertaken in partnership with the Swan Health Service
during 2001/2002:
•
Establishing a joint infection control committee.
•
Realigning the community health team within the Swan and Kalamunda Health
Services.
•
Developing a joint strategic business plan for 2001–2003.
Managing the VRE Outbreak
The collaborative management of the VRE — or vancomycin-resistant enterococci —
outbreak between the Bentley, Kalamunda and Swan Health Services has provided a
streamlined approach to patient treatment through the development of care plans,
guidelines, information sheets and packages. The VRE outbreak was of particular
concern because the antibiotic resistant bacteria can become fatal if it travels into the
bloodstream.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
King Edward Memorial Hospital and Princess Margaret Hospital
The King Edward Memorial Hospital for Women and the Princess Margaret Hospital for
Children are fully-accredited teaching hospitals.
KEMH provides a state-wide health service for women, while PMH provides the same
level of service for children. Both hospitals are supported by clinical research and
education, and promote the wellbeing of the community.
The combined clinical expertise at the two hospitals has helped to establish a major
service — the Women’s and Children’s Health Service — which is essential to the health
and welfare of women and children in WA.
The Women’s and Children’s Health Service was formed in 2001, and is committed to:
•
Supporting the improved delivery of cost-effective women’s and children’s health care
services across WA in collaboration with service providers.
•
Fostering a culture of clinical governance to ensure the best possible health outcomes
for patients.
•
Improving educational services to ensure current and future health care providers
have the appropriate skills and knowledge.
•
Supporting clinical research that ensures the provision of evidence-based health
services.
•
Introducing appropriate technology to facilitate best practice in areas of clinical care
and in the management of the organisation.
Key Operations and Achievements
Ø Completing the Douglas Inquiry Report.
Ø Recording the greatest ever growth in academic appointments at KEMH for a single
year.
Completing the Douglas Inquiry Report
The Inquiry into obstetric and gynaecological services at King Edward Memorial Hospital
1990–2000 — otherwise known as the Douglas Inquiry Report — was completed during
2001/2002, with the findings handed down on 23 December 2001.
The Director General of Health, Mike Daube, appointed a committee made up of
consumer representatives, medical and nursing university faculty members, midwives,
obstetric colleges and selected KEMH senior executives to oversee the implementation of
the report’s 237 recommendations.
The implementation committee has signed off on 54 report recommendations as having
been achieved, with a further 30 to be presented to the committee in July 2002.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Growth in Academic Appointments
The greatest growth in academic appointments ever to have occurred at the KEMH
campus was recorded during 2001/2002. This has placed the KEMH in an excellent
position to make substantial new contributions to women and infants’ research. The
appointments have included the following positions:
•
Professor of Neonatal Paediatrics.
•
Professor of Obstetrics and Gynaecology (Clinical Gynaecology).
•
Clinical Professor of Obstetrics and Gynaecology (Maternal Foetal Medicine).
•
Associate Professor of Obstetrics and Gynaecology (Maternal Foetal Medicine).
•
Associate Professor of Obstetrics and Gynaecology.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
North Metropolitan Health Service
The North Metropolitan Health Service strives to provide high quality, accessible and
integrated health services to enhance the wellbeing of people within the local community.
The Health Service is predominantly a community-based service that includes clinics
throughout Perth’s western and northern suburbs, the Osborne Park Hospital and the
Hawthorn Hospital.
Services provided by the organisation include:
•
Hospital Services — surgical, medical and maternity.
•
Rehabilitation and Aged Care Services.
•
Mental Health Services.
•
Population and Community Health Services.
•
Clinical Support Services.
•
State-wide Services.
Key Operations and Achievements
Ø Planning and construction progress on upgrades to the Osborne Park Hospital.
Ø Opening an adult gynaecology clinic at OPH.
Ø Expanding patient transfer services in partnership with Sir Charles Gairdner Hospital.
Ø Appointing an Acting Area Director of Mental Health, and establishing a child and
adolescent centre in Hillarys.
Ø Successfully continuing operation of the OPH Parkinson’s clinic.
Ø Establishing a falls rehabilitation and management program.
Ø Opening the Clarkson Child Development Centre.
Ø Distributing a Customer Service Charter brochure to relevant groups and key
stakeholders.
Ø Distributing an admission manual and clinical services directory to local GPs.
Ø Reducing the rate of lost time injuries through a new injury management program.
Ø Introducing a new diet project to improve puree meals.
Ø Celebrating OPH’s fortieth anniversary.
Progress on Health Service Upgrades
Planning began on a $13 million upgrade of the Osborne Park Hospital based on
recommendations made by the Osborne Park Hospital Review Committee.
The construction of a new theatre block and adult mental health inpatient unit is also due
for completion in 2003/2004.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Opening an Adult Gynaecology Clinic
A new adult gynaecology clinic was opened at OPH during 2001/2002. The clinic is part
of an expansion of public health gynaecology services in the NMHS area.
Expanding a Patient Transfer Partnership
A patient transfer partnership between OPH and Sir Charles Gairdner Hospital was
expanded to allow a small number of suitable orthopaedic joint-replacement patients to
be transferred between the two hospitals. This transfer process has been used to best
facilitate patient rehabilitation.
Expanding Mental Health Services
An Acting Area Director of Mental Health was appointed during 2001/2002, and mental
health services in the northern corridor were expanded with the establishment of a child
and adolescent centre in Hillarys.
Continuance of the OPH Parkinson’s Clinic
The Parkinson's clinic established in 2000/2001 at OPH is now one of two Perth-based
state-wide sites specialising in the management and care of people with Parkinson's
disease.
Establishing a Falls Rehabilitation and Management Program
A falls rehabilitation and management program was established as part of the
Rehabilitation and Aged Care Program run at OPH and the Joondalup Health Campus.
The program offers both at-home and in-hospital assessments and coping strategies to
assist with patient independence and to reduce the risk of falling.
Providing Specialised Family Health Care Services
The opening of the Clarkson Child Development Centre during 2001/2002 has provided a
specialised family-centred health care service in the upper northern corridor. The centre
is situated at the same location as the Clarkson Adult Community Mental Health Service,
and the Child and Adolescent Mental Health Service.
Distributing Customer Service Charter Brochures
A NMHS Customer Service Charter brochure with an accompanying feedback form was
produced and distributed to Health Service sites, medical practitioners, local government
libraries and politicians within the region.
Distributing a GP Admission Manual and Clinical Services Directory
An admission manual and a specialist clinical services directory were produced and
distributed to all GPs accredited with OPH or situated within the hospital’s catchment
area. These publications — along with newsletters, journal updates and education
sessions — are designed to encourage increased GP involvement in the operation of
OPH.
Reducing Lost Time Injuries
The NMHS was able to reduce lost time injury rates during 2001/2002 using an effective
injury management program. The preventative and rehabilitation measures in place under
this program include:
•
The introduction of task-specific manual handling.
•
Early intervention to assist staff in returning to pre-injury duties.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
•
Promoting the reporting of hazards by Health Service staff.
Improving Puree Meals
A texture modified diet project was started at OPH in July 2001 and resulted in increased
patient, staff and carer satisfaction with puree meals. The Puree to Perfection manual
was also produced for hospitals and aged care residential facilities. The manual includes
menus, recipes, photographs and staff training guidelines to help with improving puree
production.
Celebrating OPH’s Fortieth Anniversary
OPH celebrated its fortieth anniversary with an open day designed to increase community
awareness of hospital facilities. A plaque was unveiled at the open day and displays were
run on the range of health services available through the NHMS.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Perth Dental Hospital and Community Dental Service
The Perth Dental Hospital and Community Dental Service is committed to promoting and
improving the oral health of all Western Australians.
The Health Service achieved this goal through four core programs:
•
The School Dental Service, which provides preventative and restorative dental care to
around 250,000 school children throughout the state. These children range from preprimary level to Year 12.
•
Subsidised Specialist and General Dental Care, which helps financially and
geographically disadvantaged patients. Around 80,000 eligible patients were attended
to during 2001/2002 through public dental clinics and by private practitioners
participating in the Country Patients’ Dental Subsidy Scheme and the Metropolitan
Patients’ Dental Subsidy Scheme.
•
Special Services, which provides dental care to housebound patients, disadvantaged
groups and the institutionalised. This incorporates the provision of after-hours
emergency services for advice on dental emergencies or urgent treatment.
•
Oral Health Promotion, which encourages education on relevant dental health issues
to support clinical staff and the wider community. This also includes targeting key
health service providers, teachers and community leaders.
Key Operations and Achievements
Ø Transferring services to new locations following the closure of the Perth Dental
Hospital.
Ø Opening new dental clinics in Armadale, Rockingham and Canning Vale, and
progressing the construction of clinics at sites such as Morley and Newman.
Ø Setting up a website to improve access to oral health information.
Ø Implementing and continuing various Health Service programs.
Progress Following Closure of the Perth Dental Hospital
The Health Service has cooperated with the University of Western Australia from 1
January 2002 to transfer services previously provided by the Perth Dental Hospital to the
Oral Health Centre of WA. This transfer process was necessary following the closure of
the PDH.
The redevelopment of clinical facilities and the establishment of specialist dental
laboratories at the Warwick Dental Clinic — designed to help with the relocation of
services following the PDH closure — were also completed during 2001/2002.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Opening and Construction of New Dental Services
The following progress was made during 2001/2002 in expanding WA dental services:
•
A new dental clinic at the Armadale Health Service was opened in November.
•
The new dental therapy centres were opened at Secret Harbour in Rockingham and
at Campbell in Canning Vale.
•
The construction of a dental clinic in Morley began in February–March, and it is
scheduled for completion in September 2002.
•
A planning and tender process for the construction of a new dental clinic in Newman
commenced.
•
Plans to establish new dental clinics in Spearwood and Joondalup were initiated.
Project architects had been appointed and the Department of Health’s Facilities and
Assets Branch is negotiating sites for the two clinics.
Improving Access to Oral Health Information
A website was set up to provide improved access to oral health information, including
data on training modules and teaching materials for educators.
Implementing and Continuing Health Service Programs
The following progress was made regarding Health Service programs:
•
The Health Service successfully tendered for the provision of oral health services to
aged care facility residents on behalf of the Department of Health. The
implementation of these services — which will take place as part of a five-year
program — began during 2001/2002.
•
The integrated emergency list module of the patients management system was
implemented throughout the Health Service.
•
A program to upgrade mobile dental clinics was continued during 2001/2002. It helps
to provide mobile dental services to school children and adults in rural areas.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Rockingham Kwinana Health Service
The main goal of the Rockingham Kwinana Health Service — in conjunction with the Peel
Health Service — is to improve community health by working with both quality and
compassion in mind.
Key Operations and Achievements
Ø Widening the Care Aids and Equipment Program to incorporate new health areas.
Ø Introducing a continence service.
Ø Relocating the Health Service to a new Rockingham location.
Ø Developing the Children of Mentally Ill Parents Program.
Ø Implementing a protocol for joint services when addressing complex co-morbidity and
multi-faceted problems across key and family agencies.
Ø Developing and introducing a seven-day service across the Peel and Rockingham
Kwinana region.
Ø Developing a community-based Clozapine commencement program for adult mental
health clients.
Ø Starting many new mental health programs and services, including a carer support
service.
Ø Setting up an antenatal home visiting project for women.
Ø Extending paediatric services.
Ø Gaining state government funding to upgrade the Emergency Department and
restorative day therapy services.
Ø Introducing a new vision in the area of community health services.
Ø Participating in a national benchmarking project.
Widening the Care Aids and Equipment Program
The Care Aids and Equipment Program was expanded during 2001/2002 to include
mental and other areas of health. This has allowed for medical and health service
equipment to be provided to a larger proportion of the Rockingham Kwinana population.
Introducing a Continence Service
A continence service was introduced during 2001/2002 to cover the Peel and
Rockingham Kwinana region. The service assists people who suffer from a loss of
bladder or bowel control.
Relocating the Health Service
The Health Service was relocated to premises in Rockingham during 2001/2002. These
new premises house adult mental health, child and adolescent mental health and
community health services.
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Achievements and Highlights
Development of the Children of Mentally Ill Parents Program
The Rockingham Kwinana Child and Adolescent Mental Health Service has also
developed the Children of Mentally Ill Parents Program. The program aims to enhance
parenting skills, child development and family functioning in situations where parents
suffer or are at risk of mental health problems.
Intra-Agency Agreement Processes for Coordinated Care Planning
CAMHS was instrumental in initiating an intra-agency agreement that established explicit
protocols and processes for coordinated care planning for children and adolescents with
serious emotional and psycho-social disturbances where effective intervention was likely
to require systemic intervention by multiple agencies. There is a mandated expectation
through a signed Memorandum of Understanding that key agencies will participate in
developing a consensual and coordinated plan that best addresses the needs of children,
adolescents and their families.
Mental Health Service Seven-day Service
PARK Mental Health Service provides an emergency response to residents of the
catchment area who are experiencing mental health difficulties and require immediate
assessment of their needs. This service is provided to clients from the age of 18
upwards. The service hours are between 8.30am and 4.30pm, seven days a week.
Clozapine Commencement Program for Adult Mental Health Clients
The Clozapine service has been developed in order to streamline the prescription and
dispensation of Clozapine to clients who reside in the community. This has been
achieved by high levels of integration between mental health services, community
pharmacists and community pathology services. This has produced a service that has
reduced the time needed by clients to fully meet the stringent monitoring requirements
associated with Clozapine treatment. This year we have augmented this with the
introduction of community Clozapine commencement, involving local emergency
departments. This has reduced Clozapine initiation from a three-week hospital admission
to a one-day of monitoring at the Rockingham Kwinana District Hospital.
Starting New Mental Health Programs
The following programs and services were introduced in areas of mental health:
•
A quality initiative program looking at the validity of classifications for nursing home
and hostel residents with a primary mental health diagnosis.
•
A carer support service for those who are at risk through contact with mentally
unstable patients.
•
An intensive home support program offering alternatives to patient hospitalisation.
Setting up an Antenatal Home Visiting Project
The Health Service set up an antenatal home visiting project for women who have a
history of depression. This project has been run in conjunction with the Rockingham
Division of General Practice.
Extending Paediatric Services
The Rockingham Kwinana District Hospital extended its paediatric services to allow for
children with allergies to be treated closer to home.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Improvements to the Emergency Department
The Rockingham Kwinana District Hospital has successfully gained funding from the state
government to redevelop the Emergency Department and restorative day therapy
services. This funding was given in line with government commitments to boost service
development and enhance hospital emergency departments, and is part of a multi-million
dollar state-wide initiative.
New Vision for Community Health Services
The Health Service has implemented a new vision in the area of community health
services. This vision places emphasis on providing for the health needs of children aged
from birth to five years in the Peel and Rockingham Kwinana region.
Involvement in a Benchmarking Process
The Rockingham Kwinana District Hospital participated in a national benchmarking
project during 2001/2002 involving both public and private hospitals across Australia. This
has allowed the hospital to establish a basis of comparison for proposed services relative
to those used in other similar hospital systems.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Royal Perth Hospital
Royal Perth Hospital is a fully accredited teaching hospital that provides emergency and
elective specialty services to the community within the East Metropolitan Health Service.
The hospital’s review of its strategic plan in October 2001 led to the establishment of both
the new ‘Committed to Excellence in Health Care’ vision and a new set of objectives
emphasising the importance of:
•
High quality, timely and efficient service delivery.
•
A coordinated approach to the provision of area and state-wide health care services.
•
Building and maintaining a centre of excellence for research and evidence-based
medical practice.
•
Maintaining the educational training role expected of a leading teaching hospital.
Key Operations and Achievements
Ø Opening the Pain Medicine Centre at the Shenton Park campus.
Ø Opening a new research centre to address the health needs of the elderly.
Ø Containing and eradicating a VRE outbreak.
Ø Upgrading operating theatres and medical equipment at the Shenton Park campus.
Ø Opening the redeveloped cardiac catheterisation suite.
Ø Receiving high commendations for the Midland Dialysis Centre’s involvement in the
2001 Premier’s Awards for Excellence in Public Sector Management.
Ø Refurbishing the Radiation Oncology radiation bunker.
Ø Developing an ambulatory anticoagulation service.
Ø Starting a state-wide home cancer care service.
Ø Improving medical oncology consultant services to accommodate people living
outside the Perth metropolitan area.
Ø Redeveloping the Emergency Department resuscitation area.
Ø Opening the E Block therapy area.
Ø Improving the efficiency of state-wide DNA sequencing services.
Ø Having 40 nurses graduate from two combined refresher and re-registration courses.
Opening the Pain Medicine Centre
The Pain Medicine Centre at the Shenton Park campus was opened in February 2002.
The centre combines inpatient and outpatient services for people suffering from chronic
pain resulting in patient treatment being more efficient and effective.
Annual Report 2001/2002 Metropolitan Health Services
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Achievements and Highlights
Opening a New Research Centre
The Medical Research Centre for the Health Needs of Older People was opened in
January 2002. The centre is based at RPH and is devoted to the health needs of elderly
Western Australians. Research is developed collaboratively between teams from the
areas of geriatric medicine and psychiatry of old age, and in conjunction with researchers
from the University of Western Australia.
Dealing with the VRE Outbreak
The hospital contained and eradicated an outbreak of vancomycin-resistant enterococci
— or VRE — during 2001/2002. This feat had not been achieved before and prompted
the international medical community to look to the hospital for advice.
The hospital undertook the massive and notoriously difficult task of controlling and
terminating the VRE, a form of bacteria that can become fatal if able to travel into a
person’s bloodstream. Laboratory staff were processing 1400 VRE-screening specimens
per day at the peak of the bacterial outbreak in mid-October 2001. This process resulted
in the development of improved microbiology techniques able to greatly reduce the
turnaround time for test results.
Upgrading Operating Theatres and Equipment
Elective orthopaedic surgery recommenced following completion of the $1.29 million
upgrade to operating theatres at the Shenton Park campus. The upgrade was completed
in February 2002.
A $6.4 million allocation to the hospital made by the state government also enabled the
hospital to upgrade a range of medical equipment.
Opening the Cardiac Catheterisation Suite
RPH’s redeveloped cardiac catheterisation suite was opened in October 2001. More than
$4 million of state-of-the-art cardiac imaging, patient monitoring and reporting systems
were installed in the world-class suite.
High Commendations for the Midland Dialysis Unit
A joint undertaking by the Department of Health and the hospital allowed the Midland
Dialysis Centre to adopt a new community-orientated service model. The centre was able
to take dialysis into the community and establish a strong partnership with the private
sector. These two achievements represented a significant shift in the way dialysis
services are managed and delivered.
These developments received high commendations in both the innovation and
management improvement categories of the 2001 Premier’s Awards for Excellence in
Public Sector Management.
Refurbishing Radiation Oncology Services
The refurbishing of the radiation oncology bunker was completed during 2001/2002, and
has allowed for a brachytherapy service to be introduced by late 2002. Brachytherapy is
an advanced form of cancer treatment. Radioactive seeds or sources are placed in or
near the cancerous tumour to direct a high dose of radiation towards the tumour itself
while reducing exposure to surrounding healthy tissue. The brachytherapy service to be
introduced at RPH will be the only one of its type in WA.
Annual Report 2001/2002 Metropolitan Health Services
35
Achievements and Highlights
Developing an Ambulatory Anticoagulation Service
An ambulatory anticoagulation service has been developed at RPH to provide patients
who suffer from deep vein thrombosis and other coagulopathies with more consistent and
efficient treatment. This will help to reduce morbidity and the length of stay experienced
by patients. The service is expected to be fully operational by late 2002.
Starting a Home Cancer Care Service
The home cancer care service — initiated by an RPH employee — was developed and
run during 2001/2002. The service operates on a state-wide basis to provide
chemotherapy to patients in their homes. This allows those treated to maintain a more
normal lifestyle without the inconvenience of travelling to hospital.
Expanding Medical Oncology Consultant Services
A medical oncology consultant service has been set up by RPH to operate on a monthly
basis to care for patients in the Kalgoorlie and Northam areas. Patients are now able to
see a medical oncology consultant in their home town rather than having to travel to
Perth.
Redeveloping the Emergency Department Resuscitation Area
The Emergency Department resuscitation area was redeveloped during 2001/2002, with
additional trauma bays, improved X-ray facilities and workstations installed in October
2001. These improvements have increased available staff working areas and provided an
efficient service for patients in the Emergency Department.
Opening the E Block Therapy Area
The opening of the E Block therapy area at the Shenton Park campus in June 2002 has
given the hospital dedicated space for combined occupational therapy and physiotherapy
assessment and treatment of patients with orthopaedic and rheumatology disorders.
Improving State-wide DNA Sequencing Services
The gel technology DNA sequencer used in the Department of Clinical Immunology and
Biochemical Genetics was replaced during 2001/2002 with a new state-of-the-art high
throughput capillary instrument. This has improved the efficiency of the department’s
state-wide DNA sequencing service by more than 100 per cent. This sequencing service
is used by a number of WA hospitals and tertiary institutions.
Nurses’ Graduation
Around 40 nurses formerly enrolled at the hospital have graduated from two combined
refresher and re-registration courses conducted by the hospital.
Annual Report 2001/2002 Metropolitan Health Services
36
Achievements and Highlights
Sir Charles Gairdner Hospital
Sir Charles Gairdner Hospital is a fully accredited teaching hospital committed to health
care, service, education and research.
Clinical services are provided via a management structure encompassing the following
six units:
•
Acute Musculo-Skeletal and Rehabilitation.
•
Cancer.
•
Central Services.
•
Gastro/Renal.
•
Heart and Lung.
•
Neurosciences.
SCGH is closely associated with the University of Western Australia, Curtin University of
Technology and Edith Cowan University.
Key Operations and Achievements
Ø Securing state and Commonwealth government funding to set-up the WA Positron
Emission Tomography (PET)/Cyclotron Service.
Ø Receiving four years’ accreditation from the Australian Council on HealthCare
Standards.
Ø Planning redevelopment of SCGH’s existing main entrance and Emergency
Department.
Ø Commissioning a $1 million digital X-ray machine.
Ø Installing an e-cam gamma camera in the Nuclear Medicine Department.
Ø Opening the Lions Ear and Hearing Institute.
Ø Expanding the Oral Health Centre of WA’s two operational sites.
Ø Recording a significant milestone through the haematology unit.
Ø Opening a Care Awaiting Placement unit at Hollywood Private Hospital.
Ø Opening the Ward G74 Nursing Observation Specials Unit.
Ø BreastScreen WA’s screening and assessment service receiving accreditation.
Ø Completing construction of The Niche building.
Ø Completing the Queen Elizabeth II Medical Centre draft structure plan.
Annual Report 2001/2002 Metropolitan Health Services
37
Achievements and Highlights
Securing Funding for a Positron Emission Tomography (PET)/Cyclotron Service
The hospital secured more than $7.85 million of state and Commonwealth government
funding to set up the WA PET/Cyclotron Service. PET is a non-invasive diagnostic
imaging tool used to provide information to medical practitioners on how a person’s body
is functioning. This can assist in the diagnosis of a range of conditions, particularly
cancers. The WA PET/Cyclotron Service will be operational by early 2003.
Four Years’ Accreditation
The hospital received four years’ accreditation following a review from the Australian
Council on HealthCare Standards. The accreditation status is the maximum granted by
the ACHS. Commendations were received by the hospital for initiatives such as the
cancer shared-care project run with GPs and HomeLink.
Planning for Redevelopment of the Main Entrance and Emergency Department
The redevelopment of the hospital’s main entrance and Emergency Department was
announced in January 2002. State government funding for the project was increased to
around $9.2 million, up from the original $8.1 million estimate. The project aims to
improve operational efficiencies, reduce overcrowding, and promote occupational health
and safety and the delivery of contemporary emergency services. The new, larger
Emergency Department will cater for up to 45,000 patients per year, an increase on the
current capacity of around 38,000.
Commissioning a New Digital X-Ray Machine
A digital X-ray machine was commissioned in January 2002. The $1 million machine will
enable more accurate medical diagnosis, produce faster results and allow for greater
patient comfort. It will be installed in the Radiology Department and used to examine
patients suffering from conditions such as liver, pancreatic, vascular and arthritic disease.
Installing an E-Cam Gamma Camera
A $600,000 e-cam gamma camera was installed in the Nuclear Medicine Department in
January 2002. The camera increases the accuracy of medical diagnosis and improves
patient comfort levels. The computer system attached to the camera can also be linked to
the hospital network allowing scans to be displayed online throughout the hospital.
Opening the Lions Ear and Hearing Institute
The Lions Ear and Hearing Institute was officially opened at the hospital in November
2001. The institute is dedicated to advancing scientific research, diagnosing and treating
ear disease, and educating health professionals and other community members. These
services will help people of all ages who have hearing impairments of varying degrees.
The institute focuses on high quality clinical care, diagnosis, surgery and research in all
areas of ear, nose and throat, and is funded by the Lions Help to Hear Foundation of WA,
university grants, national and internal grants, and private sponsors and donors.
Expanding the Oral Health Centre of WA
Expansion was conducted at each of the Oral Health Centre of WA’s two Queen
Elizabeth II Medical Centre sites, with the refurbishing of the SCGH E Block and the
redevelopment of Monash Avenue. The E Block site — used to provide basic oral surgery
to eligible people living in the area — received a $500,000 facelift. The Monash Avenue
site received funding to develop a new $38 million state-of-the-art building. This new
building offers an integrated training facility for dentists, dental hygienists, therapists,
clinical assistants and technicians. The Department of Health and the University of
Western Australia jointly funded this redevelopment project.
Annual Report 2001/2002 Metropolitan Health Services
38
Achievements and Highlights
Milestone Achievement for the Haematology Unit
The haematology unit at the hospital reached a milestone during 2001/2002 when it
conducted its 100th bone marrow transplant on a 65-year-old patient with multiple
myloma cancer.
Opening a Care Awaiting Placement Unit
A 22-bed Care Awaiting Placement Unit was opened in a refurbished ward at Hollywood
Private Hospital on 30 July 2001. The unit was set up as part of a strategy to find more
appropriate accommodation for patients no longer requiring acute care, and received
funding from the Department of Health over an initial 12-month period. The ward has
been specifically set up for CAP patients and has been refurbished to include a
communal area for dining and socialising, and secure indoor and outdoor space.
Management of the unit will continue to be the responsibility of SCGH.
Opening the Ward G74 Nursing Observation Specials Unit
The Nursing Observation Specials area on SCGH Ward G74 was opened on 14
September 2001. The unit provides a 1:2 nurse-to-patient ratio for high acuity patients
that fulfil certain admission criteria. This system was designed to consolidate such
patients into one six-bed unit in a cost-effective manner, and will enable nurses to spend
more time with high dependency patients, while developing the specialised skills needed
to treat these people.
BreastScreen WA Services Receive National Accreditation
BreastScreen WA’s screening and assessment service run at the SCGH Breast Centre
received national accreditation in July 2001. Their accreditation status will expire in 2003.
The assessment centre runs around 4000 screening services each year. These services
are administered to women within the BreastScreen WA screening program and those
referred to the assessment centre by GPs and medical specialists.
Construction of The Niche Building
The construction of The Niche — located on the corner of Hospital Avenue and Aberdare
Road in Nedlands — was completed during 2001/2002, with the building fully operational
by June 2002. The Niche is a centre that brings 17 non-profit health-related community
organisations together into one building, offering them affordable premises and long-term
security. Organisations accommodated in the building include the Neurological Council,
the Cystic Fibrosis Association and the WA Independent Living Centre.
QEII Medical Centre Draft Structure Plan
A draft structure plan to guide future development on the Queen Elizabeth II Medical
Centre site in Nedlands was completed during 2001/2002. The plan was requested by the
WA Planning Commission to engage broader stakeholder and community input into the
site’s planning process. The QEIIMC Trust commissioned BSD Consultants in August
2001 to prepare a structure plan to address issues including site access, parking, building
height, scale and maintenance of a landscaped environment. The structure plan was
developed in consultation with key stakeholders and local residents who provided input
via a series of public meetings. It was anticipated the final plan would be submitted to the
QEIIMC Trust in July 2002 and — if accepted — sent to the WA Planning Commission for
final approval.
Annual Report 2001/2002 Metropolitan Health Services
39
Achievements and Highlights
Swan Health Service
The Swan Health Service is committed to providing integrated, quality health services,
which are responsive to local community needs.
The Health Service achieves this goal by placing great emphasis on service objectives
such as maximising scarce resources through building good internal and external
partnerships, and developing flexible, skilled and motivated staff.
Key Operations and Achievements
Ø Developing nursing services by pooling staff and running a local advertising campaign
and nurse refresher program.
Ø Integrating physiotherapy services with the Kalamunda Health Service.
Ø Continuing involvement in the Asthma Foundation’s Newborn and Parental Smoking
Project.
Ø Signing a Memorandum of Understanding to receive access to radiology and
ultrasonography services.
Ø Receiving state government funding to develop an observation ward and a Computed
Tomography service.
Ø Securing Central Wait List Bureau funding used to recruit additional allied health staff.
Ø Relocating the Viveash Rehabilitation Centre.
Ø Developing protocols and group support to improve mental health service delivery.
Ø Recruiting a clinical psychologist and two additional child health nurses.
Ø Running the Community Mothers Program.
Ø Providing local Year Seven school students with immunisation against hepatitis.
Ø Developing the Cullacabardee Inter-agency Committee.
Developing Nursing Services
The Swan and Kalamunda Health Services developed strategies to combine hospital
casual nursing pools. This was initiated to promote more efficient use of nursing
resources and to assist in further developing a flexible workforce.
A local advertising campaign run in May 2002 resulted in 33 nurses attending an
information night. Fifteen additional nurses were contracted as at 30 June 2002 to work
across the Swan and Kalamunda Health Services.
The Health Service also successfully obtained funding from the Department of Health to
run a two-week nurse refresher program with five registered and five enrolled nurses
participating.
Integrating Physiotherapy Services
Planning is under way for physiotherapy services run at the Kalamunda Health Service to
be in-sourced to become part of an integrated Swan and Kalamunda Physiotherapy
Department. This department is planned to be operational from 1 July 2002.
Annual Report 2001/2002 Metropolitan Health Services
40
Achievements and Highlights
Involvement in the Newborn Asthma and Parenting Smoking Program
The Swan Health Service continues to be involved in the Asthma Foundation’s Newborn
and Parental Smoking Project. The Health Service was one of the original key
stakeholders involved in developing and piloting the project.
Radiology and Ultrasonography Services Agreement
A Memorandum of Understanding was signed with Royal Perth Hospital to provide
radiology and ultrasonography services at the Health Service from November 2001.
Developing an Observation Ward and Computed Tomography Service
The state government announced $599,000 would be provided to develop an observation
ward at the Health Service. This announcement was made in line with government
commitments to boost service development and enhance hospital emergency
departments, and is part of a multi-million dollar state-wide initiative. Planning for the
new observation ward commenced during 2001/2002. The state government also
announced a further $1.7 million to develop an on-site CT service.
Securing Funding for Additional Staff
Approximately $122,000 of Central Wait List Bureau funding was secured in February
2002 enabling the Health Service to recruit additional physiotherapy, occupational
therapy, speech pathology and dietetics staff. These new staff members were employed
for four months to help address long waiting lists.
Relocating the Viveash Rehabilitation Centre
The Viveash Rehabilitation Centre is in the final stages of being relocated to a new
purpose-built facility. The relocation is designed to improve service delivery for mental
health patients in the Swan region.
Improving Mental Health Service Delivery
The Swan Mental Health Service actively participated in developing the Eastern Region
Mental Health Coordinating Group during 2001/2002. This group will seek to improve the
delivery of mental health services within the East Metropolitan Health Service. The Health
Service has also been participating in the development of protocols to improve bed
management for mental health services across the Perth metropolitan area.
Additional Staff for Children’s Health Services
A clinical psychologist was recruited to the Child Development Team, a new service
funded by the Department of Health. The state government also provided funding to
employ two additional child health nurses in Perth’s inner city area.
Running the Community Mothers Program
The Community Mothers Program operated during 2001/2002 with funding support
provided by the Department of Health. The program involved six community nurses and
22 trained volunteer mothers making home visits.
Annual Report 2001/2002 Metropolitan Health Services
41
Achievements and Highlights
Conducting Hepatitis Immunisations in Local Schools
Immunisation against hepatitis was offered to Year Seven students in all primary schools
— both public and private — in the Swan, Kalamunda and Perth inner city areas. More
than 2,000 students were vaccinated against the disease. A second dose of the vaccine
will be administered during September and October 2002.
Developing the Cullacabardee Inter-agency Committee
The Health Service’s generalist team and health promotion officer took leading roles in
the development of the Cullacabardee Inter-agency Committee. The committee operates
in partnership with members of the community, and meets regularly to take a multiagency approach in addressing community needs.
Annual Report 2001/2002 Metropolitan Health Services
42
Achievements and Highlights
Major Capital Projects
Projects Completed during the Year
PROJECT DESCRIPTION
Actual Total
Cost $
Armadale Health Service
Armadale Health Service Redevelopment
60,000,000
Bentley Health Service
Air Conditioning Upgrade to the Elderly
245,000
Mental Health Service Day Hospital
Fremantle Hospital and Health Service
Cardiac Catheter Redevelopment
498,693
Additions and Alterations to the Cell
341,294
Biology Research Unit
Graylands Selby–Lemnos and Special Care Health Service
Psychiatric Emergency Team
115,072
Fitzroy West Ward
240,000
Forensic Directorate
46,527
Wellington Fair (Community Forensic)
249,940
King Edward Memorial Hospital and Princess Margaret Hospital
PMH Cranio-Facial Department Alterations
84,000
PMH Burns Unit Alterations
42,000
PMH Diagnostic Imaging Alterations
35,000
PMH Painting of the Pathology Building
29,000
PMH Carpet Replacements
49,000
Rockingham Kwinana Health Service
Rockingham Kwinana District Hospital —
17,180
Nurses Emergency Call System
RKDH — Main Doors
14,660
Royal Perth Hospital
Refurbishment of Shenton Park Theatre
1,300,000
Complex
Upgrade of Radiology Room 12 to
220,000
Accommodate New Angiography Equipment
Sir Charles Gairdner Hospital
Chiller #6 Replacement
717,000
Theatre Light Replacement
341,500
Swan Health Service
Commission of Two Sterilisers
198,838
Replacement of Ageing Medical Equipment
246,325
Estimated
Total
Cost $
60,000,000
Annual Report 2001/2002 Metropolitan Health Services
–
500,000
350,000
115,000
240,000
47,000
250,000
–
–
–
–
–
17,180
14,660
1,300,000
235,000
712,500
380,000
210,000
280,000
43
Achievements and Highlights
Projects in Progress
Expected Year Estimated Cost to
of Completion
Complete $
Fremantle Hospital and Health Service
Alterations and Additions to
2002/2003
215,597
Ward W4.3
Additional Theatre and
2002/2003
117,354
Support Facilities
Hand Clinic/Dietetics New
2002/2003
246,323
Accommodation
Graylands Selby-Lemnos and Special Care Health Service
Forensic — Perimeter
2002-2003
120,000
Fence
Kalamunda Health Service
Kalamunda Hospital
–
5,500,000
Redevelopment
King Edward Memorial Hospital and Princess Margaret Hospital
KEMH Nursery,
2003/2004
6,900,000
Admissions, Delivery Suite
and Emergency Centre
PMH Emergency and
2002/2003
2,000,000
Front Entrance
PMH Wards 8A and 9A
2004/2005
4,400,000
refurbishment
KEMH Diagnostic Imaging
2002/2003
300,000
Upgrade
PMH MRI
2002/2003
2,900,000
WCHS Access Control
2002/2003
400,000
Replacement
PMH Hay St Building
2003/2004
2,000,000
Refurbishment
Perth Dental Hospital and Community Dental Service
Morley Dental Clinic
2002/2003
1,081,000
Newman Dental Clinic
2002/2003
500,000
Spearwood Dental Clinic
2003/2004
1,500,000
Joondalup Dental Clinic
2003/2004
1,350,000
Perth Dental Hospital
2003/2004
1,235,000
Devolution*
Rockingham Kwinana Health Service
Rockingham Kwinana
District Hospital —
2003/2004
9,510,244
Emergency Department
and Restorative Unit
Goddard Street Project
2002/2003
260,000
RKDH — Grounds Lighting
2002/2003
7,000
KCHC — Air conditioning
2002/2003
37,660
PROJECT DESCRIPTION
Estimated
Total Cost $
Annual Report 2001/2002 Metropolitan Health Services
885,000
1,600,000
330,000
120,000
5,500,000
6,900,000
2,000,000
4,400,000
300,000
2,900,000
400,000
2,000,000
1,413,000
500,000
1,500,000
1,350,000
2,300,000
9,550,000
1,015,038
17,000
37,660
44
Achievements and Highlights
PROJECT DESCRIPTION
Expected Year
of Completion
Royal Perth Hospital
Redevelopment of InCentre Dialysis Unit
Additional Single Isolation
Rooms for Intensive Care
Unit General
Conversion of Existing
Two-Bed Rooms to TwoBed Versatile Isolation
Rooms on Wards 5G, 5H,
6G and 6H
Sir Charles Gairdner Hospital
Emergency Department
Refurbishment
WA Positron Emission
Tomography (PET)/
Cyclotron Service
Swan Health Service
Supply and Housing of
New CT Scanner
Six Bed Observation Ward
in the ED
Estimated Cost to
Complete $
Estimated
Total Cost $
2002/2003
1,100,000
1,100,000
2003/2004
500,000
500,000
2003/2004
320,000
320,000
2003/2004
9,300,000
9,300,000
2002/2003
8,200,000
8,200,000
2003/2004
1,705,700
1,705,700
2003/2004
599,000
599,000
*The Perth Dental Hospital Devolution includes the:
•
Warwick Dental Clinic upgrade.
•
Transfer of psychiatric services to enable further progress on the Warwick upgrade.
•
Modification of the Mount Henry Complex.
•
Construction of a maintenance workshop at Mount Henry.
•
Establishment of a temporary maintenance workshop at Graylands.
Annual Report 2001/2002 Metropolitan Health Services
45
East Metropolitan Area
Health Service
Bentley Health Service
Kalamunda Health Service
Royal Perth Hospital
Swan Health Service
Organisational Chart
North Metropolitan Area
Health Service
Graylands Selby-Lemnos &
Special Care Health Service
North Metropolitan
Health Service
Sir Charles Gairdner Hospital
Management Structure
Women's & Children's
Health Service
King Edward Memorial &
Princess Margaret Hospitals
Perth Dental Hospital &
Community Dental Service
Annual Report 2001/2002 Metropolitan Health Services
South Metropolitan Area
Health Service
Armadale Health Service
Fremantle Hospital
& Health Service
Rockingham Kwinana Health
Service
Director General
of Health
Mike Daube
Minister
for Health
Hon. Bob Kucera
APM MLA
46
Management Structure
Accountable Authority
The Director General of Health, Mike Daube, is the Accountable Authority for the
Metropolitan Health Services.
Senior Officers
The senior officers within the Metropolitan Health Services and their areas of
responsibility are listed below:
Area of Responsibility
Title
Armadale Health Service
Health Service Corporate
Acting General Manager
Management
Nursing Services
Director
Medical Services
Director
Bentley Health Service
Health Service Corporate
Acting General Manager
Management
Nursing Services
Director of Nursing
Medical Services
Director Clinical Services
Mental Health
Director
Fremantle Hospital and Health Service
Health Service Corporate
Chief Executive
Management
Medical Services
Executive Director
Nursing and Patient Support
Executive Director
Services
Mental Health Services
Clinical Director
Name
Margaret Bennett
Chris Bone
Dr Don Coid
Garry England
David Owen
Dr Jes Sowden
Elizabeth Moore
John Burns
Dr Shane Kelly
Ruth Letts
Associate Professor
D. K. Arya
Dr Mandy Seel
Population Health
Acting Director
Graylands Selby–Lemnos and Special Care Health Services
Health Service Corporate
Operations Manager
Russell McKenney
Management
Clinical Services
Director
Dr Peter Wynn-Owen
Nursing Services
Director
Jim Thomson
Kalamunda Health Service
Health Service Corporate
General Manager
Philip Aylward
Management
Nursing Services
Director
Catherine McKinley
Medical Services
Director
Dr William Babe
King Edward and Princess Margaret Hospitals
Health Service Corporate
Acting Chief Executive
Dr Bill Beresford
Management
North Metropolitan Health Service
Health Service Corporate
Acting General Manager
Steve Marshall
Management
Annual Report 2001/2002 Metropolitan Health Services
47
Management Structure
Perth Dental Hospital and Community Dental Service
Health Service Corporate
Director
Management
Rockingham Kwinana Health Service
Health Service Corporate
Acting General Manager
Management
Medical Administration
Director
Health Services Operations
Director
Mental Health Services
Director
Nursing and Acute Services
Director
Community Health
Director
Royal Perth Hospital
Health Service Corporate
Acting Chief Executive
Management
Clinical Services
Acting Director
Nursing Services
Acting Director
Corporate Support
Director
Organisational Development
Director
Business Analysis
Director
Information Services
Director
Sir Charles Gairdner Hospital
Health Service Corporate
Acting Chief Executive
Management
Finance and Information
Director
Services
Facilities Management
Director
Medical Services
Acting Executive Director
Nursing Services
Executive Director
Human Resource Services
Acting Director
Swan Health Service
Health Service Corporate
General Manager
Management
Clinical Services
Director
Corporate Services
Manager
Nursing/Hospital Program
Acting Director
Mental Health
Manager
Primary Health
Manager
David Neesham
Sandy Thomson
Dr John Harvey
Sandy Thomson
Warwick Smith
Heather Gluyas
Angela Poole
Patricia Tibbett
Dr Philip Montgomery
Pip Hinchliff
Geoff Leech
John Love
Beress Brooks
Frank Gaglio
Craig Bennett
Walter Gilmore
Paul Hansen
Dr Mark Platell
Di Twigg
Marshall Warner
Philip Aylward
Dr Jes Sowden
Ken Dawson
Moyra Cattermoul
Nardeen Fenton
Angela Corrigan
Pecuniary Interests
Senior officers within the Metropolitan Health Services have declared the following
pecuniary interests:
•
Fremantle Hospital and Health Service Chief Executive John Burns is a board
member of the Health Services Credit Union that operates a branch two days a week
from the premises of the Fremantle Hospital. These branch arrangements were
established prior to Mr Burns taking up his current appointment.
Annual Report 2001/2002 Metropolitan Health Services
48
Our Community
Demography
The following table shows population figures for each local authority covered by the
Metropolitan Health Services:
LOCAL AUTHORITY
Armadale
Bassendean
Bayswater
Belmont
Cambridge
Canning
Claremont
Cockburn
Cottlesloe
East Fremantle
Fremantle
Gosnells
Joondalup
Kalamunda
Kwinana
Melville
Mosman Park
Mundaring
Nedlands
Peppermint Grove
Perth
Rockingham
Serpentine–Jarrahdale
South Perth
Stirling
Stirling (south-eastern)
Subiaco
Swan
Victoria Park
Vincent
Wanneroo
Population as
at 1996*
Population as
at 2001*
52,026
13,907
45,864
27,262
–
71,954
9,242
60,055
7,514
6,393
24,795
76,579
–
48,529
20,173
94,003
7,852
33,294
20,997
1,735
5,579
61,570
10,236
36,447
156,599
26,193
15,170
71,503
–
–
213,325
52,601
14,025
56,983
29,995
24,382
77,135
9,206
69,703
7,387
6,759
25,857
83,691
155,994
48,790
21,872
96,633
8,364
35,496
21,417
1,686
7,964
74,696
11,752
37,375
161,022
16,259
15,740
85,649
27,906
26,335
84,837
Projected
Population as
at 2006*
59,228
14,664
59,452
34,777
25,442
79,198
9,891
82,775
7,929
6,791
27,603
88,235
182,579
51,364
25,642
101,435
8,420
37,328
23,232
1,849
8,234
85,623
15,843
39,421
165,506
17,800
16,704
101,975
29,980
28,114
87,851
*Data sources:
Australian Bureau of Statistics 1996, Estimated Resident Population by Age and Sex in Statistical
Local Areas, WA, Cat. No. 3203.5.
ABS 2001, Population Estimates by Age, Sex and Statistical Local Area, WA, Cat. No. 3235.5.
Ministry of Planning 2000, Population Projections by Age, Sex and Local Government Area, WA.
Annual Report 2001/2002 Metropolitan Health Services
49
Our Community
The King Edward Memorial Hospital, Princess Margaret Hospital and the Graylands
Selby–Lemnos and Special Care Health Services provide specialist metropolitan areawide services. The Perth Dental Hospital and Community Dental Service provides
specialist services on a state-wide basis.
Annual Report 2001/2002 Metropolitan Health Services
50
Our Community
Available Services
The following is a list of health services and facilities available to the community through
the Metropolitan Health Services:
Direct Patient Services
Acute Surgical
Adult Mental Health
Ambulatory Care
Amputee Service
Anaesthesia
Antenatal Clinic
Bone Marrow Transplants
Burns
Cardiology
Cardiothoracic Surgery
Cardiovascular Medicine
Chest Clinic
Child and Adolescent Mental Health
Clinical Haematology
Clinical Immunology
Coronary Care
Dental Prosthetics
Dermatology
Ear, Nose and Throat
EEG/ECG
Elderly Mental Health
Emergency Medicine
Endocrinology
Epilepsy Service
Gastroenterology
General Medicine
General Surgery
Geriatric Medicine and Extended Care
Gynaecology
Haemophilia
Hand Surgery
Hepatology
HIV/AIDS
Hospital Allied Health and Nursing
Discharge Service
Hyperbaric Medicine
Infection Control
Infectious Diseases
Intensive Care
Intra-Ocular Surgery
Maternal Foetal medicine
Maxillo-Facial Surgery
Neonatal Intensive Care
Neonatology
Neurology
Neurosurgery
Nuclear Medicine
Obstetrics and Midwifery
Oncology
Ophthalmology
Orthopaedics
Paediatrics
Palliative Care
Plastic Surgery
Radiation Oncology
Radiology
Refractory Epilepsy Service
Renal Services and Dialysis
Respiratory Medicine
Rheumatology
Same Day Surgery
Sexual Health Service
Stomal Therapy
Stroke Unit
Tropical Medicine
Ultrasound
Urogynaecology
Urology
Vascular Surgery
Visiting Midwifery Service
Annual Report 2001/2002 Metropolitan Health Services
51
Our Community
Medical Support Services
Aged Care Assessment
Antenatal clinic
Audiology
Bio-Engineering
Breast Feeding Service
Clinical / Psychology
Continence Services
Dietetics
Infertility Treatment
Medical Illustration
Occupational Therapy
Orthotics and Prosthetics
Parent Education
Pathology/ PathCentre Service
Perinatal Loss Service
Pharmacy
Physiotherapy
Podiatry
Psychiatry
Radiology (PRC)
Rehabilitation
Respite Care
Social Work
Speech Pathology
Community Services
Child Health and Development
Diabetes Education
Family and Child Health Services
Health Promotion
Home Care
Physiotherapy
Primary Health Care
Respite Care
School Health
Other Support Services
Chaplaincy
Health Record Management
Library
Midwifery Education
Postgraduate Medical and Nursing
Education
Annual Report 2001/2002 Metropolitan Health Services
52
Our Community
Disability Services
Our Policy
The Metropolitan Health Services is committed to ensuring that all people with disabilities
can access the services and facilities provided by and within the Department.
Programs and Initiatives
The Health Service has aimed to improve its disability services plan during 2001/2002,
according to objectives outlined in the Disability Services Act 1993. This goal has been
achieved through programs and initiatives run on behalf of the following five key outcome
areas:
Outcome 1: Existing services are adapted to ensure they meet the needs of people
with disabilities.
•
Interpreter booking procedures have been reviewed.
•
The Disability Services Coordinating Committee
implementation of the disability services plan.
•
The following health services have been reviewed or further developed during
2001/2002 to assist people with disabilities:
− Falls clinic.
− Memory clinic for people with cognitive deficits.
− Swimming program for women with special needs.
− Water activities policy for patients with mental health problems.
− Prostheses service for amputees.
− Adult occupational therapy and physiotherapy services.
− The Stay on your Feet falls prevention program.
− Pediatric OT and speech services which now provide greater access to patients
with special needs.
continues
to
monitor
the
Outcome 2: Access to buildings and facilities is improved.
•
Health Service facilities and amenities are reviewed on an ongoing basis with
modifications and a priority implementation plan being implemented based on the
available budget. Examples of ongoing facility modifications include:
− Adding extra signage to health care units.
− Installing door handles at appropriate heights for wheelchair users.
− Improving lighting levels.
− Improving colour contrasts on floors and walls.
− Providing additional disabled parking bays.
− Providing Braille to indicate floor identification numbers in all patient lifts.
− Improving existing wheelchair-accessible toilets.
− Installing automatic doors and safety rails.
Annual Report 2001/2002 Metropolitan Health Services
53
Our Community
Outcome 3: Information about services is provided in formats which meet the
communication requirements of people with disabilities.
•
Diversity management groups and the Community Advisory Councils provide advice
to the community regarding services and facilities for people with disabilities.
•
Committees and groups are in place to coordinate and review pamphlets and
information produced by the MHS to ensure the formatting of these documents meets
criteria set by the Disability Services Commission and the Department of Health.
•
Hospital information can be obtained in alternative formats upon request, including on
audio cassettes, via an Auslan interpreter service or through a TTY — otherwise
known as a telephone typewriter.
•
Teletext televisions and TTY phones have been purchased and placed in accessible
areas in Hospitals and Health Services across the MHS.
Outcome 4: Advice and services are delivered by staff who are aware of and
understand the needs of people with disabilities.
•
Disability awareness training is held regularly for all staff in Hospitals and Health
Services across the MHS.
•
Additional criteria that specify employee knowledge of both disability services and
means of access for people with disabilities are included on job description forms as
these documents are reviewed and updated.
•
All new employees are required to attend induction programs where relevant
information on disability services is presented.
•
Pamphlets providing information on disability services are available to assist staff with
their knowledge, understanding and awareness of people with disabilities.
•
Visual displays were shown in Hospitals and Health Services across the MHS
presenting information on how to accommodate the needs of people with disabilities.
These displays were developed by the MHS in conjunction with the Disability Services
Commission, the Association for the Blind of WA and Better Hearing Australia.
Outcome 5: Opportunities are provided for people with disabilities to participate in
public consultations, grievance mechanisms and decision-making processes.
•
The MHS gains insight into its provision of health services via feedback from many
community and organisational sources. These sources include:
− Community advisory committees and councils. Feedback is received courtesy of
a comments and complaints system.
− Members of the Disability Services Reference Group who represent people with
disabilities.
− The Disability Services Commission. Feedback is received through direct
consultation with the organisation.
− Disability services coordinators who maintain direct contact with special needs
groups within the community.
•
Community Advisory Councils represent both the community, and Hospitals and
Health Services on patient and service issues, and include members who have a
special interest in disability services. The councils also provide input into renovations
of MHS facilities designed to better accommodate people with disabilities.
Annual Report 2001/2002 Metropolitan Health Services
54
Our Community
Cultural Diversity and Language Services
Our Policy
The Metropolitan Health Services strive to ensure there is no discrimination against
members of the public based upon race, ethnicity, religion, language or culture.
Programs and Initiatives
The MHS operates in conjunction with the Western Australian Government Language
Services Policy, and has the following strategies and plans in place to assist people who
experience cultural barriers or communication difficulties while accessing the service’s
facilities:
•
The MHS works collaboratively with a number of agencies that support people from
culturally and linguistically diverse backgrounds, and ensures interpreters are
available for all patients who require this assistance.
•
There has been a general increase in the availability of cultural and language
information to the community through the development of websites and information
kits. Available information incorporates specific cultural requirements such as diet and
death-related issues, and takes cultural sensitivities into account.
•
Multicultural access contact officers provide a monthly orientation seminar for all new
staff members regarding the use of interpreters and how to communicate with
multicultural groups. The seminar also provides information for employees regarding
ongoing education, advice and support on cultural issues.
•
An open forum for all MHS staff is held on Harmony Day with a number of displays
and other information on existing cultural differences within the local community
provided to employees. Harmony Day — which began in 1999 — is emerging as
Australia's largest national multicultural event, and provides Western Australians with
the opportunity to celebrate the benefits that cultural diversity delivers to our nation.
•
Aboriginal liaison officers and other specialised Indigenous services have been
employed across the MHS to assist in providing support and advice to Aboriginal
patients.
There has been an increase in expenditure on interpreter services during 2001/2002. This
suggests not only a rise in multicultural groups accessing health services, but also an
increased awareness among communities who speak a language other than English of
the facilities offered by the MHS.
Annual Report 2001/2002 Metropolitan Health Services
55
Our Community
Youth Services
Our Policy
The Metropolitan Health Services acknowledges the rights and special needs of youth,
and endeavours to provide appropriate services, supportive environments and
opportunities for young people.
The MHS is committed to the following objectives as outlined in Action: A State
Government Plan for Young People, 2000–2003:
Ø Promoting a positive image of young people.
Ø Promoting the broad social health, safety and wellbeing of young people.
Ø Better preparing young people for work and adult life.
Ø Encouraging employment opportunities for young people.
Ø Promoting the development of personal and leadership skills.
Ø Encouraging young people to take on roles and responsibilities, which lead to active
adult citizenship.
Programs and Initiatives
The MHS has run numerous programs targeting youth groups and introduced a number
of innovations such as the following:
•
Work experience programs in all occupational groups for young people.
•
Graduate registered nurse programs in which graduate nurses are given experience
in three different areas — medical, surgical and a specialty field — over a 12-month
period. There are opportunities for re-employment upon completion of the program.
•
Graduate enrolled nurse programs in which graduate nurses are given two threemonth placements to gain experience in both a medical and a surgical setting. There
are opportunities for re-employment upon completion of the program.
•
School health education programs in which nurses provide health promotion
information, health counselling and some treatment services within metropolitan high
schools. These programs place a strong emphasis on encouraging healthy lifestyles
among school children, and empowering young people to take responsibility for their
own health.
•
Educational programs aiming to provide effective information and advice on drugs are
conducted in all WA schools through curriculum support, teacher training, policy
development, and by educating parents and members of the public.
•
Providing teachers within the metropolitan area with the necessary resources to adopt
an asthma-friendly status at their schools.
•
Inspector Pickles Makes a Fresh Start and Inspector Pickles Makes a Smart Move
were two health promotion programs used to promote healthy eating among school
children aged from seven to 12.
•
The Young Parents Program — a support group used to promote parental education,
and to provide support for young teenage mothers.
Annual Report 2001/2002 Metropolitan Health Services
56
Our Community
•
YouthLink — an inner-city program aimed at enhancing the mental health status of atrisk or marginalised young people. Direct individual and group counselling, therapy
and support are provided to young people aged from 13 to 25 in the Perth
metropolitan area. The program aims to help those young people who have difficulty
accessing mainstream mental health services.
•
The Youth Self Harm Program, which funds a social worker to assist young people
who are admitted to hospital after attempting suicide or who have other self-inflicted
injuries. The program continued to perform well during 2001/2002.
•
The collaboration between various health-related agencies to provide information to
young people on mental health, alcohol and drug related issues, and on services,
general support and advice in areas such as accommodation, finance and schooling.
•
A daily roster of doctors is now in place to assist young people within the Swan Valley
region. The roster has been developed by the MHS in partnership with the Swan Hills
Division of General Practice. Both the Swan Youth Therapy Service and the Swan
Valley Child and Adolescent Mental Health Service have access to the roster. This
new service, which provides same-day access for patients, increases the chances of
engaging and improving the health of young people within the community.
•
The Swan Youth Therapy Service Aboriginal liaison officer works in conjunction with
the Swan Valley Child and Adolescent Mental Health Service senior social worker to
provide clinical, culturally appropriate services.
Annual Report 2001/2002 Metropolitan Health Services
57
TOTAL
2.43
10.64
24.40
0.10
71.63
13.01
17.12
0.14
538.22
90.95
58.77
475.23
72.83
336.87
BHS
65.00
249.56
Nursing
Administration
and Clerical*
Medical
Support*
Hotel
Services*
General
Maintenance
Medical
(salaried)
Medical
(sessional)
AHS
CATEGORY
2106.00
35.00
223.00
33.00
275.00
276.00
421.00
843.00
FH and
HS
794.95
0.00
42.22
22.66
124.66
101.16
82.43
421.82
GSL
and
SCH
2270.25
48.03
213.63
55.95
278.20
335.10
410.13
929.21
KEM
and
PMH
724.85
2.54
48.27
12.37
66.44
139.22
107.45
348.56
NMHS
709.55
0.00
116.85
14.50
30.06
182.21
82.46
283.47
PDH
and
CDS
312.56
17.18
0.00
3.92
35.76
46.02
55.65
154.03
RKHS
3849.26
62.48
419.07
79.97
557.15
708.87
745.95
1275.77
RPH
2624.06
39.28
326.24
84.85
403.07
326.11
500.34
944.17
SCGH
496.30
0.04
39.29
0.74
32.14
82.56
70.43
271.10
SHS
Annual Report 2001/2002 Metropolitan Health Services
130.59
0.00
0.00
3.21
22.23
7.60
22.62
74.93
KHS
1999/2000
15,031.82
204.79
1470.09
334.82
1898.77
2354.57
2636.29
6132.49
TOTAL
The following tables show the number of full-time equivalent staff employed at each health care unit within the Metropolitan Health Services:
Employee Profile
Our Staff
58
Our Staff
TOTAL
1.63
9.94
25.63
1.52
65.91
11.13
19.46
1.37
537.94
93.96
65.52
481.77
72.94
332.32
BHS
66.66
251.72
Nursing
Administration
and Clerical*
Medical
Support*
Hotel
Services*
General
Maintenance
Medical
(salaried)
Medical
(sessional)
AHS
CATEGORY
2151.65
35.84
234.94
28.07
280.38
290.36
423.90
858.16
FH and
HS
765.71
0.00
43.88
22.38
118.26
96.30
83.50
401.39
GSL
and
SCH
2270.90
47.11
221.47
54.90
275.13
337.92
401.48
932.89
KEM
and
PMH
756.44
9.49
50.74
12.56
61.41
152.96
120.60
348.68
NMHS
716.60
0.00
115.98
12.62
30.93
179.59
85.33
292.15
PDH
and
CDS
324.91
18.55
2.00
4.25
39.96
48.41
56.75
154.99
RKHS
3914.62
67.66
444.34
72.87
569.00
739.42
730.87
1290.46
RPH
2653.72
43.28
319.29
75.52
418.57
335.50
502.48
959.08
SCGH
523.09
1.13
34.11
0.00
34.97
89.53
75.15
288.20
SHS
Annual Report 2001/2002 Metropolitan Health Services
129.58
0.00
0.00
3.19
23.49
7.81
20.52
74.57
KHS
2000/2001†
15,226.93
225.95
1511.84
307.43
1919.64
2437.28
2640.18
6184.61
TOTAL
59
Our Staff
TOTAL
1.02
10.04
30.78
0.74
73.87
10.73
30.46
0.00
539.82
96.81
75.75
541.78
79.10
321.33
BHS
76.72
274.25
Nursing
Administration
and Clerical*
Medical
Support*
Hotel
Services*
General
Maintenance
Medical
(salaried)
Medical
(sessional)
AHS
CATEGORY
2235.72
36.52
242.58
27.74
288.15
299.65
440.29
900.79
FH and
HS
757.13
0.00
43.05
22.31
113.58
107.26
88.55
382.38
GSL
and
SCH
2081.06
49.76
232.49
57.05
274.68
55.57
437.96
973.55
KEM
and
PMH
780.68
4.93
52.33
13.07
64.49
165.20
118.46
362.20
NMHS
673.60
0.00
110.23
10.53
23.33
174.35
79.20
275.96
PDH
and
CDS
338.57
0.00
18.31
5.14
40.39
51.66
61.46
161.61
RKHS
3942.95
63.47
468.21
72.00
573.62
793.70
791.78
1180.17
RPH
2774.32
47.21
332.76
71.52
449.90
350.59
513.70
1008.64
SCGH
575.62
2.25
45.00
0.00
39.53
99.69
75.49
313.66
SHS
Annual Report 2001/2002 Metropolitan Health Services
127.28
0.00
0.00
3.04
22.97
10.19
17.89
73.19
KHS
2001/2002
15,368.53
204.88
1606.20
303.17
1965.53
2280.42
2780.60
6227.73
TOTAL
60
Medical Support — physiotherapists, speech pathologists, medical imaging technologists, pharmacists, occupational therapists, dietitians and social workers.
Hotel Services — cleaners, caterers and patient service assistants.
•
•
Staff numbers not included are InfoHEALTH Alliance 167.40 FTE, of which 109.80 FTE are Alliance partners and contractors, 12.4 FTE are Department of Health
contractors and 57.6 FTE are DoH employees.
Central Wait List Bureau 10.30 FTE are also not included.
•
•
61
Sir Charles Gairdner Hospital figures include the following:
− Agencies other than nursing 27.51 FTE.
− Nursing includes agency nurses 39.54 FTE.
•
Annual Report 2001/2002 Metropolitan Health Services
Metropolitan Health Services decided to include supply chain one under Royal Perth Hospital. A total of 115.74 FTE for supply chain one are therefore included —
Administration and Clerical 67.47 FTE and Hotel Services 48.27 FTE.
•
† Note the following for 2000/2001:
Administration and Clerical — health project officers, ward clerks, receptionists and clerical staff.
•
*Note these categories include the following:
Our Staff
Our Staff
Recruitment Practices
Industry-wide problems with the recruitment and retention of medical, nursing and certain
allied health staff within the WA health system continued to be of critical concern to the
Metropolitan Health Services during 2001/2002. Initiatives were implemented in several
hospitals to help improve the current recruitment situation. These initiatives included
running overseas recruitment drives, and refresher and re-registration courses, with the
MHS having some success in these areas.
Recruitment, selection and appointment policies were reviewed to ensure compliance
with revised amendments to the Public Sector Standards in Human Resource
Management. Training and support for relevant staff continued to be offered as in past
years.
Significant restructure activity was experienced by hospitals within the MHS during
2001/2002. A redundancy program was successfully implemented in 2002.
Another important development during 2001/2002 was the continued improvement of web
and other electronic-based recruitment services to ensure more potential applicants were
made aware of job vacancies, and to reduce the costs associated with recruitment
activities and advertising. The MHS also achieved substantial savings by rationalising
advertising content for job vacancies across the Health Service.
Several hospitals within the MHS participated in a qualitative research project into human
resource management processes. Data was mainly collected through interviews with
individual people and key decision-making groups. The data will be used to improve
people management practices and employment conditions within the MHS.
Annual Report 2001/2002 Metropolitan Health Services
62
Our Staff
Staff Development
Training and skill-development opportunities continued to be offered to all staff within the
Metropolitan Health Services during 2001/2002. Particular emphasis was placed on:
•
The development of management skills.
•
Training in performance management processes.
•
The development of e-learning strategies and facilities. E-learning is the online
delivery of information, communication, education and training.
•
Collaboration with universities in the development and delivery of various health
programs.
•
Induction and orientation programs.
•
The provision of refresher courses for specific areas of clinical practice.
•
The development of strategic and business planning skills.
Notable achievements for individual hospitals during 2001/2002 in the area of staff
development include:
•
The Fremantle Hospital and Health Service being selected as a finalist in the 2001
and 2002 Training Excellence Awards in the category of Large Employer of the Year.
The awards are run by the WA Department of Training. The 2002 award winners were
to be announced in August 2002.
•
Developing a rehabilitation and aged care program at the North Metropolitan Health
Service for registered and enrolled nurses. The program is due to start in September
2002.
•
Introducing a Diploma of Business – Management Development Program at the Royal
Perth Hospital to address the growing need for better informed and progressively
skilled frontline managers.
•
The Sir Charles Gairdner Hospital Education and Development Centre being
accredited as a registered training organisation by the Australian Qualifications
Framework.
Annual Report 2001/2002 Metropolitan Health Services
63
Our Staff
Industrial Relations Issues
The industrial relations landscape has changed in the past year with the abolition of
workplace agreements. This has seen large numbers of staff move back to enterprise
agreement coverage. Information sessions on these changes were held for all
Metropolitan Health Services staff during 2001/2002.
New enterprise agreements were negotiated with the Hospital Salaried Officers
Association of WA, the Australian Liquor, Hospitality and Miscellaneous Workers Union
and the Australian Medical Association. Hospital salaried officers took industrial action
during the negotiating process for these agreements.
Monthly meetings were held during 2001/2002 for MHS human resource and industrial
relations managers to ensure relevant issues were managed in a consistent manner
across the Health Service.
Industrial relations issues arising across the MHS during 2001/2002 include the following:
•
A hearing was conducted by the Federal Industrial Relations Commission to decide
whether to implement contracts that would allow nurses to work 80 hours each
fortnight and claim accrued days off. It was agreed nursing staff would have the option
either to continue with their existing contractual arrangements — incorporating 76
hours each fortnight without ADOs — or to increase their working hours to 80 to
include ADOs.
•
The Fremantle Hospital and Health Service returned to in-house arrangements for
non-ward cleaning and gardening services, according to government policy.
•
The closure of the Perth Dental Hospital resulted in the need to redeploy and transfer
staff. This issue has since been rectified with only five employees yet to be placed in
new positions.
•
Hospital salaried officers took industrial action in July and August 2001 in support of
improvements to the conditions of their EBA. This matter was eventually resolved
through arbitration in the WA Industrial Relations Commission.
•
A working party consisting of engineering managers and trade staff from across the
MHS worked in conjunction with union representatives to reach an agreement on a
multi-skilling matrix. The matrix will form the blueprint for future multi-skilling
processes within the engineering and building services’ areas of the MHS. The
working party also agreed on a set of baseline productivity indicators. The
considerable work achieved by this group resulted in engineering and building
services departments meeting requirements needed to receive a 3 per cent milestone
pay increase in November 2001.
Annual Report 2001/2002 Metropolitan Health Services
64
Our Staff
Workers’ Compensation and Rehabilitation
The following table shows the number of workers’ compensation claims made through the
Metropolitan Health Services:
CATEGORY
1999/2000
2000/2001
2001/2002
Nursing Services
Administration and Clerical*
Medical Support*
Hotel Services*
Maintenance
Medical (salaried)
Other
464
54
30
142
38
21
27
414
72
40
121
27
12
10
376
67
35
117
36
9
13
TOTAL
776†
696†
653†
*Note these categories include the following:
•
Administration and Clerical — health project officers, ward clerks, receptionists, and clerical staff.
•
Medical Support — physiotherapists, speech pathologists, medical imaging technologists, pharmacists,
occupational therapists, dietitians, and social workers.
•
Hotel Services — cleaners, caterers, and patient service assistants.
† Note figures in this table exclude the Graylands Selby–Lemnos and Special Care Health Services, the
Swan Health Service, King Edward Memorial Hospital and Princess Margaret Hospital. Figures for 1999/2000
and 2000/2001 exclude the Rockingham Kwinana Health Service.
The MHS has reduced lost-time injuries during 2001/2002 by using an effective injury
management program. Preventative and rehabilitation measures used to increase
workplace safety include:
•
Workplace inspections.
•
Safety representatives and committees.
•
Formalised training for hazard control and injury analysis.
•
Redesigning workplaces.
•
Rehabilitation coordination services, which operate internally and externally to provide
early return-to-work programs.
•
Introducing task-specific manual handling training.
•
Early intervention programs assisting staff to return to pre-injury duties.
•
Increasing staff awareness in reporting hazards.
The effectiveness of these preventative and rehabilitation measures has led to workers.
compensation premium refunds and a reduction in lost time across the MHS.
Annual Report 2001/2002 Metropolitan Health Services
65
Our Staff
Equity and Diversity Outcomes
Our Policy
The ability of an organisation to provide high quality health services to the general public
is closely related to workforce diversity. That diversity needs to be tapped for planning,
decision-making and service delivery.
The Metropolitan Health Services aim to achieve equity and diversity in the workplace by
eliminating any discrimination in employment based upon grounds of sex, marital status,
pregnancy, family status, race, religious or political conviction, or age, and by promoting
equal opportunity for all people.
EEO legislative requirements and compliance remains the framework within which the
MHS fulfills its responsibilities under the Equal Opportunity Act 1984, but a shift towards
the integration of diversity and equity principles and practices within the core business of
the MHS is now occurring.
Programs and Initiatives
The MHS aims to promote equal opportunity for all persons, according to the Equal
Opportunity Act 1984. This goal is achieved through activities and programs run on behalf
of the following outcomes:
Outcome 1 — The organisation values EEO and diversity and the work environment
is free from racial and sexual harassment
•
The MHS provides equal opportunity training for line managers, staff and EEO contact
and grievance officers.
•
The MHS ensures the consistent application of EEO principles by including
representatives from all areas dealing with equity and diversity within the Health
Service on Department of Health working parties.
•
Systems of support such as contact and grievance officers, the Peer Support Program
and detailed grievance procedures are available to all staff.
•
Multicultural days were run during 2001/2002 at various health care units within the
MHS.
•
All employees and contractors attend induction programs and are provided with
information on the Equal Opportunity Act 1984. The programs outline the behaviour
expected of employees in their dealings with patients, members of the public and
fellow staff.
•
EEO principles are incorporated into the MHS Code of Conduct.
Outcome 2 — Workplaces are free from employment practices that are biased or
discriminate unlawfully against employees or potential employees
•
Knowledge of EEO principles has become an essential criterion included on job
description forms.
•
Job description forms are written in neutral, gender-free language.
Annual Report 2001/2002 Metropolitan Health Services
66
Our Staff
•
EEO management plans have been developed to be effective for five years. New
guidelines have been included to help in the management of diverse workforces and
to raise awareness of the need for managerial flexibility.
•
Any EEO issues raised with contact officers or Human Resources Department staff
are dealt with as quickly as possible. Employees are advised of grievance processes
should they wish to take action on an EEO issue, and are offered support through the
Employee Assistance Program. EEO training has been carried out in specific areas as
required.
•
The Office of Equal Employment Opportunity and the Office of the Public Sector
Standards Commissioner are regularly consulted regarding proposed courses of
action to identify and avoid potential EEO issues before they arise.
•
The MHS offers a number of flexible working arrangements to help employees
balance their life with work.
•
Training is provided for selection panel members to safeguard against unlawful
discrimination or bias.
Outcome 3 — Employment programs and practices recognise and include strategies
for EEO groups to achieve workforce diversity
•
Information booklets on subjects such as pregnancy guidelines and flexible work
practices are available to all managers within the MHS.
•
Emphasis was placed on gathering information regarding patient profiles during
2001/2002 to better assess staffing, recruitment and retention strategies.
•
There has been an increase in the number of positions advertised as suitable for job
sharing. This practice allows two people to share one full-time position, with each
employee working on a part-time basis.
•
Restrictive JDF conditions that have EEO implications, such as the requirement for an
employee to have a valid driver’s licence for a community-based position, are being
reviewed.
•
Hospitals and Health Services within the MHS continue to liaise with placement
agencies representing people who speak a language other than English, Aboriginal
and Torres Strait Islanders, and people with disabilities. Opportunities have been
provided to members of these groups under work experience programs.
•
Family friendly strategies include the employment of a family services coordinator to
assist with child care placements.
Annual Report 2001/2002 Metropolitan Health Services
67
Our Staff
EEO Indicators
The following table indicates strategic plans or processes the Department of Health aims
to have in place across the health system to achieve equity and diversity in the
workplace, and the level to which the MHS has been able to meet these goals:
Plan or Process
EEO Management Plan
Organisation plans reflect EEO
Polices and procedures encompass
EEO Requirements
Established EEO Officers
Training and Staff awareness
Diversity
Level of Achievement
Plans implemented with some reviews
taking place as required
Implemented with reviews taking place as
required
Implemented with policies updated as
required
Implemented with ongoing training
provided, and reviews undertaken as
required
Various programs in place conducted on an
ongoing basis for managers, staff and EEO
contact officers
Programs in place with reviews undertaken
as required
Annual Report 2001/2002 Metropolitan Health Services
68
Keeping the Public Informed
Marketing
The MHS raised public awareness of its facilities through:
•
Websites.
•
Publications provided to patients at the time of hospital admission.
•
Community forums.
•
Displays at fairs and doctors' surgeries.
•
Health Service newsletters.
Specific promotional, public relations and marketing activities for 2001/2002 include:
•
A Filipino delegation of health workers — who were participating in an AusAID-funded
management program at Curtin University of Technology — made a field visit to the
Lockridge Community Health Centre to see the community health management team
in action.
•
The official opening of the Armadale Health Service's new private hospital facility in
March 2002.
•
Celebration of the Osborne Park Hospital's fortieth anniversary.
•
Visits to the Graylands campus by members of the public and students on a regular
basis.
Successful media promotions during the year covered a range of topics including the
following:
•
Two ABC TV programs, including a three-part series about the training of an intern at
the Royal Perth Hospital, and ‘a day in the life of’ special about a physiotherapist from
RPH’s Shenton Park campus.
•
A new and innovative aggression management program run at RPH, which received
coverage in The West Australian, and appeared as two feature articles in the national
magazine, Hospital and Healthcare.
•
TV and print media stories about the opening of a therapeutic garden for spinal
patients at RPH’s Shenton Park campus.
•
A story published in The West Australian on a new approach to surgery for epilepsy
known as awake craniotomy. The approach was developed after a WA mother was
told the brain tumour responsible for her epilepsy was inoperable.
•
TV and print media coverage on the ministerial re-commissioning of the cardiac
catheterisation service at RPH.
•
Local media coverage about a joint effort between RPH and the Swan Health Service
to save a man with a brown snake bite who had soaked up all the anti-venom supplies
in WA. The story highlighted medical advice for the treatment of bites during the peak
summer months when snakes are most active.
•
Stories published in The West Australian about the use of a new insulin delivery
system for diabetics and the opening of a new research centre to improve the health
of elderly Australians.
Annual Report 2001/2002 Metropolitan Health Services
69
Keeping the Public Informed
Publications
Many publications were produced by the Metropolitan Health Services during 2001/2002
to provide patients and the community with information on hospital and health services,
and specific medical treatments. These publications took the form of pamphlets,
brochures, posters, newsletters and booklets, and specifically included:
•
Annual reports.
•
Customer Service Charters.
•
Research and publications reports.
•
Hospital newsletters.
•
Patient information guides.
•
Patient rights and responsibilities brochures.
•
Patient information brochures.
•
Brochures on specific conditions and medical treatments.
•
Health Service complaint procedures.
MHS staff have also contributed to a wide range of local and national clinical-based
publications. These include medical journals and textbooks, and tertiary institution and
scholarly material.
Annual Report 2001/2002 Metropolitan Health Services
70
Research Projects
Research and Development
The Metropolitan Health Services continued its outstanding growth in medical research
during 2001/2002. Research of international, national and local importance was
undertaken across many disciplines. Senior staff had important research work published
in prestigious health magazines and journals, and contributed papers to major research
forums.
Research highlights for the MHS during 2001/2002 include the following:
•
A State Child Development Centre group study compared the effectiveness of
immediate release Methylphenidate (Ritalinâ) and modified release Methylphenidate
with placebo in children with attention-deficit/hyperactive disorder.
•
A trial run by the University Department of Paediatrics at Princess Margaret Hospital
assessed the safety, tolerability and immunogencity of the following vaccines when
administered concurrently to healthy children:
− Influenza virus vaccine.
− Trivalent.
− Types A and B.
− FluMist — a live, cold-adapted version of the flu vaccine.
− Measles, mumps and rubella.
− The varicella — or VARIVAX — vaccine.
•
The Department of Respiratory Medicine at PMH conducted research into the effects
JumpStart — an exercise and behavioural change program — has on the exercise
tolerance and quality of life among those who suffer from chronic lung disease.
•
The University Department of Paediatrics at PMH conducted research into the effects
smoking during pregnancy has on developing immune responses and airway
inflammation.
•
The Physiotherapy Department at PMH conducted research into the use of botulinum
toxin A in the treatment of biceps brachii, pronator teres and adductor pollucis
spasticity in children with cerebral palsy.
•
The Women and Infants Research Foundation have conducted various studies into:
− The foetal origins of adult disease.
− Pre-term birth.
− Foetal monitoring in the growth-restricted foetus.
− Induction of labour with an unfavourable cervix.
− Pain relief and anaesthesia.
− The newborn infant.
•
A joint obstetrics–psychiatry services program run at Osborne Park Hospital to identify
and help expectant mothers at risk of postnatal depression won a prestigious national
Quality Improvement Award from the Australian Council on HealthCare Standards.
The ACHS is responsible for accrediting health service providers on an Australia-wide
basis.
Annual Report 2001/2002 Metropolitan Health Services
71
Research Projects
•
Research conducted by the North Metropolitan Health Service in conjunction with the
University of Western Australia into the development of a clinical classification system
for patients with mechanical neck pain. The system would be used to test a newly
developed outcome measure for non-acute mechanical neck pain, and to evaluate
differences in response to treatment.
•
The Perth Dental Hospital and Community Dental Service conducted surveys into
child dental health, adult dental programs, aged care residents and dental fluorosis.
•
The Rockingham Kwinana Health Service has investigated the effect of navicular drop
in children with flat feet. The Health Service has also completed a project into patient
education in the Emergency Department with findings presented at the Australasian
Association for Quality in Health Care national conference.
•
The Royal Perth Hospital was involved in the international B-Aware Trial of a new
method of monitoring levels of awareness during surgery. The trial aimed to assess
whether a relatively new piece of equipment known as a bispectral index monitor
would be useful in gauging awareness levels to help anaesthetists provide more
effective medical treatment.
•
RPH conducted a study investigating possible links between people with sleep
apnoea and vascular disease.
•
RPH is developing a novel way of treating prostate cancer which scientists hope will
become an alternative to conventional treatment options. The Molecular Biology
Laboratory is testing a new method that prevents the growth and spread of cancerous
cells without the use of traditional drugs.
•
The Department of Clinical Immunology and Biochemical Genetics at RPH is
conducting a study to determine whether pre-eclampsia results from an incompatibility
of the foetal HLA–C type with respect to the mother’s natural killer cells.
•
The Department of Anaesthesia and Pain Medicine at RPH has seen a dramatic
growth in research activity during 2001/2002. Clinical trials in progress currently
involve the investigation of diverse areas of peri-operative care and pain medicine, in
areas including awareness during anaesthesia, new airway devices, new analgesic
drugs, innovative approaches to drug delivery and comparisons of anaesthetic
techniques.
•
Research undertaken on HIV disease in the Department of Immunology at RPH
resulted in several publications being produced. These publications report on topics
such as the genetic control of immune responses against HIV, genetic susceptibility to
drug hypersensitivity reactions, management of metabolic complications of
antiretroviral therapy and immune restoration diseases.
•
RPH dietitians participated in a five-year triple blind research project in conjunction
with doctors in the intensive care unit. The project established whether the practice of
supplementing enteral feeds with the amino acid glutamine would improve patient
outcomes. Results obtained from the project were presented at the 2002 American
Society of Parenteral and Enteral Nutrition conference held in February.
•
The Department of Physiotherapy at RPH is participating in a multi-centre study on
outcome post extensor tendon surgery. RPH, Sir Charles Gairdner Hospital and
Fremantle Hospital hand therapy physiotherapists will be collating the data for this
study.
Annual Report 2001/2002 Metropolitan Health Services
72
Research Projects
•
The Department of Podiatry at RPH is involved in research on determining the
validity, predictive value and reliability of the Basic Foot Assessment Checklist. The
checklist is a primary care screening tool used to identify the risk of foot ulcers in
people with diabetes.
•
Collaborative research has continued during 2001/2002 into the caregiver’s
perspective on family conferences in hospital settings. This year saw the completion
of the data collection stage. Research partners in Australia are Edith Cowan
University, the Austin and Repatriation Medical Centre in Melbourne and the Sydney
Children’s Hospital.
•
Research funded by the Commonwealth Department of Health and Ageing has led to
the development of the Cultural Awareness Tool. The WA Transcultural Mental Health
Centre designed this clinical tool in partnership with other collaborators such as the
Transcultural Psychiatry Unit at RPH and the Royal Australian College of General
Practice Research Unit. The tool is used to facilitate a clinician’s assessment of
people from ethnic backgrounds who may suffer from mental health problems.
•
The Foundation Centre for Nursing Research continued to support RPH’s research
into areas such as the nursing of burns, patient observations in surgical areas, postheart surgery recovery, delayed discharge from Intensive Care Units, staff
perceptions about ICU visiting, and staff attitudes and satisfaction in medical
specialities.
•
Research teams working at the Western Australian Institute of Medical Research — a
collaborative organisation run between Sir Charles Gairdner Hospital, Royal Perth
Hospital and the University of Western Australia — have advanced study in the
following areas:
− Research has been conducted to discover the cellular and molecular biology of
the proteins that make the receptors in the human body respond to hormones.
− Investigating the genetic basis for a range of neuromuscular disorders. The team
responsible for this project has identified a key gene indicating a susceptibility to
adult forms of myopathy.
− Experiments have begun to induce tolerance to the virus and viral-encoded
dystrophin, which avoids the use of immuno-suppressive drugs. This work has
important implications for understanding the mechanisms of muscle regeneration
following injury and degenerative diseases.
•
The Tumour Immunology Group at SCGH is working on understanding how the
body’s immune system becomes abnormal and allows cancer cells to grow. The
group has made major advances in defining the antigens associated with
mesothelioma. This disease is a cancer of the cells that make up the lining around the
outside of the lungs and the inside of the ribs, or around the abdominal organs.
Mesothelioma is largely caused by exposure to asbestos fibres.
•
The Asthma and Allergy Research Institute at SCGH is receiving Commonwealth
Government funding to investigate the genetic and environmental influences on
asthma and is working towards better treatments and diagnosis of the condition.
•
The Sleep Disorders Research Institute at SCGH has been researching the effects of
sleep apnoea. The institute has recently discovered sleep apnoea may be at least
partially the result of the tendency for a person’s upper airway to collapse during
sleep.
Annual Report 2001/2002 Metropolitan Health Services
73
Research Projects
•
A recent publication produced from the SCGH labs of the WA Heart Research
Institute has challenged the belief that antioxidant supplements provide protection for
the heart. This finding is in line with recent clinical trial results obtained at SCGH.
•
Nursing research at SCGH has received more than $396,000 in grants to fund its
activities from 2000 to 2002.
•
The Swan Health Service participated in the following research projects:
− Care for Older Australians Survey.
− Gestational breast cancer.
− Endophthalmitis in WA Study.
− The Resourceful Adolescent Program.
− The Early Psychosis Outcome Evaluation Study.
− The Surgical Site Infection Surveillance Project conducted at Swan, Kalamunda
and Mercy hospitals.
Further information about these research projects can be obtained from the public
relations departments of individual Hospitals and Health Services.
Evaluations
The Metropolitan Health Services has conducted major evaluations in the following areas
during 2001/2002:
•
The seniors’ mental health program in Melville run by the Fremantle Hospital and
Health Service.
•
Participation in the Australian Council on HealthCare Standards Evaluation and
Quality Improvement Program.
•
The School Dental Service Program.
•
The Subsidised Dental Care Program.
•
MHS hospitals periodically evaluating the extent to which patient, client and staff
confidentiality is protected within quality activities.
•
The National Standards for Mental Health Services.
•
External proficiency testing programs.
•
Medical testing accreditation by the National Association of Testing Authorities.
•
Therapeutic Goods Administration licences.
•
Australian Testing and Therapeutic Satisfaction Benchmark Study for Pathology
Services conducted by the health care industry measurement and improvement firm,
Press Ganey.
•
Laboratory medicine internal audit program.
Annual Report 2001/2002 Metropolitan Health Services
74
Safety and Standards
Risk Management
Our Policy
The Metropolitan Health Services aim to achieve the best possible practice in the
management of all risks that threaten to adversely impact upon the health service itself,
its customers, staff, assets, functions, objectives, operations, or upon members of the
public.
Strategies and Initiatives
The MHS has been progressively changing its culture away from pure reliance upon
reactive indicators towards establishing proactive management that incorporates the
development, introduction and assessment procedures against risk management
standards. The following achievements were made during 2001/2002:
•
The introduction of the new Australian Incident Monitoring System clinical incident
reporting system.
•
Establishing committees at various Health Services to consider clinical risks and
issues.
•
Establishing risk registers throughout the MHS.
•
Quality and risk-management committees are responsible for providing direction,
advice and assistance on risk management to all areas within the MHS.
•
Development of a system-wide risk management policy and register.
•
Endorsement of plans and implementation projects to assess gaps in risk
management within the MHS, and the re-implementation of a comprehensive riskmanagement system in line with national standards.
•
A significant upgrade of fire signs, alarms, equipment and evacuation maps across
the MHS following an extensive fire audit.
•
Several initiatives implemented to address growing security concerns for patients and
staff, including the installation of video surveillance equipment and security screens in
some areas, and training staff to handle aggressive behaviour.
Future Direction
The MHS will continue to review its risk management and quality improvement processes
in keeping with the above policy.
Annual Report 2001/2002 Metropolitan Health Services
75
Safety and Standards
Internal Audit Controls
The Metropolitan Health Services has established a system of internal controls to provide
reasonable assurance that assets are safeguarded, proper accounting records are
maintained and financial information is reliable. The Executive oversees the operation of
internal audit functions, and ensures management addresses any findings arising from
internal and external audit reports.
Audits were undertaken in the following areas during 2001/2002:
•
Theatre management.
•
Supply purchasing, payments and stock control.
•
Trust accounts.
•
Patient billings.
•
Clinical incidents reporting.
•
Payroll.
•
Financial Administration and Audit Act 1985 financial areas.
•
Cash handling.
•
The Princess Margaret Hospital coffee shop.
•
The ASCribe electronic prescribing system.
•
The radiology management system.
•
Performance audit on managing nursing resources.
•
Assets.
All findings are reported to the relevant audit committee for each Hospital, and action is
taken to resolve all issues raised.
Waste Paper Recycling
Approximately 300 tonnes of waste paper was recycled across the MHS during
2001/2002.
Annual Report 2001/2002 Metropolitan Health Services
76
Safety and Standards
Pricing Policy
The Metropolitan Health Services raises a number of fees and charges to recover the
estimated cost of providing certain services, except where a public service obligation
exists.
A daily bed fee is raised against all patients other than those treated under the public
health system. These fees contribute towards the cost of services required to treat
patients. The only exception to this is professional medical services, which are provided
privately by medical and dental practitioners.
No fees are raised against registered public and private outpatients of the Health Service.
Annual Report 2001/2002 Metropolitan Health Services
77
Performance Indicators Audit Opinion
To the Parliament of Western Australia
THE MINISTER FOR HEALTH IN HIS CAPACITY AS THE DEEMED
BOARD OF METROPOLITAN PUBLIC HOSPITALS
PERFORMANCE INDICATORS FOR THE YEAR ENDED JUNE 30, 2002
Scope
I have audited the key effectiveness and efficiency performance indicators of The Minister for
Health in his capacity as the Deemed Board of Metropolitan Public Hospitals for the year
ended June 30, 2002 under the provisions of the Financial Administration and Audit Act 1985.
The Director General, Department of Health is responsible for developing and maintaining
proper records and systems for preparing and presenting performance indicators. I have
conducted an audit of the key performance indicators in order to express an opinion on them to
the Parliament as required by the Act. The key performance indicators reflect the progress
made to date as part of the staged process to develop more enhanced measurement of the
performance of The Minister for Health in his capacity as the Deemed Board of Metropolitan
Public Hospitals.
My audit was performed in accordance with section 79 of the Act to form an opinion based on
a reasonable level of assurance. The audit procedures included examining, on a test basis,
evidence supporting the amounts and other disclosures in the performance indicators, and
assessing the relevance and appropriateness of the performance indicators in assisting users to
assess the Health Service’s performance. These procedures have been undertaken to form an
opinion as to whether, in all material respects, the performance indicators are relevant and
appropriate having regard to their purpose and fairly represent the indicated performance.
The audit opinion expressed below has been formed on the above basis taking into account the
ongoing development of the key performance indicators.
Audit Opinion
In my opinion, the key effectiveness and efficiency performance indicators of The Minister for
Health in his capacity as the Deemed Board of Metropolitan Public Hospitals are relevant and
appropriate for assisting users to assess the Health Service’s performance and fairly represent
the indicated performance for the year ended June 30, 2002.
D D R PEARSON
AUDITOR GENERAL
February 28, 2003
4th Floor Dumas House 2 Havelock Street West Perth 6005 Western Australia Tel: 08 9222 7500 Fax: 08 9322 5664
Annual Report 2001/2002 Metropolitan Health Services
78
Performance Indicators Certification Statement
THE MINISTER FOR HEALTH IN HIS CAPACITY AS
THE DEEMED BOARD OF METROPOLITAN PUBLIC HOSPITALS
CERTIFICATION OF PERFORMANCE INDICATORS
FOR THE YEAR ENDED 30 JUNE 2002
I hereby certify that the performance indicators are based on proper records, are relevant
and appropriate for assisting users to assess the performance of The Minister for Health
in his capacity as Deemed Board of Metropolitan Public Hospitals and fairly represent the
performance of the Board for the financial year ending 30 June 2002.
Mike Daube
Director General of Health
Accountable Authority for the Minister for Health in his capacity as the
Deemed Board of Metropolitan Public Hospitals
February 2003
Annual Report 2001/2002 Metropolitan Health Services
79
Key Performance Indicators
Table of Contents
Background
82
OUTCOME ONE
Reducing the Incidence of Preventable Disease, Injury and Premature Death
Access to Community and Allied Health Services (1.1)
85
Childhood Screening and Referral Service Rates and
Immunisation Rates (1.2, 1.13 & 1.5)
95
Provision of Community Health Services to Aboriginal
and Torres Strait Islander People (1.3)
105
Hospital Rates of Admission by Area of Residence for
Sentinel Conditions and Procedures
Tonsillectomies and Grommets (1.7)
Gastroenteritis (1.9)
Bronchiolitis (1.10)
Croup (1.10)
Acute Bronchitis (1.10)
Asthma - children (1.10)
Asthma - adults (3.7)
106
107
108
109
110
111
112
113
Average Cost per Occasion of Service for Community
Health Programs (1.14)
114
OUTCOME TWO
Restoring the Health of People with Acute Illness
Client Satisfaction (2.2)
115
Avoiding Hospital Initiated Rescheduling of Elective Care
for People on Waiting Lists (2.11)
120
Reducing Waiting Times for Admission to Hospital for
Elective Care – Public Patients (2.15)
122
Emergency Department Waiting Times (2.18)
133
Median Length of Stay in Days in Hospital and Special
Units for Mental Disorders (2.31)
149
Elective Surgery at Teaching Hospitals – Post-Operative
Pulmonary Embolism Rate (2.38)
154
Labour Outcome Rates for Hospital Obstetric Units (2.42)
155
Survival Rates for Sentinel Conditions (2.46)
Heart Attack
Stroke
Fractured Neck of Femur
156
156
156
156
Survival Rate of Patients following Coronary Artery
Bypass Grafts (2.59)
159
Survival Rates for Coronary Angioplasty (2.62)
160
Annual Report 2001/2002 Metropolitan Health Services
80
Key Performance Indicators
Average Cost per Inpatient (Casemix Adjusted) (2.70 and
2.71)
161
Average Cost per
Emergency Department Attendance (2.80)
Outpatient Clinic Attendance (2.84)
Non-Inpatient Occasions of Service (2.86)
163
163
164
164
OUTCOME THREE
Improving the Quality of Life of People with Chronic Illness and Disability
Aged Care Assessment Teams –
Total Assessment Rate per 1,000 of Population
(3.2)
First Assessment Rate per 1,000 of Population
(3.3)
Waiting Time in Days to First Appointment to see
Aged Care Assessment Team (3.4)
Average Cost per Person with Mental Illness under
Community Management (3.8)
165
166
167
168
170
Dental Services
Value/Cost per Treatment for General, Specialised and
School Dental Service
172
Dental Health Status of Target Clientele
174
Access – Rural and Remote Dental Services coverage
according to Shires
175
Treatment Rates and Health Status of Individuals using
School Dental Service
176
Percentage of Eligible People accessing Dental Services
179
Waiting Time in Weeks for General and Specialist Dental
Services
180
Annual Report 2001/2002 Metropolitan Health Services
81
Key Performance Indicators
Background
The Performance Indicators reported in the following pages address the extent to which
the strategies and activities of the Metropolitan Health Service have contributed to the
required health outcomes and outputs, viz.,
OUTCOME 1 - Improvement in health by a reduction in the incidence of preventable
disease, injury, disability, premature death and the extent and impact of drug
abuse.
Output 1 - Prevention and promotion services aim to improve the health of Western
Australians by reducing the incidence of preventable disease, injury, disability,
premature death and the extent and impact of drug abuse.
OUTCOME 2 - Restoration of the health of people with acute illness.
Output 2 - Diagnosis and treatment services aim to improve the health of Western
Australians by restoring the health of people with acute illness.
OUTCOME 3 - Improvement in the quality of life for people with chronic illness and
disability.
Output 3 - Continuing care services are provided to improve the quality of life for
those who need continuing care.
The different service activities, which relate to the components of the outcome, are
outlined below.
Output 1:
Prevention and Promotion
• Community and Public health services
• Mental health services
• Drug abuse strategy coordination, treatment and prevention services
Output 2:
Diagnosis and Treatment
• Hospital services (emergency, outpatient & in-patient)
• Nursing posts
• Community health services (post discharge care)
• Mental health services
Output 3:
Continuing Care
• Services for frail aged and disabled people (eg, Aged Care
Assessments, in-patient respite, outpatient services for chronic pain
and disability, Nursing Home Type hospital care)
• Services for the terminally ill (eg, in-patient palliative care)
• Mental health services
There are some services, such as Community Health, which address all three of the
outputs. Current information systems do not easily allow the distinction to be made
between the three and this is therefore an important area for future development. To
assure consistency in reporting and evaluation, the Health Service has, during the year,
continued to develop clear guidelines for the collection and interpretation of data for
performance reporting. Whilst steps have been taken to minimise inconsistencies, some
still exist.
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82
Key Performance Indicators
General Approach
One of the aims of the Health Service has been to deliver activity, equitably distributed to,
and accessible by, all sectors of the community.
For most of those performance indicators of health service delivery which target the
• reduction of the incidence of preventable disease, injury, disability and premature
death and
• the improvement of the quality of life of people with chronic illness and disability,
the graphs used indicate performance for those who live in each catchment area
irrespective of where service is provided and whether service is delivered in private or
public hospitals.
For most services restoring the health of those with acute illness, performance is graphed
according to where the service has been provided, irrespective of where people live and
only includes service delivered by the public sector. The indicators for these intervention
strategies are the first step in a staged process leading to more comprehensive and
meaningful measurement and reporting of performance in the above. Further indicators
are being developed to assist in measurement, management and reporting.
Output Measures
The four output measures are of quantity, quality, timeliness and cost. These are direct
measures of performance, but are not to be confused with Key Performance Indicators of
Efficiency and Effectiveness.
Quantity measures describe outputs in terms of how much, or how many are performed
and require a unit of measurement to be defined.
Quality measures usually reflect service standards based on customer needs. The
dimensions of quality as an output measure include: accuracy; completeness;
accessibility; continuity; and a customer acceptability of the output.
Timeliness measures provide parameters for how often, within what time frame, outputs
will be produced.
Cost measures reflect the full accrual cost to an agency of producing each output.
Hospitals and Health Services are required to report output measures of quantity, quality,
timeliness and cost together with a comparison between actual and target performance.
Assessing the Performance of the MHS
It is not only the KPIs and Output Measures which readers of this report should examine
when assessing the performance of the MHS. The Key Performance Indicators, Financial
Statements and Hospitals/Health Services reports, all provide information relevant to
assessment of MHS performance for 2001/02.
Annual Report 2001/2002 Metropolitan Health Services
83
Key Performance Indicators
Glossary of Terms
Performance Indicator – information about output performance or outcome
achievement, usually expressed as a unit, index or ratio.
Efficiency Indicator – a performance indicator that relates an output to the level of
resource input required to produce it.
Effectiveness Indicator – a performance indicator which provides information on the
extent to which a government desired outcome has been achieved through the funding
and production of an agreed output.
Note:
The correct legal title for the Metropolitan Health Service is - "The Minister for Health in
his capacity as the deemed Board of Metropolitan Public Hospitals." In the body of the
report, the correct legal title will be replaced with the reference, "Metropolitan Health
Service".
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84
Key Performance Indicators
ACCESS TO COMMUNITY AND ALLIED HEALTH SERVICES
(HOSPITAL AND COMMUNITY BASED)
KPI 1.1
North
Metropolitan
Joondalup
Swan
Swan Clinic
Koondoola
Osborne Park
Bentley Clinic
Bentley
Bentley
Kalamunda
Kalamunda Clinic
Fremantle Clinic
Fremantle
Armadale
Kwinana Clinic
Armadale Clinic
Rockingham Clinic
Rockingham
Kwinana
Access to health services is effective in preventing the incidence of preventable disease
and premature death by providing appropriate treatment of illness and injury. Without
access to appropriate health care the consequences of any injury or illness are likely to
be more disabling, may contribute to premature death, or may result in more
hospitalisation than is appropriate.
It is important that access to health services is provided on the basis of clinical need. If a
health service has a large number of clients waiting longer than the average, this may
reflect sub-optimal practices or under-resourcing within the health service.
Median waiting times from referral to attendance have been reported for each community
catchment population. Results are presented either by the practitioner’s profession (eg
Clinical Psychology, Physiotherapy or Speech Therapy), or where multi-disciplinary
teams are generally providing treatment and care, by the specific health condition (eg
Enuresis or Diabetes).
Location of Services
The map above shows where the clinics are located. This map should be used in
association with the charts as the basis for identifying the distribution and accessibility of
services. Action is being taken to improve access to services throughout the metropolitan
area, through a better alignment of resources with areas of need.
Three client-focused service grouping are reported:
•
•
•
Children – Community/Allied Health Clinics
General – Community/Allied Health Clinics
Mental Health – Child & Adolescent, Adult & Aged Services.
Annual Report 2001/2002 Metropolitan Health Services
85
Key Performance Indicators
KPI 1.1 - WAITING TIME (in weeks) FOR COMMUNITY / ALLIED HEALTH TREATMENTS
CHILDREN’S CLINICS
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
ENURESIS (BED WETTING)
20
15
Weeks
11
10
3
5
3
2
0
Arm adale
Bentley
Frem antle
Kw inana
Rockingham
20
15
Weeks
9
10
4
2.5
5
0
Kalam unda
Joondalup
Koondoola
Osborne Park
Sw an
OCCUPATIONAL THERAPY
Weeks
50
40
30
20
10
0
37
9
Armadale
Weeks
26
18
50
40
30
20
10
0
Bentley
14
Kalamunda
Fremantle
15
Joondalup
Kwinana
13
13
Koondoola
Rockingham
6
Osborne Park
Swan
PAEDIATRICIAN
60
45
Weeks
24
30
9
15
21
5
0
Armadale
Bentley
Fremantle
Kwinana
Rockingham
60
45
Weeks
19
30
15
10
15
0
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
Annual Report 2001/2002 Metropolitan Health Services
86
Key Performance Indicators
Children’s Clinics cont…
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
MEDICAL OFFICER
20
15
Weeks
10
3
3
5
0
Armadale
Bentley
Fremantle
Kwinana
20
12
15
Weeks
10
5
3
0
0
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
PHYSIOTHERAPY
60
45
Weeks
23
30
15
2
2
3
0
Armadale
Bentley
60
Fremantle
Kwinana
Rockingham
54
48
45
Weeks
30
7
4
15
5
0
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
PODIATRY
16
12
Weeks
8
8
2
4
0
Armadale
Bentley
Fremantle
Kwinana
Rockingham
16
Weeks
13
12
8
4
0
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
Annual Report 2001/2002 Metropolitan Health Services
87
Key Performance Indicators
Children’s Clinics cont…
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
PSYCHOLOGY - CLINICAL
Weeks
30
25
20
15
10
5
0
18
13
9
Armadale
Weeks
16
30
25
20
15
10
5
0
Bentley
Fremantle
Kwinana
Rockingham
18
11
6
2
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
SOCIAL WORK
12
8
9
Weeks
6
4
4
3
1
0
Armadale
Bentley
12
Kwinana
Rockingham
9
9
Weeks
Fremantle
9
5
6
3
0
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
SPEECH PATHOLOGY
Weeks
50
40
30
20
10
0
Armadale
Weeks
50
40
30
20
10
0
28
16
10
Bentley
5
Fremantle
28
5
Kwinana
Rockingham
36
18
17
9
Kalamunda
Joondalup
Koondoola
Osborne Park
Swan
Annual Report 2001/2002 Metropolitan Health Services
88
Key Performance Indicators
GENERAL CLINICS (Adults and Some Children)
2001/02
Financial Year
Continence Advisory/Enuresis
Clinical Psychology
3
3
Weeks
Weeks
3
1
2
1
2
1
1
0
0
Bentley
Kalam unda
Sw an
Diabetes
10
Weeks
10
8
6
4
2
0
5
2
3
2
Armadale
Fremantle
(Education)
Fremantle
(Adult)
3
Kalamunda Rockingham
Swan
Diabetes Education
8
8
8
Weeks
6
4
3
3
R o ck
S wa n
( Ind.)
3
4
2
0
0
B e nt le y
F re m
Lo c k ridge
(Ind.)
Lo c k ridge
( G ro ups )
S wa n
( G ro ups )
Dietetics
13
14
12
11
9
10
8
Weeks
8
6
5
6
3.5
3
4
2
0
Arm
Frem
Kala
Jondlp
Osb Pk
Rock
Sw an Individual
Annual Report 2001/2002 Metropolitan Health Services
Sw an Groups
89
Key Performance Indicators
General Clinics (Adults and Some Children) cont…
2000/01
Financial Year
Occupational Therapy - Adult
6
6
5
Weeks
3
4
3
2
3
2
1
2
0
1
0
Bent
Frem
Kala
M irrabooka
Osb P k
Rock
Swan
Physiotherapy - Adult
8
8
8
6
Weeks
3
4
2
2
1
1
0
Bentley
Frem antle
Osborne Rockingham Kw inana
Park
Sw an
Podiatry
13
14
12
10
Weeks
8
5
6
4
1
2
0
Frem antle
Rockingham
Sw an
Social Work
3
2
2
Weeks
2
1
0.5
1
0
0
Frem antle
Kalam unda
Kw inana
Rockingham
Sw an
Annual Report 2001/2002 Metropolitan Health Services
90
Key Performance Indicators
General Clinics (Adults and Some Children) cont…
2000/01
Financial Year
Speech Pathology
8
7
8
6
Weeks
4
3
2
0
0
Bentley
Frem antle
Osborne Park
Rockingham
Annual Report 2001/2002 Metropolitan Health Services
91
Key Performance Indicators
GENERAL ADULTS & AGED CLINICS
2001/02
Financial Year
Psychology
18
20
14
16
Weeks
10
10
Joon Coast
Joon Lake
12
8
4
8
4
4
0
Avro Subicao
Bentley
Clarkson
Mirrabooka
Osb Pk
Social Work
2
Weeks
1
1
0
0
0
0
0
Avro - Subicao Joondalup Coast
Joondalup Lake
Mirrabooka Osborne Park
Aged
2
Weeks
1
1
0
Bentley
Annual Report 2001/2002 Metropolitan Health Services
92
Key Performance Indicators
MENTAL HEALTH CLINICS
2001/02
Financial Year
Adult - Speech Pathology
Accommodation Support
16
4
3
2
1
0
Avro
3
Weeks
Weeks
Weeks
20
15
10
5
0
Child & Adolescent - Speech
Pathology
Bentley
8
6
4
2
0
7
Bentley
Child & Adolescent - Psychology
16
20
10
Weeks
15
6
10
5
6
3
5
0
Bentley
Clarkson
Kalamunda
10
Selby
Hillarys
Warw ick
Medical
10
8
Weeks
6
3
4
2
0
1
0
0
Avro
Clarkson
Joondalup Mirrabooka
Osborne
Occupational Therapy
5
4
4
Weeks
3
2
2
1
0
Mirrabooka
Osborne
Annual Report 2001/2002 Metropolitan Health Services
93
Key Performance Indicators
Mental Health Clinics cont…
2000/01
Financial Year
Rehabilitation
7
8
5
5
6
Weeks
4
2
1
0
0
0
Avro
Clarkson
Joondalup - Joondalup - Mirrabooka
Coast
Lake
Osborne
Social Work
8
6
Weeks
4
2
0
0
0
0
1
0
Avro
Clarkson
Joondalup
Mirrabooka
Osborne
At Fremantle, waiting times are used as appropriate clinical tools to manage a range of
clinical specialties including Mental Health Services. All referrals are assessed by a
clinician upon receipt and those that require urgent assessment are priorities and given
urgent appointments whilst those that can wait are given appointments a few weeks into
the future.
Annual Report 2001/2002 Metropolitan Health Services
94
Key Performance Indicators
SCREENING, REFERRAL and IMMUNISATION
Rates per 1,000 of Population
KPIs 1.2,
1.13 & 1.5
The community sets a very high priority on ensuring that the health and well being of
children are safeguarded. It is important not only to restore them to good health when
they become ill but also to maintain a state of “wellness” that allows them to develop to
full potential. The State promotes a program of health monitoring and intervention at
specific intervals in the period from birth to adolescence.
Without access to screening programs for children and appropriate referrals to other
practitioners, and without access to immunisation, the consequences of any illness or
disability are likely to be more disabling and are more likely to contribute to a premature
death.
Screening, Referral and Immunisation - Sentinel events for children aged 0-4
The charts on the left hand side of the first group of graphs show the rate of screening
events for children from birth to 4 years old, in relation to the resident child population in
the catchment for each health service. As it is possible for the same child to attend
various screening sessions during the year, some rates can exceed 100%.
Screening
All health services are conforming to the National Health and Medical Research Council’s
Screening Schedule. Variations in rates are due to the grouping of required events that
each health service finds is its most effective mode of delivery for its population. The rate
of screening this year is slightly lower over all Health Services.
The charts down the middle of the page show the rate of post-screening referrals to other
practitioners, for children from birth to 4 years old, in relation to the resident child
population in the catchment for each health service.
Again, it is possible for the same child to receive multiple referrals during the year.
Referral
Variations in post-screening referral rates are examined on an ongoing basis. Low referral
rates might not indicate poor coverage of the population, but rather that referral patterns
between community health services and private practitioners work according to different,
but equally effective protocols of care. Low rates might also indicate a healthy population.
Referral rates varied this year but were similar to previous years.
Immunisation
The charts on the right hand side of the page show the rate of immunisation against
particular diseases, for children between 24 and 27 months of age, in relation to the
resident child population in the catchment for each health service.
To be counted as immunised, each child must be fully vaccinated in accordance with the
National Health and Medical Research Council’s Standard Vaccination Schedule.
The immunisation rates shown are dependent on effective reporting by all parties, eg.
general practitioners and shires, as well as by Community/Public Health Services, to the
Annual Report 2001/2002 Metropolitan Health Services
95
Key Performance Indicators
Australian Childhood Immunisation Register. This year there has been an improvement in
rates in all Health Services.
All infants born after May 2000 are being vaccinated against Hepatitis B at birth and again
at 12 months. This effectively created two classes of immunised infants in that age group
(12-15 months). It also means that there will be some discrepancies within the 24-27
month age group of the children show even up to the end of calendar year 2002.
The 24-27 month age group has been shown in this context as it is more comparable
across areas than the earlier 12-15 months age group (shown in a later graph).
Screening
Change in pattern from those aged 0-4 to those aged 5-12
The second group of graphs show on the left hand side, a repeat of the left hand graph in
the first group, ie those screened aged 0-4 years, followed on the right hand side in a new
graph, by the pattern of experience for those aged 5-12 years; all children living in the
same area.
Referral
Change in pattern from those aged 0-4 to those aged 5-12
The third group of graphs show on the left hand side, a repeat of the middle graph in the
first group, ie those referred aged 0-4 years, followed on the right hand side in a new
graph, by the pattern of experience for those aged 5-12 years of children living in the
same area.
Immunisation
Change in pattern from those aged 12-15 months to those aged 24-27 months.
The fourth group of graphs show on the left hand side, a new graph for children aged 1215 months followed on the right hand side by a repeat of the graphs shown on the right
hand side of the first group of graphs, ie for children aged 24-27 months.
Annual Report 2001/2002 Metropolitan Health Services
96
Key Performance Indicators
KPIs 1.2, 1.13 & 1.5 – SCREENING, REFERRAL & IMMUNISATION
Calendar Year
1997
1998
1999
2000
2001
Rates Per 1,000 of Population
SCREENING (0-4 Year Olds)
Armadale
REFERRALS (0-4 Year Olds)
Armadale
63
2001
710
Year
2001
2000
19 9 9
800
Rate per
1,000
1999
1998
300
600
900
20
12 0 0
873
80
19 9 9
19 9 9
19 9 8
0
900
12 0 0
836
1999
1998
1997
900
Rate per
1,000
200
1997
0
20
40
60
80
Year
800
1999
600
1998
400
20
Rate per 1,000
1999
100
1998
1997
900
1200
0
20
40
60
2001
2002
North Metropolitan
836
1000
800
Rate per 600
1,000
400
200
0
1999
1997
0
2000
2000
1998
Rate per 1,000
80
40
2001
Year
2000
600
60
North Metropolitan
865
2001
300
40
Rate per 1,000
North Metropolitan
837
200
0
1200
2002
10 0 0
2000
1997
900
2001
Year
Kalamunda
33
2001
19 97
0
2000
100
Kalamunda
19 98
600
400
Rate per 1,000
19 99
300
842
600
1998
0
718
2002
1000
1999
1200
20 00
2001
Year
Fremantle
2000
Kalamunda
0
2000
100
800
Rate per 1,000
20 0 1
80
36
2001
Year
2000
600
60
Fremantle
2001
300
40
826
Rate per 1,000
Fremantle
0
20
2002
1000
800
Rate per 600
1,000
400
200
0
57
19 9 7
19 9 7
600
2001
Year
2000
19 9 8
300
2000
100
Bentley
20 0 1
Year
2000
Year
60
Bentley
2001
Year
40
Rate per 1,000
Bentley
0
400
0
0
0
600
200
1997
19 9 7
874
1000
2000
19 9 8
Year
IMMUNISATION (24-27 Months Old)
Armadale
80
100
Rate per 1,000
Annual Report 2001/2002 Metropolitan Health Services
2000
2001
2002
Year
97
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
Calendar Year
1997
1998
1999
2000
2001
Rates per 1,000 of Population
SCREENING (0-4 Year Olds)
REFERRALS (0-4 Year Olds)
IMMUNISATION (24-27 Months Old)
Rockingham/Kwinana
Rockingham/Kwinana
Rockingham/Kwinana
604
37
2001
1999
1998
1999
1998
1997
1997
0
300
600
900
1200
0
20
Rate per 1,000
80
807
Year
1998
1997
600
900
Rate per 1,000
1200
2000
1999
1998
0
20
40
60
80
2002
Year
861
1000
800
Rate per 600
1,000
400
200
0
1997
300
2001
Swan & Inner City
58
2001
1999
0
2000
100
Swan & Inner City
2000
Year
60
Rate per 1,000
Swan & Inner City
2001
40
874
1000
800
Rate per 600
1,000
400
200
0
2000
2000
Year
Year
2001
100
2000
Rate per 1,000
Annual Report 2001/2002 Metropolitan Health Services
2001
2002
Year
98
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
Calendar Year
1997
1998
1999
2000
2001
Rates per 1,000 of Population
SCREENING (0-4 Year Olds)
SCREENING (5-12 Year Olds)
Armadale
Armadale
710
20 0 1
20 0 0
2000
Year
Year
390
2001
19 9 9
19 9 8
1999
1998
1997
19 9 7
0
300
600
900
0
1200
Bentley
874
20 0 1
336
2001
Year
Year
1200
2000
19 9 9
1999
19 9 8
1998
19 9 7
1997
0
300
600
900
0
1200
300
600
900
1200
Rate per 1,000 Population
Rate per 1,000 Population
Fremantle
Fremantle
836
20 0 1
217
2001
20 0 0
2000
Year
Year
900
Bentley
20 0 0
19 9 9
19 9 8
19 9 7
1999
1998
1997
0
300
600
900
1200
0
Rate per 1,000 Population
600
900
1200
Kalamunda
718
20 01
300
Rate per 1,000 Population
Kalamunda
147
2001
20 0 0
2000
Year
Year
600
Rate per 1,000 Population
Rate per 1,000 Population
19 9 9
19 9 8
19 9 7
1999
1998
1997
0
300
600
900
1200
0
Rate per 1,000 Population
600
900
1200
North Metropolitan
865
20 0 1
300
Rate per 1,000 Population
North Metropolitan
269
2001
2000
Year
20 0 0
Year
300
19 9 9
19 9 8
1999
1998
1997
19 9 7
0
300
600
900
Rate per 1,000 Population
1200
0
300
600
900
1200
Rate per 1,000 Population
Annual Report 2001/2002 Metropolitan Health Services
99
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
Calendar Year
1997
1998
1999
2000
2001
Rates per 1,000 of Population
Rockingham/Kwinana
Rockingham/Kwinana
604
2001
2000
Year
Year
254
2001
2000
19 9 9
19 9 8
19 9 7
1999
1998
1997
0
300
600
900
1200
0
Rate per 1,000 Population
Swan & Inner City
900
1200
168
2001
2000
2000
Year
Year
600
Swan & Inner City
807
2001
300
Rate per 1,000 Population
19 9 9
19 9 8
19 9 7
1999
1998
1997
0
300
600
900
Rate per 1,000 Population
1200
0
300
600
900
1200
Rate per 1,000 Population
Annual Report 2001/2002 Metropolitan Health Services
100
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
Calendar Year
1997
1998
1999
2000
2001
Rates per 1,000 of Population
REFERRAL (0-4 Year Olds)
REFERRAL (5-12 Year Olds)
Armadale
Armadale
63
2001
2000
Year
Year
27
2001
2 00 0
199 9
199 8
199 7
19 9 9
19 9 8
19 9 7
0
25
50
75
100
0
Rate per 1,000 Population
Bentley
Year
Year
19 9 9
19 9 8
19 9 9
19 9 8
19 9 7
0
25
50
75
100
0
Rate per 1,000 Population
50
75
100
Fremantle
36
2001
25
Rate per 1,000 Population
Fremantle
Year
100
2000
19 9 7
55
2 00 1
2000
2 00 0
19 9 9
199 9
19 9 8
199 8
19 9 7
199 7
0
25
50
75
100
0
25
Rate per 1,000 Population
75
100
Kalamunda
33
2001
50
R a te per 1,0 0 0 P o pula t io n
Kalamunda
10
2001
2000
2000
Year
Year
75
23
2001
2000
19 9 9
19 9 8
19 9 7
19 9 9
19 9 8
19 9 7
0
25
50
75
100
0
Rate per 1,000 Population
50
75
100
North Metropolitan
40
2 0 01
25
Rate per 1,000 Population
North Metropolitan
19
20 0 1
20 0 0
2000
Year
Year
50
Bentley
57
2001
25
Rate per 1,000 Population
19 9 9
19 9 8
19 9 7
19 9 9
19 9 8
19 9 7
0
25
50
75
Rate per 1,000 Population
100
0
25
50
75
100
Rate per 1,000 Population
Annual Report 2001/2002 Metropolitan Health Services
101
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
Calendar Year
1997
1998
1999
2000
2001
Rates per 1,000 of Population
REFERRAL (0-4 Year Olds)
REFERRAL (5-12 Year Olds)
Rockingham/Kwinana
Rockingham/Kwinana
37
2001
2000
Year
Year
20
2001
2000
19 9 9
19 9 8
19 9 7
19 9 9
19 9 8
19 9 7
0
25
50
75
100
0
Rate per 1,000 Population
75
100
Swan & Inner City
58
22
2001
2000
Year
20 0 0
Year
50
Rate per 1,000 Population
Swan & Inner City
2 0 01
25
19 9 9
19 9 8
19 9 7
19 9 9
19 9 8
19 9 7
0
25
50
75
Rate per 1,000 Population
100
0
25
50
75
100
Rate per 1,000 Population
Annual Report 2001/2002 Metropolitan Health Services
102
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
2000
Calendar Year
2001
Rates per 1,000 of Population
IMMUNISATION (12-15 Month Olds)
IMMUNISATION (24-27 Month Olds)
Armadale
Armadale
880
1000
Population
per 1,000
Population
per 1,000
800
600
400
200
0
2000
2001
874
1000
800
600
400
200
0
2002
2000
Year
Bentley
Population
per 1,000
Population
per 1,000
2000
2001
2002
826
1000
800
600
400
200
0
2000
Year
Population
per 1,000
Population
per 1,000
2001
842
1000
800
600
400
200
0
2000
2002
Kalamunda
Population
per 1,000
Population
per 1,000
874
1000
800
600
400
200
0
837
2000
2002
North Metropolitan
Population
per 1,000
2001
Year
2002
North Metropolitan
890
2000
2001
Year
Year
1000
800
600
400
200
0
2002
Kalamunda
1000
800
600
400
200
0
2001
2001
Year
Year
2000
2002
Fremantle
881
2000
2001
Year
Fremantle
1000
800
600
400
200
0
2002
Bentley
826
1000
800
600
400
200
0
2001
Year
2002
836
1000
800
600
400
200
0
2000
2001
2002
Year
Annual Report 2001/2002 Metropolitan Health Services
103
Key Performance Indicators
KPI 1.2, 1.13 & 1.5 - Screening, Referral & Immunisation cont…
2000
Calendar Year
2001
Rates per 1,000 of Population
IMMUNISATION (12-15 Month Olds)
Rockingham/Kwinana
IMMUNISATION (24-27 Month Olds)
Rockingham/Kwinana
876
Population
per 1,000
Population
per 1,000
1000
800
600
400
200
0
2000
2001
874
1000
800
600
400
200
0
2000
2002
Swan & Inner City
Swan & Inner City
870
Population
per 1,000
Population
per 1,000
2000
2001
Year
2002
Year
Year
1000
800
600
400
200
0
2001
2002
861
1000
800
600
400
200
0
2000
2001
2002
Year
Annual Report 2001/2002 Metropolitan Health Services
104
Key Performance Indicators
PROVISION OF HEALTH SERVICES TO ABORIGINAL PEOPLE
KPI 1.3
The lower standard of health experienced by the Aboriginal and Torres Strait Islander
(ATSI) population has been of ongoing concern not just to the local community but to the
world at large. National and State policies focus attention and resources on Indigenous
Australians in an attempt to bring their health to a state that is comparable to the rest of
Australia.
North
Metropolitan
Swan
Bentley
Kalamunda
Fremantle
Armadale
Rockingham/
Kwinana
The chart shows the rate of Community Health occasions of service for Indigenous
Australians, in relation to the resident ATSI population in the catchment for each health
service.
As a person can receive various services during the year, some rates can exceed 100%.
To illustrate this, in the Fremantle catchment the 2001 service rate was 3,542 occasions
per thousand ATSI residents, ie an average annual service rate of 3 to 4 occasions per
person.
Community Health Services for ATSI People - Rate per 1,000 of Population
3542
4000
3000
Rate per 1,000 of
Population
2000
2319
1514
1422
1000
0
1152
929
277
A rm a da le
B e nt le y
F re m a nt le Ka la m unda
N o rt h
M e t ro
R o c k / Kwin S wa n/ Inne r
C it y
Calendar Year
1997
1998
1999
2000
Annual Report 2001/2002 Metropolitan Health Services
2001
105
Key Performance Indicators
HOSPITALISATION RATES OF YOUNG PEOPLE FOR SENTINEL
CONDITIONS AND PROCEDURES :
TONSILLECTOMIES & GROMMETS, GASTROENTERITIS,
BRONCHIOLITIS, CROUP & ASTHMA
KPIs 1.7,
1.9, 1.10
& 3.7
A principal objective of primary care and community health programs is to reduce the
incidence of preventable disease, and a key strategy of these programs is to focus on
infants and children. Although many factors can affect the onset of illness, trends in
hospitalisation rates indicate whether these programs are maintaining their effectiveness.
The following major causes of hospitalisation in the metropolitan area have been selected
as sentinel conditions and procedures:
•
•
•
•
•
removal of Tonsils for children aged 0-12 years;
insertion of Ear Grommets for children aged 0-12 years;
treatment of Gastroenteritis for children aged 0-4 years;
treatment of Bronchiolitis, Croup and Acute Bronchitis for children aged 0-4 years;
and
treatment of Asthma for individuals of all ages.
The charts on the following pages show hospitalisation rates for these sentinel groups,
based on each patient’s area of residence, in relation to the age group’s resident
population in the catchment for each community health service.
For example, a child living in Hilton who is admitted to Princess Margaret Hospital for a
tonsillectomy will be counted as a resident of the Fremantle Health Service, as that
service was the most likely source of primary care and community health care for that
child.
For the most part, these hospitalisation rates cover both public sector and private sector
hospitals; however some private hospitals’ data sets are incomplete for 1997 and 1998.
Note: Asthma is reported for all age groups.
Annual Report 2001/2002 Metropolitan Health Services
106
Key Performance Indicators
KPI 1.7 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-12 YEARS, FOR TONSILLECTOMIES OR GROMMETS
The rates in the charts are for children who live in the postcodes within each area shown
on the map; they are not based on the catchment of the admitting hospital.
In the earlier years, namely 1997 and 1998, not all procedures performed in private
hospitals have been reported to the Hospital Morbidity Data System.
North
Metropolitan
Swan
Bentley
Kalamunda
Fremantle
Armadale
Rockingham/
Kwinana
Analysis here is not against a benchmark, nor a State or Metropolitan average. The
analysis is to identify differences in treatment rates according to where people live so that
better targeting of resources is able to be addressed in the future.
REMOVAL OF TONSILS
15.0
12.0
Rate per 1,000 of
Population
9.0
8.7
7.4
6.9
5.7
6.0
5.8
5.6
5.5
3.0
0.0
A rm a da le
B e nt le y
F re m a nt le
Ka la m unda
N o rt h M e t ro R o c k ingha m
S wa n &
Inne r C it y
INSERTION OF EAR GROMMETS
15.0
10.9
12.0
Rate per 1,000 of
Population
13.8
13.1
12.5
11.4
10.2
10.2
9.0
6.0
3.0
0.0
A rm a da le
B e nt le y
F re m a nt le
Ka la m unda
N o rt h M e t ro R o c k ingha m S wa n & Inne r
C it y
Calendar Year
1997
1998
1999
2000
2001
Note: In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For
Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
107
Key Performance Indicators
KPI 1.9 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-4 YEARS, FOR TREATMENT OF GASTROENTERITIS
The rates in the charts are for children who
live in the postcodes within each area shown
on the map; they are not based on the
catchment of the admitting hospital.
North
Metropolitan
In the earlier years, namely 1997 and 1998,
not all procedures performed in private
hospitals have been reported to the Hospital
Morbidity Data System.
Swan
Analysis here is not against a benchmark,
nor a State or Metropolitan average. The
analysis is to identify differences in treatment
rates according to where people live so that
better targeting of resources is able to be
addressed in the future.
Bentley
Kalamunda
Fremantle
Armadale
Rockingham/
Kwinana
Hospital Separation Rate per 1,000 of
Population
Bentley
Armadale
14.1
0
2
4
6
8
10 12
12.5
14
0
R at e pe r 1,0 0 0 o f P o pulat io n
2
4
6
8
10 12 14
R at e pe r 1,0 0 0 o f P o pulat io n
Fremantle
Kalamunda
11.9
12.8
0
2
4
6
8
10 12
14
0
R at e pe r 1,0 0 0 o f P o pulat io n
2
4
6
8
10.0
13.4
2
4
6
8
14
Rockingham/Kwinana
North Metro
0
10 12
R a t e pe r 1,0 00 o f P o pulat io n
10 12 14
0
R a t e pe r 1,0 0 0 o f P o pula t io n
2
4
6
8
10 12 14
R a t e per 1,0 00 o f P o pulat io n
Swan & Inner City
9.5
0
2
4
6
8
10
12 14
R a t e pe r 1,0 0 0 o f P o pula t io n
Calendar Year
1997
1998
1999
2000
2001
Note: In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For
Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
108
Key Performance Indicators
KPI 1.10 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-18 YEARS, FOR TREATMENT OF BRONCHIOLITIS
The rates in the charts are for young people who live
in the postcodes within each area shown on the map;
they are not based on the catchment of the admitting
hospital.
North
Metropolitan
Swan
In the earlier years, namely 1997 and 1998, not all
procedures performed in private hospitals have been
reported to the Hospital Morbidity Data System.
Analysis here is not against a benchmark, nor a State
or Metropolitan average.
Bentley
Kalamunda
The analysis is to identify differences in treatment
rates according to where people live so that better
targeting of resources is able to be addressed in the
future.
Fremantle
Armadale
Rockingham/
Kwinana
The hospitalisation rate for those aged 5-12 and 13-18
is not significant. Only the last three years data is
reported for the older individuals.
0-4 Years
20
Adm ission
Rate per
1,000 of
Population
14 .4
15
10
9 .5
9 .3
7 .5
9 .8
7 .1
6 .0
5
0
A rmadale
B entley
Fremantle
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
5-12 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
0 .0
A rmadale
0 .0
B entley
0 .0
Fremantle
0 .0
0 .0
0 .1
0 .0
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
13-18 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
0 .0
A rmadale
0 .0
B entley
0 .0
Fremantle
0 .0
0 .0
0 .0
0 .0
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
Calendar Year
1997
Note:
1998
1999
2000
2001
In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
109
Key Performance Indicators
KPI 1.10 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-18 YEARS, FOR TREATMENT OF CROUP
The rates in the charts are for young people who live
in the postcodes within each area shown on the map;
they are not based on the catchment of the admitting
hospital.
North
Metropolitan
Swan
In the earlier years, namely 1997 and 1998, not all
procedures performed in private hospitals have been
reported to the Hospital Morbidity Data System.
Analysis here is not against a benchmark, nor a State
or Metropolitan average.
Bentley
Kalamunda
The analysis is to identify differences in treatment
rates according to where people live so that better
targeting of resources is able to be addressed in the
future.
Fremantle
Armadale
Rockingham/
Kwinana
The hospitalisation rate for those aged 5-12 and 13-18
is not significant. Only the last three years data is
reported for the older individuals.
0-4 Years
10
8
Adm ission
Rate per
1,000 of
Population
5 .2
6
4
2 .6
2 .6
2 .2
2 .5
0
2 .0
1.1
2
A rmadale
B entley
Fremantle
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
5-12 Years
10
Adm ission
Rate per
1,000 of
Population
8
6
4
2
0
0 .6
A rmadale
0 .4
B entley
0 .3
Fremantle
0 .3
0 .4
1.0
0 .5
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
13-18 Years
10
Adm ission
Rate per
1,000 of
Population
8
6
4
2
0
0 .0
A rmadale
0 .0
B entley
0 .0
Fremantle
0 .0
0 .0
0 .0
0 .0
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
Calendar Year
1997
Note:
1998
1999
2000
2001
In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
110
Key Performance Indicators
KPI 1.10 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-18 YEARS, FOR TREATMENT OF ACUTE BRONCHITIS
The rates in the charts are for young people who live
in the postcodes within each area shown on the map;
they are not based on the catchment of the admitting
hospital.
North
Metropolitan
Swan
In the earlier years, namely 1997 and 1998, not all
procedures performed in private hospitals have been
reported to the Hospital Morbidity Data System.
Analysis here is not against a benchmark, nor a State
or Metropolitan average.
Bentley
Kalamunda
Fremantle
The analysis is to identify differences in treatment
rates according to where people live so that better
targeting of resources is able to be addressed in the
future.
Armadale
Rockingham/
Kwinana
Hospitalisation rates for all ages are insignificant.
0-4 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
0 .3
A rmadale
0 .2
B entley
0 .1
Fremantle
0 .0
0 .1
0 .1
0 .3
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
5-12 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
0 .2
A rmadale
0 .0
B entley
0 .0
Fremantle
0 .0
0 .0
0 .2
0 .0
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
13-18 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
0 .1
A rmadale
0 .0
B entley
0 .0
Fremantle
0 .0
0 .0
0 .0
0 .0
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
Calendar Year
1997
Note:
1998
1999
2000
2001
In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
111
Key Performance Indicators
KPI 1.10 – HOSPITAL SEPARATION RATES BY AREA OF RESIDENCE,
CHILDREN AGED 0-18 YEARS, FOR TREATMENT OF ASTHMA
The rates in the charts are for young people who live
in the postcodes within each area shown on the map;
they are not based on the catchment of the admitting
hospital.
North
Metropolitan
Swan
In the earlier years, namely 1997 and 1998, not all
procedures performed in private hospitals have been
reported to the Hospital Morbidity Data System.
Analysis here is not against a benchmark, nor a State
or Metropolitan average.
Bentley
Kalamunda
Fremantle
The analysis is to identify differences in treatment
rates according to where people live so that better
targeting of resources is able to be addressed in the
future.
Armadale
Rockingham/
Kwinana
Note: Admissions for Asthma in individuals aged 18
years and over are reported in the next set of graphs.
0-4 Years
20
Adm ission
Rate per
1,000 of
Population
17 .0
15
11.6
10 .0
11.3
9 .7
10
9 .3
8 .4
5
0
A rmadale
B entley
Fremantle
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
5-12 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
3 .3
1.9
A rmadale
B entley
2 .9
Fremantle
3 .3
1.6
4 .8
4 .5
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
13-18 Years
20
Adm ission
Rate per
1,000 of
Population
15
10
5
0
1.0
A rmadale
1.4
B entley
1.2
Fremantle
1.6
1.0
0 .9
1.3
Kalamunda No rth M etro Ro ckingham Swan & Inner
City
Calendar Year
1997
1998
1999
2000
2001
Note: In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
112
Key Performance Indicators
KPI 3.7 – HOSPITAL ADMISSIONS BY AREA OF RESIDENCE,
FOR TREATMENT OF ASTHMA
The rates in the charts are for people who live in the
postcodes within each area shown on the map; they
are not based on the catchment of the admitting
hospital.
North
Metropolitan
Swan
Analysis here is not against a benchmark, nor a State
or Metropolitan average.
The analysis is to identify differences in treatment
rates according to where people live so that better
targeting of resources is able to be addressed in the
future.
Bentley
Kalamunda
Fremantle
Armadale
Hospitalisation rates are insignificant in comparison
with those for young children.
Rockingham/
Kwinana
19-34 Years
20
15
Admission
Rate per
1,000 of
Population
10
5
0
0.8
A rm a da le
0.7
B e nt le y
0.7
F re m a nt le
0.3
Ka la m unda
0.7
1.3
0.8
N o rt h M e t ro R o c k ingha m S wan & Inne r
C it y
35 Years+
20.0
15.0
Admission
Rate per
10.0
1,000 of
Population
5.0
0.8
0.0
Armadale
0.9
Bentley
0.6
F remantle
0.9
Kalamunda
0.9
1.1
0.7
North M etro Rockingham Swan & Inner
City
Calendar Year
1997
1998
1999
2000
2001
Note:In comparing these rates, consideration needs to be given to the ABS Socio Economic Index For Areas (SEIFA).
Annual Report 2001/2002 Metropolitan Health Services
113
Key Performance Indicators
AVERAGE COST PER OCCASION OF SERVICE
FOR COMMUNITY HEALTH PROGRAMS
A cornerstone of primary care and community health
programs is that through screening and early
intervention, they greatly reduce the need for
hospitalisation and other costly forms of treatment.
KPI 1.14
North
Metropolitan
Swan
These programs are, nevertheless, expected to deploy
their resources effectively and to apply them efficiently.
The first chart indicates trends in average cost per
community health occasion of service, for each health
service.
Bentley
Kalamunda
Fremantle
The second chart shows the results of adjusting these
average costs for inflation, expressed in terms of
1999/2000 dollars.
Armadale
Rockingham/
Kwinana
These averages have not been adjusted for any
variation, from area to area, in the combination of
professions and services.
KPI 1.14 - Community Health: Average Cost per Occasion of Service
$100
79
Dollars
$80
58
$60
31
$40
40
41
34
26
$20
$0
A rm a da le
B e nt le y
F rem a nt le
Ka lam unda
N o rt h M e t ro
R o c k ingha m
S wa n & Inne r
C it y
KPI 1.14 - Community Health: Average Cost per Occasion of Service
Adjusted for Inflation (FY1999/2000 = 100.00)
$100
72
Dollars
$80
53
$60
$40
28
37
38
31
24
$20
$0
Armadale
Bentley
Fremantle
Kalamunda
North M etro
Rockingham
Swan & Inner
City
Financial Year
1998/99
1999/00
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
114
Key Performance Indicators
CLIENT SATISFACTION
KPI 2.2
Each year a number of client groups are selected from all Health Services to answer
questions as to their level of satisfaction with their experience within the health system.
Favourable satisfaction ratings have been associated with favourable health outcomes.
Where clients’ perceptions of health service provision are favourable, it has been shown
that they will be more likely to seek the timely help, assistance or treatment which will
enhance the restoration of their health from acute illness. This indicator reports the level
of satisfaction of those who fully participate in the surveys.
This year patients who are admitted and discharged on the same day, those who are
seen in hospital Emergency Departments and those who are seen as outpatients have
been surveyed and are the subject of reporting here.
The issues, which are subject to questioning and for which satisfaction scores are
provided, are the following –
•
•
•
•
•
•
•
Getting to the hospital
Attention from doctors and nursing staff
Information and communication
Meeting personal needs
Continuity of care
Residential aspects of the hospital
Your rights as a patient.
The primary purpose of this Indicator is to provide a basis upon which to devise strategies
that will improve satisfaction levels of clients who will use services in the future.
The results for the year just ended and reported act as the threshold for next year’s
performance. The issues that are scored are those which can be addressed using
strategies that target quite specific aspects of health service staff practice and equally
specific system processes. Those that cause frustration and hinder rather than enhance
patient wellbeing and the potential for patients to experience the best level of restoration
from acute illness can be addressed to achieve the necessary improvement.
The table below shows the response rate by patient type for each site.
SURVEY QUESTIONNAIRES
PATIENT TYPE
NUMBER
SENT
NUMBER
RETURNED
RESPONSE
RATE
Same-day Patients
152
59
40%
Same-day Patients Mode of Administration Data
36
30
83%
Emergency Patients – Centrally Administered
81
27
33%
Emergency Patients- Hospital Administered
280
76
27%
Outpatients – Centrally Administered
74
29
39%
Outpatients – Hospital Administered
119
26
22%
ARMADALE/KELMSCOTT
Annual Report 2001/2002 Metropolitan Health Services
115
Key Performance Indicators
SURVEY QUESTIONNAIRES
PATIENT TYPE
NUMBER
SENT
NUMBER
RETURNED
RESPONSE
RATE
Same-day Patients
297
161
54%
Same-day Patients Mode of Administration Data
11
11
100%
Same-day Patients
192
115
60%
Same-day Patients Mode of Administration Data
10
7
70%
Outpatients
83
27
33%
Same-day Patients
376
223
59%
Same-day Patients Mode of Administration Data
28
22
79%
Outpatients
87
35
40%
Same-day Patients
228
107
47%
Same-day Patients Mode of Administration Data
40
34
85%
Emergency Patients – Centrally Administered
115
42
37%
Emergency Patients- Hospital Administered
310
68
22%
Outpatients – Centrally Administered
84
36
43%
Outpatients – Hospital Administered
130
0
0%
Same-day Patients
373
205
55%
Same-day Patients Mode of Administration Data
28
22
79%
Emergency Patients – Centrally Administered
99
39
39%
Emergency Patients- Hospital Administered
55
19
35%
Outpatients – Centrally Administered
84
31
37%
Outpatients – Hospital Administered
255
0
0%
Same-day Patients
733
370
50%
Same-day Patients Mode of Administration Data
130
99
76%
Emergency Patients – Centrally Administered
138
51
37%
Emergency Patients- Hospital Administered
65
16
25%
Outpatients – Centrally Administered
139
61
44%
Outpatients – Hospital Administered
550
101
18%
BENTLEY
KALAMUNDA
OSBORNE PARK
ROCKINGHAM/KWINANA
SWAN
FREMANTLE
Annual Report 2001/2002 Metropolitan Health Services
116
Key Performance Indicators
SURVEY QUESTIONNAIRES
PATIENT TYPE
NUMBER
SENT
NUMBER
RETURNED
RESPONSE
RATE
Same-day Patients
251
125
50%
Same-day Patients Mode of Administration Data
26
22
85%
Emergency Patients – Centrally Administered
169
65
38%
Outpatients – Centrally Administered
136
54
40%
459
245
53%
1
1
100%
Emergency Patients – Centrally Administered
135
42
31%
Outpatients – Centrally Administered
112
44
39%
Same-day Patients
733
335
46%
Same-day Patients Mode of Administration Data
140
106
76%
Emergency Patients – Centrally Administered
194
54
28%
Emergency Patients- Hospital Administered
370
20
5%
Outpatients – Centrally Administered
189
81
43%
Outpatients – Hospital Administered
380
124
33%
Same-day Patients
683
338
49%
Same-day Patients Mode of Administration Data
176
134
76%
Emergency Patients – Centrally Administered
164
64
39%
Emergency Patients- Hospital Administered
353
22
6%
Outpatients – Centrally Administered
162
81
50%
Same-day Patients
119
57
48%
Outpatients
26
13
50%
4,599
2,342
51%
626
488
78%
Emergency Patients – Centrally Administered
1,155
406
35%
Emergency Patients- Hospital Administered
1,433
221
15%
Outpatients – Centrally Administered
1,176
492
42%
Outpatients – Hospital Administered
1,434
251
18%
KING EDWARD MEMORIAL
PRINCESS MARGARET
Same-day Patients
Same-day Patients Mode of Administration Data
ROYAL PERTH
SIR CHARLES GAIRDNER
WOODSIDE
METROPOLITAN HEALTH SERVICE
Same-day Patients
Same-day Patients Mode of Administration Data
Annual Report 2001/2002 Metropolitan Health Services
117
Key Performance Indicators
The following Table shows the Overall Indicator of Satisfaction and the Standard Error of
the Mean for each Local Reporting Entity to a 95% confidence interval (in the sense that
this term is used in these Surveys).
Local Reporting Entity
Overall Indicator of
Satisfaction
Standard Error of
Mean
Same-day Patients
Armadale Kelmscott Hospital
Bentley Hospital
Fremantle Hospital
Kalamunda Hospital
King Edward Memorial Hospital
Osborne Park Hospital
Princess Margaret Hospital for Children
Rockingham Kwinana Hospital
Royal Perth Hospital
Sir Charles Gairdner Hospital
Swan District Hospital
Woodside Hospital
Metropolitan Health Service
85.05
86.64
86.17
88.54
83.64
89.83
86.61
86.45
85.57
85.30
87.33
85.32
86.35
1.28
0.96
0.59
0.83
1.20
0.51
0.59
1.05
0.65
0.60
0.75
1.68
0.23
Emergency Department Patients
Armadale Kelmscott Hospital
Fremantle Hospital
King Edward Memorial Hospital
Princess Margaret Hospital for Children
Rockingham Kwinana Hospital
Royal Perth Hospital
Sir Charles Gairdner Hospital
Swan District Hospital
Metropolitan Health Service
76.67
73.46
74.09
73.23
73.71
75.81
74.01
76.19
75.11
1.6
1.98
2.05
2.44
1.51
2.05
1.86
1.89
0.65
Outpatients
Armadale Kelmscott Hospital
Fremantle Hospital
Kalamunda Hospital
King Edward Memorial Hospital
Osborne Park Hospital
Princess Margaret Hospital for Children
Rockingham Kwinana Hospital
Royal Perth Hospital
Sir Charles Gairdner Hospital
Swan District Hospital
Metropolitan Health Service
81.16
76.02
79.68
77.19
78.12
75.67
76.39
73.10
76.77
75.13
76.11
1.41
1.22
2.85
1.77
2.27
2.02
2.41
1.12
1.47
2.62
0.54
The following table lists the estimated population of patients surveyed for each service
type.
Annual Report 2001/2002 Metropolitan Health Services
118
Key Performance Indicators
Estimated Population of Patients
Hospital Name
Sameday
Emergency
Outpatients
Armadale/Kelmscott District Memorial
Bentley Hospital
Kalamunda Community District Hospital
Osborne Park Hospital
Rockingham - Kwinana District Hospital
Swan District Hospital
Non-Teaching
3826
2299
826
2959
1822
2820
14552
19296
0
0
0
17628
15826
52750
816
0
972
4118
1958
0
7864
Fremantle Hospital
King Edward Memorial Hospital
Princess Margaret Hospital For Children
Royal Perth Hospital
Sir Charles Gairdner Hospital
Teaching
7092
1982
3228
7241
7272
26815
22646
5858
32604
31236
22747
115091
26988
15718
32501
52824
35436
163467
TOTAL METROPOLITAN AREA
41367
167841
171331
Results from the survey indicate that at Royal Perth Hospital work needs to continue in
examining issues relating to the Outpatients Department, such as getting to the Hospital,
attention from staff and continuity of care. The main concern relates to the waiting times
experienced by patients in the Outpatient Department area. In addressing these
concerns, discussions have instigated a review of clinic profiles and the number of
patients booked in each clinic.
Communication and Information is also of concern in the Emergency Department. Every
effort is made to inform patients and families of the waiting time and any new
developments regarding family members. The Hospital has developed a new pamphlet
entitled Patients Rights and Responsibilities (formerly known as the Patient Charter) and
a strategy to improve patient’s knowledge and awareness when they come into the
Hospital. Copies of the pamphlet have been placed throughout the building.
An additional disabled parking bay has been created in front of the hospital to partly
respond parking difficulties identified in the survey.
For sameday patients, residential aspects of the waiting area have been highlighted by
patients as needing attention. To provide some improvement here, staff now have been
given access to a room within this area to discuss sensitive issues with patients in private
and personal surroundings.
The Department of Health patient Satisfaction Survey has been brought to the attention of
the Quality Council and Community Advisory Council. A work plan, consisting of
strategies to address these areas of concern, is currently being developed.
Annual Report 2001/2002 Metropolitan Health Services
119
Key Performance Indicators
AVOIDING HOSPITAL INITIATED RESCHEDULING OF ELECTIVE
CARE FOR PEOPLE ON HOSPITAL WAITING LISTS
KPI 2.11
Rescheduling of admission for elective care is not in the best interests of the patient, and
it should be avoided wherever possible. Restoration of health may be compromised if
patients are waiting longer than necessary.
Rescheduling initiated by the hospital can be the result of emergency workload, bed
management policies or other work practices.
At some times during the year, peaks in the level of emergency admissions may make
rescheduling of elective admissions unavoidable. Rescheduling which is not initiated by
the hospital also occurs.
This indicator reports only on rescheduling events which were initiated by the hospital:
1. Post Admission Cancellation - Treatment is cancelled after the patient has been
admitted.
2. Deferral - The admission is rescheduled before the planned admission date arrives,
to a date later than the originally planned admission date.
3. Brought Forward - The admission is rescheduled before the planned admission date
arrives, to a date earlier than the originally planned admission date.
For each reporting hospital, the charts show hospital initiated rescheduling rates in
relation to elective admissions from the wait list.
Rescheduling rates were steady, or improved slightly from 2000/01 to 2001/02 at all
reporting hospitals.
Hospital Initiated Rescheduling Rates,
in Relation to Elective Admissions from the Wait List
KEMH
50%
40%
Rate of Rescheduling
30%
20%
10%
FY 2001/02
0%
Jul
FY 2000/01
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
PMH
50%
40%
Rate of Rescheduling
30%
20%
10%
FY 2001/02
FY 2000/01
0%
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
Annual Report 2001/2002 Metropolitan Health Services
May
Jun
120
Key Performance Indicators
Hospital Initiated Rescheduling Rates,
in Relation to Elective Admissions from the Wait List
Fremantle
50%
40%
Rate of Rescheduling
30%
20%
10%
FY 2001/02
0%
Jul
FY 2000/01
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Jan
Feb
Mar
Apr
May
Jun
Jan
Feb
Mar
Apr
May
Jun
RPH
50%
40%
Rate of Rescheduling 30%
20%
10%
FY 2001/02
0%
Jul
FY 2000/01
Aug
Sep
Oct
Nov
Dec
SCGH
50%
40%
Rate of Rescheduling
30%
20%
10%
FY 2001/02
0%
Jul
FY 2000/01
Aug
Sep
Oct
Nov
Dec
Total
50%
40%
Rate of Rescheduling
30%
20%
10%
FY 2001/02
FY 2000/01
0%
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
Annual Report 2001/2002 Metropolitan Health Services
May
Jun
121
Key Performance Indicators
REDUCING WAITING TIMES FOR ADMISSION TO HOSPITAL FOR
ELECTIVE CARE, FOR PUBLIC PATIENTS
KPI 2.15
The need for admission to hospital can be classified as elective if the clinician’s
assessment is that the procedure or treatment can safely be undertaken at a future date.
A national categorisation system has been established to indicate the clinical urgency for
elective admissions. The ability of patients to access elective public hospitalisation is
reported in this performance indicator.
Access to elective admission for public patients in Western Australian is based on the
clinical need of the individual as determined by the medical specialist at the time of initial
clinical assessment. The numbers of people on wait lists and their waiting times for
certain procedures reflect the MHS hospitals’ capacity to meet demand, even though
elective patients are only 18% of all admissions.
Waiting time is measured as the elapsed time in weeks from when an individual is placed
on an elective admission waiting list, until her/his admission to hospital. The calculations
ensure that results are not biased by changes in clinical urgency, nor by times when the
person is not ready for care. Median Waiting Times are reported for various groups of
patients.
For health services to be effective, access to them needs to be provided according to
clinical need. If patients requiring admission to hospital are waiting for long periods of
time, there is a potential for them to experience an increased degree of pain, dysfunction
and disability relating to their condition. Increased waiting periods may also be
attributable to bed management policies or other work practices.
The first two charts summarise the median waiting time in weeks and the total number of
cases on the wait list respectively, for all procedures performed by the Metropolitan
Health Services as at the end of each month between July 1999 and June 2002.
In addition, details for selected procedures have been highlighted. The procedures shown
are those which have been identified by the Australian Institute of Health and Welfare as
being typically of high volume and often associated with long waiting periods. For these
fifteen particular procedures and again for the total of all procedures, sixteen sets of
charts report the following.
1. The number of people admitted from the wait list throughout each financial year.
2. The median waiting time for people still on the wait list as at the end of June each
year
3. The number of people still on the wait list at the end of each month during 2001/02.
Annual Report 2001/2002 Metropolitan Health Services
122
Key Performance Indicators
The specific procedures reported are Cataract Extraction
Gall Bladder Operation
Coronary Artery Bypass Graft
Bladder/Urinary Tract Examination
Haemorrhoid Operation
Hysterectomy
Hernia Repair
Ears – Grommets
Ears – other than Grommets
Prostate Operation
Nasal Septum Procedure
Removal of Tonsils
Hip Replacement
Knee Replacement
Varicose Vein Removal
Notes:
For 1998/99, only people on the Wait
List for Royal Perth, Sir Charles Gairdner, Fremantle, King Edward Memorial and Princess
Margaret Hospital for Children are reported.
For 1999/2000 onwards, the reports include those waiting for admission to these hospitals as well
as to Armadale, Bentley, Kalamunda, Osborne Park, Rockingham-Kwinana and Swan District
Hospitals.
Public patients referred to other facilities are not included in these reports.
Annual Report 2001/2002 Metropolitan Health Services
123
Key Performance Indicators
KPI 2.15 – REDUCING WAITING TIMES FOR ADMISSION
TO HOSPITAL FOR ELECTIVE CARE
Median Waiting Time in Weeks,
All Elective Procedures Performed by MHS Hospitals
30
25
20
Weeks 15
10
5
0
Jul
Aug
Sept
Financial Year
Oct
Nov
Dec
Jan
1999/2000
Feb
Mar
Apr
2000/01
May
Jun
2001/02
All Cases on the Wait List, at the End of Each Month
20,000
Number of Cases
15,000
10,000
5,000
0
Jul
Aug
Sept
Financial Year
Oct
Nov
Dec
1999/2000
Jan
Feb
Mar
Apr
2000/01
Annual Report 2001/2002 Metropolitan Health Services
May
Jun
2001/02
124
Key Performance Indicators
KPI 2.15 Cont… Waiting Time for Elective Admission
NUMBERS WAITING FOR ELECTIVE ADMISSION BY TYPE OF PROCEDURE
Number on Wait List as at the End of Month During 2001/02
Cataract Extraction
Number of Cases
2,500
2,000
1,500
1,000
500
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Number of Cases
Gall Bladder Operation (Cholecystectomy)
500
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Mar
Apr
May
Jun
May
Jun
Number of Cases
Coronary Artery Bypass Graft
100
80
60
40
20
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Number of Cases
Bladder or Urinary Tract Examination (Cystoscopy)
500
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
Annual Report 2001/2002 Metropolitan Health Services
125
Key Performance Indicators
Number on Wait List as at the End of Month During 2001/02
Haemorrhoid Operation
Number of Cases
100
80
60
40
20
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Feb
Mar
Apr
May
Jun
Number of Cases
Hysterectomy
250
200
150
100
50
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Number of Cases
Hernia Repair
500
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Feb
Mar
Apr
May
Jun
Feb
Mar
Apr
May
Jun
Number of Cases
Ears - General
250
200
150
100
50
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Number of Cases
Ears - Grommets
500
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Annual Report 2001/2002 Metropolitan Health Services
126
Key Performance Indicators
Number on Wait List as at the End of Month During 2001/02
Number of Cases
Prostate Operation
100
80
60
40
20
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Mar
Apr
May
Jun
Nasal Septum Procedure
Number of Cases
1,000
800
600
400
200
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Removal of Tonsils
Number of Cases
1,000
800
600
400
200
0
Jul
Aug
Sep
Oct
Nov
Jan
Feb
Mar
Apr
May
Jun
Hip Replacement
500
Number of Cases
Dec
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Jun
Mar
Apr
May
Jun
Knee Replacement
Number of Cases
1,000
800
600
400
200
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Annual Report 2001/2002 Metropolitan Health Services
127
Key Performance Indicators
Number on Wait List as at the End of Month During 2001/02
Varicose Vein Removal
Number of Cases
500
400
300
200
100
0
Jul
Aug
Sep
Oct
Nov
Jan
Feb
Mar
Apr
May
Jun
All Procedures
20,000
Number of Cases
Dec
15,000
10,000
5,000
0
Jul
Aug
Sep
Oct
Nov
Dec
Jan
Feb
Mar
Apr
May
Annual Report 2001/2002 Metropolitan Health Services
Jun
128
Key Performance Indicators
KPI 2.15 Cont… Waiting Time for Elective Admission
Number of Patients Admitted from
Wait List During Year
Median Time Waited, in Weeks, by those on
Wait List as at the End of June Each Year
Cataracts
Cataracts
3350
4000
3124
3501
Number of
Cases
3000
2000
16.0
2002
1315
2001
15.4
2000
14.6
9.1
1999
1000
0.0
0
20.0 40.0
1998/99 1999/00 2000/01 2001/02
Weeks
Cholecystectomy
1500
1026
Number of
Cases
908
1000
Cholecystectomy
797
454
2002
13.7
2001
14.7
14.1
2000
500
21.4
1999
0.0
0
20.0 40.0
1998/99 1999/00 2000/01 2001/02
CABG
404
500
Number of
Cases
400
259
300
254
2002
3.4
2001
2.6
2.8
2000
200
3.7
1999
100
0.0
0
20.0
1998/99 1999/00 2000/01 2001/02
2186
1788
1789
40.0
60.0 80.0 100.0
Weeks
Cystoscopy
2500
60.0 80.0 100.0
Weeks
CABG
327
60.0 80.0 100.0
Cystoscopy
1702
Number of
Cases
2000
2002
2001
1500
2000
1000
1999
500
0.0
0
1998/99 1999/00 2000/01 2001/02
7.1
9.2
8.9
12.9
20.0
40.0
60.0
80.0 100.0
Weeks
Annual Report 2001/2002 Metropolitan Health Services
129
Key Performance Indicators
KPI 2.15 Cont… Waiting Time for Elective Admission
Number of Patients Admitted from
Wait List During Year
Median Time Waited, in Weeks, by those on
Wait List as at the End of June Each Year
Haemorrhoids
Haemorrhoids
288
300
254
232
Number of
Cases
2001
200
100
0
21.9
32.8
31.1
2002
2000
67
44.4
1999
0.0
20.0
40.0
1998/99 1999/00 2000/01 2001/02
Hysterectomy
1275
1500
Number of
Cases
1000
1010
1076
4.7
2002
1999
0.0
0
6.5
7.3
7.3
2000
395
500
20.0
40.0
1998/99 1999/00 2000/01 2001/02
981
1000
898
11.4
2002
Number of
Cases
18.6
500
2000
250
1999
16.1
19.4
0.0
0
20.0
40.0
1998/99 1999/00 2000/01 2001/02
Number of
Cases
200
183
178
52.4
2002
49.3
42.4
42.3
2001
2000
100
1999
0.0
0
20.0
40.0
1998/99 1999/00 2000/01 2001/02
731
80.0 100.0
Ears - Grommets
982
Number of
Cases
576
60.0
Weeks
Ears - Grommets
1000
80.0 100.0
Ears - General
242
156
60.0
Weeks
Ears - General
300
80.0 100.0
Hernia Repair
966
455
60.0
Weeks
2001
750
80.0 100.0
Hysterectomy
2001
Hernia Repair
60.0
Weeks
715
2002
13.4
32.6
2001
500
2000
1999
0.0
0
1998/99 1999/00 2000/01 2001/02
21.1
13.3
20.0
40.0 60.0
80.0 100.0
Weeks
Annual Report 2001/2002 Metropolitan Health Services
130
Key Performance Indicators
KPI 2.15 Cont… Waiting Time for Elective Admission
Number of Patients Admitted from
Wait List During Year
Median Time Waited, in Weeks, by those on
Wait List as at the End of June Each Year
Prostatectomy
388
400
Number of
Cases
300
Prostatectomy
339
340
245
2000
9.2
7.3
11.6
1999
4.9
2002
2001
200
100
0.0
0
20.0 40.0 60.0 80.0 100.0
1998/99 1999/00 2000/01 2001/02
Weeks
Septoplasty
674
800
Number of
Cases
492
600
400
200
Septoplasty
496
122
2001
40.6
31.7
2000
33.1
2002
84.0
1999
0.0
0
20.0 40.0 60.0 80.0 100.0
1998/99 1999/00 2000/01 2001/02
Weeks
Tonsils
1228
1500
Number of
Cases
891
1000
Tonsils
906
532
30.4
2002
35.1
2001
23.4
2000
500
34.0
1999
0.0
0
1998/99
1999/00
2000/01
2001/02
20.0
40.0
449
450
342
Number of
Cases
400
Hips
387
19.7
2002
2001
300
19.9
23.1
2000
200
28.0
1999
100
0.0
0
1998/99
1999/00
2000/01
80.0 100.0
Number of Cases
Hips
500
60.0
2001/02
20.0
40.0
60.0
80.0 100.0
Weeks
Annual Report 2001/2002 Metropolitan Health Services
131
Key Performance Indicators
KPI 2.15 Cont… Waiting Time for Elective Admission
Number of Patients Admitted from
Wait List During Year
Median Time Waited, in Weeks, by those on
Wait List as at the End of June Each Year
Knees
Knees
600
559
487
Number of
Cases
400
371
252
1999
200
0
27.4
27.4
28.6
23.0
2001
0.0
20.0 40.0 60.0 80.0 100.0
1998/99 1999/00 2000/01 2001/02
Weeks
Varicose Veins
600
453
Number of
Cases
0
78
35.7
2000
52.4
1999
0.0
20.0
40.0
1998/99 1999/00 2000/01 2001/02
60,000
43,614
60.0
80.0 100.0
Weeks
WEEKS WAITED - ALL ADMISSIONS
19.3
Number of
Cases
39,139
37,782
26,299
2001
21.3
19.9
29.3
1999
20,000
0
52.3
2001
197
ALL ADMITTED
40,000
61
2002
305
400
200
Varicose Veins
0.0
1998/99 1999/00 2000/01 2001/02
20.0
40.0
60.0
80.0 100.0
Weeks
Annual Report 2001/2002 Metropolitan Health Services
132
Key Performance Indicators
EMERGENCY DEPARTMENT WAITING TIMES
KPI 2.18
Introduction
Access to health services needs to be provided on the basis of clinical need and if a
hospital has large numbers of patients waiting longer than the acceptable standards, this
may reflect sub-optimal work practices or limited resources at the hospital.
When patients first enter an Emergency Department, they are assessed by nursing staff
and allocated a triage code between one and five that indicates their urgency. This code
provides an indication of how quickly patients should be reviewed by medical staff.
Urgency should not be confused with seriousness of illness, although the two things often
go together: less urgent patients in triage categories 4 or 5 might still need admission to
hospital even though immediate attention is not necessary.
This indicator focuses on the percentage of patients, in each triage category, that were
seen within the time period recommended by the Australasian College of Emergency
Medicine (ACEM).
In the five following pages the main charts indicate the percentages actually seen within
the ACEM specified time period, during the past five years at each of the seven
metropolitan hospitals providing public emergency services. Subsidiary charts show the
numbers seen in 2001/02.
For purposes of analysis we have not used the ACEM performance thresholds, nor the
more recent Coopers & Lybrand thresholds shown in columns 3 & 4 of the table below.
Instead the red line running across each main chart indicates a performance threshold
based on National Aggregated Data reported by the Australian Council on Health Care
Standards (ACHS), as shown in column 5.
EMERGENCY DEPARTMENT PERFORMANCE PARAMETERS
Triage
Category
1
2
3
4
5
ACEM
Treatment
Time
Period
Immediate
10 min
30 min
60 min
120 min
ACEM
1993
Threshold
C&L
1997
Threshold
ACHS/EQUIP 1998
National Aggregate
Performance
98%
95%
90%
90%
85%
100%
80%
75%
75%
70%
100%
75%
70%
70%
80%
The analyses by triage category are followed by some supplementary charts which
indicate the overall volumes and composition of Emergency Department attendances.
Comments
Pressure on hospital emergency departments continues to intensify, particularly in the
two most urgent patient categories. Although patient numbers increased by about 5% in
these categories, performance thresholds were generally met or exceeded. This pressure
is reflected in mixed performances for triage category 3 and in deteriorating waiting times
for the less urgent categories.
Annual Report 2001/2002 Metropolitan Health Services
133
Key Performance Indicators
Finding beds for Emergency Department patients requiring admission is a frequent
problem at all major hospitals. This phenomenon, known as “exit block”, results in
overcrowding in ED areas and reduces the ability of staff to treat new arrivals.
At Royal Perth Hospital, these problems were exacerbated by an outbreak of
Vancomycin-Resistant Enterococci (VRE) during July-December 2001.
A program to upgrade Emergency Departments was announced in the 2002/03 State
Budget. This program includes replacing the facility at Rockingham-Kwinana Hospital,
major refurbishment of the ED at Sir Charles Gairdner Hospital, and enhancements at
four other hospitals.
Supplementary Information
Overall, the number of patients attending Emergency Departments at metropolitan public
hospitals declined by 0.6%, from 251,900 in 2000/01 to 250,500 in 2001/02. This slight
decrease followed a 4.6% increase from 1999/2000 to 2000/01.
Different trends are apparent within this total, as shown in the following table. Increasing
attendances in the more urgent groups have been offset by decreases in the less urgent
groups.
EMERGENCY DEPARTMENT ATTENDANCE TRENDS
TRIAGE
CATEGORY
1
2
3
4
5
Change
from
2000/01
4.5%
5.0%
1.5%
(1.8%)
(6.2%)
Percentage
of
Total
1.0%
10.1%
31.5%
47.1%
10.3%
Attendances
in
2001/02
2,579
25,380
78,827
117,928
25,800
ACEM
TIME
PERIOD
Immediate
10 min
30 min
60 min
120 min
Attendance patterns also vary from hospital to hospital. The following charts show recent
trends in attendances overall, and by triage category.
1999/00
Financial Year
2000/01
2001/02
Emergency Department Attendances, by Financial Year
60,000
51,876
50,000
37,510
Attendances
40,000
40,472
41,174
29,722
30,000
27,540
22,220
20,000
10,000
0
RPH
SCGH
Frem antle
PMH
Arm adale
Rockingham
Sw an
Annual Report 2001/2002 Metropolitan Health Services
134
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
TRIAGE CATEGORY 1 – RESUSCITATION PATIENTS
Some patients enter hospital Emergency Departments requiring resuscitation. Their
condition is such that each person should be seen by a doctor immediately upon first
contact with the Triage Nurse.
The first charts indicate the percentage who were actually seen immediately during the
past five years at each of the seven metropolitan hospitals providing public emergency
services.
The red line running across near the top of each chart represents the national aggregated
performance.
RESUSCITATION PATIENTS SEEN “IMMEDIATELY” – THE ACEM REQUIRED TIME PERIOD
National Aggregate Performance: 100% Seen Immediately
100%
100%
100%
100%
100%100%
100%
100%
50%
Percentage Seen
Immediately
75%
75%
50%
100%
100%
100% 100%
100%
100 %
100%
Percentage Seen
Immediately
75 %
50 %
25 %
25%
25%
0%
0%
Princess Margaret
0%
RP H
SCGH
Fremantle
Financial Year
1997/98
1998/99
National Aggregrate Percentage
1999/00
2000/01
2001/02
The percentages at top of the chart are for 2001/02 only.
The second chart shows variations by month in the number of patients treated at each of
these hospitals.
Resuscitation Patients - Number Treated per Month during 2001/02
300
250
200
Number Treated
Percentage Seen Immediately
100%
100%
150
100
50
0
Jul-01
RPH
Aug-01
SCGH
Sep-01
Oct-01
Fremantle
Nov-01
Dec-01
PMH
Jan-02
Feb-02
Armadale
Mar-02
Apr-02
Rockingham
May-02
Jun-02
Swan
Annual Report 2001/2002 Metropolitan Health Services
135
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
TRIAGE CATEGORY 2 – EMERGENCY PATIENTS
The second most urgent category of patients entering hospital Emergency Departments
is described as Emergency. Their condition is not as serious as those requiring
Resuscitation but is such that each person should be seen by a doctor within 10 minutes
after their first contact with the Triage Nurse.
The first charts indicate the percentage who were actually seen within the specified
period, during the past five years at each of the seven metropolitan hospitals providing
public emergency services.
For these people, the ACEM objective is that 95% should be seen within 10 minutes of
assessment. However, the Aggregated National Data achievement of 75% has been
used as the performance benchmark, as indicated by the red line running across each
chart.
EMERGENCY PATIENTS SEEN WITHIN “10 MINUTES” – THE ACEM REQUIRED TIME PERIOD
National Aggregate Performance: 75% Seen Within 10 Minutes
84%
84%
75%
75%
80%
75%
72%
50%
25%
0%
10 0 %
75%
75%
50%
25%
Percentage
Seen Within 10
Minutes
75%
Percentage
Seen Within 10
Minutes
Percentage Seen
Within 10
Minutes
10 0 %
83 %
10 0%
75%
9 2%
75%
8 1%
75%
7 5%
5 0%
2 5%
0%
0%
P rincess M argaret
Financial Year
1997/98
1998/99
National Aggregrate Percentage
1999/00
2000/01
2001/02
The percentages at top of the chart are for 2001/02 only.
The second chart shows variations by month in the number of patients treated at each of
these hospitals.
Emergency Patients - Number Treated per Month during 2001/02
3,000
Number Treated
2,500
2,000
1,500
1,000
500
0
Jul-01
RPH
Aug-01 Sep-01 Oct-01
SCGH
Nov-01 Dec-01
Frem antle
PMH
Jan-02 Feb-02 Mar-02 Apr-02
Arm adale
May-02 Jun-02
Rockingham
Annual Report 2001/2002 Metropolitan Health Services
Sw an
136
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
TRIAGE CATEGORY 3 – URGENT PATIENTS
The condition of Urgent patients is not as serious as those requiring Resuscitation or
Emergency treatment but is such that each person should be seen by a doctor within 30
minutes after their first contact with the Triage Nurse.
The first charts indicate the percentage who were actually seen within the specified
period, during the past five years at each of the seven metropolitan hospitals providing
public emergency services.
For these people, the ACEM objective is that 90% should be seen within 30 minutes of
assessment. However, the Aggregated National Data achievement of 70% has been
used as the performance benchmark, as indicated by the red line running across each
chart.
URGENT PATIENTS SEEN “WITHIN 30 MINUTES” – THE ACEM REQUIRED TIME PERIOD
National Aggregate Performance: 70% Seen Within 30 Minutes
42%
51%
77%
68%
70%
50%
25%
70%
75%
50%
25%
0%
RP H
SC GH
P rincess M argaret
Percentage Seen Within 30
Minutes
70%
Percentage Seen
Within 30 Minutes
77%
70%
70%
70%
75%
50%
25%
0%
F rem a nt le
67%
100%
A rm a dale
R o c kingha m
S wa n
Financial Year
1997/98
1998/99
National Aggregrate Percentage
1999/00
2000/01
2001/02
The percentages at top of the chart are for 2001/02 only.
The second chart shows variations by month in the number of patients treated at each of
these hospitals.
Urgent Patients - Num ber Treated per Month during 2001/02
8,000
7,000
Number Treated
Percentage Seen
Within 30 Minutes
70%
75%
0%
58%
100%
100%
6,000
5,000
4,000
3,000
2,000
1,000
0
Jul-01
RPH
Aug-01
SCGH
Sep-01
Oct-01
Fremantle
Nov-01
Dec-01
PMH
Jan-02
Armadale
Feb-02
Mar-02
Rockingham
Apr-02
May-02
Jun-02
Sw an
Annual Report 2001/2002 Metropolitan Health Services
137
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
TRIAGE CATEGORY 4 – SEMI-URGENT PATIENTS
The condition of Semi-urgent patients is not as serious as those in the first three
categories of care, and is such that each person should be seen by a doctor within 60
minutes after their first contact with the Triage Nurse.
The first charts indicate the percentage who were actually seen within the specified
period, during the past five years at each of the seven metropolitan hospitals providing
public emergency services.
For these people, the ACEM objective is that 90% should be seen within 60 minutes of
assessment. However, the Aggregated National Data achievement of 70% has been
used as the performance benchmark, as indicated by the red line running across each
chart.
SEMI-URGENT PATIENTS SEEN “WITHIN 60 MINUTES” – THE ACEM REQUIRED TIME PERIOD
National Aggregate Performance: 70% Seen Within 60 Minutes
56%
43%
55%
41%
100%
70%
70%
50%
25%
75%
50%
25%
0%
0%
RPH
SC GH
Princess Margaret
F rem ant le
50%
57%
70%
Patients Seen Within 60
Minutes
Patients Seen Within
60 Minutes
70%
75%
Patients Seen
Within 60 Minutes
100%
64%
100%
70%
70%
70%
75%
50%
25%
0%
A rm a dale
R o c k ingha m
S wa n
Financial Year
1997/98
1997/98
National Aggregrate Percentage
1997/98
1997/98
1997/98
The percentages at top of the chart are for 2001/02 only.
The second chart shows variations by month in the number of patients treated at each of
these hospitals.
Semi-urgent Patients - Number Treated per Month during 2001/02
12,000
Number Treated
10,000
8,000
6,000
4,000
2,000
0
Jul-01
RPH
Aug-01
SCGH
Sep-01
Oct-01
Frem antle
Nov-01
PMH
Dec-01
Jan-02
Arm adale
Feb-02
Mar-02
Rockingham
Apr-02
May-02
Jun-02
Sw an
Annual Report 2001/2002 Metropolitan Health Services
138
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
TRIAGE CATEGORY 5 – ROUTINE PATIENTS
Routine patients make up the least urgent of all five Triage categories. Their condition is
such that each person should be seen by a doctor within 2 hours after their first contact
with the Triage Nurse.
The first charts indicate the percentage who were actually seen within the specified
period, during the past five years at each of the seven metropolitan hospitals providing
public emergency services.
For these people, the ACEM objective is that 85% should be seen within 120 minutes of
assessment. However, the Aggregated National Data achievement of 80% has been
used as the performance benchmark, as indicated by the red line running across each
chart.
ROUTINE PATIENTS SEEN “WITHIN 2 HOURS” – THE ACEM REQUIRED TIME PERIOD
National Aggregate Performance: 80% Seen Within 120 Minutes
80%
80%
80%
75%
50%
25%
100%
50%
25%
0%
0%
RPH
SCGH
80%
75%
P rinc e s s M a rga ret
Frem antle
7 7%
84%
Number of Cases
Seen Within 2 Hours
Number of
Cases Seen
Within 2 Hours
10 0 %
80%
82 %
80%
80%
75%
50%
25%
0%
A rm ada le
R o c k ingha m
S wa n
Financial Year
1997/98
1998/99
National Aggregrate Percentage
1999/00
2000/01
2001/02
The percentages at top of the chart are for 2001/02 only
The second chart shows variations by month in the number of patients treated at each of
these hospitals.
Routine Patients - Number Treated per Month during 2001/02
3,000
2,500
Number Treated
Number of Cases
Seen Within 2
Hours
100%
75 %
49%
57%
71%
2,000
1,500
1,000
500
0
Jul-01
Aug-01
RPH
Sep-01
SCGH
Oct-01
Nov-01
Frem antle
Dec-01
PMH
Jan-02
Feb-02
Arm adale
Mar-02
Apr-02
Rockingham
Annual Report 2001/2002 Metropolitan Health Services
May-02
Jun-02
Sw an
139
Key Performance Indicators
KPI 2.18 Cont… Emergency Department Waiting Times
Emergency Department Attendances, by Triage Category, by Financial Year
1999/00
2000/01
2001/02
Triage 1 - Resuscitation
1200
1016
1000
800
Attendances
594
600
433
400
169
200
0
RP H
SC GH
F re m a nt le
PM H
A rm ada le
147
117
103
R o ck ingham
Swa n
Triage 2 - Emergency
12000
9432
10000
8000
Attendances
5977
6000
3876
4000
0
1778
1089
2000
RP H
SC GH
F re m a nt le
PMH
A rm ada le
1949
1279
R o c k ingha m
S wa n
Triage 3 - Urgent
25000
Attendances
18815
17428
20000
15248
15000
8837
6990
10000
5925
5584
5000
0
RPH
SC GH
F rem ant le
PM H
A rm a da le
R o ck ingham
S wa n
Triage 4 - Semi-Urgent
25000
21990
21905
20000
Attendances
13945
15000
17318
15867
15899
11004
10000
5000
0
RP H
SC GH
F re m a nt le
PMH
A rm a da le
R o c k ingha m
S wa n
Triage 5 - Routine
15000
10936
12000
Attendances
9000
4661
6000
2095
3000
0
RP H
1746
SC GH
1481
F re m a nt le
3195
1686
PMH
A rm a da le
R o c k ingha m
S wa n
Annual Report 2001/2002 Metropolitan Health Services
140
Key Performance Indicators
WAITING TIME IN WEEKS TO BE SEEN IN OUTPATIENT CLINICS
KPI 2.21 & 3.1
The graphs report the waiting time for “new” patients who were referred to a hospital
outpatient department or clinic to see a specialist consultant. The term “new” is used to
differentiate between those patients who are being referred for the first time and those
patients who have previously seen a consultant at that clinic and are returning for a
subsequent appointment.
The initial group of graphs indicate according to Clinical Specialty the median waiting time
in weeks and the percentage of patients seen within 8 weeks of referral for a six month
period in 2001 for Fremantle, Royal Perth and Sir Charles Gairdner Hospitals.
Three Chronic Clinics are shown at Royal Perth and Fremantle Hospitals and these are
followed by Specialty Clinics at King Edward Memorial and Princess Margaret Hospitals.
At these hospitals only the single figure for the whole of the six month period is shown for
some Clinics.
Neurosurgery
This year at Royal Perth Hospital, there was a 25% increase in new appointments over
last year. A new sub-clinic was established during the year to service this increased
demand and this has resulted in a reduction in the waiting time.
Ophthalmology
When compared to last year, at Royal Perth Hospital, there has been an increase this
year of 12% in new appointments for this Clinic. This is one of the busiest Clinics at the
hospital and the waiting time is reflective of the large volume of patients treated. Despite
the volume, urgent patients are always seen within an acceptable period from referral.
Notes:
Waiting times are reported by all Teaching Hospitals of clinics where more than 50 patients per year are seen.
All patients are seen by a medical officer.
Annual Report 2001/2002 Metropolitan Health Services
141
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
SURGICAL CLINICS
Fremantle
RPH
Median Waiting Time, In Weeks
SCGH
Patients Seen Within 8 Weeks of Referral
Cardiothoracic
Cardiothoracic
Jul-01
2 .4
2 .6
1.7
Jul-01
100%
100%
100%
100%
100%
100%
Aug-01
0 .4
1.2
0 .6
Aug-01
Sep-01
1.3
0 .1
Sep-01
Oct-01
Nov-01
Dec-01
1.9
88%
100%
Oct-01
0 .3
0 .9
0 .7
2 .3
2 .3
2 .1
0.0
10.0
20.0
30.0
40.0
Nov-01
100%
100%
100%
Dec-01
100%
100%
100%
0%
20%
5 .9
94%
36%
11.9
4 .6
49%
8 .1
5 .9
Sep-01
8 .7
4 .3
4 .0
Dec-01
0.0
95%
31%
78%
Nov-01
52%
7 .0
10.0
20.0
30.0
40.0
0%
20%
86%
Jul-01
13 .4
Nov-01
2 .8
2 .1
Dec-01
2 .9
3 .3
100%
Aug-01
17 .1
4 .0
3 .8
74%
45%
4 .1
4 .6
Oct-01
72%
36%
Sep-01
15 .0
98%
82%
78%
10 .7
88%
Oct-01
78%
42%
7 .0
0.0
100%
33%
4 .6
2 .7
3 .8
2 .4
80%
General
13 .7
Sep-01
60%
Percentage seen within 8 weeks
General
Aug-01
40%
88%
84%
90%
Dec-01
Weeks
Jul-01
86%
78%
Oct-01
4 .1
3 .9
4 .0
3 .9
93%
69%
49%
11.3
Nov-01
71%
Aug-01
2 .4
Oct-01
100%
64%
Jul-01
1.9
3 .0
80%
31%
10 .4
Sep-01
60%
Ear, Nose & Throat
Ear, Nose & Throat
Aug-01
40%
Percentage seen within 8 weeks
Weeks
Jul-01
100%
97%
Nov-01
10.0
20.0
Weeks
30.0
40.0
0%
82%
20%
40%
60%
80%
100%
Percentage seen within 8 weeks
Annual Report 2001/2002 Metropolitan Health Services
142
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
SURGICAL CLINICS Cont…
Fremantle
RPH
Median Waiting Time, In Weeks
SCGH
Patients Seen Within 8 Weeks of Referral
Neurosurgery
Neurosurgery
4 .4
Jul-01
Dec-01
33%
3 .1
10 .4
Nov-01
9 .1
Dec-01
0.0
10.0
20.0
30.0
40.0
Aug-01
10 .3
20%
14 .6
0.0
14 .3
Aug-01
19 .9
1.2
13 .9
1.6
17 %
Sep-01
86 %
4 8%
3 9%
41%
Nov-01
83%
6 2%
10.0
3 5%
Dec-01
13 .0
15.0
20.0
0%
20%
40%
69%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Weeks
Orthopaedic
Orthopaedic
39%
10 .9
3 4 .7
Jul-01
2 8 .4
16 .6
Aug-01
3 5 .4
3 0 .6
Aug-01
2 8 .0
3 4 .1
Oct-01
3 0 .4
13 .4
Nov-01
3 5 .4
12 .9
16%
34%
5%
21%
28%
Sep-01
3 3 .3
12 .1
9%
Jul-01
10 .9
Sep-01
0.0
76 %
33 %
1.5
Dec-01
91%
91%
Oct-01
14 .9
1.3
5.0
100%
4 4%
7 .0
Dec-01
80%
33 %
3 8%
9 .1
Nov-01
60%
34%
3 8%
Jul-01
1.1
8 .6
Oct-01
40%
Ophthalmology
8 .9
Sep-01
94%
43%
Percentage seen within 8 weeks
10 .1
1.7
100%
36%
Ophthalmology
Jul-01
92%
20%
0%
Weeks
95%
32%
Oct-01
12 .9
2 .6
36%
Sep-01
9 .7
2 .7
2 .7
97%
Aug-01
10 .7
Sep-01
Nov-01
Jul-01
4 .1
Aug-01
Oct-01
90%
2 4 .7
4%
30%
11%
Oct-01
Nov-01
34%
29%
33%
8%
25%
41%
2 0 .3
3 5 .8
Dec-01
6%
42%
11.4
10.0
20.0
Weeks
30.0
40.0
0%
10%
20%
30%
40%
50%
Percentage seen within 8 weeks
Annual Report 2001/2002 Metropolitan Health Services
143
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
SURGICAL CLINICS Cont…
Fremantle
RPH
Median Waiting Time, In Weeks
SCGH
Patients Seen Within 8 Weeks of Referral
Plastic Surgery
Plastic Surgery
16%
2 0 .6
6 .0
Jul-01
Jul-01
12 .3
2 2 .6
6 .1
3 .7
Aug-01
68%
Aug-01
65%
25%
2 2 .3
Sep-01
5 .4
Sep-01
14 .8
4 .9
Nov-01
5 .1
Dec-01
4 .4
4 .0
13%
81%
Oct-01
16 .7
40%
35%
2 2 .9
78%
Nov-01
52%
7 .3
0.0
41%
2 4 .0
82%
Dec-01
10.0
20.0
30.0
40.0
66%
0%
20%
40%
Jul-01
12 .3
8 .0
9 .8
8 .9
8 .9
8 .3
33%
21%
51%
37%
Aug-01
48%
41%
46%
Sep-01
5 .4
Nov-01
10.0
47%
Nov-01
29%
Dec-01
20.0
30.0
40.0
0%
20%
3 .1
Aug-01
Sep-01
3 .0
Sep-01
Oct-01
2.3
Oct-01
2 .9
Nov-01
Dec-01
0.0
4 .0
10.0
80%
100%
68%
Jul-01
3.2
Nov-01
60%
Vascular
Vascular
Aug-01
40%
82%
Percentage seen within 8 weeks
Weeks
Jul-01
73%
65%
6 .1
0.0
60%
25%
10 .7
8 .3
5 .8
6 .4
9 .7
Dec-01
44%
Oct-01
9 .3
7 .0
59%
55%
8 .0
Oct-01
100%
35%
9 .1
9 .9
Sep-01
80%
Urology
Urology
Aug-01
60%
Percentage seen within 8 weeks
Weeks
Jul-01
87%
39%
2 4 .4
Oct-01
64%
46%
7%
86%
89%
77%
91%
93%
Dec-01
20.0
Weeks
30.0
40.0
0%
20%
40%
60%
80%
100%
Percentage seen within 8 weeks
Annual Report 2001/2002 Metropolitan Health Services
144
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
CHRONIC CLINICS
Fremantle
RPH
Median Waiting Time, In Weeks
Patients Seen Within 8 Weeks of Referral
Royal Perth Hospital Only
Back Disability
Back Disability
18 .3
Jul-01
22%
Jul-01
12 .5
3 1%
4 .4
Sep-01
69%
Sep-01
7 .0
59%
8 .2
Nov-01
45%
Nov-01
9 .3
0.0
5.0
10.0
20%
15.0
20.0
0%
Weeks
20%
40%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Fremantle Hospital Only
Chronic Renal
Chronic Renal
1.8
Jul-01
10 0 %
Jul-01
2 .0
10 0 %
4 .1
Sep-01
10 0 %
Sep-01
0 .0
3 .0
Nov-01
10 0 %
Nov-01
10 0 %
2 .1
0.0
5.0
10.0
15.0
20.0
0%
Weeks
20%
40%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Fremantle Hospital Only
Ulcer
Jul-01
Ulcer
1.4
Jul-01
89%
Sep-01
9 1%
1.4
Sep-01
10 0 %
1.0
2 .1
92%
2 .4
Nov-01
94%
Nov-01
1.0
0.0
10 0 %
5.0
10.0
Weeks
15.0
20.0
0%
20%
40%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Annual Report 2001/2002 Metropolitan Health Services
145
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
King Edward Memorial Hospital
Median Waiting Time, In Weeks
Patients Seen Within 8 Weeks of Referral
Gynaecology
Gynaecology
8.6
J ul- 0 1
3
6
9
35%
N o v-01
8.9
D ec-01
47%
Oct-01
9.1
N o v-01
52%
S e p- 0 1
8.3
Oct-01
0
67%
A ug- 0 1
7.9
S e p- 0 1
42%
J ul- 0 1
6.4
A ug- 0 1
43%
D ec-01
12
0%
20%
Weeks
3
80%
6
Weeks
100%
79%
J uly t o
D ec 01
0.8
0
60%
Genetics
Genetics
J uly t o
D ec 01
40%
P ercentage seen within 8 weeks
9
12
0%
20%
40%
60%
80%
100%
P ercentage seen within 8 weeks
Note:
Menopause and Oncology Clinics had 20 or less cases during the period, and are therefore not
reported.
Annual Report 2001/2002 Metropolitan Health Services
146
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
Princess Margaret Hospital
Median Waiting Time, In Weeks
Patients Seen Within 8 Weeks of Referral
Ear, Nose & Throat
S e p- 0 1
N o v-01
0.0
Ear, Nose & Throat
10.9
10.0
10.9
11.0
12.3
13.1
J ul- 0 1
5.0
10.0
15.0
28%
27%
J ul- 0 1
7%
S e p- 0 1
20%
10%
12%
N o v-01
20.0
0%
Weeks
N o v-01
0.0
2.8
N o v-01
0.0
3.0
91%
S e p- 0 1
4.9
4.6
4.5
5.0
N o v-01
10.0
15.0
20.0
0%
0.0
3.4
2.8
3.5
3.4
10.0
15.0
20.0
93%
87%
94%
89%
80%
0%
80%
100%
61%
83%
81%
80%
89%
S e p- 0 1
N o v-01
67%
10.0
15.0
20.0
0%
20%
40%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Orthopaedic
6.3
6.7
74%
J ul- 0 1
73%
6.6
6.9
84%
Se p- 0 1
67%
8.7
8.6
5.0
60%
J ul- 0 1
Orthopaedic
0.0
40%
Immunology
Weeks
N o v-01
20%
Percentage seen w ithin 8 w eeks
4.0
4.9
4.4
3.9
S e p- 0 1
100%
88%
N o v-01
6.6
6.6
J ul- 0 1
80%
S e p- 0 1
5.0
5.0
60%
J ul- 0 1
Immunology
N o v-01
40%
General Surgery
Weeks
Se p- 0 1
20%
Percentage seen w ithin 8 w eeks
3.2
3.4
J ul- 0 1
100%
85%
91%
89%
90%
88%
General Surgery
Se p- 0 1
80%
J ul- 0 1
Weeks
J ul- 0 1
60%
General Medicine
4.4
Se p- 0 1
40%
Percentage seen w ithin 8 w eeks
General Medicine
J ul- 0 1
20%
10.0
Weeks
43%
41%
N o v-01
15.0
20.0
0%
20%
40%
60%
80%
100%
Percentage seen w ithin 8 w eeks
Annual Report 2001/2002 Metropolitan Health Services
147
Key Performance Indicators
KPI 2.21 & 3.1 Cont… Waiting Times at Outpatient Clinics
Princess Margaret Hospital
Median Waiting Time, In Weeks (Average for 6 Month Period)
4.9
Respiratory
14.1
Ophthalm ology
13.9
Neurology
15.1
Gastroenterology
6.6
Developm ental
7.4
Derm atology
0
5
10
15
20
Weeks
Patients Seen Within 8 Weeks of Referral (Average for 6 Month Period)
86%
Respiratory
Ophthalm ology
11%
21%
Neurology
21%
Gastroenterology
58%
Developm ental
61%
Derm atology
0%
20%
40%
60%
80%
100%
Percentage Within 8 Weeks
Annual Report 2001/2002 Metropolitan Health Services
148
Key Performance Indicators
LENGTH OF STAY IN DAYS IN HOSPITAL FOR
MENTAL DISORDERS INCLUDING SPECIAL UNITS
KPI 2.31
National and State mental health policies require that people suffering acute mental
illness be treated, where appropriate, in the community rather than in hospital.
This performance indicator has been included as a measure of effectiveness because it
records changes in the median length of time that psychiatric patients are treated in
hospital. The rationale behind this measurement is that the time spent in hospital, for
patients who have had acute episodes of mental illness, will decrease as their conditions
are managed more frequently and effectively through community psychiatric services.
The psychiatric services provided by different types of hospitals differ, therefore all figures
are reported by two hospital types, acute general public hospitals and designated
psychiatric hospitals. The median length of stay is calculated using the number of days
spent overnight in hospital for those which provide psychiatric services. In designated
psychiatric hospitals, return from aftercare has been treated as a new admission. Also in
these hospitals, Adult services need to be viewed separately from Child and Adolescent
services.
The figures from acute general hospitals only includes those diagnoses classified as
major. Even doing this, there are some situations where the number of patients in each
category in each hospital is low. With this in mind the Average Length of Stay needs to be
viewed with caution as in some cases, less than 10 patients per year are represented.
At Royal Perth Hospital, the number of patients treated for physical symptoms mental
disorders has decreased from the previous year, however the proportion of these patients
treated for eating and obsessive-compulsive disorders have increased significantly. As a
result, the median length of stay for this disease category has increased.
Note :
Diagnostic groups containing less than 20 cases each have not been reported.
Patients who have been transferred from one hospital to another have not been included in the
figures.
Annual Report 2001/2002 Metropolitan Health Services
149
Key Performance Indicators
MEDIAN LENGTH OF STAY IN DAYS FOR MENTAL DISORDERS
Financial year
1998/99
1997/98
1999/00
2000/01
2001/02
Serious Psychiatric Disorders
50
40
30
Days
21
20
10
0
11
9
RP H
8
3
SC G H
F rem
7
3
A rm
B e nt
Kala
NM
7
6
R o ck
S wa n
Anxiety Disorders
50
40
30
Days
21
20
3
10
0
RP H
5
SCGH
F rem
A rm
9
7
1
1
2
1
B e nt
Kala
NM
R o ck
S wa n
Physical Symptoms – Mental Disorders
50
40
30
Days
23
20
7
10
0
RP H
S C GH
3
1
F re m
A rm
0
0
B e nt
Ka la
0
NM
2
0
R ock
S wa n
Personality and Other Developmental Disorders
50
37
40
Days
30
17
20
4
10
0
5
RP H
3
3
SC G H
F re m
A rm
1
0
B e nt
Ka la
NM
R o ck
0
S wa n
Acquired & Congenital Brain Disorders
50
40
Days
30
20
20
12
10
0
RP H
11
10
SCGH
F rem
6
A rm
18
B ent
12
9
9
Ka la
NM
R o ck
Swa n
Alcohol & Drug Disorders
50
40
Days
26
30
20
10
0
16
11
1
RP H
SC GH
1
1
1
F re m
A rm
6
1
B e nt
Ka la
NM
R o ck
S wa n
Annual Report 2001/2002 Metropolitan Health Services
150
Key Performance Indicators
MEDIAN LENGTH OF STAY IN DAYS FOR MENTAL DISORDERS – SPECIAL UNITS
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
Graylands – General
50
40
30
Days
25
20
20
19
5
10
0
S e rio us
D is o rde rs
A nxie t y
6
7
P hys ic a l
S ym pt o m s
P e rs o na lit y
A c quire d
A lc o ho l
Graylands – Special
50
40
30
Days
20
20
7
10
0
S e rio us
D is o rde rs
A nxie t y
8
P hys ic a l
S ym pt o m s
7
P e rs o na lit y
7
7
A c quire d
A lc o ho l
Bentley Lodge
50
Days
40
30
33
29
25
19
20
10
0
0
S e rio us
D is o rde rs
A nxie t y
P hys ic a l
S ym pt o m s
0
P e rs o na lit y
A c quire d
A lc o ho l
Armadale Lodge
50
41
40
40
Days
28
30
15
20
10
0
12
0
S e rio us
D is o rde rs
A nxie t y
P hys ic a l
S ym pt o m s
P e rs o na lit y
A c quire d
A lc o ho l
Bentley Child & Adolescent
78
50
40
Days
30
19
20
12
5
10
0
S e rio us
D is o rde rs
A nxie t y
2
P hys ic a l
S ym pt o m s
6
4
P e rs o na lit y
A c quire d
A lc o ho l
Annual Report 2001/2002 Metropolitan Health Services
151
Key Performance Indicators
MEDIAN LENGTH OF STAY IN DAYS FOR MENTAL DISORDERS – SPECIAL UNITS
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
Fremantle – Alma Street
50
40
Days
30
11
20
10
0
6
3
S e rio us
D is o rde rs
A nxie ty
P hysica l
S ympt o m s
11
4
P e rso nalit y
A c quire d
4
A lc o ho l
Armadale Adult Acute
50
40
Days
30
20
8
10
0
3
3
S e rio us
D is o rde rs
A nxie t y
P hys ic a l
S ym pto m s
1
P ers o na lit y
3
2
A c quire d
A lc o ho l
Fremantle Hospital – Ward 43
50
33
40
Days
30
17
20
19
10
10
0
2
0
S erio us
D iso rders
A nxie t y
P hys ica l
S ym pt o m s
P erso na lit y
A cquire d
A lco ho l
Selby Authorised Lodge
155
160
120
Days
97
68
80
34
40
0
0
0
Serio us
D iso r d er s
A nxi et y
Physical
Symp t o ms
Perso nalit y
A cq uir ed
A l co ho l
Osborne Park Lodge
50
40
Days
90 68
71
29
31
30
23
23
20
10
0
0
0
Ser io us
D iso r d er s
A nxiet y
Physical
Symp t o ms
Per so nal it y
A cq uir ed
A lco ho l
Annual Report 2001/2002 Metropolitan Health Services
152
Key Performance Indicators
MEDIAN LENGTH OF STAY IN DAYS FOR MENTAL DISORDERS – SPECIAL UNITS
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
Bentley Adult – Mill Street Centre
89
50
40
Days
30
12
20
10
3
0
S e rio us
D is o rde rs
A nxiet y
7
P hys ic a l
S ym pt o m s
3
P e rs o na lit y
4
2
A c quire d
A lc o ho l
Princess Margaret Hospital
50
40
Days
30
20
13
7
10
7
3
2
1
0
S e rio us
D iso rde rs
A nxie t y
P hys ic a l
S ym pt o m s
P ers o nalit y
A c quired
A lc o ho l
King Edward Memorial Hospital
50
Days
40
30
20
10
0
0
0
Serio us
D iso rders
A nxiety
0
P hysical
S ympt o ms
6
0
P erso nality
A cquired
0
A lco ho l
Swan – Central Drug Unit
50
40
Days
30
20
5
10
0
Serio us
D iso rders
1
A nxiet y
4
P hysical
Sympto ms
6
0
P erso nalit y
0
A cquired
A lco ho l
Swan Valley Centre
55
50
40
Days
30
20
14
0
3
4
10
S e rio us
D is o rde rs
A nxie t y
P hys ic a l
S ym pt o m s
P e rs o na lit y
6
5
A c quire d
A lc o ho l
Annual Report 2001/2002 Metropolitan Health Services
153
Key Performance Indicators
ELECTIVE SURGERY AT TEACHING HOSPITALS
POST-OPERATIVE PULMONARY EMOBOLISM (Blood Clotting) RATES
KPI 2.38
Patients post-operatively can develop blood clots in the deep veins of the leg or pelvis.
The clots can travel to the lungs and cause circulatory problems. This is known as a
Pulmonary Embolism and this is the main potentially preventable cause of death in fit
people undergoing elective surgery.
Hospital staff take special precautions to decrease the risk of this happening. A low
percentage of cases developing Pulmonary Embolism post-operatively suggest that the
appropriate precautions have been taken.
This indicator measures the percentage rate of patients who underwent surgery and
subsequently developed Pulmonary Embolism. By monitoring the incidence of postoperative Pulmonary Embolism occurring, a hospital can ensure clinical protocols which
minimise such risks are in place and are working. The monitoring of post-operative
complications is important in ensuring the optimum recovery rate for people with acute
illness.
Cases have been selected for reporting using the criteria as defined by the Australian
Council on Healthcare Standards (ACHS). Cases are only reported for Pulmonary
Embolisms if the post-operative length of stay is greater than or equal to 7 days.
ACHS Threshold: 0.2% - 0.8%
Royal Perth Hospital – Post-Operative Pulmonary Embolism Rate
0.80%
ACHS
0.29%
2001/02
0.25%
2000/01
0.17%
1999/00
0.10%
1998/99
0.00%
0.10%
0.20%
0.30%
0.40%
0.50%
0.60%
0.70%
0.80%
0.90%
1.00%
Fremantle Hospital – Post-Operative Pulmonary Embolism Rate
0.80%
ACHS
0.25%
2001/02
0.47%
2000/01
0.35%
1999/00
0.25%
1998/99
0.00%
0.10%
0.20%
0.30%
0.40%
0.50%
0.60%
0.70%
0.80%
0.90%
1.00%
Sir Charles Gairdner Hospital – Post-Operative Pulmonary Embolism Rate
0.80%
ACHS
0.33%
2001/02
0.07%
2000/01
0.20%
1999/00
0.36%
1998/99
0.00%
0.10%
0.20%
0.30%
0.40%
0.50%
0.60%
0.70%
0.80%
0.90%
1.00%
Notes:
Post-operative transfers from other health care organisations are not included for the purposes of this indicator.
Surgery is defined as a therapeutic procedure involving incision into body tissue.
Annual Report 2001/2002 Metropolitan Health Services
154
Key Performance Indicators
LABOUR OUTCOME RATES FOR HOSPITAL OBSTETRICS UNITS
(APGAR Score of 4 or Less at 5 Minutes Post-Delivery)
KPI 2.42
A well-managed labour will normally result in the birth of a minimally distressed infant.
The level of foetal well-being (ie lack of stress or other complications or conditions) is
measured 5 minutes post-delivery, via the APGAR scoring system which assesses heart
rate, respiratory effort, muscle tone, reflex irritability, and colour.
A high average APGAR score for a hospital will generally indicate that appropriate labour
management practices are employed.
This indicator focuses on births with low APGAR scores (ie 4 or less). Stillbirths and
births induced for congenital abnormality have been excluded.
As King Edward Memorial Hospital is the main unit for pre-term and complex cases, the
rate there is higher than at other obstetric units.
Percentage of Live Births with APGAR Score of 4 or Less
1.0%
0.6%
Percentage
0.8%
0.4%
0.6%
0.4%
0.2%
0.0%
KEMH
Woodside (Frem antle)
ACHS THRESHOLD = 0.1% to 1.7%
1999/00
Financial Year
2000/01
2001/02
Percentage of Live Births with APGAR Score of 4 or Less
1.0%
Percentage
0.8%
0.6%
0.4%
0.3%
0.2%
0.3%
0.2%
0.1%
0.2%
0.0%
Arm adale
Bentley
Osborne Park
Rockingham
Sw an
Note:
•
This indicator, although quite similar to that provided by the ACHS Clinical Indicators User’s Manual: Obstetrics and
Gynaecology, Version 4, 2002, counts only live births.
•
KEMH data sourced from OBICARE, July 2002; other hospitals’ data sourced from Midwives’ Notification system,
August 2002.
Annual Report 2001/2002 Metropolitan Health Services
155
Key Performance Indicators
SURVIVAL RATES FOR SENTINEL CONDITIONS –
HEART ATTACK, STROKE AND FRACTURED NECK OF FEMUR
KPI 2.46
The survival rate of hospital patients can be affected by many factors, which include:
•
•
•
•
•
the illness or injury,
the treatment given or procedure performed,
the age, sex and general condition of each individual patient,
other illness at the time of admission, or
complications occurring while in hospital.
The comparison of unadjusted overall survival rates between hospitals might not be
appropriate, due to variations in the composition of these factors.
Three serious conditions, which are major causes of hospitalisation, have therefore been
selected as sentinel conditions, and survival rates for these reported by age group:
1. Emergency admissions for heart attack;
2. All admissions for stroke; and
3. All admissions for fractured neck of femur (higher age groups only).
After allowing for the effects of age, these survival rates indicate the quality and
consistency of care at the reporting hospitals.
In general there are a small number of deaths in each age group.
The survival rate of 70% for stroke patients aged 80+ is reflective of the complications
and co-morbidities which people in this age group experience. Approximately 80% of
patients in this age group at Royal Perth Hospital had severe complications resulting from
the stroke or had other serious medical conditions when the stroke occurred.
Annual Report 2001/2002 Metropolitan Health Services
156
Key Performance Indicators
SURVIVAL RATES FOR SENTINEL CONDITIONS
HEART ATTACK
(Emergency Admissions Only)
STROKE
FRACTURED NECK OF FEMUR
0-49 Years
0-49 Years
0-49 Years
8 6%
99%
RPH
RP H
95%
97%
SC GH
SC GH
100 %
10 0%
F rema nt le
F remant le
0%
2 5%
5 0%
75%
10 0 %
0%
Per cent ag e Survi ving
2 5%
5 0%
7 5%
100 %
Percent ag e Sur vivi ng
50-59 Years
50-59 Years
50-59 Years
99 %
85 %
RP H
RPH
83 %
9 9%
SC G H
SC GH
97 %
F re mantle
10 0%
F remant le
0%
2 5%
50 %
75 %
10 0%
0%
25 %
50 %
75%
Per cent ag e Surviving
Percent ag e Survi ving
60-69 Years
60-69 Years
9 7%
60-69 Years
RPH
93 %
SC GH
83 %
SC GH
86 %
95 %
F remantle
F re mant le
25 %
50 %
7 5%
10 0%
0%
Percent ag e Surviving
25 %
50 %
7 5%
For Fractured Neck of
Femur the number of
cases are
insignificant up to
age 69.
10 0%
85%
RPH
0%
For Fractured Neck
of Femur the
number of cases
are insignificant up
to age 69.
For Fractured Neck of
Femur the number of
cases are
insignificant up to
age 69.
10 0%
Per cent ag e Sur viving
70-79 Years
70-79 Years
70-79 Years
84%
97%
82%
96%
84%
99%
92%
RPH
9 1%
SC GH
86%
F re m a nt le
0%
25%
50%
75%
P er cent ag e S ur viving
10 0 %
0%
25%
50%
75%
10 0 %
P e r c e nt a g e S ur v i v i ng
0%
25%
50%
75%
10 0 %
P e r c e nt a g e S ur v i v i ng
Financial Year
1997/98
1998/99
1999/00
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
157
Key Performance Indicators
KPI 2.46 – Survival Rates for Sentinel Conditions
HEART ATTACK
(Emergency Admissions Only)
STROKE
FRACTURED NECK OF FEMUR
80+ Years
80+ Years
80+ Years
RP H
RP H
7 9%
SC GH
8 1%
F re m ant le
25%
50%
75%
89%
7 1%
F rem a nt le
0%
89%
7 4%
SC GH
SC GH
96%
7 1%
84%
RPH
0%
10 0%
F re m a nle
25%
5 0%
75 %
10 0 %
Per cent ag e Sur vivi ng
Per cent ag e Surviving
0%
25%
50%
75%
10 0 %
P er cent ag e Sur viv ing
Financial Year
1997/98
1998/99
1999/00
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
158
Key Performance Indicators
SURVIVAL RATES OF PATIENTS FOLLOWING
CORONARY ARTERY BYPASS GRAFTS
KPI 2.59
When any new surgical technique is introduced it is important for hospitals to monitor the
results and to compare outcomes with other surgical methods.
Until recently all patients who underwent coronary artery bypass grafts were placed on a
cardiopulmonary bypass (Heart Lung) machine. Using this method, the blood is diverted
from the heart and a sophisticated pump replaces the function of the heart, while the
heart is stopped and repairs are performed.
For many patients it is now possible for coronary artery bypass surgery to be undertaken
without the use of a cardiopulmonary bypass machine. "Off Bypass" or "Beating Heart
Surgery" is a technique where the heart is held steady by a mechanical clamp which
isolates the area of the heart to be operated upon. This might lead to improved outcomes
of surgery, depending on the affected area of the heart and the condition of the heart, and
patients are selected accordingly.
This indicator compares the survival rates of patients undergoing coronary artery bypass
surgery, according to the technique used. The results show survival rates with or without
the use of the cardiopulmonary bypass machine (pump).
Survival Rates for Coronary Artery Bypass Graft Surgery
Bypass Machine - NOT USED
Bypass Machine - USED
97.1%
97.0%
100.0%
98.2%
Percentage Surviving
Percentage Surviving
97.3%
99.2%
100%
100%
90%
80%
70%
60%
90%
80%
70%
60%
50%
50%
Frem antle
Financial Year
RPH
Frem antle
SCGH
1998/99
1999/00
RPH
2000/01
Annual Report 2001/2002 Metropolitan Health Services
SCGH
2001/02
159
Key Performance Indicators
SURVIVAL RATES FOR CORONARY ANGIOPLASTY
KPI 2.62
Hospitals which carry out complicated tertiary procedures measure the survival outcomes
and benchmark themselves against peer hospitals to ensure that appropriate standards
are achieved.
This indicator reports the survival rates of patients undergoing Coronary Angioplasty.
These rates are consistently high for the reporting hospitals.
Survival Rates for Coronary Angioplasty
98.4%
99.3%
98.5%
Percentage Surviving
100%
90%
80%
70%
60%
50%
Fremantle
Financial Year
1998/99
RPH
1999/00
SCGH
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
160
Key Performance Indicators
KPI 2.70 &
2.71
AVERAGE COST PER INPATIENT EPISODE (Casemix Adjusted)
The efficient use of hospital resources can help minimise the overall costs of providing
health care or can provide for more patients to be treated for the same outlay. These
charts indicate trends in the cost-efficiency of hospitalisation for all admitted inpatient
episodes, including same-day cases.
As the range and complexity of cases vary over time and from hospital to hospital, an
adjustment method known as casemix has been used to standardise the inpatient activity
measures used in these indicators. Clinical coding and casemix classification schemes
also evolve: adjustments for 1998/99 are based on AN-DRG Version 3.1, and for
1999/2000 onwards on AR-DRG Version 4.1.
Hospital costs have been measured in a consistent manner, with appropriate adjustments
being made for changes in government accounting standards. In each group of charts,
the first chart shows average cost per casemix-adjusted episode, and the second shows
the effects of adjusting these averages for inflation. Adjustments for inflation are based
on the Perth Consumer Price Index (CPI), and the results are expressed in terms of
1999/2000 dollars.
METROPOLITAN TEACHING HOSPITALS
Average Cost per Casemix-Adjusted Inpatient Episode
$4,000
3,489
$3,500
3,341
2,752
$3,000
Dollars
3,524
$2,500
$2,000
$1,500
$1,000
$500
$0
Frem antle
KEMH/PMH
RPH
SCGH
Average Cost per Casemix-Adjusted Inpatient Episode, Adjusted for Inflation
(FY 1999/2000 = 100.0)
$3,500
3,230
3,198
$3,000
3,062
2,522
Dollars
$2,500
$2,000
$1,500
$1,000
$500
$0
Fremantle
Financial Year
KEMH/PMH
1998/99
RPH
1999/00
SCGH
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
161
Key Performance Indicators
KPI 2.70 & 2.71 Average Cost per Inpatient Episode Cont…
METROPOLITAN NON-TEACHING HOSPITALS
Average Cost per Casemix Adjusted inpatient Episode
$3,000
$2,500
2,437
2,440
2,360
2,265
2,301
2,684
Dollars
$2,000
$1,500
$1,000
$500
$0
Armadale
Bentley
Kalamunda
Osborne P ark
Rock/ Kwin
Swan
Average Cost per Casemix-Adjusted Inpatient Episode, Adjusted for Inflation
(FY 1999/2000 = 100.0)
$3,000
$2,500
2,234
2,236
2,163
2,076
2,460
2,109
Dollars
$2,000
$1,500
$1,000
$500
$0
Armadale
Financial Year
Bentley
1998/99
Kalamunda
Osborne P ark
1999/00
Ro ck/ Kwin
2000/01
Swan
2001/02
Comments
The most conspicuous feature of these charts is the sudden increase in average cost per
casemix-adjusted episode at almost every metropolitan hospital for the 2001/02 financial
year.
This increase is mainly attributable to the coincidence of salary and remuneration scale
reviews in the same year for medical, nursing, allied health, technical, administrative and
support staff. Other general influences on hospital costs were a review which resulted in
increases in prescribed nurse to patient ratios, and substantial increases in prices for
drugs and prosthetics.
At Royal Perth Hospital, these pressures were compounded by an outbreak of
Vancomycin-Resistant Enterococci (VRE), which reduced activity levels as well as
imposing additional cleaning costs.
Increased utilisation of spare capacity at Osborne Park Hospital enabled it to be the only
metropolitan hospital to show an improvement in this cost-efficiency indicator.
Annual Report 2001/2002 Metropolitan Health Services
162
Key Performance Indicators
AVERAGE COST PER EMERGENCY DEPARTMENT ATTENDANCE
KPI 2.80
AVERAGE COST PER OUTPATIENT CLINIC ATTENDANCE
KPI 2.84
AVERAGE COST PER NON-INPATIENT OCCASION OF SERVICE
KPI 2.86
These charts complement the information presented in KPIs 2.70 and 2.71, by indicating
cost-efficiency trends in treatment provided via emergency departments, outpatient clinics
and other hospital-based services, to people who have not been admitted as inpatients.
In each group of charts, the first chart shows average cost per attendance or occasion of
service, and the second shows the effects of adjusting these averages for inflation.
Adjustments for inflation are based on the Perth Consumer Price Index (CPI), and the
results are expressed in terms of 1999/2000 dollars.
Although the range and composition of cases vary over time and from hospital to hospital,
no adjustment has been made for such factors in these indicators. As far as possible,
costs have been measured in a consistent manner.
Comments
Substantial staff, drugs and prosthetics cost pressures were experienced by all
metropolitan hospitals in 2001/02, as explained in the comments on KPIs 2.70 and 2.71.
The impact of these cost increases varied according to treatment modality: inpatient and
ED costs were affected to a greater degree than costs in less intensive service areas.
At Royal Perth Hospital, these pressures were compounded by an outbreak of
Vancomycin-Resistant Enterococci (VRE), which reduced ED activity levels as well as
imposing additional cleaning costs.
METROPOLITAN HOSPITALS WITH EMERGENCY DEPARTMENTS
Average Cost per ED Attendance
$500
361
Dollars
$400
284
$300
262
251
210
188
$200
130
$100
$0
F re m
KE M H / P M H
RP H
SC GH
A rm
R o c k / Kwin
S wa n
Average Cost per ED Attendance, Adjusted for Inflation (FY 1999/2000 = 100.0)
$500
Dollars
$400
331
260
$300
240
230
192
172
$200
119
$100
$0
F rem
Financial Year
KEM H/ PM H
1998/99
R PH
SC GH
1999/00
A rm
R o ck/ Kwi n
2000/01
Annual Report 2001/2002 Metropolitan Health Services
Swan
2001/02
163
Key Performance Indicators
KPIs 2.80, 2.84, 2.86 Cont…
DOCTOR ATTENDED CLINICS AT METROPOLITAN TEACHING HOSPITALS
Average Cost per Outpatient Occasion of Service (OOS)
221
$250
Dollars
$200
132
$150
136
109
$100
$50
$0
F re m a nt le
KE M H / P M H
RP H
SC GH
Average Cost per OOS, Adjusted for Inflation (FY 1999/2000 = 100.0)
$250
203
Dollars
$200
121
$150
125
100
$100
$50
$0
F re m a nt le
KE M H / P M H
RP H
SC GH
SERVICES AT METROPOLITAN NON-TEACHING HOSPITALS
$100
Average Cost per Non-Inpatient Occasion of Service (OOS)
Dollars
$80
58
$60
31
$40
36
53
44
40
$20
$0
A rm ada le
$100
B e nt le y
Ka la m unda
Dollars
R o c k / Kwin
S wa n
Average Cost per OOS, Adjusted for Inflation (FY 1999/2000 = 100.0)
$80
53
$60
$40
O s bo rne P a rk
33
28
49
40
37
$20
$0
A rm a da le
Financial Year
B e ntle y
1998/99
Ka lam unda
1999/00
O s bo rne P ark
R o c k / Kwin
2000/01
Annual Report 2001/2002 Metropolitan Health Services
S wa n
2001/02
164
Key Performance Indicators
AGED CARE ASSESSMENT TEAMS (ACAT) :
TOTAL ASSESSMENT RATES AND INITIAL ASSESSMENT RATES
FOR ELDERLY PEOPLE
KPIs 3.2
& 3.3
Elderly people within the community are at risk of experiencing a poorer quality of life
through frailty, chronic illness or disability reducing their capacity to manage their
activities of daily living. A range of services are available to people requiring support to
improve or maintain their optimal quality of life. There are supports available to people
living in their own homes as well as supported accommodation options.
Aged Care Assessment Teams (ACAT) assess the support needs of people who might
require services to improve or maintain their quality of life and where required, Care Plans
are developed to ensure that they receive the support they need. Care Plans aim to
maintain elderly people in their own homes and communities for as long as possible.
ACAT services focus on all people aged 70 years and over, and also on Aboriginal and
Torres Strait Islander people aged 50 to 69 years. These indicators measure total ACAT
assessment rates and initial ACAT assessment rates for people within these groups, in
relation to the corresponding population in each health service area.
Results in these charts are presented according to the client’s area of residence; they are
not based on the location or catchment of the ACAT team.
Annual Report 2001/2002 Metropolitan Health Services
165
Key Performance Indicators
KPI 3.2 – AGED CARE ASSESSMENT TEAMS (ACAT)
TOTAL ASSESSMENT RATE PER 1,000 OF POPULATION
All Persons Aged 70+ Years
Armadale
ATSI Persons Aged 50-69 Years
Armadale
172
0
50
100
150
38
200
0
20
Rate pe r 1,000 pop.
40
100
150
14
200
0
20
40
Fremantle
100
150
200
0
20
150
200
0
150
40
0
200
20
40
60
80
Rate pe r 1,000 pop.
Rockingham
Rockingham
50
100
150
200
0
20
100
100
40
150
60
80
100
Rate pe r 1,000 pop.
Swan & Inner City
149
50
100
9
Swan & Inner City
47
200
0
Rate pe r 1,000 pop.
Calendar Year
80
Rate pe r 1,000 pop.
Rate pe r 1,000 pop.
0
60
6
122
0
20
North Metropolitan
170
100
100
Rate pe r 1,000 pop.
North Metropolitan
50
80
0
Rate pe r 1,000 pop.
0
60
Kalamunda
144
100
40
Rate pe r 1,000 pop.
Kalamunda
50
100
43
Rate pe r 1,000 pop.
0
80
Fremantle
128
50
60
Rate pe r 1,000 pop.
Rate pe r 1,000 pop.
0
100
Bentley
168
50
80
Rate pe r 1,000 pop.
Bentley
0
60
20
40
60
80
100
Rate pe r 1,000 pop.
1999
2000
2001
Annual Report 2001/2002 Metropolitan Health Services
166
Key Performance Indicators
KPI 3.3 – AGED CARE ASSESSMENT TEAMS (ACAT)
FIRST ASSESSMENT RATE PER 1,000 OF POPULATION
All Persons Aged 70+ Years
ATSI Persons Aged 50 to 69 Years
Armadale
Armadale
70
0
20
40
60
80
13
0
15
Rate per 1,000 pop.
66
20
40
60
80
0
15
60
80
0
15
60
80
0
15
60
80
0
15
60
80
0
15
60
60
18
80
0
Rate per 1,000 pop.
Calendar Year
45
Swan & Inner City
68
40
30
Rate per 1,000 pop.
Swan & Inner City
20
60
9
Rate per 1,000 pop.
0
45
Rockingham
62
40
30
Rate per 1,000 pop.
Rockingham
20
60
3
Rate per 1,000 pop.
0
45
North Metropolitan
59
40
30
Rate per 1,000 pop.
North Metropolitan
20
60
0
Rate per 1,000 pop.
0
45
Kalamunda
66
40
30
Rate per 1,000 pop.
Kalamunda
20
60
14
Rate per 1,000 pop.
0
45
Fremantle
49
40
30
Rate per 1,000 pop.
Fremantle
20
60
0
Rate per 1,000 pop.
0
45
Bentley
Bentley
0
30
Rate per 1,000 pop.
15
30
45
60
Rate per 1,000 pop.
1999
2000
2001
Annual Report 2001/2002 Metropolitan Health Services
167
Key Performance Indicators
WAITING TIME IN DAYS TO FIRST APPOINTMENT TO SEE
AGED CARE ASSESSMENT TEAMS (ACAT)
KPIs 3.4
All people aged 70 and over plus Aboriginal and Torres Strait Islander people aged 50 to
69 years are at risk of experiencing a poorer quality of life because of frailty, chronic
illness or disability reducing their capacity to manage their activities of daily living. A
range of services are available to people requiring support to improve or maintain their
optimal quality of life. There are supports available to people living in their own homes as
well as assisted accommodation options.
Aged Care Assessment Teams (‘ACAT’) assess the needs of people who may require
services to improve or maintain their quality of life. Appropriate coverage of the ‘at risk’
population is a measure of ensuring that the needs of this population are adequately
assessed and that plans for the provision of required levels of support are developed. All
activity is shown according to where people live, ie according to each metropolitan local
Health Service catchment area as indicated in the map, irrespective of which ACAT
performs the assessment.
North
Metropolitan
Swan
Bentley
Kalamunda
Fremantle
Armadale
Rockingham/
Kwinana
Results show good response times in all sections of the metropolitan area.
Annual Report 2001/2002 Metropolitan Health Services
168
Key Performance Indicators
MEDIAN WAITING TIME (IN DAYS) TO FIRST APPOINTMENT
TO SEE AGED CARE ASSESSMENT TEAM
Armadale
3
0
1
2
3
4
5
4
5
Days
Bentley
2
0
1
2
3
Days
Fremantle
3
0
1
2
3
4
5
Days
Kalam unda
3
0
1
2
3
4
5
4
5
Days
North Metro
0
0
1
2
3
Days
Rockingham
4
0
1
2
3
4
5
Days
Sw an & Inner City
1
0
1
2
3
4
5
D ays
Calendar Year
1999
2000
2001
Annual Report 2001/2002 Metropolitan Health Services
169
Key Performance Indicators
AVERAGE COST PER PERSON WITH MENTAL ILLNESS
UNDER COMMUNITY MANAGEMENT
KPIs 3.8
The majority of services provided by community mental health services are for people in
an acute phase of a mental health problem or who are receiving post-acute care. This
indicator gives a measure of the cost effectiveness of treatment for public psychiatric
patients under community management.
The figures for this indicator are obtained by dividing the combined gross accrued cost of
community based services by the total number of persons who received at least one
occasion of service during the period.
The explanation and rationalisation of mental health services and improvements in
treatment practice over recent years have impacted in different ways on the annual
average unit cost of hospitalisation, rehabilitation, continuing care and community-based
services provided under the Mental Health Program.
Annual Report 2001/2002 Metropolitan Health Services
170
Key Performance Indicators
AVERAGE COST PER CLIENT FOR COMMUNITY HEALTH PROGRAMS
The majority of services provided by
community mental health services are for
people in an acute phase of a mental health
problem or who are receiving post-acute care.
This indicator gives a measure of the cost
effectiveness of treatment for public psychiatric
patients under community management.
North
Metropolitan
Swan
The first chart indicates trends in average cost
per person who received at least one occasion
of service, for each health service.
Bentley
Kalamunda
Fremantle
The second chart show the results of adjusting
these average costs for inflation, expressed in
terms of 1999/2000 dollars.
Armadale
These averages have not been adjusted for
any variation, from area to area, in the
combination of professions and services.
Rockingham/
Kwinana
Com m unity Mental Health: Average Cost per Client under Com m unity Managem ent
$5,000
3,525
$4,000
Dollars
$3,000
2,545
2,217
2,354
2,588
1,385
$2,000
2,022
$1,000
$0
A rm a da le
B e nt le y
F re m a nt le
Ka la m unda
N o rt h M e t ro R o c kingha m
S wa n &
Inne r C it y
Com m unity Mental Health: Average Cost per Client, Adjusted for Inflation (FY1999/2000 = 100.0)
$5,000
$4,000
Dollars
3,231
2,333
$3,000
2,157
$2,000
1,269
2,032
2,372
1,853
$1,000
$0
Financial Year
Armadale
1998/99
Bentley
Fremantle
1999/00
Kalamunda North M etro Ro ckingham
2000/01
Swan &
Inner City
2001/02
Annual Report 2001/2002 Metropolitan Health Services
171
Key Performance Indicators
VALUE/COST PER TREATMENT FOR
TOTAL GENERAL, SPECIALISED & SCHOOL DENTAL SERVICE
DENTAL
HEALTH
This performance indicator measures the value per treatment for general and specialist
dental services and the cost per enrolled child in the care of School Dental Service.
Value:
For general and specialised dental services the trend figures shown are indicative of
whether general, emergency and specialised dental services are being delivered more or
less efficiently in terms of the value of work provided to adults in accordance with the fee
schedule used by the Department of Veterans Affairs.
The year 1994/95 has been selected as a base year with subsequent annual figures
adjusted for fee increases in the Department of Veterans’ Affairs fee schedules. This
enables a more effective comparison of the average value of work provided for the
period.
ADULT SERVICES
Adjusted Average Value of Dental Patient Treatment
Adjusted Average Value of Patient Treatm ent
$750
$619.97
Dollars
$625
$500
$375
$223.46
$250
$226.57
$97.63
$76.56
$125
$0
General
Emergency
Oral Surgery
Orthodontics
Periodontics
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
1.
There was an error in the adjustment rates for 1997/98. The fee increase was
applied for a 3 month period when it should have been 4 months. It did not apply to
Orthodontics.
2.
There was an error in the calculation of the index of Orthodontics only in the 1999/00
figures. The increase was based on a figure of 10% against 8.3%. This has been
corrected.
3.
The decrease in figures for Oral Surgery and Periodontics reflects the impact of the
transfer of a number of patients to the Oral Health Centre of Western Australia from 1
January 2002 for completion of their treatment. These figures are therefore not
comparable to previous years.
Annual Report 2001/2002 Metropolitan Health Services
172
Key Performance Indicators
Cost:
The following graph indicates the cost per enrolled child in the School Dental Services
expressed in both Cash and Accrual figures. Accrual figures are not available prior to
1997/98.
SCHOOL DENTAL SERVICES
Average Cost per Enrolled Child Under Care
Financial Year
1997/98
1998/99
1999/00
2000/01
CASH
ACCRUAL
$100.00
$62.17
$80.00
$57.08
$64.14
$65.70
$73.87
$100.00
$80.00
$60.00
$60.00
$40.00
$40.00
$20.00
$20.00
$0.00
2001/02
1997/98 1998/99 1999/00 2000/01 2001/02
$0.00
$72.14
$70.51
$67.65
$75.57
$80.24
1997/98 1998/99 1999/00 2000/01 2001/02
Cash:
Increase in 2001/02 is due to a cash appropriation to meet superannuation costs,
previously a liability of the Treasurer, being included for the first time.
Accrual:
2001/02 includes for the first time a capital usage charge.
Annual Report 2001/2002 Metropolitan Health Services
173
Key Performance Indicators
DENTAL
HEALTH
DENTAL HEALTH STATUS OF TARGET CLIENTELE
This performance indicator measures the effectiveness of strategies designed to reduce
the number of decayed, missing or filled teeth (DMFT) per person. The number of DMFT
per person is an indicator of the oral health of the targeted population. The group
selected consists of those who are financially disadvantaged and Aged 35 to 44. This
indicator has been consistent over the past five years.
Number of Decayed, Missing of Filled Teeth (DMFT) Per Financially
Disadvantaged Person in the 35-44 Year Old Age Group
13.9
13.9
14.0
DMFT
13.7
13.8
13.8
13.4
13.6
13.4
13.2
13.0
1997/98
1998/99
1999/00
2000/01
2001/02
Financial Year
1997/98
1998/99
1999/00
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
174
Key Performance Indicators
ACCESS – RURAL AND REMOTE DENTAL SERVICES
COVERAGE ACCORDING TO SHIRES
DENTAL
HEALTH
This indicator is a measure of the effectiveness in achieving the goal of ensuring that
throughout the rural and remote shires, there is access to dental care within 100
kilometres of the main town of each shire on at least an annual basis. This indicator
identifies the shires with no service against those with either a minimum of a public dental
clinic, visiting public mobile service or a local or visiting private practitioner. For the shires
with no service a measure is taken of the distance from the main town to the location of a
service in the closest adjacent shire. The shires affected still retain reasonable access to
adjacent shire services.
Distribution of Shires on the Basis of Access to Dental Services
1998/99
1997/98
40
40
19
38
43
10
19
11
2000/01
1999/00
40
40
42
17
41
17
12
11
2001/02
41
42
15
12
Shires have no service located within their Shire. Services are accessed in adjacent shire(s).
Shires have a public dental clinic.
Shires have a public mobile service, visits at least once a year.
Shires have either a local or visiting private practitioner.
Annual Report 2001/2002 Metropolitan Health Services
175
Key Performance Indicators
TREATMENT RATES AND HEALTH STATUS OF
INDIVIDUALS USING DENTAL SERVICE
DENTAL
HEALTH
This performance indicator measures the effectiveness of strategies designed to increase
the percentage of children of pre-primary, primary and high school age who are enrolled
and under the care of the School Dental Service, to reduce the number of decayed,
missing or filled teeth per child, and reduce the percentage of children who experience
dental decay.
Treatment Rates
The School Dental Service offers prevention, screening and treatment services free of
charge to all pre-primary, primary and secondary school children to Year 11. Services
are delivered throughout the State via fixed and mobile dental therapy centres.
These indicators confirm both the importance and effectiveness of operating a school
dental service. The percentage of school children enrolled in the service is confirmation
of the success of the service. The percentage enrolled and under care for pre-primary
and primary school children confirms the number accessing care.The under care figures
for the high school group vary from the enrolment figures because missed appointments
are not followed and the case is regarded as being suspended. Until such time as those
students make further contact they are not under care.
The impact of the service is reflected in the oral health status of school children in terms
of the numbers experiencing dental decay and the indices of decayed, missing or filled
teeth per child, noting that dental caries (tooth decay) is the principal disease that affects
children. The indicator for five year olds is an important base as this group has had
insufficient exposure to the service for it to have had a direct impact although the service
does impact indirectly through dental health education activities aimed at care givers and
parents of young children.
The indicator for the oral health status of five year olds continues to be of concern and
continues to emphasise the need for a strategy to provide care for young children prior to
entering pre-school. The index for 8,12 and 15 year olds continues to show significant
benefit resulting from the operation of the service.
These indices have shown a slight increase over the last three years. This is attributable
in part to an increase in the use of dental X-Rays resulting in higher levels of detection. It
also identifies the need for increasing oral health awareness through dental education
programs. This latter need is being addressed through the introduction of a web site
providing schools in particular with direct access to appropriate education programs for
schools. It will also be accessible to the wider population.
DMFT – Permanent Teeth – Decayed, Missing or Filled
dmft – Deciduous (temporary) Teeth – decayed, missing or filled.
Annual Report 2001/2002 Metropolitan Health Services
176
Key Performance Indicators
DENTAL
HEALTH
SCHOOL DENTAL SERVICE
Financial year
1997/98
1998/99
1999/00
% of Pre Primary School Children
Enrolled
100
95
95
90
84.7
84.5
83.6
85
83.9
84.2
84.7
84.5
83.6
85
83.9
84.2
80
80
75
75
1997/98 1998/99 1999/00 2000/01 2001/02
1997/98 1998/99 1999/00 2000/01 2001/02
% of Primary School Children Enrolled
100
2001/02
% of Pre Primary School Children
Enrolled & Under Care
100
90
2000/01
87.0
86.8
87.1
86.3
% of Primary School Children Enrolled &
Under Care
100
85.9
80
80
60
60
40
40
20
20
87.0
87.1
86.8
86.3
85.9
0
0
1997/98 1998/99 1999/00 2000/01 2001/02
1997/98 1998/99 1999/00 2000/01 2001/02
% of Secondary School Children Enrolled
% of Secondary School Children Enrolled
& Under Care
100
81.1
76.3
77.3
75.9
100
77.2
80
80
60
60
40
40
20
20
58.0
56.8
57.8
60.1
58.9
0
0
1997/98 1998/99 1999/00 2000/01 2001/02
1997/98 1998/99 1999/00 2000/01 2001/02
% of School Children who are enrolled who Experienced Dental Decay
39.3
5 Year Olds (deciduous)
20.1
8 Year Olds
39.1
12 Year Olds
50.4
15 Year Olds
0
10
20
30
40
50
60
Annual Report 2001/2002 Metropolitan Health Services
70
177
Key Performance Indicators
DENTAL
HEALTH
DENTAL HEALTH STATUS OF SCHOOL CHILDREN
5 Year Olds - Decayed, Missing or Filled Teeth per Child (dm ft - deciduous teeth)
3.00
2.50
dmft
2.00
1.16
1.32
1.59
1.51
1.48
1.50
1.00
0.50
0.00
1997/98
1998/99
1999/00
2000/01
2001/02
8 Year Olds - Decayed, Missing or Filled Teeth per Child (DMFT - Perm anent Teeth)
0.37
0.40
0.34
0.33
0.28
0.27
DMFT
0.30
0.20
0.10
0.00
1997/98
1998/99
1999/00
2000/01
2001/02
12 Year Olds – Decayed, Missing or Filled Teeth per Child (DMFT – Permanent Teeth)
Western Australia
"1998" International Comparisons
2.50
2.00
1.70
2.00
1.50
0.84
1.00
0.50
0.50
1997/98
1998/99
1999/00
2000/01
2001/02
0.00
1.70
1.50
1.50
1.00
1.10
1.01
Austria
Denmark
Finland
Germany
Italy
Norway
15 Year Olds - Decayed, Missing or Filled Teeth per Child (DMFT - Perm anent Teeth)
2.19
2.50
1.55
2.00
DMFT
0.00
2.12
2.50
1.5
1.68
1.51
1.50
1.00
0.50
0.00
1997/98
1998/99
1999/00
2000/01
2001/02
Annual Report 2001/2002 Metropolitan Health Services
178
Key Performance Indicators
PERCENTAGE OF ELIGIBLE PEOPLE ACCESSING DENTAL SERVICES
DENTAL
HEALTH
This indicator shows a significant increase in the number of persons accessing
government assisted dental services over the last five years since 1998/99.
Additional funding was provided in 2000/01 which enabled more treatment to be provided
through the Country Patients' Dental Subsidy Scheme (CPDSS) and the introduction of
the Metropolitan Patients' Dental Subsidy Scheme (MPDSS). This funding has been
maintained and access to services has levelled out at 21%. The figure is assessed
against national survey statistics which show that 50% of the State adult population
access dental care in any given year.
Financial Year
1997/98
1998/99
1999/00
2000/01
2001/02
Percentage of Eligible People Accessing Dental Services
21%
Percentage
Accessing Services
25%
20%
16%
16%
18%
21%
15%
10%
5%
0%
1997/98
1998/99
1999/00
2000/01
2001/02
Annual Report 2001/2002 Metropolitan Health Services
179
Key Performance Indicators
WAITING TIME IN WEEKS FOR GENERAL
AND SPECIALIST DENTAL SERVICES
DENTAL
HEALTH
This indicator identifies the obtainability of oral health care even though accessing may
not be an issue. These figures are assessed against a notional reasonable waiting time
of 12 weeks.
It is now five years since the cessation of the Commonwealth funded program and many
of those eligible patients have only recently regained eligibility and are in need of
treatment as is reflected by larger number of patients attending for emergency treatment.
The waiting times for the Country Patients' Dental Subsidy Scheme and the Metropolitan
Patients' Dental Subsidy Scheme are at acceptable levels.
The increase in waiting times in major public dental clinics is a result of increase in
demand for treatment. There is also a short term impact of the closure of the Perth Dental
Hospital and the delay in completion of new public dental clinics.
From 1 January 2002 specialist services have been provided through the Oral Health
Centre of WA.
Waiting Time for General & Specialist Dental Services
120
100
80
Weeks
60
48
40
10
20
0
M ajor Public
Clinics
Country
Patients
Subsidised
through Private
Practice
8
Oral Surgery
Orthodontics
Periodontics
Metropolitan
Patients
Subsidiesed
through Private
Practice
*
Waiting period impacted upon by closure of Perth Dental Hospital, 196 Goderich
Street, Perth on 31st December 2001 and delay in opening of new facilities.
** Specialist Services transferred to Oral Health Centre
*** Metropolitan Patients Dental Subsidy Scheme - First year of operation.
Financial year
1997/98
1998/99
1999/00
2000/01
Annual Report 2001/2002 Metropolitan Health Services
2001/02
180
Financial Statements Audit Opinion
To the Parliament of Western Australia
THE MINISTER FOR HEALTH IN HIS CAPACITY AS THE DEEMED BOARD
OF METROPOLITAN PUBLIC HOSPITALS
FINANCIAL STATEMENTS FOR THE YEAR ENDED JUNE 30, 2002
Scope
I have audited the accounts and financial statements of The Minister for Health in his capacity
as the Deemed Board of Metropolitan Public Hospitals for the year ended June 30, 2002 under
the provisions of the Financial Administration and Audit Act 1985.
The Director General, Department of Health is responsible for keeping proper accounts and
maintaining adequate systems of internal control, preparing and presenting the financial
statements, and complying with the Act and other relevant written law. The primary
responsibility for the detection, investigation and prevention of irregularities rests with the
Director General.
My audit was performed in accordance with section 79 of the Act to form an opinion based on
a reasonable level of assurance. The audit procedures included examining, on a test basis, the
controls exercised by the Health Service to ensure financial regularity in accordance with
legislative provisions, evidence to provide reasonable assurance that the amounts and other
disclosures in the financial statements are free of material misstatement and the evaluation of
accounting policies and significant accounting estimates. These procedures have been
undertaken to form an opinion as to whether, in all material respects, the financial statements
are presented fairly in accordance with Accounting Standards and other mandatory
professional reporting requirements in Australia and the Treasurer’s Instructions so as to
present a view which is consistent with my understanding of the Health Service’s financial
position, its financial performance and its cash flows.
The audit opinion expressed below has been formed on the above basis.
4th Floor Dumas House 2 Havelock Street West Perth 6005 Western Australia Tel: 08 9222 7500 Fax: 08 9322 5664
Annual Report 2001/2002 Metropolitan Health Services
181
Financial Statements Audit Opinion
The Minister for Health in his capacity as the
Deemed Board of Metropolitan Public Hospitals
Financial Statements for the year ended June 30, 2002
Qualifications
Postal Remittances - Special Purpose Accounts
The controls exercised by the Health Service over postal remittances relating to Special
Purpose Accounts were not adequate as not all remittances were being opened and recorded
before being forwarded to individuals. As a consequence, assurance cannot be provided that
all postal remittances have been receipted and properly brought to account.
Incurring and Certifying of Expenditure
The controls exercised by the Health Service over payments of moneys were not adequate and
did not comply with legislative requirements. These included incurring and certifying officers
not performing all the duties required by the Treasurer’s Instructions, and instances of officers
incurring payments outside their authority.
Qualified Audit Opinion
In my opinion,
(i) except for the effects of the matters referred to in the qualifications, the controls
exercised by The Minister for Health in his capacity as the Deemed Board of
Metropolitan Public Hospitals provide reasonable assurance that the receipt,
expenditure and investment of moneys and the acquisition and disposal of
property and the incurring of liabilities have been in accordance with legislative
provisions; and
(ii) the Statement of Financial Performance, Statement of Financial Position and
Statement of Cash Flows and the Notes to and forming part of the financial
statements are based on proper accounts and present fairly in accordance with
applicable Accounting Standards and other mandatory professional reporting
requirements in Australia and the Treasurer’s Instructions, the financial
position of the Health Service at June 30, 2002 and its financial performance
and its cash flows for the year then ended.
D D R PEARSON
AUDITOR GENERAL
February 28, 2003
4th Floor Dumas House 2 Havelock Street West Perth 6005 Western Australia Tel: 08 9222 7500 Fax: 08 9322 5664
Annual Report 2001/2002 Metropolitan Health Services
182
Financial Statements Certification
CERTIFICATION OF THE FINANCIAL STATEMENTS
FOR THE YEAR ENDED 30 JUNE 2002
The accompanying financial statements of The Minister for Health in his capacity as the
Deemed Board of Metropolitan Public Hospitals have been prepared in compliance with
the provisions of the Financial Administration and Audit Act 1985 from proper accounts
and records to represent fairly the financial transactions for the twelve months ending 30
June 2002 and the financial position as at 30 June 2002.
At the date of signing, we are not aware of any circumstances which would render the
particulars included in the financial statements misleading or inaccurate.
Accountable Authority for
The Minister for Health in his
capacity as the Deemed Board
of Metropolitan Public Hospitals
The Minister for Health in his
capacity as the Deemed Board
of Metropolitan Public
Hospitals
30 August 2002
30 August 2002
Annual Report 2001/2002 Metropolitan Health Services
183
Statement of Financial Performance
For the year ended 30 June 2002
Note
2002
$000
2001
$000
934,099
28,177
77,295
260,348
13,014
62,458
3,862
42,456
173,280
1,594,989
821,928
28,245
75,061
239,045
14,746
42,620
3,097
160,534
1,385,276
40,324
2,508
6,196
32,844
83
43,070
2,451
6,757
30,330
65
4,100
7,904
93,959
6,225
4,712
93,610
1,501,030
1,291,666
1,478,684
1,167
880
1,480,731
1,213,934
38,373
56,944
335
1,309,586
CHANGE IN NET ASSETS
(20,299)
17,920
Total changes in equity other than those resulting from
transactions with WA State Government as owners
(20,299)
17,920
COST OF SERVICES
Expenses from Ordinary Activities
Employee expenses
Fees for visiting medical practitioners
Superannuation expense
Patient support costs
Borrowing costs expense
Depreciation expense
Net loss on disposal of non-current assets
Capital user charge
Other expenses from ordinary activities
Total cost of services
Revenues from Ordinary Activities
Revenue from operating activities
Patient charges
Commonwealth grants and contributions
Grants and subsidies from non-government sources
Other revenues from ordinary activities
Trading profit
Revenue from non-operating activities
Interest revenue
Other revenues from ordinary activities
Total revenues from ordinary activities
2
3
4
5
6
7
8
9
10
11
10
Net cost of services
REVENUES FROM GOVERNMENT
Output appropriations
Capital appropriations
Liabilities assumed by the Treasurer - superannuation
Resources received free of charge
Total revenues from government
12
12
13
14
The above Statement of Financial Performance should be read in conjunction with the
notes to the financial statements.
Annual Report 2001/2002 Metropolitan Health Services
184
Statement of Financial Position
As at 30th June 2002
Note
2002
$000
2001
$000
Current assets
Cash assets
Restricted cash assets
Other financial assets
Receivables
Amounts receivable for outputs
Inventories
Other assets
Total current assets
15
16
17
18
19
20
21
47,485
37,695
4,419
33,381
46,620
11,911
2,455
183,966
18,421
29,099
11,465
28,184
11,224
3,033
101,426
Non-current assets
Property, plant and equipment
Total non-current assets
22
970,838
970,838
993,375
993,375
1,154,804
1,094,801
Total assets
Current liabilities
Payables
Interest-bearing liabilities
Provisions
Other liabilities
Total current liabilities
23
24
25
26
37,972
6,688
167,608
39,107
251,375
46,384
6,797
146,237
23,192
222,610
Non-current liabilities
Interest-bearing liabilities
Provisions
Total non-current liabilities
24
25
180,604
186,184
366,788
187,529
182,540
370,069
Total liabilities
618,163
592,679
Net assets
536,641
502,122
637,793
(101,153)
582,976
(80,854)
536,641
502,122
Equity
Contributed equity
Accumulated surplus / (deficiency)
Total equity
27
27
The above Statement of Financial Position should be read in conjunction with the notes to
the financial statements.
Annual Report 2001/2002 Metropolitan Health Services
185
Statement of Cash Flows
For the year ended 30 June 2002
Note
2002
$000
Inflows
(Outflows)
2001
$000
Inflows
(Outflows)
28
28
1,378,648
46,863
1,425,511
1,197,208
35,271
1,232,479
Cash flows from Government
Output appropriations
Capital contributions (2001 Capital appropriation)
Net cash provided by Government
Utilised as follows:
Cash flows from operating activities
Payments
Employee costs
Supplies and services
Borrowing costs
Receipts
Patient charges and fees
Commonwealth grants and contributions
Grants and subsidies from non-government sources
Interest received
Other receipts
Net cash provided by / (used in)
operating activities
29(b)
(894,768)
(546,636)
(4,131)
(811,272)
(450,129)
(3,314)
38,211
2,509
6,195
4,295
41,112
42,154
2,451
6,756
6,821
31,559
(1,353,214)
(1,174,974)
Cash flows from investing activities
Purchase of non-current physical assets
Proceeds from sale of non-current physical assets
Receipts from term deposits
Purchase of term deposits
Net cash provided by / (used in) investing activities
(40,333)
711
11,465
(4,419)
(32,576)
(59,521)
792
1,650
(11,465)
(68,544)
Cash flows from financing activities
Proceeds from borrowings
Repayments of borrowings
Net cash provided by / (used in) financing activities
(2,061)
(2,061)
(1,516)
(1,516)
Net increase / (decrease) in cash held
37,660
(12,555)
Cash assets at the beginning of the reporting period
47,520
60,076
85,180
47,520
Cash assets at the end of the reporting period
29 (a)
The above Statement of Cash Flows should be read in conjunction with the notes to the
financial statements.
Annual Report 2001/2002 Metropolitan Health Services
186
Notes to the Financial Statements
For the year ended 30 June 2002
Note 1
Significant accounting policies
The following accounting policies have been adopted in the preparation of the financial statements. Unless otherwise stated
these policies are consistent with those adopted in the previous year.
General Statement
The financial statements constitute a general purpose financial report which has been prepared in accordance with
Australian Accounting Standards, Statements of Accounting Concepts and other authoritative pronouncements of the
Australian Accounting Standards Board, and Urgent Issues Group (UIG) Consensus Views as applied by the Treasurer's
Instructions. Several of these are modified by the Treasurer's Instructions to vary application, disclosure, format and
wording. The Financial Administration and Audit Act and the Treasurer's Instructions are legislative provisions governing
the preparation of financial statements and take precedence over Australian Accounting Standards, Statements of
Accounting Concepts and other authoritative pronouncements of the Australian Accounting Standards Board, and UIG
Consensus Views. The modifications are intended to fulfil the requirements of general application to the public sector,
together with the need for greater disclosure and also to satisfy accountability requirements.
If any such modification has a material or significant financial effect upon the reported results, details of that modification
and where practicable, the resulting financial effect are disclosed in individual notes to these financial statements.
The statements have been prepared on the accrual basis of accounting using the historical cost convention, except for
certain assets and liabilities which, as noted, are measured at valuation.
(a)
Output Appropriations
Output Appropriations are recognised as revenues in the period in which the Health Service gains control of the
appropriated funds. The Health Service gains control of appropriated funds at the time those funds are deposited into
the Health Service's bank account or credited to the holding account held at the Department of Treasury and Finance.
(b)
Contributed Equity
Under UIG 38 "Contributions by Owners Made to Wholly-Owned Public Sector Entities", transfers in the nature of equity
contributions must be designated by the Government (owners) as contributions by owners (at the time of, or prior to
transfer) before such transfers can be recognised as equity contributions in the financial statements. Capital
contributions (appropriations) have been designated as contributions by owners and have been credited directly to
Contributed Equity in the Statement of Financial Position. All other transfers have been recognised in the Statement of
Financial Performance. Prior to the current reporting period, capital appropriations were recognised as revenue in the
Statement of Financial Performance. Capital appropriations which are repayable to the Treasurer are recognised as
liabilities.
(c)
Grants and Other Contributions Revenue
Grants, donations, gifts and other non-reciprocal contributions are recognised as revenue when control is obtained over
the assets comprising the contributions. Control is normally obtained upon their receipt. Contributions are recognised at
their fair value.
(d)
Acquisition of Assets
The cost method of accounting is used for all acquisitions of assets. Cost is measured as the fair value of the assets
given up or liabilities undertaken at the date of acquisition plus incidental costs directly attributable to the acquisition.
Assets acquired at no cost or for nominal consideration, are initially recognised at their fair value at the date of
acquisition.
(e)
Depreciation of non-current assets
All non-current assets having a limited useful life are systematically depreciated over their useful lives in a manner that
reflects the consumption of their future economic benefits.
Depreciation is calculated on the reducing balance basis, using rates which are reviewed periodically. Useful lives for
each class of depreciable assets are:
Buildings
Plant and equipment
Computer equipment
Furniture and fittings
Motor vehicles
3%
5-20%
30%
5-20%
37.5%
Works of art are classified as heritage assets. They are anticipated to have very long and indeterminate useful lives.
Their service potential has not, in any material sense, been consumed during the reporting period. As such, no amount
for depreciation has been recognised in respect of them.
Annual Report 2001/2002 Metropolitan Health Services
187
Notes to the Financial Statements
For the year ended 30 June 2002
(f)
Valuation of land, buildings and infrastructure
Valuation of land and buildings is at cost.
(g)
Leases
The Health Service's rights and obligations under finance leases, which are leases that effectively transfer to the Health
Service substantially all of the risks and benefits incident to ownership of the leased item, are initially recognised as
assets and liabilities equal in amount to the present value of the minimum lease payments. The assets are disclosed as
plant, equipment and vehicles under lease and are depreciated to the Statement of Financial Performance over the
period which the Health Service is expected to benefit from use of the leased assets. Minimum lease payments are
allocated between interest expense and reduction of the lease liability, according to the interest rate implicit in the lease.
Finance lease liabilities are allocated between current and non-current components. The principal component of these
lease payments due on or before the end of the succeeding year is disclosed as a current liability, and the remainder of
the lease liability is disclosed as a non-current liability.
The Health Service has entered into a number of operating lease arrangements for buildings, office equipment and
medical equipment where the lessors effectively retain all of the risks and benefits incident to ownership of the items
held under the operating lease. Equal instalments of the lease payments are charged to the Statement of Financial
Performance over the lease term as this is representative of the pattern of benefits to be derived from the leased
property.
(h)
Cash
For the purpose of the Statement of Cash Flows, cash includes cash assets and restricted cash assets. These include
short-term deposits that are readily convertible to cash on hand and are subject to insignificant risk of changes in value.
(i)
Inventories
Inventories are valued on a weighted average cost basis or at the lower of cost and net realisable value.
(j)
Receivables
Receivables are recognised at the amounts receivable as they are due for settlement no more than 30 days from the
date of recognition.
Collectability of receivables is reviewed on an ongoing basis. Debts which are known to be uncollectable are written off.
A provision for doubtful debts is raised where some doubts as to collection exists.
(k)
Revenue Recognition
Revenue from the sale of goods and disposal of other assets and the rendering of services, is recognised when the
Health Service has passed control of the goods or other assets or delivery of the service to the customer
(l)
Investments
Investments are brought to account at the lower of cost and recoverable amount and are disclosed in the statement of
financial position.
Interest revenues are recognised as they are accrued.
(m)
Payables
Payables, including accruals not yet billed, are recognised when the Health Service becomes obliged to make future
payments as a result of a purchase of assets or services. Payables are generally settled within 30 days.
(n)
Interest -bearing liabilities
Bank loans and other loans are recorded at an amount equal to the net proceeds received. Borrowing costs expense is
recognised on an accrual basis.
Annual Report 2001/2002 Metropolitan Health Services
188
Notes to the Financial Statements
For the year ended 30 June 2002
(o)
Employee entitlements
Annual leave
The liability for annual leave represents the amount which the Health Service has a present obligation to pay resulting
from employees' services up to the reporting date. The liability has been calculated on current remuneration rates and
includes related on-costs.
Long service leave
The liability for long service leave is recognised and measured as the present value of expected future payments to be
made in respect of services provided by employees up to the reporting date. Consideration is given, when assessing
expected future payments, to expected future wage and salary levels including related on-costs, experience of
employee departures and periods of service. Expected future payments are discounted using interest rates on national
government securities to obtain the estimated future cash out-flows.
The methods of measurement of the liabilities are consistent with the requirements of Australian Accounting Standard
AAS 30 "Accounting for Employee Entitlements".
Superannuation
Staff may contribute to the Pension Scheme, a defined benefits pension scheme now closed to new members, or to the
Gold State Superannuation Scheme, a defined benefit lump sum scheme now also closed to new members. All staff
who do not contribute to either of these schemes become non-contributory members of the West State Superannuation
Scheme, an accumulation fund complying with the Commonwealth Government's Superannuation Guarantee
(Administration) Act 1992. All of these schemes are administered by the Government Employees Superannuation
Board (GESB).
The Pension Scheme and the pre-transfer benefit for employees who transferred to the Gold State Superannuation
Scheme are unfunded and the liability for future payments under the Pension Scheme are provided for at reporting date.
The liabilities for superannuation charges under the Gold State Superannuation Scheme and West State
Superannuation Scheme are extinguished by payment of employer contributions to GESB.
From July 2001 employer contributions were paid to the GESB in respect of the Gold State Superannuation Scheme
and West State Superannuatiuon Scheme. Prior to 1 July 2001, the liability was assumed by the Treasurer. An amount
equivalent to the employer contributions which would have been paid to the Gold State Employees Superannuation
Scheme and the West State Superannuation Scheme if the health service had made concurrent contributions to those
schemes, was included in superannuation expense. This amount was also included in the revenue item 'Liabilities
assumed by the Treasurer'.
The note disclosure required by paragraph 51(e) of AAS30 (being the employer's share of the difference between
employees' accrued superannuation benefits and the attributable net market value of plan assets) has not been
provided. State scheme deficiencies are recognised by the State in its whole of government reporting. The GESB's
records are not structured to provide the information for the Health Service. Accordingly, deriving the information for
the Health Service is impractical under current arrangements, and thus any benefits thereof would be exceeded by the
cost of obtaining the information.
Deferred Salary Scheme
With the written agreement of the Health Service, an employee may elect to receive, over a four-year period, 80% of the
salary they would otherwise be entitled to receive. On completion of the fourth year, an employee will be entitled to 12
months leave and will receive an amount equal to 80% of the salary they were otherwise entitled to in the fourth year of
deferment. An employee may withdraw from this scheme prior to completing a four-year period by written notice. The
employee will receive a lump sum payment of salary forgone to that time.
The liability for deferred salary scheme represents the amount which the Health Service is obliged to pay to the
employees participating in the deferred salary scheme. The liability has been calculated on current remuneration rates in
respect of services provided by the employees up to the reporting date and includes related on-costs.
(p)
Accrued Salaries
Accrued salaries represent the amount due to staff but unpaid at the end of the financial year, as the end of the last pay
period for that financial year does not coincide with the end of the financial year. The Health Service considers the
carrying amount approximates net fair value.
(q)
Resources Received free of Charge or for Nominal Value
Resources received free of charge or for nominal value which can be reliably measured are recognised as revenues and
as assets or expenses as appropriate at fair value.
Annual Report 2001/2002 Metropolitan Health Services
189
Notes to the Financial Statements
For the year ended 30 June 2002
(r)
Comparative Figures
Comparative figures are, where appropriate, reclassified so as to be comparable with the figures presented in the
current reporting period.
(s)
Rounding
Amounts in the financial statements have been rounded to the nearest thousand dollars.
(t)
Special Purpose Accounts and Trust Accounts
Special Purpose Accounts are used by Hospitals and Health Services to account for contributions to which a condition
of use has been attached eg donations, gifts or grants for particular purposes. The Health Service has control of the use
of these funds, and can deploy them to meet its objectives, although the hospital has an obligation to only use these
funds for the particular purpose for which they were contributed. The use of Special Purpose Accounts enables the
contributions to be segregated from the operating funds of the hospital and to ensure they are used in a manner that is
consistent with the imposed conditions.
Trust Accounts are used by Hospitals and Health Services to account for funds that they may be holding on behalf of
another party eg patients’ cash. The Hospital or Health Service does not have control of the use of these funds, and
cannot deploy them to meet its objectives. The use of Trust Accounts enables the funds to be segregated from the
operating funds of the hospital.
The funds held in Trust Accounts must be dealt with in a manner consistent with the conditions set out in the Trust Deed
or other documentation used to set up the account.
Trust Accounts do not form part of the resources available to the Hospital or Health Service, and are not reported as
assets in the Financial Statements. However, details of Trust Accounts are reported as a note in the Annual Report.
Balances in Trust Accounts are carried forward at the end of the year.
(u)
Disclosure of Goods and Services Tax
Goods and services tax is included in the Statement of Cash Flows on a net basis.
Note 2
Employee expenses
Wages and salaries
Long service leave
Annual leave
Other related expenses
Total Employee expenses
Employee expenses include superannuation oncosts associated with the recognition of
annual and long-service leave liability. The related on-costs liability is included in
employee entitlement liabilities at Note 25.
Note 3
2001
$'000
810,231
24,883
85,580
13,405
934,099
718,005
16,144
67,556
20,223
821,928
179,180
160,687
16,000
11,451
5,285
11,594
759
11,020
18,086
6,973
260,348
14,752
11,306
5,092
11,625
1,740
9,225
17,703
6,915
239,045
41,465
2,176
11,489
5,367
1,429
532
62,458
24,507
1,160
10,789
4,569
1,308
287
42,620
Patient support costs
Medical supplies and services
Purchased external services
Medical and Surgical
Catering
Cleaning
Laundry and Linen
Other
Domestic charges
Fuel, light and power
Food supplies
Total
Note 4
2002
$'000
Depreciation expense
Buildings
Plant and equipment
Medical equipment
Computing equipment / software
Office equipment, furniture and fittings
Motor vehicles
Total
Annual Report 2001/2002 Metropolitan Health Services
190
Notes to the Financial Statements
For the year ended 30 June 2002
Note 5
(a)
(b)
Net loss on disposal of non-current assets
Loss on disposal of non-current assets:
Land
Buildings
Plant and equipment
Medical equipment
Computing equipment / software
Office equipment, furniture and fittings
Motor vehicles
Artworks
Profit on disposal of non-current assets:
Plant and equipment
Medical equipment
Computing equipment / software
Office equipment, furniture and fittings
Motor vehicles
Net loss / (profit) on disposal of non-current assets
(c)
Proceeds from sale of non-current assets
Proceeds were received for the sale of non-current assets during the reporting period as
follows:
Received as cash by the Health Service
Gross proceeds from sale of non-current assets
Note 6
47
19
370
2,906
261
294
146
4,043
99
234
1,588
792
216
208
75
3,212
5
24
8
5
139
181
4
4
9
97
114
3,862
3,097
711
711
1,086
1,086
42,456
-
6,250
25,287
16,570
7,006
45,791
10,228
7,540
29,158
5,150
8,530
8,293
147
314
378
1,538
1,101
173,280
5,888
24,045
15,744
5,494
18,833
7,460
6,839
49,782
8,187
8,131
7,460
157
275
425
329
1,486
160,534
33,396
6,928
40,324
35,794
7,276
43,070
Other expenses from ordinary activities
Administrative expenses
Repairs and maintenance
Workers compensation insurance
Consumable equipment expenditure
Purchased external services
Insurance
Printing and stationery
Other support costs
Additions and alterations (non-capital)
Communications
Lease expense
Bank charges
Audit fees - external
Audit fees - internal
Bad and doubtful debts
Inventory write offs
Total
Note 8
2001
$'000
Capital user charge
Capital user charge
A capital user charge rate of 8% has been set by the Government for 2001/02 and
represents the opportunity cost of capital invested in the net assets of the Health Service
used in the provision of outputs. The charge is calculated on the net assets adjusted to
take account of exempt assets. Payments are made to the Department of Treasury and
Finance on a quarterly basis by the Department of Health on behalf of the Health
Service.
Note 7
2002
$'000
Patient charges
Inpatients Charges
Outpatient Charges
Total
Annual Report 2001/2002 Metropolitan Health Services
191
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
106
779
1,412
211
2,508
79
2,372
2,451
4,070
8,205
8,157
12,412
32,844
4,364
3,725
7,416
14,825
30,330
339
6,013
1,548
4
7,904
423
2,848
1,439
2
4,712
1,233
1,227
1,056
1,056
1,074
1,074
177
153
Less Administration costs
94
88
Trading profit
83
65
1,478,684
1,478,684
1,213,934
38,373
1,252,307
1,167
56,944
Note 9
Commonwealth grants and contributions
Grant for assisting in training of medical students
Grant for Radiation Oncology
Grant for MRI
Other grants
Total
Note 10 Other revenues from ordinary activities
Revenue from operating activities
Public Contributions / Donations
Recoveries
Use of medical facilities
Other
Total
Revenue from non-operating activities
Rent from Properties
Income from sundry activities
Parking
Other
Total
Note 11 Trading profit
Sales revenue
Cost of sales:
Opening inventory
Purchases
Ending inventory
Cost of goods sold
Gross profit
Note 12 Government appropriations
Appropriation revenue received during the year:
Output appropriations (I)
Capital appropriations (II)
Total appropriation revenue (Statement of Financial Performance):
(I)
Output appropriations are accrual amounts as from 1 July 2001, reflecting the full
price paid for outputs purchased by the Government. The appropriation revenue
comprises a cash component and a receivable (asset). The receivable (holding
account) comprises the estimated depreciation expense for the year and any
agreed increase in leave liability during the year.
(II) Capital appropriations were revenue in 2000/01 (year ended 30 June 2001). From
1 July 2001, capital appropriations, termed Capital Contributions, have been
designated as contributions by owners and are credited directly to equity in the
Statement of Financial Position.
Note 13 Liabilities assumed by the Treasurer - superannuation
As from July 2001 Treasury provided funding so that the health service paid periodical
superannuation costs directly to the Government Employees Superannuation Board. In
previous years Treasury held the liability and the health service recognised this as an
expense and a notional income. Treasury still assumes superannuation liabilities
associated with employee transfer costs from the Old Pension Scheme.
Annual Report 2001/2002 Metropolitan Health Services
192
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
314
566
880
275
60
335
Cash on hand
Cash at bank
Term deposits
Bank bills
Total
83
27,482
18,029
1,891
47,485
57
6,736
10,434
1,194
18,421
Comprising:
Operating cash assets
Special purpose cash assets - Not restricted
Total
30,559
16,926
47,485
6,605
11,816
18,421
35,637
2,058
37,695
26,613
2,486
29,099
4,419
4,419
11,465
11,465
14,171
4,574
9,823
7,826
36,394
3,013
33,381
11,660
4,019
8,079
6,810
30,568
2,384
28,184
46,620
46,620
-
Note 14 Resources received free of charge
Resources received free of charge has been determined on the basis of the following
estimates provided by agencies:
Office of the Auditor General - audit services
Other
Total
Note 15 Cash assets (unrestricted)
Note 16 Restricted cash assets
Restricted assets are assets, the uses of which are restricted, wholly or partially, by
regulations or other externally imposed requirements.
Restricted cash assets are comprised of bills, term deposits and cash at bank with
financial institutions
Term deposits and bank bills
Cash at bank
Total
Note 17 Other financial assets
Other financial assets are comprised of term deposits greater than 90 days.
Term deposits and bank bills
Total
Note 18 Receivables
Debtors
GST receivable
Patient fee debtors
Accrued Income
Less: Provision for doubtful debts
Total
Credit risk
The Health Service does not have any significant exposure to any individual customer or
counterparty.
Net fair values
The Health Service considers the carrying amounts of receivables approximate their net
fair value.
Note 19 Amounts receivable for outputs
Current
Non-current
This asset represents the non-cash component of output appropriations. It is restricted in
that it can only be used for asset replacement or payment of leave liability.
Annual Report 2001/2002 Metropolitan Health Services
193
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
3,325
7,750
778
58
11,911
3,415
7,041
768
11,224
2,352
103
2,455
2,888
145
3,033
Land - at cost
134,260
134,308
Buildings - at cost
Less: accumulated depreciation
Net carrying amount
839,398
142,109
697,289
791,250
100,654
690,596
Plant and equipment - at cost
Less: accumulated depreciation
Net carrying amount
25,223
9,505
15,718
22,610
7,666
14,944
Medical equipment - at cost
Less: accumulated depreciation
Net carrying amount
128,030
49,721
78,309
116,708
41,056
75,652
Office equipment / furniture and fittings - at cost
Less: accumulated depreciation
Net carrying amount
20,361
5,722
14,639
17,913
4,598
13,315
Computing equipment / software - at cost
Less: accumulated depreciation
Net carrying amount
41,136
21,519
19,617
32,245
16,723
15,522
3,053
1,002
2,051
2,776
760
2,016
234
78
156
503
172
331
Work in progress
6,956
44,839
Artworks - at cost
1,843
1,855
1,200,494
229,656
970,838
1,165,007
171,632
993,375
18,261
22,072
40,333
2,127
42,460
24,250
35,271
59,521
3,290
62,811
Note 20 Inventories
Inventories valued at cost
Supply stores
Pharmaceutical stores
Engineering stores
Goods held for resale
Total
Note 21 Other assets
Prepayments
Other
Total
Note 22 Property, plant and equipment
Motor vehicles - at cost
Less: accumulated depreciation
Net carrying amount
Leased plant and equipment - at capitalised cost
Less: accumulated depreciation
Net carrying amount
Total property, plant and equipment
Less: accumulated depreciation
Total property, plant and equipment
Payments made for non-current assets
During the reporting period the Health Service paid consideration on purchase of noncurrent assets as follows:
Paid as cash
- from Operating funds
- from Capital Works funding
Paid directly by the Department of Health
Gross payments for non-current assets
Annual Report 2001/2002 Metropolitan Health Services
194
Notes to the Financial Statements
For the year ended 30 June 2002
Note 22 Property, plant and equipment - continued
2002
$'000
2001
$'000
Reconciliations
Reconciliations of the carrying amounts of property, plant and equipment at the
beginning and end of the current reporting period are set out below.
(i) Land
Beginning cost
Additions
Disposals
Ending cost
134,308
(48)
134,260
134,092
290
(74)
134,308
(ii) Buildings
Beginning carrying amount
Additions
Disposals
Capitalisation from WIP
Depreciation expense
Ending carrying amount
690,596
2,970
(69)
45,256
(41,464)
697,289
707,147
2,847
(223)
5,332
(24,507)
690,596
(iii) Plant and equipment
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
14,944
3,406
(454)
(2,178)
15,718
13,993
2,445
(372)
(1,122)
14,944
(iv) Medical equipment
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
75,652
17,751
(3,614)
(11,480)
78,309
72,817
15,398
(1,788)
(10,774)
75,652
(v) Office equipment / furniture and fittings
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
13,315
3,269
(518)
(1,427)
14,639
12,535
2,394
(306)
(1,308)
13,315
(vi) Computing equipment / software
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
15,522
10,069
(623)
(5,351)
19,617
12,967
7,846
(722)
(4,569)
15,522
2,016
1,347
(781)
(531)
2,051
2,311
994
(1,002)
(287)
2,016
331
(149)
(26)
156
396
9
(21)
(53)
331
44,839
7,373
(45,256)
6,956
16,723
33,448
(5,332)
44,839
(vii) Motor vehicles
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
(viii) Leased plant and equipment
Beginning carrying amount
Additions
Disposals
Depreciation expense
Ending carrying amount
(ix) Work in progress
Beginning carrying amount
Additions
Capitalisation
Ending carrying amount
Annual Report 2001/2002 Metropolitan Health Services
195
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
(x) Artworks
Beginning carrying amount
Additions
Disposals
Ending carrying amount
1,855
20
(32)
1,843
1,832
95
(72)
1,855
(xi) Total
Beginning carrying amount
Additions
Disposals
Capitalisation
Depreciation expense
Ending carrying amount
993,375
46,208
(6,288)
(62,457)
970,838
974,812
65,764
(4,581)
0
(42,620)
993,375
21,065
2,834
14,073
37,972
24,207
3,166
19,011
46,384
43
6,645
6,688
73
6,724
6,797
76
180,528
180,604
118
187,411
187,529
49
81
130
11
119
89
129
218
27
191
147
147
505
505
125,787
4,226
121,561
129,417
3,630
125,787
4,322
117,239
121,561
4,239
121,548
125,787
Note 22 Property, plant and equipment - Reconciliations continued
No revaluations have been taken up in the reporting period.
Note 23 Payables
Trade creditors
GST payable
Accrued expenses
Total
The Health Service considers the carrying amounts of payables approximate their net
fair values.
Note 24 Interest-bearing liabilities
Current
Finance leases - liabilities secured (i)
Borrowings
Total
Non-current
Finance leases - liabilities secured (i)
Borrowings
Total
(i) Lease liabilities are effectively secured as the rights to the leased assets revert to
the lessor in the event of default.
(A) Total finance leases - Non-cancellable (secured)
Due within one year
Due later than one year and not later than five years
Due later than five years
Minimum lease payment
Deduct: future finance charges
Total
The Health Service considers the carrying amounts of finance leases approximate their
net fair values.
Assets pledged as security
The carrying amounts of non-current assets pledged as security comprised of:
Leased plant and equipment
Total
(B) Borrowings
(i) Western Australian Treasury Corporation (WATC).
Beginning balance
Less loan repayments this year
Ending balance
Current
Non-current
Total
Significant terms and conditions:
The debt is held in a portfolio of various long and short-term loans with a range of maturity dates out to ten years
30% of the debt is held in six equal short-term loans with maturity dates out to six months.
70% of the debt is held in forty long-term loans with quarterly maturity dates out to ten years.
Annual Report 2001/2002 Metropolitan Health Services
196
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
67,831
2,219
65,612
68,782
951
67,831
2,323
63,289
65,612
2,217
65,614
67,831
517
517
-
757
240
517
-
268
249
517
Beginning balance
Less repayments this year
Ending balance
194,135
6,962
187,173
198,956
4,821
194,135
Current
Non-current
Total
6,645
180,528
187,173
6,724
187,411
194,135
Note 24 Interest-bearing liabilities - continued
Significant terms and conditions: - continued
Interest rates are fixed on each loan.
As each debt matures it can be refinanced for a new period of time.
Capital repayments are made on the outstanding debt in accordance with a WATC
specified formula.
The terms and conditions are standard with all Department of Health WATC loans.
(ii) Department of Treasury and Finance Loans
Beginning balance
Less loan repayments this year
Ending balance
Current
Non-current
Total
This debt relates to funds advanced to the Health Service via the now defunct General
Loan and Capital Works Fund. Funds advanced are repaid to the Consolidated Fund by
way of a monthly Sinking Fund contribution and interest charges. The Sinking Fund is
charged at a rate of 0.5% against the Capital advanced (gross debt) and 4.5% against
the accumulated Sinking Fund. Sinking Fund charges are not subject to variation, and
interest rates are linked to the State's debt servicing costs.
The following rates are provided for information purposes:
2001 / 2002
2002 / 2003
8.55%
8.23%
Actual effective interest rate
Estimated
Inflation rates have no impact on this debt.
(iii) Other Loans
Beginning balance
Less loan repayments this year
Ending balance
Current
Non-current
Total
This unsecured loan incurs no interest and is repayable over 5 years.
Total Loans
Annual Report 2001/2002 Metropolitan Health Services
197
Notes to the Financial Statements
For the year ended 30 June 2002
2002
$'000
2001
$'000
Current liabilities
Annual leave (i)
Long service leave (i)
Deferred salary scheme
Superannuation (ii)
Total
102,867
51,135
1,897
11,709
167,608
89,387
43,988
12,862
146,237
Non-current liabilities
Long service leave
Deferred salary scheme
Superannuation
Total
37,755
1,427
147,002
186,184
33,504
1,018
148,018
182,540
167,608
186,184
353,792
146,237
182,540
328,777
33,739
2,048
161
3,159
39,107
27
18,372
4,510
193
90
23,192
582,976
54,817
637,793
582,976
582,976
(80,854)
(20,299)
(101,153)
(98,774)
17,920
(80,854)
Note 25 Provisions
Employee entitlements
The aggregate employee entitlement liability recognised and included in the financial
statements is as follows:
Provision for employee entitlements:
Current
Non-current
(i)
The settlement of annual and long service leave liabilities gives rise to the payment
of employment superannuation oncosts. The liability for such oncosts is included
here.
(ii) The superannuation provision is mainly comprised of monies Owing Under the Old
Pension Scheme and has been established under an actuarial assessment
conducted by the Government Employee's Superannuation Board dated 31 March
2002.
The Health Service considers the carrying amount of employee entitlements
approximates the net fair value.
The following weighted factors were used to estimate the net present value of noncurrent long service leave.
Staff retention factor
63.88%
Total oncosts
9.74%
Wages inflation rate
3.25%
Discount factor
6.10%
Note 26 Other liabilities
Current
Income received in advance
Accrued salaries
Fringe Benefits Tax
Refundable deposits
Other
Total
Note 27 Equity
A. Contributed equity
Opening balance
Capital contributions (i)
Closing balance
From 1st July 2001, capital appropriations, termed Capital Contributions, have been
designated as contributions by owners and are credited directly to equity in the
Statement of Financial Position.
B. Accumulated surplus (deficiency)
Opening balance
Change in net assets
Closing balance
Annual Report 2001/2002 Metropolitan Health Services
198
Notes to the Financial Statements
For the year ended 30 June 2002
Note 28 Notional cash flows
2002
$'000
2001
$'000
3,949
2,061
4,920
29
42,456
53,415
5,432
2,114
6,458
951
240
2,443
17,637
1,478,684
44,289
2,332
53,415
1,378,648
1,213,934
910
17,637
1,197,207
54,817
7,954
38,373
3,102
46,863
35,271
47,485
37,607
88
85,180
18,421
28,652
447
47,520
85,180
47,520
The following items were paid directly by the Department of Health on behalf of the
Health Service and are not included in the Statement of Cash Flows.
Interest paid to WA Treasury Corporation
Repayment of borrowings to WA Treasury Corporation
Interest paid to Department of Treasury and Finance
Repayment of borrowings to Department of Treasury and Finance
Settled
Other
Capital user charge
Total notional cash flow
Cash flows from Government have been consequently reduced as follows:
Output appropriations as per Statement of Financial Performance
Subsidy in Advance
Less accrual appropriations - Depreciation
Less Accrual appropriations - Employee Entitlements
Less total notional cash flow (above).
Adjusted cash Output appropriations as per Statement of Cash Flows
Capital contributions (2001 Capital appropriation)
Less capital items purchased by the Department of Health
Adjusted cash Capital contributions (2001 Capital appropriation) as
per Statement of Cash Flows
Note 29 Notes to the statement of cash flows
(a) Reconciliation of cash assets at the end of the financial year as shown on the
Statement of Financial Position.
Cash at the end of the financial year is shown in the Statement of Financial Position
as follows:
Cash assets - refer to note 15
Restricted assets - refer to note 16
Investments - refer to note 16
Total cash assets as per Statement of Financial Position
Cash assets at the end of the reporting period as per the Statement of
Cash Flows
(b) Reconciliation of net cost of services to net cash flows provided by / (used in)
operating activities
Net cost of services
Non-cash items:
Capital User Charge paid by Department of Health
Loss on disposal of fixed assets
Profit on disposal of fixed assets
Depreciation
Donations of non-current assets
Resources received free of charge
Interest on loans paid by the Department of Health
Other expenses paid by the Department of Health
Liabilities assumed by Treasurer
Adjustments to non-current assets
(Increase) / decrease in assets:
Prepayments
Inventories
Other assets
Receivables
Increase / (Decrease) in liabilities:
Provision for doubtful debts
Payables
Provisions
Other liabilities
Other items:
Net GST receipts / (payments)
Net cash provided by (used in) operating activities
(1,501,030)
(1,291,666)
42,456
4,043
(180)
62,458
(2,379)
811
8,869
2,392
1,166
969
3,097
1
42,620
(2,038)
335
11,890
56,944
536
536
(687)
42
(1,247)
(1,625)
(1,025)
577
(2,834)
628
(8,412)
25,015
15,915
(52)
(1,970)
15,824
(5,588)
(4,579)
(1,353,214)
(1,174,975)
Annual Report 2001/2002 Metropolitan Health Services
199
Notes to the Financial Statements
For the year ended 30 June 2002
Note 30 Revenue and other public property written off or presented as gifts
i) Revenue written off
ii) Public and other property written off.
The amounts above were written off under the authority of the accountable authority.
iii) Gifts of public property. [TI 952(8)].
Total
2002
$'000
2001
$'000
1,027
447
829
980
0
1,474
0
1,809
133
93
40
152
52
100
216
172
65
48
501
229
114
0
99
442
28,021
8,823
36,844
19,071
19,071
Note 31 Losses of public monies and other property
Losses of public monies and other property through theft or default
Less recovery of losses
Net losses
Note 32 Resources provided free of charge
During the year the following resources were provided free of charge to other agencies
for functions outside the normal operations of the agency.
Ministry of Justice - dental treatment to inmates
Disabilty Services Comm - dental treatment to DSC clients
Graylands Health Serv - dental treatment to GHS clients
Dept of Education - transfer buildings closed DTC's
Total
Note 33 Commitments for expenditure
(a) Capital expenditure commitments
Capital expenditure commitments, being contracted capital expenditure additional to the
amounts reported in the financial statements are payable as follows:
Within 1 year
Later than 1 year and not later than 5 years
later then 5 years
Total
This is made up of commitments for construction work at:
Bentley Hospital building, 'A' Block level 1 upgrade.
Fremantle Hospital principally relating to the acquisition of biomedical equipment.
Major works at PMH and KEMH
Dental Services :
North Metro Dental Clinic (Morley) - underway;
Newman Dental Clinic - underway; PDH Devolution - underway;
Joondalup Dental Clinic - new works; South Metro Dental Clinic - new works.
RPH - redevelopment of Incentre Dialysis Unit
SCGH - Emergency dept. upgrade; PET installation and equipment purchase.
Swan Health service - completion of the Chidlow Child Health and GP Clinic and
purchase of medical equipment.
Total
(b) Operating lease commitments
Due not later than one year
Due later than one year and not later than five years
Due later than five years
Total
(c) Other expenditure commitments
Committed Medical Equipment and deferred maintenance at Swan and Aged Care
dental equipment and overseas orders for dental chairs at Dental Services
Within 1 year
Later than 1 year and not later than 5 years
later then 5 years
Total
549
4,555
3,880
5,628
1,100
20,868
264
36,844
6,794
13,210
5,825
25,829
7,349
14,295
6,443
28,087
311
311
-
(d) Guarantees and undertakings
There are no guarantees and undertakings that have been provided other than those
that are recognised as liabilities in the Statement of Financial Position.
Annual Report 2001/2002 Metropolitan Health Services
200
Notes to the Financial Statements
For the year ended 30 June 2002
Note 34 Contingent liabilities
2002
$'000
2001
$'000
23,769
28,549
2002
2001
In addition to the liabilities incorporated in the financial statements, the Health service
has the following contingent liabilities:
(a) Litigation in progress
Pending potential litigation that may affect the financial position
2002
Number of claims
164
2001
148
Note 35 Events occurring after reporting date
There were no events that occurred after reporting date that have a material effect on
these financial statements.
Note 36 Remuneration of Accountable Authority and Senior Officers
Remuneration of Members of the Accountable Authority
The Metropolitan Health Service Board was dissolved in 2000-2001 year. The 2001 year information below refers to that
board. The accountable authority for the health service from 1 July 2001 is the Director General for Health. The
remuneration for the Director General for Health is paid by the Department of Health.
The number of members of the Accountable Authority whose total of fees, salaries, superannuation and other benefits
received or due and receivable for the reporting period, falls within the following bands:
$0
$1 - $10,000
$10,001 - $20,000
$20,001 - $60,000
$60,001 - $70,000
$70,001 - $150,000
$150,001 - $160,000
$160,001 - $170,000
$170,001 - $180,000
$180,001 - $640,000
$640,001 - $650,000
-
2
5
1
1
1
1
Remuneration of Senior Officers
Senior Officers are defined as those employees who are chief executives, general managers and executive directors.
The number of Senior Officers (other than Senior Officers reported as members of the Metropolitan Health Service
Board, now dissolved), whose total of fees, salaries, superannuation and other benefits received or due and receivable
for the reporting period, falls within the following bands:
$0 - $10,000
$10,001 - $20,000
$20,001 - $60,000
$60,001 - $70,000
$70,001 - $80,000
$80,001 - $90,000
$90,001 - $100,000
$100,001 - $110,000
$110,001 - $120,000
$120,001 - $130,000
$130,001 - $140,000
$140,001 - $150,000
$150,001 - $160,000
$160,001 - $170,000
$170,001 - $180,000
$180,001 - $190,000
$190,001 - $220,000
$220,001 - $230,000
$230,001 - $240,000
$240,001 - $250,000
$250,001 - $260,000
$260,001 - $270,000
$270,001 - $280,000
$280,001 - $290,001
1
1
1
4
1
2
1
11
Annual Report 2001/2002 Metropolitan Health Services
1
2
1
1
3
1
3
1
1
1
2
1
1
1
20
201
Notes to the Financial Statements
For the year ended 30 June 2002
Note 37 Related Bodies
A related body is a body which is financially dependent (receives more than half its funding) on the Health Service, is
subject to operational control by the Health Service and was formed independently of the Health Service.
The Health Service does not provide financial assistance to any related body or class of related bodies for which it does
not receive remuneration at the cost of providing those services.
Note 38 Affiliated bodies
An affiliated body is a body which is financially dependent (received more than half its funding) on the Health Service,
but is not subject to operational control by the Health Service.
The Health Service does not provide financial assistance to any affiliated body or class of affiliated bodies for which it
does not receive remuneration at the cost of providing those services.
2002
2001
Note 39 Remuneration of Auditor
$'000
$'000
The total of notional fees charged or due and payable to the Auditor General for the
reporting period is:
Fees for External Audit
314
275
Note 40 Financial Instruments
(a) Interest rate risk exposure
The following table details the Health Service's exposure to interest rate risk as at the reporting date:
Weighted
Fixed Interest Rate Maturities
Average
Floating
NonEffective
Interest
1 Year
1 to 5
Over 5
Interest
Interest Rate
Rate
or less
Years
Years
Bearing
30 June 2002
%
$000
$000
$000
$000
$000
Financial assets
Cash assets
Restricted cash assets
Other financial assets
Receivables
Total
4.77%
4.77%
4.70%
Financial liabilities
Payables
Accrued salaries
Borrowings from WATC
Borrowings from Treasury
Finance lease liabilities
Total
5.61%
8.55%
6.70%
22,197
1,026
23,223
21,304
36,134
4,419
9,165
71,022
0
0
3,984
535
24,218
28,737
47,485
37,695
4,419
33,383
122,982
-
8,024
3,400
4,325
2,324
43
18,116
15,484
4,845
76
20,405
101,753
58,443
160,195
29,948
30,339
60,287
37,972
33,739
121,561
65,612
119
259,003
Net Financial assets (liabilities)
As at 30 June 2001
Financial assets
Financial liabilities
Net Financial assets (liabilities)
Total
$000
(136,021)
4,332
4,332
49,896
6,914
42,982
27,421
(27,421)
159,991
(159,991)
31,950
64,754
(32,804)
86,178
259,080
(172,902)
(b) Credit Risk Exposure
All financial assets are unsecured
Amounts owing by other government agencies are guaranteed and therefore no credit risk exists in respect of these
amounts.
In respect of financial assets carrying amounts represent the Health Service's maximum exposure to credit risk in
relation to those assets.
(c) Net fair values
The carrying amount of financial assets and financial liabilities recorded in the financial statements are not materially
different from their net fair values, determined in accordance with the accounting policies disclosed in note 1 to the
financial statements.
Annual Report 2001/2002 Metropolitan Health Services
202
Notes to the Financial Statements
For the year ended 30 June 2002
Note 41 Assets held in a trustee capacity or administered by the Health Service
2002
$'000
2001
$'000
297
247
1,366
1,663
1,382
1,629
1,223
440
1,332
297
547
550
4,995
30
14
5,586
5,438
15
27
6,030
903
4,226
69
388
810
4,562
111
547
Assets Held in a Trustee Capacity
These assets are not controlled by the Health Service and are therefore not recognised
in the financial statements.
The Health Service administers trust accounts for the purposes of holding patients'
private monies and other external parties. A summary of the account transactions are as
follows:Beginning balance
Add receipts
- Patient deposits
- Interest
Less payments
- Patient withdrawals
Ending balance
The Health Service administers trust accounts, such as for salaried medical practitioners
under the rights to private practice scheme. A summary of the transactions in these
accounts is as follows:
Beginning balance
Further allocation to trust accounts for salaried medical practitioners under the rights to
private practice scheme
Add receipts
- Collections
- Fees
- Interest
Less payments
- Payments to medical practitioners
- Payments to hospital - fees/charges/trust funds
- Interest / charges
Ending balance
Annual Report 2001/2002 Metropolitan Health Services
203
Notes to the Financial Statements
For the year ended 30 June 2002
Note 42 Explanatory Statement
(A) Significant variations between actual financial items for the reporting period and those for the immediately
preceding reporting period.
Note
2002
$000
2001
$000
Variance
$000
Statement of Financial Performance - expenses
Employee expenses
Patient support costs
Borrowing costs expense
Depreciation expense
Capital user charge
Other expenses from ordinary activities
(a)
(b)
(c)
(d)
(e)
(f)
934,099
260,348
13,014
62,458
42,456
173,280
821,928
239,045
14,746
42,620
160,534
112,171
21,303
(1,732)
19,838
42,456
12,746
Statement of Financial Performance - revenue
Patient charges
Interest revenue
Other revenues from ordinary activities
Output appropriations
Capital appropriations
Liabilities assumed by the Treasurer
(g)
(h)
(i)
(j)
(k)
(l)
40,324
4,100
32,844
1,478,684
1,167
43,070
6,225
30,330
1,213,934
38,373
56,944
(2,746)
(2,125)
2,514
264,750
(38,373)
(55,777)
Statement of Financial Position - assets
Cash assets
Restricted and Other cash assets
Receivables
Amounts receivable for outputs - current
(m)
(n)
(o)
(p)
47,485
42,114
33,381
46,620
18,421
40,564
28,184
-
29,064
1,550
5,197
46,620
Statement of Financial Position - liabilities
Provisions
Other liabilities
(q)
(r)
353,792
39,107
328,777
23,192
25,015
15,915
(a) Employee expenses
The increase is primarily due to the increased cost of awards. The cost of awards increased by an average of 4.5%
across all categories causing wages costs to increase. The award increases also caused an increase in the
provisions for employee leave liabilities. Average staffing levels increased by 511 over the previous year.
(b) Patient support costs
The increase is primarily due to increased cost of drugs and increased use and cost of medical, surgical and
prosthetic supplies and nurses' uniforms. Additional costs were also associated with the VRE outbreak at Royal Perth
Hospital.
(c) Borrowing costs expense
The decrease is due to decreased interest rates and the gradual extinguishment of debt.
(d) Depreciation expense
The majority of the increase due to accelerated depreciation pending the demolition of Perth Dental Hospital ($14m)
and Anstey House ($5.2m) at Sir Charles Gairdner Hospital.
(e) Capital user charge
A cost, introduced for the first time this year, payable to the State Government based upon 8% of net assets. The
cost is intended to promote the best use of the organisation's resources. The Government funded the capital user
charge through increased appropriations.
(f) Other expenses from ordinary activities
Increased cost of insurance premiums, additional contract purchases of outside beds, and increased levels of
expenditure on non capitalised building works and equipment. There were also increased dental costs due to
payments to private dentists for the Country Patients Dental Subsidy Scheme, Metropolitan Dental Subsidy Scheme
and Orthodontic Subsidy Scheme.
(g) Patient charges
Patient charges have reduced due to the closure of Perth Dental Hospital, the shutdown of various wards at Royal
Perth Hospital during the VRE outbreak and fewer overseas patients due to the closure of Australia Clinic.
(h) Interest revenue
Interest receipts fell due to government appropriations being paid weekly instead of monthly. This reduced the
amount available to place on short and long-term deposits. Also, rates of interest for short and long term deposits
were lower than those of the previous year.
(i) Other revenues from ordinary activities
Increased revenue from external project work completed by InfoHealth Alliance and a rebate of insurance premiums.
Annual Report 2001/2002 Metropolitan Health Services
204
Notes to the Financial Statements
For the year ended 30 June 2002
Note 42
Explanatory Statement - continued
(j) Output appropriations
Appropriations increased for the year due to: i) monies were provided to pay superannuation costs whereas
previously these costs were paid directly by the Treasurer; ii) revenues were provided the first time to account for
depreciation costs and increases in employee leave liability provisions; iii) revenues were provided to account for a
capital user charge; iv) Increased funding for salaries and wages cost of award increases, and; (v) Annual CPI
increase for consumable items.
(k) Capital appropriations
Due to a change in accounting policy Capital appropriations are now classified as a contribution to owner's equity and
not an income. Contributed Equity increased during the year due to provision of capital monies.
(l) Liabilities assumed by the Treasurer
The Treasurer previously assumed the liability for Gold State and West State employee superannuation payments.
From 1 July 2001 the health service paid the employer contributions direct, having received additional appropriation
funding to do so from the Government. The residual amount in this account relates to costs associated with Transfer
benefits from the old Employee Pension Scheme.
(m) Cash assets
The increase represents tied cash funds to meet commitments primarily associated with: i) AMA and MWU arrears; ii)
delays in the delivery of capital equipment and capital work; iii) funds commitment for equipment, replacement
equipment and deferred maintenance; iv) specific purpose project funds; v) redundancies to be paid in July, and; vi)
unspent Capital funding associated with election promises received late in the year. The prior-year cash balance was
influenced by a policy to provide appropriations based upon immediate cash needs.
(n) Restricted and Other cash assets
Reflects a general increase in cash assets as per the reasons stated in (m) above.
(o) Receivables
The increase in receivables is in accordance with the increase in Other revenues, a large refund due for Fringe
Benefits Tax and substantial billing for project work at the end of the financial year.
(p) Amounts receivable for outputs - current
This is a new Government policy item representing the non-cash component of output appropriations that will be used
in future years for asset replacement or payment of leave liability.
(q) Provisions
The provision for employee entitlements increased mainly due to increases in the level of wages. Also the estimate of
employee retention for non-current long service leave liability increased for some hospitals.
(r) Other liabilities
Increase in accrued payroll expenses on account of additional days due at June 2002, substantial amounts accrued
for AMA, MWU and Nurses award increases not paid and an increase due to the significant amounts accrued for
redundancies not paid.
(B)
Significant variations between estimates and actual operating results are detailed below:
Actual
$000
Estimates
$000
Variance
$000
(a)
(b)
934,099
660,890
1,594,989
904,600
525,100
1,429,700
(29,499)
(135,790)
(165,289)
(c)
93,959
1,501,030
65,000
1,364,700
(28,959)
(136,330)
Note
Cost of Services
Employee expenses
Other goods and services
Total expenses from ordinary activities
Revenues from ordinary activities
Cost of services
(a) Employee expenses
Employee expenses were greater than those estimated mainly due to greater than expected increase in wages and
salaries award rates.
(b) Other goods and services
The estimate for Other goods and services excluded Capital user charge $42.5M as this amount relates to a new
Government policy item where the amount was not available for inclusion in these estimates. There was also a
greater than anticipated increase in patient support costs as detailed in Note 42(b) above.
(c) Revenues from ordinary activities
Revenues from ordinary activities increased mainly due to those detailed in Note 42(i) above.
Annual Report 2001/2002 Metropolitan Health Services
205
community health services
screening services
communicable disease management
health regulation and control
community information and education and
admitted care
ambulatory care
emergency services and
dental services
*
*
*
*
home care services
specialist geriatric services
inpatient and home palliative care services and
residential services
Services provided within this output include:
Annual Report 2001/2002 Metropolitan Health Services
Continuing care services are provided to improve the quality of life for those who need continuing care.
Continuing Care
*
*
*
*
Services provided within this output include:
The objective for the diagnosis and treatment services is to improve the health of Western Australians by restoring the health of people with acute illness. The services provided to diagnose
and treat patients include emergency services, ambulatory or outpatient services, services for those people who are admitted to hospitals and other supporting services such as patient
transport and the supplying of highly specialised drugs.
Diagnosis and Treatment
*
*
*
*
*
Services provided within this output include:
Prevention and Promotion
Prevention and Promotion services aim to improve the health of Western Australians by reducing the incidence of preventable disease, injury, disability, premature death.
Prevention and Promotion differs from the other two outputs in that it primarily focuses on the health and well being of populations, rather than on individuals. The value added by public,
Aboriginal and mental health programs consists of defining populations at-risk and ensuring appropriate interventions are delivered to a large proportion of these at-risk populations.
Output groups as defined in the 2001 / 2002 Budget Papers are as follows:
Note 43 Health Service output information
For the year ended 30 June 2002
Notes to the Financial Statements
206
48,191
0
59
33
48,283
(2,635)
Total Revenues from Government
Output appropriations
Capital appropriations
Liabilities assumed by the Treasurer - superannuation
Resources received free of charge
Total revenues from government
CHANGE IN NET ASSETS
3,139
35,786
3,817
1,742
15
41,360
38,221
72
75
1,127
62
139
2,043
50,918
509
5
59
407
0
24,025
1,612
2,092
6,008
212
1,357
69
0
3,973
39,348
30,076
1,070
2,758
6,400
260
4,085
166
1,338
6,808
52,961
1,209
14
63
556
0
2001
$000
2002
$000
Prevention and
Promotion
Net cost of services
Revenues from Ordinary Activities
Revenue from operating activities
Patient charges
Commonwealth grants and contributions
Grants and subsidies from non-government sources
Other revenues from ordinary activities
Trading profit
Revenue from non-operating activities
Interest revenue
Other revenues from ordinary activities
Total revenues from ordinary activities
COST OF SERVICES
Expenses from Ordinary Activities
Employee expenses
Fees for visiting medical practitioners
Superannuation expense
Patient support costs
Borrowing costs expense
Depreciation expense
Net loss on disposal of non-current assets
Capital user charge
Other expenses from ordinary activities
Total cost of services
Note 43 Health Service output information continued
For the year ended 30 June 2002
Notes to the Financial Statements
14,791
1,156,012
34,104
54,091
315
1,244,522
1,229,731
6,118
4,621
92,056
42,373
2,435
6,670
29,774
65
782,149
26,466
71,635
229,611
14,444
40,634
2,998
0
153,850
1,321,787
2001
$000
456
36,770
0
12
20
36,802
36,346
57
98
1,174
472
33
73
441
0
23,712
281
2,068
5,339
149
962
55
729
4,225
37,520
2002
$000
(10)
22,136
452
1,111
5
23,704
23,714
35
22
427
188
11
28
143
0
15,754
167
1,334
3,426
90
629
30
0
2,711
24,141
2001
$000
Continuing Care
(20,299)
1,478,684
0
1,167
880
1,480,731
1,501,030
4,100
7,904
93,959
40,324
2,508
6,196
32,844
83
934,099
28,177
77,295
260,348
13,014
62,458
3,862
42,456
173,280
1,594,989
2002
$000
Total
2001
$000
17,920
1,213,934
38,373
56,944
335
1,309,586
1,291,666
6,225
4,712
93,610
43,070
2,451
6,757
30,330
65
821,928
28,245
75,061
239,045
14,746
42,620
3,097
0
160,534
1,385,276
Annual Report 2001/2002 Metropolitan Health Services
(18,120)
1,393,723
0
1,096
827
1,395,646
1,413,766
3,981
7,667
90,742
38,643
2,461
6,060
31,847
83
880,311
26,826
72,469
248,609
12,605
57,411
3,641
40,389
162,247
1,504,508
2002
$000
Diagnosis and
Treatment
207
Notes to the Financial Statements
For the year ended 30 June 2002
Note 44 Statement of Financial Performance by Region
East Metropolitan
Region
2002
$000
COST OF SERVICES
Expenses from Ordinary Activities
Employee expenses
Fees for visiting medical practitioners
Superannuation expense
Patient support costs
Borrowing costs expense
Depreciation expense
Net loss on disposal of non-current assets
Capital user charge
Other expenses from ordinary activities
Total cost of services
Revenues from Ordinary Activities
Revenue from operating activities
Patient charges
Commonwealth grants and contributions
Grants and subsidies from non-government
sources
Other revenues from ordinary activities
Trading profit
Revenue from non-operating activities
Interest revenue
Other revenues from ordinary activities
Total revenues from ordinary activities
Net cost of services
North Metropolitan
Region
South Metropolitan
Region
2001
$000
2002
$000
2001
$000
2002
$000
314,472 274,307
12,638 13,619
25,849 25,133
110,169 103,114
2,364
3,239
12,331 12,369
1,412
666
13,625
0
43,435 40,225
536,295 472,672
255,297
5,203
21,019
73,816
4,567
17,710
921
10,851
37,315
426,699
228,738
4,783
20,133
69,833
5,129
12,106
1,142
0
33,867
375,731
182,062
9,899
14,704
45,913
3,316
9,301
353
10,419
26,274
302,241
2001
$000
Women and
Children's Health
2002
$000
Central Support
Services
Dental
2001
$000
2002
$000
2001
$000
2002
$000
156,268 145,838 126,509
9,390
437
422
14,023 11,666 10,595
39,037 27,598 23,608
3,502
2,402
2,583
10,321
6,501
6,123
704
631
427
0
5,995
0
21,274 19,888 19,754
254,519 220,956 190,021
29,609
0
3,672
2,770
365
15,312
547
1,385
10,945
64,605
28,645
0
5,123
3,194
294
1,396
157
0
9,021
47,830
6,821
0
385
82
0
1,303
(2)
181
35,423
44,193
2001
$000
Total All
2002
$000
2001
$000
7,461
934,099
821,928
31
28,177
28,245
54
77,295
75,061
259
260,348
239,045
(1)
13,014
14,746
305
62,458
42,620
1
3,862
3,097
0
42,456
0
36,393
173,280
160,534
44,503 1,594,989 1,385,276
15,498
6
1,216
17,559
0
713
11,662
2,320
3,267
11,547
2,317
3,645
4,090
76
536
4,338
55
743
5,512
106
1,177
5,421
79
1,656
3,562
0
0
4,205
0
0
0
0
0
0
0
0
40,324
2,508
6,196
43,070
2,451
6,757
10,386
0
11,367
0
11,661
0
10,118
0
5,407
0
3,077
0
3,978
83
5,347
65
309
0
408
0
1,103
0
13
0
32,844
83
30,330
65
1,265
4,850
33,221
2,555
1,108
33,302
1,319
174
30,403
1,374
454
29,455
447
794
11,350
769
933
9,915
646
1,996
13,498
956
2,134
15,658
30
90
3,991
183
106
4,902
393
0
1,496
388
(23)
378
4,100
7,904
93,959
6,225
4,712
93,610
503,074 439,370
396,296
346,276
290,891
244,604 207,458 174,363
60,614
42,928
42,697
44,125 1,501,030 1,291,666
394,063
0
276
325,487
1,077
16,525
284,726
0
154
224,818 211,019 166,708
32,357
0
1,050
10,983
162
8,608
46,434
0
165
39,510
118
2,342
42,605
0
0
48,461 1,478,684 1,213,934
0
0
38,373
0
1,167
56,944
89
394,428
83
343,172
58
284,938
105
43
37
268,263 211,224 176,403
11
46,610
15
41,985
499
43,104
0
880
335
48,461 1,480,731 1,309,586
REVENUES FROM GOVERNMENT
Output appropriations
499,837 408,950
Capital appropriations
0
3,771
Liabilities assumed by the Treasurer 410 18,486
superannuation
Resources received free of charge
180
95
Total revenues from government
500,427 431,302
CHANGE IN NET ASSETS
(2,647)
(8,068)
(1,868)
(3,104)
(5,953)
23,659
3,766
2,040 (14,004)
(943)
407
4,336
(20,299)
17,920
Total changes in equity other than those
resulting from transactions with WA State
Government as owners
(2,647)
(8,068)
(1,868)
(3,104)
(5,953)
23,659
3,766
2,040 (14,004)
(943)
407
4,336
(20,299)
17,920
Annual Report 2001/2002 Metropolitan Health Services
208
Notes to the Financial Statements
For the year ended 30 June 2002
Note 44 Statement of Financial Position by Region
East Metropolitan
Region
North Metropolitan
Region
South Metropolitan
Region
Women and
Children's Health
Central Support
Services
Dental
Total All
2002
$000
2001
$000
2002
$000
2001
$000
2002
$000
2001
$000
2002
$000
2001
$000
2002
$000
2001
$000
2002
$000
2001
$000
2002
$000
2001
$000
Current assets
Cash assets
Restricted cash assets
Other financial assets
Receivables
Amounts receivable for outputs
Inventories
Other assets
Total current assets
17,433
14,743
4,419
9,099
13,172
5,554
894
65,314
2,773
8,540
11,465
7,712
0
5,105
374
35,969
12,676
15,565
0
9,897
12,815
2,884
421
54,258
6,887
13,885
0
8,899
0
2,623
277
32,571
5,202
4,298
0
4,432
10,747
1,745
162
26,586
858
4,201
0
2,974
0
1,727
557
10,317
9,503
3,089
0
3,962
6,515
1,202
867
25,138
4,948
2,473
0
3,895
0
1,280
210
12,806
335
0
0
687
3,371
526
111
5,030
2,289
0
0
595
0
489
219
3,592
2,336
0
0
5,306
0
0
0
7,642
666
0
0
4,109
0
0
1,396
6,171
47,485
37,695
4,419
33,383
46,620
11,911
2,455
183,968
18,421
29,099
11,465
28,184
0
11,224
3,033
101,426
Non-current assets
Property, plant and equipment
Total non-current assets
290,936
290,936
293,561
293,561
266,411
266,411
276,251
276,251
229,945
229,945
227,607
227,607
155,645 156,369
155,645 156,369
22,210
22,210
36,176
36,176
5,691
5,691
3,411
3,411
970,838
970,838
993,375
993,375
Total assets
356,250
329,530
320,669
308,822
256,531
237,924
180,783 169,175
27,240
39,768
13,333
12,760
1,391
57,030
16,129
87,310
16,223
1,627
48,584
8,638
75,072
9,196
2,528
48,110
9,809
69,643
11,543
2,470
42,945
6,186
63,144
7,845
1,406
30,633
5,819
45,703
7,241
1,378
25,830
3,242
37,691
4,055
1,183
26,884
6,285
38,407
7,224
1,149
23,726
4,328
36,427
152
180
4,025
1,063
5,420
300
173
4,315
689
5,477
3,964
0
926
2
4,892
3,853
0
837
109
4,799
37,972
6,688
167,608
39,107
251,375
46,384
6,797
146,237
23,192
222,610
Non-current liabilities
Interest-bearing liabilities
Provisions
Total non-current liabilities
35,776
65,906
101,682
37,408
62,930
100,338
70,923
47,823
118,746
73,451
47,815
121,266
37,907
28,854
66,761
39,316
28,146
67,462
31,284
29,567
60,851
32,461
29,684
62,145
4,714
13,868
18,582
4,893
13,793
18,686
0
166
166
0
172
172
180,604
186,184
366,788
187,529
182,540
370,069
Total liabilities
188,992
175,410
188,389
184,410
112,464
105,153
99,258
98,572
24,002
24,163
5,058
4,971
618,163
592,679
Net assets
167,258
154,120
132,280
124,412
144,067
132,771
81,525
70,603
3,238
15,605
8,275
4,611
536,643
502,122
Equity
Contributed equity
Accumulated surplus / (deficiency)
201,622
(34,364)
185,838
(31,718)
191,088
(58,808)
181,352
(56,940)
135,172
8,895
117,923
14,848
98,073 90,917
(16,548) (20,314)
8,581
(5,345)
6,946
8,659
3,257
5,018
0
4,611
637,793
(101,153)
582,976
(80,854)
Total equity
167,259
154,120
132,280
124,412
144,067
132,771
3,236
15,605
8,275
4,611
536,641
502,122
Current liabilities
Payables
Interest-bearing liabilities
Provisions
Other liabilities
Total current liabilities
81,525
70,603
9,582 1,154,806 1,094,801
Annual Report 2001/2002 Metropolitan Health Services
209
Notes to the Financial Statements
For the year ended 30 June 2002
Note 44 Statement of Cash Flows by Region
East Metropolitan
Region
2002
2001
$000
$000
Inflows
Inflows
(Outflows)
(Outflows)
Cash flows from Government
Output appropriations
Capital contributions (2001 Capital
appropriation)
Net cash provided by Government
North Metropolitan
Region
2002
2001
$000
$000
Inflows
Inflows
(Outflows)
(Outflows)
South Metropolitan
Region
2002
2001
$000
$000
Inflows
Inflows
(Outflows)
(Outflows)
Women and
Central Support
Dental
Children's Health
Services
2002
2001
2002
2001
2002
2001
$000
$000
$000
$000
$000
$000
Inflows
Inflows
Inflows
Inflows
Inflows
Inflows
(Outflows) (Outflows) (Outflows) (Outflows) (Outflows) (Outflows)
Total All
2002
$000
Inflows
(Outflows)
2001
$000
Inflows
(Outflows)
470,658
404,347
367,935
323,892
260,217
219,492
196,108
163,469
41,306
38,943
42,424
47,065
1,378,648
1,197,208
13,525
1,705
9,754
669
14,537
31,847
5,741
1,050
49
0
3,257
0
46,863
35,271
484,183
406,052
377,689
324,561
274,754
251,339
201,849
164,519
41,355
38,943
45,681
47,065
1,425,511
1,232,479
(294,212)
(197,643)
0
(268,346)
(169,035)
0
(247,165)
(138,760)
(4,131)
(225,784)
(113,561)
(3,314)
(175,493)
(93,728)
0
(156,095)
(69,974)
0
(140,612) (125,466)
(63,445) (47,020)
0
0
(29,530)
(17,346)
0
(28,630)
(13,345)
0
(7,757)
(35,715)
0
(6,952)
(37,194)
0
(894,769)
(546,637)
(4,131)
(811,273)
(450,129)
(3,314)
14,234
7
17,371
0
11,361
2,320
11,505
2,317
3,552
76
4,646
55
5,770
106
4,458
79
3,352
0
4,174
0
(58)
0
0
0
38,211
2,509
42,154
2,451
1,215
712
3,267
3,645
536
743
1,177
1,656
0
0
0
0
6,195
6,756
1,245
15,192
3,130
11,041
1,281
11,146
1,395
10,473
444
7,422
769
3,734
626
4,246
956
5,808
306
399
183
514
393
2,707
388
(11)
4,295
41,112
6,821
31,559
(459,962)
(405,127)
(360,681)
(313,324)
(257,191)
(216,122)
(192,132) (159,529)
(42,818)
(37,104)
(40,430)
(10,582)
(6,577)
(7,931)
(7,557)
(13,122)
(35,702)
(4,627)
(4,911)
(490)
(1,256)
(3,581)
(3,518)
(40,333)
177
366
452
372
0
34
82
20
0
0
0
0
711
792
11,465
(4,419)
1,650
(11,465)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
11,465
(4,419)
1,650
(11,465)
(3,359)
(16,026)
(7,479)
(7,185)
(13,122)
(35,668)
(4,545)
(4,891)
(490)
(1,256)
(3,581)
(3,518)
(32,576)
(68,544)
0
0
0
0
0
(2,061)
0
(1,516)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
(2,061)
0
(1,516)
0
0
(2,061)
(1,516)
0
0
0
0
0
0
0
0
(2,061)
(1,516)
Net increase / (decrease) in cash held
20,862
(15,101)
7,468
2,536
4,441
(451)
5,172
99
(1,953)
583
1,670
(222)
37,660
(12,556)
Cash assets at the beginning of the
reporting period
11,314
26,415
20,773
18,237
5,060
5,511
7,420
7,321
2,287
1,707
666
885
47,520
60,076
Cash assets at the end of the reporting
period
32,176
11,314
28,241
20,773
9,501
5,060
12,592
7,420
334
2,290
2,336
663
85,180
47,520
Utilised as follows:
Cash flows from operating activities
Payments
Employee costs
Supplies and services
Borrowing costs
Receipts
Patient charges and fees
Commonwealth grants and contributions
Grants and subsidies from nongovernment sources
Interest received
Other receipts
Net cash provided by / (used in)
operating activities
Cash flows from investing activities
Purchase of non-current physical assets
Proceeds from sale of non-current
physical assets
Receipts from term deposits
Purchase of term deposits
Net cash provided by / (used in)
investing activities
Cash flows from financing activities
Proceeds from borrowings
Repayments of borrowings
Net cash provided by / (used in)
financing activities
(43,769) (1,353,214) (1,174,975)
Annual Report 2001/2002 Metropolitan Health Services
(59,521)
210