NURSING/HEALTH

Hospital Review/Report

September 16, 2012

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Australia belongs to a number of the countries with the developed health care system. The structure of health care of the state includes a number of all-medical, profile, pre-hospital and hospital medical, paramedical and other components. The important place in the structure of the Australian health care is occupied by the rendering of medical care to the population in hospital establishments. The considerable share of the means allocated for financing of such medical services from the state budget testifies to it. In 2010-2011 86.9 billion Australian dollars were allocated for them. At the expense of the state budget 93 % of the hospital expenses and 7 % of private and other sources are financed. An average cost of one day of a patients stay in the state hospital makes 600-700 Australian dollars. St. Vincents hospital, Melbourne is the main hospital in Fitzroy, Melbourne, Australia. It is located at the corner of Nicholson Street and Victoria Street. Its address is: Ground floor, 41 Victoria Parade, Fitzroy VIC 3065.

Mailing address is: St Vincents PO Box 2900, Fitzroy VIC 3065. Inspired by the caring tradition of the Sisters of Charity and the healing ministry of Christ, St. Vincents Hospital Melbourne strives to be a leader in providing high quality and innovative health care to the community. Our values and concern for all people permeate every aspect of the life and work of the hospital. Our leadership is achieved through the outstanding contribution of our people in delivering a range of specialist hospital and community services, underpinned by excellence in education and research (St. Vincents Hospital Melbourne: 2012). St. Vincents Hospital was open in 1893 as a Catholic hospital which was managed by the Sisters of Charity. Originally conceived as a branch of the Sydney St. Vincents Hospital, St. Vincents Hospital, Melbourne, was intended to be a charitable establishment which will

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help to support the minimal health care of Melbourne. This idea was supported by the Catholic archbishop of Melbourne, Doctor Thomas Karr who liked the idea of the hospital to care for poor and homeless patients and abandoned children. These ideals corresponded directly to the widespread Victorian ideas of favor which especially were pleasant to the middle classes. The hospital was quite small with a room less than for 100 beds for the first years. The hospital soon created the communications with the suburbs where the working class of Fitzroy (in which the hospital was located) lived. The hospital was built owning to charity. In July 2002, the hospital was officially called St. Vincents Hospital. St Vincents Private Melbourne is part of St Vincents Health Australia, and operates under the direction of the Trustees of Mary Aikenhead Ministries (TMAM). TMAM was established by the Sisters of Charity of Australia on 1 July 2009 to continue their work in health, education and welfare services. The name Mary Aikenhead Ministries was adopted in tribute to the foundress of the Sisters of Charity, Mother Mary Aikenhead. Inspired by her extraordinary example, we work together with TMAM to continue to bring this great tradition of service to all in need of care (St. Vincents Private Melbourne: 2012). A new building has been constructed recently behind the old one. It was highly appreciated for its innovative design ideas, additional medical and surgical peculiarities such as neuralgia/neurosurgery. It includes the centralized nursing centers and satellite drugstores. St. Vincents Hospital is placed as a specially constructed hospital. The hospital has a centrally-blocked system. Such a system provides a clear functional split of several blocks connected among themselves - multystoried wards, diagnostic and service premises, natural illumination of all wards, offices of doctors, clinic-diagnostic and service premises. In hospitals there is a zoning of the territory including the zone of a hospital garden.

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The internal accomplishment of the wards in St. Vincents Hospital has a number of differences from the other Australian hospitals. Some of them are provided with the phones of city communication, but in case of their absence the patient is given opportunity to communicate via the landline phone established in the other rooms. St. Vincents Hospital is a bright example of a compact building. The hospital has 450 beds. For a year more than 3000 medical employees render medical aid for about 30 000 hospital patients and 40 000 patients, needing emergency medical aid. It includes such medical departments as: cardiology, neuralgia, gastroenterology, oncology, clinical microbiology, endocrinology, nephrology, rheumatology, haemotology, and therapy. Besides, it has the following surgical departments: microsurgery, plastic surgery, cardiac surgery, orthopaedic surgery, rectal surgery, urology, neurosurgery, general surgery, gastrointestinal surgery. Moreover, the hospital has the psychiatric department with a special Expanded Crisis Assessment and Treatment Team, which manages the psychological state of the patients.

Pic. 1. St. Vincents Hospital Campus Map

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St Vincents works with collaborative partners to deliver high quality treatment, teaching, education and research. As a tertiary public healthcare service, St Vincent's provides acute medical and surgical services, emergency and critical care, aged care, diagnostics, rehabilitation, allied health, mental health, palliative care and residential care, as well as undertaking research and educating the next generation of healthcare professionals. In 2009-10 St Vincent's had 53,212 separations and 257,444 bed days. We provided more than 500,000 occasions of service to patients through our emergency department, specialist clinics and other services. We operate across 17 locations in metropolitan Melbourne including St George's health service and Caritas Christi Hospice in Kew and our main campus in Fitzroy (Yellow Pages: 2012).

Pic.2. Organizartional Chart of St. Vincent Hospital. The key figure in the hospitals organizational structure is the general practitioner. The general practioners conduct the primary reception of the patients addressing to them. The office of any physician in St. Vincents Hospital consists of the reception room; the doctors consulting room, and medical treatment room.

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The reception room serves for the waiting patients. They wait in it until the doctor invites them for consulation. The consulting room usually occupies 14-20 squre meters. It has all the necessary equipment for the specialist. Medical treatment room serves for some ambulatory interventions, medical procedures and specialized medical check-ups. Proceeding from different reasons (including financial), the doctors in St. Vincents Hospital choose the scheme of reception of patients more convenient for them. The majority prefers the reception by preliminary telephone call for a certain time. Such a way is convenient also for the patients since in this case it is not necessary for them to wait long. The duration of a patients reception makes on average 12-15 minutes, but it can also make 30-40 and more minutes at primary reception, a combination of a simple survey to the additional procedures or selection of blood tests, specification of these or those questions by phone with the other establishments of health care, specialists, etc. There are no standards which strictly regulate the duration of the working day of VOP in Australia. The average annual salary of the ordinary intern in St. Vincents Hospital makes about 100-150 thousand Australian dollars, specialist - 300-400 thousand (in some cases much higher); nurse - 65-75 thousand. As well as in the majority of the other countries, hospitalization of the patients in the hospital is carried out in two main directions: according to the plan and urgent medical indications. The patients, delivered by a brigade of an emergency medical service, are accepted the first. The organization of nutrition both for patients and medical personnel is presented in a very high level in the hospital. Every hospital patient is provided with three meals a day. Moreover, the patients with diabetes are provided with a light diet snack with tea or coffee during the consultation with endocrinologist.

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Performance management is important for the success of St. Vincents Hospital. The main thing at efficiency increase is to provide the fulfillment of the operations in order to satisfy the inquiries of buyers. The organization provides the patients with the medical services they require. Performance management is the major labor indicator; all main indicators of production efficiency, and all labor indicators depend on the dynamics level: effectiveness of medical services, a number of workers, etc. Performance management is closely connected with the control of its change from the point of view of identification of adverse deviations of a labor productivity level in definite periods of time. St. Vincents Hospital uses the workforce planning in its performance management system. Workforce planning can be a very difficult procedure with the use of computer modeling and difficult mathematical methods for forecasting. The effective manager should be responsible for the organization and planning of a workforce in his division or department. Effective workforce planning in St Vincents Hospital can be represented as a sequence of the following actions: The analysis of the existing Future needs forecast resourses Planning of measures for these needs satisfaction

Table 1. The Process of Effective Workforce Planning in St. Vincents Hospital. Human resource managers in St Vincents Hospital are limited in their direct impact on financial, material and energy aspects of productivity. These are prerogatives of the other officials and divisions. However, human resource managers can and should have more influence on a labor component of productivity. A competent human resource manager in St Vincents Hospital can actively influence a level of executive discipline of workers and a

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philosophy of the overall management. Thus, they influence an increase of the hospitals effectiveness. The accurate mechanism of motivation and estimation of the results for workers and teams will inspire confidence that they will get the award for an effective work, and the management of St. Vincents Hospitals will feel confidence that the goals achievement will be performed with the greatest diligence and productivity. Such an acceleration of the processes represents a dilemma for the majority of the organizations. The personnel of St. Vincents Hospital demands the newest knowledge which it is necessary to give more often and in conditions as much as possible close to occurring changes; however, training should be conducted within the limits of the time they can spend on it. Health Information Management (HIM) is a strictly structured service in St. Vincents Hospital. In general, HIM includes diagnostics, treatment, prevention, expertise, and care for the patients. Health Information Manage in St. Vincents Hospital administers all medical records according to the current legislation and requirements of the hospital. The tasks of the Health Information Manager include: Maintenance of the health information systems; Design of the medical records forms; Recruitment and training of the medical record staff; Organization of the efficient workflow; Control of the recorded information; Facilitation of the effective communication between the hospital staff and the patients; Evaluation of the health care researches conducted within the hospital.

Medical records storage has a special system in St. Vincents Hospital. The exchange of information is carried out in the NHIN network (Nationwide Health Information Network).

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The construction of this network was conducted under the direction of the Australian Department of Health and Human Services Office of the National Coordinator. The used technologies provide accuracy, efficiency and safety. Besides, they allow avoiding redundancy and additional checks. Possessing the means of medical information exchange, the patients can instantly address to the medical records and receive the necessary help in any hospitals department. Owning to the implementation of the new program, the procedure of cards transfer occurs within several seconds. Thus, as a result, the quality of medical services improved, the level of the patients safety increased, and the efficiency of information exchange and rendering of medical care grew. Moreover, St. Vincents Hospital widely uses the Imaging module, which became available to physicians in 2005. Its application gives the papers-free technology of work for doctors and access to all medical images (also to video, photo and audio-materials, and scanned documents). St Vincents Hospital has a strategic plan for its development. According to the plan 2010-2015, many strategies aimed at the development of the hospital and its services will be implemented up to 2015. St Vincents has enunciated a number of key short and long term objectives in the recently issued St Vincents Strategic Plan 2010-2015. Some of the core objectives are to: Build relationships with strategic partners; Strengthen surgery, medicine and interventional care; Deliver services of significance and value; Continue to innovate to grow a smarter business focussed on the future;

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The manner in which these objectives are to be achieved is set in detail in the Strategic Plan 2010 - 2015. St Vincents measures its performance in detailed monthly Finance and Activity reports that are issued to the Senior Executive, Board and Department of Health (St. Vincents Hospital: 2009).

NURSING/HEALTH References Department of Health. (2010-2011). Statement of Priorities. Available

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at:

http://www.health.vic.gov.au/hospitals/sops/st_vincents_signed1011.pdf General Medical Admissions at St. Vincents Hospital Melbourne: Nature of Patients and Factors Influencing Length of Stay. Available at:

http://imsanzconference.co.nz/september/edit/ftpuploads/1665759958_cimsanz0912ab stract00075%20Tey%20C.pdf History of St. Vincent hospital, Melbourbne. (2009). About St. Vs. Available at: http://stvcancercentre.org.au/about-stvincents/history.htm St. Vincents Hospital Melbourne. (2012). St. Vincents Hospital Melbourne Campus Map. Available at:

http://obesityconsortium.unimelb.edu.au/about_us/about_us_extra_files/svhmmap.pdf St. Vincents Private Melbourne. (2012). Our History. Available at:

http://www.stvincentsmercy.com.au/about/history/ St. Vincents Hospital Melbourne. (2012). Information and Guidelines for Undergraduate Nursing Students and Clinical Educators. Available at: http://library-

macfields.swsi.wikispaces.net/file/view/Information+for+Students+clinical+placemen ts.pdf St. Vincents Hospital (Melbourne) Limited. (2009). Report of Operations. Financial Statements. Available at:

http://www.svhm.org.au/aboutus/newspublications/Documents/Financial%20Stateme nts%20and%20Report%20of%20Operations.pdf Yellow Pages. (2012). St Vincents Hospital Melbourne. Available at:

http://www.yellowpages.com.au/vic/fitzroy/st-vincents-hospital-melbourne12424199-listing.html