"A number of concerns."

About: Broome Health Campus / Emergency Department

(as the patient),

Really, this about a series of observations and experiences during an emergency admission for a infected skin graft on the leg:

I spent 3 hours in ED waiting before seeing medical staff

The triage consisted of a finger meter pushed through the glass and the observation that - you don't have an infection. 

The failure to elicit my relevant medical history and the reasons for my admission were crucial in delaying correct action later. My records showed for the first 36 hours that I had no relevant medical history at all despite advising admissions and other staff that I had a melanoma related skin cancer causing the infected graft.

I was admitted under a former name even though I handed my current medicare card to the admissions.

My first major surprise was in the ED waiting room.

The hospital sells soft drinks, chocolate and chips. This is noteworthy because Broome is often referred to as the diabetes capital of Australia. I would like to see a medical justification for the sale of these unhealthy products. When I mentioned my concern they suggested that management wanted to provide comfort food to people used to consuming those products. I'd like to see the medical justification for that.

Also in the ED waiting area at the same time as me was a very treasured and local resident. In for their regular treatment, I witnessed this special person left for an extended time alone in the waiting area, and later after their treatment it seemed that they were left abandoned outside near the vehicle pickup area. This treasured local is wheelchair bound and is a person of significant distinction in our local area. I believe this person deserves somewhat more respect than I witnessed them receiving. 

The hospital emergency department and treatment rooms were so cold, as to cause shivering and for me, an increase in pain and loss of balance. 

The blanket I was eventually provided was covered in someone else's hair.

I was left alone for extended periods with an open wound and no indication of what processes were being followed. I was surrounded by my very soiled, discarded bandages and gauze.

Six hours after arrival (approx 9pm), I was offered something to eat. In my opinion, it was a stale cheese and stale bread sandwich. As far as I'm concerned, indigestible and totally without nourishment or healthy ingredients. I discarded it.

During this initial stage a swab was taken for pathology assessment. I believe no results were obtained, or more seriously, not acted upon, with the result. Therefore, the 3-day intravenous antibiotic, followed by the 5 day oral script was not ever going to be effective. The pathology results showed quite clearly that the prescribed antibiotic was inappropriate and would not clear the infection. Fortunately, an alert doctor who was coincidentally called in for an assessment of my wound at the outpatients dressing clinic 3 days after being discharged, asked for the pathology results. They had not been requested before now!  From there, with the path results, he was able to prescribe the correct antibiotics.

I feel something is wrong in the system, or the protocols of the hospital which led to this gross oversight.

It could be that you are understaffed?

During the first night in the ward I had to wait for more than 30 minutes for who I felt was an overworked nurse to attend to my intravenous machine, so that I could go to the toilet. 

Because the ward was so cold I was provided with extra blankets which are so heavy they affected my wounded legs and could ultimately not be used.

I had plenty of time to observe your staff. There appears a high proportion of staff who are unfamiliar with the system. Temps? Locums? Seemingly not enough permanent staff who can guide and direct newcomers. It's affecting the quality of service.

I would like to receive an informed and honest response to my opinion please.

 

  

Responses

Response from Wendy McKinley, Operations Manager, Broome Hospital

picture of Wendy McKinley

Dear many concerns,

Thank you for having taken the time out of your day to post about your observations and experience in the Broome Emergency Department and Ward.

You raise some very salient points and issues that I would like to address.

I can and will address the issue of the vending machine and the food based on the feedback you have already provided and I will post here to let you know what changes/actions have been taken as a result.

In respect of your clinical care, the situation you describe is of real concern to me and I would like to have a senior practitioner review your case. In order to do this, I do need to speak with you and would very much appreciate a call on 08 9194 2855.

I hope to hear from you soon so that we can work through your concerns.

Thanks once again.

Sincerely

Wendy McKinley

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Response from Wendy McKinley, Operations Manager, Broome Hospital

picture of Wendy McKinley

Dear many concerns

Thank you for meeting with me recently to work through the issues you raised in your post.

FOOD

As discussed, I have investigated the issues regarding the food vending machines and after hours food. I have determined that the drink vending machine only offers sugar-free options and that the food vending machine offers a mix of healthy and unhealthy options.

The Dietitian is currently working with staff to ensure that an appropriate mix of foods is available through the machine.

The machine itself is not designed to accommodate larger items and staff have struggled to find single portion healthy foods that fit in the machine.

Should the design of the machine continue to be a barrier to offering healthy options it will be removed and replaced with another machine or service that will allow for appropriate foods to be offered.

In respect of the food being provided after hours, I am advised that the sandwiches did not include salads in an attempt to reduce food spoilage/wastage. I have asked that a variety of sandwiches and snacks be made available in future.

STAFFING

We did discuss the challenges that rural hospitals face in attracting and retaining staff and agree that a stable workforce is an important factor in delivering safe, quality care. The site has made a concerted effort to recruit to vacant positions and reduce reliance on agency and locum staff. There have been several recent appointments made and there is a recruitment process for Registered Nurses being finalised as we speak.

TEMPERATURE & BLANKETS

I apologise that the temperature of the building was too low for your comfort. The air temperature is controlled through a Building Management System and the engineering is quite complex. There is little scope to adjust the temperatures.

In respect of the blanket resting on your leg, we do have frames available that raise the blanket off the body and one of these should have been made available to you.

CLINICAL CONCERNS

I have asked that Dr James Harris, Senior Medical Officer, review your case. On completion of the review he will contact you to arrange a time to go through the findings and any recommendations and actions taken for improvement/change.

Thank you again for providing this opportunity for improvement. Your feedback is important.

Sincerely

Wendy McKinley

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Updates, changes and questions related to this story

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