"When is an emergency NOT?"

About: Bunbury Hospital / Emergency Department Sir Charles Gairdner Hospital

(as a carer),

My wife has a history of an aneurysm, which was clipped.  After the clipping they then experienced a subsequent stroke.

My wife, the person that I care for, was admitted to ED Bunbury Regional Hospital recently after experiencing dizziness and nausea. The service at Bunbury Regional Hospital was excellent. 

As part of the review, a CT scan was performed indicating that abnormalities were present suggesting that an aneurysm may be present.

We were referred to Sir Charles Gairdner Hospital, and the ED was advised to send referral to OP Neurosurgery clinic as the “CT finding does not explain the current presentation”

Given our history, the amount of concern expressed by my wife, as well as myself would have been, I thought, self evident.

We were discharged from Sir Charles Gairdner Hospital (SCGH), and it was only when I rang to find out what was going on that I was made aware that my wife had in fact been categorised as a CAT 2 and that an appointment would take place within the next two years (!)

As one would appreciate - from emergency, diagnosed aneurysm, referral to SCGH and then nothing!

We feel we were left in a state of limbo - effectively being given a diagnosis and referral with little information as to what was going to happen next. The fact that there was no correspondence is disappointing and the fact that it took a number of phone calls to SCGH to obtain any information exasperated the situation.

I was referred to the patient liaison service within SCGH - introducing a third party to the journey.

After talking to the patient liaison service I documented the issues and my concerns and restating the course of events.

Now one would think that if you had expressed a lack of understanding as to what was going on - someone would ‘enlighten’ you.

I also listed the issues as a result of this journey, which includes communication in an expedient manner.

The fact that there are concerns regarding the suggestion from Bunbury Hospital to SCGH ED to lodge a referral indicates that there are issues but there was no explanation of why my wife was classed as a CAT 2 -‘semi urgent’, lets face it, you need an explanation. One was not forthcoming.

It appears that there is an underlying assumption that individuals are conversant the terminology used in hospitals - that simply put is not the case. Given the fact that SCGH was made aware that my wife has a cognitive impairment it accentuates the assumptions made at hospital level in terms of information that is explained and presented in simple speak.

Instead the questions and concerns expressed were not addressed by the hospital in a letter sent a week later.

I subsequently rang the hospital very recently and talked to a staff member in the Department of Neurosurgery. I expressed my concerns regarding the fact that the issues raised in an email I sent to patient liaison (my understanding is that it was forwarded to the Dept of Neurosurgery) were not addressed. 

Long story, short - I was then passed back to patient liaison - where, I was asked, once again, to document the issues - even though they were already documented?

Patient liaison indicated that we discuss this matter at my wife's next appointment .

It seems that there are a number of systemic issues regarding the process a patient and his/her carer are exposed to and the underlying assumptions that individuals have an understanding of that process.

The fact that you are bounced between departments does not help the matter in terms of obtaining clear, concise and intelligible information for both patients and their carers.

The introduction of a third party (Patient Liaison) simply extends what is already a problematic experience.

Responses

Response from Janet Zagari, A/Executive Director, Sir Charles Gairdner Osborne Park Health Care Group

picture of Janet Zagari

Dear monocerosfg96

Thank you for taking the time to bring your concerns to my attention. I am sorry that we have not met your expectations with your wife’s care and appreciate that it would have been extremely frightening for you to learn that your wife had further abnormalities given her history of aneurysm and stroke. I understand that the health system is not easy to navigate and that it is so important that ‘next steps’ are clearly communicated and in a way which is well understood.

I am sorry that you were dissatisfied with communication with you and your wife, and between hospital departments. I understand that your concerns have been bought to the attention of the head of the neurosurgery department, and we are currently reviewing the concerns that you have raised in relation to the information that you received, so that we can respond in detail and try to ensure that you have all the information that you need.

We are committed to improving our service and where improvements can be made, they will be made.

Thank you again and I wish you and your wife all the best.

Regards,

Janet Zagari.

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Response from Glen Matters, Bunbury Operations Manager, WACHS South West

Dear monocerosfg96,

Thank you for posting your feedback on Patient Opinion and the team at Bunbury Hospital would like to thank you for the wonderful positive feedback. I am sure my colleagues at Sir Charles Gairdner Hospital will assist you in working through the issues you have raised. If through this process there are any learnings for Bunbury Hospital to assist in the pathways to the metro sites please make contact with us.

I do hope your wife is better and things can be sorted out and if I can assist in anything please let me know.

Regards

Glen Matters

Operations Manager Bunbury Hospital

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Update posted by monocerosfg96 (a carer)

Thank you for your responses.

While I understand that the response from SCGH is couched in my/our expectations, that, is incorrect.

Our rights, as opposed to expectations, are clearly delineated in the DAIP policies of the hospital. Communication forms a basic tenant in that document and certainly in the Australian Charter of Healthcare Rights.

What has not been acknowledged, is the fact that an impairment is also involved and communication policies with those that have a disability becomes another consideration on this particular part of the journey.

So while Access and Inclusion are words that are used, the practice may well fall short of the stated aims and aspirations?

While I acknowledge the responses, I am observing more energy being devoted to the complaint lodged, as opposed to the patient and her carer being informed. As of writing this response, we still are none the wiser, as to what is happening, apart from a formal complaint being lodged. Am I missing something? With respect, the adage - "talk is cheap" may well apply?

Response from Janet Zagari, A/Executive Director, Sir Charles Gairdner Osborne Park Health Care Group

picture of Janet Zagari

Dear monocerosfg96,

Thank you for your latest email/posting.

I understand the Manager of the SCGH Patient Liaison Service (PLS) provided you with Department of Health Policy and Guidelines for referral to specialist services in WA health and how the triaging process is determined. We acknowledge that the pathway and guidelines for accessing specialist services are not always explained clearly and recognise there is room for improvement in terms of how we communicate what will happen next for our patients.

I understand you have also been advised that the wider issue of E-Referrals, those referrals from other health service providers, do not have acknowledgement letters automatically generated when they are entered on the patients database. We recognise this is also as an opportunity to improve our process and to that end this issue will be raised at the next state wide User Forum meeting for discussion.

In closing, I am advised following your discussion with the Manager of PLS, the Department of Neurosurgery have been in contact with your wife’s GP.

Kind regards

Janet Zagari

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