Consumer update

At Royal Perth Hospital we keep our consumers, patients and the community informed about the services we provide, how we are delivering those services against the National Safety and Quality Health Service (NSQHS) Standards and report on areas for improvement.

June consumer update

Emergency Department

RPH continues to be a busy inner-city tertiary hospital. This graph shows that since the opening of Fiona Stanley Hospital, the amount of people coming to the RPH Emergency Department is gradually decreasing

RPH last year averaged more than 200 Emergency Department presentations a day (2540 per week).

It is expected that presentations will reduce to around 180 presentations a day (1263 per week).

What is ramping?

Ramping is when ambulance officers are unable to transfer the clinical care of their patient to Emergency Department staff due to a lack of beds or appropriate clinical space.

Patients are never left in the back of an ambulance and are brought into the hospital and cared for by ambulance officers until space and clinicians are available.

It is not ideal for RPH to be “ramping” patients but sometimes it is necessary as patients rarely flow in a steady stream into the Emergency Department.

The following graph highlights the varying levels of ramping at RPH. You will notice the winter months see a significant increase of ramping as we see greater numbers of patients presenting to the Emergency Department with flu-like symptoms

From the graph below you can see that Monday 25 May 2015 was one of our worst performing days as we ramped a total of 15.2 hours. However on Saturday 30 May 2015 we did not ramp at all.

We aim to have no ramping and we will continue to work with Fiona Stanley Hospital and other hospitals within Perth to reduce Emergency Department  presentations.

Graph of ramping numbers

Falls Prevention

Falls are one of the largest causes of harm in health care and are a national safety and quality priority. The Australian Commission on Safety and Quality in Health Care assists health services to reduce the number of falls and harms from falls, through a number of national initiatives.

RPH has seen a significant reduction in falls since November 2009.

It is our aim to have zero falls across RPH. However accidents do happen. The current fall rate is 3.33 falls for every 1000 occupied bed days.

Hand Hygiene

Hand hygiene practices have been universally poor among health care workers due to:

- Heavy workloads: the busier you are the less likely you are to wash your hands.
- Time consuming: there just isn't enough time to wash your hands as often as you need to if using the traditional Hand Hygiene techniques.
- Hands don't appear dirty: bugs are there even if you can't see them.
- Problems with skin irritation: frequent washing with soap and water removes skin lipids, and in some people causes dryness, skin irritation and damaged skin. -
- Sinks poorly located: if it's hard to get to a sink you are less likely to use it.

May hand hygiene compliance is at 78.8%

RPH has seen a steady increase in hand hygiene compliance but it is still below the national average.

RPH continues to run education programmes about the importance of hand hygiene and ask that you as consumers of our service ask our staff to wash their hands or use the alcohol wash provided before and after touching you.

We won’t be offended if you ask us to wash our hands.

Pressure Injury Prevention

Pressure injuries are localised areas of damage to the skin or underlying tissue, caused by unrelieved pressure or friction. They occur most commonly over bony areas such as the area at the base or bottom of the spine and heel, but they can develop anywhere on the body.

While pressure injuries are generally considered to be preventable, research shows that pressure injuries are a major contributor to the care needs of patients within healthcare facilities.

RPH averages 0.85 pressure injuries for every 1000 occupied bed days. This is below the national average of 1.2.

RPH has seen a rise in pressure injuries over the past few months and it is believed that this increase is due to better reporting from staff and staff looking for signs of pressure injuries.

Consumer Feedback

In the first quarter of 2015, RPH received 155 direct complaints from patients, carers or family members (consumers). We also received 75 enquiries from the Minister for Health’s office relating directly to consumer complaints and on a very positive note, received 33 compliments.

What are consumers complaining about?

The greatest number of complaints relate to communication and the quality of clinical care, 38 complaints for each of these areas.

In the area of communication, the overwhelming trend is that consumers felt that clinical staff did not explain something or were perceived as being dismissive or rude.