Staff resign over resources

LATROBE Regional Hospital has been forced to defend the safety of its pharmaceutical practices following the resignation of its two pharmacy directors last week.

Several sources told The Express that mounting frustrations over resource shortages and inadequate provisions for appropriate medicine management at LRH led its pharmacy director and deputy director to tender their resignation.

One source claimed understaffing, drug treatment and patient safety was “at the heart of the matter” and said LRH management had failed to act on those matters.

Claims that staff feared LRH patient safety was being compromised were confirmed by professional representative body Society of Hospital Pharmacists Australia.

National SHPA president Sue Kirsa told The Express she was aware of concerns related to “a gap between staffing resources (at LRH) and those recommended in the clinical pharmacy services standards of practice”.

She said staff had also expressed concern about the number of errors occurring in the administering of medications at LRH in recent years.

LRH acting chief executive Amanda Cameron refuted suggestions of unsafe practices, saying LRH followed “rigorous processes to ensure medication safety” and “data for the previous 12 months shows that there has been no increase in the number or severity of medication errors for (that) period.”

It is unknown how many errors have been reported to the Department of Health in past years but Ms Kirsa said some LRH pharmacy staff believed their capacity to “raise concerns in the usual ways, in terms of incident reports” was restricted.

Ms Cameron countered those suggestions, saying LRH’s culture “strongly encourages reporting of any errors.”

Ms Kirsa said SHPA produced standards of practice used as “professional guidelines for pharmacists who operate through hospitals” and while they had “no legal standing in their own right” the standards were supported by the Pharmacy Board of Australia.

“Those standards have ‘pharmacist to

bed’ ratios within them” Ms Kirsa said, adding she was aware the LRH pharmacy director had been “working over a period of time to be able to provide the resources required to adequately service the patients of LRH”.

Ms Cameron acknowledged the SHPA’s ratios but said the level of funding was a “complex matter” that depended on the “acuity of the patients being cared for.”

Ms Kirsa said it was essential pharmacists be available at admission, preferably in the emergency department, to undertake “medication reconciliations”, documenting “what medications a patient has been taking on the outside” to prevent potentially dangerous drug allergies or interactions once in-hospital treatment commenced.

She said accurate medicine lists upon patient discharge also needed to be prepared for GPs.

“Pharmacists play a really important role at that interface and where it doesn’t happen well, it is potentially very serious,” Ms Kirsa said.

Ms Kirsa said LRH pharmacy directors had shared concerns that few recommendations had been adhered to, relating to “additional resources for the pharmacy so they could provide clinical services, 

particularly in the emergency department and mental health unit”, arising from a 2012 independent review of LRH pharmacy services.

Ms Cameron said the review, undertaking “in light of an increasing demand on services” evaluated the hospital pharmacy against national benchmarks and “a number of recommendations” arose, “most of which were aimed at improving processes and efficiencies”.

“From that, an action plan was drawn up and was finalised this month, with implementation to begin immediately,” Ms Cameron said.

“We are disappointed that the pharmacy director and deputy director are leaving right as we are implementing these improvements but we wish them well in their future plans.”

Ms Kirsa said the SHPA was considering its approach to the events at LRH.

She said the association had already warned health ministers about “what happens when the focus is directed solely on financial matters,” in light of a recent UK review into hospital quality and safety issues.

The review, known as the Francis Report, “highlighted the sort of situation as we see happening at LRH,” Ms Kirsa said.

“It showed where there is a lack of clinical staff and support for medicines used at the ground level, with pharmacists assisting nurses and doctors to safely manage (medications), it can result in significant errors.”