The Auditor-General in a report issued today highlighted management issues, including the lack of lack of a centralised computerised list of pending operations, as factors causing the backlog of operations at Mater Dei Hospitals.
Stronger growth in the number of operations was also being hampered by the hospital's inability to persuade staff to work longer hours, and a shortage of hospital beds for post-op treatment.
The report notes an increase in operations over the past two years, and patient satisfaction at the outcome.
However, it says, the attraction of better remuneration packages was making it difficult for Mater Dei Hospital (MDH) to persuade its consultants and other professionals to extend their working hours at the hospital.
COMPUTERISED WAITING LIST
"MDH is still in the process of computersing its waiting lists in a centralised system. This project, which commenced three years ago, has focused on the Cardiology, Ophthalmic, Orthopaedics and Surgical Departments. This System is considered as a pre-requisite to effective waiting lists management since it transfers the ownership of waiting lists to the Hospital’s Management. The project also helps to strengthen transparency and management oversight," the auditor said.
"The management function of elective surgery waiting lists is hampered by the non-integration of the relative stand-alone information systems. The resultant data fragmentation impinges on the administrative and management aspects of elective surgery.
LOW UTILISATION OF OPERATING THEATRES
The auditor said that in July 2012 a review of the 18 Main Operating Theatres and five Endoscopy theatres showed that, on average, each operating theatre was used for 31 and 27 hours per week respectively. The utilisation of the operating theatres was effected, amongst others, by bed-turnover limitations.
"This situation is limiting the daily number of operations carried out at MDH," the auditor said.
At the operational level, a number of process inefficiencies were noted. In some cases interventions started later than scheduled, operation turnaround times were prolonged, and in some instances under-running surgery lists led to early session finishes.
"The lack of a central authority within the Operating Theatres Department to assume full responsibility for this function weakens management control over this critical and most valued asset within the Hospital.
"To date, the increase in intervention throughput can be attributed to the Hospital identifying and addressing specific areas of inefficiencies. Although the continuous changes to work-practices have led to positive results, these efforts need to be complemented with the adoption of the strengthening of strategic, operational and public private partnerships policies, as well as the availability of comprehensive and integrated information systems.
"This will strengthen management direction and control over the elective surgery processes, as well as contribute to the sustainability of this sector."