DEDICATED TO THE TASK: MBH Perioperative Services manager Katrina Allen, right, and MBH registered nurse Kira Murray.
By JOHN DOOLEY
WHEN I visited the Mildura Base Hospital (MBH) recently, I was greeted by Perioperative Services manager Katrina Allen, who escorted me through the large facility to the surgical theatre department.
Katrina has a big job running the Perioperative Services Department, and is responsible for more than 50 staff, all of whom have a critical role to play in a patient’s stay in the theatre wards.
‘Perioperative’ is the term given to overseeing the entire operative experience, from pre-admission through to the end of the patient’s stay.
“Patients wouldn’t realise that it takes more than 50 people to facilitate their surgery, that includes office administration, nursing, theatre and instrument technicians, patient service assistants, our night cleaner and technician extraordinaire,” Katrina said.
The last time I was in this place I entered as a day patient, about to undergo a procedure requiring a general anaesthetic and some oral surgery. My personal experience went exceptionally well, I couldn’t fault the system, in fact, the whole process was seamless, and fortunately for me the outcome was positive.
Far too often, it seems, we hear negative stories about the health sector and hospitals in particular, with our own hospital not immune to such adverse commentary.
I asked Katrina if she thought criticism of the hospital on some occasions was justified.
“Sometimes I think we can all be quick to find a negative when things affect us, and that’s understandable,” she said. “Given it is such a busy, complex system, there is always potential for issues to occur, however we also receive a lot of positive feedback from the community.”
Something that also concerns Katrina is when a patient’s surgery has to be cancelled due to unforeseen circumstances. She points out, however, that the level of this occurring is relatively low, and sits within the hospital’s key performance indicator (KPI) targets.
“When we run our numbers, the rate is around four percent, or four in 100 cases, which by comparison is quite a reasonable KPI figure,” she said. “I know this doesn’t give comfort to the patient, they are of course inconvenienced and that always disappoints us.”
As we make our way to Katrina’s office, we pass the Central Sterilising Department (CSD) which houses hi-tech machines that sterilise every instrument used in the operating theatres, and also provides a service to outside medical clinics and facilities in the district.
“We received some grant funding for these a few years ago and they are brilliant, I love them,” she said.
MBH performs a large number of colonoscopy, endoscopy and other ENT procedures on a daily basis, and the equipment used needs to be sterilised and in ready supply.
“Sterilisation is at the heart of the integrity of the department, which works in a highly audited environment, and having this facility means we maintain the highest level of hygiene,” she said.
Regular orthopaedic surgery, including knee and hip replacements, are an everyday occurrence, together with general surgery and emergency procedures which account for the bulk of other surgical activities.
A team of 28 surgeons performs all types of procedures, including elective, emergency and trauma.
In addition to this, 15 specialised theatre nurses share on-call duties outside staffed theatre times, which typically has them on call two nights a week, including weekends.
Around 120 operations are performed each week, the majority being day surgeries.
Today, it’s possible for a patient to have a gall bladder removed or a hernia repaired in the morning and go home in the evening. Years ago the patient may have remained in hospital for a week or more.
“Our goal is to only have you wait about an hour before you go in for your surgery, that can and does vary depending on ‘the list’ for the day, and as is often the case, emergency cases come in and of course they are given priority,” Katrina said.
“Therefore we need to manage the day surgery area tightly, to ensure everything runs smoothly and efficiently, and the volume of cases we handle are dealt with in a timely manner.”
The hospital was opened 17 years ago, and heralded a new era of health care in Sunraysia. It employs 70 medical staff, covering 11 speciality areas, and has an annual operational budget of $110million.
Like most hospitals, there is sometimes a shortage of beds at MBH, with executive management constantly fighting to gain more funding to ease the situation.
The reality is the hospital is dealing with more sick people than ever, this is due in part to the region’s ageing population, and also because people can now be treated in Mildura, whereas some years ago very ill patients would be transferred to Adelaide or Melbourne.
“Today we generally don’t send people away, for example an elderly person with a broken hip is treated here and they will usually require intensive resources and care to make a full recovery, and that equals more resources and a lot of money,” Katrina said.
The presence of the Monash University Medical Campus has meant that many of the doctors in training return to the region once they are qualified, and also tell their colleagues that Mildura is a great place to live and work.
“It’s absolutely fabulous, we have a lot of medical students come through the system and they are involved in theatre operations. Many of the surgical registrars and obstetrics registrars return to spend time at the hospital,” Katrina said.
The hospital is fortunate to have a very local workforce, and Katrina said that around 75 percent grew up in the region, while many others have moved to Mildura and have now been here for some time.
The average age of theatre nurses is about 55, but the hospital is now seeing a trend towards younger graduates because they want to live in Mildura and become theatre nurses – something they have the opportunity to achieve at MBH.
Nurses make up the largest group within Katrina’s department, and are broken into different roles within the wards.
Katrina is particularly proud of her staff, many of whom haven’t come from highly educated backgrounds, but are people keen to learn.
She said that every one of them has gained some specific qualifications, with many continuing to undertake further study.
“We are really passionate about our patients leaving here improved, that’s what we are here for,” Katrina said. “We are locals looking after locals, we work really hard and the reason we all keep turning up is because we all love it.”