New chief eyes holistic healthcare reforms

Newly appointed chief executive Neil Clark has outlined a comprehensive vision to overhaul healthcare delivery at the Queen Elizabeth Hospital. 

Clark, a seasoned healthcare executive who took up his post on April 2, laid out plans to address pressing issues and ensure “citizens receive the quality care they deserve”.

A key priority is improving the long-troubled accident and emergency (A&E) department, which Clark acknowledged had been blighted by overcrowding before its recent expansion. “It was very cramped, very tight. It didn’t look good. It didn’t feel good. Too many patients waiting, family members with them,” he said. “Working in that department must [have been] extremely stressful for the staff.”

But Clark insisted enlarging A&E alone would not solve the systemic problems. “It’s not just about having the A&E department the right size. What happens in the A&E is a consequence of a whole system, a whole healthcare system.”  

The CEO said he intends to work with polyclinics, private clinics and the Ministry of Health to educate the public and reduce unnecessary A&E visits. “A&E departments are for accidents and emergencies. Not all the patients in the A&E department are accidents or emergencies,” he said. “Some of those emergencies could have been avoided … people’s strokes, people’s heart attacks, and people’s chronic conditions could be managed better, stop them coming into the hospital when they’re acutely ill.”

Clark outlined a “holistic approach” to improving patient flow from admission to discharge, calling for coordinated efforts across departments like pathology and radiology to optimise operational efficiency. He also plans to review procedures for dealing with escalating A&E demand.

Lengthy waiting times for outpatient appointments and diagnostics are another “challenge”, Clark said, citing a lack of centralised data collection. But he revealed a new health information system will be implemented later this year to identify and address bottlenecks.

“We don’t have a health information system, so it’s quite hard sometimes to capture information on the waiting times,” he said. “We should be going out for tender for that system this summer, so we can bring in a system that will help us then gather the information to make sure that we’re very clear on where the pain points are.”

Clark also plans to closely scrutinise the functioning of the hospital’s wards to ease bottlenecks preventing patients from being transferred out of A&E.

“If the A&E department’s full because it can’t move patients from the department onto a ward, upstairs into the medical beds, we need to make sure that the wards are functioning as efficiently and as effectively as possible,” he said.

“So we’ve already started some work with the medical leads and how we can maybe manage the medical beds slightly differently to improve flow through those inpatient beds.”

At the other end of the care pathway, Clark said he must collaborate with external parties to ensure discharged patients have appropriate places to go, highlighting the need for “where will the elderly for care patients go and what are the different options”.

To drive these ambitious reforms, the new CEO has introduced “balanced scorecards” to identify top priorities and risks. He has also tasked the chief operating officer with developing “plans for how we’re going to tackle some of those areas” including outpatient waits, theatre delays and cancellations, and A&E waiting times.

Clark insisted data analysis would be central, saying: “I’ve already requested and redirected the chief operating officer to focus on what I call patient flow, how patients flow through the system and quality outcomes.”

The CEO, who has hit the ground running just weeks into his tenure, projected confidence that the QEH can turn around its fortunes despite long-standing issues.

“As a team of people, we can find solutions to this and I’ve seen that done in different places before,” Clark affirmed. 

(RG)