NHPPD Annual Report July 2011 - June 2012

Nursing Hours per Patient Day Annual Report
1st July 2011 30th June 2012
Content
1. Introduction 2. Executive Summary 3. Results Metropolitan and Regional data Small County Hospital (SCH) 6 15 2 4
4. Emergency Department Metropolitan Emergency Departments Regional Emergency Department Small Country Hospitals Emergency Departments 20 22 23 25 25 29
5. Current and future workload developments 6. Current Recruitment and attraction strategies 7. Benchmarks classifications and reclassifications 8. Appendices Metropolitan and Regional ward NHpPD inpatient data Small Country Hospitals inpatient NHpPD data Legend of tables NHpPD variance reports from health sites
31 37 40 42
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Introduction
This report is prepared by the Western Australian Department of Health (WA DoH) as part of its ongoing commitment to maintaining a comprehensive workload management process for nurses. This report also wishes to inform the nursing and management staff of the current workload of nursing and midwifery staff within our public health care system. In consultation with the Minister for Health, the DoH is committed to the ongoing implementation and monitoring of the Nursing Hours per Patient Day (NHpPD) model. This report is consistent with the Departments continued application of NHpPD principles as required by and in accordance with the Registered Nurses, Midwives and Enrolled Mental Health Nurses, Australian Nursing Federation WA Industrial Agreement 2010 Part 2, clause 9 and the WA Health LHMU-Enrolled Nurses and Assistant in Nursing Industrial, Aboriginal and Ethnic Health Workers Agreement 2011. The data provided in the 22nd report is for the period 1st July 2011 to the 30th June 2012 (unless otherwise stated). The report represents NHpPD data from the following clinical areas: Metropolitan Inpatient Area Regional Inpatient Areas at : Albany Regional Hospital; Broome Regional Hospital; Bunbury Regional Hospital; Geraldton Regional Hospital; Kalgoorlie Regional Hospital and Port Hedland Regional Hospital Small Country Hospital Inpatient Areas Metropolitan Emergency Departments Regional Emergency Departments Small Country Hospital Emergency Departments -which are contained within a ward. All reported inpatient data is provided by hospitals and health services through the Nursing Workload Monitoring System. The data source for all metropolitan Emergency Department is the Emergency Department Data Collection (EDDC) provided by the Activity & Quality Division at the Department of Health WA.
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Abbreviations used throughout the document:
Abbreviation AMHS DoH EDDC FTE GNC HDU KEMH NHpPD NHpPP NMBA NSU OPH OAMH PMH RGH RPH PHRH SCGH SKHS YTD
Description Adult Mental Health Service Department of Health Emergency Department Data Collection Full Time Equivalent Graduate Nurse Connect High Dependency Unit King Edward Memorial Hospital Nursing Hours per Patient Day Nursing Hours per Patient Presentation Nurses and Midwifery Board Australia Nurse Special Unit Osborne Park Hospital Older Adult Mental Health Princess Margaret Hospital Rockingham General Hospital Royal Perth Hospital Port Hedland Regional Hospital Sir Charles Gairdner Hospital Swan Kalamunda Health Service Year to Date
of
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Executive Summary 86 Hospitals / health care facilities with 217 clinical areas across the state of Western Australia (WA) have provided NHpPD data for the period 1st July 2011 30th June 2012 Princess Margaret Hospital (PMH) were unable to provide data for their site due to difficulties they have experienced with NWMS Overall of the (217) reported Clinical areas, 194 (89.4%) were on or above target.
Table 1: Shows comparison of NHpPD data from 2009 - 2012 2011/2012 Annual Report 1st July 201130th June 2012 Number of Wards Above 10% Above 5-10% Above 0-5% Below 0-5% Below 5-10% Below 10% or more Above or on target Below Target On, Above or Less than 10% Below
# PMH
2010/2011 Annual Report 1st July 2010 30th June 2011 #214
2009/2010 Annual Report 1stJuly 2009 30th June 2010 * 232
217
92 (44.2%) 15 (6.9%) 37(17%) 35(16.1%) 15(6.9%) 23(10.5%)
99 (46.2%) 23 (10.7%) 30 (14%) 37 (17.2%) 10 (4.6%) 15 (7%)
105 (45.26%) 28 (12.07%) 32 (13.79%) 31 (13.36%) 19 (8.19%) 17 (7.33%)
144(66.3%)
152 (71%)
165 (71.12%)
73(33.6) 194(89.4%)
62 (28.9%) 199 (92.9%)
67 (28.88%) 215 (92.67%)
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Graph 1: Represents comparison NHpPD data 2009/10 2011/12 annual reports
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Metropolitan & Regional Inpatient Data All reported inpatient data for metropolitan and regional sites are provided in Appendix 1. This section provides ward inpatient data for metropolitan tertiary, metropolitan secondary and regional sites. Regional sites include Albany, Broome, Bunbury, Geraldton, Port Hedland and Kalgoorlie Hospitals. 146 Regional and metropolitan wards provided data for this report. Information on these sites are categorised within the following tables: Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Wards that are 0 5% above set NHpPD targets Wards that are 5 10% above set NHpPD targets Wards that are 10% or more above set NHpPD targets Wards that are 0 5% below set NHpPD targets Wards that are 5 10% below set NHpPD targets Wards that are 10% or more below set NHppD targets
Table 2: Metropolitan & Regional Inpatient Wards that are on or 0 5% above set NHpPD targets 21.7% (n=32) of inpatient areas were on or 0 5% above set NHpPD targets.
Ward
Category C B A+ (FHHS) D HDU B D C C B B C&D (Albany) Satellite Dialysis A+ (GSL Smith) ICU
Target 5.75 6 11.2 5 12 6 5 5.75 5.75 6 6 5.5
YTD 5.75 6.02 11.25 5.03 0.03 12.06 6.04 5.04 5.79 5.83 6.08 6.09 5.61 0.04 0.08 0.08 0.09 0.06 0.04 0.04 Variance 0.00 0.02 0.05
% variance 0.02 0.31 0.41 0.51 0.52 0.61 0.73 0.73 1.34 1.35 1.48
Site RPH RPH Fremantle Hospital Osborne Park Hospital Albany Regional Hospital RPH Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital RPH RPH SCGH Albany Regional Hospital Hedland Health Campus Area Mental Health Service Fremantle Hospital
Ward 8 SPC Ward 8A Ward 4.1 (MH) Ward 4 Aged Care & Rehab High Dependency Unit Ward 5E Paediatrics Ward D Surgical Ward 4A (SSSU) Ward 1 SPC Ward G61 CAMS Ward C Paediatric /Medical /Surgical Dialysis unit Smith Units Intensive Care Unit
0.11
2.18 8.66 31.6
1.92 1.99 2.03 2.03
2.22 0.04 8.84 0.18 32.24 0.64
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Ward
Category B (Selby A)
Target 6.41
YTD Variance 6.54
% variance
Site Older Adult Mental Health Program (North Metro) Osborne Park Hospital SCGH SCGH Osborne Park Hospital Albany Regional Hospital KEMH Area Mental Health Service RPH SCGH RPH RPH Bunbury Regional Hospital Fremantle Hospital Fremantle Hospital RPH Osborne Park Hospital
Selby A (Blue Wing)
0.13 Ward 3 Aged Care & Rehab Ward G62 H & L Ward C 16 CAMS Ward 5 Aged Care & Rehab Ward A Surgical Obstetrics Ward 5 Ward D 20 Phy Unit Ward 9 SPC Ward G64 Neuro Ward 7B/3k (GEM Unit) Ward 4F Surgical Ward B8S Ward B7S Ward 6A Maternity
D A B D+ (OPH) C B C B A D B C B B B D+Del (Osb Park) 5 7.5 6 5.33 5.75 6 5.75 6 7.5 5 6 5.75 6 6 6 8.97
2.08 2.11 2.34 2.46 2.59 2.67 2.69 3.06 3.25 3.27 3.54 3.79 4.13 4.36 4.52 4.79 4.84
5.11 7.68 6.15 5.47 0.14 5.90 0.15 6.16 0.16 5.93 0.18 6.19 7.75 5.18 6.23 5.99 6.26 0.26 6.27 6.29 9.40 0.27 0.29 0.43 0.19 0.25 0.18 0.23 0.24 0.11 0.18 0.15
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Table 3: Metropolitan & Regional Inpatient Wards that are on or 5 10% above set NHpPD target. 8.8% (n=13) of inpatient areas were on or 5 10% above set NHpPD targets.
Ward Category HDU Satellite Dialysis B (Selby B) Target 12 2.18 6.41
YTD Variance 12.64 0.64 2.30 0.12 6.82
% variance
Site Bunbury Regional Hospital Kalgoorlie Regional Hospital Older Adult Mental Health Program (North Metro) RPH Osborne Park Hospital Area Mental Health Service Swan Districts Hospital Bentley Hospital Armadale Hospital Bunbury Regional Hospital RPH SCGH SCGH Coronary Care Unit High Dependency Unit Dialysis Unit Selby B (Lemon & Gray Wing)
5.32 5.56
Ward 9C Ward 6 Surgical Banksia Swan Valley Centre (Acute/Secure) Ward 4 Rehabilitation Carl Streich Rehab & Aged Care Paediatrics Coronary Care Unit Ward G72 CAMS
B C B+ (Graylands) A+D (Swan Valley Centre) D D
6 5.75 6.49 6.87
6.40 6.14 6.93
0.41 0.40 0.39 0.44
6.32 6.63 6.73 6.84
7.34 0.47 6.91 7.57
5 5
5.38 0.38 5.41 0.41 8.17 8.47 8.90 8.91 9.58
B CCU B+ (SCGH G72) CCU
6 14.16 6.8 14.16
6.51 0.51 15.42 1.26 7.41 0.61 15.52 1.36
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Table 4: Metropolitan & Regional Inpatient Wards greater than 10% above set NHpPD target.
34% (n=50) of inpatient areas were greater than 10% above set NHpPD targets
Ward Category B B B C D+Deliv (Albany) D+Del (Rockingham) B+ A,B,C (Kalgoorlie) C/D+(Swan) D+Del (Geraldton) B E (Murch) B B B B B+(Pibara) D+ (KH) Target 6 6 6 5.75 8.19 7.61
YTD Variance 6.61 6.64 6.65 6.38 0.63 0.61 0.64 0.65
% variance
Site Fremantle Hospital RPH Fremantle Hospital Fremantle Hospital Albany Regional Hospital Rockingham Hospital SCGH Kalgoorlie Regional Hospital Swan Districts Hospital Geraldton Regional Hospital Swan Districts Hospital Area Mental Health Service Fremantle Hospital Fremantle Hospital SCGH KEMH Hedland Health Campus Kalamunda Hospital Fremantle Hospital Older Adult Mental Health Program (North Metro) Older Adult Mental Health Program (North Metro)
Ward B9N Ward 9B Ward B7N Ward V6 Ward B Maternity Obstetrics
10.09 10.62 10.78 10.94 11.24
9.11 0.92 8.48 0.87 0.79 11.45 12.09
Ward G41 H & L Mental Health
6.5 7.71
7.29 8.71
1.00 Restorative/Stroke Unit Maternity

6.15 8.55
13.01 13.87
7.00 0.85 9.81 1.26 14.72 15.16 15.31 15.38 15.62 15.68 17.14 17.32
West Wing (Medical) Murchison House Ward B9S Ward 4.3 (MH) Ward G66 Neuro Gynaecology Ward 6 Med/Surg/ HDU ( Vickers) Anderton (Med/Surg/Palliative Care) Kaleeya Maternity Unit Selby Red Wing (Graylands)
6 4.74 6 6 6 6 6.37 5.47
6.91 0.91 5.47 0.73 6.92 0.92 6.94 6.94 7.03 7.47 1.10 6.44 0.97 17.80 18.32 0.94 0.94 1.03
D+Del (FHHS) B+(OAMHP)
8.35 7.13
9.88 1.53 8.44
1.31 Psychiatric Intensive Care Unit (PICU)

A+ (PICU) 8.15
18.34
9.65
1.50
18.43
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Ward
Category D D A+ (Acacia) C (SKHS) E (Hutch) A+ (Casson) C C C Satellite Dialysis D C D B C C B
Target 5 5 11.81 5.75 4.56 8.51 5.75 5.75 5.75 2.18
YTD Variance 5.93 0.93 5.96 0.96
% variance
Site SCGH Fremantle Hospital Area Mental Health Service Swan Districts Hospital Area Mental Health Service Area Mental Health Service RPH Armadale Hospital Fremantle Hospital Geraldton Regional Hospital Bentley Hospital Rockingham Hospital Bentley Hospital Swan Districts Hospital Rockingham Hospital RPH Armadale Hospital Gairdner Rehabilitation Unit Restorative Unit Acacia East Wing (Surgical) Hutchison Unit Casson Ward 2 SPC Colyer Surgical Ward F6 Dialysis Unit
18.67 19.23 19.25 19.99 20.85 22.72 23.05 23.44 24.37
14.08 2.27 6.90 1.15 5.51 0.95 10.44 7.08 7.10 7.15 1.40 2.76 0.58 26.63 27.40 27.47 29.64 32.16 32.32 39.82 1.93 1.33 1.35
Ward 3 Medical/ Surgical Medical Geriatrics Unit Maternity, Nursery & Birthing Suite Surgical Acute Admissions Unit (AAU) Banksia_MHS for Older People Inpatients Secure Unit Ward 6
5 5.75 5 6 5.75 5.75 6
6.37 1.37 7.33 6.48 7.93 7.61 1.86 8.04 2.29 8.46 2.46 40.94 1.58 1.48 1.93
Bentley Hospital Bunbury Regional Hospital Armadale Hospital Bentley Hospital Fremantle Hospital Rockingham Hospital Area Mental Health Service
A+Misc (Bentley SU) C+ (BMH)
8.5
12.09 3.59 42.22
Mental Health
6.16
8.93 2.77 45.01
Leschen_Adult Mental Health Inpatients Ward 2 Maternity Coronary Care Unit Older Adult Evaluation & Rehabilitation Unit Yvonne Pinch
7.5
10.94 3.44 45.83 55.92 65.46
D+Del (Bentley) CCU D
6.86 14.16 5
10.70 3.84 23.43 9.27 8.39 3.39 67.87 68.30
A+ (GSL Pinch)
14.72
24.77 10.05
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Ward
Category B D+Del (Hedland) B A D
Target 6 6.43 6 7.5 5
YTD Variance 10.59 4.59
% variance
Site Fremantle Hospital Hedland Health Campus Armadale Hospital Fremantle Hospital Hedland Health Campus
Ward D4 Maternity / SCN Campbell Pediatrics Cardiothoracic Surgery Paediatric
76.53 81.04 87.31 117.72 137.82
11.64 5.21 11.24 5.24 16.33 8.83 11.89 6.89
Table 5: Metropolitan & Regional Wards that are 0 5% below set NHpPD targets. 18% (n=27) of inpatient areas were 0 5% below set NHpPD targets.
Ward Category B B+ (Graylands) E (Plast) B ICU C Target 6 6.49 4.5 6 31.6 5.75
YTD 5.71 6.23 4.33 -0.17 Variance -0.29 -0.26
% variance -4.87 -4.02 -3.68 -3.61 -3.58
Site RPH Area Mental Health Service Area Mental Health Service Fremantle Hospital RPH Older Adult Mental Health Program (North Metro) Bentley Hospital Bunbury Regional Hospital Fremantle Hospital Bentley Hospital KEMH SCGH RPH SCGH Armadale Hospital SCGH Area Mental Health Service Albany Regional Hospital
Ward 5G Caesia Plaistowe Unit Ward 4.2 (MH) Intensive Care Unit Osborne Older Adult
5.78 -0.22 30.47 -1.13 5.56
-0.19 Adult Acute Ward 7 Maternity

B D+Del (Bunbury) B B B B B B (Ortho) B B A+ (GSL Dorrington) D 6 8.3
-3.36 -3.31
5.80 -0.20 8.04 -0.26 -3.18 -2.96 -2.66 -2.44 -2.34 -2.27 -2.20 -1.69 -1.66 -1.19 -0.90
Ward 5.1 (MH) Adult Acute Ward 8 Obstetrics Ward 4 Ward G73 Cancer Ward 9A Ward G53 Neuro Benson Medical Ward G51 Neuro Dorrington Ward E Medical / General
6 6 6 6 6 6.5 6 6 8.66 5
5.82 -0.18 5.84 -0.16 5.85 -0.15 5.86 5.86 6.36 5.90 5.90 8.56 4.95 -0.05 -0.14 -0.14 -0.14 -0.10 -0.10 -0.10
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Ward
Category A+ (GSL Montgomery) B A D+Del (Kalgoorlie) A&C (Albany) No BM (SKHS) A+ (PICU Bunbury)
Target 8.66
YTD Variance 8.58 -0.08
% variance
Site Montgomery Unit Area Mental Health Service SCGH SCGH Kalgoorlie Regional Hospital Albany Regional Hospital Swan Districts Hospital Bunbury Regional Hospital RPH KEMH Ward G63 Gast/Renal Ward G54 H&L Ward C Maternity
-0.87 -0.83 -0.79
6 7.5 8.07
5.95 7.44 8.01 -0.05 -0.06
-0.06 Ward G Mental Health Paediatric Ward PICU (Psychiatric Intensive Care Unit) Ward 7A Obstetrics Ward 3
6.28 6 12
-0.77 -0.74 -0.68
6.23 -0.05 5.96 -0.04 11.92
B B
6 6
5.99 5.99
-0.08 -0.01 -0.01
-0.67 -0.23 -0.11
Table 6: Metropolitan & Regional Wards that are 5 - 10% below set NHpPD targets. 8% (n=12) of inpatient areas were 5 10% below set NHpPD targets.
Ward Category B B B+HDU (SCGH G52) A B+ A C Target 6 6 9.51
YTD 5.45 5.52 8.77 6.93 -0.57 Variance -0.55 -0.48 -0.74
% variance -9.10 -8.04 -7.74 -7.60 -7.36 -7.34
Site RPH RPH SCGH SCGH SCGH Area Mental Health Service Older Adult Mental Health Program (North Metro) RPH Bunbury Regional Hospital Kalgoorlie Regional Hospital RPH SCGH
Ward 5B Ward 5F/7B Ward G52 Neuro Ward G74 Gast/Renal Ward G71 Cancer Ellis Ward Swan Older Adult
7.5 6.5 7.5 5.75
6.02 -0.48 6.95 -0.55 5.36
Ward 6H Medical Ward B Medical Ward 5A Intensive Care Unit
B C C B ICU
6 5.75 5.75 6 31.6
5.60 5.38 5.39 5.64 29.90
-0.39 -0.40 -0.37 -0.36 -0.36 -1.70
-6.75 -6.66 -6.52 -6.28 -6.05 -5.38
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Table 7: Metropolitan & Regional Wards that are 10% or more below set NHpPD targets. 8.8% (n= 13) of inpatient areas were 10% or more below set NHpPD targets
Ward
Category D+Del(Armadale) HDU
Target 7.02 12
YTD Variance 3.46 -3.56 9.20 -2.80 -1.62 -1.49
% variance
Site Armadale Hospital Geraldton Regional Hospital RPH RPH Kalgoorlie Regional Hospital RPH RPH RPH Geraldton Regional Hospital Albany Regional Hospital Broome Regional Hospital RPH RPH Maude Bellas Maternity High Dependency Unit BMTU Ward 6G High Dependency Unit Ward 5H Ward 2K Ward 10 SPC Hospital Ward
-50.71
A A HDU
7.5 7.5 12
5.88 6.01 9.92
-23.32 -21.66 -19.86
A B C C
7.5 6 5.75 5.75
6.39 5.16 4.96 5.00
-2.08 -1.11 -0.84 -0.79
-17.31 -14.80 -13.97 -13.78
-0.75 Dialysis Unit

Satellite Dialysis 2.18
-13.05
1.91 -0.27 -12.30
General / Maternity Ward 11 SPC Ward 10AB
C+D+Del(Broome)
5.98
5.29 -0.69 -0.81 -0.61 -11.47 -10.78 -10.08
A B
7.5 6
6.69 5.39
Small Country Hospitals (SCH) data For this report period 70 inpatient areas provided data. Reporting indicates that 90% (n=63) of reported country small offices were on, above or less than 10% below set NHpPD targets. All reported CSH ward inpatient data is provided in Appendix 2. The reports are categorised into the following tables: Table 8 Table 9 Table 10 Table 11 Table 12 Table 13 SCH that are on or 0 5% above set NHpPD targets. SCH that are on or 5 10% above set NHpPD targets. SCH that are on or 10% or more above set NHpPD targets. SCH that are 0 5% below set NHpPD targets. SCH that are 5 10% below set NHpPD targets. SCH that 10%or more below set NHpPD targets.
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Table 8: Small Country Hospital that are on or 0 5% above set NHpPD targets 7% (n=5) of SCH inpatient areas were on or 0 - 5 % above set NHpPD targets
Ward Category E+Del (Denmark) E E+Del (Northam) D+Del (Busselton) E+F (Nth Midlands) Target 4.56
YTD Variance % variance 4.56 0.00 0.11 0.89 1.23
Site Denmark District Hospital Dongara District Hospital Northam Regional Hospital Busselton District Hospital North Midlands (Three Springs) Hospital General / Maternity General / Aged Care General / Maternity General / Maternity General / Aged Care
4.5 4.73 5.26
4.54 0.04 4.79 0.06 5.38 0.12 2.23
4.23
4.39 0.16 3.76
Table 9: Small Country Hospital that are on or 5 - 10% above set NHpPD targets 2.8% (n=2) of SH inpatient areas were on or 5 - 10 % above set NHpPD targets
Ward Category E+F (Kununoppin) E+F (Bruce Rock) Target 4.21
YTD Variance % variance 4.45 0.24 5.75
Site Kununoppin District Hospital Bruce Rock District Hospital General / Aged Care General / Aged Care
4.13
4.49 0.36 8.72
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Table10: Small Country Hospital that are 10%or more above set NHpPD targets
60%(n=42) of SCH inpatient areas were 10% or above set NHpPD targets
Ward Category D E+F+Del (Bridgetown) D+Del(Narrogi n) Target 5 4.65
YTD Variance % variance 13.46 5.67 0.67 5.44 0.79 16.89
Site Kojonup District Hospital General General/ Aged Care / Maternity Combined Ward: Gen/ Mat/ Paed/ Surg General/ Aged Care General / Aged Care General General / Aged Care General / Aged Care General / Aged Care General / Maternity General / Aged Care General / Maternity General/Aged Care/Maternity General / Aged Care General / Maternity General / Aged Care General / Aged Care General / Aged Care General / Aged Care General / Aged Care
Bridgetown Hospital
5.16
6.04
Narrogin Regional Hospital Wagin District Hospital Cunderdin District Hospital Fitzroy Crossing District Hospital Exmouth District Hospital York District Hospital Quairading District Hospital Margaret River District Hospital Wyalkatchem District Hospital Nickol Bay District Hospital Warren District Hospital Donnybrook District Hospital Murray Districts Hospital Leonora District Hospital Boyup Brook Hospital Dalwallinu District Hospital Narembeen District Hospital Dumbleyung District Hospital
0.88
E+F (Wagin) E+F (Cunderdin) E E (Exmouth) E+F (York) E+F (Quairading) E+Del (Margaret River) E+F (Wyalkatchem ) D+Del (Nickol Bay) E+Del (Warren) E+F (Donnybrook) E+Del (Murray) E+F (Leonora) E+F (Boyup Brook) E+F (Dalwallinu) E+F (Narembeen) E+F (Dumbleyung) 4.18 4.07 4.5 4.5 4.18 4.14 4.72
17.10 17.34 17.55 17.58 17.99 26.05 28.65
4.90 0.72 4.78 0.71 5.29 0.79 5.31 0.81 5.27 1.09 5.33 1.19 6.16 1.44 30.58
4.25
5.62 1.37 32.30 32.48 38.39 39.93 41.33 41.94 42.66 46.46
5.8 4.71 4.54 4.69 4.33 4.37 4.13 4.11
7.68 1.88 6.52 1.81 6.35 1.81 6.63 1.94 6.15 1.82 6.23 1.86 6.05 1.92 6.26 2.15 52.22 56.22
4.04
6.31 2.27
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Ward
Category E+F (Boddington) E+F (Merredin) E+F (Ravensthorpe ) E+F (Pemberton) E+F (Norseman) E+F (Nannup)
Target 4.14 4.23
YTD Variance % variance 56.90 6.50 2.36 6.66 2.43 57.56
Site Boddongton District Hospital Merredin District Hospital Ravensthorpe District Hospital Pemberton District Hospital Norseman District Hospital Nannup District Hospital Kondinin District Hospital Wyndham Corrigin District Hospital Kellerberrin District Hospital Newman District Hospital Lake Grace District Hospital Beverley District Hospital Wongan Hills District Hospital Southern Cross District Hospital Tom Price District Hospital Onslow District Hospital Laverton District Hospital Pingelly District Hospital Roebourne District Hospital General Parburdoo
E 4.5
General / Aged Care General
General / Aged Care General /Aged Care General / Aged Care General / Aged Care General / Aged Care General General / Aged Care General / Aged Care General
4.23
6.81 2.58 61.07 64.85 68.68
4.46 4.28 4.01
7.35 2.89 7.22 2.94 6.98 2.97 74.16 95.98 115.12
E+F (Kondinin) E E+F (Corrigin)
4.19 4.5 4.11
8.21 4.02 9.68 5.18 9.26 5.15 125.39 138.75
E+F (Kellerberrin) D
4.3 5
10.27 5.97 13.09 8.09 161.89 175.11
General / Aged Care General / Aged Care General / Aged Care General / Aged Care General / Extended Care General / Aged Care General/aged care General / Aged Care General
E+F (Lake Grace) E+F (Beverley) E+F (Wongan Hills) E+F (Southern Cross) E
4.16 4.19
11.44 7.28 11.60 7.41 176.80
4.17
11.75 7.58 181.79 187.29
4.19 4.5
12.04 7.85 19.26 14.76 327.93 385.48 470.09 475.30
E E+F (Pingley) E+F (Pingelly) E
4.5 4.47 4.14 4.5
21.85 17.35 25.48 21.01 23.82 19.68 39.70 35.20 57.45 52.95 1176.56 782.11
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Ward
Category E
Target 4.5
YTD Variance % variance 1320.81 63.94 59.44
Site Kalbarri District Hospital General / Aged Care
Table 11: Small Country Hospital that are 0 5% below set NHpPD targets. 11% (n=8) of SCH inpatient areas were 0 5% below set NHpPD targets
Ward Category E+D+Del (Carnarvon) E+F (Northampton) E+F (Moora) E D+Del (Derby) E+F (Harvey) E+Del (Collie) E Target 5.2
YTD Variance % variance 4.99 -0.21 -4.13
Site Combined Acute Wards Carnarvon Hospital Northampton District Hospital Moora District Hospital Mullewa District Hospital Derby Regional Hospital Harvey District Hospital Collie District Hospital Halls Creek District Hospital General / Aged Care General / Aged Care General / Aged Care General/Mater nity/Paeds General / Aged Care General / Maternity General
4.17
4.00 -0.17 -4.12 -3.49 -1.49 -1.27 -0.71 -0.39 -0.33
4.3 4.5 5.34 4.54 4.72 4.5
4.15 -0.15 4.43 -0.07 5.27 -0.07 4.51 -0.03 4.70 -0.02 4.49 -0.01
Table 12:
Small Country Hospital that are 5 10% below set NHpPD targets.
4% (n=3) of SCH inpatient areas were 5 10% below set NHpPD targets
Ward Category E+Del (Katanning) E+Del (Esperance) E Target 4.94
YTD Variance % variance 4.52 -0.42 -8.42
Site Katanning District Hospital Esperance District Hospital Gnowangerup District Hospital Combined General & Maternity General / Maternity General / Aged Care
4.88
4.49 -0.39 -8.04 -5.51
4.5
4.25 -0.25
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Table 13: Small Country Hospital that 10%or more below set NHpPD targets. 14% (n=10) of SCH inpatient areas are 10% or more below NHpPD targets
Ward Category F F Target 4 4
YTD Variance % variance -71.10 1.16 -2.84 1.25 -2.75 -68.73 -68.14 -56.27
Site Katanning District Hospital Plantagenet District Hospital Mt Barker Carnarvon Hospital Merredin District Hospital Plantagenet District Hospital Mt Barker Meekatharra District Hospital Morawa District Hospital Kununurra District Hospital Augusta District Hospital Goomalling District Hospital Permanent Care Unit Aged Care General / Maternity General / Aged Care General / Aged Care General/ Maternity General / Aged Care General / Aged Care
F F E+Del (Plantagenet) E+F (Meekathara) E+F (Morawa) D+Del(Kununu rra) E+F (Augusta) E+F (Goomaling) 4 4 4.68
Kerry Lodge Lodge
1.27 -2.73 1.75 -2.25 2.59 -2.09 -44.62
4.43
3.17 -1.26 -28.54 -19.65 -18.19 -15.74
4.34 5.32 4.39 4.1
3.49 -0.85 4.35 -0.97 3.70 -0.69 3.62 -0.48 -11.63
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Table 14: Metropolitan Emergency Department Activity 16.6% (n=1) site reported they where between 5 - 10% below set NHpPD target 83.3% (n=5) sites reported they where greater than 10% below set NHpPD target
Sir Charles Gairdner Hospital
Attendances by triage category NTS 1 NTS 2 NTS 3 NTS 4 NTS 5 total Average occupancy
Swan District Hospital
Royal Perth Hospital
Fremantle Hospital
Armadale Kelmscott Hospital
Rockingham General Hospital
Princess Margaret Hospital
318 3643 6914 4264 368 15507
123 1887 4157 4326 588 11081
482 3414 7060 7291 1238 19485
134 2103 4297 5435 1809 13778
80 1958 5688 6624 632 14982
64 1544 4847 6293 279 13027
108 698 4875 13364 122 19167
18.26
3.05
16.33
15.74
3.06
0.99
4.09
Obs ward NHpPD Nsg FTE for Obs ward Nsg FTE for ED Additional shift coordinator FTE Sum FTE for cover Leave FTE (based on 22.35% factor) Sum FTE required for establishment
*6.00
6.00
6.00
6.00
6.00
6.00
6.00
20.18 72.28 4.57 118.71
3.37 52.15 4.57 63.81
18.05 100.53 4.57 123.00
17.40 74.56 4.57 91.23
3.38 63.41 4.57 77.58
1.09 49.06 4.57 60.03
4.52 65.14 4.57 79.70
21.69
11.66
22.47
16.67
14.17
10.97
14.56
118.71
63.81
123.00
91.23
77.58
60.03
79.70
Actual NH reported on the NWMS Actual FTE Variance FTE %
208921 105.72 - 10.9%
118002 59.71 -6.4%
209201 105.87 -13.9%
149039 75.42 -17.3%
120871 61.16 -21.2%
86811.5 43.93 -26.8%
NHpPD for Obs ward has been increased from 5.75 to 6.0 to allow for the impact of the 4 hour rule
- 19 -
- 20 -
Regional Emergency Department Regional Emergency Departments (6 units) provided data from 1st July 2011- 30th June 2012. Table 15: Provides an overview of the large regional emergency department activity against actual and projected NHpPD. Reporting indicates that during this period: (n=2) sites reported they were on or above their set NHpPD (n=1) site reported they were between 0 10% below their set NHpPD (n=3) sites reported they where greater than 10% below their set NHpPD
Table 15: Regional Emergency Department Data

Hedland Health Campus Total Triage presentations OBD obs Total Target hours Actual NH Actual FTE Target FTE Variance 21276 1382 29706.3 27529.63 13.93 15.03 -1.10 Bunbury 35843 984 53749.9 55048.9 27.86 27.20 0.66 Kalgoorlie 27300 295 34674.5 29103.4 14.73 17.55 -2.82 32550.3 30666.24 15.52 16.47 -0.95 Albany 24504 Geraldton 29388 542 42901.1 30106.9 15.24 21.71 -6.47 Broome 20683 264 27494 29365.05 14.86 13.91 0.95
- 21 -
Small Country Hospital Emergency Department within a ward

Information provided on Small Country Hospitals Emergency Departments within a ward reflects presentations and activity only. Current models do not take into account adjusted benchmarks to consider both inpatient and emergency department nursing hours required. Table 16: Small Country Hospital Emergency Department within a ward Activity.
Site L1
Augusta District Hospital Beverley District Hospital Boddington District Hospital Boyup Brook Hospital Upper Blackwood Bridgetown District Hospital Bruce Rock District Hospital Busselton District Hospital Carnarvon Hospital Collie District Hospital Corrigin District Hospital Cunderdin District Hospital Dalwallinu District Hospital Denmark District Hospital Derby Regional Hospital Donnybrook District Hospital Dumbleyung District Hospital Esperance District Hospital Exmouth District Hospital Fitzroy Crossing District Hospital Geraldton Regional Hospital Gnowangerup District Hospital Goomalling District Hospital Halls Creek District Hospital Harvey District Hospital Katanning District Hospital Kellerberrin District Hospital Kojonup District Hospital Kondinin District Hospital Kununoppin District Hospital Kununurra District Hospital Lake Grace District Hospital Laverton District Hospital Leonora District Hospital Margaret River District Hospital Merredin District Hospital Moora District Hospital Nannup District Hospital Narembeen District Hospital Narrogin Regional Hospital Newman District Hospital
2 14 6 3 6 2 48 26 29 1 2 0 21 27 7 0 28 6 17 131 2 6 19 25 24 0 3 5 2 19 2 3 9 7 14 10 2 1 64 13
L2 61 63 69 40 217 19 1181 312 285 26 24 60 252 401 195 16 641 137 131 2572 82 41 298 234 846 25 167 30 34 383 49 45 64 309 192 105 28 36 906 312
L3 244 186 366 124 649 74 4441 1205 936 147 69 309 814 1733 633 41 3464 482 682 10551 248 221 1753 717 1375 154 266 149 126 2175 125 172 285 1352 784 508 132 132 3298 1460
L4 418 161 727 325 2582 137 9322 3049 2835 290 125 643 1243 5372 865 155 9840 1932 1377 13748 323 437 3218 991 1680 635 299 353 177 5359 267 587 1307 3066 1733 972 423 266 3550 4309
L5 134 136 371 189 572 87 2254 3316 1839 136 231 284 788 4099 555 153 1670 3569 1375 2386 117 173 1722 291 1579 358 252 302 160 4665 232 2911 2481 499 725 388 194 94 1404 1979
Total 859 560 1539 681 4026 319 17246 7908 5924 600 451 1296 3118 11632 2255 365 15643 6126 3582 29388 772 878 7010 2258 5504 1172 987 839 499 12601 675 3718 4146 5233 3448 1983 779 529 9222 8073
- 22 -
Site
Nickol Bay District Hospital Norseman District Hospital Northam Regional Hospital Onslow District Hospital Pemberton District Hospital Pingelly District Hospital Plantagenet District Hospital Mt Barker Quairading District Hospital Ravensthorpe District Hospital Roebourne District Hospital Southern Cross District Hospital Tom Price District Hospital Wagin District Hospital Warren District Hospital Wongan Hills District Hospital Wyalkatchem District Hospital Wyndham York District Hospital
L1 34 2 23 1 9 2 9 1 6 9 3 11 10 21 3 4 2 10
L2 1115 106 640 102 88 95 301 80 54 167 72 231 112 213 42 55 89 104
L3 4251 322 2969 361 302 255 873 216 273 621 230 682 409 1013 177 202 570 405
L4 10695 619 5823 1154 958 234 1486 432 632 1153 424 1799 481 3440 366 366 2145 603
L5 3759 1882 773 929 488 315 862 200 1548 1444 128 785 308 2557 318 198 1254 203
Total 19854 2931 10228 2547 1845 901 3531 929 2513 3394 857 3508 1320 7244 906 825 4060 1325
- 23 -
Current and Future Workload Developments

A number of strategies to support NHpPD are in place for the ongoing support and development of the NHpPD. Feed back from the Health Services on NHpPD Variances. Directors of Nursing continue to provide feedback regarding site/region specific strategies to address data variances and workload issues. Formal feedback from each site identified as having clinical areas 10% below set targets are attached in Appendix 3. Nursing Workload Monitoring System (NWMS) The NWMS continues to provide reliable data from all sites. The system is however, currently undergoing a major review which will see the introduction of a more automated system that will draw the information required from existing systems therefore reducing the time required by NM when inputting data and improve accuracy.
Current Recruitment and Attraction Strategies

WA Health maintains a range of attraction and retention strategies to address workforce capacity and capability at a state-wide level. A. Undergraduate Recruitment and Positions: Graduate Connect (GC) is the centralised recruiting process for graduate nurses and midwives wishing to apply for a position in either a public or participating private hospital in WA. Graduate Connect is now a biannual recruitment process, as it was identified that annual recruitment could disadvantage enrolled nurse applicants who may have not commenced any clinical placements prior to applying for graduate positions. For the 2013 recruitment year 34 hospitals and health services including participating private hospitals used GNC as their main method of recruiting graduates for graduate programs commencing in 2013. Over the two recruitment processes for positions due to commence in 2013 programs WA health received 1146 Registered Nurse (RN) applications, 68 Midwifery (MW) and 185 Enrolled Nurse (EN) applications. For 2013 WA health and participating private hospitals have offered, 586 RN positions, 35 MW positions and 82 EN positions. Round two is currently in progress it is anticipated that an additional 100 RNs 49 ENs and 6 MW places will be filled by the end of this round. WA health will continue to provide support to public hospitals via the Liberal National Government commitment to provide financial support in the transition of graduate nurses/midwives into the work force. For 2013 this equates to $1500.00 per RN/MW and $750.00 per EN graduate.
- 24 -
B. Refresher and Renewal of Registration Programs Refresher Programs The Nursing and Midwifery Office (NMO) continues to support refresher programs for ENs, RNs and Midwives who wish update their clinical skills and knowledge to return to the acute clinical setting. The NMO continues to receive large volumes of applications for refresher programs and in the 2011/2012 period 36 Nurses (RNs and ENs) and 10 Midwives successfully completed a refresher program. Currently the NMO is conducting a review of the support and structure of WA Health refresher programs. The primary aim of this project is to evaluate the strengths and limitations of current programs and to improve educational resources and develop an alternative model of delivery for future programs. The NMO is exploring online study modules and flexible full-time or part time study options for refresher participants. A survey was recently sent to all participants who completed a refresher program between 2008 and 2012. This survey will also assist the NMO to evaluate the validity and outcomes of refresher programs and aid in the continuous improvement of future programs. The survey results will be available on the NMO website by end November 2012. EN Principles of Emergency Care Program In 2011/2012 the NMO provided ongoing support for the EN Principles of Emergency Care (EN PEC) Program for ENs employed in WA Health. 100 ENs were fully funded to attend a 2-day workshop facilitated by the College of Nursing in September 2011 and May 2012, followed by a 6 month distance education unit. Financial assistance for travel accommodation was also available for staff travelling from WA Country Health regions. The EN PEC program is recognized as a relevant post registration qualification allowing ENs to apply for the Advanced Skills EN classification. Critical Care Workforce Plan and Up skilling In September 2011, 24 Registered Nurses (including private sector nurses) successfully completed the 3rd Adult Critical Care Up skilling program (ACCUP). The ACCUP, funded by the NMO, was offered as part of a state wide Adult Critical Care Workforce Plan initiative to address critical care nursing workforce issues. The aim of the ACCUP was to develop the basic knowledge, skills and attitudes of registered nurses wishing to practice in the high dependency / adult intensive care area. The program equipped beginner level critical care RNs with the knowledge and skills to effectively address the complex health needs of high acuity adult patients. The 2011 program coincided with the opening of additional intensive care beds at Fremantle Hospital and to continue the up skilling of staff at the newly opened Level 1 ICUs at Armadale Health Service and Rockingham Hospital.
C. Marketing In 2011/12, a $400,000 nursing and midwifery recruitment campaign, which utilised the branding concepts from the 2008 Nursing and midwifery...can take you anywhere campaign, was implemented to support a State Government target to employ 800 additional FTE nurses - 25 -
and midwives (a target of 11,617 FTE) prior to the end of 2012. The campaign also sought to address demand modelling from the Workforce Branch that indicated that by 2014/2015, WA Health would need to employ 13,361 FTE nurses/midwives to meet demand an increase of 1700 FTE. The Nursing and Midwifery Office had also identified an increasing usage of agency staff; an ageing workforce with high levels of retirement expected; and younger staff choosing to work part-time as issues impacting the nursing workforce. The 2011/2012 recruitment campaign promoted nursing and midwifery careers in mainstream media, professional publications, and online sites and at career expos. Advertising focussed on employment opportunities, training and development to position nursing and midwifery as rewarding careers with WA Health. Advertising was supported by media and public relations activity and other below-the-line tactics. Target audiences included young people and their parents, nurses and midwives eligible to re-enter the profession, and working nurses and midwives who will see the campaign as an investment in their profession, promoting selfesteem. It was implemented from January to 30 June 2012. Post-campaign research which evaluated the creative concepts from the 2011/12 campaign will inform the development of concepts for the 2012/13 2013/14 campaign.
D. Scholarships The DoH recognises the importance of professional development to maintain the high standards of our nursing and midwifery workforce. In order to encourage nurses and midwives to pursue further studies, financial assistance via scholarships is offered who are enrolled in post graduate studies and meet the selection criteria. Areas of specialisation for which scholarships have been given are as follows: Areas of Specialisation Aged Care Clinical Management Coronary Care Diabetes Mental Health International Health Oncology Palliative Care PICU
Acute Care Critical Care Child & Adolescent Health Emergency Neonatal Intensive Care Orthopaedics Peri operative PNSA
The following amounts of money have been allocated for the period of 2012 Postgraduate Clinical Specialisation Postgraduate Midwifery Master of Nursing (Nurse Practitioner) EN-RN / Undergraduate TOTAL 321 94 49 455 919 $1,365,116.00 $294,089.00 $91,030.00. $1,107,000.00 $2,857,235.00 - 26 -
E. Nurse Practitioner (NP) As of 26/4/2012 the National Office of the Australian Health Practitioner Regulation Agency have 570 Registered Nurses with Nurse Practitioner endorsement across Australia. 107 of these identified Western Australia as their place of residency. WA has the third highest number of endorsed NPs behind New South Wales and Queensland. Designated NP areas that allow for the employment of NPs are: WA Country Health Services (WACHS) Remote area nursing posts 21 Remote practice sites 12 Emergency care services 73 WACHS mental health services Kimberley paediatric health services WACHS aged care service Metropolitan Area SMAHS 15 NMAHS 11 CAHS - 3 Government Agencies Corrective services Defence force - Navy
Designated Areas - Metropolitan Royal Perth Hospital Sir Charles Gairdner Hospital Princess Margaret Hospital for Children Royal Perth Hospital Royal Perth Hospital
Rockingham Kwinana District Hospital Armadale Kelmscott Health Service Sir Charles Gairdner Hospital Fremantle Hospital Swan District Hospital Royal Perth Hospital Royal Perth Hospital Fremantle Hospital
Date designated
08-Apr-05 08-Apr-05 22-Aug-05 04-Sep-06 06-Dec-06 06-Dec-06 19-Feb-07 08-Jun-07 29-Aug-07 14-Sep-07 28-Nov-07 28-Nov-07 14-Jan-08
Speciality Liver services Haematology oncology Haematology oncology total care services Emergency services Wound management
Emergency Services Renal Services Wound Management Services Continence Services Emergency Services Heart Failure and Cardiac Transplant Service Nephrology Service Emergency Services
- 27 -
Sir Charles Gairdner Hospital Princess Margaret Hospital for Children Royal Perth Hospital Armadale Kelmscott Health Service Sir Charles Gairdner Hospital Armadale Kelmscott Health Service Fremantle Hospital Royal Perth Hospital Graylands Sir Charles Gairdner Hospital Fremantle Hospital Women's and Newborn Health Services Fremantle Hospital Sir Charles Gairdner Hospital Sir Charles Gairdner Hospital
6Mar-08 22-Sep-08 12-Nov-08 16-Mar-09 20-Apr-09 16-Mar-09 16-Jul-09 01-Oct-09 03-Nov-09 15-Feb-10 15-Feb-10 03-Feb-11 06-Sep-11 15-Dec-11 15-Dec-11
Mental Health Services Diabetes and Endocrinology Services Palliative Care Services Emergency Services Emergency Services Emergency Services Rottnest Island Nursing Services Thrombosis and Haemophila Services State Forensic Mental Health Service Respiratory Medicine Wound Management Service Obstetrics and Gynaecology Services Sexual Health Services Orthopaedic Services Anticoagulation Services
Sir Charles Gairdner Hospital Princess Margaret Hospital for Children
12-Mar-12 12-Mar-12
Residential Care Line Emergency Services
Designated Areas Private Providers

Carinya Aged Care Joondalup Health Campus Brightwater Care Group Southern Cross Care (WA) Inc Revive Clinic Booragoon Healthscope Medical Centres Carepoint Industrial Health Services Silver Chain Association
Date designated
08-Apr-05 07-Jul-06 29-Aug-07 14-Jan-08 30-Oct-08 12-Dec-08 19-May-09 19-May-09
Speciality
Aged Care Emergency Services Aged Care Services Aged Care Services Health Care Centre Health Care Centres Industrial Health Primary Health Care
Revive Clinic
St John of God Hospital, Murdoch St John of God Hospital, Murdoch Hall & Prior Nurse Practitioner Clinics Australia Geraldton Regional Aboriginal Medical Service Primary NP Healthcare Revive Clinics Collaborative Primary Health Care WA Primary Health Care Children's Equity CEDARs Centre REDiMED Total Injury Management East Fremantle Medical Practice & Health Service Murray Medical Centre Kwinana Medical Centre
11-Nov-09
23-Apr-10 23-Jun-10 10-Sep-10 10-Sep-10 10-Sep-10 12-Oct-10 02-Mar-11 02-Mar-11 29-Jun-11 29-Jun-11 06-Sep-11 06-Sep-11 15-Dec-11 15-Dec-11
Primary Health Care

Emergency Services Acute Care After Hours Service Residential Health and Aged Care Primary Health Care Primary Health Care Primary Health Care Primary Health Care Services Primary Health Care Services Primary Health Care Developmental Delayed Children and Family Industrial Health Primary Care Primary Care Primary Care
- 28 -
Leda Medical Centre Coolbellup Medical Centre Aubin Grove Medical Centre The Bethanie Group Inc Emerge Surgical Women's Healthworks Victoria District Medical Centre Amana Living
15-Dec-11 15-Dec-11 15-Dec-11 12-Jan-12 12-Jan-12 12-Jan-12 12-Jan-12 12-Mar-12
Primary Care Primary Care Primary Care Aged Care Services General and Bariatric Surgery Women's Sexual and Reproductive Health Primary Care Aged Care Services
St John of God Hospital, Subiaco

Aspen Medical Pty Ltd Australian Community Health Services Pty Ltd T/A FibreMed
12-Mar-12
03-May-12 03-May-12
Acute Pain Service

Primary and Emergency Health Care Health Care
- 29 -
Benchmarks and Reclassification Since the 2011/12 interim report 8 applications for ward reclassification were submitted and reviewed by the State Workload Review Committee. All 8 new submissions where approved by the committee.
Table 17: Ward area that have been revised and approved for reclassification Hospital Bunbury Rockingham General Hospital Osborne Park Hospital Kalamunda Hospital Selby * Royal Perth Hospital Rockingham General Hospital Sir Charles Gairdner Hospital Sir Charles Gairdner Hospital Ward PICU ICU/HDU Ward 5 Anderton Ward Selby Older Adult Ward 2K Multistay surgical unit G41 C16 Previous category & benchmark New classification New Unit D 5.0 D 5.0 A+ 8.15 C 5.75 D 5.0 B 6.0 C 5.75 Revised category & benchmark 12 NHpPD 28.76 NHpPD D+ 5.33 D+ 5.47 A+ 8.15 B 6.0 C 5.75 B+ 6.5 B 6.0
*Selby Older Adult was reclassified in early 2010 and was required to submit a full year of supporting data to uphold their classification
- 30 -
Appendices
- 31 -
Appendix 1: Metropolitan and Regional Wards NHpPD

Ward Category C Target 5.75
Site Albany Regional Hospital Albany Regional Hospital Albany Regional Hospital Albany Regional Hospital Albany Regional Hospital Albany Regional Hospital Albany Regional Hospital Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service Area Mental Health Service
% variance
Ward A Surgical
2.67
Ward B Maternity
D+Deliv (Albany)
8.19
9.11 0.92 11.24
Ward C Paediatric /Medical /Surgical Ward E Medical / General Ward G Mental Health High Dependency Unit Dialysis Unit
C&D (Albany)
5.5
5.61 0.11 1.92
4.95 -0.05 -0.90
A&C (Albany)
6.28
6.23 -0.05 -0.74
HDU
12
12.06 0.06 0.52
Satellite Dialysis
2.18
1.91 -0.27 -12.30
Yvonne Pinch
A+ (GSL Pinch)
14.72
24.77 10.05 68.30
Acacia
A+ (Acacia)
11.81
14.08 2.27 19.25
Montgomery Unit
A+ (GSL Montgomery) A+ (GSL Smith)
8.66
8.58 -0.08 -0.87
Smith Units
8.66
8.84 0.18 2.03
Casson
A+ (Casson)
8.51
10.44 1.93 22.72
Banksia
B+ (Graylands)
6.49
6.93 0.44 6.84
Caesia
B+ (Graylands)
6.49
6.23 -0.26 -4.02
Ward D 20 Phy Unit
5.75
5.93 0.18 3.06
Hutchison Unit
E (Hutch)
4.56
5.51 0.95 20.85
Plaistowe Unit
E (Plast)
4.5
4.33 -0.17 -3.68
Murchison House
E (Murch)
4.74
5.47 0.73 15.31
- 32 -
Ward
Category A+ (GSL Dorrington) A
Target 8.66
Site Area Mental Health Service Area Mental Health Service Armadale Hospital Armadale Hospital Armadale Hospital Armadale Hospital Armadale Hospital Armadale Hospital Armadale Hospital Bentley Hospital Bentley Hospital Bentley Hospital Bentley Hospital Bentley Hospital Bentley Hospital Bentley Hospital Broome Regional Hospital Bunbury Regional Hospital Bunbury Regional Hospital Bunbury Regional Hospital Bunbury Regional Hospital
% variance
Dorrington
-1.19
Ellis Ward
7.5
6.95 -0.55 -7.34
Carl Streich Rehab & Aged Care Leschen_Adult Mental Health Inpatients Campbell Pediatrics Banksia_MHS for Older People Inpatients Benson Medical Colyer Surgical Maude Bellas Maternity Ward 2 Maternity Ward 3 Medical/ Surgical Ward 4 Rehabilitation Secure Unit Ward 6
5.41 0.41 8.17
7.5
10.94 3.44 45.83 87.31
B B
6 6
11.24 5.24 8.46 2.46 40.94 -1.69 23.44 -50.71 55.92 27.40 7.57
B C D+Del(Armadale) D+Del (Bentley) D D A+Misc (Bentley SU) B B D C+D+Del(Broome)
6 5.75 7.02 6.86 5 5 8.5
5.90 -0.10 7.10 1.35 3.46 -3.56 10.70 3.84 6.37 1.37 5.38 0.38 12.09 3.59 42.22 -3.31 -2.66 29.64
Adult Acute Ward 7 Adult Acute Ward 8 Geriatrics Unit General / Maternity
6 6 5 5.98
5.80 -0.20 5.84 -0.16 6.48 1.48 5.29 -0.69 -11.47
Surgical
5.75
5.99 0.24 4.13
Medical
5.75
5.38 -0.37 -6.52
Paediatrics
6.51 0.51 8.47
Maternity
D+Del (Bunbury)
8.3
8.04 -0.26 -3.18
- 33 -
Ward
Category C+ (BMH)
Target 6.16
Site Bunbury Regional Hospital Bunbury Regional Hospital Bunbury Regional Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Fremantle Hospital Geraldton Regional Hospital Geraldton Regional Hospital Geraldton Regional Hospital Geraldton Regional Hospital
% variance
Mental Health
45.01
High Dependency Unit PICU (Psychiatric Intensive Care Unit) Cardiothoracic Surgery Ward 4.1 (MH) Ward D4 Ward B8S Ward B7S Ward B7N Ward B9S Ward B9N Ward 4.2 (MH) Ward 5.1 (MH) Ward F6 Ward V6 Ward 4.3 (MH) Restorative Unit Intensive Care Unit Coronary Care Unit Kaleeya Maternity Unit Maternity
HDU
12
12.64 0.64 5.32
A+ (PICU Bunbury) A A+ (FHHS) B B B B B B B B C C B D ICU CCU D+Del (FHHS) D+Del (Geraldton)
12
11.92 -0.08 -0.67 117.72 0.41 76.53 4.36 4.52 10.78 15.38 10.09 -3.61 -2.96 24.37 10.94 15.62 19.23 2.03 65.46 18.32
7.5 11.2 6 6 6 6 6 6 6 6 5.75 5.75 6 5 31.6 14.16 8.35 8.55
16.33 8.83 11.25 0.05 10.59 4.59 6.26 0.26 6.27 0.27 6.65 0.65 6.92 0.92 6.61 0.61 5.78 -0.22 5.82 -0.18 7.15 1.40 6.38 0.63 6.94 0.94 5.96 0.96 32.24 0.64 23.43 9.27 9.88 1.53 9.81 1.26 14.72
High Dependency Unit Hospital Ward
HDU
12
9.20 -2.80 -23.32
5.75
5.00 -0.75 -13.05
Dialysis Unit
Satellite Dialysis
2.18
2.76 0.58 26.63
- 34 -
Ward
Category B+(Pibara)
Target 6.37
Site Hedland Health Campus Hedland Health Campus Hedland Health Campus Hedland Health Campus
% variance
Med/Surg/ HDU ( Vickers) Maternity / SCN
17.32
D+Del (Hedland)
6.43
11.64 5.21 81.04
Paediatric
11.89 6.89 137.82
Dialysis unit
Satellite Dialysis
2.18
2.22 0.04 1.99
Kalamunda Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital Kalgoorlie Regional Hospital KEMH KEMH KEMH KEMH Older Adult Mental Health Program (North Metro) Older Adult Mental Health Program (North Metro) Older Adult Mental Health Program (North Metro)
Anderton (Med/Surg/Palliative Care) Ward D Surgical
D+ (KH)
5.47
6.44
0.97
C 5.75
17.80
5.79 0.04 0.73
Ward B Medical
5.75
5.39 -0.36 -6.28
Paediatrics
5.04 0.04 0.73
Ward C Maternity
D+Del (Kalgoorlie)
8.07
8.01 -0.06 -0.77
High Dependency Unit Mental Health
HDU
12
9.92 -2.08 -17.31
A,B,C (Kalgoorlie)
7.71
8.71 1.00 13.01
Dialysis Unit
Satellite Dialysis
2.18
2.30 0.12 0.16 1.03 -0.01 -0.15 5.56 2.69 17.14 -0.11 -2.44
Obstetrics Ward 5 Gynaecology Ward 6 Obstetrics Ward 3 Obstetrics Ward 4 Selby Red Wing (Graylands)
B B B B B+(OAMHP)
6 6 6 6 7.13
6.16 7.03 5.99 5.85 8.44
1.31 Osborne Older Adult

C 5.75
18.34
5.56
-0.19 Swan Older Adult

C 5.75
-3.36
5.36
-0.39
-6.75
- 35 -
Ward
Category A+ (PICU)
Target 8.15
YTD Variance 9.65
Site Older Adult Mental Health Program (North Metro) Older Adult Mental Health Program (North Metro) Older Adult Mental Health Program (North Metro) Osborne Park Hospital Osborne Park Hospital Osborne Park Hospital Osborne Park Hospital Osborne Park Hospital Rockingham Hospital Rockingham Hospital Rockingham Hospital Rockingham Hospital RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH
% variance
Psychiatric Intensive Care Unit (PICU) Selby A (Blue Wing)
1.50
B (Selby A) 6.41
18.43
6.54
0.13 Selby B (Lemon & Gray Wing)

B (Selby B) 6.41
2.08
6.82
0.41 Ward 5 Aged Care & Rehab Ward 4 Aged Care & Rehab Ward 3 Aged Care & Rehab Maternity Ward 6 Surgical Medical Surgical Obstetrics
D+ (OPH) D D D+Del (Osb Park) C C C D+Del (Rockingham) D 5.33 5 5 8.97 5.75 5.75 5.75 7.61
6.32 2.59 0.51 2.11 4.84 6.73 27.47 32.32
5.47 0.14 5.03 0.03 5.11 0.11 9.40 0.43 6.14 0.39 7.33 1.58 7.61 1.86 8.48 0.87 11.45
Older Adult Evaluation & Rehabilitation Unit BMTU Ward 11 SPC Ward 5H Ward 6G Ward 1 SPC Ward 5A Ward 5B Ward 5F/7B Ward 5G Ward 6H Ward 7A Ward 9 SPC Ward 9C Ward 10 SPC Ward 10AB Ward 4A (SSSU) Ward 5E Ward 6A
8.39 3.39 -1.62 -0.81 -1.11 -1.49 0.08 -0.36 -0.55 -0.48 -0.29 -0.40 -0.01 0.19 0.40 -0.79 -0.61 0.08 0.04 0.29 67.87 -21.66 -10.78 -14.80 -19.86 1.35 -6.05 -9.10 -8.04 -4.87 -6.66 -0.23 3.25 6.63 -13.78 -10.08 1.34 0.61 4.79
A A A A B B B B B B B B B C B C B B
7.5 7.5 7.5 7.5 6 6 6 6 6 6 6 6 6 5.75 6 5.75 6 6
5.88 6.69 6.39 6.01 6.08 5.64 5.45 5.52 5.71 5.60 5.99 6.19 6.40 4.96 5.39 5.83 6.04 6.29
- 36 -
Ward
Category D C B B B C B ICU CCU C B B+HDU (SCGH G52) A A A B+ B A B+ B+ (SCGH G72) B B B B (Ortho) B B ICU CCU D C (SKHS)
Target 5 5.75 6 6 6 5.75 6 31.6 14.16 5.75 6 9.51 7.5 7.5 7.5 6.5 6 7.5 6.5 6.8 6 6 6 6.5 6 6 31.6 14.16 5 5.75
YTD Variance 5.18 5.75 6.02 5.86 6.64 7.08 5.16 30.47 15.42 8.04 6.23 8.77 7.68 6.93 7.44 7.29 5.95 7.75 6.02 7.41 5.86 6.94 5.90 6.36 6.09 6.15 29.90 15.52 1.36 5.93 0.93 6.90 1.15 0.18 0.00 0.02 -0.14 0.64 1.33 -0.84 -1.13 1.26 2.29 0.23 -0.74 0.18 -0.57 -0.06 0.79 -0.05 0.25 -0.48 0.61 -0.14 0.94 -0.10 -0.14 0.09 0.15 -1.70
Site RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH RPH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH SCGH Ward 7B/3k (GEM Unit) Ward 8 SPC Ward 8A Ward 9A Ward 9B Ward 2 SPC Ward 2K Intensive Care Unit Coronary Care Unit Acute Admissions Unit (AAU) Ward 4F Ward G52 Neuro Ward G62 H & L Ward G74 Gast/Renal Ward G54 H&L Ward G41 H & L Ward G63 Gast/Renal Ward G64 Neuro Ward G71 Cancer Ward G72 CAMS Ward G73 Cancer Ward G66 Neuro Ward G51 Neuro Ward G53 Neuro Ward G61 CAMS Ward C 16 CAMS Intensive Care Unit Coronary Care Unit SCGH SCGH Swan Districts Hospital Swan Districts Hospital Swan Districts Hospital Swan Districts Hospital Gairdner Rehabilitation Unit East Wing (Surgical) West Wing (Medical) Restorative/Stroke Unit Maternity, Nursery & Birthing Suite
% variance 3.54 0.02 0.31 -2.27 10.62 23.05 -13.97 -3.58 8.90 39.82 3.79 -7.74 2.34 -7.60 -0.79 12.09 -0.83 3.27 -7.36 8.91 -2.34 15.68 -1.66 -2.20 1.48 2.46 -5.38 9.58
18.67
19.99
6.91 0.91 15.16
C/D+(Swan)
6.15
7.00 0.85 13.87
7.93 1.93 32.16
- 37 -
Ward
Category A+D (Swan Valley Centre) No BM (SKHS)
Target 6.87
Site Swan Districts Hospital Swan Districts Hospital Swan Valley Centre (Acute/Secure) Paediatric Ward
% variance
6.91
5.96 -0.04 -0.68
- 38 -
Appendix 2: Country Small Hospital Ward Inpatient NHpPD.

Ward Category E+F (Augusta) Target 4.39
Site Augusta District Hospital Beverley District Hospital Boddongton District Hospital Boyup Brook Hospital Bridgetown Hospital Bruce Rock District Hospital Busselton District Hospital Carnarvon Hospital Carnarvon Hospital Collie District Hospital Corrigin District Hospital Cunderdin District Hospital Dalwallinu District Hospital Denmark District Hospital Derby Regional Hospital Dongara District Hospital Donnybrook District Hospital Dumbleyung District Hospital
% variance
General / Aged Care
-15.74
General / Aged Care
E+F (Beverley)
4.19
11.60 7.41 176.80
General / Aged Care
E+F (Boddington)
4.14
6.50 2.36 56.90
General / Aged Care
E+F (Boyup Brook) E+F+Del (Bridgetown) E+F (Bruce Rock)
4.37
6.23 1.86 42.66
General/ Aged Care / Maternity General / Aged Care
4.65
5.44 0.79 16.89
4.13
4.49 0.36 8.72
General / Maternity
D+Del (Busselton)
5.26
5.38 0.12 2.23 -68.14
Permanent Care Unit Combined Acute Wards
F E+D+Del (Carnarvon) E+Del (Collie) E+F (Corrigin)
4 5.2
1.27 -2.73 4.99 -0.21 -4.13 -0.39
General / Maternity General / Aged Care
4.72 4.11
4.70 -0.02 9.26 5.15 125.39
General / Aged Care
E+F (Cunderdin)
4.07
4.78 0.71 17.55
General / Aged Care
E+F (Dalwallinu)
4.13
6.05 1.92 46.46
General / Maternity
E+Del (Denmark)
4.56
4.56 0.00 0.11
General/Maternity/Paeds
D+Del (Derby)
5.34
5.27 -0.07 -1.27
General / Aged Care
4.5
4.54 0.04 0.89
General / Aged Care
E+F (Donnybrook) E+F (Dumbleyung)
4.54
6.35 1.81 39.93
General / Aged Care
4.04
6.31 2.27 56.22
- 39 -
Ward
Category E+Del (Esperance) E (Exmouth)
Target 4.88
Site Esperance District Hospital Exmouth District Hospital Fitzroy Crossing District Hospital Gnowangerup District Hospital Goomalling District Hospital Halls Creek District Hospital Harvey District Hospital Kalbarri District Hospital Katanning District Hospital Katanning District Hospital Kellerberrin District Hospital Kojonup District Hospital Kondinin District Hospital Kununoppin District Hospital Kununurra District Hospital Lake Grace District Hospital Laverton District Hospital Leonora District Hospital
% variance
General / Maternity
-8.04
General / Aged Care
4.5
5.31 0.81 17.99
General
4.5
5.29
0.79 General / Aged Care

E 4.5
17.58
4.25 -0.25 -5.51
General / Aged Care
E+F (Goomaling)
4.1
3.62 -0.48 -11.63
General
4.5
4.49 -0.01 -0.33
General / Aged Care
E+F (Harvey)
4.54
4.51 -0.03 -0.71
General / Aged Care
4.5
63.94 59.44 1320.81
Kerry Lodge
1.16 -2.84 -71.10
Combined General & Maternity General / Aged Care
E+Del (Katanning) E+F (Kellerberrin)
4.94
4.52 -0.42 -8.42
4.3
10.27 5.97 138.75
General
5.67 0.67 13.46
General / Aged Care
E+F (Kondinin)
4.19
8.21 4.02 95.98
General / Aged Care
E+F (Kununoppin)
4.21
4.45 0.24 5.75
General/ Maternity
D+Del(Kununurra)
5.32
4.35 -0.97 -18.19
General / Aged Care
E+F (Lake Grace)
4.16
11.44 7.28 175.11
General / Aged Care
E+F (Laverton)
4.47
25.48 21.01 470.09
General / Aged Care
E+F (Leonora)
4.33
6.15 1.82 41.94
- 40 -
Ward
Category E+Del (Margaret River) E+F (Meekathara)
Target 4.72
Site Margaret River District Hospital Meekatharra District Hospital Merredin District Hospital Merredin District Hospital Moora District Hospital Morawa District Hospital Mullewa District Hospital Murray Districts Hospital Nannup District Hospital Narembeen District Hospital Narrogin Regional Hospital Newman District Hospital Nickol Bay District Hospital Norseman District Hospital North Midlands (Three Springs) Hospital Northam Regional Hospital Northampton District Hospital Onslow District Hospital
% variance
General / Maternity
30.58
General / Aged Care
4.43
3.17 -1.26 -28.54
Aged Care
1.75 -2.25 -56.27
General
E+F (Merredin)
4.23
6.66 2.43 57.56 -3.49
General / Aged Care General / Aged Care
E+F (Moora) E+F (Morawa)
4.3 4.34
4.15 -0.15 3.49 -0.85 -19.65
General / Aged Care
4.5
4.43 -0.07 -1.49
General / Maternity
E+Del (Murray)
4.69
6.63 1.94 41.33
General / Aged Care
E+F (Nannup)
4.01
6.98 2.97 74.16
General / Aged Care
E+F (Narembeen)
4.11
6.26 2.15 52.22
Combined Ward: Gen/ Mat/ Paed/ Surg
D+Del(Narrogin)
5.16
6.04
0.88 General
D 5
17.10
13.09 8.09 161.89
General / Maternity
D+Del (Nickol Bay) E+F (Norseman)
5.8
7.68 1.88 32.48
General / Aged Care
4.28
7.22 2.94 68.68
General / Aged Care
E+F (Nth Midlands)
4.23
4.39
0.16 General / Maternity

E+Del (Northam) 4.73
3.76
4.79 0.06 1.23
General / Aged Care
E+F (Northampton) E
4.17
4.00 -0.17 -4.12
General / Aged Care
4.5
21.85 17.35 385.48
- 41 -
Ward
Category
Target
YTD Variance
Site Parburdoo Pemberton District Hospital Pingelly District Hospital Plantagenet District Hospital Mt Barker Plantagenet District Hospital Mt Barker Quairading District Hospital Ravensthorpe District Hospital Roebourne District Hospital Southern Cross District Hospital Tom Price District Hospital Wagin District Hospital Warren District Hospital Wongan Hills District Hospital Wyalkatchem District Hospital Wyndham York District Hospital General General /Aged Care
E E+F (Pemberton) 4.5 4.46
% variance 1176.56
57.45 7.35
52.95
2.89 General / Aged Care

E+F (Pingelly) 4.14
64.85
23.82 19.68 475.30
Lodge
1.25
-2.75 General / Maternity

E+Del (Plantagenet) 4.68
-68.73
2.59
-2.09 General / Aged Care

E+F (Quairading) 4.14
-44.62
5.33 1.19 28.65
General / Aged Care
E+F (Ravensthorpe) E
4.23
6.81 2.58 61.07
General
4.5
39.70 35.20 782.11
General / Aged Care
E+F (Southern Cross) E
4.19
12.04 7.85 187.29
General / Extended Care
4.5
19.26 14.76 327.93 17.34
General/ Aged Care General/Aged Care/Maternity General / Aged Care
E+F (Wagin) E+Del (Warren)
4.18 4.71
4.90 0.72 6.52 1.81 38.39
E+F (Wongan Hills) E+F (Wyalkatchem) E E+F (York)
4.17
11.75 7.58 181.79
General / Aged Care
4.25
5.62 1.37 5.18 1.09 32.30 115.12 26.05
General General / Aged Care
4.5 4.18
9.68 5.27
- 42 -
Appendix 3: Legend of tables
Table number Table 1 Table 2 Table 3 Table 4 Table 5 Table 6 Table 7 Table 8 Table 9 Table 10 Table 11 Table 12 Table 13 Table 14 Table 15 Table 16 Table 17 Graph 1 Graph 2 Appendix 1 Appendix 2 Appendix 3 Appendix 4
Table title and Description Comparison of the NHpPD Data. 2008/09 2010/11 Data Metropolitan & Regional Wards that are 0-5% above set NHpPD targets Metropolitan & Regional Wards that are 510% above set NHpPD targets Metropolitan & Regional Wards that are 10% or more above set NHpPD targets Metropolitan & Regional Wards that are 0-5% below set NHpPD targets Metropolitan & Regional Wards that 5-10% below set NhpPD targets Metropolitan & Regional Wards that are 10% or more below set NHpPD targets Country Small Hospitals that are on or 0-5% above set NhpPD targets Country Small Hospitals that are 5-10% above set NHpPD targets Country Small Hospitals that are 10% or more above set NhpPD targets Country Small Hospitals that are 0-5% below set NHpPD targets Country Small Hospitals that are 5-10% below set NHpPD targets Country Small Hospital that are 10% or more below set NHpPD targets Metropolitan Emergency Department Activity Regional Emergency Department Activity Small Country Hospital Emergency Department Activity Wards Areas that have been revised and approved for reclassification Comparison of the NHpPD Data. 2008/09 2010/11 Data Represents comparison NHpPD for Country Hospitals Small 2008/09 2010/11 Metropolitan and Regional Ward Inpatient NHpPD Data Small Country Hospital Ward Inpatient NHpPD Data Table Legend In Patient Areas with variances greater than 10% below (site responses)
- 43 -
Hospital: Royal Perth Hospital Ward: Ward 10 AB

Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Target NHpPD: 6.0 Reported NHpPD: 5.39 Variance: -0.61 % Variance: -10.08
Improvements in patient flow practices have significantly decreased the bed time to fill, therefore affecting the denominator in the NHPPD equation. High number of nursing specials recorded during March and April requiring a combination of nursing and PCA resource. Constraints by the organisation implemented to manage FTE has impacted on the ability to backfill ward shift profiles, particularly on morning shifts with divisional nursing staff such as the SDN & CNS assisting with the patient workload.
Clause 7.2.2.3 Provide information as to the progress achieved in implementing these or other similar steps, or to generally relieve or alleviate the workload of nursing staff for this clinical area
Ongoing shift shortfall created by issues relating to workers compensation, and parental leave has resulted in short term backfill, including agency, with reduced shift length.
Clause 7.2.2.4 Outline this health sites future plans or intentions in relation to proposals to address the question of workloads of nursing staff for this clinical area.
The staffing profile will continue to be monitored to ensure safe levels of staffing. Ongoing monitoring of shift shortfall will continue, with every effort to replace nursing resources with appropriately skilled staff. Actively recruiting locally and internationally to existing long and short-term vacancy.
44
Hospital: Royal Perth Hospital Ward: BMTU

BMTU is a 10 bed highly specialised unit. Staffing profile usually does not vary due to the small patient numbers. When acuity of the patient group increases, the staffing profile is increased accordingly.
Improvements in patient flow practices have significantly decreased the bed time to fill, therefore affecting the denominator in the NHPPD equation. Previously, issues had been identified with regards to RoStar resource balancing. This has since been resolved.
Staffing profile will continue to be reviewed and adjusted on a shift-by-shift basis to meet patient activity and acuity requirements.
45
Hospital: Royal Perth Hospital Ward: Ward 6G

The patient case mix for this ward has undergone change with the service realignment as part of the clinical redesign process for RPH. The ward is now comprised of cardiothoracics, vascular, and urology.
Ward 6G has not met the NHPPD target due to variable cardiothoracic activity and a reduction in the use of the high acuity bed area in the ward.
Staffing profile was adjusted to meet activity requirements based on patient activity and acuity. On occasions the ward was staffed to a reduced bed capacity due to lack of demand for this specialty beds.
Constraints by the organisation implemented to manage FTE has impacted on the ability to backfill ward shift profiles, particularly on morning shifts with divisional nursing staff such as the SDN & CNS assisting with the patient workload.
Clause 7.2.2.4 Outline this health sites future plans or intentions in relation to proposals to address the question of workloads of nursing staff for this clinical area...
46
Hospital: Royal Perth Hospital Ward: Ward 5H

Improvements in patient flow practices have significantly decreased the bed time to fill, therefore affecting the denominator in the NHPPD equation. Inability to fully recruit to vacancy has been a major issue to meet FTE and NHPPD targets. During the current reporting period, on occasions the ward was staffed to a reduced bed capacity due to lack of demand for this specialty beds. Parental leave has significantly impacted resulting in large component of unproductive nurses for the ward, and there have been issues convincing nurses to accept fixed term work contracts.
The high acuity room is staffed at a higher nurse patient ratio. During this reporting period, the use of the high acuity room was consistent with shift deficits impacting on non-high acuity ward beds covered by divisional nursing staff resources such as SDN/CNS.
Staffing profile was adjusted to meet activity requirements based on patient acuity.
47
Hospital: Royal Perth Hospital Ward: Ward 10SPC

During the current year, Ward 10 was used as the decanting area for Ward 2 whilst it underwent renovation, thus increasing the patient hours (but without changing the nurse hours). Ongoing shift shortfall created by issues relating to workers compensation, and parental leave has resulted in short term backfill, including agency, with reduced shift length. The model of care for Ward 10 includes a complement of Assistants in nursing assisting with patient care duties (excluded from NHPPD). Constraints by the organisation implemented to manage FTE has impacted on the ability to backfill ward shift profiles, particularly on morning shifts with divisional nursing staff such as the SDN & CNS assisting with the patient workload.
Ward 10 returned to its usual 22-bed ward during the second quarter of 2011/12. Ward 10 is the area at SPC designated to receive over census patients.
Ongoing recruitment to address issues of shortfall and those vacancies created by periods of extended leave. The staffing profile will continue to be monitored to ensure safe levels of staffing.
48
Hospital: Royal Perth Hospital Ward: Ward 11 SPC

The ward has had a high number of supernumerary shifts with Induction, worke rs compensation etc. These shifts have been excluded from the nursing hours (as per business rules); however they remain as an available resource in the ward.
The model of care for Ward 11 includes a complement of Assistants in Nursing assisting with patient care duties (excluded from NHPPD). There has been a decrease in the number of ventilator dependent spinal patient specials. A percentage of Nursing Specials for this area was built into the 7.50 NHPPD target. Constraints by the organisation implemented to manage FTE has impacted on the ability to backfill ward shift profiles, particularly on morning shifts with divisional nursing staff such as the SDN & CNS assisting with the patient workload.
It was recently identified that the community based sub acute spinal injury program was being resourced from the ward roster. Strategies have been put in place to ensure that this resource is not removed from the ward productive hours.
It was previously identified that the reported NHPPD has not reflected their actual profile due to a change in Rostar work practice (failing to resource balance). resolved. This has been addressed and
The staffing profile will continue to be monitored to ensure safe levels of staffing. Ongoing monitoring of shift shortfall will continue, with every effort to replace nursing resources with appropriately skilled staff.
49
Hospital: Royal Perth Hospital Ward: Ward 2K

Ward 2K was reclassified to a category B in October 2011, was only staffed to category C prior to this. Ward 2K has regularly utilised the over census bed during this period which affects NHpPD stats Staffing deficits are monitored and identified early and all attempts are made to fill these deficits through, casual, nursewest, extra shifts and OT Open ended recruitment pool has been running to increase available casual nurse pool
Staffing profile has been increased in line with Ward reclassification and is being recruited into Short term contracts have been offered to Nurses to fill known long-term staffing deficits such as LSL, WC etc Casual nurse pool has increased resulting in more availability of nurses for backfill
Clause 7.2.2.4 Outline this health sites future plans or
The staffing profile will continue to be monitored to ensure safe levels of staffing. Ongoing monitoring of shift shortfall will continue, with every effort to replace nursing resources with appropriately skilled staff Actively recruiting locally and internationally to existing vacancy.
intentions in relation to proposals to address the question of workloads of nursing staff for this clinical area.
50
Hospital: Goomaling District Hospital Ward: General/Aged Care Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Variance occurs in relation to the use of PCAs in order to support the clinical model. Currently EN recruitment is being undertaken in order to increase our nursing FTE.
PCAs being utilized continue to support the registered nurse in alleviating work load. Recruitment and selection process is being commenced.
As above.
51
Hospital: Katanning District Hospital Ward: Kerry Lodge Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Target NHpPD: 4 Reported NHpPD: 1.16 Variance: -2.84 % Variance: -71.10
Support staff non regulated workers- employed to work under the direction of nurses to provide care.
Initial Target was calculated on nursing care for all shifts. The employment of non regulated workers as above has ensured the care is given safely but the hours of non regulated workers is not recorded against NHpPD
Plan to review Targets for all RAC units attached to regional sites, to align with this new rostering structure
52
Hospital: Plantagenet District Hospital Ward: Lodge Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Target NHpPD: 4 Reported NHpPD: 1.25 Variance: -2.75 % Variance: -68.73
Support staff non regulated workers- employed to work under the direction of nurses to provide care. Base rosters consistently met.
53
Hospital: Plantagenet District Hospital Ward: General/maternity Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
If ED not busy, nurse from ED cay assist but main pressure is in the am when ED busy.
Nil progress. Unable to increase base roster and call more staff in due to organisational constraints
Improved documentation for NHpPD to assist with argument for increase in base roster funded by the organisation.
54
Hospital: Merredin District Hospital Ward: Aged Care Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Support staff non regulated workers- employed to work under the direction of nurses to provide care.
55
Hospital: Augusta Hospital Ward: General/Aged Care Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
The workforce model used at Augusta utilises Patient Care Assistants as part of the nursing hours per shift. This results in us being under our allocated NHpPD allocation as only actual nursing hours are calculated. Safe care is delivered with all PCAs requiring a minimum of Certificate 3 in Aged Care to work unsupervised providing basic nursing care
Team Nursing and patient allocation ensures adequate supervision of unqualified staff. In house training and education e.g. Aged Care Channel workshops and medication training for PCAs required to work in the community Reduction of permanent care residents and aiming to reduce back to ten rather than thirteen
Augusta will continue to utilise PCAs as part of the nursing team as we are a Multi Purpose Service Hospital. This means that many of the roles do not require a qualified staff member e.g. respite. If the PCA;s were counted into the hours per day for patient care then we would be equal or above our allocation. Provision of appropriate equipment and facilities to aid nursing care
56
Hospital: Goomaling District Hospital Ward: General/Aged Care Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Variance occurs in relation to the use of PCAs in order to support the clinical model. Currently EN recruitment is being undertaken in order to increase our nursing FTE.
PCAs being utilized continue to support the registered nurse in alleviating work load. Recruitment and selection process is being commenced.
As above
57
Hospital: Albany Regional Hospital Ward: Satellite Dialysis Unit Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Satellite unit staffed for patient occupancy. Clinical Nurse has Management Days in which he assists in the busy times within the unit. Clinical Nurse also relieved in another position but assisted in Dialysis Unit for approximately 4 hours per week None of these hours were included in the NHpPD calculations
Base roster adequate to patient load and additional support ensures safe practice. RO machine checking is deducted from the data in these results though this is part of the safe running of the unit and is performed by nursing staff
No planned changes in staffing Review of collection of data planned.
58
Hospital: Broome Regional Hospital Ward: General Maternity Ward Clause 7.2.2.2 Please detail the measures that this health site has implemented, including specific steps, to relieve the workload of nursing staff for this clinical area.
Increase in activity for both General and Maternity OBD. Transfer of paediatric and neonatal services to Broome in July 2011 has increased activity. Review of nursing hours occurred October 2011 with an increase in roster profile from 7/6/4 to 7/6/5. Still not meeting needs of activity and acuity of acute ward. Nurse specials for June
Currently recruiting
59
Hospital: Armadale Hospital Ward: Maude Bellas Maternity

Target NHpPD: 7.02 Reported NHpPD: 4.48 Variance: -2.18 % Variance: -31.00% Maternity services at Armadale health service have undergone significant change in the last 12 months, to address the additional demand that were currently experiencing by consolidating our services and resources. The labour wards on both Maud Bellas and Bickley were amalgamated on the 24th October; this has resulted in all deliveries taking place on Maud Bellas. The consolidation of this part of the service has resulted in better outcomes for the patients and staff by having appropriately experienced / skilled midwives in each of the delivery rooms with a hands free coordinator to provide additional resources and clinical support. Bickley ward is now a 10 bedded post natal ward. The nursery on Bickley has been closed and all neonates are now cared for in the level 2a nursery situated on Maud Bellas. Operational ante/post natal beds on Maud Bellas have been reduced from 18 to 14. A 4 bedded antenatal assessment/outpatient unit has been established which is staffed 24hrs per day, which has reduced the impact on the staff working in the labour ward who used to provide this service. An additional 10fte has been allocated to support the growth across all aspects of maternity services.
60
All the above have been implemented with the exception of the recruitment to the additional 10 fte, only 4.3fte recruited at this point in time, but the process is ongoing. Initial evaluation / review of the changes have indicated that most of the staff are happier, feel better supported and have more structure to their work.
Dedicated
Womens
and
Childrens
unit,
which
would
allow
further
consolidation of services. Implementation of Continuity of Carer Model for maternity patients. All gynaecological patients to be diverted to surgical services.
61
Hospital: Katanning Hospital Ward: Kerry Lodge

Target NHpPD: F 4 Reported NHpPD: 0.98 Variance: -3.01 % Variance: -995
Kerry Lodge- is a small MPS site mainly consisting or residential aged care and permanent care patients. Other models of rostering nursing care are utilised and provided.
No action on Variance as it is a small regional WACHS health service site
No action required on variance as is a small regional WACHS health service
62
Hospital: Plantagenet Hospital Ward: Lodge

Target NHpPD: F 4 Reported NHpPD: 1.05 Variance: -2.95 % Variance: -68.75
- is a small MPS site mainly consisting or residential aged care and permanent care patients. Other models of rostering nursing care are utilised and provided.
No action on Variance as it is a small regional WACHS health service site
No action required on variance as is a small regional WACHS health service
63
Hospital: Kununurra Hospital Ward: General /Maternity

Target NHpPD: D + Del 5.32 Reported NHpPD: 4.27 Variance: -1.05 % Variance: - 19.7
Use of new CNM positions to support the clinical areas relieving staff of burdensome administrative tasks e.g. organising RFDS Business plan for more staff successful Strategies introduced to improve opportunities
More staff are being recruited and overall FTE increased to meet variance
Reviewing model of care Maintain increased recruitment
64
Hospital: Geraldton Ward: High Dependency Unit

Target NHpPD: HDU 12 Reported NHpPD: 8.20 Variance: -3.8 % Variance: - 31.66%
Actively recruiting to staff vacancies to ensure full complement of staffing Monitoring of acuity of patients within the unit
Actively building capacity within our current nursing teams for clinical Up skilling to work high dependency Actively participating in WACHS travelling nurse programs
Future planning includes expansion from a 6 bed HDU to a 9 bed ICU which will encourage experienced ICU and CCU nurses to move to Geraldton due to increased services for this specialised area Ensuring full complement of Nursing Staff in the future by recruitment and up skilling
65
Hospital: Meekatharra District hospital Ward: Genaral/aged care

Target NHpPD: E + F 4.43 Reported NHpPD: 2.9

Active recruitment pools open Participation in travelling nurse/ graduate programs Other models of rostered nursing care utilised in the permanent care unit Offer of short term placements to sustain current staff
Variance: -1.44
% Variance: -33.18%
Some success with recruitment
Continue to actively recruit skilled staff Continue to support travelling nurse and graduate programs Continue to explore alternative staffing and rostering process to retain staff
66
Hospital: Morawa Ward: General /Aged Care

Target NHpPD: E + F 4.34 Reported NHpPD: 3.78 Variance: - 0.43 % Variance: - 33.18%
Active recruitment open ended pool advertisements This is a small WA Country Health MPS site consisting of Residential aged care and permanent care patients Other models of rostering Nursing Care are utilised in our smaller sites across WACHS
Successful recruitment to vacancies Subscribed to the travelling nurse program No other actions required on variances as they are a small regional WACHS Health service site
Reviewing the model of care Increasing the RN coverage to build critical mass No other actions required on variances as they are a small regional WACHS Health service site.
67
Hospital: Merredin Hospital Ward: Aged care

Target NHpPD: F 4 Reported NHpPD: 2.52 Variance: -1.48 % Variance: -37.00%
Merredin Merredin Aged Care target should not be read in isolation to the total Merredin NHPPD figure. Because of the makeup of the Merredin Hospital roster and the operations of the facility the all up figure of 8.23 should be the review figure.
Clause 7.2.2.3 Provide information as to the progress achieved in implementing these or other similar steps, or to generally relieve or alleviate the workload of nursing staff for this clinical area See above
Clause 7.2.2.4 Outline this health sites future plans or See above
68
Hospital: Kalgoorlie Ward: HDU

Target NHpPD: 12 Reported NHpPD: 10.29 Variance: -1.72 % Variance: -14.33%
Actively recruiting to staff vacancies to ensure full complement of staffing Monitoring of acuity of patients within the unit Staff to meet acuity needs.
Non nursing hours reviewed quarterly, if not earlier. Only patients whom warrant admission to the HDU admitted Range of patients from 1-5.
2-2 roster, dependent on acuity and patient number.
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Hospital: Kalgoorlie Ward: Dialysis Unit

Target NHpPD: 2.18 Reported NHpPD: 1.77 Variance: -0.41 % Variance: -18.8%
Patients not always turning up to dialysis. Advertising for more staff.
Non nursing hours for regular review. Non nursing hours follow up of lab results etc for all patients and stats done by nursing staff. Staff work short shifts.
2-2 roster, dependent on acuity and independent of patient number.
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Hospital: Kalgoorlie Ward: Maternity

Target NHpPD: 8.07 Reported NHpPD: 5.9 Variance: -2.17 % Variance: -23.88%
Increase FTE advertising ongoing. Short shifts 6hrs. Staff up according to birth times per month how many births and due dates.
12 hour shifts introduced less staff required to staff unit, less nursing hours worked. On call instead of shift coverage dependent on patient numbers, patient in labour. Review non nursing hours frequently. Staff presentations and reports non nursing hours.
Birth rate model Student midwives look at how many per intake. Graduate Midwife program. Offer split between ED and Maternity to up skill staff.
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NHPPD Annual Report July 2011 - June 2012

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NHPPD Annual Report July 2011 - June 2012

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Nursing Hours per Patient Day Annual Report

1st July 2011 30th June 2012

Abbreviations used throughout the document:

2009/2010 Annual Report 1stJuly 2009 30th June 2010 * 232

92 (44.2%) 15 (6.9%) 37(17%) 35(16.1%) 15(6.9%) 23(10.5%)

99 (46.2%) 23 (10.7%) 30 (14%) 37 (17.2%) 10 (4.6%) 15 (7%)

105 (45.26%) 28 (12.07%) 32 (13.79%) 31 (13.36%) 19 (8.19%) 17 (7.33%)

62 (28.9%) 199 (92.9%)

67 (28.88%) 215 (92.67%)

Graph 1: Represents comparison NHpPD data 2009/10 2011/12 annual reports

Target 5.75 6 11.2 5 12 6 5 5.75 5.75 6 6 5.5

1.92 1.99 2.03 2.03

2.22 0.04 8.84 0.18 32.24 0.64

YTD Variance 6.54

Selby A (Blue Wing)

YTD Variance 12.64 0.64 2.30 0.12 6.82

B C B+ (Graylands) A+D (Swan Valley Centre) D D

6 5.75 6.49 6.87

6.40 6.14 6.93

0.41 0.40 0.39 0.44

6.32 6.63 6.73 6.84

7.34 0.47 6.91 7.57

5.38 0.38 5.41 0.41 8.17 8.47 8.90 8.91 9.58

B CCU B+ (SCGH G72) CCU

6 14.16 6.8 14.16

6.51 0.51 15.42 1.26 7.41 0.61 15.52 1.36

Ward B9N Ward 9B Ward B7N Ward V6 Ward B Maternity Obstetrics

10.09 10.62 10.78 10.94 11.24

9.11 0.92 8.48 0.87 0.79 11.45 12.09

Ward G41 H & L Mental Health

1.00 Restorative/Stroke Unit Maternity

6 4.74 6 6 6 6 6.37 5.47

D+Del (FHHS) B+(OAMHP)

9.88 1.53 8.44

1.31 Psychiatric Intensive Care Unit (PICU)

Category D D A+ (Acacia) C (SKHS) E (Hutch) A+ (Casson) C C C Satellite Dialysis D C D B C C B

Target 5 5 11.81 5.75 4.56 8.51 5.75 5.75 5.75 2.18

YTD Variance 5.93 0.93 5.96 0.96

18.67 19.23 19.25 19.99 20.85 22.72 23.05 23.44 24.37

5 5.75 5 6 5.75 5.75 6

A+Misc (Bentley SU) C+ (BMH)

12.09 3.59 42.22

8.93 2.77 45.01

10.94 3.44 45.83 55.92 65.46

D+Del (Bentley) CCU D

10.70 3.84 23.43 9.27 8.39 3.39 67.87 68.30

Category B D+Del (Hedland) B A D

Target 6 6.43 6 7.5 5

YTD Variance 10.59 4.59

Ward D4 Maternity / SCN Campbell Pediatrics Cardiothoracic Surgery Paediatric

76.53 81.04 87.31 117.72 137.82

11.64 5.21 11.24 5.24 16.33 8.83 11.89 6.89

YTD 5.71 6.23 4.33 -0.17 Variance -0.29 -0.26

% variance -4.87 -4.02 -3.68 -3.61 -3.58

5.78 -0.22 30.47 -1.13 5.56

-0.19 Adult Acute Ward 7 Maternity

YTD Variance 8.58 -0.08

-0.87 -0.83 -0.79

5.95 7.44 8.01 -0.05 -0.06

-0.77 -0.74 -0.68

6.23 -0.05 5.96 -0.04 11.92

-0.08 -0.01 -0.01