latest health care news

08.03.16

‘Fragmented and dysfunctional’ leadership at hospital with high heart surgery death rate

“Fragmented and dysfunctional” leadership thrived at a hospital cardiac surgery unit currently under inspection for its high mortality rate, according to a new report released today.

The report, from a short notice CQC inspection of the Queen Elizabeth Medical Centre cardiac surgery on 21 and 22 December last year, followed a tip-off from the Healthcare Quality Improvement Partnership that the hospital was an outlier for surgery mortalities.

It says that problems in the hospital, where 76 patients died between 2011-14, include a lack of leadership vision, low staffing and a “bullying and blame” culture where staff were discouraged from reporting incidents or challenging poor performance.

The report says: “The cardiac surgery service had no vision or strategy and lacked clear clinical and operational leadership at service and divisional level. This resulted in a service that was fragmented and dysfunctional, with departments working in isolation rather than as a team.”

The CQC says that consultant staff were demoralised, lacked morale, and failed to properly supervise trainees or undertake ward rounds, nursing staff were concerned that they lacked up-to-date knowledge and skills to look after cardiac patients, and it was institutionally common for surgeons to show up late to operations.

The service failed to properly monitor surgery outcomes or follow the Five Steps to Safer Surgery Protocol, there was no monitoring of risk for patients whose operations had been cancelled, post-surgery re-bleeding rates were higher than expected and the service had not anticipated the impact of taking more complex patients for transplant surgery.

Following recommendations in the report, the Queen Elizabeth hospital is now required to make weekly reports of the number of its cardiac surgery deaths to the CQC, and is undergoing an independent inspection by the Royal College of Surgeons.

A spokesperson for University Hospitals Birmingham NHS Foundation Trust, which runs the Queen Elizabeth hospital, said: “We welcome the CQC report in the interests of delivering the safest possible care for our patients.”

They added that the hospital had implemented a quality improvement plan in July 2015, although the report criticises them for failing to do so sooner, given that concerns were first identified in 2013.

(Image c. John Chew)

 

Comments

TKN   09/03/2016 at 13:05

An acquaintance of mine with very little family support went into the QE for a routine Cardiac Surgical procedure. He was reasonably fit person and was reassured that he was a low risk case and the outcome should be excellent. Unfortunately he died following his surgery a couple of days later. Not being a family relative I was never able to get any information. This does come as a shock to me and am surprised that this was not highlighted previously.

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