Government revises ‘health roadmap’, new recovery programme designed

The government has had to revise its "health roadmap" after it realised that the problems afflicting the Accident & Emergency Department at Mater Dei Hospital were "much bigger than expected".

It has now produced a new roadmap, which together with a smart action plan, is expected to start delivering on a "recovery programme: everything is based on target times linked with key performance indicators".

Addressing parliament, Health Minister Godfrey Farrugia also presented a Gannt Chart - a project schedule which illustrates the start and end dates of a project's element.

He said that for the immediate term, the government had issued a call to increase human resources within the A&E while a strategy has been documented and action on performance management has kick started.

For the medium term, the health department was working on the introduction of a pilot scheme to gauge work during peak hours at the hospital during winter. "The results will help us to fine tune our policy according to the needs which arise," Farrugia said.

Medium-term plans also include improved management of the flow of patients at Mater Dei and the migration of services offered by the emergency pediatric services to a different part of the hospital in order to provide better service.

Long-term plans focus on the implementation of strategic care which includes the setting up of a mini lab at the emergency department, a comprehensive primary care with outreach units and rehabilitation centres.

Four new ambulances by end of year

By the end of year, the number of ambulances is set to increase from seven to 11 vehicles and two outreach units in Mosta and Rahal Gdid. The outreach unit in Rahal Gdid is expected to be opened in January, later to be followed by the one in Mosta.

The management and operations of the ambulance service will be grouped under one unit, the national dispatch centre. For the first time, 28 nurses will form part of the emergency service team and therefore, no nurses will be called out from the staff compliment of the emergency department.

Following discussions with the General Workers Union and the Union Haddiema Maghqudin, the number of responders will gradually increase from 46 to 88 workers by the end of year.

'Cultural earthquake' required in emergency service

Godfrey Farrugia said "a cultural earthquake" was required in the medical service. This would be achieved through the introduction of key performance indicators (KPI). KPIs would be time based and therefore include admission pathways which start with the patient's registration at the reception until the medical team decides whether to admit the patient or send him home.

"The introduction of KPIs are a complete new concept for Malta and these will help in increasing efficiency," Farrugia said.

These would include the time and type of the first medical contact, an effective triage system, specific period for ECG, efficiency in bed management, patient's satisfaction and team performance according to thresholds.

All this, the minister said, would require an increase in human resources, patient tracking and increased space at the A&E.

According to the plans, the health department is working to return Area 2 to the A&E by the end of September. The health minister also said that patient tracking would come at no cost for government as two of the four health department consultants were IT specialists.

"If we had to commission a private company to design the system, the design on paper alone would have cost us €6,000 - thousands which we spared," he said.