Terms of Reference

The Health Information and Quality Authority has had ongoing concerns in relation to the quality and safety of the care provided to patients requiring acute admission to the Adelaide and Meath Hospital, incorporating the National Children’s Hospital (the Hospital), and who receive initial care in the Hospital’s Emergency Department, and has previously sought assurances in relation to how the Board and Executive of the Hospital are governing and managing these risks.

Following a recent patient safety event, the Authority continues not to be assured that the Hospital is effectively managing the risks to patients requiring acute admission to the Hospital and who receive initial care in the Emergency Department and believes that this poses a serious risk to these types of patients.

Consequently, in accordance with Section 9(1) of the Health Act 2007 (the Act), and having formed the opinion required by subsection 9(1)a of the Act, the Authority will undertake an investigation into the quality, safety and governance of the care provided for patients who require acute admission to the Hospital.

In the Investigation, the Authority will seek to identify and quantify any serious risks to patients and to ascertain the safety and quality of the system of care in place for patients requiring acute admission to the Hospital, in particular those patients admitted through the Emergency Department, and the effectiveness of the Board in assuring that these risks are being appropriately managed. Following this process, the Authority will make recommendations with a view to eliminating or reducing any identified risks to patients. The Investigation shall be carried out on the basis of the following terms:

1. The Authority will assess the quality, safety and governance of, and accountability for, services provided to patients that present to the Emergency Department in the Hospital and are awaiting admission to the Hospital’s in-patient wards. Specific patient cases, where the Investigation Team deems appropriate, will be incorporated in this assessment.

2. The Authority will assess the quality, safety, governance and timeliness of the system and process of care for patients requiring acute admission into the Hospital with a particular focus on the patient journey from initial assessment, through admission to discharge.

3.  The Authority will assess the effectiveness of, and accountability for, the corporate and clinical governance arrangements in place within and between the Board, the Transitional Board and Executive of AMNCH in addressing the quality and safety of services provided to patients in the Hospital.

4. The Authority will assess how the Health Service Executive’s regional and national governance arrangements are supporting and monitoring the provision of safe, quality services in the Hospital.

5. The Investigation shall be carried out by the Authority in accordance with its statutory powers under Part 9 of the Health Act 2007 and in whatever manner and with whatever methodology the Investigation Team believes is the most appropriate. The scope of the Investigation will be limited to those aspects of safety and quality that the Investigation Team considers are most relevant and material to the Investigation.

6. If, in the course of the Investigation, it becomes apparent that there are reasonable grounds to believe that there is a further or other serious risk to the health or welfare of any person receiving services, and that further investigation is necessary beyond the scope of these terms of reference, the Investigation Team may in the interests of investigating all relevant matters, and with the formal approval of the Authority, extend these terms to include such further investigation within their scope or recommend to the Authority and/or the Minister for Health, that a new investigation should be commenced as appropriate.

7. The Investigation Team shall prepare a report which will be submitted to the Board of the Authority for approval and then published. This report shall outline the Investigation, its findings, conclusions and any recommendations that the Authority sees fit to make. In the interests of wider service improvement, national recommendations may also be made where the Authority considers appropriate.

8. The investigation will be conducted by an Investigation Team appointed and authorised by the Authority in accordance with Part 9 of the Health Act 2007. The Team will carry out the investigation and may exercise such powers as it has, pursuant to Part 9 of the Health Act 2007, including rights of entry, its rights to inspect premises, records and/or documents and its rights to conduct interviews.

These Terms of Reference were approved by the Board of the Authority on 28 June 2011.