This supplementary report details the Office of the Health Ombudsman’s (the office) monitoring of implementation of recommendations arising from an investigation into Gold Coast Hospital and Health Service (GCHHS) radiology services.

On 12 November 2014, the then Health Ombudsman initiated an investigation into the low reporting rate of radiology results by the GCHHS. The office’s Investigation report: Radiology services at the Gold Coast Hospital and Health Service was finalised in August 2016 and focused on the findings from the Department of Health’s (DoH) 2014 Health service investigation into reporting of radiology services at the GCHHS and the GCHHS’s Internal audit of medical imaging report. The office’s report made nine recommendations for improvements required to support the appropriate reporting of radiology results; some recommendations had statewide implications and required a number of agencies’ support for implementation.

Monitoring progress

The office actively monitors the implementation status of recommendations to:

• support and assess the timely and appropriate implementation of recommendations
• assure the Health Ombudsman and the public that appropriate activities and improvements have been implemented in response to systemic issues identified during an investigation
• promote the safety and quality of health service delivery through public reporting of shared learnings.

For this active monitoring the office seeks progress reports and supporting evidence from the relevant stakeholders regarding the implementation status of recommendations. Three progress reports were provided during the course of monitoring the radiology recommendations; these were received on 21 December 2016, 28 June 2017 and 25 August 2017. The final progress report in August 2017 was conducted via a stakeholder meeting in order to obtain a broader understanding of the improvement actions and challenges associated with implementing the radiology recommendations. During this meeting, agreement was reached on both the implementation status of each recommendation and a proposed monitoring approach involving the redrafting of more targeted recommendations, to be made as part of this supplementary report.

Findings

In relation to implementation of the nine recommendations, the supplementary report finds:

• The office is confident the GCHHS will continue to progress the longer term system changes necessary to meet radiology reporting requirements relevant to each of its facilities, patient type and modality into the future. Accordingly, no further reporting is required by the GCHHS against recommendations 1, 2, 3 and 7.
• While there are multiple agencies within the DoH currently involved in facilitating and progressing various radiology reporting initiatives, these activities appear to be fragmented and disadvantaged by the lack of a clearly articulated and coordinated governance structure. Accordingly, no further reporting is required by DoH against recommendations 4, 5, 6 and 9; these recommendations have instead been reframed and consolidated into a revised recommendation.

Recommendations

Due to the ongoing challenges in the governance supporting radiology services, this office makes the following recommendation:

1. Queensland Health undertake a review to identify the governance systems and processes provided by the Department of Health, to support the provision of safe and high quality diagnostic imaging services in hospital and health service facilities in Queensland.

The review will:

1. identify the functions, responsibilities and reporting relationships of the agencies
2. identify opportunities to improve current governance systems and processes
3. develop clinically relevant and robust standardised statewide indicators for radiology reporting.

Response

All relevant stakeholders were given an opportunity to respond to the draft report prior to its publication. The GCHHS advised that ‘the draft Supplementary Report for Radiology is noted and supports findings as they relate to GCHHS’ implementation of recommendations’. The DoH was supportive of the recommendation to undertake a review noting that ‘implementation of this recommendation will create clearer delineation and support better accountability to ensure safe, high quality radiology services for Queenslanders’.

You can also download the original investigation report in full.