Tygerberg Hospital Private Bag X3, Francie van Zijl Avenue, Tygerberg, 7505 tel: +27 21 938 4911 fax: +27 21 938 4890 Website: www.capegateway.gov.za Health The Afrikaans & Xhosa electronic versions are available on request Cape Government Health Western Annual Report 2011 Tygerberg Hospital Health Annual Report 2011 Tygerberg Hospital Tygerberg Hospital Annual Report 2011 Vision, Mission and Values Vision Quality health for all. Mission To provide equitable access to health in partnership with the relevant stakeholders within a balanced and well managed health system. Values The overarching values identified by the Provincial Government of the Western Cape are: • Caring • Competence • Accountability • Integrity • Responsiveness The core values that will be reflected in the way in which the vision and mission are achieved are: • Integrity • Public accountability • Innovation • Openness and transparency • Commitment to high quality service • Respect for people • Excellence TYGERBERG HOSPITAL ANNUAL REPORT 2011 Contents CONTENTS Foreword 4 Message from Professor Craig Househam 4 Message from Dr Beth Engelbrecht 5 Message from Dr Dimitri Erasmus 6 Finance 7 Administration 19 Nursing 64 Biomedical Science 74 Clinical Psychology 85 Community Health 87 Forensic Medicine 92 Medical Imaging and Clinical Oncology 95 Medicine 104 Obstetrics and Gynaecology 134 Paediatrics and Child Health 148 Psychiatry 178 Surgical Sciences 187 Clinical Engineering 199 Human Nutrition 202 Occupational Therapy 209 Physiotherapy 212 Speech Therapy and Audiology 215 Voluntary Aid Services 217 Hospital School 219 Statistics 220 TYGERBERG HOSPITAL ANNUAL REPORT 2011 3 Foreword FOREWORD Message from Professor Craig Househam Head of Western Cape Health Tygerberg Hospital has a special and important place in the health services of the Western Cape. It is the largest hospital in the province, with 1310 operational beds, and it is closely associated with the Faculty of Health Sciences of Stellenbosch University. While the hospital is old in terms of the normal life span of a hospital and in urgent need of refurbishment or replacement, the staff continued to deliver essential health services to a wide spectrum of patients. On my visits to Tygerberg Hospital the innovation and commitment of health workers despite the fact that conditions in the hospital itself are not always optimal, has impressed me. I was privileged last year to experience the great spirit among hospital staff at the annual CEO Ball held at the hospital. It was a very enjoyable evening that demonstrated that, apart from professional skills, many employees have remarkable talent on the dance floor! During 2011 the first steps were taken in the long process to modernise and probably replace Tygerberg Hospital. The appointment of a project manager for the redevelopment of the Tygerberg premises marked the beginning of what will ultimately constitute a hospital revitalisation project costing several billion rand. Those who have seen the new Khayelitsha Hospital will realise what a difference a modern and purpose-built hospital makes to the working conditions, efficiency and, indeed, enjoyment of staff. I trust that when this project eventually comes to fruition the “new” Tygerberg Hospital will carry the proud tradition of the current hospital forward well into the future. Meanwhile I acknowledge the good work done by staff in all sections of Tygerberg Hospital during the past year, admitting over 60 000 patients and seeing over 300 000 people in the outpatient departments of the hospital. In particular, the hospital should be acknowledged for the support given to the core of the new Khayelitsha Hospital, which it hosted for several years and continue to support as the referral hospital for this new hospital. My sincere thanks to Dr Dimitri Erasmus and his management team, who have continued to strive to improve health service delivery, for their hard work and commitment. 4 TYGERBERG HOSPITAL ANNUAL REPORT 2011 Foreword Message from Dr Beth Engelbrecht Deputy Director General: Secondary, Tertiary and Emergency Care (DOH) The year 2010 marked the end of the Comprehensive Service Plan. It has come and gone and the new service-plan horizon of 2020 has emerged. The focus for the future is on patient-centred care, increasing health outcomes, and having a values-based service and organisation. These are critical elements to improve the quality of care and are invaluable for the Department and the hospital to achieve national core standards certification. The multilateral agreement (MLA) between the Western Cape Government and the four higher- education institutions (HEIs) progressed well, with all parties committed to find sufficient common ground to conclude the MLA in 2012. This will form the firm basis to revise the range of current agreements with the HEIs with regard to their access to the service platform for clinical teaching, clinical training and research, and for the joint staff system. An understanding of the new horizon is an important filter to look at a year gone by. The opening of Khayelitsha District Hospital early in 2012 majorly affected the patient profile at TBH. Preparatory joint planning in the metro East Geographic Service Area (GSA) across district services and TBH ensured a service and referral system that kept the focus on the patient and managing the impact on TBH. Service reengineering in the hospital improved the labour ward service, and the addition of emergency physicians in the emergency centre significantly strengthened the emergency care service. The hospital consistently operated 10 Paediatric ICU beds, and commissioned 4 additional neonatal high-care beds. Theatre, radiology and critical-care bottlenecks remain a challenge. Steps have been taken in response. Five operating theatre practitioners have enrolled for the two-year training program, and the MRI and CT service ran extended hours. The donated PET-CT was officially commissioned at the end of the financial year, marking a significant milestone in the nuclear medicine service. Hospital-acquired infections are a challenge to both staff and patients in any hospital setting. The hospital continued to focus on complying with the Best Care Always bundles, such as preventing ventilator-associated pneumonia and surgical-site infections. The project manager for the rebuilding of TBH was appointed and he commenced the planning that will continue over the next few years. Strategic decisions would be required. The design must be modern, the emergency centre needs to be spacious, and the general specialist beds should be organized in such a way that the whole Metro East is optimally supported. TBH is a majestic service with solid foundations in its clinical staff as well as its management and HEI partners. The district health services in its drainage area(s) are systematically being strengthened. With a future unfolding towards 2020 it embodies all the necessary elements to launch towards the future, which would culminate in a new Tygerberg Hospital. TYGERBERG HOSPITAL ANNUAL REPORT 2011 5 Foreword Message from Dr Dimitri Erasmus Chief Director: Tygerberg Hospital Tygerberg Hospital continues to play a central role in the delivery of specialised and highly specialised health services in the Western Cape and remains an institution of academic excellence through its partnership with the Faculty of Health Sciences of Stellenbosch University. This annual report reflects the activities and achievements of 2011. The hospital has experienced quite a busy year with just over 61 000 admissions and 315 000 outpatient headcounts. The total expenditure for the 2011/12 financial year amounted to R1 754 982. The key achievements in 2011 were: • the appointment of Dr Ludwig Martin as Project Officer for the development of the hospital revitalisation project • the appointment of Dr Neshaad Schrueder as the Head of General Medicine • the commissioning of four additional neonatal high-care beds • the implementation of extended scanning hours for CT and MRI scanning • the commissioning of the new cardiac catheterisation theatre and cardiac echocardiography suite scanner • key equipment purchases including a mammography machine, a neuro-navigation system for neurosurgery and a reverse osmosis water treatment system for renal dialysis • the social highlights, namely the Open Day, the end-of-year staff function, and the CEO ball. During this period the following key staff members retired: • Mr Desmond Matthews: Deputy Director Engineering Services • Ms Conelle Ford: Head of Pharmacy • Dr Richard Muller: Manager Medical Services • Prof. Shaheen Mehtar : Specialist in Infection Prevention and Control Their contribution to Tygerberg Hospital is greatly appreciated and I wish them well in their retirement. Finally, I wish to thank all the staff for their hard work and commitment which has culminated in the many achievements and activities as reflected in this annual report. 6 TYGERBERG HOSPITAL ANNUAL REPORT 2011 Finance FINANCE Financial Overview of Tygerberg Hospital in 2011/12 Director: Mr Touflek Salie Tygerberg Hospital is the single biggest health facility in the Western Cape. Its funding is secured from the National Tertiary Services Grant (NTSG), the Health Professional Development Training Grant (HPDTG) and a portion from the Provincial Equitable Share. A smaller allocation is derived from the Medium Term Strategy Grant. An overview of the hospital’s annual financial results: 2011/12. BUDGET ACTUAL VARIANCE % Expenditure R1 756,1 m. R1