Service Profile for Biloela Hospital - Infrastructure Renewal Planning Project for Rural and Remote Areas July 2010 - Queensland Parliament
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Part B (2)
Service Profile
for Biloela Hospital
Infrastructure Renewal Planning
Project for Rural and Remote Areas
July 2010
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this timeInfrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
Contents
1 Executive summary ........................................................................................................ 3
2 Service profile for Biloela Hospital ............................................................................... 4
2.1 Geographic profile ......................................................................................................4
2.2 Demographic profile ...................................................................................................5
2.2.1 Catchment population...............................................................................5
2.2.2 Services in the secondary catchment.......................................................7
2.3 Biloela Hospital...........................................................................................................8
2.3.1 Hospital inpatient activity including current beds......................................9
• Current activity ............................................................................................... 9
2.3.2 Projected activity ....................................................................................10
2.4 Core services ...........................................................................................................12
• Surgical and procedural ............................................................................... 12
• Maternity ...................................................................................................... 12
• Emergency Department ............................................................................... 13
• General medical ........................................................................................... 14
• Non-admitted occasions of services............................................................. 14
2.4.1 Visiting specialist services ......................................................................15
• Medical Specialist Outreach Assistance Program........................................ 15
2.4.2 Current support services ........................................................................16
• Pathology ..................................................................................................... 16
• Medical imaging ........................................................................................... 16
• Pharmacy ..................................................................................................... 16
• Dental/oral health services ........................................................................... 16
2.5 Primary health care and community health services................................................17
• Other Service Providers ............................................................................... 17
• Integrated mental health services ................................................................ 18
• Allied health services ................................................................................... 18
3 Current and future bed requirements ......................................................................... 19
3.1 Summary of projected bed requirements .................................................................19
4 References..................................................................................................................... 20
5 List of figures and tables ............................................................................................. 21
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
2Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
1 Executive summary
The Infrastructure Renewal Planning Project for Rural and Remote Areas has been
identified by the Deputy Premier as a priority project aimed at providing a
comprehensive and prioritised health infrastructure program for rural Queensland.
The need to address health inequities and access to hospitals in remote areas has
also been identified by the Commonwealth Government’s National Health and
Hospital Network Agreement 2010.
This Service Profile for Biloela Hospital is one of 12 profiles developed for each of the
Queensland prioritised rural sites. The profile identifies that the current level (draft
CSCF v3.0 Level 3) and mix of clinical services provided at each site, with a focus on
the core services of surgical and procedural, maternity, Emergency Department and
general medical.
Table 1 outlines the current and future bed requirements for Biloela Hospital. To
improve the efficiency of current service delivery at Biloela Hospital, infrastructure
upgrades will be required for the Emergency Department and maternity services
area. In addition, an Outpatients Department is required so that services can be
relocated from their current location in an unused ward.
Biloela Hospital Emergency Department does not currently have an appropriate
resuscitation bay or acute treatment spaces—monitored beds located in the ward are
used for this purpose. The layout of the maternity services area requires
improvement, and specific maternity consultation rooms and a child-friendly waiting
area are needed. Infrastructure improvement to these two services would enable
growing levels of emergency activity to be safely accommodated and provide an
enhanced environment for women to access maternity care close to where they live.
Rural hospitals rely on visiting clinicians to provide a range of specialist services.
Dysfunctional layouts and insufficient treatment spaces make it difficult to attract
specialists to the hospital to provide these services. Without the services provided by
visiting specialists rural communities will continue to experience health inequities.
Rural hospitals typically have difficulty recruiting staff, and the age and condition of
accommodation provided is a major barrier to attracting and retaining a skilled
workforce. If staff cannot be recruited and retained, patient access to safe and
sustainable services will be compromised.
Table 1: Summary of current and future bed requirements for Biloela Hospital
Bed and treatment spaces Current number Number required by 2021/22
Overnight beds 25 16
Same day beds 0 2
Bed alternatives 0 0
Emergency Department 6 5
treatment spaces
Multipurpose consultation rooms 0 5+
(for outpatients) 3 maternity consultation rooms
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
3Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2 Service profile for Biloela Hospital
2.1 Geographic profile
Biloela Hospital is located in the Central Queensland Health Service District (the
District), which extends from the central Queensland Coast west to the Central West
Health Service District between Emerald and Alpha. It incorporates four distinct
areas: Rockhampton, Gladstone, Banana (Biloela) and Central Highlands (Emerald).
Central West Health Service District (neighbouring to the west) also flows into the
District for higher level services (Figure 1).
Banana
The main town in the Banana area is Biloela, located 146 kilometres south of
Rockhampton and 121 kilometres west of Gladstone. The rural area includes the
smaller towns of Moura, Theodore and Baralaba.
Figure 1: Map of Central Queensland Health Service District
Source: http://www.health.qld.gov.au/maps/mapto/centralQld.asp
According to the Australian Statistical and Geographical Categories, Biloela is
classified as ‘outer regional’ with a remote area score of RA3.1 Other areas in the
District, such as Springsure and Gemfields, are classified as ‘remote’ with a remote
area score of RA4.1
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
4Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.2 Demographic profile
2.2.1 Catchment population
In 2006, approximately 56 per cent of the District population resided in the
Rockhampton Base Hospital primary catchment area, 24 per cent in Gladstone,
12 per cent in Emerald and eight per cent in Biloela.
Rockhampton is the main population centre, accommodating more than half of the
District’s population. The second largest population centre is Gladstone and
surrounds, supporting approximately one quarter of the District population.
As Rockhampton Base Hospital provides a higher level of service, its secondary
catchment area covers the whole of the District and includes some flows from Central
West Health Service District. The proportion of District activity provided by hub sites
is shown in Table 2. These proportions are a better indication of demand for services
by site and for assessing distribution of resources.
Table 2: Proportion of inpatient activity provided in Central Queensland Health
Service District by hub hospitals 2006/07
District Hospital % Inpatient Separations
Rockhampton and Yeppoon 60
Gladstone 19
Emerald 8
Biloela 3
Other District hospitals 10
Total 100
Source: Hardes Associates, May 2008
Note: Excludes Chemotherapy and Renal Dialysis
Based on the 2001 Census projections for Statistical Local Areas (SLAs), the
populations of Gladstone and Emerald are expected to increase most sharply
between 2006–2026 (62% and 55% respectively), with a 35 per cent increase for the
Rockhampton Base Hospital catchment population and only eight per cent for the
Biloela catchment. Current and projected resident population by SLA is shown in
Table 3.
Table 3: Estimated population in the District by SLAs (2006) and percentage
projected change 2006–2026
% Change % Change
SLA 2006^ 2006–2016^^ 2006–2026^^
Banana 14,224 2 5
Bauhinia 2,324 9 18
Calliope 17,538 34 73
Duaringa 7,187 20 38
Emerald 15,364 34 68
Fitzroy* 11,213 34 60
Gladstone 31,028 29 55
Livingstone 30,637 30 61
Mount Morgan 3,170 10 15
Peak Downs 3,401 18 37
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
5Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
% Change % Change
SLA 2006^ 2006–2016^^ 2006–2026^^
Rockhampton 62,610 11 18
Taroom – CQ Part 1,399 N/A N/A
Woorabinda 928 N/A N/A
Total 201,023 21 41
Source: Medium Series Population Projections, based on 2006
Census, Dept of Infrastructure & Planning (PIFU)
^ PIFU 2006 Edition, Area Grouping Created by Queensland Health
^^ PIFU, 2008 Edition, LGA boundaries.
* Excludes Balance of Fitzroy SD (c) – 918 people (2006).
In 2006, the majority of residents in the District were born in Australia, with residents
born in other countries mostly originating from New Zealand or the United Kingdom.
In 2006, statistics indicated that 97–98 per cent of residents spoke English at home,
reflecting the predominantly Australian and English-speaking population.
Table 3: Estimated Aboriginal and Torres Strait Islander population in
Central Queensland District 2006 Census
Age Group in Years 2006 % Aboriginal and Torres Strait Islander Population
0–14 4,153 40.1
15–44 4,718 45.6
45–64 1,218 11.8
65+ 261 2.5
Total 10,350 100
Source: Office of Economic and Statistical Research (March 2008)
Note: Aboriginal and Torres Strait Islander splits have been synthetically estimated and should be used
with caution.
In 2006, five per cent of the District population identified as Aboriginal and Torres
Strait Islander. It is a very young population, with 86 per cent of Aboriginal and Torres
Strait Islander people being under 44 years and 40 per cent under 14 years and only
2.5 per cent of people over 65 years in 2006. Of that population, 4.8 per cent resided
in the SLA of Banana (493 persons).
In the Biloela area, the meat industry has attracted immigrants from South America,
some of whom have specific health problems, including respiratory tuberculosis.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
6Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.2.2 Services in the secondary catchment
Rockhampton Base Hospital is the main referral hospital for the District, and to some
extent the Central West Health Service District. In addition to Rockhampton Base
Hospital, there are three other hub hospitals that provide services for local areas of
the District and some support smaller facilities within their area. These include:
Gladstone, Emerald and Biloela Hospitals. Hub hospitals and smaller
hospitals/outpatient clinics included in their areas are as follows:
• Rockhampton Base Hospital and Yeppoon, Mount Morgan, Woorabinda, and
Duaringa Outpatient Clinics
• Gladstone Hospital
• Emerald Hospital and Blackwater, Springsure, Clermont, Dysart, Rolleston,
Middlemount, Tieri, Capella and Gemfields Outpatient Clinics
• Biloela Hospital and Baralaba, Moura, Theodore, Taroom and Cracow
Outpatient Clinics.
The District provides a range of hospital services and has a District-wide total self
sufficiency of:
• 66 per cent for adult overnight separations
• 53 per cent for adult same day separations
• 61 per cent for paediatric overnight separations
• 80 per cent for paediatric same day separations.
The majority of patients (90%) from the SLA of Banana, who were admitted to a
hospital other than Biloela Hospital, were admitted to a hospital in Central
Queensland, with a total of 3344 separations. The next highest Health Service
District used by Banana residents was Metro North, with smaller numbers scattered
across the state. The highest numbers of separations were for obstetrics and
non-subspecialty medicine and surgery, with similar numbers for both same day and
overnight separations.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
7Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.3 Biloela Hospital
Biloela Hospital is a 25 bed facility that provides a range of general medical, low risk
surgical procedures and birthing services.
There are two general practitioners in Biloela who currently provide anaesthetics and
obstetrics services to the Hospital. However, the District advises that one general
practitioner is retiring in September and the other is reducing his general practitioner
clinic to one day per week. Two locums with obstetrics and gynaecology skills are
commencing employment at Biloela Hospital in July and September for six months.
Clinical support services include x-ray services and simple pathology testing via
iSTAT machine provided by licensed medical and nursing staff. There is a
pharmacist on site at Biloela Hospital (the pharmacist position is currently filled by
locum staff). There are also two private pharmacies located in town.
The basis for identifying gaps in service capability against the core service profile is
to secure and consolidate services provided at Biloela Hospital, identified as the
primary hub service in the District. This may involve enhancing existing service roles
and staffing levels to support its role in the District.
The current level of service capability at Biloela Hospital is outlined in Table 4.
Services provided should align with the draft CSCF v3.0 Level 3 or lower. Gaps are
identified against this level of service in Table 4.
Providing the minimum suite of core services aims to ensure the provision of surgical
and procedural, maternity, Emergency Department and general medical services at
Biloela Hospital.
Table 4: Draft CSCF v3.0 service gap analysis for Biloela Hospital
Current
Draft CSCF CSCF
Core services v3.0 Level Current services Level Gaps
Emergency services 3 Emergency services 3
Medical services 3 Medical services 3
Surgical services 3 Surgical services 3
Peri-operative services 3 Peri-operative Services 3 Currently no
permanent staff–
services provided by
locums
Anaesthetics services 3 Anaesthetics services 3
Maternity services 3 Maternity services 3
Neonatal services 3 Neonatal services 3
Mental health Services 2 Mental health services 2
Rehabilitation services 3 Rehabilitation services 3
Palliative care services 2 Palliative care services 2
Pathology services 3 Pathology services 2 No laboratory on site –
specimens transferred
to Gladstone and
Rockhampton
Medical imaging 3 Medical imaging 2 No ultrasonographer
services services on site – visiting
service only
Pharmacy services 3 Pharmacy services 3
Source: Queensland Health, February 2010
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
8Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.3.1 Hospital inpatient activity including current beds
Current activity
Biloela Hospital has an annual average occupancy rate of around 40 per cent for all
age services. Patients from the District account for 95.4 per cent of separations. The
remaining five per cent of patients are predominantly from the Sunshine Coast–Wide
Bay Health Service District.
Table 5: All age activity at Biloela Hospital by separations and district of residence
2008/09
District of residence Separations %* Beddays
Central Queensland 1154 95.4 3101
Sunshine Coast-Wide Bay 33 2.7 75
Other States and Overseas 7 0.6 6
Metro South 5 0.4 2
Darling Downs-West Moreton 2 0.2 4
Gold Coast 2 0.2 4
Mackay 2 0.2 2
Metro North 2 0.2 2
Townsville 1 0.1 1
South West 1 0.1 1
Mt Isa 1 0.1 0
Total 1210 100 3198
Source: Queensland Health Admitted Patient Data Collection, April 2010
*Rounded to nearest 0.1 per cent
The acute ward at Biloela Hospital is a 25 bed unit. As a hub service, Biloela Hospital
should provide draft CSCF v3.0 Level 3 services. Table 6 shows the top overnight
Service Related Group (SRG) in 2008/09 was obstetrics with 133 separations,
closely followed by non-subspecialty medicine with 118 separations. Medical
separations, including non-acute, non-subspecialty medicine and respiratory
medicine, accounted for the highest number of beddays. Non-subspecialty surgery
was the top same day SRG, closely followed by gynaecology and orthopaedics.
As there is minimal paediatric activity at Biloela Hospital, this has been combined
with the adult activity (Table 6).
Table 6: Top 10 all age Service Related Groups at Biloela Hospital 2008/09
SRG Same Day SRG Overnight Separations Beddays
Non-subspecialty Surgery 47 Obstetrics 133 321
Gynaecology 33 Non-subspecialty Medicine 118 371
Orthopaedics 33 Non-subspecialty Surgery 98 230
Cardiology 25 Respiratory Medicine 89 486
Ophthalmology 21 Cardiology 75 172
Non-subspecialty Medicine 19 Orthopaedics 73 238
Obstetrics 14 Gastroenterology 50 132
Neurology 11 Neurology 33 211
Urology 11 Endocrinology 25 181
Respiratory Medicine 8 Non-acute 23 265
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
9Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
As shown in Table 7 and Table 8, the five year trend in all age separations for Biloela
Hospital was for a slight increase (10%), whereas total beddays decreased slightly
(9%).
Table 7: Five year trend for separations for combined medical surgical and
procedural activity (all age) at Biloela Hospital 2004/05–2008/09
% Change
Separations 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
All age activity 1254 1347 1007 982 1377 10
Source: Queensland Hospital Admitted Patient Data Collection, Queensland Health, Oct 2008
# Preliminary data, subject to change
Note: Includes chemotherapy, renal dialysis and qualified neonates (if applicable)
Table 8: Trend in bed utilisation (beddays) for combined medical surgical and
procedural activity (all age), Biloela Hospital 2004/05–2008/09
% Change
Bed utilisation 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
All age activity 3808 3611 3432 3952 3472 -9
Source: Queensland Hospital Admitted Patient Data Collection, Queensland Health, Oct 2008
# Preliminary data, subject to change
Note: Includes chemotherapy, renal dialysis and qualified neonates
2.3.2 Projected activity
In rural hospitals providing a draft CSCF v3.0 Level 3 service, beds are not
designated into specific bed type categories as there are no specialist clinical units.
This arrangement also provides flexibility at the local District/facility level to use beds
as needed dependent on local activity. The profile of projected activity in rural
hospitals is not expected to change, however, with improved infrastructure—including
modernised layouts and or refurbishment of current buildings—strengthening of
current services would occur. Maternity, emergency services, surgical and outpatient
services could continue to grow and provide more efficient services.
The bed types and treatment spaces set out in Table 20 and Table 21 reflect the
categories from the More Beds for Hospitals Strategy.2 It should be noted that many
of the categories outlined in the More Beds for Hospitals Strategy2 are not applicable
for rural hospitals. The projections have been calculated using aIM data and data
templates developed by the Planning and Coordination Branch Statewide (Data)
Team. The benchmarks and methodology used for calculating the projected bed
categories are described in the Methodology Section of the Statewide Implications for
Rural Service Provision.
Biloela Hospital currently has 25 multi-purpose overnight beds, which are sufficient to
meet activity requirements until 2021/22. Projections indicate that by 2021/22, 16
overnight beds will be required (applying an 85 per cent occupancy rate) and 19
overnight beds (applying a 70 per cent occupancy rate).
Currently, there are no same day beds, but it is projected that two will be required by
2011/12, with no further increase to 2021/22. There are currently no designated
Stage 2 recovery chairs at Biloela Hospital as ward beds are utilised for this purpose.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
10Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
Unlike inpatient activity, detailed projections are not available for Emergency
Department activity. As a result, future emergency demand has been assessed using
current activity data by facility, projected population growth and an application of
previous trends in activity.
While the current number of Emergency Department treatment spaces is sufficient up
to 2021/22, the current Emergency Department at Biloela Hospital does not have an
appropriate resuscitation bay or acute treatment spaces—monitored beds located in
the ward are used for this purpose. Biloela Hospital also requires an
isolation/decontamination room and psychiatric treatment space.
There is currently no defined Outpatient Department—an unused ward is utilised for
this purpose—so there are no designated outpatient consultant rooms. A minimum of
five consultation rooms are required to meet demand for visiting specialist outpatient
clinics up to 2021/22.
Biloela Hospital currently has one Operating Theatre, which is sufficient to meet
needs up to 2021/22 based on current activity levels. Using the Victorian Normative
Benchmarks, Biloela Hospital currently requires an additional Stage 1 recovery bay.
Biloela Hospital has sufficient delivery and treatment suites to meed expected
demand up to 2021/22. However, three maternity consultation rooms, a
multipurpose/staff/education room and a child-friendly waiting area are currently
required.
Table 9 details total birth projected for residents of the District, regardless of where
the birth takes place. It is estimated that Central Queensland will account for 5.3 to
5.5 per cent of total births (4387) in Queensland during the period of 2005/06 and
2021/22. Total births for the Central Queensland Health Service District as a district
of residence are projected to increase significantly (107%) by 2021.
The primary catchment area for Biloela Hospital is the Banana Statistical Local Area
(SLA). Projections for the Banana SLA estimate there will be 259 births in 2021/22.
There is expected to be a 21 per cent increase in births at Biloela between 2007/08
and 2021/22.
Table 9: Current and projected births 2007/08–2021/22
% of change
2007/08 2011/12 2016/17 2021/22 2007/08–2021/22
Total births for the Central
Queensland Health Service 2120 3650 4080 4387 107
District as a district of residence
Biloela
214 236 258 259 21
(including Banana SLA)^
Source: Queensland Hospital Admitted Patient Data Collection, April 2010
^Projections developed by Office of Economic and Statistical Research (OESR) using Perinatal Data
Collection and SLA using high series birth projections
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
11Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.4 Core services
Outlined below is a description of the four core services provided at Biloela Hospital:
surgical and procedural, maternity, Emergency Department and general medical.
Surgical and procedural
Biloela Hospital provides surgical and procedural services at a draft CSCF v3.0 Level
3 service.
In rural hospitals, allowance must be made for adequate bed numbers to
accommodate scheduling and case numbers on the theatre list on the days
specialists visit. Currently, Biloela Hospital uses its overnight beds for day surgery
admissions as there are no Stage 2 recovery chairs.
In 2008/09, gynaecology (same day activity) and obstetrics (overnight activity)
accounted for the highest number of surgical separations at Biloela Hospital.
Obstetrics also accounted for the highest number of beddays, with an average length
of stay of three days.
Table 10: Top 10 surgical and procedural Service Related Groups same day and
overnight for Biloela Hospital for 2008/09
Same Day Overnight
Surgical and procedural SRGs Separations Separations Beddays
Obstetrics - 28 83
Plastic and Reconstructive Surgery 7 11 38
Non-subspecialty Surgery 5 7 22
Colorectal Surgery - 6 11
Ophthalmology 17 9 9
Gynaecology 24 7 8
Vascular Surgery - 1 8
Urology 3 2 7
Extensive Burns - 1 2
Source: Queensland Hospital Admitted Patient Data Collection, Queensland Health, April 2010
Maternity
In the District, 98 per cent of births occur at Rockhampton, Gladstone, Emerald or
Biloela Hospitals, with 80 per cent being at Rockhampton or Gladstone Hospitals.
Biloela has the least births per year amongst the hub hospitals, with around 130–150
per year.
The Maternity Unit at Rockhampton Base Hospital is the main hub for obstetrics in
the District, supporting lower level services at Gladstone, Emerald and Biloela.
Maternity services are provided at Rockhampton Base Hospital for low, medium and
high risk pregnancies and deliveries for 32 weeks gestation or later.
Biloela Hospital had on average 137 births per year between 2003/04–2007/08, and
received women from outlying towns of Moura, Baralaba, Theodore, Monto and
Taroom (Table 11).
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
12Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
Table 11: Births at Biloela Hospital 2003/04–2007/08
2003/04 2004/05 2005/06 2006/07 2007/08^
Births 140 131 143 151 120
Source: Perinatal Data Collection, Queensland Health, October 2008
^Data for July-Dec 07 extrapolated to full year.
Based on current patterns of use by 2021, 56 per cent of births will be at
Rockhampton Base Hospital (1302), 27 per cent at Gladstone (633), 12 per cent at
Emerald (278) and five per cent at Biloela (126). The average length of stay for
caesarean sections is 4.8 days and for vaginal births is three days.
Over the last five years, there has been a 59 per cent decrease in maternity
outpatients at Biloela Hospital (Table 12).
Table 12: Gynaecology and maternity occasions of service at Biloela Hospital
2004/05–2008/09
Clinics 2004/05 2005/06 2006/07 2007/08 2008/09
Gynaecology 129 124 92 107 67
Maternity 231 48 7 138 94
Source: Queensland Hospital Admitted Patient Data Collection, Queensland Health, April 2010
Paediatrics
Monthly paediatric outreach clinics are conducted at Woorabinda, Emerald, Biloela
and Yeppoon, supplemented by telehealth consultancy advice.
Paediatric activity is low, with the total number of beddays for 2008/09 at 173,
including both same day and overnight separations. Only one bed will be required to
manage future paediatrics activity at Biloela Hospital based on current activity.
Emergency Department
Overall, emergency activity at Rockhampton, Gladstone, Emerald and
Biloela Hospitals has increased by 11 per cent over the past five years.
The total number of Emergency Department presentations at Biloela Hospital has
increased by 17 per cent in the period between 2004/05 and 2008/09 (Table 13).
This is despite the fact that Biloela Hospital does not have a functional Emergency
Department. Monitored beds in the ward are currently used as a resuscitation
treatment space. The other acute treatment spaces are also dysfunctional as there is
inadequate space to manoeuvre trolleys.
In the period 2004/05 to 2008/09, the majority of Emergency Department activity was
for Triage Categories 4–5 (approximately 75% of all Emergency Department activity)
and there was a slight increase in activity for Triage Categories 1–5. During this
period the number of patients admitted and transferred decreased by 55 per cent
(Table 13).
Where percentages do not total 100 per cent, this is due to patients who did not wait
for treatment for reasons unknown (these patients are reflected in Table 13).
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
13Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
Table 13: Percentage of Emergency Department presentations admitted/transferred,
Biloela Hospital 2004/05–2008/09
% Change
Presentations 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
Total number of 4000 3440 3357 4324 4676 17
Presentations
% of admitted transferred 20 15 12 15 9 -55
% of Triage Categories 1– 7 7 13 9 13 86
3
% of Triage Categories 4– 72 78 74 76 77 7
5
Source: Queensland Hospital Admitted Patient Data Collection, Queensland Health, April 2010
General medical
General medical services at Biloela Hospital are routinely provided by nursing,
medical (general practitioner and senior medical officers) and allied health staff. In
addition, there are visiting medical specialists who provide services on a regular
basis.
Between the years 2004/05 and 2008/09, utilisation of beds for non-acute activity at
Biloela Hospital increased slightly (10%), the number of beddays decreased by 21
per cent during this period. This follows significant peaks in activity for the years
2005/06 to 2007/08 (685 and 603 bed days respectively), which may be due to the
change in workforce or availability of aged care beds. There was no same day
activity recorded for non-acute care.
Table 14: Five year trend for non-acute activity at Biloela Hospital 2004/05–2008/09
% of Change
Non-acute 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
Separations
Same day 0 0 0 0 0 0
Overnight 21 33 14 28 23 10
Beddays
Overnight 335 685 446 603 265 -21
Source: Queensland Health Admitted Patient Data Collection, April 2010
Non-admitted occasions of services
Outpatient services at Biloela Hospital provide a range of non-admitted services.
These include the following clinics: general practice (provided by hospital medical
officers or visiting general practitioners), minor operations, pre-
admission/anaesthetic, dressing/wound management, gynaecology and maternity,
and ophthalmology. There is also a range of allied health services provided at the
Hospital. An unused ward is used for outpatient clinics and ward spaces are used for
consultation rooms.
Although Central Queensland has experienced an average annual increase in
specialist outpatient services of around six to seven per cent per year over the past
five years, Biloela Hospital has experienced a decline in overall outpatient activity.
The decrease was across all specialist categories, except for increases in pre-
admission clinic and clinical haematology activity.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
14Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
Table 15: Specialist outpatient clinic attendances, Biloela Hospital 2003/04–2007/08
% Change
Specialty 2003/04 2004/05 2005/06 2006/07 2007/08# Over 5 Years
Clinical Haematology 59 141 200 275 141 139
Ear Nose and Throat - - - 70 62 -
Paediatrics - - - 9 - -
General Surgery - - 62 100 15 -
Gynaecology 136 129 124 92 107 -21
Maternity 376 231 48 7 138 -63
Ophthalmology 403 428 410 379 293 -27
Orthopaedics 89 4 8 - - -
Pre-admission 136 301 486 540 512 276
Psychiatry 359 288 286 227 176 -51
Wound Management 498 417 412 350 327 -34
Total 2056 1939 2036 2049 1771 -14
Source: Monthly Activity Collection, Queensland Health (Extracted Oct 14, 2008)
# Preliminary data, subject to change
2.4.1 Visiting specialist services
Services provided by visiting/external specialists are shown in Table 17. In addition, a
private gynaecologist (funded under the Medical Specialist Outreach Assistance
Program), a private sonographer and the Royal Flying Doctor Women’s Health
Services provide services in Biloela. The main referral hospital is Rockhampton Base
Hospital or Brisbane hospitals for higher level services.
Table 16: Services provided by visiting/external specialists to Biloela Hospital
Specialty Frequency Provider Public/private
Obstetrics and Gynaecology Monthly Flying O&G, Roma Public
Ophthalmology Monthly (2 days) Munduberra Public & Private
Psychiatry Fortnightly Rockhampton Public
Ear, Nose and Throat 3 monthly Rockhampton Public
General Physician Monthly Private Rockhampton Private only
Dermatology Bi-monthly Private Rockhampton Private only
Orthopaedics Fortnightly Private Rockhampton Private only
Source: Biloela Hospital for draft Central Queensland Health Service Plan, August 2008
Medical Specialist Outreach Assistance Program
Where there is a demonstrated need in rural and remote areas, the Medical
Specialist Outreach Assistance Program provides a range of Commonwealth-funded
visiting services. The program funds the following services to the District:
• Ear, Nose and Throat specialist (eight times per year)
• Flying Obstetrician and Gynaecologist visits monthly, treating public patients.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
15Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.4.2 Current support services
Pathology
There is no pathology laboratory in Biloela. All pathology testing is done using an
iSTAT machine provided by licensed medical and nursing staff, or specimens are
transferred to Rockhampton.
Table 17: Pathology Occasions of Service for outpatient clinics at Biloela Hospital,
2003/04–2007/08
% Change
Pathology 2003/04 2004/05 2005/06 2006/07 2007/08 Over 5 Years
Occasions of Service 1248 1414 1124 1274 3893 212
Source: Monthly Activity Collection, Queensland Health (Extracted Oct 14, 2008) from draft Central
Queensland Health Service Plan
# Preliminary data, subject to change
Medical imaging
Biloela Hospital currently provides x-ray, ultrasound and processing services on site.
Medical imaging occasions of service have decreased by 20 per cent between
2004/05 and 2008/09.
Table 18: Medical imaging and pharmacy Occasions of Service at Biloela Hospital,
2004/05–2008/09
% Change
Services 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
Medical imaging 2028 1625 1312 1699 1620 -20
Pharmacy 1454 813 744 1220 1030 -29
Source: Queensland Health Admitted Patient Data Collection, April 2010
Pharmacy
There is a pharmacist on site at Biloela Hospital (the pharmacist position is currently
filled by locum staff). There are also two private pharmacies in town. Pharmacy
occasions of service decreased by 29 per cent between 2004/05 and 2008/09 (Table
18).
Dental/oral health services
Dental technician services are provided at Biloela Hospital which currently has one
dental chair. Specialised dental/oral health services are provided from Rockhampton
Hospital.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
16Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
2.5 Primary health care and community health services
One of the major challenges of health services in the catchment is to effectively
implement evidence-based interventions aimed at addressing preventable disease.
The growth in population, the travel required to access health services and the need
to provide services to sparsely populated regions has created a need to reconsider
current models of care and look for alternative service delivery models.
Implementation of alternative models of care such as Hospital in the Home, Hospital
in the Nursing Home, integrated models of care across primary health care and acute
services, and nurse practitioner led clinics may achieve some efficiency in service
delivery.
A key strategy in achieving these efficiencies will be expanding community-based
resources for identifying, targeting, and managing key chronic diseases and common
conditions of ageing, in collaboration with other local agencies.
Future community-based service requirements have been broadly considered in the
context of the catchment and opportunities for enhancing community-based services.
Detailed consideration of future community health services and capacity
requirements will occur if the preliminary evaluation progresses to a Business Case.
A range of primary heath care and community health services are available in
Biloela. Community health services are provided by Queensland Health, including a
community health nurse, two Aboriginal and Torres Strait Islander health workers, a
child protection liaison officer, child health nurse and a school based youth heath
nurse.
A range of community health services are also provided from Rockhampton,
Gladstone, Emerald, Biloela and Yeppoon. These include:
• child and family health (including child protection, but not allied health child
development) services – provided from Biloela
• Alcohol, Tobacco and Other Drugs – a single position based in Biloela.
Other Service Providers
Division of General Practice
There are two Divisions of General Practice within the District boundaries. The
Capricornia Division covers the Rockhampton, Gladstone and Capricornia Coast
(Yeppoon) areas. The Central Queensland Rural Division covers Biloela, Emerald
and surrounding areas.
Central Queensland Rural Division of General Practice
The Central Queensland Rural Division of General Practice has staff based in
Biloela, Emerald and Woorabinda. The area has 57 general practitioners (100%
membership) within 24 practices. Twenty five per cent operate on a solo basis, with
75 per cent operating with two general practitioners or more. Seventy five per cent of
practices have practice nurses.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
17Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
The Division offers a number of programmes, including:
• Chronic Disease Program, part of Queensland Health’s Health Lifestyle
programmes, alcohol and drugs, Aboriginal and Torres Strait Islander young
parents’ support worker
• Partners in Mind (mental health initiative)
• mental health support in drought areas
• Immunisation programme support
• Prevention of type 2 diabetes
• Aged Care Access Initiative.
The Division supports approximately six full time equivalent staff under the More
Allied Health Services programme, including a dietician, diabetes educator, speech
pathologist, occupational therapist, social worker, psychologist, drug and alcohol
counsellor, mental health nurse and counsellor. Coverage is provided to all
communities, although not all services are provided to all communities.
Integrated mental health services
Non-medical community mental health staff teams are based at Gladstone, Yeppoon,
Emerald, Biloela and Rockhampton. They provide the basic range of community
mental health services for adults, older people, children and youth, and Aboriginal
and Torres Strait Islander residents, and increasingly provide drug and alcohol (dual
diagnosis) support. Other more specialised community mental health positions are
generally based at Rockhampton. Regular psychiatrist sessions are provided from
Gladstone (four days per week) and less frequently to Yeppoon, Emerald and Biloela
(generally fortnightly). Consultations are provided from other smaller sites as
required.
Allied health services
Biloela Hospital offers a basic range of allied health therapy services, including:
physiotherapy, occupational therapy, social work and speech pathology. The largest
increase in occasions of service in the years 2004/05 to 2008/09 has been in
physiotherapy (44%). Over the past five years, allied health services have decreased
by 17 per cent, with nutrition, psychology and social work services no longer provided
at Biloela Hospital.
Table 19: Allied Health Occasions of Service at Biloela Hospital 2004/05–2008/09
% Change
Services 2004/05 2005/06 2006/07 2007/08 2008/09 Over 5 Years
Nutrition 39 28 1 - - -
Physiotherapy 1091 1023 1176 1319 1573 44
Psychology - 252 141 - - -
Social Work 718 1336 342 - - -
Wound Management 417 412 350 327 311 -25
Total 2265 3051 2010 1646 1884 -17
Source: Queensland Health Admitted Patient Data Collection, April 2010
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
18Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
3 Current and future bed requirements
3.1 Summary of projected bed requirements
Table 20 and Table 21 present a high-level summary of the projected bed and other
treatment space requirements for Biloela Hospital to 2021.
Table 20: Current and projected bed requirements for Biloela Hospital
Current Projections using Projections using
numbers 85% occupancy rates 70% occupancy rates
Beds/Alternatives 2010 2011 2016 2021 2011 2016 2021
Overnight Beds
Total multipurpose
25 15 15 16 17 18 19
overnight beds
Same day beds/bed alternatives
Same day beds 0 2 2 2
Stage 2 recovery chairs 0 0 0 0
Chemotherapy chairs 0 0 0 0
Renal dialysis chairs
0 0 0 0
(in centre)
Other medical
0 0 0 0
(inc. Discharge Lounge)
Total same day beds/
0 2 2 2
bed alternatives
Other treatment spaces
Projected requirements for recovery spaces, delivery suites, Outpatient Clinic rooms
and Emergency Department spaces currently exceed the current built capacity at
Biloela Hospital.
Table 21: Current and projected other treatment space requirements for
Biloela Hospital
2010 2011 2016 2021
Operating Theatres 1 1* 1* 1*
Procedure rooms 0 0 0 0
Stage 1 recovery
1 2 2 2
spaces
Delivery Suites 2 2 2 2
Outpatient clinic 5+ 5+ 5+
0
rooms 3 maternity 3 maternity 3 maternity
ED treatment spaces 6 4 5 5
X-ray rooms, 1 x-ray room 1 x-ray room 1 x-ray room 1 x-ray room
Ultrasound, plain film 1 ultrasound 1 ultrasound 1 ultrasound 1 ultrasound
x-ray room room room room
1 processing 1 processing 1 processing 1 processing
room room room room
CT scanner 0 0 0 0
*May require an additional theatre if surgical needs are expected to increase.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
19Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
4 References
1 Australian Bureau of Statistics. Australian Statistical and Geographical
Categories. Australian Standard Geographical Classification (ASGC) 2009
(cat. no. 1216.0); Australian Standard Geographical Classification (ASGC) -
Electronic Structures 2009 (cat. no. 1216.0.15.001) and Australian Standard
Geographical Classification (ASGC) Correspondences 2009 (cat. no.
1216.0.15.002); 2009.
2 Queensland Government. More Beds for Hospitals Strategy. Queensland
Health; 2006.
3 Australasian Health Infrastructure Alliance and University of New South
Wales. Australasian Health Facilities Guidelines Revision v.3.0. Centre for
Health Assets Australasia; 2009.
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
20Infrastructure Renewal Project for Rural and Remote Areas
Service Profile for Biloela Hospital Paper 2, July 2010
5 List of figures and tables
Table 1: Summary of current and future bed requirements for Biloela Hospital ................. 3
Figure 1: Map of Central Queensland Health Service District ............................................. 4
Table 2: Proportion of inpatient activity provided in Central Queensland Health
Service District by hub hospitals 2006/07 ............................................................. 5
Table 3: Estimated population in the District by SLAs (2006) and percentage
projected change 2006–2026 ............................................................................... 5
Table 3: Estimated Aboriginal and Torres Strait Islander population in
Central Queensland District 2006 Census............................................................ 6
Table 4: Draft CSCF v3.0 service gap analysis for Biloela Hospital ................................... 8
Table 5: All age activity at Biloela Hospital by separations and district of
residence 2008/09................................................................................................. 9
Table 6: Top 10 all age Service Related Groups at Biloela Hospital 2008/09 .................... 9
Table 7: Five year trend for separations for combined medical surgical and
procedural activity (all age) at Biloela Hospital 2004/05–2008/09 ...................... 10
Table 8: Trend in bed utilisation (beddays) for combined medical surgical and
procedural activity (all age), Biloela Hospital 2004/05–2008/09 ......................... 10
Table 9: Current and projected births 2007/08–2021/22 .................................................. 11
Table 10: Top 10 surgical and procedural Service Related Groups same day and
overnight for Biloela Hospital for 2008/09 ........................................................... 12
Table 11: Births at Biloela Hospital 2003/04–2007/08 ........................................................ 13
Table 12: Gynaecology and maternity occasions of service at Biloela Hospital
2004/05–2008/09 ................................................................................................ 13
Table 13: Percentage of Emergency Department presentations
admitted/transferred, Biloela Hospital 2004/05–2008/09.................................... 14
Table 14: Five year trend for non-acute activity at Biloela Hospital 2004/05–
2008/09 ............................................................................................................... 14
Table 15: Specialist outpatient clinic attendances, Biloela Hospital 2003/04–
2007/08 ............................................................................................................... 15
Table 16: Services provided by visiting/external specialists to Biloela Hospital ................. 15
Table 17: Pathology Occasions of Service for outpatient clinics at
Biloela Hospital, 2003/04–2007/08 ..................................................................... 16
Table 18: Medical imaging and pharmacy Occasions of Service at Biloela
Hospital, 2004/05–2008/09 ................................................................................. 16
Table 19: Allied Health Occasions of Service at Biloela Hospital 2004/05–2008/09.......... 18
Table 20: Current and projected bed requirements for Biloela Hospital ............................. 19
Table 21: Current and projected other treatment space requirements for
Biloela Hospital ................................................................................................... 19
“PRINTED COPIES ARE UNCONTROLLED”
Endorsed by IPPEC—does not represent Queensland Health policy at this time.
21You can also read
