Case Studies
Greater Western Consortium
In 2006 and 2007, highly uneven distribution of the basic physician trainee workforce and training opportunities led to the development of five consortia of basic physician training around Victoria. Dr Ka Chun Tse was the inaugural manager of the Greater Western Consortium of Basic Physician Training, which increased cross-organisation rotation of basic physician trainees among Melbourne Health, Western Health, Ballarat Health Service, Northeast Health Wangaratta and Wodonga Regional Health Service. Through the sharing of medical education events and video-conferencing technology, basic physician trainee education activities were increased in all five health services, particularly at the rural sites.
Albury Wodonga Health.
In 2008 and 2009, Wodonga Regional Health Service was in the process of merging with Albury Base Hospital to form Albury Wodonga Health. As part of the senior management of Wodonga Regional Health Service, Dr Ka Chun Tse led the harmonisation of quality and risk management systems across the two health services. These included policies and procedures, incident management, consumer feedback management, the consumer participation program and the structure of the Quality, Risk Clinical Governance Unit in the new health service.
Sale Hospital
In 2010 and 2011, Central Gippsland Health Service was at risk from multiple vacancies and high locum use in paediatrics and the junior medical workforce. Through an intensive recruitment campaign, Dr Ka Chun Tse recruited two full-time staff paediatricians which eliminated locum use in that service. A planned leave management process was introduced for the junior medical workforce, which largely replaced locums with full-time Hospital Medical Officers, significantly improving both continuity of care and financial performance.
Bairnsdale Regional Health Service
In 2010 and 2011, Bairnsdale Regional Health Service was experiencing difficulties in governance and senior management, and having a medical workforce which meets the demands of a growing community and contemporary standards for junior medical staff supervision. These issues culminated in an external review of governance and management, adverse publicity surrounding the surgical service and significant conditions being placed on the health service’s accreditation with the Postgraduate Medical Council of Victoria. While the organisation grappled with the loss of executive, senior management and senior medical staff, Dr Ka Chun Tse continued to engage with staff, Visiting Medical Officers, the Board of Management and external stakeholders such as the Victorian Department of Health and the Postgraduate Medical Council of Victoria. From 2011 to 2015, this resulted in the development and implementation of four foundation frameworks for Bairnsdale Regional Health Service: its Junior Medical Workforce Plan, Senior Medical Workforce Plan, Clinical Governance Framework and Elective Surgical Access Coordination Business Rules. These led to a medical workforce that became compliant with Postgraduate Medical Council of Victoria and Medical Board of Australia requirements, and a transition from a GP model of care to a hybrid model of care involving GPs and medical staff specialists. A comprehensive clinical quality and safety framework was put into place, which influenced the development of similar systems in a number of other rural Victorian health services. Dr Ka Chun Tse replaced a solo General Surgeon model with a General Surgical unit of three specialists and two Hospital Medical Officers, and developed and managed an Elective Surgical Access Coordination service that complied with state policy as well as balanced pressures from community demand, the surgical services workforce and activity/funding constraints.
Swan Hill District Health
From 2016 to 2018, Dr Ka Chun Tse led the response of Swan Hill District Health to address the conditions of the health service’s accreditation with the Postgraduate Medical Council of Victoria. As part of this process and from this platform, Swan Hill District Health was able to increase the size and skill-mix of its medical workforce, formalise its medical education program, participate in the Loddon Mallee rural generalist program and create a medical services division to support and sustain these improvements. Dr Ka Chun Tse reviewed the structures and processes supporting clinical governance at Swan Hill District Health, formalising its Limited Adverse Occurrence Screening program and introducing a Mortality & Morbidity Committee. He facilitated the planning and implementation of new services such as a visiting Opioid Replacement Pharmacotherapy Nurse Practitioner service, telehealth fracture, oncology and cardiology clinics, and a visiting Infectious Diseases Physician service.
Rural DMS
Since 2016, following the revelation of avoidable neonatal deaths at Djerriwarrh Health Service, the Targeting Zero review of hospital quality assurance was conducted, which provided a blueprint for system-wide reform and involved all health services in Victoria. Dr Ka Chun Tse provided medical executive management or consultancy services to a number of Victorian small rural health services during this time, including Alexandra District Health, Beechworth Health Service, Cobram District Hospital, Cohuna District Health Service, Hepburn Health Service, The Kilmore and District Hospital, Kyabram District Health Service, Nathalia District Hospital, Numurkah District Health Service, Rochester and Elmore District Health Service and Yarrawonga Health. This has supported the development or review of service capability frameworks, scope of clinical practice statements and clinical governance frameworks, as well as medical workforce planning and management.
Dr Ka Chun Tse provides clinical governance consultancy services to the health services (immunisation and maternal child health) at Moira Shire Council, and has previously consulted for Bendigo Community Health Service and Mallacoota District Health and Support Service.