A BALI TIMES EXCLUSIVE
Bali’s leading hospital, Sanglah in Denpasar, will soon be twinned with acknowledged Australian trauma centre Royal Darwin Hospital (RDH) in an innovative plan that will bring world-class triage and trauma practice within immediate reach of badly injured victims of accident, disaster or terrorism on the island.
RDH, a 363-bed, 1,700-staff teaching hospital in the Northern Territory capital under three hours flying time from Bali, is Australia’s National Critical Care and Trauma Response Centre. It already works with other Australian hospitals and within South-East Asia in this role.
The hospital won international recognition for its key part in the retrieval, treatment and transfer of victims of the 2002 Bali bombings. Within 62 hours of the blasts, medical staff had resuscitated 61 patients, including 20 intensive care patients, and evacuated 48 patients to burns centres around Australia.
RDH again treated more than 20 victims evacuated following the second Bali bombings in October 2005 and in 2006 has treated victims evacuated from East Timor.
Under the plan, put forward by Northern Territory Health Minister Kon Vatskalis, Sanglah would apply the same nursing and medical accreditation and practice as those operated by RDH.
“It will provide seamless unified standard treatment between the two hospitals and help save lives,” Vatskalis said in Bali this week. He was visiting the island on holiday but took time out to discuss development of the plan with Sanglah Hospital authorities and the Indonesian Health Ministry.
Vatskalis told The Bali Times some of the 2002 Bali bombing victims would most likely have lived if protocols now being established here with assistance from Royal Darwin had been in place at the time.
“Our mission is to work for the future,” Vatskalis said.
The director-general (medical) of the Health Ministry, Dr Supriyantoro, and Sanglah Hospital director Dr Wayan Sutarga will visit Darwin next month to finalise the proposal, expected to be put in place in March.
RDH trauma treatment protocols include bar-coding patients on site so that doctors at receiving hospitals have instant matching data on which to base treatment.
It would mean a patient bar-coded in Bali would arrive in Darwin with initial injury and treatment options already recorded and transmitted via the internet, saving valuable time and making it possible to prepare intensive care and operating theatre procedures before arrival.
The plan is a second vital element in Royal Darwin-Sanglah cooperation, begun three years ago when former RDH director of nursing Diane Brown arrived in Bali as an Australian volunteer.
Brown, who has a PhD in applied nursing practice, developed and implemented a bedside nursing handover procedure at Sanglah that has so improved patient care that it is being adopted as standard practice in every public hospital in Indonesia.
Brown, who works as a nurse educator at Sanglah, introduced both patient-centred care and a nursing handover card at the hospital in 2009, changing attitudes and improving care.
There is no culture in Indonesian hospitals of patient empowerment or practice of involving them directly in decisions about their care. One of the first changes introduced by Brown at Sanglah was a move from nurses giving handover between shifts at the whiteboard to them giving handover by the patient’s bed.
“This was a big change but one that was embraced enthusiastically by both patients and nurses,” Brown said when the new Sanglah nursing protocols were evaluated last year.
“Initially the nurses were very nervous about giving their handover in front of the patients; they were worried that they may not know how to answer patient’s questions and also that patients may not like being discussed in front of other patients in the ward,” she said.
The 2010 evaluation showed nurses’ caring behaviours such as touching, talking, smiling and explaining increased by more than 50 percent following introduction of the new system.
Patients and families said they felt much more satisfied with their care as they are introduced to the oncoming nurses each shift and have an opportunity to ask questions and to understand what the plan of care is for each day.
The handover card won the annual Quality Award at Sanglah Hospital last year and was later presented at the National Quality Awards. Health minister Endang was at Sanglah for the presentation and asked that the new handover process be implemented in all government hospitals.