CHI report shows concerns were flagged last year over children's spinal surgeries at Temple Street
Hospitals Concerns Culture Raising Published In Feel Developing Remends By Children's A The Ireland Staff Health The Safe Report (chi) Where
Children undergoing complex spinal surgery in CHI at Temple Street for spina bifida were more likely to need an unplanned follow-on surgery than at international hospitals, a report published by Children's Health Ireland (CHI) shows.
The report, published by CHI on Monday, shows concerns were flagged as far back as July 2022 and recommends developing a culture in the hospitals where staff feel safe raising concerns. The report is a summary created by CHI of two reviews, one carried out internally and one carried out externally by the Boston Children’s Hospital.
The report was published as the HSE, also on Monday, announced a separate external review of elements of the Paediatric Orthopaedic Surgical service at CHI at Temple Street following a number of serious spinal surgical incidents there.
CHI’s own report shows concerns were raised in July and September 2022 following internal reports of two serious post-operative surgical incidents in spinal surgery.
However it also states while “there were concerns raised regarding the outcomes of paediatric spinal surgeries in children with Spina Bifida”, they now recommend that “more attention is needed to create a culture where all members of the care team are encouraged and comfortable sharing safety questions and concerns”.
Data shared in this document shows out of 16 files examined by the internal review team 13, or 81.2%, required further unplanned surgery. International data which they analysed showed a rate of 44% for surgeries carried out between 2004 and 2022.
“One of these patients who had multiple procedures, unfortunately, died and this death is the subject of a Serious Incident Investigation Review,” the report states.
It later says: “The post-operative complication findings from the clinical reviews demonstrate that the Kyphectomy procedure outcomes in CHI at Temple Street are higher when compared to the results in the high-level summary of published articles on this procedure for returns to theatre and revision of metal work.”
The document shows CHI paused certain surgeries, saying the last short-segment Kyphectomy performed in CHI at Temple Street was in July 2022, and it has been formally paused since November. It also notes Ireland has one of the highest rates of spina bifida in the world.
Based on findings in both reviews, the CHI report indicates changes which are needed. These include “a robust quality improvement programme and meaningful opportunities to speak up for safety, which are taken seriously and addressed, “should be part of the culture".
It highlights “a defined governance structure” as central to future success, as well as transparent clinician accountability and standards. It states the physical infrastructure at the Temple Street site is limited with only four operating theatres.
“A state-of-the-art paediatric hospital will open in 2025 which should help to alleviate the long wait times and provide updated infrastructure and physical facilities,” the report states.
This new children’s hospital in Dublin has been the subject of much controversy over rising costs and changes to the date by which patients can expect to be treated there.
The report by CHI "Report on Spinal Surgery for Patients with Spina Bifida in Children’s Health Ireland at Temple Street Summary of Findings and Recommendations" can be read on the CHI website.