Senior management at a Tasmanian hospital where a male pedophile nurse worked for almost two decades showed "inertia" to implementing child safety reforms after his death, a review has found.
The Launceston General Hospital (LGH) was the subject of harrowing evidence at an inquiry into child sexual abuse in state institutions, which will deliver a final report by May.
The inquiry, which wrapped up public hearings in September, was told of missed red flags relating to pedophile nurse James Geoffrey Griffin.
Griffin died by suicide in 2019 after being charged with multiple child sexual abuse offences.
The state government in July announced a child safe governance review of the hospital.
The review's final report was published on Wednesday, with Premier Jeremy Rockliff pledging to implement all of its 92 recommendations.
It found the hospital had no clearly designated executive with oversight responsibilities for the effective functioning of child safety.
It also found that despite significant work across Tasmania's health system, there remained a "level of confusion" about individual mandatory reporting obligations at the LGH.
All medical practitioners and nurses are required by law to report suspicions of child abuse or neglect.
The review determined there had been significant work by the health department since 2019 aimed at strengthening child safety.
"Despite these state-led changes, we found a level of inertia present in the engagement of the senior executive management team at the LGH in making changes locally and with the review itself," it reads.
"From our perspective, there appeared to be a lack of the responsive leadership necessary to drive change at the local level."
The review, by adjunct professors Debora Picone AO and Karen Crawshaw, found poor governance systems and responses, ill-defined executive and clinician accountabilities and an absence of strong organisational leadership.
They found clinical leaders struggled to deliver necessary reforms, such as implementing patient safety and quality systems.
There was inadequate risk management and complaints management, some loss of confidence in the incident management system and a failure to escalate and adequately deal with serious complaints.
The inquiry was told during investigations following Griffin's death, the hospital failed to accurately inform the health department of allegations of inappropriate behaviour made against him.
Peter Renshaw, executive director of medical services at the LGH since 1989, told the inquiry he was "not certain" systems at the hospital had markedly changed since Griffin's death.
Following the hearings it was announced Dr Renshaw, nursing director Helen Bryan and hospital chief executive Eric Daniels would retire.
Mr Rockliff said the review was an important step in rebuilding the trust of the community.
"We have accepted the recommendations in full and we will implement them so that we keep our children and young people safe," he said.
Recommendations include creating a flow chart to provide patients, carers, families and staff clarity about how to report child safety concerns.
The review recommended the digitisation of all current and historical family violence and sexual assault medical records "as soon as possible" so there is one record for each patient.
The review said a new management structure in place for a short period of time at the hospital had already made a positive change.
