There are fewer tears shed in Bernadette McDonald's office these days.
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To her, that's a pretty good indication things at Canberra Health Services are slowly but surely starting to improve.
It's almost a year since she took up the top job at the new organisation, formed when ACT Health split into two organisations.
As chief executive she oversees Canberra's publicly run health services - including Canberra Hospital - and is responsible for about 5000 staff.
She walked into an organisation with deep cultural issues and significant performance problems.
Year after year the ACT has performed poorly compared to other states against key national indicators.
Staff were damaged and they were often unlikely to come forward and report problems.
McDonald's appointment seemed as much about healing wounds with staff as it was improving how the hospital was run.
"They needed someone to listen to them and make them feel safe," she says.
"I have to admit it's been extremely challenging."
The past year has been dominated by discussions of bullying and harassment within Canberra Hospital with the final report from an independent review handed down in March.
Canberra Hospital's emergency department performance has continued to plummet and capacity issues have made headlines.
She says she's not trying to change the service overnight but thinks building a strong culture is the top priority.
Once it's got that, she says, the focus can turn to performance.
"It's hard to know what the causes [of poor culture] are, I think there were probably people not speaking up and not feeling safe to speak up."
Canberra Hospital continues to rate poorly among its peers in many wait time categories, especially its ability to treat urgent emergency patients.
There is a steady stream of stories about a hospital that seems filled to the brim: staff forced to use storage rooms as consulting rooms, patients treated on beds in corridors and ambulances diverted from the busy hospital.
The much hyped hospital expansion project - dubbed SPIRE - now won't be open until 2024 and construction likely won't start until 2021.
The country's peak medical body, the Australian Medical Association, thinks a lot of the issues come down to resourcing and a hospital that has not been able to keep up with population increases.
But McDonald says she's not worried about bed numbers and the current available infrastructure.
She thinks most of the problems can be fixed by improving poor processes and thereby improving the flow of patients within the hospital.
And if it hadn't have been for a horror flu season that slammed the emergency department, she thinks improvements would have already been seen.
"I feel quite positive that there's a lot of things we can do and we'll start to see some improvement in the next 12 months," McDonald says.
"It's a real complex balancing act to move people through an organisation because there are so many decisions being made at different points in time.
"People often say to me, just open more beds, but it's not that simple at all."
While she would love to be able to have SPIRE (which stands for Surgical Procedures, Interventional Radiology and Emergency) up and running tomorrow, she says the organisation could work with the infrastructure it has in the mean time. It just has to be more efficient with what it has.
She admitted it was stressful knowing her performance would be scrutinised based on the wait times figures and if she could improve them.
"But you've also got to be realistic about that I can't change it by myself and I certainly can't change it overnight," she says.
She has worked in health for decades in Victoria, but she's never faced so much media attention and public scrutiny as she does here.
While Victoria has more than 80 health services (probably too many, she notes), ACT has just one, which puts Canberra Hospital under a spotlight.
It also means she interacts with the Minister and department far more frequently.
McDonald is now settled in Canberra, with her husband recently joining her.
She wants to stick around at least long enough to see SPIRE open, which will hopefully have a new and improved name.
"I'd like to walk in the front door," she says. McDonald says it's the work she's done getting the trust back from staff she's most proud of.
"People tell me they feel more optimistic and hopeful," she says.
"I don't have as many tissues being used in my office anymore."
Perhaps speaking volumes to how dismissed staff and community sector groups felt under previous leadership, many are quick to praise McDonald.
Health Minister Rachel Stephen-Smith said McDonald had been a "game changer" for ACT's health system.
"Almost everyone I've met with, whether they are consumers, doctors, nurses, educators or community sector leaders, has taken the opportunity to express their appreciation for the work Bernadette has been doing over the last year," she says.