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Volume 9, Issue 1 – February 2017

Clinician Connect

Feature Editorial

A/Professor Andrew Briggs, PhD FACP Curtin University, WA

Andrew Briggs

Evaluating musculoskeletal models of care

Musculoskeletal conditions like arthritis, osteoporosis/osteopenia and persistent musculoskeletal pain conditions such as back and neck pain are familiar to everyone. The impacts of musculoskeletal conditions on physical function, participation, mental health and financial security are enormous for individuals. At scale, these impacts have very significant implications for human capital across societies. Indeed, the prevalence and impacts of musculoskeletal conditions and persistent pain transcend race, sex, age and geography and now eclipse most other chronic non-communicable disease. The shift in disease burden from diseases more closely associated with mortality, such as heart disease, cancer and communicable conditions, to those associated with morbidity, such as musculoskeletal conditions, is not just observed in the developed world, but is a global phenomenon. The Global Burden of Disease (GBD) study provides up to date data on the burden of disease of non-communicable diseases, communicable diseases and injuries across all areas of the globe. The GBD Compare data visualization tools clearly demonstrate the enormous impact of musculoskeletal conditions. Locally, recent whitepapers highlight the impacts of musculoskeletal conditions on Australians, our health system and our society more broadly.1-5

The sheer scale of the prevalence of musculoskeletal conditions seems to almost normalise their existence leading to societal complacence for compromised musculoskeletal health, rather than an expectation for improved management options that support a continued quality of life. Such attitudes are likely to be a key reason why health strategy, policy, funding and research resources for musculoskeletal conditions lag significantly behind other chronic, non-communicable diseases. Times are changing, however, with musculoskeletal health being integrated for the first time in 2016 into the World Health Organization (European Region) action plan for prevention and control of non-communicable diseases.6 Importantly, impaired musculoskeletal health is not an inevitable part of ageing and a large volume of evidence points to effective prevention and management options across the various conditions. Similarly, a large volume of evidence highlights ineffective diagnostic and therapeutic interventions for musculoskeletal conditions. Despite this knowledge, the translation of evidence for 'what works' and 'what doesn’t work' into policy and practice remains systematically inadequate. Consequently, consumers are not routinely receiving the right care, at the right time, from the right team in the right place and the burden of musculoskeletal disease continues to rise.

Models of care (MoCs) have been identified as an acceptable enabler to the translation of evidence into policy and practice, across a range of conditions, and particularly for musculoskeletal conditions.7 Australia leads the world in the development, implementation and evaluation of MoCs for musculoskeletal conditions.8,9 This enviable position has been made possible by leadership and foresight from the governments of Western Australia and New South Wales, with MoCs having been developed for musculoskeletal health across these states, and now others, since 2006. Across the world, nations are following the lead from Australia and embarking on developing nationally or provincially-relevant musculoskeletal MoCs in recognition of the unsustainable burden of disease imposed by these conditions.10 While increasing international attention and activity towards musculoskeletal MoCs is positive, sustainable implementation of system-level reform initiatives across different settings and geographies remains a very significant challenge. Of course, this situation is not just isolated to musculoskeletal health – it is relevant across service reforms for all health conditions. A recent special issue of Best practice and research clinical rheumatology, edited by myself, Helen Slater (Australia) and Madelynn Chan (Singapore) and contributed to by 62 authors from 13 nations, has been devoted solely to tackling this issue for musculoskeletal health. In further recognition of the importance of optimally supporting implementation, the publisher has made all papers open access until the end of February 2017.11

Our team also sought to address these wicked implementation issues. I had the pleasure of leading a project in partnership with colleagues from the ACI (Robyn Speerin), South Western Sydney Local Health District (Matthew Jennings), HealthSense Australia Pty Ltd (Dr Joanne Jordan), WA Health (Jason Chua and Anna Huska), Curtin University (A/Prof Helen Slater) and BehaviourWorks Australia (Dr Peter Bragge). Funding was provided from WA Health, ACI, South Western Sydney Local Health District, Curtin University and the Physiotherapy Research Foundation. The aim of the project was to establish a framework to guide developers and users of MoCs in an ideal approach to development, implementation and evaluation. While the impetus for the project developed from our experiences with musculoskeletal MoCs, we set out to develop a framework that could be used flexibly across conditions and populations. The framework was developed over 18 months and involved a series of phases:

  1. In-depth interviews with Australian subject matter experts and consumers to understand what makes a MoC ‘ready’ for implementation and how to judge the ‘success’ of a MoC. In one of the largest qualitative studies undertaken with Australian subject matter experts, very positive value judgements were placed on MoCs for facilitating system-level reform, yet resources and time devoted to ensuring a MoC was ready for implementation and later evaluating its success, were identified as barriers to sustainable implementation.12
  2. Development of indicators to guide judgements about ‘readiness’ and ‘success’ of MoCs and testing these with an international panel of 93 experts across 30 nations, including high, middle and low-income economies. This process was undertaken in partnership with the Global Alliance for Musculoskeletal Health of the Bone and Joint Decade. Using a Delphi method of iterative scoring and feedback, the concepts of readiness and success were refined over three rounds.13
  3. Translation of the data into a user-friendly, meaningful evaluation framework, under the guidance of BehaviourWorks Australia and the Australasian Cochrane Centre.
  4. Testing the acceptability of the framework with the international panel.

The final framework is intended to complement MoCs (and other health policy or service resources) in planning, active development and those already completed and being implemented. The framework is designed to assist users in:

  • judging whether a MoC is ready for implementation
  • preparing for implementation
  • planning an evaluation and/or considering whether the MoC has been successful in implementation.

It contains detailed instructions, case examples and checklist of essential items to consider. The framework is now freely available and is publicly supported by 54 international organisations, representing the largest cross-sector musculoskeletal health report to date. See: A Framework to Evaluate Musculoskeletal Models of Care13

The next phase of work is to examine how well the framework performs in practice. The project team is keen to partner with health service teams to undertake such an evaluation.  

References

  1. Ackerman IN, Bohensky MA, Pratt C, et al. Counting the Cost: Part 1 - Healthcare costs. The current and future burden of arthritis. Sydney: Arthritis Australia; 2016.
  2. Arthritis and Osteoporosis Victoria. A problem worth solving. The rising cost of musculoskeletal conditions in Australia. Melbourne: Arthritis and Osteoporosis Victoria 2013.
  3. Australian and New Zealand College of Anaesthetists. National Pain Strategy. Melbourne: Faculty of Pain Medicine; 2010.
  4. Schofield D, Shrestha R, Cunich M. Counting the Cost: Part 2 - Economic Costs. The current and future burden of arthritis. Sydney: Arthritis Australia; 2016.
  5. Watts JJ, Abimanyi-Ochom J, Sanders KM. Osteoporosis costing all Australians. A new burden of disease analysis 2012-2022. Sydney: Osteoporosis Australia; 2013.
  6. World Health Organization Regional Office for Europe. Action plan for the prevention and control of noncommunicable diseases in the WHO European Region. Copenhagen: WHO Regional Office for Europe; 2016.
  7. Briggs AM, Chan M, Slater H. Models of Care for musculoskeletal health: Moving towards meaningful implementation and evaluation across conditions and care settings. Best Pract Res Clin Rheumatol 2016;30:359-74.
  8. Briggs AM, Bragge P, Slater H, et al. Applying a Health Network approach to translate evidence-informed policy into practice: a review and case study on musculoskeletal health. BMC Health Serv Res 2012;12:394.
  9. Briggs AM, Towler SC, Speerin R, et al. Models of care for musculoskeletal health in Australia: now more than ever to drive evidence into health policy and practice. Aust Health Rev 2014;38:401-5.
  10. Briggs AM, Cross MJ, Hoy DG, et al. Musculoskeletal health conditions represent a global threat to healthy aging: A report for the 2015 World Health Organisation World Report on Ageing and Health. Gerontologist 2016;56:S234-S55.
  11. Briggs AM, Slater H,Chan M. eds. Extending evidence to practice: implementation of models of care for musculoskeletal health conditions across settings. Best Pract Res Clin Rheumatol. June 2016; 30(3):357-58. Available from: http://www.bprclinrheum.com/issue/S1521-6942(16)X0005-8
  12. Briggs AM, Jordan JE, Speerin R, et al. Models of care for musculoskeletal health: a cross-sectional qualitative study of Australian stakeholders' perspectives on relevance and standardised evaluation. BMC Health Serv Res 2015;15:509.
  13. Briggs AM, Jordan JE, Jennings M, et al. Supporting evaluation and implementation of musculoskeletal Models of Care: Development of a globally-informed framework for judging ‘readiness’ and ‘success’. Arthritis Care Res 2016;DOI: 10.1002/acr.22948.
  14. Global Alliance for Musculoskeletal Health. A Framework to Evaluate Musculoskeletal Models of Care. [online] 2017. Available from: http://bjdonline.org/a-framework-to-evaluate-musculoskeletal-models-of-care/

Comment by the Chief Executive

by Professor Donald MacLellan – Agency for Clinical Innovation

Professor Donald MacLellan
Acting Chief Executive, ACI
donald.maclellan@health.nsw.gov.au

Welcome to the first issue of Clinician Connect for 2017. I hope that everyone had a restful and enjoyable break over the holiday period, and has come back looking forward to the challenges of a new year.

Our guest editorial this issue is from Professor Andrew Briggs, who discusses the impacts of musculoskeletal health and the models of care being developed across the world to manage and prevent many of these challenging and complex conditions. Professor Briggs also highlights the new A Framework to Evaluate Musculoskeletal Models of Care document developed by an expert team including members of the ACI Musculoskeletal Network. I encourage you to learn more about this innovative new framework in that article.

I am pleased to congratulate Lyn March and Mark Longworth, who were recognised for their outstanding contributions to the health sphere in the Australia Day 2017 Awards. Both awards recognise the many years of work and innovation Lyn and Mark have each contributed to improving healthcare for patients across the system.

Congratulations also go to the graduates of our Centre for Healthcare Redesign (CHR) Graduate Diploma program, held in partnership with the University of Tasmania, who received their diplomas at a ceremony in December 2016. You can read more about the program in our CHR Update.

I would also like to take this opportunity to farewell outgoing Minister for Health and Minister for Medical Research, the Hon. Jillian Skinner. Minister Skinner has been a strong champion for the work of the ACI and other Pillars since they were established and has overseen many significant improvements to the way healthcare is delivered across NSW while in the role. On behalf of the ACI, I wish her all the best for the future.

2017 will be a busy year for the ACI and we look forward to continuing to work with you all to design and promote better healthcare for NSW.

ACI update

Australia Day Award Honours

Congratulations to Lyn March and Mark Longworth, who were both recognised for their outstanding contributions to health in the Australia Day 2017 Awards.

Lyn was awarded a Member in the General Division of the Order of Australia (AM). Lyn has been an active member of the Musculoskeletal Network since its inception in May 2009, was a founding Co-Chair until July 2015, and currently leads the work the Network is undertaking to support implementation of musculoskeletal health models of care in primary care settings. Lyn has been a leader in supporting teams to use Patient Reported Measures in their interactions with patients to guide care that is founded on true partnerships between clinician and patient.

As well as her clinical work and research, Lyn is a true advocate for improved musculoskeletal health locally, nationally and internationally, with leadership roles across the globe including her current work to gain acceptance by the World Health Organisation that musculoskeletal healthcare needs to be incorporated in their new policy on the needs of the older person.

The photo of Lyn embodies what she does day to day – supporting professional groups and clinicians of all specialities to aim for the best possible care for their patients. She is seen here presenting the ACI Musculoskeletal Network Lyn March Award for best presentation at the Annual Forum in October 2016 to Marie March and Gen Langron from the physiotherapy team at Blacktown/Mount Druitt Hospitals.

Congratulations on a well-deserved award Lyn!

Lyn March presenting award to Marie March and Gen Langron

Lyn March presenting award to Marie March and Gen Langron

Mark Longworth was also awarded a Member in the General Division of the Order of Australia (AM). Mark has been a driving force behind many of the great ACI initiatives that have significantly improved stroke care for patients in NSW and across Australia, and was recognised for his ‘significant service to community health through the development of programs to assist people affected by stroke’.

Mark was the Network Manager of the ACI Stroke Network (Stroke Services NSW) from 2003 until his retirement in 2016. In this role, Mark helmed a network of expert clinicians, consumers and managers from across NSW to drive improvements in the care provided to stroke patients across the state. In this role he also oversaw the development of statewide partnerships with NSW Ambulance, HETI- Rural teaching, Clinical Excellence Commission, NSW Rural Stroke Care Co-ordinators Network, Stroke Recovery Association, National Stroke Foundation, Australian Catholic University, Sydney University, University of NSW and Newcastle University.

Mark was also the founder of the annual Smart Strokes conference, which sees clinicians and researchers come together with a strong focus on improving the clinical care and management of stroke. Since its beginning in 2005, the conference has joined with a number of other professional organisations, becoming Australia wide and seeing more than 1,000 people attend each year.

Congratulations Mark!

Mark Longworth, John Worthington and Phillip McConnell celebrating

Mark Longworth, John Worthington and Phillip McConnell celebrating. Photo: L. Brodie

Farewells and welcomes

In early 2013, the ACI commenced a partnership with the Australasian College of Health Service Managers (ACHSM) and the Health Education and Training Institute to become a placement organisation for NSW Health’s Graduate Health Management Program (GHMP). The GHMP is an intensive and highly sought after two year program for people looking to advance their career in health service management.

Approximately 15 participants are selected to undertake the program in NSW each year, which involves full time work placements in health organisations and local health districts across the state, regular professional development and mentoring, and the completion of a Masters in Health Administration. As part of the collaboration, the ACI hosts two management trainees for a 12 month work placement, providing Trainees with a rich, varied and challenging experience of health system management.

The ACI’s focus on partnerships to produce evidence-based clinician and consumer developed models of care and its robust approach to implementation exposes management trainees to the importance of participant engagement and project management. Trainees develop a strong skill base in clinical redesign and change management, two areas of knowledge vital for any future career as a health manager.

ACHSM trainees Joshua Tatham and Michaela Ward joined the ACI in 2016 and are now finishing their term with the organisation as they move on to their second year placements at the NSW Ministry of Health Activity Based Funding Taskforce and the Clinical Excellence Commission, respectively. The ACI wishes both Josh and Michaela well in their new roles and their final year as Trainees.

To learn more about the experience of Josh and Michaela while at the ACI, watch their videos below.

The ACI was also pleased to welcome two new trainees in January. Jessica Harris will undertake her second year of the ACHSM with the ACI, commencing with a placement in the Acute Care Projects Team. Madeline Johns is a first year trainee and will commence the program with a placement in the ACI Chronic Care for Aboriginal People Team. Welcome Jessica and Madeline.

Acute Care Projects Team update

Acute Care Projects Team

Olivia Hibbitt and Michelle Frawley

9464 4624 and 9464 4610

olivia.hibbitt@health.nsw.gov.au
michelle.frawley@health.nsw.gov.au

Acute Care

Investigating clinical variation in acute care: statewide launch

Variation in clinical care remains a significant barrier to providing safe and effective care for patients in NSW public hospitals. The soon to be released Bureau of Health Information Healthcare in Focus report is expected to highlight significant variation in readmission and mortality outcomes for a variety of conditions across NSW, including chronic obstructive pulmonary disease (COPD), community acquired pneumonia (CAP) and chronic heart failure (CHF). There is a pressing need to address variation in outcomes; however, the underlying cause for differences seen between sites in mortality and readmission rates is currently unknown. In order to address these issues, the ACI is launching a statewide initiative to address clinical variation and improve patient outcomes in the above three areas.

To support this work, in late 2016 the ACI Acute Care Project Team completed a pilot at seven hospitals across NSW. The pilot was undertaken in a mix of rural, regional and metropolitan settings to test newly developed clinical audit tools for COPD and CHF. The audit tools were developed in conjunction with members of the ACI Respiratory and Cardiac Networks to identify variation in inpatient care against established best practice. A CAP clinical audit tool was also developed and piloted in 2015.

An approach was trialled where sites were presented with comprehensive local reports that included administrative data triangulated with clinical audit data. Local teams were then supported to develop an improvement plan to address any variation in care that was identified as [potentially] unwarranted.

Statewide roll-out of this project has now commenced, with Local Health District Chief Executives invited to express their interest in partnering with the ACI to investigate clinical variation in the inpatient management of COPD, CHF and CAP. The project will use processes developed in the pilot, as well as the offer of assistance from the ACI Implementation Team to implement identified solutions. Additionally, sites will be offered the opportunity to pilot a patient reported measure and to be involved in the statewide collaboratives that will be established to support this work and share local quality improvement initiatives.  

For more information about the Investigating Clinical Variation project please contact the Acute Care Project Team Managers.

Aged Health Network update Co-Chairs: Bill Thoo, Viki Brummell

Aged Health Network Manager

Executive changes

The ACI Aged Health Network would like to thank Viki Brummell, Geoff Berry and Terry Finnegan, who are retiring from the Network’s Executive committee.

Thank you to Viki Brummell, who is stepping down as Co-Chair of the Aged Health Network after five years in the role. Viki has provided strategic leadership on issues affecting the care of older people across acute, community and residential care, and has overseen the development of a number of important Network initiatives including the Care of Confused Hospitalised Older Persons Program (CHOPS), Building Partnerships for the integrated care for older people with complex health needs program, subacute care guidance, and role delineation of clinical geriatric services. Viki will stay on for an interim period until a new Co-Chair is appointed.

Thank you to Geoff Berry, who has been a consumer representative on the Aged Health Executive for the past five years. Geoff has been a strong voice for consumers during this time, especially in promoting the transfer of care to and from hospital. Geoff will continue to be involved in the work of the Aged Health Network.

Terry Finnegan is also stepping down from the Aged Health Executive. Terry was the Medical Co-Chair of the Network from 2014 to 2015 and continued as an executive member for 2016. Thank you Terry.

Viki Brummell

Viki Brummell

Geoff Berry

Geoff Berry

Terry Finnegan

Terry Finnegan

Network Manager changes

Glen Pang

Congratulations to Aged Health Network Manager Glen Pang, who is taking an internal secondment for 12 months to the role of Knowledge Manager. The Knowledge Manager role is responsible for developing a learning organisation to promote better sharing and integration of knowledge within the ACI and across NSW Health and partner organisations. The Aged Health Network Manager position is currently being advertised for recruitment.

Centre for Healthcare Redesign update

AIM Project Officer

December Centre for Healthcare Redesign School Graduation

Congratulations to the 31 participants of the ACI’s Centre for Healthcare Redesign (CHR) Diploma Program who graduated at a ceremony held in late December 2016 at the Mint in Sydney CBD.

Then NSW Health Minister Jillian Skinner awarded participants with their diplomas at the ceremony and praised the commitment to supporting innovation and improvement in their services.

“As a system we are continuously exploring the latest innovations in healthcare and service delivery to ensure that every patient in NSW receives best practice, timely care,” Minister Skinner said while speaking at the event.

“The dedication and passion these staff members have for improving patient care in their facilities is an outstanding example of the committed people we have working across NSW Health and I commend them on their successes.”

The Redesign Diploma Program is an intensive 20 week course which provides the latest knowledge and training in project management, clinical redesign and change management to build the capability of healthcare staff in NSW. Graduates of the program are awarded an accredited Diploma of Project Management through a partnership with the University of Tasmania.

The CHR School supports local healthcare staff to identify, design and implement innovative improvements for patients and carers. Networking, shared learning and working collaboratively with patients, clinicians and management to improve healthcare are a strong focus of the course.

During the program, healthcare staff are supported with comprehensive training from the ACI CHR team, workplace mentoring by local healthcare redesign managers, and sponsorship from a local senior executive.

To date, the program has seen more than 600 improvement leaders from across a range of metropolitan, rural and statewide health services from NSW and interstate complete the training.

More information on the CHR Diploma Program

For information and posters from the initiatives in this graduation, visit the ACI Innovation Exchange

Chronic Care Network update Co-Chairs: Linda Soars, Franca Facci

Manager, Chronic Care Network

Farewell Lissa Spencer and welcome Franca Facci

Thank you to Lissa Spencer, who is stepping down from her position as a founding Co-Chair of the ACI Chronic Care Network. Lissa has guided the beginnings of the Network with her thoughtful, intelligent leadership and her ongoing contribution to improving care for people with chronic conditions.

A warm welcome to Franca Facci, Integrated Care Stream Leader from Illawarra Shoalhaven Local Health District, who steps into Lissa’s shoes to join Linda Soars in the Co-Chair role.

Lissa Spencer

Lissa Spencer

Franca Facci

Franca Facci

Social determinants of health guest speakers come to ACI

In late November 2016 the Network hosted two international guest speakers, Sir Harry Burns and Dr Ruth Hussey OBE, who spoke to a packed house about improving health inequality through system change. Sir Harry has consistently championed the importance of early years and the impact of social determinants on a community’s health, demonstrating this through the world-leading Early Years Collaborative in Scotland - a ‘bottom-up’ method for changing the system. Dr Hussey spoke passionately about improving healthcare, especially improving outcomes and addressing the role that poverty can play in creating ill health.

View the presentations on the Chronic Care Resources page

Sir Harry Burns

Sir Harry Burns

Dr Ruth Hussy OBE

Dr Ruth Hussy OBE

Stories of people living with chronic conditions

Learning to live with chronic disease can be challenging and confronting. The Chronic Care Network met five very different, but determined, people who have generously shared their personal experiences of learning to live with, and manage, their chronic conditions. Their inspiring and empowering stories are now available on the Chronic Care Stories webpage.

ICHOM update

Australasian forum: catalyzing the value agenda - 4 May 2017, Sydney

The ACI is proud to be an event partner for the upcoming Australasian forum: catalyzing the value agenda to be held in Sydney on 4 May 2017. Focussing on value-based health care and restructuring health systems to achieve real value for patients, this forum is led by the International Consortium for Health Outcomes Measurement (ICHOM) alongside partners HCF and Ramsay Health Care.

ICHOM is a small, non-profit organisation aiming to 'transform health care systems worldwide by measuring and reporting patient outcomes in a standardised way'. Increasingly, the ACI is focussing on ways to support clinicians and consumers to collect and apply clinically meaningful information to improve patient care.

This one-day forum will provide a passionate case for shifting to a more transparent, value-based approach to health service delivery, payment and policy. National and International leaders in this field will present on the theory and practical applications of this approach along with their reflections about what concrete steps we can take to make this happen.

For more information and to register for the event, visit the forum website

Institute of Trauma and Injury Management update

Welcome Michael Dinh

Michael Dinh

Welcome to Michael Dinh, who commenced in the role of Clinical Director for the ACI Institute of Trauma and Injury Management (ITIM) on Tuesday 6 December 2016. Michael is a full time emergency clinician and early career researcher. Michael was appointed as a Staff Specialist Emergency Physician and Co-Director of Trauma Services at Royal Prince Alfred Hospital in 2007 and was appointed as Clinical Associate Professor at The Sydney Medical School in 2013.

Michael is currently completing his Doctoral studies at The George Institute for Global Health after having completed a Master in Public Health from Harvard University, majoring in quantitative methods.

Michael has been involved with ITIM since 2007 and is currently the Co-Chair of the ITIM Research Advisory Committee.

2015 annual trauma data report

ITIM has recently published Major Trauma in NSW, 2015: A report from the NSW Trauma Registry. This annual trauma report is compiled by ITIM using data collected and reported by the designated NSW Trauma Services (20) as part of the trauma minimum data set.

The report describes how the NSW trauma system responded to these patients, from the time of injury and provision of pre-hospital services, through to in-hospital services provided at a NSW Trauma Service. The report investigates the data to determine whether the NSW trauma system is functioning effectively, to ensure that the right patient arrived at the right hospital in a timely matter.

The report helps to understand the nature of the injuries sustained and how they occurred. The findings are used by various agencies concerned with minimising the likelihood and effects of traumatic injury and contributing to safety and injury prevention efforts. Data from the NSW Trauma Registry is used by ITIM to provide advice and feedback to clinicians and other stakeholders and enables research into patterns of service demand and staffing. This data also supports benchmarking and performance improvement activities.

The 2015 trauma data report, together with reports from previous years, is available on the NSW Trauma Registry Annual Reports page of the ITIM website.

Recent research

Sarrami, Pooria, Rafael Ekmejian, Justine M. Naylor, Joseph Descallar, Robindro Chatterji, and Ian A. Harris. "Spine surgery outcome in patients who sought compensation after a motor vehicle accident: a retrospective cohort study." BMC surgery 16, no. 1 (2016): 76. URL: www.biomedcentral.com/1471-2482/16/76

Nutrition Network update Co-Chairs: Suzanne Kennewell, Natalie Wilson, Janet Bell, Kelli Ward

Nutrition Network Manager

Development of NSW’s first training program in gastrostomy care

The ACI Nutrition Network is collaborating with the Institute of Academic Surgery (IAS) and the Nutrition and Dietetics Department at Royal Prince Alfred Hospital (RPAH), Sydney Local Health District to develop NSW’s first ongoing training program in gastrostomy care.

Michelle Harrison with gastrostomy tube

This project builds on the ACI Gastroenterology and Nutrition Network’s A Clinician’s Guide: Caring for people with gastrostomy tubes and devices. Similar training and credentialing programs have been established in other states and have contributed to better patient and health system outcomes.

Once established, the program will be accessible to employees from NSW Health and other agencies such as primary health networks, NSW Ambulance, residential aged care facilities and disability services.

The project is being chaired by David Storey, Director of Surgical Education at the IAS and Sharon Carey, Head of Department Nutrition and Dietetics, RPAH. Michelle Harrison, Dietitian at RPAH, has been appointed to the role of Project Officer.

Please contact the Network Manager for more details.

Michelle Harrison with gastrostomy tube. Photo: S. Lane

Enhancing implementation of 'My Food Choice'

The Network is working with HealthShare NSW over the next few months to support implementation of a new food service delivery model in hospitals across NSW.

‘My Food Choice’ (MFC) introduces a number of changes to hospital food services including ordering meals closer to meal times using tablet technology, new food choices, new food preparation and delivery methods and recording how much patients have eaten.

The model has a significant impact on clinical services and requires workforce redesign. This project aims to provide clinical support to LHDs and Networks and to enhance the implementation of MFC.

Melanie Schier has been appointed to the role of Project Officer and a Steering Committee has been established to oversee the project. The major deliverables are to:

  • develop an initial range of practical tools and resources to form an online toolkit to support ongoing implementation of MFC from a clinical perspective
  • establish a community of interest during the project
  • prepare recommendations for future implementation sites.

Please contact Melanie Schier for more information melanie.schier@health.nsw.gov.au

Melanie Schier and Lucia Contreras

Melanie Schier and Lucia Contreras. Photo: S. Rashid

Sanzida Rashid (Dietitian Assistant, Blacktown Hospital)

Sanzida Rashid (Dietitian Assistant, Blacktown Hospital). Photo: M. Schier

Patient Experience Symposium 2017

Registrations now open for the 2017 Patient Experience Symposium, 2-3 May, Sydney

The ACI and Clinical Excellence Commission, along with event partners the Health Education and Training Institute, Bureau of Health Information, Cancer Institute NSW, eHealth NSW, Mental Health Branch and Health and Social Policy Branch of the NSW Ministry of Health, and Health Consumers NSW, are pleased to announce the 2017 NSW Patient Experience Symposium to be held at the Masonic Centre, Sydney, from the 2 - 3 May 2017.

Now in its third year, the Patient Experience Symposium brings together NSW Health staff and consumers to share and showcase innovative work and initiatives aimed at improving patient experience.
The theme of the 2017 Symposium is “Communication and Connecting People”. Keynote speakers include Jason A. Wolf, President, The Beryl Institute, USA, which organises the international Patient Experience Week, and Tim Blake, Engaged Patient and Carer, Managing Director, Semantic Consulting, with more to be announced.

Registrations are now open. The cost of attending the Symposium is $140 for two days. Get in quick to reserve your spot at this exciting event!

To register, and for further information, please visit the Symposium website

Follow the event hashtag on Twitter at #PEXS2017

Patient experience symposium

Patient Reported Measures Team update

Program Manager, Patient Reported Measures

Patient Reported Measures online capability training

The ACI Patient Reported Measures (PRMs) Program has developed a series of online education modules to support the collection and use of PRMs in clinical settings. The PRMs team worked with consumers, clinicians and managers from proof of concept sites in the PRMs Program to create a series of short and engaging educational modules that introduce concepts relevant and important to each of these groups. The modules are hosted on the ACI learning management system, and are free to access.

View the PRMs e-learning modules. You'll be prompted to register your details, set a password, and choose your course of interest.

If you have any questions or feedback please contact the Program Manager.

Rural Health Network update Co-Chairs: Richard Cheney, Patrick Frances

Rural Health Manager

Living Well in Multipurpose Services Collaborative

Twenty-Five Multipurpose Services (MPS) across seven local health districts (LHDs) will participate in the Living Well in Multipurpose Service Collaborative (MPS) throughout 2017. The collaborative will support staff in providing care for residents of MPS; not as patients in hospital, but as people living in their home.

NSW’s 64 MPS bring together emergency, subacute, community and residential aged care services in a single location to provide a flexible approach to health and aged care service delivery in small rural communities. MPS, as a part of their LHD, are accredited against National Safety and Quality Healthcare Standards, not Aged Care Standards as is the case with residential aged care facilities. Traditionally, a clinical caring culture exists in many MPS, with a focus on acute hospital inpatient care rather than an enablement focus for residents living in their home.

Eight principles of care have been developed to assist MPS in adopting person-centred residential aged care approaches to enhance quality of life and lifestyle for people who call an MPS home. The areas covered include a positive dining experience, homelike environment, the role of the person in their own care, recreation and leisure activities, and expertise in aged care. The principles are accompanied by a toolkit which includes a self-assessment tool, a resource guide and an evaluation package to support staff in promoting wellness and quality of life for people living in MPS across NSW.  

The Collaborative aims to:

  • deliver person centred care and enhance lifestyle, independence and wellbeing for residents living in an MPS, and their families
  • support staff capability in providing individualised aged care specific care for residents.

MPS Teams will share learnings as they adapt, implement and monitor small scale changes relevant to the eight principles of care, supported by a team at the ACI. MPS Teams are currently undertaking work to identify their priority areas for improvement and to establish a baseline of the current resident experience, prior to participating in three learning sets and action periods in 2017.

This is a very exciting initiative and one that we are looking forward to continuing throughout 2017.

For more information visit the Living Well in Multipurpose Service Collaborative on the ACI website.

MPS Principles of care

Sax Institute

Emerging infectious diseases

The threat of emerging infectious diseases is the focus of the latest issue - 26(5) Dec 2016 - of Public health research & practice which includes papers on mosquitoes, Zika virus and Australia’s response to the Ebola threat.

The guest editor for this issue is Dr Jeremy McAnulty, the Director of Health Protection NSW and themed articles include a perspective article co-authored by former Australian Chief Medical Officer Professor Chris Baggoley, which examines how emerging infectious diseases pose a risk to countries such as Australia, and why effective responses need to be well coordinated and flexible. In another article, former Ebola ‘tsar’ Professor Gwendolyn Gilbert takes a fresh look at how Australia responded to the Ebola threat in West Africa. Other themed articles discuss the value of surveillance systems for arboviruses and mosquito monitoring in NSW; the latest recommendations on the use of topical mosquito repellents; and the research needs in the field of emerging infectious diseases, especially relating to genomics, digital epidemiology and pathogens jumping the species barrier.

Our non-themed articles look at the perceptions of meningococcal disease in a regional area of NSW; the availability and acceptability of falls prevention services for older Aboriginal people, and a continuous quality improvement approach to Aboriginal tobacco resistance and control. Lastly, we include an analysis of online news and blog comments about an Australian celebrity who admitted smoking while pregnant, which suggests that more resources are needed to strengthen the public health response to online media.

Public health research & practice is Australia’s first online-only open access peer-reviewed public health journal, published by the Sax Institute with a strong focus on the connection between research, policy and practice.

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Stroke update Co-Chairs: Martin Jude, Clare Quinn

Stroke Network Manager

Stroke Network non-medical Co-Chair

Claire Quinn

Welcome to Clare Quinn, who has stepped in to the role of non-medical Co-Chair for the ACI Stroke Network.

Clare is currently the manager of Speech Pathology at Prince of Wales Hospital. She has spent the majority of her clinical career working with stroke patients, beginning at the Prince Henry Hospital as a new graduate on one of the first Acute Stroke Units in NSW. This experience allowed her to see patients in an acute setting and follow them through their rehabilitation journey to discharge.

Clare steps in to the role with extensive experience, having chaired the South Eastern Sydney Local Health District (SESLHD) Stroke Rehabilitation Working Party for ten years, Co-Chaired the SESLHD Stroke Group for many years and has been a member of what is now the ACI Stroke Network since its beginnings in the days of GMCT in 2004. She has worked across a wide range of areas in her career, which has given her a broad perspective of how the health system works

Clare was a founding member of the NSW Speech Pathology Evidence Based Practice Network and was a lead in the formulation of the Stroke Dysphagia Framework, which was the beginning of the ASSIST swallow screen. She is also a member of the ACI Acute Care Taskforce and the Clinical Council of the Clinical Excellence Commission.

Welcome Clare, we look forward to having your valuable experience as Co-Chair of the Stroke Network!

Save the date: Stroke Quality Improvement Forum - 16 March 2017

The ACI Stroke Network will be holding a Stroke Quality Improvement Forum on 16 March 2017. The forum will provide an opportunity for stroke services to share lessons learned from quality improvement initiatives they have implemented locally. It will also provide an introduction to the collaborative concept and an opportunity to workshop the design of a NSW Stroke Quality Improvement Collaborative.

Implementation of the Early Access to Stroke Thrombolysis Program: The Dubbo Base Hospital recognised as an Acute Thrombolysis Centre

The Dubbo Base Hospital has successfully completed a process, under the ACI Early Access to Stroke Thrombolysis Program, to support commencement as a 24/7 Acute Thrombolysis Centre.

Dubbo is the 23rd Acute Thrombolysis Centre in NSW. One of the aims of the Early Access to Stroke Thrombolysis Program is to increase the access for stroke patients to centres providing thrombolysis in NSW.

Congratulations to the team in Dubbo on their achievement!