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Volume 8, Issue 1 – February 2016

Clinician Connect

L Lobb, M Doran, R Wilkins, S Hanson, N McGowan and S Castree-Croad at the Palliative and End of Life Care Blueprint for Improvement website. See the Palliative Network report for more.

Feature Editorial

by Sue Hanson, National Director Clinical Services Calvary, Co-Chair NSW ACI Palliative Care Network

Sue Hanson

A great deal has been achieved in NSW over the past three decades to improve care for people who are approaching or reaching the end of their life, their families and carers. The establishment and support for the delivery of specialist palliative care services across the state has been one of the factors that has contributed to Australia being rated by The Economist Intelligence Unit (2015) as second in the world (behind the UK) in terms of the Quality of Death Index1.

While we have undoubtedly come a long way there would be few clinicians who did not understand the challenging nature of the problems we face as we continue to look for more effective and efficient ways to deliver care to those who will approach and reach the end of their life over the next three decades and beyond. There are many factors that contribute to those challenges:

  • the rapidly increasing number of older Australians with multiple co-morbidity and functional limitations
  • the increasing number and proportion of people living in the last year of their life
  • the health, aged and social care systems that are increasingly burdened by the need to provide care to address increasing community needs
  • increasingly fragmented systems that make it difficult to deliver care in accordance with the needs and wishes of people approaching and reaching the end of life
  • and the perverse funding models and financial incentives that privilege acute, curative care.

Changes in the way that people die are mirrored in health care cost patterns. Care for people in the last year of life cost almost $1 billion in NSW in 2011/122. There is growing recognition that the limitless pursuit to cure may result in diminishing benefits in terms of health outcomes and an increasing emotional and physical burden on the individual. The End of Life Care Roundtable3 in 2013 pointed to the missed opportunity costs and greater burden for society at large of a system oriented towards an imperative to treat, even when the benefits to patients appear to decrease as they approach the end of life.

Almost 50,000 people died in NSW in 2011/12, the last year that linked data was available for analysis4. Of these 77% (38,282) were hospitalised at least once in the last year of their life - on average each person was hospitalised four times. The majority of people will die in hospital and this is likely to continue into the future. Sixty-one per cent of people who had at least one hospital admission in a NSW public hospital in the last year of life ultimately died there. Sixteen per cent of people will die in a residential care facility and less than 20% will be able to remain at home. When asked however 70% of people state that they would choose to remain at home at the end of their life. Not all people who want to stay at home are able to do so and there are many factors influence the place of care at the end of life – the complexity of the patient's needs, the availability of family support, the changing wishes of the patient, a failure to recognise dying, and fear all contribute to decisions about the place of care. Supporting families to provide care at home – and in the process increasing the proportion of patients who can achieve their goal to remain at home is a priority of the NSW Government Plan to Increase Access to Palliative Care – and a key component of the ACI Blueprint for Improvement in Palliative and End of Life Care5.

The Blueprint is intended to provide guidance for broad system level improvement in end of life care. It emphasises the need for integration, for education and training and most importantly for the construction of sustainable, locally supported models of care. Developed by the ACI Palliative Care Clinical Network and based on consultation with more than 1200 clinicians and consumers across the state the Blueprint provides a shared vision, an underpinning set of values and principles and a collective agreement on the essential components of care wherever it is delivered. It is an enabling, capability building resource that is intended to help us to move independently but in unison towards a common goal of improved outcomes for people who are approaching or reaching the end of their life wherever they may receive care.

Our healthcare systems are full of vulnerable patients, families and health care professionals. In order to provide better end of life care to patients and families we need to identify them, offer support, listen and give advice and treatment tailored to their needs.

The ACI Palliative Care Network looks forward to continuing this journey in partnership with the people of NSW and the clinicians that provide care each and every day to people who are approaching or reaching the end of life, their families and carers.

For more information on the work of the ACI Palliative Care Network contact Lea.Samuels@health.nsw.gov.au. The Blueprint can be accessed at: www.aci.health.nsw.gov.au/palliative-care-blueprint

1. The Economist Intelligence Unit Limited (2015) The 2015 Quality of Death Index: Ranking palliative care across the world. A report by The Economist Intelligence Unit. London, October 2015.

2. NSW Agency for Clinical Innovation (2015) Fact of Death Analysis 2011/12: Use of NSW public hospital services in the last year of life by NSW residents. Sydney. November 2015.

3. Australian Centre for Health Research (2013) End of Life care: Leadership and quality in end of life care in Australia: Roundtable recommendations. February 2013.

4. ACI. 2015. Facts of Death Analysis 2011/12. Available at: http://www.aci.health.nsw.gov.au/__data/assets/pdf_file/0005/289094/ACI_FactsOfDeath_Report_F3-LR.pdf.

5. Ministry of Health (2012) The NSW Government Plan to Increase Access to palliative Care 2012-2016. Sydney. September 2012.

Welcome to the February issue of Clinician Connect

by Nigel Lyons – Agency for Clinical Innovation

Reflecting on how we work with our partners to support service improvement and innovation in healthcare has never been so important, and the start of a new year is a perfect time for this to occur. Over the last 12 months, healthcare providers have told us that they are inundated with information – and overwhelmed with the many improvement initiatives available. We need to listen to this feedback and respond to make sure that clinicians and care providers get the maximum benefit from their partnership with us, to build capacity and deliver the best possible health outcomes for patients in NSW.

There are many hundreds of dedicated nurses, allied health professionals, doctors and managers in Local Health Districts and Specialty Health Networks (LHDs/SHNs) across the state making a difference every day to patient care. They are focussed on the issues affecting their patients, on generating better ways to care for patients and promoting initiatives that work locally.

Over the coming months I, and the new Chief Executive of the Clinical Excellence Commission (CEC), Carrie Marr, will together meet with LHDs/SHNs to better understand how we can jointly support service improvement. Within the ACI we will have discussions with our Networks, teams and partners, using this advice and input to continuously shape our approach to supporting service improvement and innovation.

If we are going to improve healthcare in NSW, we need to collaborate more broadly and effectively on local priorities and we need to work together - the ACI and the CEC, clinicians, consumers and managers - to support local improvement efforts and to spread the benefits to patients.

While 2015 has been a year of achievement and progress, 2016 is the year where we work even more closely with our partners, turning plans into actions to deliver real health benefits.

I look forward to the year ahead, working with you to bring positive change to patients across our health care system.

Dr Nigel Lyons
Chief Executive, ACI
Nigel.Lyons@health.nsw.gov.au

Acute Care Taskforce Co-Chairs: Vicki Manning and Jeremy Wilson

Acute Care Taskforce Manager

Anthea Temple

9464 4623 | 0467 711 274

anthea.temple@health.nsw.gov.au

Acute Care Taskforce

More than 120 people attended the final Acute Care Taskforce meeting of the year on Friday 27 November 2015. The meeting was open to LHD and SHN managers and clinicians with the theme of Criteria Led Discharge (CLD).

As an important aspect in the coordination of the inpatient journey, CLD maximises the multidisciplinary team to streamline transfer of care by making the discharge process not solely reliant on a final review by the admitting medical officer.

The purpose of CLD is to formalise and coordinate transfers of care to:

  • improve the patient experience and outcomes
  • reduce unnecessary length of stay and bed days
  • minimise waste and enhance staff experience.

Local clinicians and managers from individual hospitals shared their experiences in implementing CLD across a number of speciality services. Thank you to Marc Aquilina and Sonia Marshall, Wollongong, Deb Stewart and Jacinta Kilpatrick, Northern Sydney, Tracy Millen and Jenny Cubitt, Sydney, Pamela Bold and Cindy Johansen, Sydney Children's Hospital Network - Westmead, Lauren Abdy and Coralie Gower, Sydney Children's Hospital Network - Randwick.

Adjunct Associate Professor Susan Pearce, Deputy Secretary System Purchasing and Performance Division, NSW Health presented an overview of the Winter 2015 Issues and Strategies and outlined the Minister's Initiatives and Peak Activity Team priorities.

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Tracy Millen and Jenny Cubitt. Photo: A. Temple.

Marc Aquilina and Sonia Marshall. Photo: A. Temple.

The afternoon session allowed people to brainstorm ideas and strategies to enhance implementation and identify opportunities for further service improvements.

Visit here for more information on CLD.

Aged Health Network Co-Chairs: Terry Finnegan and Viki Brummell

Aged Health Network Manager

Glen Pang

9464 4630 | 0407 995 329

glen.pang@health.nsw.gov.au

Aged Health Network

Caring for Cognitive Impairment Campaign

The Australian Commission on Safety and Quality in Health Care (ACSQHC) has launched a Caring for Cognitive Impairment Campaign. The campaign is a call for action to unite those who care for people with cognitive impairment.

Doctors, nurses, allied health professionals, health service managers, care and support staff, workers in primary health or community care, patients and families can all make a difference.

To learn more about the campaign, visit the ACSQHC website at www.cognitivecare.gov.au.

The ACI is a supporter of the Caring for Cognitive Impairment campaign. The Aged Health Network's Care of Confused Hospitalised Older Persons (CHOPs) Program complements the campaign by arming hospitals with comprehensive resources to develop and implement strategies to improve the experiences and outcomes of confused older people in hospital.

There are currently 13 hospital in NSW participating in the CHOPs program. For more information visit the CHOPs website at www.aci.health.nsw.gov.au/chops.

CHOPs website

Welcome to Atosha Clancy, Aged Health Project Officer

Atosha Clancy has joined the ACI Aged Health Network to undertake the Allies in Dementia Healthcare project funded by Alzheimer's Australia and conducted in partnership with the Consumer Dementia Research Network. The project aims to provide people living with dementia with information, ideas and inspiration about partnering with allied health workers to enhance quality of life.

Atosha joins the ACI on a secondment until 30 June 2016 from Northern NSW LHD. Atosha's experience includes being the Team Leader of the multidisciplinary Far North Coast Dementia Outreach Service (DOS) for ten years. DOS provides services to people with early stage dementia and their carers. She is an experienced clinician who provided individual and group services to people living with dementia and their families. Through her role as chair of the Far North Coast Dementia Pathways Forum, Atosha provided sector leadership, promoting innovation, collaboration and cohesion amongst service providers to achieve best outcomes for the people living with dementia. Atosha also provides clinical supervision to social workers within the local health district.

Clinical Innovation Program Co-Chairs: Sarah Smith and Neil Rickwood

Clinical Innovation Program Manager

Chris Ball

9464 4656 | 0408 627 228

chris.ball@health.nsw.gov.au

Clinical Innovation Program

Clinical Innovation Program Workshop

In 2014, the ACI established the Clinical Innovation Program (CIP) to support successful implementation of clinical innovation in NSW hospitals.

In November 2015, 24 representatives from the eight hospitals implementing the two individual CIP Model of Care projects - Specialist Geriatric Outreach (SGO) and Service Access and Care Coordination Centres (SACCC) - attended a three day workshop in Chatswood.

Participants learning some solutions generation activities with Estelle Marque. Photo: S. Smith.

The workshop was designed in collaboration with the ACI's Centre for Healthcare Redesign to complement the Accelerated Implementation Methodology (AIM) training and monthly capability building that is provided by the CIP team.

Some highlights of the workshop program included:

  • Solutions design approach
  • Prototyping framework
  • A3 reporting
  • Project leadership
  • Team planning
  • Learning from others

On completion of the workshop the eight hospitals implementing the models of care were able to identify when to finalise the 'assessment' phase of the project and had learnt the skills and tools to successfully start the 'operationalise' phase. This completes the formal training package for the CIP and complements the ongoing capability training delivered by the ACI implementation team.

For more, visit the CIP webpage.

Spotlight on: Kate Russell (RN/RM) Specialist Geriatric Outreach Project Officer, Grafton Base Hospital.

How long have you been in your role as Implementation Project Officer for Specialist Geriatric Outreach?
I started work at Grafton Base Hospital in Northern NSW as an Implementation Project Officer for the Specialist Geriatric Outreach (SGO) and the Council of Australian Governments (COAG) Telehealth project in September 2015.

What do you like about the Specialist Geriatric Outreach model?
The SGO Model of Care is tailor-made to the local area and is going to improve the quality of life of residents and the treatment they receive by offering further service options and support for clients that live in Residential Aged Care Facilities (RACFs). The SGO will also have a positive impact on relationships between the RACFs and the hospital by opening communication pathways, improving documentation and offering further education and support to RACF and hospital staff.

What did you think of the two day Accelerated Implementation Methodology (AIM) course you attended in September?
I enjoyed the AIM training, I felt it gave me a good practical guide to increase the success rate of my projects and effectively manage change. My first contact with the other project officers working on the SGO project was at AIM training. We exchanged contact details and now liaise with each other on a regular basis to share our ideas and update each other on our projects.

The monthly capability training provided by ACI, how does this benefit you with your daily work?
The monthly capability training is really beneficial to me. The capability training allows me to develop the skills and knowledge I need in order to ensure the project objectives are being met, I am working within the scope of my project, and that I am following the timeline of the project and ensuring that the model of care is successful and viable.

What did you get out of the Solutions Generation Workshop held in November?
I really enjoyed the Solutions Generation Workshop. The speakers were fantastic, the content really practical and informative and the workshop was very interactive. I find meeting with the other SGO Project Officers is really beneficial as we are able discuss where we are up to in our sites, and brainstorm ideas about the project.

Kate's sponsor for the Specialist Geriatric Outreach Program, Dr Abbey Perumpanani, Director of Medical Services (DMS) for Grafton Base Hospital, said that "she can definitely see the skills and capabilities that Kate has developed during the course of her participation". When asked to describe features he would attribute to Kate, Dr Perumpanani responded with "uses her initiative well, is an organised person and has quickly established effective stakeholder networks for her project".

The next phase for the SGO Project will include the creation of a community of interest. The SGO Community of Interest teleconference is scheduled for: Wednesday 24 February at 2:00PM. For more information on the SGO Community of Interest or the SGO model, please visit www.aci.health.nsw.gov.au/make-it-happen/cip or contact Sarah Smith, Implementation Officer: sarah.smith@health.nsw.gov.au, (02) 9464 4653.

ICCMU and ICSNCo-Chair: Dr Sean Kelly

Launch of the Intensive Care Service Model Project

The ACI ICSN Intensive Care Service Model Project was launched on 11 January in nine sites across seven Local Health Districts (LHDs).

The project aims to standardise the way Level 4 Intensive Care Services are delivered, utilised and networked within a LHD or region, improving the access and delivery of care to critically ill patients in rural, regional and smaller metropolitan hospitals across NSW.

Due to the large number of sites expressing an interest in partnering with ACI in the implementation of the Service Model, a phased implementation will occur, with Bathurst, Bega, Broken Hill, Dubbo, Grafton, Griffith, Goulburn, Kempsey and Shoalhaven hospitals commencing implementation now, followed by a second phase in September 2016.

For more information visit the ICCMU webpage.

New CVAD resources now available

Central venous access devices (CVAD) are a medical device which can be used to administer medication or fluids that are unable to be taken by mouth, obtain blood tests and measure central venous pressure. Insertion of a CVAD is a common hospital procedure with an estimated 15,000 devices inserted in NSW Intensive Care Units every year.

The ACI, CEC, NSW Nursing and Midwifery Office and HETI have collaborated to address associated risks of CVAD use. A 2015 Clinical Excellence Commission (CEC) clinical focus report made nine recommendations to improve care. The ICCMU team worked with the CEC, NSW Nursing and Midwifery Office and key clinicians to develop the recommendations into a clinical practice guideline, along with a host of supporting educational tools.

These resources are now available here:

  • Clinical Practice Guideline – Post Insertion Management
  • Education resources:
    • Vascular air embolism (standard slide deck)
    • Vascular air embolism (podcast)
    • CVAD care poster
    • Guideline overview (podcast)
    • Removal of CVAD (podcast)
    • Scrub the Hub (podcast)

The Health Education and Training Institute (HETI) has provided a course code so that completion of the Vascular Air Embolism online education modules can be logged in staff professional development records. The Vascular Air Embolism podcast is supported by the HETI Fundamentals of CVAD online course and the Edmore Insertion of Central Line Training.

For more information, contact the Manager, Kelly Cridland, 9464 4691.

Innovation Exchange

Innovation Exchange Manager

The ACI Innovation Exchange provides a collaborative place online to share and promote local innovation and improvement projects and resources.

The site showcases great work that is happening across the state, promotes innovations and improvements to health services, and recognises the commitment and expertise of staff working in the NSW Health system.

The IE recently topped more than 200 projects. Examples of some of the innovative projects showcased include:

A Public-Private Rural Physiotherapy Service - Murrumbidgee Local Health District, Murrumbidgee Primary Health Network
This project established a partnership between the local health district, Primary Health Network and private physiotherapists, to pool resources and deliver physiotherapy services in rural communities.

Smoke-free Commercial Outdoor Dining for NSW - NSW Ministry of Health
A NSW Health public notice campaign was implemented using stakeholder engagement and social marketing strategies, to increase awareness of the smoking ban in commercial outdoor dining areas enacted on 6 July 2015.

Kidney Dialysis Vascular Access: A Vascular Surgeon and CNC-led Access Clinic - Prince of Wales Hospital
A vascular clinic with an integrated health approach was established, to address the high number of emergency procedures and prolonged hospitalisations incurred by haemodialysis patients.

Your Health Link: Information the Right Way - Mid North Coast Local Health District
Your Health Link is an online gateway to a broad suite of health information, linking the community, patients, carers, teachers and students to over 500 Australian health-related organisations and services chosen by health professionals.

Kempsey Patient Transport Project - Mid North Coast Local Health District
MNCLHD upgraded the Patient Transport Service and expanded its capacity to provide after-hours services. It also educated emergency department (ED) staff on how to use these services most effectively.

Reducing Anxiety in Cancer Patients Using 3D Videos - Hunter New England Local Health District
Hunter New England Local Health District staff volunteered their time to develop information videos incorporating 3D animation for patients undergoing radiation therapy. Patient engagement led to videos that were tailored to specific treatment situations and information needs.

VIP Project: Reducing Re-presentations and Readmissions to Hospital for Very Intensive Patients - Hunter New England Local Health District
The VIP project developed a strategy to identify Very Intensive Patients (VIPs) who are at high risk of re-presenting to hospital and implemented methods to address their medical and psycho-social needs. This new model of care has reduced the need for hospital-based care by using interagency partners in the primary care sector to provide support for VIPs in the community.

For more information or to submit a project visit www.aci.health.nsw.gov.au/ie.

Intellectual Disability Network Co-Chairs: Ms Maria Heaton and Prof. Les White

Intellectual Disability Manager

Tracey Szanto

9464-4632 | 0408 365 528

tracey.szanto@health.nsw.gov.au

Intellectual Disability

Exercise Intervention Program for Children with Intellectual Disability at the Improvement and Innovation Award

It is widely accepted within the research community that children and adolescents with intellectual disability are more likely to be inactive and overweight or obese than their healthy peers. They also face significant barriers to sports participation and involvement in physical activity. Improving fundamental movement skills, aerobic fitness, balance and strength has the potential to improve quality of life and health outcomes in this population.

In order to address this issue, the ACI partnered with the Specialist Disability Health Team that serves the Bankstown, Fairfield and Liverpool Local Government Areas (LGAs) to develop an exercise intervention program for children with moderate to severe Intellectual Disability (ID).

The project was funded by the ACI and allowed an exercise intervention specifically adapted to the needs of children with ID implemented in the regions by an accredited exercise physiologist.

Jessica Bellamy, Accredited Exercise Physiologist with Specialist Disability Health Team (SDHT). Photo: L. Azouz (Project Officer – UNSW Australia).

Results from the project to date have demonstrated:

  • the feasibility of conducting a group-based exercise intervention program, based on 30 minutes sessions of guided exercise, conducted on a weekly basis over a period of 16 weeks
  • key outcome measures including physiological parameters and movement skills can be reliably assessed, pre- and post-intervention, to evaluate the effectiveness of the program
  • the initial results on a small sample (10 children) showed a trend towards reduction on obesity, increase in aerobic fitness and improved fundamental movement skills following completion of the program
  • In 2015 the program was awarded a 'highly commended' at the annual Sydney Children's Hospital Network Quality Innovation and Improvement Awards ceremony.

Institute of Trauma and Injury Management

Major Trauma in NSW, 2014 : A Report from the NSW Trauma Registry

Each year more than 3,400 people are admitted to a NSW Trauma Service for moderate to critical injuries. A key priority for ITIM is to monitor the effectiveness of the NSW trauma system response to these patients.

The Major Trauma in NSW 2014 Report describes how the NSW trauma system responded to patients in 2014, from the time of injury and provision of pre-hospital services, through to in-hospital services provided at a NSW Trauma Service.

The report helps clinicians, managers and health services to understand the nature of the injuries sustained and how they occurred. The findings are then used by 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 also used by ITIM to provide advice and feedback to clinicians and other stakeholders, enables research into patterns of service demand and staffing, benchmarking, and performance improvement activities.

Report highlights

  • 3,458 major trauma patients
  • 3,566 major trauma admissions
  • Average age was 51.7 years old
  • Males were 2.4 times more likely to be injured
  • Overall case fatality rate was 13.0%
  • Females have higher case fatality rate (16.0%) compared to males (11.7%)
  • Falls accounted for 42.6% of all major trauma, exceeding road trauma (37.4%)
  • "Three or more fractured ribs" was the most common single injury sustained
  • 29.1% of major trauma was sustained in a rural area.
View the full report.

Palliative Care Network Co-Chairs: Sue Hanson and Peter Cleasby

Palliative Care Network Manager

Taking the quality improvement journey in palliative and end of life care

The Palliative Care Network was pleased to welcome Health Minister Jillian Skinner MP on 17 December 2016 to celebrate the launch of a new website for healthcare professionals caring for people approaching or reaching the end of their life.

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The Hon. Jillian Skinner speaks about the Blueprint in the context of the NSW Government Plan to Increase Access to Palliative Care 2012-2016.

L Lobb, M Doran, R Wilkins, S Hanson, N McGowan and S Castree-Croad.

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J Russell speaks about the Blueprint at the forum.

Rob Wilkins.

The Palliative and End of Life Care Blueprint for Improvement website offers a flexible framework for local services, providing clinical tools and resources for each of the Blueprint's ten essential components for care. The online resource was developed by the Agency for Clinical Innovation's (ACI) Palliative Care Network of clinicians, researchers, consumers and managers following extensive consultation with NSW healthcare services.

The website provides a comprehensive space for clinicians, consumers and managers to access the latest palliative and end of life care resources produced by the ACI and the Clinical Excellence Commission (CEC).

The Blueprint aims to guide services and Local Health Districts in constructing their own, localised models of care and can be implemented across all settings of care – acute, subacute, aged and community spanning across public, private, not-for-profit and community sectors.

A Palliative and End of Life Care Blueprint for Improvement Statewide Forum on 2 March 2016 will examine the case for change in more depth, and support services to assess local starting points and priorities as the basis for action. The Network Executive is keen to mobilise training and access to service improvement-related expertise as needed, foster collaboration across services on improvement activities and provide regular opportunities to come together to share progress and learnings.

For more information, visit the website at www.aci.health.nsw.gov.au/palliative-care-blueprint.

Patient Experience and Consumer Engagement

PEACE Team Manager

Bringing Music & Memory to NSW

The PEACE team and the Arts Health Institute have partnered in an initiative to improve the experience of patients in NSW health facilities.

The Music & Memory program uses individual, personalised playlists on iPods to help improve the lives of people accessing healthcare. Music is profoundly linked to personal memories and the brain is hard-wired to connect music with long-term memory. The program highlights the ability of music to powerfully improve mood and reduce stress among other health benefits.

A pilot of the program will be run in two NSW health services after the collaboration was one of three projects to win the inaugural Health and the Arts start-up grant from the NSW Ministry of Health. The grant is part of a wider initiative from NSW Health to promote the health and wellbeing of patients through the arts.

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The grant was announced at the NSW Health and Innovation Symposium in October 2015 in front of an audience of 1000 people, including NSW Health Minister Jillian Skinner.

The Music & Memory concept was developed in the US by social worker Dan Cohen. Originally designed for people with dementia, it was found that the program also has benefits for anyone in pain, feeling isolated or experiencing mental health issues.

For more information or to get involved visit the ACI PEACE webpage.

For more details about Music & Memory visit www.artshealthinstitute.org.au.

Rehabilitation Network Co-Chairs: Dr Garry Pearce and Ms Sandra Lever

Rehabilitation Network Manager

Clinical Services Planning launch

ACI Rehabilitation Network Manager Claire O'Connor attended the Murrumbidgee Local Health District (MLHD) Rehabilitation Clinical Service Plan (CSP) launch in Griffith on 18 November 2015.

More than 50 key stakeholders and clinicians participated from across MLHD to set priorities for the implementation of the CSP.

MLHD's Rehabilitation CSP is based on the Rehabilitation Model of Care developed by the Network, tailored to a rural setting. MLHD previously participated in the ACI Rehabilitation Redesign Project in 2011 and the Rehabilitation Redesign Project: Gap Analysis of Rural NSW Rehabilitation Services in 2012. Following these activities the MLHD Rehabilitation Clinical Services Plan 2014 - 2018 was developed through a process of consultations held across the district in 2013.

Claire joined Dr. Louis Baggio (Overview of the Murrumbidgee LHD Rehabilitation Clinical Service Plan 2014-2018) and Sally McMahon (A Patients Rehabilitation Journey) as a guest presenter at the event.

The outcomes from the workshop are now available on the MLHD intranet.

Respiratory Network Co-Chairs: Claudia Dobler and Sheree Smith

Respiratory Network Manager

Respiratory Clinical Innovations Forum

The Respiratory Network hosted the inaugural NSW Respiratory Clinical Innovations Forum in November 2015. The event showcased innovative and effective initiatives in adult and paediatric respiratory care in NSW and was attended by 140 clinicians from acute, sub- acute, community and primary care settings.

Clinicians keen to review respiratory eMR pathways at the forum. Photo: S. van de Scheur.

Guest key note speakers Peter Gibson, Vanessa McDonald and Chris Grainge kicked off the forum with a 'respiratory slant' on integrated care, patient reported outcome measures and understanding clinical variation. Four breakout sessions followed which gave NSW clinicians and researchers an opportunity to present their exciting work across a broad range of topics including community based pulmonary rehab, acute non-invasive ventilation, advance care planning, asthma in pregnancy, respiratory health pathways, and cognitive behavioural therapy for anxiety in people with chronic obstructive pulmonary disease (COPD).

The eHealth team were available at computer stations throughout the day to provide clinicians with a hands on experience and an opportunity for feedback on the new COPD and pneumonia inpatient pathways which are being developed in collaboration with the Respiratory Network clinical eMR working group.

John Haydon, an ACI consumer representative and patient with COPD, told his powerful story which highlighted how care is often fragmented and even well informed patients can easily fall through the cracks in our systems.

The forum closed with a panel discussion on Integrated Care – are we moving from concept to reality and questions from the floor.

Sax Institute

Strengthening prevention in primary care

The January 2016 issue of Public Health Research & Practice is out now, with a focus on primary health care and how to strengthen links between primary care and population health to maximise outcomes.

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

Guest editor for Issue 1 (2016) is Professor Mark Harris, from the Centre for Primary Health Care and Equity at the University of New South Wales. Prof Harris identifies the importance of primary health care in prevention in a perspective article about the need for integration and partnership between primary health care organisations and public health services and programs.

Other themed articles include: three viewpoints on the role in prevention of the new Primary Health Networks; a view from Liverpool (UK) describing the important role primary care has played in preventing poor health; and a research article examining community-based care provided after hospital discharge for patients with acute coronary syndrome.

Other articles look at successful scaling up of public health interventions; a record low in adolescent smoking; 'poor compliance' with a 2007 NSW Ministry of Health policy on elective or pre-labour caesarean section; breast cancer recurrence; and designing a maternity care survey.

The Sax Institute hopes the journal's focus on innovation and perspectives from policy and practice will support policy makers, program agencies and practitioners in making decisions that are informed by evidence.

You can subscribe to receive quarterly e-alerts when the journal is published, make suggestions about themes or topics for future issues, submit papers and follow us on Twitter @phrpjournal.

Telehealth

Telehealth Project Officers

Julia Martinovich & Chloe Moddel

9464 4654 | 9464 4654

julia.martinovich@health.nsw.gov.au & chloe.moddel@health.nsw.gov.au

Telehealth

Development of a Telehealth Capability Interest Group

In order to further support the ongoing development of Telehealth technology in NSW health services, the ACI has created a Telehealth Capability Interest group, which will cater for the various breadth of knowledge that is held in this space and provide a forum for clinicians to learn from the experience of others.

The purpose of this group is to:

  1. Share information and knowledge
  2. Identify common issues at a state level
  3. Networking and capacity building
  4. Identify pockets of excellence and promote innovative models
  5. Expand use of the ACI Guidelines for the use of Telehealth for Clinical and Non Clinical Settings in NSW.

Membership of this group is statewide and can include any clinicians with an interest in telehealth.

The group will meet via teleconference. Regular newsletters showcasing excellence will also be distributed, which will also provide a place to raise any issues that need to be addressed at a state level.

The first newsletter is scheduled to be distributed in February 2016.

To register for this group, please enter your details here:

Transition Care Network Co-Chairs: Sue Towns and Mae Rafraf

Transition Care Network Manager

Lynne Brodie

9464 4617 | 0414 015 115

lynne.brodie@health.nsw.gov.au

Transition Care Network

Get the conversation started

A new Get the Conversation Started online education module is now available on the Health Education and Training Institute (HETI) website. The 30 minute course was developed by collaboration between the ACI, HETI, Sydney Children's Hospitals Network and the Office of Kids and Families (formerly NSW Kids and Families).

The module explores ways a health worker can use the HEEADSSS Framework to engage a young person in a conversation that will assist with meeting their health and wellbeing needs. Aims include improving knowledge on:

  • Recognising the value of the HEEADSSS tool to engage, build rapport, and empower a young person to be an active partner in their own health
  • Using HEEADSSS to identify risk and protective factors that impact a young person's health
  • Confidently providing appropriate support and follow-up which assists in meeting the health and well-being needs of young people.

HEEADSSS is a psychosocial assessment tool developed by J. Goldenring in 1988 and updated in 2004. The tool covers:

  • H Home
  • E Education and Employment
  • E Eating and Exercise
  • A Activities and peer relationships, drug use
  • S Sexual activity and sexuality
  • S Suicide, depression and mental health
  • S Safety and spirituality

ACHSM Graduates at the ACI

Since 2013, the ACI has been in partnership with the Australasian College of Health Service Managers (ACHSM) and the Health Education and Training Institute (HETI) as 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 LHDs across the state, regular professional development and mentoring, and the completion of a Masters in Health Administration. The ACI hosts a small number of Management Trainees for a twelve month work placement, providing Trainees with a rich, varied and challenging experience of health system management.

The ACI's focus on working with clinicians, consumers and managers to produce evidence-based resources with a strong emphasis on 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.

In 2015, the ACI hosted two first year Trainees, Crystal Burgess and Jessica Drysdale. Jessica undertook placements with the SACC, PCCS and CPDI Portfolio teams, while Crystal was placed with the CPDI and Acute Care teams. Both Trainees describe their experiences at the ACI as 'fantastic' and they would 'recommend it to anyone'.

To hear more about the ACHSM placement experience at the ACI, watch the videos below.

Aboriginal Cultural Competency and Safety Working Party

We are very excited to be partnering with local Aboriginal artist Jessica Birk to create a unique painting to symbolise the work of the ACI to design and promote better healthcare for NSW. Staff have been given an opportunity to work alongside Jessica and contribute to the artwork.

Acknowledgements

Congratulations to ACHSM Trainees Jessica and Crystal for completing their one year placement at the ACI.

Welcome to our new placement Trainees Joshua and Michaela.

Learn more here.

Upcoming events
March
11

2016 ANZBA Burns Nursing Seminar

March
15

Rural Innovations Changing Healthcare (RICH)

Please visit our Events Calendar for program details and information on how to register.