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Volume 10, Issue 3 – June 2017

Clinician Connect

Patient Experience Symposium

Guest Editorial

Deputy Secretary, Strategy and Resources

Nygel Lyons

In the delivery of a patient centred healthcare system, it is important to focus on what matters to patients. As clinicians we are quick to ask 'What is the matter?' but in seeking to determine the best course of treatment for the patient, we can be slow to ask 'What matters to you?'. By understanding what matters to patients we can start to develop a shared understanding and commitment to a treatment plan.
Health care is changing and so are the needs and expectations of communities, patients and carers. Increased demand, an ageing population and the higher prevalence of chronic disease provide challenges for the planning, delivery and evaluation of health services. The key focus of the NSW health system is to provide health services which are patient focussed, evidence based, safe and of high quality, effective and efficient.
Value in health care is a comprehensive approach that includes the Institute of Healthcare Improvement (IHI) triple aim1 of; improving the health of the public (health outcomes), providing efficient and effective care and improving the experience of care relative to cost. In this context, health outcomes are the results that matter most to patients2 .
NSW Health is refocusing the health system to focus on the delivery of value based care. To achieve this, NSW Health has initiated the Leading Better Value Care (LBVC) program. This program has created shared priorities for initiatives identified for implementation across the NSW health system. This involves clinicians, pillars, local health districts, specialty networks and the NSW Ministry of Health working together to improve the health of the public, improve the patient’s experience and to provide efficient and effective care.
Leading Better Value Care supports the concept of shared system priorities and forms part of NSW Health’s strategic initiatives.
The LBVC program is being conducted in tranches to optimise the benefits of a strategic approach, alongside learning and the flexibility of incorporating new and innovative initiatives.
The key goals of the program are:

  • Focussing on patients through adopting a patient experience and health outcomes approach
  • Focussing on value across the triple aim to support moving away from volume
  • Addressing future demand and fiscal pressures by creating future system capacity through efficient and effective care and services

From 1 July 2017, with implementation to be completed by 30 June 2018, Leading Better Value Care initiatives will impact clinical teams across NSW who are caring for people:

  • with osteoarthritis
  • at risk of osteoporotic refracture
  • with chronic heart failure (CHF)
  • with chronic obstructive pulmonary disease (COPD)
  • with diabetes
  • at risk of diabetes related foot complications
  • at high risk of falls in hospital
  • with end stage renal disease.

All of NSW shared services and pillar agencies are part of the support network for the implementation of the Leading Better Value Care initiatives.
You might well ask why is this program necessary. NSW Health must act now to capitalise on current opportunities:

  • Accelerate implementation of key strategies which have demonstrated benefits for patients and the system.  
  • Establish shared priorities across the system (LHDs, Pillars, Clinicians, MoH).
  • Focus on getting the clinical processes right – resulting in efficient care, enhanced capacity and avoided costs.
  • Understand variation and address any unwarranted clinical variation.
  • Consolidate projects to improve patient experience and reported outcomes and to enable more effective and efficient healthcare.
  • Reframe the NSW Health system as a world leading, sustainable, patient centred health system.

There are considerable challenges in implementing a program such as Leading Better Value care. Such a long term program requires strategic vision, commitment to and investment in, analytics that support informed decision making. As well, appropriate drivers such as purchasing, evaluating, monitoring, and incentivising quality need to be aligned. Considerable work is underway to streamline the process of collection, analysis and reporting by leveraging existing infrastructure and capability.
In many cases though, changes in the longer term are also required in care settings outside NSW Health. Our relationships with Primary Health Networks will be critical to the work of providing better value healthcare.
Leading Better Value Care initiatives are designed and led by clinicians, working in collaboration with statewide clinical networks providing significant clinical engagement, and in conjunction with the Agency for Clinical Innovation and the Clinical Excellence Commission.

For more information please check website www.eih.health.nsw.gov.au/bvh

 


  1. Institute for Healthcare Improvement

  2. ICHOM 2016

ACI Board Chair Comment

by Prof. Brian McCaughan Chair, ACI Board

Professor Brian McCaughan

It is appropriate at this time of change that we recognise the tremendous volume of work initiated, co-ordinated and implemented by the various Clinical Networks, Taskforces and Institutes which are the core of what is the ACI. Great credit to all our staff who have maintained the momentum initiated by Nigel Lyons and sustained so capably by Donald MacLellan over the last nine months in his role as the acting Chief Executive. The Board and I personally have appreciated the role Donald has played in extending the twilight of his very successful career in surgery and management.

We now look forward to a new era in ACI as we focus on Elizabeth Koff’s vision of ‘Value, not Volume’ in her role as Secretary of the Ministry of NSW Health. As many of you are aware we have been recruiting staff for the Leading Better Value Care program.

We welcome our new Chief Executive, Dr Jean-Frédéric Levesque, to harness the ACI’s enthusiasm for better care for all our patients and carers in New South Wales. Jean-Frédéric is known to many of us in ACI and he has worked extremely closely with many of the Clinical Networks and the Unwarranted Clinical Variation Taskforce in his role as CE of the Bureau of Health Information (BHI). Jean-Frédéric’s medical training in Canada and subsequent role in addressing health system issues both in Canada and Australia position him ideally for leading the ACI into its next phase.

Over the next two years we will continue the increasing collaboration with CEC and both Carrie Marr and Jean-Frédéric will be instrumental in this phase as we head towards co-location on the new St Leonard’s site later this decade. There are some roles and functions of CEC and ACI that are quite unique to each of those organisations but we share so much in common in terms of patient care that our work must continue in a mutually strong and collaborative fashion.

With the appointment of Jean-Frédéric, we also look forward to filling the senior vacant positions and bringing even greater stability to the workforce at ACI. I would like to thank all of those people who have stood up and accepted acting roles whilst we have had vacancies, as well as staff seconded to the Ministry.

Critical to the success of ACI has always been the clinical involvement in all our processes and this is certainly a point that is to continue unabated. I am delighted as part of that process to be able to announce that Dr Sarah Dalton, our Clinical Lead at the ACI, will be increasing her commitment to the organisation and moving to a 0.8 position once her secondment at the Ministry is complete.

It is certainly an exciting time ahead and I look forward to discussing any these issues with all of you at the ACI.

Chief Executive Comment

by Prof. Donald MacLellan Outgoing A/Chief Executive, ACI

 Prof. Donald MacLellan

After four years as the ACI Director of Surgery, Anaesthesia and Critical Care (SACC) and then the last eight months as Acting Chief Executive (a wee surprise), the time has come for me to finally bask in the pleasures of retirement!

It has been a great privilege to have worked in this unique organisation. The ACI is an indisputable leader in healthcare improvements and benefits from the extraordinary commitment of large teams of clinicians and managers who freely give their time to improve patient care. ACI continues to embrace change as it now enters a new and exciting phase with major programs, including Better Value Patient Care and Patient Recorded Outcomes Measures, and led by a new Chief Executive.

I wish to thank my colleagues in SACC for their support and congratulate them for their tremendous achievements over the last four years. I have appreciated the support and advice of Professor Brian McCaughan during my time at the ACI, and in particular over the last eight months in his role as Board Chairman. Finally, thank you to all ACI staff who I have had the pleasure to work with and I wish them well in their continuous endeavours to improve patient care across NSW.

Best of luck to Dr Jean-Frédéric Levesque as he steps in to this role, I will continue watch with interest as the ACI continues to deliver innovation to the system.

Chief Executive Comment

by Dr Jean-Frédéric Levesque Incoming A/Chief Executive, ACI

Dr Jean-Frédéric Levesque

Dr Jean-Frédéric Levesque
Acting Chief Executive, ACI
JeanFrederic.Levesque@health.nsw.gov.au

Change is opportunity. Change is challenging. In the healthcare sector, change is also constant, sometimes planned through explicit policies and programs, sometimes emergent through innovations led by clinicians and local champions. The NSW Agency for Clinical Innovation (ACI), through its various programs proactively seeking to spur change, and through its expertise responding to requests to support innovations, has a crucial role to play in the improvement of healthcare.

It is with great excitement that I start acting in the role of Chief Executive of the ACI. The mandate is clear: build on the foundations of the organisation to ensure the continuation of activities that make change feasible in clinical settings and improve alignment of our efforts to ensure that system priorities are better addressed. The end goal: the population of NSW receives better access, better care, and better outcomes.

From a personal perspective, I arrive with great enthusiasm and a desire to bring evidence-based innovation to the core of the organisation’s activities through the clinical networks, taskforces and institutes. To support the advancement of a learning healthcare system, the ACI has to model change and be a learning organisation. This means that clinical information will be both a material we will work with to support local change, as much as it will be an input to our work to identify where we are needed. It also means that the evidence we will provide to the system to support the implementation of policies and redesign programs, as well as the emerging innovations, has to come both from what is recognised as best practice and leading ways to organise care, as well as from what we measure empirically about how care is actually provided. I will strive to promote a culture of measurement and evaluation as a key component to our work.

From an organisational perspective, the ACI is at a crossroads. The scope of work of the organisation has expanded in recent years and a variety of programs have been implemented. Clinical networks, taskforces and institutes are active and facilitate discussions around clinical improvements. I feel privileged to have the opportunity to lead the organisation at a time when so much has been established and the potential for innovation is so great. This great juxtaposition of expertise, ranging from change management, organisational design, implementation science, and clinical leadership, represents an amazing opportunity to integrate our activities around poles of innovation, to create bridges and foster a team approach to ensure the integration of our work and enhanced synergies between our change management expertise and our clinical leadership.

From a system perspective, the expertise of the ACI is key to achieving the goals and aims of the healthcare system in NSW and instrumental to the success of many priorities and policies. Working in synergy with the Ministry of Health, local health districts, and other pillars will be key to our work. Finding a balance between investing in programs aimed at supporting innovation across the entire healthcare system and aligning our organisational priorities with broader system priorities - to make a difference on those difficult problems that require a concerted effort - will be required. I will work with our executive leadership team and our clinical leads to ensure that we find the right equilibrium between supporting both planned policies and emergent change.

According to some definitions, agency is the capacity of an organisation to act in a specific environment, clinical relates to the diagnosis, treatment and care of patients, innovation is the process of introducing new ideas, procedures, or methods. I invite you to work with me and the leadership team and clinical leads to work towards the mission that is embedded in our name - acting to introduce new ways to organise care to produce better outcomes for patients in NSW. You have my entire commitment.

ACI update

Staff Forum

The ACI held a forum for all ACI staff on 25th of May. The theme was ‘Our story’, which embodies a number of concepts; it recognises that the ACI is made up of a large number of individuals, each with their own story. It also reflects ACI’s story as an organisation, acknowledging where we have come from and where we are going. Finally, it introduces the concept of storytelling to assist us to learn and share ideas, and translate complex data and information using creative ways to drive change.

Ian and Anna from Limelight Creative Media provided an overview of the considerations needed when communicating complex information to drive change, particularly via visual mediums such as film.

Updates were given on a number of previous key priority pieces for the ACI, including cultural competency, the ACI - LHD operating model, and the NSW Government 2016 People Matters Survey results.

A fantastic keynote session was also provided by Annabel Crabb. Annabel is a writer, and broadcaster with the ABC. She is a regular guest on ABC News 24's 6pm current affairs show The Drum, and on ABC TV's Sunday morning politics programme Insiders. Annabel also hosts her own ABC1 political cooking show, Kitchen Cabinet, in which she invites herself around to the homes of federal MPs in search of food and conversation. Annabel wowed the crowd with her entertaining and informative session on finding and shaping the story.

Values and Behaviour Award

Congratulations to Rhiannon Beck, Primary and Chronic Care Project Officer, who was presented with the ACI Award for Values and Behaviours at the recent ACI Staff Forum.

Rhiannon Beck receiving award from Donald MacLellan

Promoting and recognising our shared values though the workplace is important in continuing to create a positive and supportive working environment. The ACI Values and Behaviours Awards provide an opportunity to recognise staff who consistently demonstrate our shared values and behaviours.

Nominations for the award are open to all ACI staff. People working within the organisation are given the opportunity to highlight individuals in recognition of their achievements in the demonstration of the ACI values and behaviours charter each quarter.

Rhiannon was awarded the honour after being nominated for the third time, due to her outstanding and consistent collaboration, respect, professionalism, and achievements, in particular with the Navigating Healthcare Neighbourhoods project. Congratulations Rhiannon!

Aged Health Network Update Co-Chairs: Bill Thoo, Kelli Flowers

Aged Health Network

New Network Manager

Kelly Flowers

Welcome to Kelli Flowers, who will be Acting as Manager of the ACI Aged Health Network while Glen Pang is on secondment to the Knowledge Manager role. Kelli comes from Liverpool Hospital where she is the Aged Care Clinical Nurse Consultant. She has been part of the Aged Health Executive for the past six years and is Co-Chair of the Nurses Subgroup.

Kelli brings a wealth of knowledge and experience to the role and will be a valuable driving force in continuing to meet the goals of the Network. Welcome Kelli.

Burn Injury Network update Co-Chairs: John Harvey, Diane Elfleet

Burn Injury Network Manager

Taking the heat off burn prevention

The ACI Statewide Burn Injury Service (SBIS) continues to work on the preventing frequently occurring burns with the release of the revised Burn Injury Prevention and First Aid brochure and magnet.

Designed to help NSW families understand how to prevent and treat common burns that can occur around the home, the factsheet and magnet will be distributed free at events such as Bandaged Bear Day and the Pregnancy Baby & Child Expo. It is also distributed by Kidsafe NSW, as well as to GP offices, early childhood centres and community health centres across NSW.

SBIS Chair John Harvey emphasised the practical advice provided by the pack in helping to reduce the risk of burns around the home through simple, clear first aid advice.

“Around 87 per cent of the burn injuries we see result from avoidable accidents. By highlighting some of the common risks we hope to provide information to help people reduce the possibility of burns at home,” he said.

“For example, many people don’t realise that water from a standard household hot water system can reach up to 75°C. At that temperature you can sustain a serious burn in under one second. By installing a hot water temperature valve or mixer, you can greatly reduce the risk of getting burnt.”

Tips to help prevent burns occurring in the home include.

  • Be careful when drinking hot drinks such as tea and coffee, or eating foods such as two minute noodles as these can easily fall into the lap causing painful burns.
  • Keep children away from objects such as irons, heaters, BBQs, oven doors and exhaust pipes and monitor their use when children are about.
  • Take care when removing food and liquids from the microwave after heating.
  • Keep an eye on small children around home fitness equipment – the rotating belts of treadmills and stationary bikes can cause serious friction burns.
Burn injury prevention and first aid magnet Burn injury prevention and first aid brochure

 

Centre for Healthcare Redesign Update

Manager, Centre for Healthcare Redesign Update

Redesign Program Building Capability in LHDs

Twenty six participants from 11 Local Health Districts (LHDs) and Specialty Health Networks (SHNs) across NSW were awarded a Graduate Certificate in Clinical Redesign at the most recent NSW Agency for Clinical Innovation’s (ACI) Centre for Healthcare Redesign (CHR) graduation ceremony in April.

Participants were recognised at the ceremony for their project to improve care in their Iocal health services.

Through the Redesign Program, the ACI is investing in the people working across NSW Health, building capability and capacity across the districts, and ensuring that the innovations being developed at the heart of our services are able to be effectively implemented.

The ACI Centre for Healthcare Redesign Graduate Certificate 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 Graduate Certificate in Clinical Redesign through a partnership with the University of Tasmania.

Redesign Program Building Capability graduation

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 650 improvement leaders developed across a range of metropolitan, rural and statewide health services from NSW and interstate.

For more information on the ACI Centre for Healthcare Graduate Certificate Program webpage

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

HARC Scholarship

HARC scholars focus on challenge of reducing clinical variation in healthcare

HARC Five future healthcare leaders, including one ACI staff member, are set to embark on research in areas ranging from responding to the threat of antimicrobial resistance to tackling clinical variation in cancer care after being awarded 2017 HARC scholarships.

HARC (Hospital Alliance for Research Collaboration) is a collaboration between the ACI, Sax Institute, the Clinical Excellence Commission (CEC), the Cancer Institute NSW and the Bureau of Health Information (BHI). It aims to build the NSW health system’s capacity to close evidence-practice gaps by fostering the use of research evidence in policies and programs.

The Collaboration’s focus for 2016-17 is to better understand the role of clinical leadership in effecting change in the health system to address unwarranted clinical variation. The scholars were invited to apply to conduct projects either on this theme, or on closing evidence-practice gaps.

The 2017 HARC Scholars are:

  • TARA DIMOPOULOS-BICK, MANAGER OF PATIENT EXPERIENCE AND CONSUMER ENGAGEMENT AT ACI

    Tara Dimopoulos-Bick is looking at what can be learnt from international evidence and experiences to improve the uptake of shared decision making within NSW health services.

    She said Australia was behind other countries in using shared decision making processes and decision aids, and the project would help to connect ACI to experts in countries that had progressed further in the field, including the US, England, France, Germany, Netherlands and Canada.

  • AMY BISSON, PROJECT OFFICER, HEALTHCARE ASSOCIATED INFECTIONS AT THE CEC

    HARC scholar Amy Bisson from the CEC will study multi-drug resistant organisms.
    Amy is set to investigate ways of reducing unwarranted clinical variation and harm from multi-drug resistant organisms for NSW patients, with a particular focus on the emerging threat posed by carbapenemase-producing Enterobaceriaceae (CPE).

    Having previously worked as a nurse, Amy said she was well aware of the frontline impact of the spread of multi-drug resistant bacteria. While Australia had not seen the same numbers of CPE infections as some other countries, it was recognised as a public health priority, with the first Australian hospital outbreak documented in 2012 and cases rising since.

    “It is the last line of antibiotic treatment after other options have failed, and that is why it is so critical,” she said. “Infections are often in very sick patients, and the mortality rate is very high.”

    Amy will use the scholarship to travel to Melbourne, Switzerland and the UK to study strategies that had been proven to bring about change in practice improvements, communication, education and quality improvement.

    She said she hoped the information she gathered would help inform the CEC ‘s development of guidelines, outbreak plans and tools to reduce unwarranted clinical variation and patient harm when responding to multi-drug resistant organisms such as CPE.

  • TINA CHEN, MEDICAL AND SCIENTIFIC ADVISOR AT THE CANCER INSTITUTE NSW

    Dr Tina Chen will use her scholarship to investigate how point-of-care, patient-reported outcome and experience measures can be used to achieve more effective, patient-centred care.

    Dr Chen will look at what patient-reported data is most pertinent and how to best obtain that data at the point of care, as well as how to appropriately analyse such data to form pragmatic measures and linked clinical endpoints that will enable evaluation and comparisons of treatment effectiveness.

  • LILIAN DALY, LEAD RESEARCHER AT BHI
  • Lilian Daly will visit Canada and England to build her knowledge and skills in the development of patient safety measures to assess hospital performance.

    She said she would investigate the relative merits of composite measures such as harm-free care and risk-adjusted measures that were focused on particular complications in specific patient groups – such as joint surgery – to help build internal BHI capacity.

  • RUYAMURO KWEDZA, MANAGER, QUALITY AND SYSTEM PERFORMANCE AT THE CANCER INSTITUTE NSW

    Dr Ruyamuro Kwedza will use the HARC scholarship to investigate ways to strengthen approaches to collaboratively understanding and addressing clinical variation in cancer care across NSW.

    In her application, Dr Kwedza said the process of moving from identifying variations in care – such as cancer care – to determining if variation is unwarranted and then to reducing undesirable variation remained a challenge for health systems. The project will enable her to visit international agencies with expertise in this area, as well as to conduct a literature review, to help inform future approaches for the Cancer Institute.

For more information on the 2017 HARC Scholarship Program, visit www.saxinstitute.org.au/news/introducing-the-2017-harc-scholars/.

Intensive Care NSW Update

IC NSW Manager

Launch of Intensive Care NSW

Intensive Care NSW In May 2017, the ACI’s Intensive Care Coordination and Monitoring Unit (ICCMU) and the Intensive Care Service Network (ICSN) relaunched as Intensive Care NSW (ICNSW) at the Critical Care at the Vineyards Conference.

This change has occurred as a result of evolved roles and functions for both ICCMU and the ICSN, with a merge established as the most effective way forward for the previously individual functions.

ICCMU was first established on a recommendation in the 2001 New South Wales (NSW) Intensive Care Plan. Its work was centred on knowledge management, quality and safety, data integration, and analysis. ICCMU achieved a significant amount in these areas, supporting clinicians in improving delivery of intensive care services on many fronts, including a significant contribution to quality and safety research.

In November 2016, representatives of the Intensive Care Service Network (ICSN), ICCMU and other key stakeholders attended an Intensive Care Planning Workshop to reassess the future purpose and function of the ICSN and ICCMU, and to determine how to best support clinicians working in the 45 public Intensive Care Units across NSW. This is an exciting time for the ACI, SACC and Intensive Care NSW in determining the new direction to support safe quality Intensive Care for the people of NSW.

As part of this process, the ACI website has been revised, including the new Intensive Care NSW logo and strategic direction. For more information on ICNSW, please don’t hesitate to contact the Manager. More information on the roles and functions of ICNSW can be found onICNSW Website.

Intensive Care NSW team

Intellectual Disability Network Update Co-Chairs: Maria Heaton, Jenny Martin and Less White

Intellectual Disability Network Manager

Building Capability in NSW Health services for People with Intellectual Disability: The Essentials Launch

The ACI Intellectual Disability Network will launch a resource and website which guides LHDs in the way they deliver health services for people with intellectual disability at an event on Thursday, 27 July 2017. The Essentials initiative includes a self-assessment checklist for LHDs to help identify areas of strength and need. The half day event will include showcasing LHD projects aligned with The Essentials to generate interest and possibilities for action from mainstream health services.

Please contact the Manager for more information.

Ryde Hospital developing pathways and partnerships

Leah Whitton

Leah Whitton – lead clinician in Hospitalisation project at Ryde Hospital.

Photographer: B Bonham

Ryde Hospital is working on two collaborative projects to improve health services for people with intellectual disability. These projects align with actions identified in The Essentials package.

Northern Region ADHC has partnered with Ryde hospital, the ACI, Lifestart and Sydney Children’s Hospital Network (SCHN) to adapt the visuals and training resources Say Less Show More for adults.

Ryde Hospital is also leading another collaborative project with partners from NSW Ambulance, primary health networks (PHNs), non-government organisations (NGOs), Ageing, Disability and Home Care (ADHC), and the ACI on hospitalisation, in order to improve staff awareness, pathways, and prevent unnecessary presentations. Links to the project resources will link to The Essentials website alongside other practical tools like Daniel’s story, guidance from clinicians and people with ID and A2D.

Institute of Trauma and Injury Management Update

Trauma 2017 Research Workshop

Institute of Trauma and Injury ManagementThe ACI Institute of Trauma and Injury Management (ITIM) team presented the The epidemiology and predictors of post-injury multiple organ failure in New South Wales study at the Research Workshop of the Trauma2017 Conference in Melbourne in April.

Post-injury multiple organ failure (MOF) is the primary cause of late trauma death and has a significant impact on resource utilisation after blunt multisystem trauma. Patients who develop MOF not only have a higher mortality rate among major trauma patients (25% versus 3%) admitted to the intensive care unit (ICU), but are at greater risk of poor long term functional outcomes. In addition, patients with MOF stay longer in the ICU and use more significant resources.

There is no specific treatment for MOF; prevention through timely care, control of bleeding, resuscitation, and organ support are the key elements of today's practice. In order to focus preventive efforts against this deadly and debilitating syndrome, it is essential to describe its epidemiology and identify the predictors.

Patient experience symposium
photographer: Christine Lassen

This is the first time in Australia that MOF will be evaluated by a multi-centre prospective study.

This project is funded and supported by ITIM and will be undertaken at all major trauma services in NSW.

For more information on this or other research projects please visit the ITIM Research page.

Ophthalmology Network Update Co-Chairs: Michael Hennessy, Julie Heraghty and Andrew White

Network Manager

Vision Defect in Stroke Tool

The Vision Defect in Stroke Tool has been endorsed by the State Forms Management Committee and is available for use in NSW public hospitals.

The vision screening tool was developed to be used by non‐eye care practitioners to assist in the identification of pre‐existing and recently acquired vision problems in patients who had had a stroke. The need for such a tool had been previously identified, with many patients failing to have eye conditions detected and therefore managed during the early stages of their recovery.

The tool, developed and tested by the ACI Orthoptic Standing Committee, was validated in a further study conducted in conjunction with the University of Technology and Northern Sydney Local Health District.

The tool comprises a mini questionnaire with a vision screening test designed to be conducted at the bedside. The questionnaire determines current and newly acquired ocular conditions in response to straightforward questions and guided observations by non‐eyecare practitioners.

An eLearning module to support the implementation of the tool is currently under development and is due for completion at the end of June. The training module will be hosted on the Health Education and Training Institute (HETI) professional development platform.

On behalf of the Ophthalmology Network Executive, a huge congratulations to the Orthoptic Standing Committee who championed the tools development, refinement and advocacy.

Vision defect in stroke screening tool

New Co-Chair

Clinical A/Prof Andrew White  -  Photo courtesy of MiVision We are pleased to welcome Andrew White, Associate Clinical Professor and Head of Ophthalmology at Westmead hospital as the new Co-Chair of the ACI Ophthalmology Network. Andrew steps in to the role vacated by Ross Ferrier, who stood down in February 2017.

Andrew has a subspecialty interest is glaucoma and brings a wealth of international and local experience in Ophthalmology. He is also a member of the Association for Research in Vision and Ophthalmology (ARVO), sits on the Executive of the Australian Society of Ophthalmologists, and is a member of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) NSW State Branch Committee. He is an author of the Asia Pacific Glaucoma Society Guidelines on the management of glaucoma (to be published this year), as well as the lead author on the RANZCO endorsed Guidelines for collaborative management of glaucoma.

Andrew has been the chair of the NSW Community Eye Care project since its inception in 2015 and is the lead clinician in the implementation for the glaucoma and diabetic retinopathy arms of the project at Westmead.

Welcome Andrew.

Pain Management Network Update

Pain Management Network

Pain management program for CALD community

The NSW Pain Plan 2012-2016 has now been widely implemented across NSW. Service capacity has been significantly enhanced as a result, with waiting lists reduced to 63 days on average across the state.

It has become evident, particularly for some areas of NSW where culturally and linguistically diverse (CALD) populations are prevalent, that adaptation of existing materials and service models is necessary to breach cultural barriers around understanding and uptake of these services. Materials require translation and cultural adaptation in order to optimise learning of the self-management approaches known to be the most effective strategy in managing chronic pain

Pain management program and a complete toolkit have been developed, translated and adapted for the top four language groups identified; Chinese (traditional and simplified), Arabic, Vietnamese and Greek. Pain management education and self-management program for people with chronic pain from the four cultural backgrounds will be implemented through multicultural health services in the following Local Health Districts, commencing in mid-May 2017:

  • Sydney LHD
  • South Eastern Sydney LHD
  • South Western Sydney LHD
  • Western Sydney LHD
  • Illawarra Shoalhaven LHD
  • Hunter New England (HNE) LHD

The programme runs in the community once per week for six weeks. People with chronic pain will learn skills to manage their pain in a group setting with others from their cultural background.

For more information about the program and resources, visit the ACI Pain Management Network webpage or contact the Network Manager.

Patient Experience Symposium 2017

The 2017 Patient Experience Symposium was held on 2 – 3 May 2017 at the Sydney Masonic Centre, with the theme Communication and Connecting People.

The Symposium is organised by a network of NSW Health organisations, with the ACI and Clinical Excellence Commission (CEC) as lead co-sponsors.

The 2017 Symposium was extremely successful, with 596 people attending the event, including 91 identifying as consumers. Attendees mainly included managers, clinicians and consumers from NSW Health, however also included interstate colleagues, primary healthcare and international guests working in patient experience.

Keynote sessions by 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, were well received, as well as several consumer panel sessions across the two days.

The annual Patient Experience Symposium aims to bring people together to improve the experiences of care for people from NSW. The Symposium provided the opportunity for people to network, learn, and share their ideas, work and projects with each other, cooperatively building our knowledge of this evolving aspect of patient care.

Participants were encouraged to follow along through social media using the event hashtags #PExS2017. The conference program, presentations, and the plenary livestreamed sessions are now available on the event website.

Evaluation of the 2017 Symposium is underway, and planning has commenced for the 2018 event.

If you would like any further information please contact: Melissa Tinsley Melissa.tinsley@health.nsw.gov.au.

Primary and Chronic Care Team Update

Manager, Primary and Chronic Care Team

Drug and Alcohol, Mental Health and Primary Care: Working Towards Integration event

On Friday, 28 April 2017, the ACI Primary Care and Chronic Care team hosted a Drug and Alcohol, Mental Health and Primary Care: Working Towards Integration event.
Keynote speaker Kirsten Meisinger MD discussed the patient centred medical home model and how it has been used in the United States to integrate mental health and drug and alcohol services with general practice. Kirsten is the Medical Staff President and Primary Care Physician at Cambridge Health Alliance, Boston, USA.

Local speakers at the event included Hester Wilson, Charlotte Hespe and Sandra O’Brien.

Recordings of the event can be found on the Navigating the Healthcare Neighbourhood website on the videos page.

Kirsten Meisinger MD addressing the audience

Photographer Rhiannon Beck

Sax Institute

Sax Institute

SAX Institute New approaches to suicide prevention are under the spotlight in the latest issue of Public Health Research & Practice (PHRP), which includes an article on a decision-support tool for policy makers and communities.

The Guest Editor for Issue 2 (2017) is Professor Ian Hickie, Co-Director, Health and Policy, at the Brain and Mind Centre in Sydney. Themed articles include an ‘In practice’ paper on how system dynamics modelling ‒ a “what if” tool to test the likely impact of different interventions ‒ has found that increasing general practitioner training could have the biggest impact on preventing suicides in Australia. A perspective article describes a ‘systems’ approach to suicide prevention, which is now being trialled in New South Wales, and another proposes new ‘transdiagnostic’ models of stepped care for mental health, arguing that the current stepped-care models of service delivery do not cater well for comorbidities or complexity in real-world clinical practice. In a consumer’s perspective, National Mental Health Commissioner Jackie Crowe describes how Australia’s mental health sector is nearing a tipping point for transformation.

Other articles discuss the development of an online alcohol-related health promotion animation aimed at Baby Boomers; and review the evidence available on disability income support design and mental illness.

A non-themed article in the issue questions whether tobacco and alcohol companies should be allowed to influence the Australian National Drug Strategy. Other non-themed articles include research into identifying adverse drug reactions in hospital ICD-coded data; and explore the challenges of integrating evidence into health policy and planning.

PHRP 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.

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.

Transition Care Network Update Susan Towns, Mae Rafraf

Manager, Transition Care Network

Youth Week 2017

ACI Transition Support Worker Mae Rafraf and members of the WSLHD youth week committeeYouth Week commenced in 1989 as an initiative by the NSW government and is now celebrated across every state and territory as a mass recognition of younger people. ACI Transition Care Coordinators and Support Workers joined youth health teams at Royal Prince Alfred (RPA), Westmead, Children’s Hospital Westmead, and John Hunter Hospitals to promote health related youth activities, including transition care.

ACI, Canteen and RPAH youth team sharing a stall to celebrate and promote youth week at RPAH.

ACI, Canteen and RPAH youth team sharing a stall to celebrate and promote youth week at RPAH.

Transition care support worker Amanda Loughmann joining in the inspiration art project as part of youth week at RPAH

Transition care support worker Amanda Loughmann joining in the inspiration art project as part of youth week at RPAH

Visit by Sandy Whitehouse

Members of the ACI Transition Network Executive were provided with a wonderful insight into transition care services in British Columbia, Canada when visiting doctor Sandy Whitehouse presented on Maintaining connections for youth as they transition from Pediatric to Adult Care at the Network’s Executive Meeting on Monday, 8 May 2017.

Sandy is Founder, Medical Director, Clinical Associate Professor, Dept. of Paediatrics, University of British Columbia, Canada. The primary differences between BC and NSW relates to the systems to engage young people with primary care in BC. This engagement includes providing a medical home through community general practice, and their focus on supporting young people to become more health literate and engaged in their transition through resources such as TickIT and the TRAC toolkit, which help young people with their transition planning.

For more information visit website.

Inaugural Transition Graduation in the Hunter

The inaugural ceremony for young people graduating from John Hunter Children’s Hospital to adult health services was held on Wednesday, 14 June 2017 at thee Hunter Medical Research Institute (HMRI). Congratulations and good luck to all of the young people involved.

For enquiries please contact ACI Transition Coordinator Angie Myles at Angela.Myles@hnehealth.nsw.gov.au

Sarah Cullen – Consumer Champion

Sarah and her mum Emilia on a beach in southern India in December last year

Sarah and her mum Emilia on a beach in southern India in December last year

This year marks the 10th year that Sarah has been involved as a consumer representative with the ACI Transition Care Network. The occasion was marked late last year at the November Executive Meeting. Sarah also partners with the ACI Nutrition and Stroke Networks. She is well qualified to represent young people with a chronic condition / disability as during her adolescent years she survived two strokes. She has since completed a degree at Macquarie University and currently works at Mary Mackillop Outreach. Sarah was awarded the National Disability Award in 2008 for Services to Stroke NSW, launch of different strokes for young stroke survivors and their carers and her work with the ACI Transition Care Network. She has spoken at numerous forums and her ongoing involvement and support of the Network is greatly appreciated.