tOTal Improvement is designed to improve communication within the multidisciplinary team at Morisset Hospital and to better direct consumers’ support needs within the clinical rehabilitation program.

An auditing process at Sydney/Sydney Eye Hospital revealed that patients are not as involved as they could be during the routine bedside handover processes that occur between nursing shifts. A project was established to address this, and in doing so, improve the safety and satisfaction of the patient.

This project implements a clinical pathway for referral and treatment that includes screening, triage, and assessment; and provides adults referred to Richmond Adult Community Mental Health Service with cognitive behavioural therapy – enhanced. This is a form of cognitive behavioural therapy specifically for eating disorders.

This program evaluates and re-invents St Vincent's Hospital’s weekly rapid discharge rounds model. This is carried out by introducing ward-level clinical leads and creating better documentation around discharge plans. The goal is to improve safe and timely patient discharges.

This project explored how demand for dental services can be met and sustained over time, with a focus on preventative care.

REACH Out is an independent patient and family activated response system for small sites. The REACH response is provided by on off-site patient flow team via Telehealth.

A project to implement a shared mortality and morbidity clinical review process across four small rural health services in northeast Victoria. The project includes development of standardised tools and the formation of a collaborative clinical review forum to help address the common risks experienced by patients in care at small rural health services in the region.

Various services in the local area were concerned about the increase in young adolescents presenting in crisis, with either potential self-harm or harm to others. Police and ambulance workers were often required to intervene, and emergency department beds used. This project aims to reduce the waitlist time for a multidisciplinary diagnostic assessment for older school age and adolescent children, by 25% by March 2018....

Incomplete clinical history information on emergency x-ray referrals can lead to insufficient imaging, missed pathologies, longer time spent in emergency and higher radiation doses. This project aims to ensure that a concise clinical history is included on every emergency x-ray referral at the Cowra Health Service. This will enable accurate imaging and diagnostic reporting and lead to the best possible outcome for patients....

Nepean Hospital established an Obstetric Pre-anaesthetic Assessment Clinic for high-risk obstetric patients and those undergoing an elective caesarean section. Anaesthetists at the clinic assess the patient and explain anaesthetic procedures in a way that allows patients to give informed consent.

Liverpool Hospital is implementing a home-based subcutaneous immunoglobulin replacement therapy program for patients with impaired immune systems.

Sydney Children’s Hospital Randwick developed an integrated model of care for children with non-complex asthma, including care coordination, communication with general practitioners, parent education and emergency department resources and processes.

This project developed a number of tools and guides to help staff collect data and enter it into the electronic donor record more efficiently.

NSW Ambulance introduced a falls package to address the year-round problem of falls in people aged 65 and over in the community. It incorporated a new falls risk assessment, protocol, clinical pathway and screening tool for paramedics, as well as education materials for consumers and general practitioners.

Central Coast Local Health District established regular meetings with the NSW Department of Family and Community Services and all health services involved in the care of pregnant women, in cases where there were child protection concerns.

Staff at Blue Mountains District ANZAC Memorial Hospital implemented a standardised phone screening tool with fasting instructions, to prepare patients for their surgical procedure.

John Hunter Children’s Hospital developed a step-by-step guide to encourage the delivery of Kangaroo Care to premature babies, and provided education to staff and parents on the topic.

St George Hospital developed an Allied Health Discharge Care Plan, established an allied health care coordinator role and implemented new administration processes, to support the transition of stroke patients out of hospital and into the community.

This project added an additional multidisciplinary team meeting to the Older Persons Mental Health Team schedule each week and adjusted the meeting agenda, to allow more time for mental health care reviews.

The Department of Microbiology at Royal Prince Alfred Hospital reconfigured its staff rosters, to better manage peaks and troughs in specimen processing. This optimised staff workflow and enhanced the delivery of services to the local health district.

Prince of Wales Hospital screened all patients booked for elective cardiac surgery, to diagnose diabetes and identify those requiring blood glucose level control before admission.

Royal North Shore Hospital is developing a clinical pathway for people who frequently present to hospital emergency departments with chronic pain and complex conditions, which will be rolled out across the state following evaluation of the pilot program.

St George Drug and Alcohol Service established a clear process for blood-borne virus screening, by delivering training to staff and embedding the test into the initial assessment of new clients.

Prince of Wales Hospital implemented a cost-saving strategy in the cardiothoracic intensive care unit, incorporating ordering and procurement practices, storage management and intra-hospital stock rotation.

Belmont District Hospital implemented an education package for nursing staff, to improve the use of the Confusion Assessment Method (CAM) screening tool in the emergency department (ED). The CAM tool is an affordable and easy way to dramatically improve the outcomes of patients presenting to the ED with delirium.

Nepean Hospital provided patients in a trial ward with a template containing prompts, so they could deliver a handover of their healthcare journey once a day to nursing staff.

Croydon Community Health Centre implemented a new model of care, including scheduled multidisciplinary team meetings, revised documentation and communication processes, as well as training for emergency department and generalist nursing staff.

SESLHD trained dental professionals to help clients quit smoking and implemented a number of solutions to increase accountability and knowledge in this area.

Sutherland Hospital Mental Health Rehabilitation Unit implemented new policies and processes for managing admissions, then educated staff on the changes.

It Takes Two was designed to educate nursing staff and managers on NSW Health and local policies regarding medication handling, with the aim of improving patient safety in the emergency department.

This project reduced the number of patients who absconded (ran away) from the Coffs Harbour Mental Health Inpatient Unit, by implementing an environmental review, courtyard supervision, flexible visiting hours, multidisciplinary team reviews, leave prescriptions and capital works.

Hunter New England Mental Health implemented a new screening tool and staff education to ensure patients with delirium are provided with the right care pathway.

Mid North Coast Local Health District (MNCLHD) centralised requests for expert witness certificates (EWCs) and developed a new review process in collaboration with staff and NSW Police.

St Vincent’s Hospital Sydney (SVHS) improved patient information, treatment procedures and staff education, to ensure the placement of gastronomy feeding tubes aligned with best practice and Agency for Clinical Innovation (ACI) guidelines.

This project delivered education and resources on HOTV vision charts to all staff in Northern NSW Local Health District (NNSWLHD) who deliver the Statewide Eyesight Preschooler Screening (StEPS) Program.

This project improved care delivered to people with eating disorders in Broken Hill and surrounding areas in FWLHD. It focused on increasing clinicians’ skill and confidence by providing education sessions, improving access to resources and increasing opportunities for professional networking.

This project addressed barriers experienced by nursing staff when using the malnutrition screening tool, by introducing staff education, streamlined education pathways and a cheat sheet for nursing staff.

MLHD identified an alternative option for iron replacement therapy and developed guidelines to deliver it in the community setting where clinically indicated, in collaboration with patients and carers.

Belmont Hospital introduced a 24-hour escalation plan and daily emergency report, to help emergency department staff manage periods of high demand, without reducing the quality or timeliness of patient care.

This project defined the role of the resource representative and increased awareness of this role among staff at Northern Sydney Home Nursing Service, to ensure patients are referred to the most appropriate clinician.

Macksville Hospital developed a 24-month New Graduate Program for nursing staff that involved a 12-week intensive induction period, with clinical exposure and support over the course of the program.

The Forensic Hospital developed a tool to help patients prepare for their Mental Health Review Tribunal, held every six months. This tool was designed to increase the satisfaction of patients with their level of engagement in Tribunals.

The Heart and Lung Clinic at St Vincent’s Hospital Sydney implemented a number of changes to the way it follows up and communicates external pathology results. This included the development of a new standard operating procedure, a dedicated area for reviewing patient files, new staff rosters, patient information brochures, patient database updates and standardised communication tools.

Blacktown Hospital educated administration staff on the importance of maintaining accurate contact details in patient records. It also displayed signage in the emergency department to remind families and carers to include their contact details on the patient’s admission form.

The JH&FMHN is developing a talent management strategy to improve the access, allocation and appropriateness of learning opportunities for its staff.

This project implemented a guideline in the emergency department to help staff manage patients with chronic anaemia due to iron deficiency.

This project delivered an education program for staff and implemented a new process of cleaning the ventilation vents in delivery suite bathrooms, to reduce the risk of falls.

This project streamlined its booking and referral processes, standardised templates and introduced electronic systems to ensure all patients received timely and appropriate care.

The steps in the perioperative pathway were reviewed and a number of interventions trialled to maintain the temperature of patients prior to, during and following surgery.

This project added potential discharges to the agenda of a weekly meeting and developed a discharge process where oncologists worked in teams of two during ward rounds.

CCLHD designed a new anaesthesia form, produced educational posters for staff and developed a dental package that encouraged anaesthetists to document the dental state of patients prior to surgery.

This project developed next-generation sequencing protocols and a bioinformatics platform for diagnosing mitochondrial disease, as well as a diagnostic pipeline that improved the speed and accuracy of diagnosis.

Sydney Local Health District developed an electronic oral health assessment form that provides appropriate information to the oral health clinician, as well as a comprehensive summary that can be easily understood by the participant, their carer and general practitioner.

This project improved education and workflow processes around medication administration, to reduce instances where patients either don’t receive their medication or don’t have a documented reason as to why their medication was not administered.

The project will identify barriers to compliance and introduce solutions that aim to improve nursing assessments for new admissions at St George Hospital.

The Subjective, Objective, Assessment and Plan (SOAP) methodology was selected as a prescriptive documentation style for use in all nursing progress notes. Staff education and resources were provided to support the implementation of this methodology in clinical practice.

Prince of Wales Hospital developed a communication pathway that reported incidental findings, unexpected findings and changes to provisional medical imaging reports back to the referring clinician within an agreed timeframe.

Blacktown Hospital implemented a number of processes to track the use and improve the storage of walking belts and sticks in the Stroke and Aged Care Ward.

This project identified and examined the systemic issues leading to the use of seclusion at The Children’s Hospital at Westmead. It implemented preventative strategies to reduce the use of seclusion, including multidisciplinary team care plans, staff education, daily intake and handover meetings, as well as supervision sessions for nursing and allied health staff.

This project standardised the recruitment process and conducted training for nurses and midwives in SNSWLHD to help them understand their professional obligations and maintain the skills required to safely undertake their role in the organisation.

This project reimagined the way hospital food is delivered to patients in public hospitals, using new workflow processes, menus, staff training and technology, while remaining inside the current budget footprint.

By introducing the routine use of rapid nucleic acid amplification tests, the median time for results of accurate laboratory tests for influenza and respiratory syncytial virus infections reduced from more than three days to less than 12 hours. This has the potential to significantly enhance infection prevention and control, inpatient bed management, appropriate antiviral prescribing and antimicrobial stewardship initiatives.

This project developed a new model of care for its Hospital in the Home (HITH) program, by integrating the services delivered by ambulatory care and community health nursing teams.

Liverpool Hospital implemented an education program for emergency department staff, to ensure venous thromboembolism prophylaxis is prescribed to all appropriate patients on admission.

A staff engagement and education process was developed by Bombala Multipurpose Service (MPS) and Delegate MPS, to improve admission documentation for high-risk patients.

CCLHD standardised the process of documenting care for clients with leg ulcers within the ComCare system.

CCLHD implemented a number of pre-warming strategies, to reduce the incidence of inadvertent hypothermia in surgical patients.

This project is developing a statewide Record of Labour Document (ROLD) that standardises labour and delivery care for women and babies in NSW.

The endocrine department at Sydney Children’s Hospital Randwick implemented education strategies for clinicians and families, to increase awareness of alternative support options.

The Hunter Brain Injury Service developed a new process for completing community access, upper limb and activities of daily living (ADL) assessments, using a transdisciplinary rehabilitation approach.

The Forensic Hospital made changes to its treatment and management plan, introduced the NSW Mental Health Care Plan and conducted staff and patient education on the value of developing a care plan in collaboration with consumers.

JH&FMHN developed a streamlined chronic disease process that addressed the barriers to completing a multidisciplinary care plan, by engaging frontline clinicians.

The Elouera Unit promoted healthy weight through education and review of the meal provision program, in collaboration with patients.

The renal unit at ISLHD developed a structured home visit program and implemented changes to the staff orientation program, as well as training for patients and staff.

The Cowra ‘Let’s Bring Healthy Back’ nine-week program used a multidisciplinary approach, using the expertise of a dietician, social worker, exercise physiologist, Aboriginal health worker and community nurse to help the Cowra community lose weight and improve their health and wellbeing.

Grafton Base Hospital encouraged general practitioners to follow a new care pathway for patients requiring an ascitic tap procedure, to reduce avoidable emergency department admissions and improve the patient experience.

Liverpool Hospital implemented a sustainable process for monitoring, management and early escalation of long stay patients. The goal was to provide a structure for helping clinical teams develop appropriate and high-quality patient management plans.

This project examined the sequence of events from arrival to the ward and transfer of patients admitted to an inpatient ward through the emergency department, to identify improvements that would reduce the number of admitted patients with an ED length of stay of more than four hours.

This project identifies gaps between the skills that new graduate and Level 1 physiotherapists have gained via study and the skills required to work within the physiotherapy department of Broken Hill Health Service. This gap analysis will allow individual professional development pathways to be developed for physiotherapists, to maintain a high quality of service within the physiotherapy department.

This project developed guidelines and resources to improve occupational therapist staff compliance with departmental protocols in place at Blacktown Mount Druitt Hospital.

This project implemented training and staff communication to improve the accuracy and amount of data collected in the electronic patient record, with a focus on pathology International Classification of Diseases (ICD) code, disease stage, tumour laterality, date of diagnosis, performance status and acute radiation toxicity.

This project implemented a screening and triage tool within the outpatient cancer service at Illawarra Shoalhaven Local Health District, to improve the care coordination of patients during their treatment journey.

This project identified ways to optimise the use of nursing resources, to meet donor care, customer service and risk management requirements.

The APPLE project developed a new process to obtain and store Alternating Pressure Air Mattresses at Orange Health Service. Patients identified at ‘high risk’, those who have an existing pressure injury and/or those who are clinically indicated, are provided with pressure relieving equipment in a timely manner.

A group rehabilitation class was established for eligible clients in weeks 6-12 of the Blacktown Transitional Aged Care Program, incorporating education, physical activity and social activities.

This project developed a new model of care to allow children with standard or medium risk acute lymphoblastic leukemia, who have received high dose methotrexate, to be discharged within two days instead of five.

This program will provide better and more appropriate clinical care to the dying patient and their family, through improved education, End of Life Care policies, referral pathways, nursing resources and the use of volunteers as support for carers.

This project developed an integrated model of care that facilitated early discharge from inpatient units and transferred care back to the community, with home-based treatments provided by an Acute Care Team.

A Chronic Disease Oral Health Service has been established at Royal North Shore Hospital (RNSH), with a dental officer and oral health therapist. The service provides an expedited course of dental care with a strong focus on oral hygiene for chronic disease patients. A referral pathway to this clinic has been implemented using a referral form that is completed by chronic disease services....

Approximately 50 CVADs are inserted per month by CVAD Procedural Clinical Nurse Consultants (CNC) at SVH. By implementing small-scale changes within the hospital, SVH has been able to reduce the usual incident rate for CVAD patient bookings from one in five at the beginning of 2014, to one in 20 by the end of the year.

This project conducted a detailed examination of forensic mental health services in NSW and assessed the needs of current forensic patients, to see whether they are being met. This information will inform the need for service reform and development.

This project aims to reduce overall sick leave rates of Mid North Coast Local Health District (MNCLHD) staff by introducing a ‘Fitness Passport’ program, which targets 850 staff and encourages them to attend a gym on a regular basis.

Patients transition through their episode of care and often require changes to their diets based on allergies, intolerances, procedural and/or diagnostic requirements. Clinicians often become confused by the diet choices available and do not assess the patient’s diet history due to a lack of understanding on the impact that an incorrect diet can have on the patient. This project aimed to investigate the causes of the errors and develop solutions that were systematic, achievable and sustainable....

This project examined the issue of coronial autopsy tissue retention and implemented policies and practices that reduced the amount of tissue retained and the proportion of autopsy cases where tissue was retained, without decreasing the quality of service provided.

This project aims to enhance multidisciplinary teamwork in a rural hospital, by ensuring that acute ward and community health staff participate in care planning for admitted patients and improve the interface between the acute settings and community health services.

Illawarra Shoalhaven Local Health District is establishing a model of care for people with eating disorders, in line with Stage 1 implementation of the NSW Service Plan for People with Eating Disorders 2013-2018.

A four-bed Emergency Medicine Unit (EMU) is planned for the ED of Orange Health Service, to admit selected patients with conditions that can be dealt with in less than 24 hours but don’t require high-level nursing care or monitoring. This will avoid referrals, formal admission and registrar review, ensuring rapid transfer home after a short stay. Patients with certain conditions will be admitted to the EMU on specific pathways to ensure compliance, avoid bed block and enable nurse-led transfer of...

Essential to seamless transfer of care is the engagement of and communication with relevant clinicians from the inpatient and community settings, as well as the consumer or carer during discharge planning. This project has highlighted the real issues underlying care coordination, which have persisted and become more complex as local services have evolved. An objective analysis of these issues has occurred with focused strategies and an implementation plan that places the patient at the centre of care....

This project focused on ensuring that patients presenting to the emergency department are able to receive appropriate treatment by an appropriate person, within triage benchmark timeframes, and provided escalation of care to a senior medical officer as required. It was implemented with a supporting clinical governance structure, clinical nurse protocols and standing orders, as well as an education and training program, which defines the extended scope of the emergency registered nurse....

Gum disease is a chronic inflammatory disease which has a direct impact on blood sugar levels, yet diabetic patients are not routinely referred for oral health checks. This project works with high risks groups such as the elderly, people with chronic disease and Aboriginal people. It encourages people with diabetes to make healthy choices by educating them on the importance of oral health and its impact on blood sugar levels. Following dental evaluation, treatment and education, home packages are given...

This procedure will provide a process from registration of a new client, assessment tools, monitoring tools and end of life pathway tool and bereavement follow up for the generalist community health nurses. It will provide Generalist Community Nurses and Palliative Care Nurses with a structured format and standardised processes and tools to use when assessing palliative care clients.

The Gosford Surgical Admissions Centre (GSAC) is a short stay surgical admissions centre providing care to 1350 elective patients per month. The project aim is to improve the patient satisfaction rate by focusing on communication, the waiting room environment, the admission processes and streamline documentation.