Quality of Care Report - Goulburn Valley Health

GOULBURN VALLEY HEALTH
quality of care report
2014/15
healthy communities
Consumer, Carer and Community Participation
Doing it with us not for us
2
Cultural responsiveness
3
Consumer involvement
6
Listening to consumers
6
Consumer voices are heard throughout GV Health
8
Engage with us online
9
Quality and Safety
Accreditation report
10
Residential aged care services
12
Reducing the spread of infection
14
Community health services
16
Medication safety
17
Continuity of Care
Responding to needs
22
Improving care for those with chronic and complex conditions
28
Improving care for consumers travelling for care
30
Improving care for cancer patients
34
Improving care for families
35
Improving continuity of care for Aboriginal patients
38
Improving care for acute patients
40
Victorian Healthcare
44
Readers’ Survey
45
Welcome
O
n behalf of the GV Health Board, staff and volunteers, we are pleased to present
our annual Quality of Care Report.
This report is designed to describe the quality and safety systems, processes and
achievements of our health service for you, consumers, carers and partners in our
community.
As our community grows, we are treating and providing care for more people throughout
the organisation than ever before. We continue to plan for the future, using the Service Plan
as our guide, to meet the growing need for improved access to health care services and
facilities locally.
Quality and safety remain a key focus at all times and we enjoyed a fantastic outcome with
the successful accreditation of many of our services this year.
This report showcases areas in which we are improving the high number of safe and positive
experiences already occurring within our health system, and striving toward our vision of
ensuring we have a strong and healthy community.
In developing this report, we took into account the feedback from the community on the past
editions and suggestions from consumer advisers about inclusions for the current edition.
We always like to hear your feedback about our annual quality report to the community. We
welcome your contribution by completing the survey at the back of this report or on the GV
Health website Quality of Care Report web page. We look forward to hearing from you and
encourage you to tell us what you think of the report and what topics you would like to read
about in future editions.
Dale FraserPeter Ryan
CEOBoard Chair
1
Consumer, Carer and
Community Participation
Doing it with us not for us
I
nternational Nurses
Day at GV Health was
celebrated this year with
an entertaining bed race
competition, which was
fun for all involved but also
helped improve patient care.
Each of the seven teams of
staff raced around the track on
the GV Health Graham Street
campus The surgical team won
the fastest race time category,
dressed as members of the
4077 M*A*S*H* team from the
television show.
The Child and Adolescent Unit
won the prize for most creative
entry. Their team costumes were
themed around Katy Perry’s hit
song, Roar, and organised for
the song to play during their time
trial around the course.
Nurses Day
race raises
funds for
beds
The bed races were a great
way for staff to participate and
celebrate the great work nurses
do every day.
The race entry fees were
donated toward the muchneeded replacement of 100
patient beds at GV Health. Each
patient bed costs $4,800 to
purchase new.
GV Health Foundation Director,
Carmel Johnson said the
bed race was also a great
opportunity to help raise funds
for the new patient beds.
“We were delighted that GV
Health staff enthusiastically
embraced this great fun way to
support the organisation,” said
Ms Johnson.
GV Health continues to raise
funds to replace patient beds.
If you are interested in donating
toward this fundraising effort,
please contact GV Health
Foundation Director, Carmel
Johnson on (03) 5832 2192.
2
Cultural responsiveness
Making
health
services
more
accessible
for newly
arrived
migrants
Those who have migrated to
Australia, specifically the Goulburn
Valley, from other countries are not
necessarily familiar with the local
hospital and health care services
available or how to access them.
It contains 24 main topics that
were determined via consultation
with organisations that provide
settlement services locally and
community members from refugee
or migrant backgrounds.
With the influx of refugees and
migrants to the Shepparton area,
GV Health identified that a local
health service directory was
needed to provide migrants and
refugees with easy-to-understand
information about the Australian
health care system and how to
access local health services.
The printed booklet is available in
English, Arabic, Swahili and Dari.
The My Health in Shepparton
booklet was written in easy-tounderstand language, with images.
3
As it was identified, at community
focus groups, that not all migrants
and refugees can read in their
native language, the booklet will
soon be available in an online
video. The video will be available
in multiple languages on the GV
Health website and the websites
of other local migration and
community support organisations.
Consumer, Carer and
Community Participation
Celebrating
cultural diversity
The Goulburn Valley is home to many culturally and linguistically diverse communities.
The diversity of our population is reflected in the number of requests for interpreters we
receive each year. We received 3,152 requests for an interpreter in 40 different languages
in 2014/15, compared to 3,035 requests in 2013/14.
The top five languages have remained the same for the
last three years. The use of Hazaragi interpreters has
steadily increased over the last three years, from being
the fifth most used language locally in 2012/13 to being
the third most used in 2014/15. Hazaragi is a dialect of the
Persian language, native to some areas of Afghanistan,
Iran and Pakistan.
TOP 5 SERVICE PROVISION BY LANGUAGE
GV Health dental clients and maternity clients requested the
most assistance from interpreters this year.
At GV Health, interpreting services are available face to
face or by phone, when we are unable to secure a local
interpreter in the language required.
TOP 5 INTERPRETER BOOKINGS
BY GV HEALTH DEPARTMENT
800
1500
700
600
1200
500
900
400
300
600
200
300
0
100
2014/15
2013/14
Arabic
Hazaragi
Dari
Turkish
0
2012/13
2014/15
Dental
Albanian
2013/14
Antenatal (maternity outpatients)
Specialist Consulting Suite
Diabetes
4
2012/13
Admissions
34% of interpreting services
were provided by phone
66% of interpreting services
were provided face to face
Interpreters are provided to GV Health clients
who require one at no charge.
If you would like to request the use of an
interpreter, please contact the GV Health
Service Access Unit on
1800 222 582
5
Consumer, Carer and
Community Participation
Consumer involvement
GV Health volunteer
team wins award
O
ur outstanding team of
volunteers at GV Health won
the ‘Team Award’ in the
City of Greater Shepparton’s 2015
Volunteer Recognition Awards.
The awards recognise the valuable work
that volunteers undertake as part of our
community. There were 12 nominees for
the Team Award category.
GV Health Foundation Director, Carmel
Johnson said: GV Health is proud of the
men and women who give so much of
their time.
“Our dedicated volunteers provide care,
compassion and respect for every patient
in the voluntary role they undertake. They
are enthusiastic and reliable and we are
very fortunate to have them,” said Ms
Johnson.
Congratulations to every member of the
GV Health volunteer team on this welldeserved recognition!
Left to right – John Patterson, Nola Wilson, Iris Taylor
and Joan Thompson
Listening to consumers
At GV Health, we take all
feedback received from
consumers seriously and
confidentially. This valuable
information is used to inform
changes to the way we do
things and improve the patient
experience.
The receipt of compliments reinforces to
staff at GV Health that they are contributing
to a positive consumer experience and
their efforts have been recognised.
•
Consumers told us that they want
more timely, relevant and personalised
responses to their very personal and
individual experiences.
Feedback from people who have lodged
complaints tells us that not all complainants
are happy with the way their complaints are
handled.
•
Consumers advised they want to be
better guided and supported to make
a complaint, if necessary.
GV Health conducted an evaluation of
the complaints process and, as a result,
has developed actions to address the
recommendations.
6
Since implementing changes to the
feedback process the year, complainant
satisfaction survey ratings have improved
15% over the survey rating in 2013.
Compliments
If you would like to tell us what you think
about our services, please contact the
Consumer Liaison Officer on
(03) 5832 2258.
I would just like to say how amazing the
care from Dr Hamia Pirouznia has been
over the last couple of months. If it wasn’t
for him, my foot would not be healing as
well as it is… He also has a wonderful
manner. He referred me to NVOPS for
orthotics and even the lady there said
how good his referrals are and that he
always knows exactly what is best for the
patient. He has been brilliant! I would also
like to comment on the excellent care
I received from nurse Lynda. She is so
caring and does the best casts! Thank
you!
Tess Mutimer, Tatura
I feel the need to send this form after
having received such terrific help
from Occupational Therapist, Gracie
Shephard. I have been caring for
“mother” since her husband died in
September 2013 and as her physical and
mental state has deteriorated since then
I have been able to keep her in her own
room because of the help from Gracie.
I am writing to express my gratitude to all of
the doctors, nurses and staff involved with
the ongoing recovery of Mr John Hegerty.
John has been in your care for some
weeks now and at present we do not have
a discharge date. Although his condition
has improved immensely during the short
time since he suffered his stroke.
Therapists involved have worked
wonders. Never having been involved
with a stroke victim previously, I am
amazed at what they have to do.
Realising how much of the body is
damaged is distressing to know but
to see the work that is carried out is
humbling in itself.
Robert has Alzheimer’s and as a result,
has very limited vocabulary. After a
thorough evaluation by Mary James,
it was decided that we could work
together to produce a communication
book. Robert is very proud of his “book
about me”. It contains Robert’s history,
medical information, daily routines, how
he communicates and lots of familiar
photos. This book has been very useful
to family, friends, respite carers and now
to help him settle into permanent care.
Bob still has his special book by his bed.
I would recommend this to anyone with
communication difficulty.
Susan Walsh, Shepparton
Every time I enter the ward, everyone has
been so friendly and helpful. I have chatted
to lots of them and they are wonderful…
John is a very kind and caring man and he
is enjoying the friendly atmosphere that is
so apparent when you enter the ward.
Many thanks from a grateful family
member.
Pamela Groat, Euroa
Gracie is so professional, proficient,
obliging, polite, respectful, caring, helpful,
reliable and friendly that I cannot sing her
praises high enough and need to thank
her continually.
Janine Dreyer, Dhurringile
David was admitted to Mary Coram
and had a duodopa pump fitted for
his Parkinson’s. He was in hospital for
two weeks and we could not fault his
treatment in any way. All the staff were
very helpful and keen and interested in
learning all they could about the pump
and Parkinson’s in general. Some staff
even stayed back at the end of their shift
to see how to connect or disconnect the
pump. David has had Parkinson’s since
2008 and has had a few stays in Mary
Coram and I can see each time how
much the staff have progressed in their
knowledge of Parkinson’s treatment.
They are all to be complimented.
Shirley Keating, Shepparton
7
Jan Phillips, Consumer
Liaison Officer
Consumer, Carer and
Community Participation
Consumer
voices are heard
throughout
GV Health
Chair - Wendy Hunt
Pat Moran
Bruce McCleod
Loretta Mitchell
Elizabeth Perry
Geoff Long
Graeme Taylor
Joanne Kinder
John Courtie
Rita Bloomfield
Margo Koskelainen
Resource Officer
GV Health’s Consumer Advisory Committee
was established in 2005 and continues to grow and
provide outstanding contributions to the organisation.
The Advisory Committee enables consumers to be
involved across all aspects of GV Health operations and
enables consumer voices to be heard as part of decisionmaking processes.
Consumer representatives are experts in relation
to their own health care needs (and those of their
families); they can provide insights into how health
care can best be provided to support their own needs
and to help them manage their own health.
Consumer representatives are included as members
of many committees, focus groups and workshops
throughout GV Health and are involved with many
improvement initiatives and service re-design activities.
Consumers contribute to the GV Health patient
information development process to ensure the
information is easy to understand and meets the needs
of all consumers.
GV Health staff who have worked with consumers
see the results of consumer involvement and have
commented that it has changed the way they think
about the information GV Health provides to consumers.
Consumer representatives include past and current
patients, family members and carers, and community
members with an interest in health care.
8
Engage with us
online
A new website for GV Health is now live at:
The site includes information for patients,
visitors, volunteers, staff, partner and
support organisations, the broader medical
community and donors. The site provides
helpful information about what services are
available and how to access them, as well as
information about news and events.
All information on the site has been
extensively reviewed by staff and
consumers to ensure it meets the needs of
the community.
The website will continue to be developed
and enhanced in future with social media,
video content and much more, to continue
to meet the evolving needs of the community.
www.gvhealth.org.au
Facebook
Follow GV Health on Facebook to stay up to
date on the latest news and find out about
upcoming events!
Linkedin
Get connected and network with GV Health
via Linked In. Find out about jobs and training
opportunities available at GV Health and
much more.
Twitter
Follow Tweets from the GV Health
executive team to stay abreast of important
developments and achievements.
Dale Fraser, CEO
@gvhceo
Bill Morfis, Executive Director Planning
and Resources
@BillMorfisGVH
Donna Sherringham, Executive Director
Clinical Operations
@DMSherringham
Fiona Brew, Executive Director
Community and Integrated Care
@FionaBrewGVH
Leigh Rhode, Executive Director
Community and Integrated Care
@LeighRhodeGVH
9
Quality and Safety
A fully accredited
health service
T
he use of health service accreditation
programs has been adopted by
health and aged care services
worldwide as part of their safety and quality
frameworks. This provides consumers with
assurance that the health service provides
high quality, safe healthcare.
Health service accreditation programs have
both compliance and quality elements that
promote quality and safety.
Accreditation programs focus on
continuous quality improvement strategies.
They usually consist of a process that
involves self-assessment, review or
assessment of performance against
predetermined standards by an external
independent body, and monitoring
of ongoing performance against the
standards by the accreditation body.
PUBLIC HOSPITAL
ACCREDITATION
National Safety and Quality Health Service
Standards (NSQHSS) accreditation aims
to maintain appropriate standards of care
and quality improvement. Accreditation
results are used to identify improvements to
Victoria’s healthcare system and evaluate
the effectiveness of statewide quality and
safety strategies.
The Department of Health has promoted
accreditation of acute hospitals as a
significant component of its quality
policy since 1993. Since 1 July 2000 all
Victorian public hospitals are required to be
accredited.
In Victoria the 10 National Safety and
Quality Health Service Standards apply to:
•
all public hospitals, including small
rural health services
•
public dental services in community
health services
Goulburn Valley Health acute and
sub-acute services are fully accredited
against the 10 National Safety and Quality
Health Service Standards.
GOULBURN VALLEY
AREA MENTAL HEALTH
SERVICE
The National Safety and Quality Health
Service Standards apply to public mental
health services delivered by Victorian
public hospitals. It is an expectation that
public mental health services will continue
to be required to be accredited against the
2010 National Standards for Mental Health
Services as well.
Goulburn Valley Area Mental Health
Service, which includes Grutzner House,
is fully accredited against both the 10
National Safety and Quality Health
Service Standards and the 2010 National
Standards for Mental Health Services.
RESIDENTIAL AGED CARE
SERVICES
Residential aged care homes in Australia
are required to be accredited to receive
Australian Government subsidies. The
Australian Aged Care Quality Agency
assesses each residential aged care
facility’s performance against a set of
legislated accreditation standards.
Residents and families can be assured
that all accreditation expected outcomes
were met this year throughout GV Health’s
residential facilities, including Grutzner
House, Tatura Parkvilla, Waranga Nursing
Home and Waranga Aged Care Hostel.
10
COMMUNITY HEALTH
SERVICES
IMAGING AND
PATHOLOGY SERVICES
A number of Goulburn Valley Health
community health service programs
undertake accreditation specific to the
services they provide.
The Goulburn Valley Health Imaging and
Pathology service areas are required to
undergo assessment against accreditation
standards specific to their service areas.
The Home Nursing Service, Waranga
District Nursing Service, Rural Allied Health
Team and Community Interlink are all fully
accredited against the three Community
Care Common Standards.
Goulburn Valley Health’s Imaging
services have successfully achieved
accreditation against the Diagnostic
Imaging Accreditation Scheme (DIAS)
and the Goulburn Valley Health Pathology
service has been successful in gaining
accreditation against the specific Medical
Testing standards. The National Association
of Testing Authorities, Australia (NATA) is
responsible for assessing both of these
service areas.
Goulburn Valley Health Flexible Support
Packages, Case Management, Behaviour
Intervention, Therapy and Sexual Assault
Support services are fully accredited
against the three Department Health and
Human Services Standards.
All consumers of Goulburn Valley Health
services can be assured of a high standard
of care and service provision knowing that
they are supported by a fully accredited
health service.
11
Quality and Safety
Residential
Aged Care
Indicators
Number of
pressure ulcers
Total number of falls
Number of fractures relating to falls
Incidence of use of physical restraint
Incidence of residents using 9 or more different
medications
Prevalence of unplanned weight loss
Number of residents who experienced significant
unplanned weight loss during the quarter
Number of residents who experienced unplanned
weight loss over three consecutive months
QUARTER
Tatura
Parkvilla
Waranga
Aged Care
Hostel
Waranga
Nursing
Home
Grutzner
1
2
1
1
0
2
0
1
0
1
3
0
1
0
0
4
0
0
0
0
1
8
19
3
18
2
8
19
5
13
3
14
17
5
9
4
7
5
5
5
1
0
1
0
1
2
0
0
0
0
3
0
0
0
0
4
0
0
0
1
1, 2, 3, 4
None
None
None
None
1
6
21
8
14
2
8
20
5
7
3
4
16
6
7
4
4
5
5
2
1
1
3
0
4
2
1
3
0
4
3
0
1
0
1
4
1
1
1
4
1
2
3
0
4
2
0
3
0
3
3
0
1
0
1
4
0
1
1
4
12
Volunteers
beautify
R
garden wall
for residents
odney Arts Group kindly volunteered their time this year to
beautify a bland concrete wall near the back garden at the
GV Health Tatura Hospital and Parkvilla Aged Care.
They painted an extraordinary and colourful mural of a window
setting, featuring a nurse with Lucky the Cat, who is a long-time
and loved resident of the Tatura campus.
A big thank you to the Rodney Arts Group and the Tatura Men’s
Shed for bringing a smile to the residents, patients and staff!
13
Quality and Safety
Carolyn Kamenjarin, Clinical Supervising
Admitting Officer, Emergency Department
Reducing the
Spread of
Infection
75.5%Staff
2014 flu season
Have you had a flu shot?
Influenza (the flu) can be a serious disease that can
lead to hospitalisation and sometimes even death.
P
eople with flu can spread it to others. Influenza viruses are spread
when people with flu cough, sneeze or talk.
Most healthy adults may be able to infect others beginning one day
before symptoms develop and up to seven days after becoming sick.
That means that you may be able to pass on the flu to someone else
before you know you are sick, as well as while you are sick.
Since health care workers may care for or live with people at high risk for
influenza-related complications, it is especially important for them to get
vaccinated annually.
Annual vaccination is important because influenza is unpredictable, flu
viruses are constantly changing and immunity from vaccination declines
over time.
An annual flu vaccine is the first and best way to protect against influenza.
This year, 82.5% of GV Health staff were vaccinated against the flu; more
than the 80% target set by the Department of Health and Human Services.
14
vaccinated
82.5%
2015 flu season
80% Department
Health and Human Services Target
It’s OK to
ask about
hand hygiene
Good hand hygiene is the most effective way to reduce the spread of
infection in hospital, health care and residential care.
That’s why GV Health takes hand hygiene seriously and conducts
regular audits at all locations, making sure staff wash their hands with
soap and water or an alcohol-based solution, before and after contact or
performing a procedure with a patient.
Visitors are also strongly encouraged to maintain good hand hygiene in
the healthcare setting and at home.
Hand hygiene rates are currently above the compliance requirements
rate. However, we are determined to improve that rate in the future.
GV Health Hand
Hygiene Compliance
81%
30 June 2015
80% Department Health and
Human Services Target
<
66.1%
30 June 2014
Vasudha Iyengar, Chief Medical Officer
15
Quality and Safety
Community Health Services
SHE PPA R TON’S F IRST
MOBILITY SCOOTER PARKING
Greater Shepparton Mayor Denis Patterson with Julyan Howard, GV Health Divisional Director Primary Care
with mobility scooter users.
Four mobility scooter parking
bays have been constructed in
front of the Community Health
@ GV Health facility in Corio
Street.
T
he clearly marked bays, designed
in consultation with GV Health
staff and Shepparton Council’s
Disability Advisory Committee,
are the first of their kind in Victoria.
Previously, mobility scooters were
being parked alongside the GV Health
building, often blocking the footpath for
pedestrians. The new parking bays are
free to use and ensure that the footpath
is kept clear for pedestrians and visitors
accessing the building.
Julyan Howard, GV Health Divisional
Director, Primary Care, said it is
important for patients/clients who use
mobility scooters to be able to maintain
their independence.
16
“Having the freedom to attend health
appointments autonomously is important
for our clients/patients who use mobility
scooters. We are proud to provide
this first-of-its-kind facility to ensure
accessible parking for clients/patients
and safety for pedestrians using the
sidewalk,” said Mr Howard.
The scooter bays were part of a larger
streetscape improvement project, which
also included two new accessible parking
bays and a new, smooth concrete
footpath.
Medication Safety
A DOSE OF
MEDICATION
SAFETY
We all take medicines but we rarely
question what we’re taking, why we’re
taking it, what’s in it and how it might
interact with something else we’re taking.
GV Health is committed to medication safety and the
wellbeing of patients. It is recommended that patients
maintain a comprehensive list of all medications and to
share that list with treating doctors, nurses, pharmacists
and other health professionals they are seeing.
Systems are in place throughout the organisation, in
line with the National Safety and Quality Health Service
standards, to ensure the safe prescription, dispensing
and administration of appropriate medicines to patients
and carers.
The GV Health clinical workforce accurately records a
patient’s medication history. This history is reconciled
on admission, when transferred between wards and at
discharge from hospital to help reduce medication errors.
The process of reconciliation involves obtaining,
verifying and documenting a list of each patient’s current
medicines and comparing this list to the medication
orders and the patient’s condition, to identify and resolve
any discrepancies.
Each patient’s medications are documented in one
central location, saving time for staff and preventing
potential medication errors and adverse drug events.
Bill Burgess, GV Health Pharmacy Director
17
Quality and Safety
DENTAL
INDICATORS
ACCESS TO DENTAL SERVICES
The GV Health Dental Service was able to improve access
for patients to receive local public and private dental care,
which in turn has reduced the waiting times for fillings and
dentures.
2012/13
2013/14
2014/15
3,037
11,731
17,129
New patients
11,093
7,006
5,411
Individual patients
19,486
25,595
21,636
Overall treatments
63,143
61,140
65,793
Patients attending
18
RESTORATIVE RE-TREATMENT
Re-treatments of fillings are on par with the State average. Some patients request fillings on teeth, despite contrary
advice and the clinic respects the patient’s wishes.
State
Region
GV Health Dental Service
2012/13
2013/14
2014/15
7.4%
8.3%
7.7%
8%
8.1%
8.9%
9.1%
8.7%
7.8%
UNPLANNED RETURN WITHIN SEVEN DAYS AFTER EXTRACTION
The unplanned return rate is significantly less than the State and Regional average, indicating a high quality of
patient care.
2012/13
2013/14
2014/15
State
0.8%
1.10%
1.2%
Region
0.5%
2.1%
1.8%
GV Health Dental Service
0.5%
0.4%
0.8%
ENDONTIC TREATMENT WITHIN 12 MONTHS (BY EXTRACTION)
In 2014/15, there were 341 teeth treated and 42 of these were extracted at GV Health.
Some teeth are treated as an open and drain procedure to relieve the patient’s pain and then extracted at a later
date (eg. as an addition to a denture or patient preference to have it extracted). This will often over-estimate the
figure, although GV Health remains within a standard deviation of the State average.
2013/14
2014/15
Region
9.3%
9.6%
GV Health Dental Service
8.2%
12.3%
DENTURE REMAKES WITHIN 12 MONTHS
In 2014/15, 554 dentures were inserted. Patients often lose or break their dentures, which kept our numbers on par
with the regional average for remaking dentures.
The GV Health Dental Laboratory also completed more than 1,000 denture maintenance cases (repairs, relines and
additions), along with 19 oral splints and 18 orthodontic plates.
2012/13
2013/14
2014/15
State
6%
4.3%
2.5%
Region
7%
3.9%
6.3%
5.2%
3.1%
5.8%
GV Health Dental Service
19
Quality and Safety
MENTAL
HEALTH
28 DAY RE-ADMISSION
RATES – ADULT
KEY PERFORMANCE
INDICATORS
Target = Less than 14%
2014/15 = 14%
State average =14%
T
he State Government is focused on reducing restrictive
interventions in the treatment and management of people
admitted to acute inpatient mental health care. Considerable
activity has been undertaken within Wanyarra Acute Inpatient Unit to
reduce restrictive interventions through improved patient assessment,
treatment options and the physical environment with the establishment
of a sensory therapy room.
ED TO MENTAL HEALTH
BED WITHIN EIGHT
HOURS
Target = 100%
2014/15 = 86%
2014/15 MENTAL HEALTH
SECLUSION RATES
State average = 68%
Per ‘000
Target State average
occupied bed Per ‘000 occupied per ‘000 bed
days
days
Acute aged
0.7
Less than 15
0.80
Acute adults
9.0
Less than 15
10.0
Children
and Youth
n/a
n/a
n/a
POST-DISCHARGE
FOLLOW UP WITHIN
SEVEN DAYS
Target = Greater than 75%
2014/15 = 87%
State average = 87%
20
ACTION TAKEN IN RESPONSE TO
THE VICTORIAN HEALTHCARE
EXPERIENCE SURVEY
The Victorian Healthcare Experience Survey is a statewide survey of people’s public healthcare experience.
The survey was undertaken at GV Health in June 2014 and June 2015.
The overall experience of care received at GV Health in 2015 was 93.3%, which was higher than the State average of 91.3%.


What we’re doing well:
What we need to improve:
1.
1. Inpatients rating of the discharge process decreased
85.2% to 77.9%
Lower than peers 86.1%
Paediatric inpatient rating:
a.Hospital offered child educational things to do increased from 53.3% to 61.3%.
Higher than peers 44%
2. Adult emergency patients
b.Care your child received from the doctors
increased from 88.2% to 96.3%.
Higher than peers 93%
c.rating of care/treatment from nurses decreased 87.5% to
83.2%.
Lower than peers 86.9%
c.Overall, how would you rate the doctors’ manner with your
child?
Result: 98% said very good or good, compared to 92.7%
in 2014.
Higher than peers at 94.3%
2.
d.Decrease from 3.4% to 2.6% when asked whether
provided with updated information on how long you would
have to wait in the waiting area.
Peer ranking 8.4%.
3. Adult emergency patients rating:
Paediatric emergency patient care rating:
d.Care your child received in Emergency increased 75.6% to
81.4%.
Higher than peers 78.4%
e.Care your child received from their doctors in
Emergency increased 81.7% to 82.5%.
Higher than peers 78.4%
f. Were there enough nurses and doctors on duty to care for
your child in Emergency increased 42.2% to 59%.
Higher than peers 55.8%
g.When you first arrived at the ED, was it clear who to talk
to?
Result: 72.2% said yes, definitely, which is an
improvement from the 2014 result of 53%
d.Care received from nurses decreased 87.5% to 83.2%.
Lower than peers 86.9%
e.how well doctors and nurses worked together decreased
51.2% to 46.2%
Lower than peers 51.8%
f. the discharge process improved 47.9% to 55.3%.
Lower than peers at 60.9%
4. Paediatric emergency patient care rating:
e.Care your child received from nurses decreased from
89.3% to 85.4%.
Lower than peers 87.6%
f. Was there enough for your child to do when waiting to be
seen?
Decreased 8% to 4.1%. Peers at 18.1%.
h.Were you involved, as much as you wanted to be, in
decisions about your child’s treatment?
Result: 69% said yes, definitely, which is an improvement
from the 2014 result of 58.3%.
Higher than the peer group of 66.5%
GV Health is developing and implementing action plans to
address these identified issues.
21
Continuity of Care
Responding to needs
DETERIORATING
PATIENTS
GV Health now has a Medical Emergency
Team available to respond faster to
inpatients whose condition is deteriorating,
to help decrease in-hospital, unexpected
cardiac arrests.
Research has shown that 66-88% of
inpatients experiencing a cardiac arrest
showed one or more vital signs of
deterioration during the previous eight
hours. Having a Medical Emergency Team
(MET) means that extra assistance is
available quickly for patients before they
become critically unwell.
Research has shown that when the
numbers of MET calls rise, the number of
cardiac arrests go down; which is ideal.
GV Health took the lead in initiating this
medical emergency process in 2004, well
in advance of other Australian hospitals.
The results now speak for themselves;
cardiac arrest rates have decreased as
acute inpatients, who are showing signs
of deteriorating health, are now receiving
attention from the Medical Emergency Team
faster, preventing further deterioration.
24 MET
CALLS
HOW MET IS MAKING
A DIFFERENCE
2004/05
A 93-year-old woman acute inpatient,
whose vital signs had been stable, was
identified as suddenly having a fast and
irregular heart rate. A Medical Emergency
Team (MET) call was initiated by a nursing
staff member.
As a result of the extensive education
of ward staff, the numbers of Medical
Emergency Team calls are increasing, which
highlights that GV Health staff are identifying
the patients who are deteriorating and that
there is a timely response to this.
As the number of Medical Emergency Team
calls increase, there is a corresponding
decrease in the recorded numbers of
cardiac arrests at GV Health.
>
381 MET
CALLS
2014/15
GV Health intensive care nurse, Lynn Morcom
with patient Adrian Gleeson.
The MET team ordered medication
to help slow down her heart rate.
Additionally, her potassium level was
identified as low in the morning, which
may have contributed to her heart rate
becoming fast and irregular. This was
appropriately treated and the patient
improved and was discharged home four
days later.
22
ADULT CARDIAC ARRESTS
Vs MET CALLS
2006-2007
2007-2008
2008-2009
Adult Code Blue/Cardiac Arrests
2009-2010
Adult MET Calls
2010-2011
2001-2012
2012-2013
2013-2014
2014-2015
05
0
100
150
200
250
300
350
400
PATIENTS
This graph shows when the number of MET Calls increases,
the number of cardiac arrests decreases. This highlights
that GV Health patients are receiving appropriate care for
their condition, in a timely manner which prevents further
deterioration.
Example:
GV Health introduced Partnerships with Patients, a
communication process that empowers patients and
families/carers to share and raise concerns about
themselves or their loved one in November 2014. This
enhanced the process to escalate cares for patients. It
aims to address issues or concerns that have not yet been
identified or acted upon by staff.
A 29-year-old female acute inpatient
in the general medical ward suddenly
developed chest pain and her breathing
and heart rate increased.
The Partnerships with Patients is an easy three-step
process:
A Medical Emergency Team (MET) call
was initiated by a nursing staff member
and the patient was quickly transferred
to the Intensive Care Unit for closer
monitoring. The patient remained in the
Intensive Care Unit for three days before
being transferred back to the general
medical ward and then discharged the
following day.
Step 1: Talk to your nurse, midwife or doctor regarding
your concerns.
Step 2: If you are not satisfied with the response, ask to
speak to the nurse or midwife in charge of the
ward at that time.
Step 3: If you are still concerned, phone (03) 5832 3417.
The senior nurse on duty for Patient Safety will
respond and assist you. This response should
occur within 30 minutes.
Please provide the nurse with the following information:
1. The patient’s name.
2. The reason for the call.
3. The ward and room (if known).
23
Continuity of Care
Responding to needs
SPECIALIST HEART CARE
NOW AVAILABLE IN GV
S
pecialist cardiology care is now
available at GV Health, thanks to a
partnership formed this year between
GV Health and St Vincent’s Hospital,
Melbourne.
The new service, led by St Vincent’s Dr
Andrew MacIsaac and Dr David Prior, means
local patients requiring cardiology have
improved access to cardiac care. Patients can
be referred directly and see a visiting specialist
at GV Health in Shepparton, rather than having
to travel to other locations.
typically have higher cholesterol in their diet,
higher blood pressure and were therefore
more likely to have heart disease.
Heart failure is particularly prevalent in the
Greater Shepparton area. A 2011 National
Health Foundation study found that more
than 52 per cent of people in the Greater
Shepparton area were either overweight or
obese. Those who are overweight or obese
Higher numbers of smokers, more cases of
diabetes and having an ageing population are
also contributing factors to the region’s greater
need for specialist cardiology care.
L-R Dr Arup Bhattacharya, GV Health Divisional Clinical Director - Medical, Dr David Prior, St Vincent’s, Dr
Andrew MacIsaac, St Vincent’s, Donna Sherringham, GV Health Executive Director Clinical Operations
24
IMPROVING
EMERGENCY
CARE FOR
RESIDENTS
OF AGED
CARE
FACILITIES
W
hen a resident of an aged care
facility has a medical issue, such
as a chest infection, urinary
tract infection or cellulitis, the aged care
facility typically arranges for the resident
to attend the GV Health emergency
department for assistance.
These types of ailments can typically be
treated by a GP.
Research identified that approximately 120
aged care residents per month have been
attending the emergency department. Of
these clients, approximately 90 per cent of
presentations are triaged as categories 3-5
(the least urgent).
Aged care facility staff report that they
can now better identify, monitor and act
upon changes to the health status of
residents in a timely manner, reducing
the need for residents to present to the
emergency department.
GV Health currently provides a visiting
health service, known as the Residential
In Reach service, to seven residential
aged care facilities (648 beds) within
the Shepparton/Mooroopna area, as an
alternative to sending their residents to the
emergency department.
Feedback about the education sessions
has been very positive and there have
been ongoing suggestions for other
medical conditions to be included in
the 2016 education sessions, such as
dementia and Parkinson’s Disease.
Residential In Reach staff are highly skilled
nurses who have extensive experience
within the emergency department and
liaise with local GPs, as well as specialist
Emergency Medical Staff if required to
provide care for aged care facility residents.
In order to decrease the frequency of
presentations by residents from residential
aged care facilities to the GV Health
emergency department, GV Health
developed a series of education sessions
to improve the knowledge and skills of
aged care facility carers so they can better
understand the most common medical
conditions, signs and symptoms to
observe, treatment options, tests that may
be beneficial and more.
GV Health’s Cath Kelly with Grutzner House staff
25
The GV Health Residential In Reach
staff have been working closely with
Ambulance Victoria to reduce the use of
unnecessary ambulance transfers from
aged care facilities to the emergency
department.
Ambulance Victoria is now a referral
service for GV Health’s Residential In
Reach service and will promote the
Residential In Reach service to residential
aged care facilities who request the
transfer of a resident that could be
managed within the aged care facility by
Residential In Reach staff.
Working in partnership with residential
aged care facilities and Ambulance
Victoria is helping to ensure the best
possible health outcomes for residents of
aged care facilities in the Goulburn Valley.
Continuity of Care
Responding to needs
PROUD TO BE SMOKE FREE
Katie Clavarino,
GV Health Clinical
Coordinator, Self
Management Support
“The staff on the wards were
wonderful. When they first asked
about patches, I said no, but then I
changed my mind. The doctor got
me patches and then organised for
me to speak to somebody about my
smoking…talking to someone away
from the house and family, it does
good…it helps a lot. My confidence
is better…it is wonderful.”
Sarah
26
GV Health patients, residents, visitors, volunteers and staff
deserve a safe, healthy and comfortable environment. That's
why GV Health is proud to be smokefree. It's just one of the
ways we care for each other and the environment in which
we live, work and play.
Smoking tobacco remains the number one cause of
preventable death and disease in Australia. Everyone
exposed to tobacco smoke is affected. Smoking can lead
to a range of cancers, emphysema, fertility problems,
increased risk of heart disease and stroke, and other health
complications.
Smoking rates in Australia continue to fall to record low
levels. According to new data from The National Drug
Strategy Survey, fewer Australians are smoking than ever
before, with daily smoking rates having almost halved since
1991 (from 24.3% in 1991 to 12.8% in 2013).
In 2008, GV Health introduced a totally smoke free policy.
This year, new legislation introduced means that anyone
found smoking within four metres of the entrance to any GV
Health building can be fined.
GV Health’s policy remains the same; no smoking is allowed
anywhere, on any GV Health campus.
Supporting patients to be smokefree has become part of
routine care at GV Health. This has been accomplished by:
•
Providing training for staff on how to have conversations
with patients about their smoking.
•
Reviewing documentation and forms to help identify
smokers and offer information and support.
•
Communicating clearly with other health professionals,
via an electronic referral process. This enables Quit
Educators to visit patients while in hospital and provide
more information about withdrawal symptoms and
support, while in hospital and once discharged.
•
Reviewing guidelines, including nicotine replacement
therapy processes.
It can be very difficult for patients who are smokers to cope
with withdrawal symptoms during their stay in hospital. By
providing staff with the tools, skills and confidence to start a
conversation with patients about their smoking, and offering
the options of nicotine patches or follow-up with a Quit
Educator, patients are more likely to attempt to quit smoking,
and continue with this effort once discharged from hospital.
The benefits of quitting smoking are significant.
GV Health patients are supported to be smokefree while
they are an inpatient, as part of routine care.
•
Within a month, your immune system will start to
recover and you will be less vulnerable to disease.
Receiving brief advice from a health professional can double
the rate of quitting and it only takes a minute, that’s why GV
Health has implemented the ABCD Model, to ensure we:
•
In one year, your risk of dying from heart disease is
halved, compared to a continuing smoker.
•
After 10 years, your risk of lung cancer is less than half
that of a continuing smoker.
Ask if a patient smokes
Briefly have a conversation with the patient,
if they do smoke
CD communicate this information at discharge
If you would like some help to quit smoking,
call the GV Health Quit Educators at
Community Health @ GV Health on
1800 222 582 to book an appointment.
27
Continuity of Care
Improving care for those with chronic
and complex conditions
GV Health CEO Dale Fraser with Dr Arup Bhattacharya, GV Health Divisional Clinical Director - Medical
INTRODUCING A
NEW STROKE UNIT
P
atients requiring treatment for
stroke can access enhanced care
options, thanks to the introduction
of a new specialist stroke unit.
The Victorian Stroke Clinical Network
recommended that all hospitals admitting
100 or more stroke patients per year should
have an Acute Stroke Unit. GV Health
identified that patient presentations were
above 100 per year, and decided to form
this specialist unit.
Stroke patients are now geographically
co-located in the GV Health medical ward,
where they are attended to by a dedicated
team of medical, nursing and allied health
staff (including occupational therapy,
physiotherapy, speech pathology, dietitians
and social workers) who have specialist
expertise in stroke care.
This new model of care will enable stroke
patients to be treated with expert care in the
shortest time possible.
The ‘My Stroke Journey’ information pack,
provided by the National Stroke Foundation,
is provided to all stroke patients in the
Medical Ward. This pack provides helpful
information for planning the transition from
hospital to home after a stroke. Contact
details are also supplied to patients and
family members for the Shepparton Stroke
Support Group.
GV Health had:
162 stroke patients in 2011/12
135 stroke patients in 2012/13
146 stroke patients in 2013/14
8-19 stroke patients have been treated
in the Acute Stroke Unit each month
since it opened in September 2014.
28
A SUCCESSFUL MODEL OF CARE:
MOVEMENT
DISORDER NURSE
A
position was created in 2012
for a Movement Disorder Nurse
to support people with various
movement disorders in the local
community, including Parkinson’s Disease
and other movement disorders.
The role was established as part of a unique
partnership agreement between GV Health,
Parkinson’s Victoria and the Shepparton
Parkinson’s Support Group which drove the
trial project.
This year, an evaluation of the trial position
was conducted to ascertain the effectiveness
of the role and to make a recommendation
as to whether it should continue.
More than 200 people with Parkinson’s
Disease or another movement disorder
received services from the Movement
Disorder Nurse during the two year project.
The report highlights that patients were
happy to have easy and prompt access
to the nurse locally, often in the comfort of
their own home. Seeing the local Movement
Disorder Nurse also resulted in reduced
travel to metropolitan areas.
The Movement Disorder Nurse has improved
the confidence of patients and carers to selfmanage symptoms and medications without
reliance on a GP, increased knowledge of
150 local health care providers through
23 education sessions (13 in residential
aged care facilities) and improved clinical
care through the introduction of advanced
therapies at GV Health.
The report measured quality of life changes
for patients who accessed the Movement
Disorder Nurse; 76% of those patients
surveyed said their quality of life was
maintained or improved as a result of being
able to access support from the local
Movement Disorder Nurse.
Considered a great success, the Movement
Disorder Nurse position will continue to be
funded as an ongoing component of the GV
Health Community Rehabilitation Program.
Sheree Ambrosini,
Movement Disorder Nurse
29
Continuity of Care
Left to right: Mihir Hargovan, Merrin
Tonks, Leigh Rhode, Aimee Brond, David
Whelan, Tarryn Tomkins
MOBILE DENTAL SERVICE
HELPS AGED CARE RESIDENTS
GV Health introduced a new mobile dental
service, to ensure aged care residents in
rural and remote communities have improved
access to dental care.
GV Health received funding to purchase
a light weight IVECO van, complete with
a dental chair, digital x-ray equipment,
wheelchair access and an instrument
steriliser. Dentists can access electronic
patient notes/treatment charts at the time
of care via dental software in the van and
digital x-rays can be viewed at the time of
treatment.
The van, which can be driven by any
licensed driver, will visit aged care centres
throughout the region, as well as remote
areas, kindergartens, youth and infant
welfare centres and centres for the
intellectually disabled for familiarisation,
treatment and oral health promotion.
Previously, dental staff had portable
equipment they would take in a car to
community facilities to provide dental
treatment; only a limited range of services
were available with the makeshift facilities.
The mobile dental van reduces barriers to
access, such as cost and transport, and
will increase the levels of preventative and
early intervention treatments provided to
vulnerable groups.
By providing these vital dental services now,
it will help reduce the need for emergency
dental treatments over time.
The mobile dental van will improve access
to a broader range of dental services for
disadvantaged individuals and groups who
find it difficult to travel for treatment.
30
Access to care will be improved for those
with higher levels of oral disease and will
enable treatment, in a familiar setting, for
clients who cannot easily be moved.
Jayne French, Manager, GV Health Tatura
Parkvilla Aged Care, and Acting Waranga
Nursing Home and Waranga Aged Care
Hostel, said this will be a fantastic service for
residents of aged care facilities throughout
the region.
“Regular dental health check-ups are
important for maintaining good oral health.
This mobile dental clinic is an innovative
service that will provide our region’s most
vulnerable people and those who have
restricted mobility with vital preventative and
restorative dental care,” said Ms French.
Helping to manage
chronic health conditions
at home
T
he Hospital Admission Risk Program Disease Management Team (HARP-DMT)
sees clients, who have a diagnosis of
Chronic Obstructive Pulmonary Disease
(COPD) or Chronic Heart Failure (CHF), in their
own home to help them improve their ability to
manage their health conditions, thereby reducing
the likelihood of needing to come to hospital and
enhancing their quality of life.
Kerry and Richard
The Hospital Admission Risk Program (HARP) Team gives my
husband and I peace of mind! I am better able to balance my work
and carer roles, knowing that the HARP team and the Rural Allied
Health Team come to our home to care for Richard, who has multiple
The service provides clients with education on
factors such as signs and symptoms of their
condition and how to best manage these to
prevent a more serious episode of illness.
chronic conditions.
The service also assists clients with suggesting
exercises and equipment that might be suitable for
their condition, dietary advice, and social support
to help them maintain their independence in the
community.
hospital is exhausting for him. The specialist HARP team visits him
The team consists of a variety of health
professionals, including nursing, physiotherapy,
occupational therapy, dietitian, social worker and
team assistants who all work closely together to
achieve the best possible outcomes for clients.
in their absence.
Travelling to Shepparton from a small rural town for follow-up
care and treatment is not easy for my husband; a long day at the
at home, in his own comfortable, familiar surroundings. The team
members communicate well and provide us with useful advice and
education, ensuring that we know how to continue the plan of care
Richard wit
The team also facilitates a 10-week group program
called ‘Happy Hearts’, specifically for clients with
Chronic Heart Failure. This group helps people to
exercise safely and learn how to best manage their
condition and medications in a supportive group
environment.
A recent survey found that:
93% of clients reported an increase in
confidence in the management of their health
condition thanks to Hospital Admission Risk
Program Team.
77%
of clients had not needed to come to
hospital since they had been seeing the HARP
Team.
100%
of clients said the HARP DMT staff
always treated them with respect.
31
h Toby Daff
, GV Health
podiatrist
Continuity of Care
Telehealth means people talk with their medical specialist over a
video link, rather than seeing them in person. It is just like a visit to
the specialist – but it happens using video and the internet, and
people don’t have to travel long distances to a bigger city or take
time off work.
What is
telehealth?
It happens in real time – just like a phone call but with video as
well. It is not recorded, although sometimes photos might need
to be taken for diagnosis or treatment.
GV Health clients in rural and remote areas, who don’t have
specialist health services nearby, have been able to benefit from
this service.
There are now 23 registered different types of telehealth services
being conducted; including psychiatry, stroke telemedicine
and oncology/haematology. It is hoped and expected this will
increase in future to ensure residents of rural and remote areas
have better access to health services.
GV Health prostate cancer nurse, Sonia Strachan
32
Providing mental
health services via
telehealth
The Department of Health and Human Services allocates
funding to Goulburn Valley Area Mental Service to provide acute
and community services to people with severe mental illnesses.
However, many people with mental health disorders, such as
anxiety and depression, did not have the ability to travel for
treatment to Shepparton and were not accessing the services
they need.
A model of care was developed to provide consultation liaison
psychiatry clinics, in partnership with GP practices and Primary
Care providers, via telehealth.
Consultant Psychiatrist consultations to residents of Grutzner
House at GV Health, a specialist mental health aged care facility and
Rumbalara Aboriginal Medical Clinic, previously provided but not
funded, are now covered by Medicare.
A patient satisfaction survey was conducted in 2014.
98% of patients were very satisfied or satisfied with the
waiting time to see a consultant, the quality of the consultation and
the telehealth experience. These patients were highly likely or likely
to recommend the service to family or friends.
Consultant psychiatrists now provide assessment of patients
referred by their GP, who then receive a mental health plan or
a report recommending ongoing
management.
A robust governance system was
established to ensure there are no
clinical or financial risks with this model.
Each GP takes responsibility for the
administration of the clinic and provides
consultation space and equipment.
Medicare funding is utilised with no
cost to patients.
Telehealth clinics have been
established with four GP clinics in
outlying areas of the region.
Clients of headspace Shepparton and
the Peri-natal Emotional Health Program
have been able to access psychiatry
consultation under this arrangement.
Dr Ravi Bhat, GV Health
Divisional Clinical Director
Mental Health
“Patients have expressed
their thanks to us. They
feel comfortable with the
psychiatrist. As for our doctors,
the opportunity to arrange a
fairly rapid thorough assessment
with a quick report has been of
great assistance in managing
difficult cases.”
“The last five months
have been worse
than I could have ever
imagined but with
help from both you
and my GP, I now feel
I can move forward.”
33
Continuity of Care
Improving care for cancer patients
Prostate
Cancer Nurse
A
s prostate cancer is the most prevalent of all cancers
in the Goulburn Valley, it was identified that a specialist
nurse was needed to support local men undergoing
treatment for prostate cancer and their families.
From 2008 to 2012, the reported incidence of prostate cancer in
the Goulburn Valley was 564. During 2012 and 2013, a total of 148
patients were admitted to GV Health with prostate cancer.
A Prostate Cancer Specialist Nurse role was created as a
local resource for men and Sonia Strachan started work 1
September 2014.
This model of care is unique in that it is funded by sponsorship
from the annual Shepparton Biggest Ever Blokes Lunch, a major
local prostate cancer fundraising event. The Committee for the
Lunch committed to providing $300,000 over three years to
establish the role at GV Health. Other regions are now looking to
emulate our partnership arrangement to fund a Prostate Cancer
Specialist Nurse.
Sonia Strachan has made a significant difference to the lives of
local men and their families.
She works closely with each patient’s medical team, assists
patients to understand their diagnosis and treatment plans,
coordinate their care, offer support and refer to relevant services.
Since she started, she has seen 123 patients and she has begun a
number of specialist services, partnerships and programs to help
raise awareness of the importance of early detection.
Sonia Strachan, GV Health
prostate cancer nurse
with patient Michael Gaffy
34
THE VERY BEST
CARE FOR LOCAL
FAMILIES
The GV Health maternity ward is always
busy supporting local women and families
to welcome new babies into their lives.
> 1,206
Total Births
1,186
2014
2015
> 15
Twin Borns
13
2014
2015
Caesarean Births
22.68%
2014
> 26.94%
2015
Age of parents
giving birth at GVH
years
(17%)
35+
20 years and under
(6%)
21-34 years
(77%)
35
Continuity of Care
Improving care for families
Introducing
Rosewood…
Women’s health services were
this year consolidated under one
roof in Building M at GV Health,
otherwise known as Rosewood,
to create a centre of excellence.
Women can now go to one
central, easy-to-access location
for obstetric, maternity, antenatal
and gynaecology appointments.
Improving Care Through Research
T
he GV Health Research Unit was
established in March 2015, with
Dr Md Rafiqul Islam appointed
Clinical Research Coordinator. Dr
Islam has a PhD in Community Medicine
and Clinical Epidemiology (2014) from the
University of Newcastle and has substantial
clinical, research and teaching experience.
The Research Unit aims to address the
healthcare needs of the local community
through facilitating and leading high quality,
locally-relevant, world class research.
During the last financial year the Research
Unit contributed significantly to improving
GV Health’s research, audit processes and
ethics. The unit has developed GV Health’s
research and publication policy and ethics
forms; is collaborating with many Victorian
universities; and has guided many junior
doctors and other health professionals in
relation to research and audits. A number
of research articles and case reports are
being prepared.
36
(
New oxygen equipment
for children keeps families
together, closer to home.
(
Improving local
respiratory
care for children
W
hen a baby or child
had severe pneumonia
or bronchiolitis, GV
Health had to send
them to a Melbourne hospital for
treatment, in a high dependency
unit, because GV Health did not
have the specific oxygen delivery
equipment to be able to support
their breathing needs.
Sending children to Melbourne for care
is less than ideal; especially when both
parents cannot go to Melbourne together
to be with the child. Families become
separated in these situations, which can be
emotionally stressful, as well as expensive
for accommodation, meal and fuel costs.
To be able to provide specialised
respiratory support, GV Health purchased
six Airvo 2 machines this year, thanks to
funds raised by the annual Give Me 5 for
Kids campaign. GV Health was the first
Victorian regional hospital to purchase
these systems.
37
The Airvo 2 is easy for staff to use, enables
higher level care to be provided in the GV
Health Child and Adolescent Unit and
reduces the need to transfer children to
Melbourne hospitals.
Higher level oxygen is now able to be
delivered to babies and children, starting in
the Emergency Department and continuing
in the Child and Adolescent Unit.
Continuity of Care
Improving care for
Aboriginal patients
G
GV Health staff participated in workshops led by Aboriginal
community elders and artists from Kaiela Gallery, to construct and
decorate clay turtles as part of a community arts project aimed at
raising awareness of the importance of the long neck turtle to Yorta
Yorta people. This project was well received by staff:
V Health works in partnership with a range of
organisations and networks to improve services to
Aboriginal patients.
GV Health celebrates NAIDOC week each year in partnership with
Rumbalara Aboriginal Co-operative and the local community. All
Aboriginal and Torres Strait Islander patients who were in hospital
during the week of activities were presented with a tabletop flag
and show-bag of NAIDOC materials. “I just wanted say such a big, big thank you for offering for staff
to take part in the 1000 Turtle Muster. I truly had the best day
ever...”
A display promoted the range of activities undertaken by
GV Health staff aimed at improving Aboriginal health, from
health promotion and education events about Bowell Cancer
Awareness, PAP screening and breast screening, to cultural
awareness training activities for staff.
“Thank you for encouraging me to participate in the 1000
Turtles Project. It has been 12 years or more since I have
played with clay and it brought back so many fond memories.
Hearing the story of the long neck turtle was great..”
A follow-up project is underway to construct an installation
made up of turtles made by staff at the Community Health @ GV
Health campus.
GV Health…where cultural differences are respected
38
Patient experience
survey
P
atient Experience Surveys were conducted
with Aboriginal and Torres Strait Islander
patients attending the Emergency
Department in 2013 and repeated in 2014. The survey results highlighted the following:
78%
of Aboriginal consumers were asked whether
they were of Aboriginal or Torres Strait Islander origin; a 12%
improvement from the 2013 survey.
Porsha Atkinson, GV Health
Aboriginal Health Transition Officer
It is a mandatory requirement of the Department of Health
and Human Services that every person presenting to the
Emergency Department must be asked this question.
It should never be assumed that a person is or is not
Aboriginal or Torres Strait Islander simply based on
appearance or previously recorded status.
18%
of Aboriginal consumers were asked whether
they would like an Aboriginal Liaison Officer or Transition
Officer to visit them during their hospital stay; a 10%
decrease from the previous year’s report.
Additional training has since been introduced to address
this issue, ensuring Emergency Staff are more familiar
with the staff liaison resources available and how to
access them.
80% of Aboriginal consumers said that GV
Health staff treated them with dignity, courtesy and
respect always or most of the time during their visit; an
improvement of 6% from the 2013 survey.
79%
of Aboriginal consumers said they had an
active say in making decisions about their treatment always
or most of the time; an improvement of 5% from the 2013
survey.
A consultation forum with Aboriginal community elders
was held in November 2015 and feedback from the elders
will be used to inform our future plans.
39
Continuity of Care
Improving care for acute patients
More patients
are accessing
Speech
Pathology than
ever before
Nicole Limbrick, GV Health
Speech Pathologist
S
peech Pathologists can make
a significant difference to
patients with swallowing and
communication difficulties and have a
positive impact on patient wellbeing,
safety, nutrition and hydration.
Not all patients who could benefit
from seeing a Speech Pathologist at
GV Health were referred between July
2014 and March 2015. It was identified
that approximately 30% of patients
admitted with stroke, or swallowing and
communication difficulties were not having
access to Speech Pathology services.
A survey of nurses and doctors was
conducted to measure their level of
awareness and knowledge regarding
Speech Pathology and when a referral
is needed.
Results revealed the referral pathway was
complex and not well understood. GV
Health staff were only aware of some of
the patient symptoms which may require
referral to Speech Pathology.
A range of strategies were implemented
throughout GV Health during the past six
months to improve staff knowledge and
awareness of the Speech Pathology role.
One of the key strategies was adding
Speech Pathology to the Stroke Call page
from the Emergency Department, which
streamlined the referral process and
increased stroke referrals.
The other main initiative was the
development of a four-minute Speech
Pathology Referrals cartoon, which was
shown to more than 120 nurses and
doctors on a tablet, computer screen or
40
projector, at any opportunity
(e.g. break times, hand overs, meetings).
The cartoon also had more than 170
views on YouTube after the web link was
displayed on the intranet and emailed to
nurses and doctors.
Following staff education and process improvement, Speech Pathology referrals have increased by 20% on average for
patients experiencing the following conditions:
Stroke Swallowing problems
Communication problems Aspiration pneumonia
Chronic Obstructive
Pulmonary Disease (COPD)
Pre-project
69% referred
64% referred
57% referred
37% referred
vs. Post-intervention
→ 90% referred
→ 88% referred
→ 86% referred
→ 55% referred
9% referred → 17% referred
100
% Patients referred to
Speech Pathology with
at-risk conditions
July 2014 to March 2015
August 2015
80
60
40
20
0
Stroke
Swallowing Communication Aspiration
Impairment
Impairment
Pneumoniaa
COPD
D
Nurses and doctors improved their knowledge about the risks of swallowing and communication difficulties associated
with patient symptoms seen every day on the wards.
Compared with data gathered at the start of the project:
30%
30%
more staff would now refer to
Speech Pathology if a patient is
not alert or fully conscious, due to
knowledge of the risks involved in
feeding these patients
more staff would refer to Speech
Pathology for shortness of breath,
as they now know it is linked with
swallowing problems
24%
20%
41
more staff would refer to Speech
Pathology if a patient was having
trouble following instructions, as it
likely suggests a communication
difficulty
more admitted patients at GV
Health are now accessing Speech
Pathology services that need it.
Continuity of Care
Improving care for acute patients
Sensory
therapy
for mental health patients
42
The Victorian Government and Health Services
is committed to reducing and, where possible,
eliminating restrictive interventions in mental health
services, as per the Department of Health and
Human Services 2013 framework, Providing a safe
environment for all.
Area Mental Health Services were asked to
provide a Local Action Plan to reduce the use of
restrictive interventions in acute inpatient units.
The plan was to focus on:
•
Educating staff as to the impact of restrictive
interventions, and providing informed care
training and gender sensitive practice training.
•
Raising awareness of staff and consumers/
carers of recovery-orientated practice and of
the shared responsibility in treatment.
•
Educating staff on de-escalating agitation
and potentially aggressive behaviour,
using informed care and including the use
of alternative strategies, such as sensory
modulation.
A sensory modulation room has been created
this year at GV Health’s Wanyarra Acute Inpatient
Unit, for consumers and staff to use alternative
approaches to reduce agitation and promote selfmanagement and self-soothing.
What is sensory
modulation?
Sensory modulation is a clinical intervention that
focuses on the use of environments, equipment
and activities to regulate an individual’s sensory
experience and optimise physiological and
emotional wellbeing.
During mental health crises, the convergence
of high levels of stress, significant cognitive and
perceptual changes and emotional distress can
result in hyper or hyposensitivity to sensory input.
Providing opportunities for people experiencing
acute symptoms to regulate their own emotional
and behavioural responses through sensory input
is seen as a promising strategy in acute mental
health care.
Some of the equipment available in the Wanyarra
sensory room includes:
•
a massage chair
•
weighted blankets and shoulder wraps
•
weighted toy animals
•
an LED projector with moving stars, clouds
and night time theme
•
vibrating tubes that can be molded into many
shapes
•
glowing eggs
•
aroma therapy equipment
•
sensory food
•
tactile objects, such as silly putty, gel objects
and squishy balls
43
Continuity of Care
Victorian Healthcare
Bernice with her Community Interlink Care Coordinator
Improving care
for older people
L
ocal people are being supported to
stay living independently in their own
homes longer as they age, thanks
to services provided by GV Health’s
Community Interlink.
This year, the Federal Government
changed the way people access funds
for their care, to provide consumers with
greater control.
Previously, the funding was given to
organisations, which provide the services.
Now, consumers can choose their own
health service provider, who will assist
them. Consumers work with their chosen
agency to develop a care plan and a
tailored budget to support their individual
health and wellbeing needs.
The new Consumer Directed Care model
enables clients to choose how and when
their services are going to be delivered.
Most importantly, the consumer has the
choice about how much involvement they
want to have in managing their own care
and services. This is usually dependent on
their individual capabilities and the support
network they have around them.
Community Interlink has experienced staff
who live locally, know the local services
available and have relationships with local
support organisations to ensure every
consumer is connected to services and
programs that suit their needs and goals.
Through Community Interlink, local people
can get connected to local support
services such as:
•
social and support groups
•
allied health professionals, such
as occupational therapists and
physiotherapists
•
home assistance, such as gardeners
and home cleaning services
•
personal care professionals
If you are interested in finding out more about what services might be available to help you stay living independently at
home, please call Community Interlink on 1800 222 582 (press option 1).
44
Readers’ Survey
We invite you to comment on GV Health’s Quality of Care Report so that we can continue to improve and meet
your needs.
Please complete and return your reader survey to Quality and Risk Unit, Goulburn Valley Health, Graham
Street, Shepparton VIC 3630 to be entered in the draw to win one of two vouchers for dinner at Sebastians
Restaurant, Shepparton. Simply return this survey by 29 January 2016. The winner will be notified via phone/email
on 12 February 2016.
What is your overall opinion of this report?
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What did you like most about this report?
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What did you like least about this report?
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How could the report be improved next year?
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Do you have any suggestions of other services that GV Health could offer the community?
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Are you interested in becoming a volunteer at GV Health?
YES (please include contact details)
NO
Other general comments?
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Please tick the age range that applies to you:
<20 21-3031-4041-5051-6060+
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45
Cert no. L2/0004.2010