southern health: an overview

Transcription

CONTENTS
Year 2002/2003 in Review
2
The Board
4
Southern Health: an overview
5
Achieving operational effectiveness
6
Leading in integrated services to improve health status
10
Creating and maintaining effective partnerships
15
Developing organisational competencies
21
Our commitment to improve quality
25
Summary information
27
Organisation Chart
28
Management
29
Legislative Framework
30
Asset Management
32
FOI Applications
32
Southern Health Services
33
Service, Activity and Efficiency Measures
35
Staff Numbers
36
Merit & Equity at Southern Health
36
Summary of Financial Performance
37
Compliance Index – Disclosure Requirements
39
Financial Statements
41
Page 1
Annual Review Southern Health
YEAR 2002/2003 IN REVIEW
The delivery of health services continues to be extremely challenging but
our staff has responded in a truly professional way. We are very proud
of our achievements over the past 12 months in an environment of
unprecedented pressure.
We have managed an ever-increasing demand for our services and deal with
the resultant stress at all levels of our organisation to ensure our care is
efficient, effective and of high quality. This demand reflects changes in our
population as well as issues caused by the availability of general practitioners
and residential aged care beds. The community has an expectation that
Medicare will provide appropriate access to public health care and while this
is largely achieved, there are definite signs that not all expectations can be
met in a timely manner.
We are currently working with the Victorian Government and Department of
Human Services to further improve access. We are encouraged by this
strong support in testing new ideas to improve our services and there are
many examples of successful initiatives detailed in this Annual Report.
The roll out of our strategic plan, formally released in 2002, has set
a template for dealing with some of the challenges we see ahead.
Already we believe we have achieved significant success by pursuing that
strategic approach.
We have established four key result areas in which to measure our progress.
They are:
●
leading in integrated services to improve health status;
●
achieving operational effectiveness;
●
developing organisational competencies;
●
creating and maintaining effective partnerships.
These interrelated goals guide us in delivering a health service that
is effective, efficient and accessible for the communities we serve.
The distinguishing characteristic about Southern Health is its ability to
traverse all levels of care. Our commitment to developing closer links with
our community through primary care and community health services has
resulted in some outstanding examples of integrated service delivery which
we believe will result in improved health outcomes. These successes
are a base on which we will continue to build and develop our model of
integrated care.
The close interaction between acute, sub-acute and primary care means
that we do not concentrate only on the acute episode of care but see the
continuum of care across all sectors as being appropriate.
The major focus for urgent care continues to be at our public hospitals where
growth in demand for inpatient care continues at about 4% each year. At the
same time, demand for services in our emergency departments has grown 78% per year.
Monash Medical Centre’s emergency department is the busiest in
Melbourne with 51,029 attendances last year. Our Dandenong Hospital
Emergency department is also a major service provider with 45,269
attendances recorded for the year.
Among the year's highlights was the solid progress on the new Casey
Hospital in Berwick, which promises a great boost for the people of this
rapidly growing part of our community. The building program is now well
underway and the hospital is expected to be passed over to Southern Health
to commence operations late in 2004.
Page 2
Southern Health Annual Review
It was also very pleasing that the Government
announced several significant capital
commitments at Dandenong, Moorabbin and
Clayton. We will look forward to working with
Government to implement these commitments. A good deal of planning work has also
been undertaken on the re-development of
our sub-acute and residential aged care
facilities, particularly at Kingston Centre.
Across Southern Health we are actively
improving care through several quality
For example, we
improvement initiatives.
have implemented a Medical Triage system
where patients in the Emergency waiting room
with relatively minor complaints are assessed,
tested and treated by doctors prior to entering
the department. In many cases these patients
will not require hospital admission. This
reduces waiting times and allows emergency
physicians to spend their time on the more
seriously ill patients.
At Monash Medical Centre we have built a
Day Treatment Centre, which means patients
can receive the care they need without
needing to be admitted to a hospital ward,
freeing up more beds for emergency patients.
We have entered an agreement with the Shire
of Cardinia to relocate the Pakenham
community health facility in the Shire’s new
premises to be built in the Pakenham
shopping precinct. This service will be more
accessible to the community, and a “state of
the art” facility.
We have been at the forefront of developing
the nursing profession with support for
nursing research and education in collaboration with University partners.
We are committed to including members of
the community in how we plan and deliver our
services. Our Community Advisory Committee
is working well and reports to the Board on
key issues affecting health care planning and
service delivery. As our area in the south east
of Melbourne has a high overseas-born
population, we particularly look at how our
services can better deliver services to people
of non-English speaking background –
through our Cross Cultural Advisory
Committee.
We are also working hard at creating better connections between different
levels of care and different health care providers. The wide range of services
available through Southern Health enables this concept of "integrated care"
to become reality. Developing closer relationships with primary carers, such
as general practitioners, is a key focus of how we address the challenges of
providing high quality care to our community.
Southern Health demonstrated its tremendous capacity to respond to new
challenges during the world-wide SARS crisis, as we successfully cared for
the first suspected cases in Australia.
Our organisation also showed great resilience and professionalism during
and after a series of shootings at nearby Monash University.
The inaugural Chair of Southern Health, Garry Richardson resigned during
the year to take up a position as Chair of Health Super Pty Ltd. Garry was
an outstanding Chair, having shown great integrity and professionalism in
fulfilling his role.
Garry’s background and experience in health insurance, his State and
Federal appointments and his role with Health Super has given us the
advantage of a Chair who has possessed a broad understanding of the
health care sector. His role in the transition between the previous
Southern Health Care Network and Southern Health is acknowledged and
very much appreciated.
Meredith Carter also left the Board during the year and her valuable
contribution to Southern Health remains in evidence through the strong
community focus that continues to prevail throughout the organisation.
The strength of our Community Advisory Committee and the involvement
of consumers in their health care were two of the issues enhanced by
Meredith’s participation.
We are grateful for the continuing support of auxiliary members, volunteers,
corporate and individual donors and members of the community who,
at many levels, have contributed to us in our achieving our goals.
We would finally like to acknowledge and thank our dedicated members
of staff who have continued to display the highest levels of professionalism.
As an organisation, it is impossible for us to deliver quality services without a
team of people committed to the highest standards of care and Southern
Health is very proud of our staff who form that team.
We hope you enjoy reading this Annual Report about one of Australia’s great
health services.
Mr Peter Maloney
Chair
Prof Stan Capp
Chief Executive
Page 3
THE BOARD
Garry Richardson. Chair. Member Audit Committee, Chair
Finance and Remuneration Committees. Former chair of
Southern Health Care Network, Commissioner of Private Health
Insurance Administration Council, a Commonwealth regulatory
authority. Director Health Super Pty. Ltd., Independent Chair of
Audit Committee, Stonnington City Council, Chair of Housing
Guarantee Fund Ltd (from 1/8/02). Mr Richardson retired as
Managing Director of National Mutual Health Insurance Pty. Ltd.
in 1997. He is a Fellow of the Australian Institute of Company
Directors. Resigned 31 March 2003.
Meredith Carter. Executive Director, Health Issues Centre
and National Resource Centre for Consumer Participation
and a Director of the Consumer Law Centre Victoria.
Extensive experience at senior levels of public, private and
community sectors. Meredith holds a Master of Laws, has
published widely and is a frequent lecturer and media
commentator on health policy. Resigned 6 April 2003.
Mr David Cowlishaw. David Cowlishaw retired from the
National Australia Bank in 2001 following an extensive and
varied career, which began in Western Australia in 1962. Senior
appointments included: District Manager Metropolitan
Melbourne, Head of Credit Victoria and Tasmania, secondment
to an associate Merchant Bank in Indonesia as Company
Secretary, General Manager of the Bank’s U.S. operations
based in New York, Managing Director National Australia
Trustees. David is currently Chairman of Crisis Support
Services a non profit telephone counselling service, Chairman
of the Dandenong Transit Cities Advisory Committee.
Ms Kathy Grigg. Member Audit Committee. Ms Grigg is a
Fellow of the Australian Institute of Company Directors and
Australian Society of Certified Practising Accountants. She
has extensive international executive experience in the wool
industry, including serving as Chief Financial Officer and in
operational management positions with The Woolmark
Company and the Australian Wool Corporation. She is a
director of CoINVEST Ltd, the Grape and Wine Research and
Development Corporation and serves on the Clinical
Research and Ethics Committee of the Melbourne Health
Research Directorate and is Vice-President of Hawthorn
Community House Inc. (From 1/07/02).
Dr Jane Hendtlass. Dr Hendtlass is a lawyer, biochemist
and Director of Professional Standards for the Anglican
Diocese of Melbourne. She is a member of the Victorian
Quality Council for Quality and Safety in Health. She has an
extensive history with community organisations including
Fitzroy Legal Service and Liberty Victoria and with policy
development, implementation and evaluation in the public
and private sectors.
Mr Neil Hewitt. Chair Audit Committee. Mr Hewitt was a
partner of KPMG from 1971-1998 and is now a company
director, with a particular interest in the Health Industry.
Presently a director of Turning Point Drug & Alcohol Service,
Youth Substance Abuse Service, National Ageing Research
Institute, International Diabetes Institute and Schiavello
Project Solutions. He has extensive professional skills in
financial management and strategy.
Page 4
Mr Naim Melhem. Mr Melhem has extensive experience in
local Government as a Councillor with the City of Springvale
and City of Greater Dandenong. He served as Mayor of the
City of Greater Dandenong in 1999-2000 and was re-elected
to Council in 2000. He has an extensive history of involvement
with local community organisations including the South
Eastern Arabic Association, St Nicholas Orthodox Church,
Springvale Community Aid and Advice Bureau and Springvale
Community Health Centre Board.
Mr Peter Maloney. Mr Maloney has held senior executive
financial and commercial positions in Australia and
internationally, served as a director of a number of public and
private companies and organisations and has been actively
involved in the development of a number of businesses.
Executive positions held by Mr Maloney include Treasurer of
WMC Ltd, Executive General Manager Finance of Santos
Limited, and CFO of F H Faulding.
Prof Pauline Nugent. Associate Prof Nugent is Head of
School of Nursing at Deakin University and Associate Dean of
the Faculty of Health and Behavioural Sciences, and has 25
years nursing experience specialising in Critical Care Practice.
She is President of the Australian Council of Deans of Nursing,
and the Australian Vice Chancellors Committee representative
on the Australian Health Workforce Advisory Committee. She
has been on the Victorian State Nurse Recruitment and
Retention committee and is a member of the Nurses Board
Victoria Nurse Practitioner Implementation Committee.
Prof Nicholas Saunders. Dean Faculty of Medicine,
Nursing and Health Sciences at Monash University. He was
formerly Dean of the School of Medicine at Flinders University
of South Australia and before that Professor of Medicine at
the University of Newcastle. He stepped down as Chair of the
National Health and Medical Research Council of Australia in
May, 2003.
Mr Colin Wise. Mr Wise is a Fellow of the Australian Institute
of Company Directors and is the principal of his own
consultancy practice. As a senior legal counsel and manager he
has had significant practical in-house experience in Australia and
internationally with a wide range of business, corporate
management, dispute resolution and litigation issues, including
extensive experience in the management of complex
governance, corporate and business matters at Board level. Mr
Wise has served as General Counsel to the WMC Group of
Companies (a major world minerals and energy resources
group) and subsequently as Counsel to the New York law firm
of Howard, Smith & Levin LLP. He has been Chairman of the
ASX listed New Holland Mining NL and of a company preparing
to list on the ASX. Previously, he was President of the Australian
Mining and Petroleum Law Association Limited and the
Corporate Lawyers Association of Victoria and is a former
Council member of the Law Institute of Victoria and the
Australian Institute of Judicial Administration. He is a Fellow of
the Australasian Institute of Mining & Metallurgy.
SOUTHERN HEALTH: AN OVERVIEW
Southern Health is the largest metropolitan
health service in Victoria and provides
comprehensive primary, secondary and tertiary
health care services to people living in the SouthEastern suburbs of metropolitan Melbourne.
Southern Health provides services to the
Southern, Bayside and South-Eastern suburbs
of Melbourne, an area in excess of 2,800
square kilometres with a population of over
730,000. The primary catchment area includes
the cities of Bayside, Cardinia, Casey, Greater
Dandenong, Kingston and Monash. Southern
Health also provides specialist services to a
rural catchment including Gippsland.
Southern Health services are provided from
a number of hospitals and community
health services:
●
Monash Medical Centre (Clayton)
●
Monash Medical Centre (Moorabbin)
●
Dandenong Hospital
●
Kingston Centre
●
Mooraleigh Hostel
●
Yarraman Psychogeriatric Nursing Home
●
Hampton Rehabilitation Hospital (services
moved to Kingston Centre in late 2002)
●
Cranbourne Integrated Care Centre
●
Casey Cardinia Community Health Service
(Berwick, Cranbourne, Doveton and
Endeavour Hills, Bunyip, Cockatoo and
Pakenham)
●
Greater Dandenong Community Health
Service (Dandenong and Springvale)
Southern Health services are also provided
from other health service sites, such as
Central Bayside Community Health Service.
A new Casey Hospital, which will form part of
Southern Health is currently under construction
in Berwick and will be opened in 2004.
Southern Health is affiliated with Monash
University for teaching medical and
postgraduate nursing students, and for
postgraduate study and medical research.
Southern Health is affiliated with other
universities
for
undergraduate
and
postgraduate clinical education of nurses and
allied health professionals.
We have a streamlined organisational
structure, with clinical programs that cross the
health service. Each site provides important
support to the programs.
Our aim is to provide seamless care, giving
you the care you need, when you need it.
Southern Health Clinical Programs
●
Critical Care Program
●
Medicine Program
●
Primary Health Care Program
●
Mental Health Program
●
Rehabilitation and Aged Services Program
●
Speciality Program
●
Surgery Program
●
Women’s and Children’s Program
We are committed to pushing back the boundaries of health knowledge
through education and medical research. We have close ties with Monash,
Deakin and La Trobe universities, and other world leading research and
teaching organisations such as the:
●
Monash Institute of Health Services Research, which is focused on linking
technology and healthcare
●
Monash Institute of Reproduction and Development, which is researching
prostate disease, infertility treatment, molecular genetics, foetal and
neonatal development and women’s and children’s health
●
Prince Henry’s Institute of Medical Research, a world leader in the study
of hormones and their effect on bodily functions, health and disease.
Southern Health employs more than 9,420 staff and has an annual turnover of
$623.8m Last year we treated more than 120,000 patients in our hospitals,
7,000 more than last year, and provided in excess of 690,000 episodes of care.
Page 5
ACHIEVING OPERATIONAL EFFECTIVENESS
The appointment of a paediatric admission/
discharge coordinator has enabled us to
maintain our throughput of children’s elective
cases including surgery despite the highest
winter demand and presentation to
Emergency on record.
Within our Emergency departments 100% of
Category 1 patients received immediate
attention, and we have made significant
progress in treating those patients who are
less urgent within the prescribed time frames.
We have also significantly decreased the
incidence of Ambulance Bypass.
These achievements have resulted from
continued restructuring and reorganisation to
improve our efficiency.
Southern Health continues to deliver high quality care to more people than
ever before.
We provided 120,365 occasions of inpatient care, an increase of 6.7% from
last year. Our beddays now exceed half a million, with outpatient occasions
of service approaching 700,000.
At the same time we have delivered on or exceeded major access and
waiting list targets.
We treated 100% of category 1 elective surgery patients within the prescribed
30 days, and have reduced the total number of people awaiting surgery.
The Surgery Program achieved its targets for separations and WIES across
Southern Health with a significant improvement in the day of surgery
admissions and reductions in the length of stay. Dealing with the high
demand for elective surgery continues to be a challenge but the new Casey
Hospital, which will have a significant focus on elective surgery, will improve
this situation.
Each program and site rolled out operational
plans which are putting into practice the steps
which will allow us to deliver on Southern
Health’s strategic objectives.
There has been a great deal of effort at the
major acute facilities, Monash Medical Centre
Clayton and Dandenong Hospital, to improve
patient flows through the system, and to
overcome existing delays.
At Clayton this included engaging medical,
nursing and allied health staff in developing
innovative improvements to harness all parts
of the hospital to work together to improve
access and discharge planning.
Initiatives include a new Day Treatment
Centre to provide better access for day
surgery and day medical procedures, new
models of care in medicine to speed access
to ward areas with additional clinical support,
and a number of initiatives to maximize theatre
sessions and bed availability to improve
elective access and reduce elective
cancellations.
These included appointing a Patient Access
Manager and Senior Medical Coordinator to
help decrease elective surgery cancellations,
increase day of surgery admissions, decrease
the average length of stay and improve the
efficiency of the systems in place.
An Emergency Management Response
Sequence was also introduced to better
manage periods of high emergency demand
and avoid the need for bypass.
Page 6
At Dandenong innovative approaches to improving patient flows and system
responsiveness included the expansion of the Transit Lounge, the opening of
an 8-bed Rapid Assessment Medical Unit, the introduction of Short Stay
Surgery Without a Bed and “Quick” Neck of Femur projects.
The site is also continuing to re-engineer key processes such as theatre
sessions and patient scheduling to enhance efficiency.
This determined effort is paying dividends for our patients, ensuring more
people than ever can access the care they need, where and when they need it.
A number of significant infrastructure projects were commenced or
progressed during the year which will play a significant role in boosting our
operational effectiveness.
Casey Hospital
The most significant among these was the continuing development of the
south-eastern suburbs’ newest public hospital at Berwick, to be known as
the Casey Hospital.
The hospital is on target and on budget to be completed in late 2004, and
will be open for business soon after.
The state-of-the-art 229-bed hospital will bring new services closer to local
people, and will integrate with the specialist support of the whole range of
services and infrastructure available within Southern Health’s many sites,
including Dandenong Hospital and Monash Medical Centre.
Dandenong Hospital
There was also significant progress on the major redevelopment and
expansion of Dandenong Hospital. The Stage 2 works, which commenced
last October, will ensure that Dandenong retains its role as one of Melbourne’s
key hospitals.
Part of the works include refurbishing the emergency and imaging
departments, a new state-of-the-art medical resonance imaging facility and
relocating the information technology, medical records and staff
change areas.
Also included in this stage of works are the first two levels of a new building.
The first level will include 14 intensive care beds, with a rehabilitation ward
proposed for the second level. Computer Services successfully relocated the
computer room from the lower ground floor to the midwifery wing to allow for
the Stage 2 demolition.
Moorabbin
The expansion and development of radiotherapy services at Monash Medical
Centre - Moorabbin through a Victorian Government grant of $19 million is
also most welcome. This will increase our ability to care for patients requiring
treatment for their cancer and will significantly reduce waiting lists.
A further $3 million has been granted for Monash Medical Centre Moorabbin that will increase operating capability and expand our high
dependency capability. This will assist in reducing waiting times for elective
surgery - directly benefiting the community.
There are also exciting plans to reconfigure maternity services
across Southern Health to improving consumer choice for birthing outcomes.
This would see the Birth Centre move from Moorabbin Campus.
The aim is to provide a continuum of care across all sites providing maternity
services, encompassing low risk through to very high risk pregnancies based
on a collaborative doctor/midwife model.
Page 7
Kingston Centre
The much-anticipated relocation of
rehabilitation services from Hampton
Rehabilitation Hospital to newly-built facilities
at Kingston Centre in Cheltenham was
successfully completed. The move involved
a carefully staged transfer of patients,
staff and equipment.
This allowed closer integration between
rehabilitation and aged care services at the
Kingston Centre, where world-class
rehabilitation is now delivered, which would
not have been possible in the old facilities.
At Kingston a Sub-acute Service Plan,
Redevelopment Master Plan, Feasibility Study
and Investment Evaluation were completed.
These activities have paved the way for a
future major rebuilding program.
Primary Care
Within Primary Care capital improvement
plans were developed for all sites requiring
upgrade. Southern Health has committed to
relocating to a new facility in Pakenham with
the Shire of Cardinia.
Recruitment
and retention
Southern Health continues its success in
recruiting and retaining staff - an achievement
fundamental to realising our vision. Word of
mouth is our most powerful recruitment
method and we thank our staff for promoting
our organisation.
Recruitment to nursing positions remains
strong despite a global shortage of nurses.
The successful development of an active
nurse bank for example, provides 1548 more
shifts per month now than in the same month
just 2 years ago. This has reduced our
reliance on agency nurses, improved the
continuity of care provided to our patients,
and reduced the cost of casual staffing.
Page 8
World standard care
It was in part recognition of the excellence of
the standard of care we provide that Monash
Medical Centre was chosen as the site to care
for Australia’s first three, and several
subsequent, probable SARS cases.
Prior to the admission of these children, who
had recently arrived from Canada, Southern
Health had already developed and
implemented a SARS protocol. The children
were cared for in specially designed room,
under strict infection control guidelines.
The children were successfully discharged
after five days, with later testing excluding
them from having SARS.
Southern Health Information Systems
for the future
Southern Health has embarked on a series of major projects focused on
improving our Information Systems, and ensuring we are ready for the
Department of Human Services Information and Communication Technology
initiatives announced in the 2003/2004 State budget.
Preliminary planning for ten Project Teams has been undertaken by a Project
Enabling Group drawn from across Southern Health programs.
Team Leaders were nominated by the Senior Operations Group to represent
Program and professional interests across Southern Health. Project team
membership will reflect an information systems “user” as well as “supplier”
perspective.
Full network connectivity via radio links is now available to 95% of Primary
Care sites.
New Allied Health Director
A new position of Director of Allied Health for Acute Services was created.
This appointment enhances the development and integration of allied
health services, supporting Southern Health goals particularly strategic,
data and budget.
Primary Care expands role
The Primary Care Program successfully led the submission for service
expansions for the Hospital Admissions Risk Program (HARP).
Southern Health now has nine projects funded by HARP and these projects
aim to prevent unwarranted Emergency Department and inpatient
admissions. The projects focus on providing an improved continuum of care
for patients with chronic respiratory conditions, patients with chronic heart
failure, children with diabetes and people with alcohol and drug problems.
The Primary Care Program has restructured resulting in improvements in the
level of service integration, savings in management costs and an increased
ability to develop a more strategic approach.
Mental Health’s new model
The staff in the Mental Health Program have been working hard to meet a
significant increase in demands for both inpatient and community-based
services.
They have actively participated in the development and implementation of a
new service model which is based on available evidence of best practice.
This new service model will simplify entry into the service and patient access
to rehabilitation and continuing care.
We believe the process of developing the new service model was innovative
and the model will result in improved quality of care.
The Mental Health Program has also had the opportunity to take up new
Government initiatives in Primary Mental Health, Dual Diagnosis and Hospital
Admission Risk Program (HARP).
Page 9
LEADING IN INTEGRATED SERVICES
TO IMPROVE HEALTH STATUS
Southern Health is better placed than any Victorian Health Service to offer
truly integrated care.
Our goal is to make care seamless for our patients, residents and clients.
But to achieve this each level of care, from community-based through acute
hospital care and return to the community, we must work co-operatively and
be closely coordinated.
Many projects and processes are underway across our organisation to
achieve this aim.
Internal Review
In November, we held the first Hospital Demand Management Strategy
(HDMS) Internal Review.
HDMS is a Department of Human Services initiative for the development of
strategies to address problems of access to services in the major
metropolitan hospitals with emergency departments.
The focus areas include improving Emergency Department processes,
patient flow, preventing visits to the Emergency Department (by managing
patients more effectively in the community), and developing new models of
patient care.
Five teams reviewed more than twenty poster presentations of Southern
Health’s current HDMS initiatives. The review teams included members of the
Southern Health Executive, and representatives from the Monash Institute of
Health Services Research, Department of Human Services, and other
Metropolitan Health Services.
Hospital Demand Strategy
Southern Health has been funded for three major new projects for the
2003/04 financial year under the Department of Human Services Hospital
Demand Management Strategy. These include a specially-designed area for
behaviourally-disturbed patients at Dandenong Hospital and a new position
for coordinating patient access across Southern Health.
Page 10
Peak Flow
At Monash Medical Centre Clayton we have
obtained funding to implement an innovative
model of care for patients presenting with
respiratory disease.
This new model of care for respiratory
patients promotes early identification of those
with acute or acute on chronic respiratory
disease, enabling them to be fast-tracked
through or bypass the Emergency department
completely. We are now able to provide rapid
access to assessment, investigations, and
treatment by the Respiratory Medicine Unit
prior to admission to hospital or discharge to
the care of their General Practitioner.
Every year approximately 3500 patients are
admitted with a primary diagnosis of
respiratory-related disease, 80% of these are
admitted via the Emergency Department.
These patients are generally older with
conditions that tend to worsen suddenly but
which also respond to treatment.
Presentations for this group of patients tend
to peak in winter but many of them are
admitted several times throughout the year.
The Peak Flow initiative aims to change this
experience by providing additional care and
support to patients and their general
practitioners in the community which will
assist them to manage their condition better
thereby reducing the need for hospital
admission. Peak Flow will also streamline
access to hospital care when it is required.
Clayton Day Treatment Centre opens
A permanent Day Treatment Centre at Monash Medical Centre Clayton
opened in early October to improve patient access, assist elective surgery
and reduce pressure in the Emergency Department.
The Centre operates from 7am to 10pm, seven days a week.
It accommodates patients who require hospital treatment at Clayton but do
not need to occupy a multi-day inpatient bed or Emergency Department bay.
It also allows new flexible models of care to meet the changing clinical needs
of patients in a tertiary hospital. These new models are supported by
associated system and clinical practice changes to streamline patient care
and enhance the use of resources.
Rapid Assessment Medical Unit
(RAMS Ward) - Dandenong Hospital
This Unit was initially funded as a pilot study late in 2001/02, but continues
to attract funding and to provide outstanding acute medical and surgical care
for patients needing up to 48 hours of in-patient treatment. In the 12 months
up to June 2003, 504 patients have been treated.
Acute Medical Care Unit
This Unit was funded by Hospital Demand
Management and officially opened on
February 3rd, 2003.
The Unit is functioning as a new collaborative
model of intensive medical, nursing and allied
health for General Medicine patients who
present to Monash Medical Centre Clayton.
It incorporates streaming patients from the
emergency department into the unit,
as well as taking direct admissions from
the community.
The aim is to reduce the average length of
stay of medical patients by providing intensive
and timely multi-disciplinary care to patients.
Eighty per cent of patients stay less than
96 hours, and all patients are looked after
by same multi-disciplinary team.
The Unit admits patients within 4-6 hours
of attendance to the Emergency Department,
and includes elective admissions. It emphasizes improved communication both within the
Unit and with other areas and incorporates all
health disciplines in a multi-disciplinary team
located on the unit.
The initiative has been successful in reducing patient length of stay RAMS patients stay for almost 30% less time than similar patients
elsewhere in the State. RAMS enables the reduction of ambulance
bypass and long waits in Emergency.
Transition ward success
Dandenong’s Aged Transition Unit achieved much during its short duration.
The Department of Human Services funded the short-term opening of extra
beds to relieve pressure on emergency departments both at Dandenong
Hospital and Monash Medical Centre. The unit achieved great results
successfully relocating patients who were either awaiting residential care or
rehabilitation, and who otherwise would have continued to use acute care
facilities and beds.
New options for people awaiting
residential care
In recent years, if a patient was admitted to hospital and they required
placement either in nursing home or hostel, they would be transferred to an
interim care ward until a bed became available.
The delay in an interim care ward could be weeks or months, due to limited
community support available.
A new option called the Home Interim Care Program is now available through
the Rehabilitation and Aged Services Program and offers people the option of
spending their interim time at home with the support of services and families.
A case manager works closely with the patient and family to set up a
personal care plan which can include personal care, respite, nursing care,
physiotherapy, occupational therapy, speech therapy, dietician, podiatry and
other programs.
Page 11
Short stay surgery at Dandenong
HARP funding
The launch of the “Short Stay Surgery Without A Bed” project at Dandenong
Hospital aimed for a streamlined approach for patients requiring day case
surgical admission.
Southern Health was allocated $1.2 million
for 2002 by the Department of Human
Services under the Hospital Admission
Risk Program (HARP). The three successful submissions were “Care in Context”,
“Management of Chronic Respiratory
Conditions” and “Paediatric Ambulatory
Diabetes.”
A multi-disciplinary team including staff from Emergency, Operating Room,
Wards, Anaesthetics and the Surgical Programs designed a new process to
manage this patient group. Initiatives include developing new admission criteria
to facilitate fast-track service in Emergency and improved patient information.
The aim of the “Care in Context” initiative is to
help people manage chronic illness in their
long term living environment.
The “Management of Chronic Respiratory
Conditions” initiative aims to improve the
quality of life for patients with chronic
respiratory conditions and reduce their visits
to hospital.
The services under this program are provided
in a planned way across the hospitals or in
community health settings.
Monash Medical Centre officially opened
Victoria’s first Diabetes Ambulatory Care Unit,
catering predominantly for people who are
insulin dependent, in July.
It aims to reduce Emergency Department
presentations and hospital admissions for
diabetes education by providing quality
ambulatory care for new diagnoses and
individuals with unstable diabetes.
Emergency Departments
The Emergency Department Quality Management Team is the umbrella for a
number of quality initiatives within our Emergency Departments.
The team relies on the close involvement and commitment of Emergency
Department staff, Southern Cross Pathology, Victorian Imaging and our
Departments of Diagnostic Imaging and Obstetrics and Gynaecology.
Current initiatives include:
●
decreasing pathology turn-around-times, guideline development for
early and appropriate pathology testing, and nurse-initiated pathology;
●
nurse-initiated and fast track X-ray;
●
earlier pain management;
●
a Bereavement Program to improve care for bereaved families, friends
and staff;
●
first trimester bleeding pathway - evidence-based to ensure
“best practice”;
●
the timing of exercise stress testing for Emergency Department patients
and management of chest pain presentations are being reviewed;
●
surveying patient satisfaction;
●
assisting nurses collect information on trauma patients.
Page 12
Mental Health restructures
Surgery Achievements
Within Mental Health a new service model
and structure was developed and implemented. Work continues on further integration.
Funding has been provided for the Waiting List Enhancement Program to
develop a clinical review process for varicose vein surgery to be conducted
at Cranbourne Integrated Care Centre.
Primary Mental Health Teams are now
operating successfully, and the Dual
Diagnosis Team has integrated with South
East Alcohol and Drug Services.
A Fracture of Neck of Femur Program, mainly on the Clayton Campus but
also used at the Dandenong Hospital has significantly reduced length of stay
for these patients.
Primary Health reforms
Within Primary Care an executive restructure
was completed with efficiency savings and
greater integration.
Followed with the appointment of a Primary
Care Quality Improvement Coordinator and
development and implementation of Primary
Care Quality Plan and tracking tool for
recording of Quality activities.
The Program reviewed and upgraded
complaints management procedures, tracking
and benchmarking of complaints. The
Program also completed a major customer
survey which showed a very high level of
satisfaction.
A comprehensive review of the intake system
within Greater Dandenong, led to
recommendations for a global intake system
for Primary Care services.
Associate Professor Mark Frydenberg has been coordinating the
development of Cancer Surgery Service at Moorabbin Campus by
initiating a multi-disciplinary approach, foreshadowing the developments
in service planning.
A Regional Eye Centre at Cranbourne has been most successful providing a
Centre for day-case eye surgery for patients, not only within Southern Health
but within Bayside and Peninsula Health Services.
A Day Surgery Centre at Dandenong Hospital was developed adjacent to the
new West 3 Day Ward, increasing the efficiency of day surgery, with over 1,366
patients being managed from November 2002. This has allowed the general
surgery units to perform day laparoscopic cholecystectomy as a pilot study.
Laser Surgery for Prostate Disease has been introduced at Moorabbin
Campus increasing the efficiency of transurethral resection of the prostrate,
reducing length of stay and improving outcomes.
Most adult elective and emergency plastic surgery is now consolidated at
Dandenong Hospital, along with a significant amount of emergency paediatric
plastic surgery. The Plastic Surgery Unit also provides a service at Moorabbin
Campus in Reconstructive Breast Surgery and Head and Neck Surgery.
Page 13
Dandenong Dialysis Unit
Haemodialysis patients welcomed a new nine-chair satellite dialysis unit
in Dandenong. The service will be operational six days a week, with a total
of 36 patients.
Patients from the Dandenong area previously had to travel to other units
at Cranbourne, Berwick and Moorabbin, adding considerable travel time to
their treatment.
The unit is close to Dandenong Hospital in a fully refurbished free-standing
house, near to other medical amenities and public transport.
New rehabilitation service
for Kingston and Monash
A new community rehabilitation service opened adjacent to Monash
Medical Centre.
The service formerly based at Hampton Hospital, is now called Clayton
Community Rehabilitation Centre. It will offer a community-based
rehabilitation service for people living in the Cities of Kingston and Monash.
It aims to enable clients who are disabled, frail, chronically ill or recovering
from traumatic injury, to achieve and retain optimal functional independence.
Caring for you at home
The Hospital in the Home (HITH) program, which cares for people in their
own homes who would previously have required hospital admission,
increased activity over 50%.
The Cardiothoracic Hospital in the Home service at Monash Medical Centre,
Clayton allows suitable patients to be discharged home between days three
to day five post-operatively. Up to 60% of all cardiac surgical cases are now
discharged this way, creating much needed additional capacity.
HITH also extended its service into neonatal care.
Team supports pregnant women
with drug and alcohol issues
ADAPT is the Alcohol, Drug And Pregnancy Team based at Clayton campus
of Monash Medical Centre. It provides services for women who have issues
with alcohol and drug use throughout their pregnancy. The service was
established in response to the growing need for support that many pregnant
women from the south east needed for drug and alcohol abuse.
When ADAPT began there were some 30-45 clients seeking assistance with
their pregnancy. This year it will see approximately 110 women, who have
access to many health professionals, including obstetricians, two social
workers, two drug and alcohol workers and a psychologist. The unit also links
women to outside services, such as drug rehabilitation programs.
Alcohol and Drug Liaison
Approximately 20% of patients presenting to our emergency departments
have alcohol and drug problems. The new Alcohol and Drug Liaison service
is based at Monash Medical Centre Clayton and Dandenong Hospital and is
providing invaluable service. It also assists hospital clinical staff treat patients
with these problems.
Page 14
CREATING AND MAINTAINING EFFECTIVE PARTNERSHIPS
Southern Health depends on productive
and respectful partnerships with many other
organisations and individuals to achieve
its goals.
We work closely with Governments at
Federal, State and local levels to implement
policy. We interact closely with other health
service providers to ensure the best
possible use of resources. We continue to
work with Universities, research and teaching
institutions to extend the boundaries of
health knowledge.
Southern Health also seeks to encourage
community participation in key decisions, and
productively engages with the community at
many levels.
This commitment will be strengthened
following a Community Participation in
Action Forum in September. The forum
endeavoured to find effective ways to
include the community in key health issues,
and was the first of its kind to be held in
Australia. The forum included international
speakers who presented the important work
that has been undertaken in the United
Kingdom and the USA.
A Community Advisory Committee advises
the Board on key issues affecting health
service planning and delivery.
The Committee has developed a
Community
comprehensive
three-year
Participation Plan, which they review each six
months. The plan outlines several activities to
increase and enhance consumer and
community participation.
Recently,
the
Community
Advisory
Committee has provided advice on:
●
●
Acute services planning issues including
development of Casey Hospital in Berwick
and proposed changes to obstetric and
orthopaedic services;
Several documents including Cultural and
Linguistic Diversity Guidelines, Nursing
Care in Death and Dying Protocol and
Spiritual and Religious Belief in Death &
Dying Guidelines;
●
How to increase consumer representation
throughout the organisation; and
●
Development of the Annual Quality of
Care Report.
The Committee has also developed a Consumer and Community
Participation Policy and guidelines, endorsed by the Board in April.
They have established a web page within Southern Health’s Internet site
to provide staff, consumers and community members with information
about its role and members.
A 16-member Community Reference Group was appointed to advise on
aspects of the new hospital in Berwick and successfully recommended to
the Minister that it be called Casey Hospital.
Southern Health has also listened and responded to the information gained
through the state-wide Victorian Patient Satisfaction Monitor.
A Primary Mental Health Team Community Stakeholder Group meets
monthly, and a consumer/carer strategy for Primary Care is being developed.
In Mental Health a Consumer Satisfaction Survey was followed by an action
plans to address issues identified.
Celebrating cultural diversity
The Minister Assisting the Premier on Multicultural Affairs John
Pandazopoulos officially opened Southern Health’s Cross Cultural Awareness
Week at Dandenong Hospital on 11th October.
The week celebrated diversity, highlighting both the needs and the great
contribution of people of culturally and linguistically diverse backgrounds.
The Minister also launched Southern Health’s Cultural and Linguistic
Diversity Policy. The Cross Cultural Advisory Committee developed the Policy
with strong input from the Community Advisory Committee.
The importance of working with our diverse communities is highlighted with
figures from our Interpreting Service.
During 2002/03 Southern Health treated a total number of 45,558 people
from a diverse cultural and linguistic background whose preferred language
was other than English. This is an increase of 7.2 % from the previous year.
The top 5 languages were Vietnamese, Greek, Italian, Chinese and Arabic.
The Interpreting Service has provided approximately 29,000 occasions of
service to consumers of the acute, mental health, rehabilitation and aged care
programs - an increase of 31% from the previous year.
In partnership with other members of Southern Health’s Cross Cultural
Advisory Committee, interpreting services were involved in the development
of an Action Plan to work towards the implementation of Southern Health’s
Cultural and Diversity Policy.
This included the translation of our “Patients Rights and Responsibilities”
brochure into eleven languages and put on the Intranet for access by all staff
within Southern Health.
The Rehabilitation and Aged Services Program (RASP) recognized
the special needs of clients from diverse linguistic and cultural backgrounds,
and established an Ethnic Health Quality Sub-committee to advise the
RASP executive.
RASP also recognized the special needs of the veterans community by
establishing a Veterans Liaison Committee.
Page 15
Working with our Aboriginal communities
Music and beautiful handicrafts were a highlight of NAIDOC week
celebrations at Southern Health, which celebrated Aboriginal people’s cultural
heritage and contribution to Australian society. The 2003 theme of NAIDOC
was “children are our future”.
This universal theme fits well with our organisation too - as one of the largest
providers of children’s services in Victoria we are closely involved in trying to
give children the best chance for a healthy and fulfilling life.
We know that to be effective in this aim we also need to ensure our services
are responsive and respectful of the cultural needs of the significant Aboriginal
communities in our area.
Several initiatives demonstrated our commitment to working productively
with our Aboriginal communities.
The Greater Dandenong Community Health Service established an
integrated professional development program with the Dandenong
and District Aboriginal Cooperative. The project is funded by the Department
of Human Services and includes mentoring, coaching and training between
the two services.
The Service responded to increased needs and opened a half-day dental
service at its Thomas Street site for the Aboriginal community.
The introduction was strongly supported by the Dandenong and District
Aborigines Co-operative who have also provided practical assistance
through their health workers. The clinic will offer culturally sensitive services
and means Aboriginal people do not have to travel to similar outlets in Fitzroy
and Bairnsdale.
Cardinia Casey Community Health Service identified its local Aboriginal
community as the priority population for health promotion.
Liaison with Bunurong Aboriginal Cooperative & Health Service has resulted
in a new collaborative approach. A health promotion project has begun to
improve access to services, and to improve the cultural appropriateness of
services and projects delivered to Aboriginal and Islander people living within
the City of Casey.
Cardinia Shire move
The Cardinia Casey Community Health Service will relocate to the new
Cardinia Shire civic centre. Under the move, the amount of space for
community health will almost double.
The Shire has factored in the space required for the health centre in the
current design for its new civic centre in the heart of Pakenham.
Residents will have much better access to a wide range of services,
including community health, drug and alcohol services, community
rehabilitation, Hospital in the Home, community mental health, a dental clinic
and family day care. As well, there will be acquired brain injury
services, post-acute care, early childhood community mental health,
case management, a GP clinic, pathology and private consulting.
This is a major step forward for the Casey and Cardinia community, as local
government and the health system work together in the interests of residents.
Page 16
Productive partnerships
SECASA web site
Southern Health worked productively and
creatively with many other organisations to
help improve the health status of the
Some of the
communities we serve.
highlights included:
The South East Centre Against Sexual Assault (SECASA) provides services
within the Southern Metropolitan Region to children and adults, both female
and male, who have been sexually assaulted.
Infection surveillance
In February SECASA’s web site was named the Victorian State Winner of the
Crime and Violence Prevention Awards for Major Technological Innovation
and Design. The award was presented by the Minister for Police and
Emergency Services the Honourable Andre Haermeyer.
Southern Health’s Infection Control Unit
joined with others across the State to survey
infections across a range of surgical
procedures, which will allow both national and
international benchmarks to be established.
The Centre also works with non-offending family members, partners,
caregivers and support workers.
It has continued to be extremely well used, with people from all over the
world, but particularly from South East Asia accessing the site.
“Health for Kids” Project
Preventing sexual abuse
This is a cross-sector project involving
hospital, general practice, community and
local government agencies to develop
optimum services for children in the south
east following evidence-based guidelines.
The Southern Sexual Abuse Counselling Prevention Program, which aims to
prevent sexual abuse in Melbourne’s south, achieved success. The program
is funded by Southern Metropolitan Region of the Department of Human
Services and involves cognitive behavioural therapy for adolescents who
engage in sexually abusive behaviours. The program provides risk
assessment, group and individual therapy and family counselling.
A Child and Adolescent Mental Health
Conference was held at Monash Medical
Centre for consumers, health, welfare and
education personnel. Stimulating workshop
presentations included early intervention
strategies in infant mental health, chroming,
classroom management of children with
ADHD, and risk in addressing self-harming
behaviours.
Training is also provided for foster and residential care workers who care for
children and young people who have been assaulted or who are engaging in
sexually aggressive behaviours. Research shows that untreated sex
offenders commit multiple offences over their lifetime, and the majority of sex
offenders begin their offences in adolescence.
This program is a joint initiative of the Children’s Protection Society, which
runs a similar program in the Northern Region and SECASA, a Southern
Health service offering a 24-hour crisis service for victims of sexual assault.
A Survivors Guide to P Block
New bus for homeless youths in Dandenong
A unique video for patients of the psychiatric
inpatient unit at Monash Medical Centre
Clayton was launched recently to help patients
understand the functioning of the unit and the
support available to them in a patient-sensitive
manner. It was developed and scripted with
input from consumer consultants and
managers of the mental health service, and
coordinated by consumer consultants
Ms Jude Stamp and Mr Scott Findlay.
New project supports carers
of the mentally ill
Carers looking after the mentally ill will have
access to vital information and links through
an innovative new program. The Mental
Illness Carer Advisory Link offers carers
access to timely and relevant information to
assist them in their role of caring for people
with mental illness. The initiative is a
partnership between Southern Health,
Southern Mental Health Association and the
Carer Respite Centre, Southern Region.
Staff from Greater Dandenong Community Health Service are part of a new
outreach bus to help homeless youths. The Green Cross Outreach Bus runs
throughout the Greater Dandenong area offering vital health services to young
people in need.
Southern Health workers and volunteers include nurses, youth, social, and
health workers who will ensure young people have access to people from a
variety of disciplines.
The project is the idea of the Military and Hospitaller Order of St Lazarus of
Jerusalem that had its origins in a leper hospital during the fourth century AD
and whose aim is to help the outcast and disadvantaged members of society.
Raising awareness of mental health
The Schools Mental Health Awareness Project is a joint initiative between the
Southern Adult Mental Health Service (Dandenong) and the Eastern Regions
Mental Health Association.
Schools involved this year were Dandenong (the winner), Noble Park,
Springvale and Eumemmerring Secondary Colleges. The competition follows
a series of mental health sessions held in six secondary schools Dandenong, Noble Park, Springvale, Eumemmerring, Pakenham and Koo
Wee Rup - with year 11 students studying psychology. Over 200 students
took part in this segment of the project.
Page 17
Fundraising and Community Support
As a public health service, Southern Health receives generous donation and
sponsorship support from patients (past and present), community service
organisations and clubs, auxiliary groups and corporate partners, amounting
to $1.4 million in donation income in the past year.
This support assists us to enhance and develop our services, including the
purchase of new medical equipment, the refurbishment of patient
accommodation and clinical areas and the expansion of clinical programs.
Recognising the benefits that more of this support can bring the
organisation, the Southern Board this year appointed a new Development
Director to the expanded Public Relations and Fundraising Department,
whose task it will be to develop and implement a strategic fundraising plan
that will deliver a growth in this income and community support.
Initial key areas of focus for our new Fundraising Team have been:
●
the development of grant funding submissions to numerous charitable
trusts and foundations;
●
the development of relationships with the local business community and
major corporations;
●
the introduction of some new community event fundraising initiatives;
●
the production of new printed promotional material and the
implementation of a new donor management information system.
Fundraising highlights have included:
●
the acquisition of a number of items of equipment for the Intensive Care
Unit at Monash Medical Centre through the charitable trust sector;
●
the securing of further philanthropic funding to assist in the renovation
and redevelopment of temporary respite accommodation facilities at
Monash Medical Centre;
●
raising valuable funds to support the Greater Dandenong Community
Service’s Youth Program initiative “Sports For All”, which engages at-risk
youth in positive sport and recreational activities;
●
the development of an evolving fundraising event calendar, which now
includes a community based Walk/Run health promotion, a Corporate
Golf Day, an annual BBQ fundraising event and a proposed Southern
Health Race Day, in association with a prominent Victorian racing club;
●
the procurement of seed funding for a scoping study into the
future establishment of an adolescent eating disorders day centre for
Southern Health;
●
support funding for a new Diabetes Ambulatory Care Unit, which enabled
the purchase of several pieces of diagnostic equipment and educational
resource material.
While being responsive to the emerging needs of the organisation, Southern
Health’s fundraising team will be focusing much of its efforts on capital
projects in the immediate future including securing corporate and community
support for a major expansion its paediatric services, the development of
cancer services at Moorabbin and supporting the opening of the new Casey
Hospital in Berwick.
Southern Health acknowledges the generous support of our auxiliary and
support agencies, corporate partners, community groups, services clubs and
philanthropic bodies who have assisted our fundraising efforts throughout the
past year. We look forward to a continuation of this support to further
strengthen and enhance our many health services.
Page 18
Our dedicated supporters
Southern Health received a total of $87,045
from its Central Council of Auxiliaries in May.
The money was raised by seven auxiliaries
based at Dandenong Hospital and Monash
Medical Centre and was used to purchase
medical equipment. Professor Capp
congratulated the auxiliaries for their tireless
support to Southern Health.
A further $17,506 was raised during the year
by the KOALA and Monash Kids support
groups. Both groups assist young patients at
Monash Medical Centre.
Volunteers at Monash Medical Centre worked
a total of 20,716 hours during the year.
A Volunteer Appreciation Day was held at
Rupertswood, a grand mansion in Sunbury, to
thank them for their continued support to the
medical centre.
Cath Heib and Jim Stewart were given
Monash Medical Centre Volunteer Awards
during the event. More than 120 volunteers
saw Jim and Cath receive their awards.
Thirtynine other volunteers also received
long service badges representing 515 years
of service.
Volunteers from the Kingston Centre and
Dandenong Hospital were presented long
service badges at Rupertswood on other
appreciation days.
Volunteer Services at Monash Medical Centre
started two new programs at the Clayton
Campus which offer unique opportunities for
volunteers. The Hug A Bub and Junior
Volunteer Program were launched in June.
The Hug A Bub program is being run in the
Special Care Nursery in NICU where a select
team of volunteers assist parents and staff.
Their core duty involves cuddling babies born
with neonatal abstinence syndrome.
When Hug A Bub was being launched at
NICU, the Junior Program was beginning in
the Children’s Ward. Four students from
Avila College arrived to do 20 hours of
community work on the ward. The Junior
Program is being offered to a limited number of
students who are involved in various
community work initiatives.
at
Dandenong
Hospital
Volunteers
contributed 11,890 hours towards enhancing
patient care and providing services which
complemented the efficient running of the
Hospital’s day-to-day activities.
Many of the hospital’s volunteers work in the Kiosk/Gift Shop where they
contributed 7,540 hours. Other areas include Patient Library Service, Floral
Ladies, Patient Services, Children’s Ward and Emergency Department.
The Dandenong Hospital Ladies’ Auxiliary continued their fundraising
activities with bus trips, raffles, trading tables and hospital stalls - the proceeds
all contributing to the purchase of new equipment.
Carmella Grynberg joined us as the new volunteer coordinator at
Kingston Centre.
The volunteer program at the Kingston Centre has 86 volunteers on its
register. The volunteers assist in the Nursing Home Wards, Eastwood Hostel,
Rehabilitation Wards, Aged Persons Mental Health Program, Gift Shop,
Opportunity Shop and in the Pastoral Care Program.
Over the last year a concerted effort has been made to recruit more
volunteers who wish to work directly with residents and patients either during
organized activity sessions or by visiting at other times for a welcome chat or
walk in the gardens.
A monthly newsletter is circulated to all volunteers each month and every six
weeks a Volunteer Meeting is held. The meetings are a way for volunteers to
get to know each other, to debrief and also to update their knowledge as a
guest speaker from a variety of disciplines is invited to address the volunteers
at each meeting.
Many other dedicated supporters provide their time throughout our Primary
and Mental Health Programs.
Page 19
Research leads the way
Southern Health remains a leading research organisation.
There is an enormous amount of research being conducted across the
organisation, in this year 189 research projects were approved. The research
projects vary across the disciplines from allied health to medicine and surgery.
Southern Health maintains strong ties to other leading research
institutions including the Monash Institute of Health Services Research,
Monash Institute of Reproduction and Development and Prince
Henry’s Institute of Medical Research.
There are four Human Research Ethics Committees (HREC’s) at Southern
Health, two are based at Monash Medical Centre, and one at Dandenong
Hospital and Kingston Centre respectively. At Monash Medical Centre, 165
projects were approved, 87 across Medicine and Surgery, and 78 in
Paediatrics, Psychological Medicine and Clinical Nursing. At Dandenong
Hospital there were 17 projects approved. Dandenong’s HREC approves
projects relating to all areas of research, however they are largely vascular
medicine, mental health, general medicine, general surgery, children’s and
women’s health. At Kingston Centre, there were 7 research projects
approved in the field of aged care.
A number of clinical trials were approved in the last year. The majority of
clinical trials were sponsored by a drug company with the remainder being
investigator driven and grant-based funded clinical trials. There were drug
trials ranging from Phase I studies where the drug has not been tested on
humans before, through to Phase IV studies where a drug is being evaluated
for its safety and efficacy.
Much has been achieved this year in the area of nursing research with a
strong research culture now developing.
Nursing research has primarily focussed on the impact of nursing
interventions on patient outcomes; workforce issues, including workplace
perceptions and models for learning and supervision; and collaborative
research with university partners and/or inter-disciplinary colleagues.
Bright future ahead for maternity services
A study which paves the way for enhanced communication between
clinicians and pregnant women was launched at Monash Medical Centre
during the year.
The largest ever evaluation of Maternity Services Program initiatives found
postnatal care in hospitals has clearly improved.
The evaluation of maternity service changes at Southern Health and
Sandringham Hospital saw 2,200 mothers take part in the study funded by
the Department of Human Services.
The collaborative project was conducted by La Trobe University’s Centre for
the Study of Mother’s and Children’s Health, Southern Health, and
Sandringham Hospital.
The evaluation found women were better prepared for their time after birth,
with positive responses to newly-written information and midwife discussion
visits during pregnancy.
Page 20
DEVELOPING ORGANISATIONAL COMPETENCIES
We depend on the experience and expertise
of the people who work for us to deliver the
highest quality care.
We are striving to create an organisation that
values and supports its staff, and we are
making great progress towards that goal.
The last twelve months saw significant change in Southern Health Human
Resources, which underwent an all-encompassing review of the scope of services,
structure and strategy.
This resulted in a strategically-focussed
Human Resources service delivery model and
organisational structure aligned with the
needs of the business of Southern Health.
The new model and structure emphasises
a three-pronged approach focussing on
Human Resources Services, Strategy and
Client Interface.
A significant number of activities were
undertaken that have positively impacted on
services to the organisation and to key clients
and stakeholders.
Some of these activities have focused on
building a strong performance culture,
and include:
●
●
●
●
●
Endorsement of an overarching Performance Management Strategy;
Implementation of a 360-degree performance evaluation system for all Managers;
Refinement and implementation of an
Executive and Senior Management
performance planning and management tool;
Development and trial of a “Balanced
Scorecard” Performance Appraisal Tool
for Senior Medical Staff, this is currently
being translated into an electronic tool
and will be rolled out during 2003. A grant
has been awarded by the Victorian Office
of Public Employment to develop a “tool
kit” to support this project;
Development of a generic performance
appraisal tool for Managers and staff;
●
A “Fast Track” Diploma in Management
program in partnership with the University
of Ballarat;
●
An Emerging Leaders Program
Other activities include the development of a Staff Health strategy and
framework which is to be progressively implemented through 2003/04.
A restructure within the Workplace Health area and a shift in the reliance on
external rehabilitation providers has resulted in improved claims management
and rehabilitation processes to ensure smoother and better quality of service
as well as significant cost savings in the WorkCover insurance premium.
The roll out of the BackSafe program at Dandenong Hospital has been
completed and the program is being implemented at all other sites.
There has also been considerable emphasis on recruitment and retention
strategies in Nursing, and developing further strategies for other areas such
as Allied Health.
Nurse Unit Manager Leadership Program
Southern Health recognizes the critical role played by Nurse Unit Managers
(NUM’s). This year our investment in this key group included the development
and implementation of a Leadership Program developed specifically for Nurse
Unit Managers at Southern Health.
The program, requiring attendance one day per fortnight from January to
May 2003, brought together our ninety NUM’s from across our organisation community, aged, mental health and acute - and Southern Health’s Nurse
Executive, who facilitated the program.
Enormous energy was generated and many proposals from the Nurse Unit
Managers will be put into action.
Page 21
Developing medical leadership
Infection control
Over the past 18months a Registrars Professional Development Program
developed to promote professionalism, provide support and develop
leadership skills among Medical Registrars. This exciting initiative recognizes
the significant role Registrars play in both the care of patients and also their
critical, but previously under-acknowledged leadership and teaching roles.
A revised and improved occupational
exposure protocol included the education
and training of more than 60 senior clinical
nurses in occupational exposure coordination.
This provides 24 hour cover for each shift and
site, 7 days a week, to manage issues relating
to occupational exposure. Support is available
from the Infectious Diseases unit 24 hours
per day should additional treatment, advice or
counselling be required.
Medical registrars are required to multi task in a demanding role at a relatively
early stage in their careers. They are the providers of care, important
communicators to patients and family, teachers to students and residents,
and vital communicators with nursing and allied health staff.
The program focuses on professionalism, leadership and self-awareness
with components including team work, conflict management,
time management and teaching skills. With the vital assistance of an
external consultant with a background in healthcare and significant
expertise in leadership and management training the course also
endeavours to provide perspective, career counselling and support.
Safety and Quality Projects
In October 2002 the Australian Council for Safety and Quality in Health Care
agreed for the second year to provide funding for innovative and practical
projects that would provide demonstrated improvements in patient safety.
Southern Health received grants for three projects. These are:
●
Maximising team performance in critical events utilising high fidelity
simulation – Simulation Centre at Monash Medical Centre Moorabbin;
●
A follow-up program based on consumer consultation to improve
compliance with self-management regimes for young people with cystic
fibrosis – Physiotherapy at Monash Medical Centre Clayton;
●
Educational video series in several languages for patients receiving
chemotherapy to promote self-help concepts and early reporting of
complications – Day Chemotherapy at Monash Medical Centre
Moorabbin.
Dandenong Hospital Education Centre
The Minister for Employment, Gaming, Tourism and the Minister Assisting
the Premier on Multicultural Affairs, the Hon John Pandazopoulos officially
opened the Dandenong Hospital Education Centre. The centre includes
a Lecture Theatre, four seminar rooms, a clinical training room and a library
featuring the latest audio visual technology.
Primary Care Conference
During the year the Primary Care Program conducted a Primary Care
Conference showcasing clinical and organisation achievements.
A comprehensive staff satisfaction survey was completed resulting in a
detailed report and action plan. The Program also established an
Occupational Health and Safety Committee and developed a risk assessment
audit tool to address issues pertinent to Primary Care.
Page 22
The pathology laboratory provides rapid
processing of specimens as occupational
exposures such as needlestick injuries are
treated as a medical emergency. This enables
staff to be treated promptly with preventative
medication if required. Issues related to safety
can be addressed at the time of the exposure.
This is aimed at avoiding recurrence of an
incident if appropriate.
Social Work
Social Work was involved in a six sigma
project to improve quality and timeliness of
residential care placement. There has already
been a reduction in the steps required,
sharing of knowledge, development of
information technology and identification of
further potential improvements. There have
been significant reductions in time taken to
transfer people to residential care across the
health service.
Enlightening
Geriatricians about
Parkinson’s disease
Late June saw the Annual Scientific Meeting
of the Australian Society of Geriatric Medicine
in Melbourne. The focus for the meeting was
“Changing Perceptions in Ageing” and was a
wonderful success. A highlight of the meeting
was the interactive visit to the Kingston Centre
where Professor Robert Iansek, Professor of
Geriatric Neurology together with research
physiotherapist Jenny McGinley, provided an
exciting presentation, exploring our gait
laboratory and its applications.
Effective management of anaesthetic crises
The Southern Health Simulation and Skills Centre began a course that is now
a requirement for specialist anaesthetist training. The course, Effective
Management of Anaesthesia Crises (EMAC), is directed at anaesthesia
trainees to enhance the management of crises encountered as part of
anaesthesia practice, and will be conducted three or four times a year
according to need. The centre developed the course in conjunction with the
Simulation Centres in Sydney and Wellington and the Australian and
New Zealand College of Anaesthetists.
Psynet team
The much-awaited Psynet team (Psychiatric Nursing Education Team) is now
on board at Southern Health and has hit the ground running. The team is a
result of an enterprise bargaining agreement and their purpose is to assist
nurses at Southern Health to recognize and attain a standard of psychiatric
nursing excellence. They believe that this can be achieved by the facilitation
of training, education and clinical supervision.
Evidence-based nursing practice workshop
Approximately 50 clinical nurses and other health professionals attended a
workshop on Evidence-Based Practice at Monash University Peninsula
Campus. The Centre for Health Services Operations Management presented
the workshop in conjunction with Southern Health and Peninsula Health.
Security responds
Southern Health’s Security Services introduced several initiatives to provide
a better service. Additional security resources are now located within the
Emergency Departments at Clayton and Dandenong during peak periods.
Computer software was upgraded for the security management system and
our monitoring and recording capability at both Dandenong and Clayton.
A 24-hour Security presence and upgrading of car parking at Kingston Centre
enables greater flexibility and control over access and egress at that site.
A Security Operations Coordinator has also been appointed.
Honouring our long-serving staff
Years of dedication and commitment to our organisation were celebrated
at Dandenong Hospital, Monash Medical Centre and Kingston Centre
when several hundred staff members were recognized for their long service.
Site management praised and thanked the long-term commitment of the
staff members who had collectively dedicated over 3000 years of service
to the hospitals. They were presented with long service medals at an
afternoon tea ceremony.
Page 23
Queen’s Birthday Honours
Two of our eminent Senior Medical Staff, Associate Professor Michael
Adamson, AM, and Professor Bob Atkins, AM were recognize in the Queens
Birthday Honours. Both have long and distinguished careers with Monash
Medical Centre and its predecessor hospitals.
Associate Professor Adamson was awarded a Member of the Order of
Australia for his work in neonatal paediatrics and medical research, whilst
Professor Atkins received his for medicine, particularly nephrology.
Professor Atkins completed his Presidency of the International Society of
Nephrology (ISN) which culminated in the ISN meeting in Berlin.
Dr Flanagan chairs international meeting
Dr Brendan Flanagan, Medical Director of Southern Health’s Simulation and
Skills Centre, was appointed the Program Chair of the International Meeting on
Medical Simulation. The conference, held in San Diego, California, is the
premier meeting on patient mannequin-based simulation in the world. This is
the first time anyone from Australia has been asked to undertake this role and
highlights the credibility the centre has attracted since its inception.
Leading the way
Hospital Liaison Officer, Helen Bnads, completed one of the most inspiring
years of her life as part of the highly acclaimed Williamson Community
Leadership Program. She graduated in November after what was a unique
year of leadership broadening experiences.
The Williamson program attracts some of the most influential up-and-coming
leaders in Victoria. The aim is to assist in developing and enhancing the quality
of these leaders by building relationships characterised by respect, trust and
understanding.
Carolyn Worth, Coordinator of the South Eastern Centre Against Sexual
Assault, was awarded a Williamson Foundation Victorian Leadership award.
Shannon is a true professional
Shannon Wight Nurse Unit Manager of Monash Medical Centre’s 54 North won
the prestigious VHA annual True Professionals Award for 2002. The award is for
individuals working in the healthcare industry who have demonstrated sustained
and outstanding professional achievements, exceptional quality service,
leadership, exceptional human qualities and successful mentoring of other staff.
Keeping older drivers safe
Neuropsychologist Marita Flynn was awarded an RACV annual Sir Edmund
Herring Memorial Study Grant for research into brain impairment and its effects
on driving behaviour in older drivers. Ms Flynn works as a clinical
neuropsychologist within the Aged Persons Mental Health Service at the
Endeavour Hills Campus, and is a qualified driving instructor.
Diabetes Grant
Monash Medical Centre is amongst ten of the nation’s leading medical
research centres that will further their work in the understanding and
management of diabetes thanks to the $170,000 Eli Lilly 2003 Endocrine
Research Grant Program. Diabetes educator Emma White was one of the first
recipients in a new category of awards specifically for Diabetes Nurse
Educators. Emma and her team at the Paediatric Diabetes and Endocrine Unit
will measure improvements in glycaemic control that can be achieved through
the use of a continuous blood glucose monitoring system in young people with
poorly-controlled type 1 diabetes.
Page 24
Dietetics
A specialist Gastroenterology nutrition
textbook was written by two department staff
members and will be sold nationally. Sue
Shepherd was awarded the Dietitians
Association Australia annual national award
for achievement for her work in the area of
Coeliac disease, whilst Caitlyn Green won the
branch service award for work in professional
education.
Interpreters
In order to raise the awareness of staff
members of Southern Health on cultural
issues and to maximize the efficient use of the
Southern Health’s Interpreting Services, a
training program began. In addition,
Interpreting Services are working with the
Quality Unit towards the development of
performance indicators to measure the
effective use of the interpreting services.
OUR COMMITMENT TO IMPROVE QUALITY
Southern Health is committed to providing
integrated and high quality care that improves
the health status of our community. Our
commitment to clinical excellence is based on
the belief that even the very good can be
better. To continually improve we must identify
problems and weaknesses as well as
acknowledge areas of improved performance.
Our quality improvement framework clearly
identifies those responsible for improving
performance and includes a systematic
approach to monitoring the quality of care
provided to our consumers.
Improving the quality of care is aided by
performance data that identifies opportunities
for improvement and evaluates the
effectiveness of change. We use a systems
approach to delivering care with a range of different mechanisms in place to
measure key processes. These help us to identify groups for whom we
should improve the quality of services such as improving communication with
culturally and linguistically diverse consumers across our service. Southern
Health has implemented a Community Participation Strategy, supported by
our Community Advisory Committee, to ensure all areas of the organisation
have specific targets in relation to involving consumers and community
members. The six-monthly review of the Community Participation Strategy
demonstrates significant achievements. For example, a community-based
dialysis service commenced in Dandenong this year in response to a
consumer identified gap in dialysis services.
At Southern Health, clinical staff and the Board use a range of measures,
known as quality indicators, to monitor the quality of care. Quality indicators
measure what health professionals do and what happens to consumers from
admission to discharge and into the community. To ensure that our systems
for monitoring quality are comprehensive and balanced, we use a range of
quality indicators for each of the Victorian Government’s care dimensions.
Page 25
Monitoring Quality
In recent years Southern Health has focused on developing systems to
collect quality indicator data so that we can efficiently identify areas requiring
our attention and evaluate the effectiveness of actions to improve quality. A
variety of methods are used to collect this important data. They include:
●
Checking consumer status. For example, our Infection Control Team
regularly reviews surgical wounds for signs of infection;
●
Reviewing consumer medical records after discharge for events that may
be linked to hospital system deficiencies and contribute to poor
consumer outcomes;
●
Auditing compliance with quality systems and processes. For example,
we check that assessment and treatment activities known to reduce the
incidence and severity of pressure ulcers are completed;
●
Collecting consumer feedback and participating in consumer satisfaction surveys;
●
Reporting incidents every time something out of the ordinary happens.
problems. In addition to our internal review of
quality indicator results, we provide our quality
indicator results to the Victorian Government
and participate in other benchmarking
programs that compare our results with
similar hospitals and services. Every six
months we submit results to the Australian
Council on Healthcare Standards and
compare our results with a wide range of
Australian hospitals.
We also participate in external accreditation
programs, which involve teams of independent
health care experts reviewing the quality of
services and measuring our performance
against best practice standards. Southern
Health’s acute, sub-acute, mental health and
primary care services are accredited by the
Australian Council on Healthcare Standards
and our residential aged care services are
accredited by the Aged Care Standards and
Accreditation Agency.
Whilst our staff pride themselves on striving to
deliver the best possible care, at times the
organisation of that care can seem fragmented
and discontinuous from a consumer’s view.
Consumers talk to us of their concerns: poorly
sequenced services, increased waiting times
for services, cancellations, duplication and
misunderstandings.
In recent times we have started to use
consumer journeys as a way to improve our
understanding of how consumers experience
our care processes and where we can act to
improve their experience.
Whilst several systems now exist for collecting and reviewing quality indicator
data, we believe that these systems can be better. Feedback from staff and
consumers help us to determine whether the data we collect is meaningful
and useful. We have recently identified opportunities for system improvement
including the need to:
●
Change our incident reporting system to increase our understanding of the
medications that are more likely to be associated with a medication error;
●
Review systems and committees involved in monitoring medication errors
to develop a coordinated and comprehensive program for reducing
medication errors;
●
Increase the level of consumer feedback by enhancing the education of
staff and consumers about our complaints management system.
Quality indicator results are reviewed regularly by several internal quality
committees and reports are provided to the Board. These reports highlight
the areas requiring our attention and outline the plans for addressing
Page 26
We participated in the acute to sub-acute
patient flow collaborative, a process
supported by the Department of Human
Services which engaged agencies from
across the state in examining and trialing
improved patient journeys across the acute to
sub-acute hospitals.
“Journeys in Health”, Southern Health’s
Quality of Care Report 2003, highlights our
achievements but also identifies opportunities
for improvement and areas requiring our
ongoing attention. It is designed to show staff,
consumers and our community that providing
high quality care is pivotal in assisting
Southern Health achieve its vision.
If you would like to know more about quality
at Southern Health, our quality of care
report is available through the Quality Unit or
on 9594 2712.
SUMMARY INFORMATION
Page 27
ORGANISATION STRUCTURE: ROLES & RESPONSIBILITIES
Chief
Executive
Directors
Clinical
Services
Director
Strategy &
Innovation
Director
Director
Infrastructure Operations
Clayton
(Chief Medical Officer)
(Chief Nursing Officer)
Program
Directors:
Medical
Specialty
Surgery
W&C
Critical Care
Clinical
Support:
Imaging
Pathology
Pharmacy
Allied Health
Infection
Control
Clinical
Education
& Research
Director
Operations
Dandenong
Office of the Chief Executive:
Director
Operations
Casey,
Moorabbin &
Cranbourne
●
PR
●
Internal audit
●
Organisational performance
●
Quality
●
Corporate Counsel
Director
Director
Primary Care Rehabilitation
& Mental
& Aged Care
Health
Responsible for:
Director
Finance &
Corporate
Services
Director
Human
Resources
Responsible for:
●
Planning
●
Operational support
●
Strategy
●
Information services
●
Resource allocation
(activity & budgets)
●
Finance
●
Payroll
●
Service integration
●
"Hotel" services
●
Quality
●
Staff appointments
●
Staff rotation
●
Info specification
●
Innovation
●
Infrastructure
●
Research
●
Professional
development
●
Advocacy
Page 28
Operational units
accountable for:
●
Day-to-day operations
●
Staff development
●
Meeting activity targets
●
Management training
●
Meeting budget
●
Staff performance
management
●
Staff rostering
●
Access & discharge
●
Coordination of site
activities.
MANAGEMENT
Senior Executive
Southern Health Corporate Executive
Prof Stan Capp
Rehabilitation & Aged Services Program
Chief Executive
Prof Barbara Workman
Medical Director
Dr Syd Allen
Ms Jill Peterkin
Nursing Director and Kingston Site DON
Chief Medical Officer
Medicine Program
Ms Kim Sykes
Associate Prof Richard King
Medical Director
Chief Nursing Officer
Ms Sharon Wood
Nursing Director
and Moorabbin Site DON
Mr John Stanway
Director, Operations, Clayton
Dr Lakshmi Sumithran
Women’s & Children’s Program
Dr Caroline Clarke
Medical Director
Dr Michael Wilson
Nursing Director and
Director Nursing Education and Research
Director, Operations, Dandenong
Mr Peter Faulkner
Director, Rehabilitation
and Aged Care Services
Director Operations Casey Hospital,
Cranbourne and Moorabbin
Dr Bill Shearer
Medical Director
Ms Kym Forrest
Nursing Director and Clayton Site DON
Ms Robyn Batten
Prof Julian Smith
Medical Director
Director, Primary Care and Mental Health
Ms Marguerite Abbott
Nursing Director and Dandenong Site DON
Mr Michael Sammells
Surgery Program
Director, Finance and Corporate Services
Associate Prof Bruce Waxman Medical Director
Ms Christine Fitzherbert
Specialty Program
Ms Shirlee Graham
Nursing Director, Cranbourne
and Casey Hospital DON
Director, Human Resources
Dr John Morris
Prof Saji Damodaran
Clinical Director
Director, Infrastructure
Acute Allied Health
Mr Michael Robinson
Ms Sue Blake
Director
Director, Strategy and Innovation
Finance
Mr John Snowdon
Mr Tim Hogan
Deputy Director
Corporate Counsel
Director of Information Services
Office of the
Chief Executive
Mr Peter Corrigan
Internal Auditor
Ms Jane Miller
Manager, Quality
Mr Andrew Williamson
Manager, Public Affairs
Dr Andrew Rothfield
Chief Information Officer
Jessie McPherson Private Hospital
Ms Wendy Cameron
General Manager and DON
Diagnostic Imaging
Dr John de Campo
Director
Southern Cross Pathology
Prof Stewart Bryant
Director
Page 29
LEGISLATIVE FRAMEWORK
By Government Gazette Notice dated 1 July 2000 the Governor in Council,
on the recommendation of the Minister for Health, established Southern
Health as a metropolitan health service. Southern Health acquired all the
assets and liabilities of the former Southern Health Care Network save for
those asset and liabilities associated with the former Sandringham Hospital
campus and the Monash Link Community Health Centre. Metropolitan health
care networks of which the Southern Health Care Network was one were
disaggregated on 1 July 2000. Southern Health is incorporated as a
metropolitan health service under the provisions of the Health Services Act
1988 as amended.
Board of Directors
The Board of Directors of Southern Health is appointed by the Governor in
Council on the recommendation of the Minister for Health in accordance with
the Act. The Minister is required under the Act to ensure that the Board
includes at least one person who is able to reflect the perspectives of users
of health services and that men and women are adequately represented.
The functions of the Board of Southern Health are:
●
To monitor the performance of Southern Health;
●
To oversee the management of Southern Health by its Chief Executive;
●
To monitor the performance of the Chief Executive;
●
To develop strategic plans for the operation of Southern Health;
●
To develop plans, strategies and budgets to ensure accountable
and efficient provision of health services by Southern Health and the long
term financial viability of Southern Health;
●
To establish and maintain effective systems to ensure that the
health services provided meet the needs of the community served
by Southern Health and that the views of users of health services are
taken into account;
●
To ensure effective and accountable systems are in place to monitor
and improve the quality and effectiveness of health services provided
by Southern Health;
●
To ensure that any problems identified with the quality and effectiveness
of health services are addressed in a timely manner and that Southern
Health strives to continuously improve quality and foster innovation;
●
To develop arrangements with other health care agencies and health
service providers to enable effective and efficient service delivery and
continuity of care;
●
To establish the organisation structure including the management
structure of Southern Health;
●
To appoint a person to fill a vacancy in the position of Chief Executive;
●
To establish a Finance Committee, an Audit Committee and a Quality
Committee and other Committees to assist it in carrying out its functions;
●
To facilitate health research and education and any other functions
conferred on the Board by or under the Act;
●
The Board must also appoint at least one Community Advisory
Committee and must appoint a Primary Care and Population Health
Advisory Committee under the Act.
Page 30
Board Committees
Audit Committee
The role of the Audit Committee is to advise
the Board of Directors on audit matters
and matters relating to the financial,
accounting and legislative compliance and the
operational effectiveness and efficiency of
Southern Health. The Committee also advises
the Board on the level of business risk or
exposure that Southern Health might be
subject to.
Finance Committee
The role of the Finance Committee is to
advise the Board of Directors on matters
relating to the use of financial resources by
Southern Health.
Quality Committee
The goal of all quality activities is to ensure
that patients/clients receive the best possible
care and that their safety, and that of staff,
is protected. The Quality Committee advises
the Board of Directors on the service
standards achieved by all areas of Southern
Health’s operations; on appropriate reporting
of achievement against standards and
indicators; on structures and systems to
support and improve service quality; and on
measures to monitor and assure quality.
Community Advisory Committee
The Community Advisory Committee will be
an enabler of community participation by
assisting the Board to appropriately
integrate consumer and community views at
all levels of its operation. The Committee will
have the responsibility to advise on
governance, policy and strategy in relation to
community participation and its impact on
health service outcomes.
Primary Care & Population Health
Advisory Committee
The Primary Care and Population Health
Advisory Committee’s primary role will be to
provide strategic advice to the Southern
Health Board on the interaction with relevant
external service providers. This Committee
will recommend the creation of structures and
process/es to enable health services to
develop over time. These services need to
more closely respond to the health needs and
expectations of people who live in, work in
and visit the Cities of Monash, Cardinia,
Casey, Greater Dandenong and Kingston.
This Committee and the Community Advisory
Committee will coordinate strategies through
common representation, a single secretariat
and the use of an issue-based approach.
Legislative Changes
Acts
Audit (Amendment) Act 2003
Fundraising Steering Committee
Business Licensing Legislation (Amendment) Act 2003
In recognition of the potential growth in
donations and fundraising income for the
organisation, the Southern Health Board, this
year, established a new Fundraising Steering
Committee, comprising members of both the
Board and Executive Team. The Committee’s
first task was to appoint a Development
Director to develop a fundraising growth
strategy, which would include the introduction of a number of new initiatives,
programs and policies. With this appointment
now having been made, the Steering
Committee will play an important role in
guiding and overseeing the growth in the
organisation’s fundraising initiatives.
Drugs, Poisons and Controlled Substances (Volatile Substances) Act 2003
Environment Protection (Resource Efficiency) Act 2002
Health Legislation (Research Involving Human Embryos and Prohibition of
Human Cloning) Act 2003
Pay-roll Tax (Maternity and Adoption Leave Exemption) Act 2003
Public Holidays and Shop Trading Reform Acts (Amendment) Act 2003
Residential Tenancies (Amendment) Act 2002
Road Safety (Heavy Vehicle Safety) Act 2003
Wrongs and Limitation of Actions Acts (Insurance Reform) Act 2003
Wrongs and Other Acts (Public Liability Insurance Reform) Act 2002
Regulations
Building (Amendment) Regulations 2003
Building (Legionella Risk Management) (Amendment) Regulations 2002
Strategic Plan
Pursuant to the Act the Board must, at the
direction of the Minister, prepare and submit
a strategic plan for the operation of
Southern Health.
National
Competition Policy
Southern Heath continues to comply with the
Victorian Government’s Competitive Neutrality
Policy. In addition, the Victorian Government’s
Competitive Neutrality pricing principles for all
relevant business activities have been applied
by Southern Health from 1 July 1998.
Cancer (BreastScreen Victoria Registry) Regulations 2003
Drugs, Poisons and Controlled Substances (Fees) Regulations 2002
Drugs, Poisons and Controlled Substances (Fees) Regulations 2003
Electricity Safety (Bushfire Mitigation) Regulations 2003
Emergency Management Regulations 2003
Environment Protection (Vehicle Emissions) Regulations 2003
Fundraising Appeals (Amendment) Regulations 2002
Health (Consultative Council on Obstetric and Paediatric Mortality and
Morbidity) Regulations 2002
Health (Infectious Diseases) (SARS) Regulations 2003
Health (Radiation Safety) (Fees) Regulations 2003
Health Services (Supported Residential Services) (Fees) Regulations 2003
Occupational Health and Safety (Asbestos) Regulations 2003
Pathology Services (Exempted Tests) (Amendment) Regulations 2003
Directions of the Minister
for Finance
All the information described in the directions
of the Minister Part 9.1.3(iv) exists and is
available to the relevant Minister, Member of
Parliament or the public upon request.
Subordinate Legislation (Freedom of Information (Access Charges)
Regulations 1993 - Extension of Operation) Regulations 2003
Subordinate Legislation (Occupational Health and Safety (Noise)
Regulations 1992 Extension of Operation) Regulations 2003
Tobacco (Amendment) Regulations 2003
Transport Accident (Amendment) Regulations 2003
Whistleblowers Protection (Amendment) Regulations 2002
The Whistleblowers Protection Act 2001
In accordance with Section 104 of the above Act, Southern Health states
that no disclosures that fall within the scope of the Act were received by
Southern Health during the 2002-2003 financial year. Three matters raised
in purported reliance on the Act disclosed alleged misconduct unrelated
to the Act.
Page 31
ASSET MANAGEMENT
FOI APPLICATIONS
Building Standards and Condition
Assessments
Calculated as from:
1st July 2002 to
30th June 2003
Since Southern Health was formed in 1995, the condition of its buildings has
been assessed through site inspections and existing condition reviews
undertaken by architects and consultant engineers in support of Master
Planning for redevelopments. In addition, during 1998-99, fire audits and
qualitative risk assessments were undertaken by consultant Fire Engineers for
every residential site to establish compliance with the updated requirements
of the DHS Fire Risk Management Engineering Guidelines.
Number of requests
1425
Access in full
947
Access in part
36
Access denied in full
8
Recommendations from the fire audit and risk assessments have been
actioned through a series of projects developed in association with the
Department of Human Services, to achieve a high degree of fire safety.
Significant fire upgrade projects completed in 2002-03 include the installation
of fire sprinkler systems at Monash Medical Centre (Moorabbin Campus),
Kingston Centre, and the Doveton Community Care Units.
Other
The initial fire risk assessments have been reviewed as part of a three-year
fire re-audit cycle. Monash Medical Centre (Clayton Campus), and
Dandenong Hospital were reaudited in 2000-01. Yarraman, Mooraleigh,
Middle South Community Care Units, and the Western Port Drug and Alcohol
Unit were re-audited in 2001-02. Monash Medical Centre (Moorabbin
Campus), Doveton Community Care Units, and the Kingston Centre were reaudited in 2002-03 completing the first round of the re-audit cycle. The next
round of re-audits will commence in 2003-04.
Fees and charges
$53,926.60
Fees collected
$34,081.05
Fees waived
$19,845.55
Essential Services Maintenance
Southern Health buildings constructed after July 1994 have been designed
to conform to the Building Act 1993 and its Regulations, as well as to meet
other statutory regulations that relate to health and safety matters, and have
been issued with Occupancy Permits.
Southern Health Buildings constructed prior to July 1994 were not subject
to the issue of Occupancy Permits. However, regardless of the age of each
building, Southern Health has adopted a policy to maintain Essential
Services, as far as is practical, in accordance with Part 11 of the Building
Regulations 1994.
Compliance involves ensuring that all essential services called up by
the Regulations are being maintained to fulfil their purpose, as well as
keeping records of maintenance checks, completing an Annual Essential
Services Report, and retaining records and reports on the premises for
inspection by the Municipal Building Surveyor or the Chief Fire Officer at any
time on request.
Essential Services Reports (Form 15s) are prepared annually for properties
owned by Southern Health to confirm that all of the essential services are
operating at the required level of performance.
Page 32
Exemptions cited
434
35, 33(1),
33(4), 35(1)(a),
35(1)(b), Other
Average decision time (days)
40.5
Initial Decision Makers
Claire Pierce
Health Information Services Manager;
Privacy Officer
Assoc. Prof. Saji Damodoran
Director of Mental Health Services
Internal Reviewer
Prof Stan Capp
Chief Executive
John Snowdon
Corporate Counsel
SOUTHERN HEALTH SERVICES
Primary Care Services
Acquired Brain Injury Support Services
Aged and Disability Support
Aged Care Assessment Service
AIDS Prevention Programs
Alcohol and Drug
Allied Health & Rehabilitation
Birthing Support
Children’s Early Intervention
Community Aged Care Packages
Community Nursing
Counselling and Casework
Chronic & Complex Care Care Needs
Dental
Diabetes Education
Domestic Violence Support
Dual Diagnosis Service
Financial Counselling
Health Information and Referral
Health Promotion & Education
Hospital In The Home
Housing
Immunisation
Liver Clinic
Medical
Men’s Health
Mental Health
Needle and Syringe Exchange Program
Optometry
Post Acute Care
Problem Gambling Counselling
Sexual Health
Women’s Health (community based)
Youth Health
Medicine Program
Clinical Haematology
Clinical Immunology
Clinical Nutrition
Dermatology
Diabetes
Diabetes Education
Emergency Medicine
Endocrinology
Gastroenterology
General Medicine
Infectious Diseases & Clinical Epidemiology
Medical Oncology
Palliative Care
Respiratory Medicine
Rheumatology
Vascular Medicine & Hypertension
Adolescent Recovery Centre - High Dependency Day Program
Adult Inpatient Psychiatry Service
Adult Mental Health Community Teams
Child & Adolescent Mental Health Community Teams
Child & Adolescent Inpatient Unit
Community Care Units
Consultation Liaison Psychiatry - Child, Adolescent & Adult
Crisis Assessment
Eating Disorders
Emergency Psychiatric Service
Ethnic Mental Health
Gender Dysphoria Co-ordination
Lifeskills Team
Mobile Assessment, Support & Treatment
Mother & Baby Inpatient Unit
Primary Mental Health Team
Sexual & Relationship Clinic (SARC)
Specialist Clinics
Telepsychiatry
Women’s Mental Health Consultant
Rehabilitation and Aged Care
Services Program (RASP)
Acute Rehabilitation (Inpatient & Outpatient)
Aged Care Residential Services (High & Low Care)
Aged Rehabilitation
Aged Persons Mental Health Service
Case Management & Service Co-ordination Program
Chronic Pain Clinic Outpatients
Cognitive Memory and Dementia Service
Community Access Service
Community Rehabilitation Centres
Falls & Balances Clinic
Geriatric Evaluation and Management
Interim Care Services (Inpatient & Home-based)
Movement Disorders Services
Rehabilitation in the Home
Southern Continence Service
Specialty Program
Cardiology
Cardiothoracic Surgery
Coronary Care
Echocardiography
Nephrology
Neurology
Neurosurgery
Renal Surgery
Stroke
Page 33
Women’s and Children’s Health Program
Adolescent Medicine
Birth Centre
Breast Surgery
BreastScreen
Contraceptive Counselling
Delivery Suite
Dental
Developmental Disabilities
Foetal Diagnostic
General Gynaecology
General Obstetrics
General Paediatrics
Genetic Services
Growth & Development
Gynaecological Oncology
Lactation Consultant
Maternal Foetal Medicine
Maternity
Menstrual & Menopause
Midwives Community Birth Centre
Newborn Services
Obstetric & Gynaecological Ultrasound
Paediatric Cardiology
Paediatric Dental
Paediatric Endocrinology
Paediatric ENT
Paediatric Gastroenterology
Paediatric Intensive Care
Paediatric Nephrology
Paediatric Neurology
Paediatric Neurosurgery
Paediatric Oncology/Haematology
Paediatric Ophthalmology
Paediatric Orthopaedics
Paediatric Plastic & Maxillofacial
Paediatric Respiratory
Paediatric Rheumatology
Paediatric Surgery
Play Education
Pregnancy Care
Prenatal Education
Reproductive Biology
Reproductive Medicine Services
Special Care Nursery
Spina Bifida Service
Thalassaemia Medical Therapy
Page 34
Surgery Program
Vascular Surgery & Transplant
Gastrointestinal Surgery
General Surgery
ENT Surgery
Ophthalmology
Orthoptics
Urology
Dental
Orthopaedic Surgery
Maxillofacial Surgery
Plastic & Reconstructive Surgery
Anaesthesia
Intensive Care
Operating Theatres
Clinical Support and
Interface Services
Aboriginal Liaison (Koori Health Unit)
Aids for Disabled People
Audiology
Chaplaincy & Pastoral Care Service
Diagnostic Imaging
Dietetic Services
Health Information Services
Hospital In The Home
Interpreter Services
Library
Occupational Therapy
Oncology Day Centre
Orthotics
Outpatient Department
Pathology
Pharmacy
Physiotherapy
Podiatry
Post Acute Care Project
Social Work
South Eastern Centre Against Sexual
Assault
Speech Pathology
Stomal Therapy
SERVICES, ACTIVITY AND EFFICIENCY MEASURES
Access
2002/03
2001/02
Category 1 proportion of patients
admitted within 30 days %
100%
100%
Category 2 proportion of patients
admitted within 90 days %
66.9%
70.9%
7483
7979
Category 1 patients receiving
immediate attention
100%
100%
attention within 10 minutes
84%
79%
attention within 30 minutes
72%
62%
2b. % of patients staying in emergency
departments for over 12 hours while
waiting for a hospital bed
21%
29%
1. Elective Surgery Performance
Total Waiting List
2. Emergency Department Performance
2a. Triage Performance
2c. Ambulance Bypass
269
356
Acute Beds
973
943
Other beds (incl psych, Pall Care,
Sub-Acute & Residential)
723
745
1696
1688
Total Average Open
21
21
Total Average Available
21
21
Total Average Open
33
33
Total Average Available
33
33
3. Average Available Beds
Total
4. Critical Care
4a. Number of Intensive Care Beds
4b. Number of Coronary Care Beds
Page 35
Activity
Acute
Mental Health*
Sub Acute
Pall Care
Total
Same Day
61055
117
25
14
61211
Multi Day
53467
2122
3222
343
59154
114522
2239
3247
357
120365
Emergency
44566
7
7
50
44630
Elective
55973
0
2484
264
58721
Other incl maternity
13983
2232
756
43
17014
Total Separations
114522
2239
3247
357
120365
Public Separations
109900
2239
2974
350
115463
117.7
7.8
15.5
22.3
81.1
322975
92980
84603
4108
504666
97063
0
0
0
97063
460528
0
13883
0
474411
13064
102690
4478
0
120232
570655
102690
18361
0
691706
Admitted Patients
Separations
Total Separations
Total WIES
89095.24
Separations per available bed
Total Beddays
Non-Admitted Patients
Emergency Medicine Attendances
Outpatient Services - OOS
Other Services - OOS
Total Occasions of Service
VACS Encounters
122390
* Mental Health Beddays are occupied beddays.
STAFF NUMBERS
Staff (Full-time equivalents)
MERIT AND EQUITY AT
SOUTHERN HEALTH
2002/03
2001/02
2,704
2,479
887
855
1,139
1,078
Hotel & Allied
654
616
Senior Medical
105
100
Hospital / Resident Medical
452
432
Sessional Medical
130
120
3
4
*6,074
5,684
Nursing
Administration / Clerical
Medical Support
Sec. 97
* More than 9,420 individuals
Page 36
The year 2002-2003 has seen significant
consolidation in the organisation’s approach
to Merit and Equity with a particular focus on
strategies to minimize the frequency of issues
relating to Discrimination and Harassment.
The "Respect, Rights and Responsibility"
brochure and education package, designed
and made by Southern Health and launched
in 2002, has been rolled out across the
organisation thereby allowing staff at all sites,
working all shifts, to have access to this
valuable information. To date, the incidence of
inappropriate behaviours amongst staff and in
the delivery of service to our clients has been
minimal and anecdotal feedback has
positively supported this initiative.
SUMMARY OF FINANCIAL PERFORMANCE
The 2002/03 financial year saw a period of increasing demand on services
across the organisation, in a period in which we also achieved our agreed
financial target.
The reported Net Result from Ordinary Activities for the year was a deficit of
$12.5m. This result includes a material one-off benefit of $13.5m resulting
from the termination of a finance lease associated with Monash Medical
Centre - Clayton.
In reviewing this final result it is important to note that Southern Health
received no funding to offset the impact of depreciation and that capital
expenditure is funded either via a specified grant from the Department of
Human Services or from internal reserves.
The break up of the respective operational business segments are
summarised below.
Health Service Agreement Operations
Business Unit Operations
Special Purpose Funds
Finance Lease Surrender
Recurrent Capital
Depreciation & Other Capital Income
Net Result from Ordinary Activities
$22.8m deficit
$1.2m surplus
$2.4m surplus
$13.5m surplus
$4.7m surplus
$11.5m deficit
$12.5m deficit
For the year, Southern Health recorded a decrease in net cash held of
$27.5m resulting in a closing balance of $23.8m in liquid cash assets
available to meet liability obligations.
The results for 2002/03 were impacted by the following major issues:
1. Acute Services Activity
Southern Health’s inpatient activity again exceeded previous years, although it was
below target. As such, we were unable to achieve the maximum inpatient revenue
available from the Department of Human Services during the year.
In response to these increasing demands for services Southern Health, as in prior
years, provided a level of Outpatient services to the community in excess of our
Department of Human Services negotiated funding and activity target.
2. Revaluation of Land & Buildings
Consistent with existing accounting guidelines Southern Health revalued its
portfolio of Land and Buildings effective 30th June 2003.
The impact of this was to generate an increase in the Asset Revaluation
Reserve of $28.1m.
3. Salaries and Wages
Southern Health is a major employer and movements in wage rates
and conditions have a direct impact on the operational result. During the year
a number of Enterprise Bargaining Agreements were renegotiated.
4. Patient Consumables
Expenditure on patient consumables increased in the year 2002/03.
Increases in this area are consistent with experiences in prior years and
throughout the sector and are influenced by fluctuation in the Australian
dollars, growth in patient volumes and accessing improved technologies.
Southern Health achieved an annual turnover of $623.8m during 2002/03,
a 7.6% increase over the previous year.
Page 37
Summary of Financial Results 2002/03
2002/03 2001/02 2000/01 1999/00 1998/99
$’000
$’000
$’000
$’000
$’000
Total Expenses
636,306 588,775 526,648 498,258 502,165
Total Revenue
623,811 579,657 525,912 487,475 595,535
Net Result from Ordinary Activities
(12,495)
(9,118)
Retained Surplus (Accumulated Deficit)
(16,351)
(2,922)
Total Assets
523,866 507,761 504,315 496,952 502,650
Total Liabilities
152,869 151,429 139,995 115,571 116,450
Net Assets
370,997 356,332 364,320 381,381 386,200
Total Equity
370,997 356,332 364,320 381,381 386,200
(736) (10,783)
6,196
93,370
94,390 104,815
Revenue Indicators
Average Collection Days
2002/03 2001/02
Private
44
64
286
59
Victorian Workcover Authority (VWA)
72
85
Psychiatric
48
46
Nursing Home
40
73
Under 30
days
31-60
days
61-90
days
2128
1447
431
118
109
4232
3043
TAC
14
29
15
5
160
224
724
Victorian Workcover Authority
82
116
54
36
255
543
194
Psychiatric
29
9
5
3
46
92
99
124
22
10
9
53
218
386
Transport Accident Commission (TAC)
Debtors outstanding as at 30 June 2003
Private
Nursing Home
Consultants
Southern Health Consultant Fees for Financial Year 2002/03.
Paxton Partners Pty Ltd
338,397
Topwheel HR P/L
208,377
Rod Anderson & Associates
174,269
JWGroup
148,000
Kadar and Bradley Pty Ltd
129,513
Total number of consultants
Total Expense
Page 38
203
2,713,363
91-120 Over 120 2002/03 2001/02
days
days
Total
Total
COMPLIANCE INDEX - DISCLOSURE REQUIREMENTS
The Annual Report of the entity is prepared in
accordance with the Financial Management
Act 1994 and the Directions of the Minister for
Finance. This index has been prepared to
facilitate identification of compliance with
statutory disclosure and other requirements.
Report of Operations
Clause
Disclosure
Page
Charter & purpose
9.1.3 (i) (a)
Manner of establishment and relevant Minister
30
9.1.3 (i) (b)
Objectives, functions, powers and duties
30
9.1.3 (i) (c)
Services provided and persons or sections
of community served
5, 30, 33
Management & structure
9.1.3 (i) (d) (i)
Names of governing board members,
audit committee and chief executive officer
9.1.3 (i) (d) (ii)
Names of senior office holders and brief
description of each office
29
9.1.3 (i) (d) (iii)
Chart setting out organisational structure
28
9.1.3 (i) (e)
Workforce data and application of merit
& equity principles
36
Application and operation of FOI Act 1982
32
9.1.3 (i) (f)
4, 29
Financial & other information
9.1.3 (ii) (a)
Summary of financial results
37, 38
9.1.3 (ii) (b)
Summary of significant changes in
financial position
37, 38
9.1.3 (ii) (c)
Operational and budgetary objectives
for the year and performance against
2, 3, 6 - 26, 35, 37, 38
those objectives
9.1.3 (ii) (d)
Financial analysis of Operating
Revenues and Expenses
37, 38
Major changes or factors affecting
achievement of objectives
37, 38
9.1.3 (ii) (f)
Events subsequent to balance date
37, 38
9.1.3 (ii) (g)
Consultancies > $100,000 Full details of each consultancy
38
9.1.3 (ii) (h)
Consultancies < $100,000 Number and total cost of consulting agreements
38
9.1.3 (ii) (i)
Extent of compliance with Building Act 1993
32
9.1.3 (ii) (j)
Statement that information listed in Part 9.1.3 (iv)
is available on request
9.1.3 (ii) (k)
A compliance index
9.1.3 (ii) (l)
Statement on implementation and compliance
with National Competition Policy
9.1.3 (ii) (e)
31
39, 40
31
Service Activity and Efficiency Measures
Financial Statements
Preparation
9.2.2 (ii) (a)
Statement of preparation on an accrual basis
45
9.2.2 (ii) (b)
Statement of compliance with Australian Accounting
Standards and associated pronouncements
45
9.2.2 (ii) (c)
Statement of compliance with accounting policies
issued by the Minister for Finance
71
Page 39
Clause
Disclosure
Page
Statement of financial operations
9.2.2 (i) (a)
A statement of financial operations for the year
9.2.3 (ii) (a)
Operating revenue by class
48 - 50
9.2.3 (ii) (b)
Investment income by class
48 - 50
9.2.3 (ii) (c)
Other material revenue by class including sale of
non-goods assets and contributions of assets
48 - 50
Material revenues arising from exchanges of
goods or services
48 - 50
9.2.3 (ii) (d)
42
9.2.3 (ii) (e)
Depreciation, amortisation or diminution in value
9.2.3 (ii) (f)
Bad and doubtful debts
9.2.3 (ii) (g)
Financing costs
55
9.2.3 (ii) (h)
Net increment or decrement on the revaluation
of each category of assets
64
9.2.3 (ii) (i)
Auditor-General’s fees
69
55
51, 52, 56
Statement of financial position
9.2.2 (i) (b)
A statement of financial position as at 30 June 2002
43
Assets
9.2.3 (iii) (a) (i)
Cash at bank or in hand
43, 55
9.2.3 (iii) (a) (ii) Inventories by class
57
9.2.3 (iii) (a) (iii) Receivables, including trade debtors,
loans and other debtors
56
9.2.3 (iii) (a) (iv) Other assets, including prepayments
43
9.2.3 (M) (a) (v) Investments by class
9.2.3 (iii) (a) (vi) Property, plant & equipment
57
58 - 60
Liabilities
9.2.3 (iii) (b) (i)
Overdrafts
9.2.3 (iii) (b) (ii) Bank loans, bills payable, promissory notes,
debentures and other loans
n/a
n/a
9.2.3 (iii) (b) (iii) Trade and other creditors
60
9.2.3 (iii) (b) (iv) Finance lease liabilities
60
9.2.3 (iii) (b) (v) Provisions, including employee entitlements
61
Equity
9.2.3 (iii) (c) (i)
Capital
9.2.3 (iii) (c) (ii) Issued capital
9.2.3 (iii) (d)
Reserves and transfers to and from reserves
43, 62
n/a
43, 62
Statement of Cash Flows
9.2.2 (i) (c)
A statement of cash flows for the year
44
Notes to the financial statements
9.2.2 (i) (d)
Ex-gratia payments
9.2.2 (i) (d)
Amounts written off
9.2.3 (iv) (a)
Charges against assets
9.2.3 (iv) (b)
Contingent liabilities
69
9.2.3 (iv) (c)
Commitments for expenditure
65
9.2.3 (iv) (d)
Government grants received or receivable
and source
9.2.3 (iv) (e)
Employee superannuation funds
66
9.2.3 (iv) (f)
Assets received without adequate consideration
53
9.4.2
Transactions with responsible persons and
their related parties
Page 40
n/a
51
n/a
48 - 50
66 - 69

southern health: an overview

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