In August this year, Northern Health was pleased to be announced as the health service chosen by the Minister for Health to run a fit testing pilot.

To date, we have tested over 800 staff. The pilot is part of a broader program of work – the Respiratory Protection Program – that Northern Health is undertaking which seeks to ensure the optimal protection of our staff from respiratory pathogens, such as COVID-19. The pilot focused on fit testing staff working in high-risk areas such as COVID-19 wards, ICU, Emergency Department, Fever Clinic, Residential In-Reach and operating theatres.

Fit testing is a process to verify if a selected brand, model or size of an P2/N95 mask adequately fits the wearer. Testing is carried out with all the different types of masks available, to identify the best fitting mask and is repeated at regular intervals to ensure a consistent fit. P2/N95, which filter airborne pathogens, are currently recommended when health care workers are caring for hospitalised patients with COVID-19.

Dr Victoria Madigan, Infectious Diseases Physician and Clinical Lead for Respirator Fit Testing Pilot Program said, “We have been reaching out to offer fit testing to staff particularly from high-risk areas to ensure they know which masks are most appropriate for them.”

“Pleasingly, many of the staff from these areas have been able to come in and have a test and find out which mask best suits them. The majority of staff adequately fit a mask that we have available.”

During the testing, five to six masks are tested. The testing process assesses how well each mask achieves a close seal against the wearers face.

“We have done the first wide-spread fit testing program in health care in Victoria. Northern has been asked by Safer Care Victoria to use the information gained from developing this process help inform Respiratory Protection Programs being introduced across Victoria. In developing our program, we’ve relied a lot on the expertise of the occupational hygienists from Eva & Associates performing the fit testing as well as from our Clinical Nurse Educators who have been helping staff with the testing process.” Victoria said.

“Moving forward, fit testing is certainly going to be a key part of the Respiratory Protection Program,” Victoria added.

Information from this pilot is also being used to guide Victoria’s purchasing of P2/N95 stock, and support other health services establishing similar programs.

Clare McCarthy, Project Manager, said, “It’s really rewarding to be involved with the pilot, as we’re actually contributing to the evidence on fit testing and helping DHHS with its selection of P2/N95 respirators.”

The pilot has been a wonderful collaboration between different departments across Northern Health.

“This is Northern Health at its best — everyone has rallied to make it a success for our staff. From Operations, to Learning and Development, Nursing Education, Research, Supply, NCHER, Nursing and Medical Workforce — so many parts of our organisation have rolled their sleeves up to make this happen for more than 800 of our staff,” Clare explained.

“Nursing Education has played a crucial role in our staff welfare. We’ve been involved from day one, from providing information beforehand about what happens during the fit test, through to afterwards, by supporting staff with their result,” explained Tanya Williams, Clinical Nurse Educator.

“The occupational hygienists have also been really wonderful in helping everyone understand the process, and all the various aspects of the testing – there’s also a larger group of staff who sit on our working group and contribute,” Victoria added.

Fit testing has now transitioned to the Respiratory Service, with our respiratory scientists performing the testing on our staff.

Eventually, fit testing will be available for all staff who are required to wear P2 or N95 masks. Information about specific requirements for testing and how to book in to have this done will be available on the intranet in the near future.

“The aim is to test between 2,000 to 3,000 staff per year at this stage, so the next challenge will be to work out what the new normal is going to be.”

NAIDOC Week is an opportunity to participate in a range of activities and support your local Aboriginal and Torres Strait Islander community.

It is also an opportunity to look back on the year and highlight the good work done by the Aboriginal Support Unit at Northern Health.

It was in October last year that we saw the launch of Northern Health’s 2019-21 Innovate Reconciliation Action Plan, known as the RAP.

At the launch Jennifer Williams AM, Northern Health Board Chair said, “This is Northern Health’s first ever RAP and is a ground-breaking plan which demonstrates our commitment to the Aboriginal community of the north.”

Underlining their commitment and leading by example, the Board, Executive and senior managers all attended Aboriginal cultural competence training, currently offered across all campuses to staff.

This year the Aboriginal Support Unit has a new name- Narrun Wilip-giin and their team sports a new uniform designed by local Aboriginal artist Gary Saunders. Narrun Wilip-Giin is a Woiwurrung name that means ‘Spirit Keepers’.

Artworks from Gary and another local Aboriginal artist Kahli Luttrell can be seen across our campuses.

Gary was also involved in developing a colouring book to be provided to Aboriginal and Torres Strait Islander children during their hospital journey at Northern Health, launched on National Aboriginal and Torres Strait Children’s Day.

The development this year of our first Aboriginal Employment Strategy has seen Northern Health actively recruited Aboriginal consumers for various committees besides employing a second Aboriginal Liaison Officer (ALO), an Access & Support Worker, and an Aboriginal Midwife.

Northern Health is working towards creating a culturally safe space for Aboriginal and Torres Strait Islander people by carrying Wominjeka ‘Welcome’ signs and Acknowledgement Plaques displayed in foyers, wards and other prominent areas. The plaques acknowledge the traditional custodians of the land and is a reminder that we all walk on sacred ground.

The launch of our Smoking Ceremony Garden is yet another example of creating a culturally safe space. The Garden called Jornung-bik, ‘A Pleasant Place’,  features indigenous plants native to this area, artwork by Kahli Luttrell and an audio bollard or ‘message stick’ to educate the broader community about the significance of Smoking Ceremonies to Aboriginal and Torres Strait Islander people. See video below:

 

The Northern Health Aboriginal smoking ceremony garden is a space not only for Aboriginal people to use, but also a beautiful nature space for staff and visitors to Northern Health to spend time.

The revamped Stow Family Aboriginal Garden too has a mural by Kahli Luttrell with new indigenous plants.

Northern Health is ‘Asking the question’ of all patients at entry points, if they are of Aboriginal/Torres Strait Islander origin, to help meet their health care needs and close the gap . Narrun Wilip-giin runs ‘Asking the question’ training throughout the year, across all campuses.

A live Aboriginal Patient Monitor which allows us to know in which wards there are Aboriginal patients, and in which clinics Aboriginal patients have appointments, is another step, aimed at providing better care for those of Aboriginal/Torres Strait Islander origin.

Last year saw the introduction of Aboriginal and Torres Strait Islander programs to promote the careers of Aboriginal and Torres Strait nurses and midwives (Aboriginal and Torres Strait Islander RUSON model). The Registered Undergraduate Student of Nursing (RUSON) model offers Aboriginal and Torres Strait Islander students, the opportunity to join Northern Health, as an employee and working closely with a Registered Nurse or Midwife, build their knowledge and skills even as they build their confidence.  More about this later this week.

Later this week we also launch Bilang-‘Straight Talk’, an online service directory, listing Aboriginal services located and operating within the Northern Health catchment.

Looking to the future, Narrun Wilip-giin is in talks with the Victorian Aboriginal Health Service to formalize their partnership.

On Wednesday 2nd December, Narrun Wilip-giin will be hosting an Aboriginal women’s health and wellbeing workshop in partnership with Victorian Aboriginal Health Service and Djirra.

Our Koori Maternity Service along with our Physiotherapists are planning a six week post birth Physiotherapy Clinic in 2021.

Much has been achieved. “I think we are making good progress towards the implementation of our Reconciliation Action Plan,” says Toni Gabelish, Aboriginal Liaison Officer, yet points out that more remains to be done. “I hope we will be able to gain more human resources to continue achieving our objectives, and better address the needs of our Aboriginal and Torres Strait Islander Peoples,” she adds.

Featured image shows the Northern Health Smoking Ceremony Garden launch.

NAIDOC Week this year is being celebrated from 8 to 15 November. NAIDOC Week celebrations are traditionally held across Australia each July to celebrate the history, culture and achievements of Aboriginal and Torres Strait Islander peoples.

The November dates follow the decision by the National NAIDOC Committee (NNC) to postpone NAIDOC Week from the original July dates due to the uncertainty from the COVID-19 pandemic.

NAIDOC originally stood for ‘National Aborigines and Islanders Day Observance Committee’. This committee was once responsible for organising national activities during NAIDOC Week and its acronym has since become the name of the week itself. Find out more about the origins and history of NAIDOC Week.

NAIDOC is celebrated not only in Indigenous communities, but by Australians from all walks of life. The week is a great opportunity to participate in a range of activities and to support your local Aboriginal and Torres Strait Islander community.

This year’s theme ‘Always Was, Always Will Be’ recognises that First Nations people have occupied and cared for this continent for over 65,000 years.

It acknowledges that Aboriginal and Torres Strait Islander people were Australia’s first explorers, first navigators, first engineers, first farmers, first botanists, first scientists, first diplomats, first astronomers and first artists.

To mark NAIDOC Week, members of our Aboriginal community at Northern Health, from our Narrun Wilip-giin (Aboriginal Support Unit) to Allied Health to the Koori Maternity Service, share their views and reflect on subjects such as ‘Caring for Country, Treaty and Sovereignty’, ‘Australia Day’, and ‘Oral Stories’, which can be found here.

They draw attention to how First Nation people read the night sky well enough to know when it will rain, when best to hunt and gather, to use it to encode stories that record history, and much more.

They also talk about the growing adoption of Indigenous farming practices such as Aboriginal fire management, here in Victoria.

NAIDOC Week is also a good time to consider some sobering facts. Facts such as Australia is the only Commonwealth nation that doesn’t have a treaty with its Indigenous people. Our writers make a claim for sovereignty on the grounds that, ‘Indigenous people never ceded sovereignty and that a treaty must acknowledge Indigenous sovereignty’.

They also explain why for many Indigenous Australians, the 26th of January isn’t a day for celebrating.

Oral stories are a recurring theme. “Storytelling is a traditional method used to teach about cultural beliefs, values, customs, rituals, history, practices, relationships, and ways of life… First Nations storytelling is a foundation for holistic learning, relationship building, and experiential learning,” we learn.

They come with a recommended reading list including Bruce Pascoe’s book, Dark Emu, which challenges prevailing views of Australian history and opens our eyes to Aboriginal farming, fishing and land management and links for readers interested in learning more.

NAIDOC Week 2020 acknowledges and celebrates that our nation’s story didn’t begin with documented European contact whether in 1770 or 1606 – with the arrival of the Dutch on the western coast of the Cape York Peninsula.

The very first footprints on this continent were those belonging to First Nations peoples.

This nation’s story began at the dawn of time.

NAIDOC 2020 invites all Australians to embrace the true history of this country – a history which dates back thousands of generations.

Join us as we celebrate the oldest continuing cultures on the planet and acknowledge that sovereignty was never ceded.

Always Was, Always Will Be.

The video above was created by Yue Hu from Transcultural Language Services (TALS) and a member of the NAIDOC working group.

Northern Health Foundation Patron and Board Member, Trudi Hay, recently hosted her annual High Tea to raise money for Northern Health Cancer Services.

Trudi has been a dedicated supporter of our cancer services for over ten years. Every year, she hosts a High Tea event to raise funds to support patients undergoing cancer treatment – something very dear to her heart.

However this year the event looked a bit different. Held virtually this year due to the pandemic, Trudi welcomed guests with their cups of tea and grazing boxes.

Guest speakers from Northern Health, Wanda Stelmach, Chief Medical Officer and Melissa Gwynne, Day Oncology Nurse Unit Manager, spoke on the challenges of cancer, general health and wellbeing and caring for our community during the COVID-19 pandemic.

Wanda and Melissa answered questions from guests and encouraged everyone to maintain their routine health checks – because even though we have all been in lockdown, cancer hasn’t been. Wanda thanked Trudi for continuing to host her annual event, despite current challenges, and she also thanked the community for doing the right thing during the second wave.

Over the years, Trudi has raised over $60,000 from her events. This year, the virtual High Tea raised an amazing $11,000.

“While planning for this event, I was very conscious of the fact that people are out of work at the moment and doing it tough, so people didn’t need to donate to be able to participate in the High Tea. It was more about getting the word out and raising awareness of cancer,” Trudi said.

Melissa Gwynne, Day Oncology Nurse Unit Manager, said, “Thank you to Trudi for organising a different High Tea this year and doing such a great job. The funds raised will go towards patient equipment, like an ECG machine that we require to monitor the patient’s heart during chemotherapy in the Day Oncology Unit, and also the patient care bags which will be given to patients utilising our new service – chemotherapy at home”.

“On the wish-list, there were a couple of items and I thought I would be able to buy only one – which was the care packages for patients. Because we raised $11,000, we are able to buy two items from the wish-list, which is the ECG machine, as well as the care packs! Everyone was extremely generous,” Trudi added.

Attendees were treated to musical entertainment and a number of prizes including accommodation packages, beauty packs and beautifully wrapped gift hampers.

 

Featured Image: Trudi Hay hosting the High Tea from her home 

Northern Health Foundation Patron and local fundraising hero, Josie Minniti OAM, has been named a Westfield Local Hero for 2020.

‘Westfield Local Heroes’ is a recognition and awards program that discovers and celebrates individuals who make a positive impact to their local community. Local Heroes are nominated and voted for by their communities, with winners awarded a $10,000 grant for their chosen charity.

We are thrilled that Josie Minniti has nominated Northern Health as her chosen organisation, contributing the grant towards the purchase of an EBUS machine for our respiratory department. This will help speed up the time for a respiratory diagnosis, so treatment can start sooner for our patients.

Josie is an inspiring volunteer who has dedicated over 20 years to fundraising for cancer services and strives to make a difference to the lives of patients, something very dear to her heart with her own family dealing with cancer.

On winning the award, Josie said, “This is an amazing achievement, not just for me, but for the Northern Health respiratory department and their patients. The EBUS machine will help detect lung cancer earlier for patients in our community.”

“I’m very grateful to Westfield and every person who voted for me because I know many people did, so I’m truly appreciative. Thank you to Northern Health Foundation for their amazing support, the dedicated staff at Northern Health, my fundraising group and everyone in the community – it’s not just about me, it’s about everyone – and I encourage our community to continue to support and donate to Northern Health.”

Through her tireless fundraising efforts, Josie has helped raise over $700,000 to support patients with cancer and kidney disease at Northern Health.

Funds raised have contributed to medical equipment upgrades and the purchase of equipment to make patients more comfortable while undergoing treatments. This has included a scalp cooling machine to help patients retain hair during chemotherapy treatment, a blanket warmer machine, patient treatment chairs and defibrillators.

“Whenever I am fundraising, my motto is ‘there is always someone worse off than you’, so I will do all I can to improve their lives,” says Josie, who has received an Order of Australia (OAM) for her dedication.

For anyone wishing to donate to Northern Health Foundation and support patients in our community, head to nhfoundation.org.au.

Northern Health is pleased to announce it has commenced its Electronic Medical Record (EMR) Project after signing an agreement with Cerner Corporation last week.

Electronic Medical Record systems are the way health services document, manage and store relevant health information as part of patient care.

Northern Health is committed to patients receiving the highest quality of care and implementing the EMR across our health service will continue to ensure patients receive safe and timely care into the future.

Siva Sivarajah, Chief Executive held a virtual signing of the agreement with Cerner last Wednesday, 28 October, to mark the official commencement of the project.

“In line with our commitment to provide safe, trusted care to our community, Northern Health is pleased to announce the commencement of our EMR Project.”

“We look forward to working with Cerner to implement the integrated EMR across Northern Health, to ensure our patients continue to receive the best possible care.”

Cameron Burt, Vice President and Managing Director Asia Pacific, Cerner Corporation, on the day of the signing said, “Today marks a significant milestone in Northern Health’s EMR journey and we are honoured to partner with them in their mission to provide better health care for their community.”

EMRs streamline health care information by providing clinicians access to up-to-date medical information in one place. The EMR will enhance coordination of care by allowing clinicians access to a health service-wide view of clinical information to create and apply decisions that would promote patient safety.

The clinically-led program will help shape how clinical care is provided to our community. This clinical engagement a key to the success of an EMR project.  We will be working with our clinicians to ensure our EMR best meets the needs of our patients.

 In partnership with Cerner, Northern Health is planning a full stack implementation to be in place by late-2022.

Trish Aldridge is the Director of the EMR Project and is looking forward to working on the project over the next two years.

“We are excited to start this project to optimise the quality and safety of our patient care, with the vision of ‘one patient, one integrated record’,” Trish said.

 Featured Image: Siva Sivarajah, Chief Executive, Northern Health with Cameron Burt (on screen), Vice President and Managing Director, Asia Pacific, Cerner Corporation 

This week, new case numbers are finally down and have been for a few days. Zero cases on Monday and Tuesday, and only a few over the past two days. As the weather in Melbourne is changing for the better, hopefully soon too will the spirits of its residents.  It has been a long and hard winter for many of us.  The pandemic has affected all of us, albeit different people in different ways, but all of us nonetheless.

I am a doctor in the northern suburbs of Victoria, where arguably the state took the largest hit, with several of the worst aged care outbreaks in the country.

Dear colleagues and friends,

Thank you for your efforts. Thank you for your time, your energy, your dedication. Thank you for your compassion, your empathy.

When the first nursing home outbreaks were known of, the hospital’s Residential in-Reach service mobilised rapidly to provide staff and support to the affected nursing homes. Doctors and nurses from the hospital geriatrics department quickly formed teams to enter these facilities to test, treat and provide palliative care to residents. They were in there seven days a week: in full PPE, caring for residents but also communicating with anxious families wanting the best for their loved ones but unable to see and be with them due to strict visitor restrictions. Sometimes even helping with meal prep! Ultimately some of the residents would recover, but some would not.  My colleagues faced these challenges every day for weeks that turned into months. Thanks to the geriatrics team’s forward planning from the first wave, when the second wave hit they were able to respond in a timely fashion to not only support but provide first hand medical and nursing care to residents in the affected nursing homes.

Arguably no one hospitals’ response to the pandemic has been perfect – this is something we have never faced before.  But I say with pride that at my hospital overall we responded well; we did our best and beyond.  An emergency department outbreak was quickly contained with lockdown, contact tracing and deep cleaning procedures undertaken immediately. Specific wards were designated for “suspected” and “confirmed” COVID-19 patients.  Infectious diseases, respiratory, general medicine and ethics teams collaborated closely to formulate strategies for best inpatient models of care for all patients in the hospital.  Collaboration with emergency medicine and intensive care teams were also paramount.

That specific COVID-19 wards were opened was a key initiative. One was primarily staffed by general medicine, infectious diseases and respiratory teams, and a daily huddle amongst teams, nursing, allied health and palliative care staff allowed for a multidisciplinary approach to management.

A second ward for patients for whom a more palliative approach to their management was appropriate was also created. These patients were more frail, multi-morbid, and many already had advance care directives and limitations on extent of aggressive treatments. This ward was staffed by doctors with both geriatrics and palliative care expertise. Teams on the COVID wards focussed not only on the medical aspects of care but also ensured that communication with families or carers was maintained by a ritual of daily phone calls post-ward rounds. To address the impact of visitor restrictions, a simple request for donations yielded even more devices than what the hospital already provided, for patients to use to communicate with loved ones who could not visit.

At this juncture I should declare my bias: I am a palliative care doctor, and I am proudest of the team that I work with for proactively rising to the occasion and providing symptom-based care for patients; whether or not deemed to dying, but suffering from effects of COVID-19.

Apart from actively participating in ward-based care, the palliative care team also created accessible quick reference guides for all clinicians for symptom management, end-of-life care and communication strategies in COVID-19, care-at-home packages for families wanting to look after their loved ones at home, and medications packs for symptom management for patients returning to nursing homes to ensure they had supplies on return.  I am also a cancer doctor, and I am proudest of my team for negotiating the difficult and delicate balance of protecting our vulnerable patients from COVID-19 while still trying our hardest to provide best possible cancer care.

Another important initiative – hospital wide survey – was instigated by two junior doctors to pro-actively address staff concerns and stressors (this is ongoing and directly linked to the Occupational Health and Safety team). The hospital has responded to feedback in positive and concrete ways such as developing wellbeing sessions, clearing outdoor spaces for staff to eat and take breaks while still being able to achieve social distancing, and thanking staff by not only acknowledging gratitude in public forums but also providing tokens of thanks in the form of goodie bags.

All staff, from consultants, who led teams by presence and example, junior doctors and nurses, who worked tirelessly and sometimes in full PPE every day, allied health teams, non-clinical personnel (administration, clerical, cleaners, porters), all parts of the hospital – people were asked to step up, adapt, be flexible about their work – and they were.  People were anxious, tired – some depressed and scared – later weary and exhausted, but people pushed on.

This week, we celebrated as Melbourne’s months-long restrictions were eased. Colleagues and friends, take a bow. Thank you for all you’ve done. I know now, COVID-19 or no COVID-19, we’re going to be OK.

Jaclyn Yoong

Medical Oncologist | Palliative Care Physician Northern Health

A major part of Northern Health’s trusted care and High Reliability Organisation (HRO) initiative is the Comprehensive Unit Based Safety Program (CUSP). A monthly safety meeting, open to all staff, and aimed at enhancing teamwork, communication and identifying and improving quality and safety, is now making its mark in Northern Health’s emergency department (ED).

In July, Dr Kirin Channa stepped into the Chair role, following Dr Dean Pritchard’s sabbatical leave. Kirin explained the CUSP began January this year, and, due to COVID-19, meetings are being held via MS Teams.

“We have a variety of staff participating — medical, nursing, allied health and other specialties. It is a great forum for everyone to talk about quality and safety at the department, review any incidents and prevent future ones. Around 20 to 30 staff take part in these virtual meetings, and we had a peak of 50 a couple of months ago,” she said.

During the CUSP meeting, the team looks at the quality score card, reviews data from the ED and looks at incidents from the previous month. The team also discuss current quality initiatives, which can vary every month.

“For example, this month we talked about the new ED Virtual Triage, the Code AAA Procedure and then we went through different departments like allied health or clerical. The meeting usually generates a lot of discussion and, from that, action lists are pulled and projects implemented,” Kirin added.

Janice Fernandes, ED Nurse Unit Manager, said an example of an outcome from one of the CUSP meetings is how the department handles mental health patients.

“The CUSP has identified areas to streamline care for mental health patients who present to ED. They are flagged for early review, with the right medication, administered at the right place, within the ED,” she said.

Another example of a topic raised at the CUSP meeting was that conjunctivitis in the eyes could potentially be an unusual sign of COVID-19.

“One of our consultants did some research and consultations, and then we implemented new triage criteria with patients presenting with a red eye, who are now triaged in the suspected COVID-19 waiting room area,” Kirin added.

The ED staff have embraced the CUSP with open hands and minds, and are enjoying the proactive approach to quality and safety.

“The staff feel that they have a platform to express ideas, an opportunity to bring up something that hasn’t been discussed previously and make a difference,” Janice said.

Clare McCarthy, HRO Project Manager, said the ED CUSP is the ninth CUSP at Northern Health and represents a significant step forward for the quality and safety program.

“Northern Health’s ED is the busiest in Victoria and presents unique challenges for our health care workers,” she said.

“The CUSP is ideally suited to this setting — it gives us the leverage we need to identify problems, learn from mistakes, develop solutions and continue to learn while acting on them,” said Clare.