Long-stay patient, 57-year-old Mark Lazaric (pictured above with ICU staff), recently visited the Northern Hospital Intensive Care Unit (ICU) to say thank you to the staff that cared for him during his 43 days in ICU.

Mark spent a total of almost three months admitted to hospital during one of the most challenging times our health care staff have ever faced – during the height of the COVID-19 pandemic.

After suffering a major heart attack while walking his dog in August last year, Mark was rushed to Northern Hospital Epping. This week, Mark celebrated an amazing accomplishment – he was back at work for the first time since the heart attack.

Mark doesn’t remember much from the first five days in hospital but said, “the doctors had their work cut out for them.”

“I do remember opening my eyes and having six doctors looking at me, and I was confused where I was,” he explained.

During his ICU stay, Mark felt assured in his recovery from the dedicated team caring for him.

“I had a nurse sitting at a station watching me 24/7 for 43 days – they didn’t leave me by myself the entire time I was there. It showed their massive commitment,” he said.

“I’d never really been to hospital before so I didn’t know what to expect but I was blown away, they’d come in and have a chat to me. One of the nurses, Courtney, set up her laptop for me so I could watch the basketball.”

“The staff always made sure I was OK, urging me to get up and do my physio. They would constantly encourage me and talk about the plan to get me to the ward. They would keep telling me I was doing well, which meant a lot,” Mark explained.

“And the reassurance for my wife, Wendy – there were times she rung at three in the morning – and one nurse spoke to Wendy for about 40 minutes. There was no such thing as no time for you.”

Even though he was admitted during the height of the second wave of COVID-19 in Victoria and staff were required to wear full PPE, Mark was impressed with the excellent care he received, as well as impressed at his surroundings in our state of the art ICU.

“There were no gaps in care and no excuses from the staff – even though they were wearing gowns and masks – everything was delivered as promised,” he explained.

Mark expressed his sincere appreciation of the ICU team and was keen to return to Northern Hospital to personally thank each and every staff member who was involved in his care.

Narkitaa Van Ekeren, ICU Nurse Unit Manager, and her dedicated team welcomed Mark – who was fighting fit – and Wendy to the unit to say thank you.

“We were delighted to welcome Mark back to visit the ICU. It isn’t often we get to see the progress our patients make after transfer to the ward. Moments like this leave a lasting impression on many nurses, making us proud,” Narkitaa said.

“We have invited Mark and Wendy back to assist with the planning and development of the Intensive Care Long Stay Procedure, and we look forward to their input and ideas for our soon-to-be opened outdoor space,” Narkitaa added.

In an interesting twist of fate, Mark was recently also pleased to see one of the dedicated nurses who cared for him during his time in ICU at the gym they both go to.

The objective of Closing the Gap (the National Agreement) is to enable Aboriginal and Torres Strait Islander people and governments to work together to overcome the inequality experienced by Aboriginal and Torres Strait Islander people, and achieve life outcomes equal to all Australians.

The National Agreement has been developed in partnership between Australian governments and the Coalition of Aboriginal and Torres Strait Islander Peak Organisations (the Coalition of Peaks).

Our Koori Maternity Service (KMS) and our Narrun Wilip-giin, Northern Health’s Aboriginal Support Unit, have been busy providing ever-improving services for our Aboriginal and Torres Strait Islander community and Northern Health staff members. Below are a couple of the initiatives they were responsible for over the last year.

Koori Maternity Service Women’s Health Physiotherapy Clinic

The Northern Health’s Koori Maternity Service aims to provide accessible and culturally appropriate pregnancy care for Koori families in the north. Early motherhood is a critical time where early intervention, comfort and reassurance can make a big difference to a woman’s post-natal experience.

The addition of a Women’s Health Physiotherapist to the KMS team aims to ensure Aboriginal & Torres Strait Islander women are receiving appropriate multi-disciplinary post-natal follow-up.

Historically, there has been an under-representation of referral to outpatient physiotherapy services of Koori mothers during their ante-natal & post-natal journey. Now, these women are routinely offered a 6 week post-natal physiotherapy assessment.

Due to COVID-19, all appointments thus far have been via Telehealth with face to face appointments to commence in coming weeks. Despite the limitations of Telehealth appointments, all women who have participated in a KMS physiotherapy appointment have said they found the appointment helpful and 85 per cent of patients said they would be likely to recommend the service to friends or family. 

Aboriginal Women’s Health Promotion Workshops

Narrun Wilip-giin, Northern Health’s Aboriginal Support Unit, ran a health promotion Women’s Health Workshop for Aboriginal & Torres Strait Islander women aged 18 to 44 years in December last year as well as one last week. 25 participants registered, and, over Zoom, listened to knowledgeable speakers on subjects such as cervical screening, breast awareness and screening, healthy relationships and sexual health. The participants received amazing Dilly Bags with health information brochures on the topics covered by the guest speakers and more.

The Zoom session ran for two hours and was hosted by Karen Bryant, our Senior Aboriginal Liaison Officer.

This initiative was run on behalf of Northern Health Narrun Wilip-giin, Djirra (Aboriginal Family Violence Legal Service) & VAHS (Victorian Aboriginal Health Service). Funding was sourced through the generosity of Tobin Brothers by Northern Health Foundation.

Due to this Women’s Workshop being booked out quickly, Narrun Wilip-giin have planned two more Women’s Health Workshops in March 2021 for our Koori community and will include relevant topics for women aged 45 years and over.

Dr Eda Gungormez, last years’ intern, now a gastro HMO, has been awarded the title of ‘Emergency Department (ED) Intern of the Year’ for 2020.

Her skills, and the willingness to help others, also led her to become the Intern Support Person and help the 2021 interns navigate their new roles.

Eda completed five rotations at Northern Health last year and remembers how it took her some time to adjust.

“I wasn’t from this hospital as a medical student – so had to quickly learn things like the layout of the hospital and the jobs and responsibilities of an intern. My internship was pretty good here. The culture is super nice at the Northern! It was very busy at the time, and still is – we do have the busiest ED, so I guess that is to be expected,” she said.

Eda enjoyed the busy 12-week ED rotation, because it meant she was learning something new every day. However, the ‘ED Intern of the Year’ award came as a surprise.

“I found out from friends I was awarded, as I really didn’t expect that, even though I did put a lot of effort as an ED intern. What I liked in the ED was that, there, I felt like a ‘real doctor’ as I was able to see patients coming to ED, and then find a destination and outcome for them,” she said.

The intern support role was another task Eda thoroughly enjoyed. In this role, she was a designated support person for the new interns, someone who stays with them for one week and answers their questions, helps with small tasks, and supports via email and Whatsapp.

“We also had a Medtasker role this year, so I was helping in that space too. On some occasions, when they are overwhelmed, it was just about sitting down and talking with them. It is hard when you transition from a medical student to an intern, as there is more responsibility. I was there to assure them and advise on who they can ask for help. I am impressed with the quality of our interns this year, and how they are helping each other too,” Eda said.

After her own great experience as an intern, she decided to stay at Northern as a resident.

“I am now doing basic physician training, and planning to continue. I am doing gastro and cardiology this year as specialist fields, and I am also interested in infectious diseases, so maybe I would like to pursue that in the future. It is a growing field and there is a lot of research to be done, as we see now with COVID-19. Besides that, I enjoy cardiology and gastro – I like procedures and the practical side of it,” she explained.

For the new 2021 interns, Eda advises finding the work-life balance, taking time for yourself and not being afraid to ask for help.

“Sleep well and make sure to take lunch breaks to sit down and eat. Even if it’s just five minutes, it will help recollect your thoughts. Sitting down is actually really important, as we sometimes forget we have been standing and running around most of the day. That will help you not only feel better, but make better decisions too. Never be afraid to reach out for help – from colleagues, seniors, family – nobody can know you are struggling if you don’t express yourself. And remember to have fun!”

Our patient experience team have been hard at work over the past year to develop the new Northern Health Welcome Pack.

The packs are available at each bedside across our sites and available online to provide important information for patients and visitors coming to Northern Health.

Included in the packs is information regarding visiting, patient rights and responsibilities, privacy and confidentiality, medical emergencies, preparing to leave hospital and how to provide feedback to us.

The packs have been developed with significant input with consumers, to ensure they are easy for patients to read and understand.

The new pack takes into consideration situations like the COVID-19 pandemic where visiting restrictions may apply, and directs patients and families to the latest updates on the Northern Health website.

Paula Murray, Health Literacy Coordinator, explained the importance of these new packs for patients and visitors.

“The Welcome Packs are a mandatory requirement for hospitals to provide to all patients. We have worked hard to ensure the information is useful and helpful, outlining the essential information that people may need,” Paula said.

“The packs have had input from a huge range of staff, and in particular the Standard 2 Committee and Patient Experience team, as well as Public Affairs who designed the fresh new look. Many staff also spent time in the evenings and weekends laminating and collating the packs – a real team effort!” Paula explained.

A unique aspect of the development of the new Welcome Packs is that they have been translated into the top languages in our catchment area by our dedicated Transcultural and Language Services (TALS) team.

A significant amount of work has been done by the TALS team in collaboration with the patient experience team to ensure our diverse community are able to receive important information about our services in their own language.

“The Welcome Pack allows patients to familiarise themselves with their hospital journey, and facilitates their care, so that they can return home safely as soon as possible,” explained Emiliano Zucchi, Director of Transcultural & Language Services (TALS) and Narrun Wilip-giin Aboriginal Support Unit (ASU).

“The northern catchment is one of the most culturally diverse in Melbourne, having the Welcome Pack available in our top 10 languages allows all communities to have equitable access to culturally safe health care services,” Emiliano said.

Click here to view the new Welcome Packs!

Two simulations, Code Red and Code Grey/Black, were held in the South East Building at Northern Hospital Epping last week. These simulations are aimed at providing staff the opportunity to simulate potential real life incidents that they may face in a new environment. The simulations also involved our partners – emergency services, Fire Rescue Victoria and Victoria Police, working together to provide a safer environment for our colleagues, patients and visitors.

Jason Amos, Manager, Emergency Management, explained staff are able to put into practice the skills that they are taught as part of their orientation training to their new workspace.

“Thankfully, evacuation of patients is rarely undertaken in Australian hospitals, but it’s important for staff to have confidence that, should we ever need to, they are prepared and know how to safely evacuate patients. The simulations are designed to provide a safe learning experience where we can ensure our procedures are effective, and they are never a test of how the staff perform,” he explained.

The Code Red and Code Orange simulations involved the evacuation of three patients – one ambulant, one non-ambulant bariatric and one non-ambulant patient. Staff had to assess the situation, nominate a safe evacuation plan and facilitate the evacuation of these patients. Staff were also required to evacuate one of the patients via the Albac evacuation mat down a flight of stairs safely. The involvement of Fire Rescue Victoria also allowed an opportunity for both organisations to understand each other’s role in dealing with a Code Red and how we can support each other.

The following day, the Code Grey/Black simulation involved a simulated aggressive patient whose behaviour escalated, initially requiring a Code Grey response, before escalating to a Code Black. This simulation allowed staff to recognise increasing aggressive behaviour and respond to a Code Grey while trying to deescalate the situation, before identifying the need to escalate to a Code Black when the patient was able to locate and use a oxygen cylinder as a weapon.

“A really important part of this simulation was for staff to identify that equipment we use every day, but is often not stored away appropriately, can be used as a weapon by a patient. This can include something as simple as patient folders, to other equipment such as IV poles, wheelchairs, infusion pumps and oxygen cylinders. Victoria Police were also on site, to participate and provide feedback on dealing with aggressive patients,” Jason added.

“The simulation team were really proud of our nursing staff who participated. We witnessed a strong understanding of Code procedures and their ability to remain calm and follow instructions,” he added.

Tracey Martin, Project Manager, explained both of the simulations were extremely successful, and a lot of background work has gone into planning and organising, including coordinating the attendance from Fire Rescue Victoria and Victoria Police.

“The Organisational Simulation Project Leads, Dr Nancy Sadka and Dr Keith Amarakone, along with the assistance and commitment to the project from Elise Sutton and Jason Amos, have done a fantastic job these past few weeks in helping our staff not only familiarise themselves to new working spaces, but also to test our emergency responses to ensure our existing systems are supported and effective in the new building. While generally most of the simulations have utilised our simulation manikins, the Code Grey/Black simulation could not have been completed as realistically without the volunteering from our very own – Ariana Carrodus – who provided an award-winning performance as the aggressive patient,” she said.

Dr Sadka added: “These simulations support the staff who will be working in the new wards to test the hospital response systems, identify areas of risk for improvement, and practice together in a safe environment. The staff engagement in these simulations and their feedback identifying areas of improvement have been great.”

Darren Conlin, Asst. Chief Fire Officer, Northern District said: “Days like today are fantastic opportunities for Fire Rescue Victoria and Northern Hospital to work in collaboration in a practical sense to enhance the safety of the community, staff and responders alike.”

The Simulation team are in the process of undertaking a number of simulations to assist staff as they begin to transition into their new wards. This has included MET call response, Code Blue, ward rounds and patient flow, Code Grey, Code Pink, Code Red and Code Black. Additional simulations are planned in the new theatres, ground floor and wards in the South East Block.

Please see more simulation photos below.

Code Red:

Code Grey/Black:

In the lead up to organisation wide Accreditation from 24-28 May 2021, each week Northern Health will be focusing on a different Standard. You will hear from the Chairs of each Standard Committees on what you need to know.

This week we spoke to Briana Baass, Executive Director, Chief Allied Health Officer and Partnerships about Standard 2: Partnering with Consumers.

Briana explained that partnering with consumers is our way of ensuring that our patients and their carers are at the centre of all the work that we do.

“Patient and consumer partnerships are key to delivering person-centred care. This care focuses on the relationship between a patient and a clinician, as well as between the broader community and northern health, and recognises the importance of trust, mutual respect and sharing knowledge to deliver the best health outcomes,” she said.

What is this standard about?

Standard 2- Partnering with Consumers is about making sure that our consumers are a partner in their own care and that how our service grows and changes allows us to meet their needs.

This standard is about partnering with consumers at all levels of our work, including: in their own care; at a service level; and at a system level.

At a direct care level it is about getting to know your patients and their preferences and values, meeting their needs and providing them with information that they can understand and use to make decisions about their care.

At a service and system level this is about listening to the voices of our patients and their carers and involving them in the work we do to improve our services.

At Northern Health, this standard looks like….

These examples show the impact of partnering with the consumers on our Consumer Network or the consumers in a local area on:

The patient journey: consumers have provided feedback on the Q-Flow system in Outpatients and influenced the information displayed on the screens and tickets printed.

Building and infrastructure: consumer input has influenced the design of our new ICU and creating a family zone in each ICU bay.

Our strategic direction: a consumer joined the working group that informed our new strategic plan and 500 consumers provided feedback through surveys and focus groups to create our new values.

Our publications: the CLEAR group (consumer group) provides feedback on the patient information Northern Health produces so that they get the consumer tick of approval that they are written in language our community can understand.

Developing our staff: consumers have presented their stories and experiences at training sessions such as the Safe Practice Forum and Refugee and Asylum Seeker Study Day.

What are the top five ways staff can be prepared for Accreditation against this Standard?

1. Involve your patients and their carers in goal setting and care planning and document this on the bedside communication board.
2. Identify the substitute Medical Treatment Decision Maker if a patient does not have the capacity to make decisions for themselves – click here for how to ask (or visit https://intranet.nh.org.au/departments-and-services/advance-care-planning/brochures-forms-documentation/)
3. Provide your patients with the Rights and Responsibilities patient information brochure.
4. Check that your patient understands the information you are providing and encourage patients to provide feedback and act to resolve any problems while they are in your care
5. Wear your name badge and introduce yourself

What are the top five questions staff needs to be able to answer about this Standard?

1. When should a patient be provided with Northern Health’s Healthcare Rights and Responsibilities?
2. How do you partner with patients and carers in care planning and treatment decisions?
3. What do you do if a patient is at risk of not understanding the information you are providing to them?
4. How would you respond to a patient who was dissatisfied with their care?
5. How is Northern Health partnering with consumers in activities to improve our services?

Is there anything else you would like staff to know about this Standard?

This is all about providing person-centred care, like Rebecca experienced – click here to see the video.

Click here to learn more about Standard 2: Partnering with consumers.

For the first time in the Medical Education Unit’s history, the mentoring program for interns was rolled out online.

There was both excitement and trepidation from Dr Carol Chong, Intern Supervisor, who explained that the team couldn’t put the interns and consultants together in a room to meet each other, unlike the previous ten years of the program.

“We improvised and ran it via MS Teams. It was a very quick decision as lockdown 3.0 was announced four days prior to the session running,” said Dr Chong.

More than 18 senior medical staff tuned into the virtual session to introduce themselves and to talk candidly about their experiences as interns.

“Effective mentorship can make a real difference in guiding decision making for our interns in important areas such as career planning and work-life balance,” said Dr Chong. “It is incredibly heart-warming that 103 consultants volunteered to be mentors to our 45 new interns this year.”

Some of the consultants have been mentors for many years and have gone above and beyond for their mentees. Examples include Dr Jackie Yoong, Oncologist and Palliative Care Consultant, who went on a 10km charity fun run with her mentee. Also, Mr Rodrigo Teixiera, Plastic Surgeon’s mentorship resulted in one of his mentees becoming a research fellow in plastic surgery at Northern Health.

“The aim of the program is to match an intern to a consultant mentor mainly based on the specialty he or she is interested in or would be a good fit. Prior to the online session, the Medical Education Unit staff, Susie Sangas, Medical Education Manager and Rebecca Hartmann, Medical Education Assistant, emailed interns and consultants who they were matched in a very short turnaround. Despite the change to the online session this year, the mentoring session was still rated highly by the large number of interns who tuned in.”

“Mentors and mentees are expected to meet at least once a term during the year,” explained Dr Chong.

“Our mentoring philosophy is to create a connection between a senior doctor and intern, and to provide a safe haven where it is possible to share experiences, reflect, seek advice or discuss sensitive issues without prejudice.”

“The simplicity of the program is one of the reasons for its longevity, as well as the incredible support of our consultants,” reflected Dr Chong.

Featured image: Dr Carol Chong, Supervisor of Intern Training; right hand corner Dr Pavany Arulliah, General Medical Consultant and her mentee Dr Helen Pho, Intern

Our ‘Executive patient safety walk-arounds’ are integral to improving safety and getting the feedback from the staff on the floor, patients and their families. Due to COVID-19, the walks have been slightly modified, but will continue throughout 2021, commencing from next week.

Based on feedback gathered during walk-arounds, the team monitors the improvements suggested and puts in place clear strategies and procedures to reduce risk in those areas.

Debra Bourne, Chief Nursing and Midwifery Officer, said they are a great opportunity for the Executive team, with consumers, to walk around each unit and speak with our staff and their patients.

“This is a great opportunity to talk and understand what matters to them and how we can improve things to keep them safe in their unit,” she said.

Briana Baass, Chief Allied Health Officer and Partnerships, highlighted the continued collaboration with consumers, and said consumers are actively participating in safety improvements for a certain ward or area, while families provide feedback by the bedside.

“This is a great opportunity to just slow down and have a conversation about safety,” she said.

Wanda Stelmach, Chief Medical Officer, said it is important to do the walk-arounds to know what is happening in a ward or area.

“We might think we know what is safe practice and what will work in an area, but until you actually work in an area, you don’t understand the issues faced. This isn’t an audit, it’s about us finding out what is occurring on the floor and how things are working,” she said.

In the video below, hear more from Debra, Briana and Wanda about the importance of these walk-arounds and how they contribute to improved patient care: