‘Learning Improvement Science at Northern Health (LISN)’ workshop was established in June 2015, with the aim to give Northern Health staff a way to understand improvement methodology and feel empowered to go back to their work environment and make improvements.

LISN is an action learning improvement workshop built around a simulation of Day Procedure Unit (DPU). Multiple cycles are conducted to improve patient’s clinical outcomes and access, reduce documentation errors, while at the same time, improve efficiency. This workshop is crucial to the High Reliability (HRO) – Trusted Care transformation, as one of the critical success factors in achieving HRO is creating enabled healthcare workers who have an understanding of improvement science (LISN) and Reliable Innovation and Safety Science (RISSN).

On Wednesday this week, the workshop was delivered for the 50th time.

Ariana Carrodus, Project Manager, has been part of LISN since it began.

“I look forward to delivering LISN every month – it’s always such a rewarding experience to see participants grow, learn and even have some fun throughout the day. I feel very privileged that I have been able to be part of LISN for the last three and a half years,” she said.

Since 2015, over 500 participants from Northern Health and health services from across the state have attended. Currently, Northern Health is working in partnership with the Royal Children’s Hospital (RCH) to deliver LISN regularly to RCH staff and consumers.

Simon Lane, Improvement Capability Advisor at RCH, was involved with Northern Health’s team in 2015, when the workshop was first developed, and has witnessed it evolving considerably.

Upon identifying that RCH hadn’t had improvement workshops with simulations, the decision was made to collaborate with Northern Health. Simon is a firm believer that in order to know something deeply, you need to try to teach it to others.

“Ariana and I are now co-presenting to our staff. It’s been really effective and we’ve found that having mixed groups from various health organisations is valued by the participants. They get to hear that some of the concepts are similar and exchange ideas. Healthcare is a complex system and all departments need to work together to achieve a particular service delivery for a patient,” he said.

Simon explained that in order to make changes, organisations need input from all departments, and that is why all areas need to have the skills and knowledge of improvement science.

If you are interested in attending LISN please email the team at lisn.hro@nh.org.au

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On 7 February 2009, the worst bush fires in our nation’s history, the Black Saturday fires claimed 173 human lives, injured 5,000 people, destroyed 2,029 homes, killed countless animals, and burnt through over 4,500-square kilometres of land.

Today marks the 10 year anniversary of that day, an event that occurred very close to Northern Hospital, marked by a commemoration ceremony at The Chapel of Northern Health .

The smiling faces of our volunteers are the first people you see as you enter the hospital. Our volunteers form an integral part of how the hospital operates and help us to provide trusted care to our community.

Brian Hoctor is a volunteer driver who has been with Northern Health for five years, and is a wonderful example of true community spirit.

A humble man, Brian says, “I’m not here for pats on the back, I’m here to help.”

His role is to drive patients receiving chemotherapy or dialysis to and from their appointments at the hospital, and to make sure they are settled, comfortable and feel safe.

Brian feels he is very much on a journey with the patients he brings in, providing comfort and an ear to listen. He refers to the front passenger seat of his car as a ‘confessional’, as the people he drives around tend to open up to him.

“These people are scared, they don’t know what they’re in for, they’re going to chemo or they’re going to dialysis, so the front seat of my car is very much like a confessional. It’s very honest and it’s like the chair that tells the truth,” Brian says.

Lynda Williams is one of those passengers, and is very grateful to Northern Hospital for the opportunity of meeting Brian.

“Brian is genuine and caring. He’s always listened to me, but never given advice, just listened. He’s stopped many tears and he’s made me laugh,” Lynda says.

“Because I don’t drive, I’d have to catch buses, so being picked up and dropped off removes a lot of stress. When Brian started picking me up, I was really freaked out about my hair, but his smiling face has helped me through it.”

A cancer sufferer himself, Brian forms close bonds with his passengers, as he can relate to the hardships they are facing. He says that sometimes he does struggle with emotional attachment.

“When you’re picking up the same person for two or three years, you get pretty close to them and you feel you are part of their lives. It’s a struggle to let go, but you have to let go and let them rest in peace,” Brian says.

Brian brings a lot to the lives of the people he drives around, but says volunteering at Northern Health has also brought a lot to his life.

“I’ve learnt to be more humble, I’ve learnt to smile on the outside and I’ve learnt to be compassionate,” he says.

“I’ll be here until I can’t do it anymore.”

Do you have an interesting story for iNews? Please send it to our team at iNews@nh.org.au.

Dr Prahlad Ho, Program Director of Diagnostic Services and Director of Clinical Haematology, was recently awarded his PhD for his thesis, ‘Evaluation of the management of venous thromboembolism and application of novel global coagulation assays’, completed in conjunction with the Florey Institute of Neuroscience and Mental Health, University of Melbourne.

Dr Ho is a joint NHMRC and Heart Foundation Scholar, who studied the risk of clot recurrence in patients with venous thrombosis by the use of novel global coagulation assays.

His work has defined subgroups with higher risk of recurrence, as well as identified unique mechanisms that regulate clot dissolution, adding enormous value to existing knowledge.

“When I started this interesting and rewarding journey in 2014, my bemused colleagues firstly asked why I was doing a PhD, then why I was doing a PhD in Thrombosis and then why at Northern, as they thought I would never succeed doing research here,” Dr Ho says.

“My response to them was why not?”

Cardiovascular disease and thrombosis remain a leading cause of mortality and morbidity in Australia.

For Dr Ho, Northern Health is ‘home’ – where all the patients are, where he began his internship and where he received postgraduate fellowships from.

The last five years at Northern Health have proven those doubts wrong and highlighted that research and clinical practice needs to go hand in hand.

The epidemiological arms of Dr Ho’s project, which reviewed over 1,000 deep vein thrombosis (DVT) and pulmonary embolism patients at Northern Health, has highlighted the importance of minor venous thromboembolism, such as below knee DVT and provoked events, which have substantial rates of recurrence and morbidity.

This review, which has been published in four international journal articles, formed the basis of the creation of Northern Health’s very own Thrombosis Service, which reviews over 1,000 patients every year.

Similarly, the challenge to clinicians today remains the ability to predict the risk of thrombosis and cardiovascular disease within our population.

“To address this, we looked at new blood biomarkers that evaluated the whole clotting system. We have demonstrated that these global coagulation assays, including thromboelastography and thrombin generation, are able to differentiate subtle differences in clotting parameters, which are not seen by routine coagulation testing,” Dr Ho says.

Using Dr Ho’s PhD as a basis, a thrombosis research laboratory has been established at NCHER, supported by Northern Pathology Victoria, to further address these questions with fellow colleague and PhD student, Dr Yin Lim.

Dr Ho hopes to inspire others to consider incorporating research into their lives.

“Research is a long and hard journey. The purpose of this journey is not the reward at the end, but the experience you gain through it, and something I would highly recommend.”

Do you have an interesting story for iNews? Please send it to our team at iNews@nh.org.au.

Broadmeadows Hospital patient, Keith Vandome, was diagnosed with type 1 diabetes when he was just 7 years old.

Today, he is 78, manages his condition very well, exercises regularly and with the help of new diabetes technology, he hopes to see the usual day to day blood glucose monitoring become easier.

“The insulin choices and treatments at the time I was diagnosed were nothing like today. I’ve seen a lot of changes over the years, and the management of the condition got much better,” Keith said.

Last year, Keith received the 70th Kellion Victory Medal through Diabetes Australia, for recognition of living with diabetes for more than 70 years. These medals are awarded every year to patients living with diabetes type 1 or 2 for more than 50 years.

Keith has been seeing the diabetes educators and dietitian at Broadmeadows Hospital since 2008, and attends The Northern Hospital every 4 months to see the Endocrinologists. At his recent visit in January 2019, Keith was put on the Libre Flash Glucose monitoring system.

The Libre Flash Glucose monitoring system is a new diabetes technology approved by the FDA in 2017, which requires the user to “scan” the sensor to obtain current glucose readings and replaces the need to prick the person’s fingers constantly.

Diabetes Educator, Susan Abraham, explained the scanning process.

“The sensor is placed on the back of the patient’s arm, and the patient obtains their glucose reading by scanning over it. Patients are finding this very helpful as the sensor not only eliminates the need for finger pricking, but also shows data in a form of a graph, indicating glucose levels for the last 24 hours,” she said.

Keith is looking forward to easier monitoring and said the secret to living with diabetes for so long is doing the right things and being open to new technologies.

“I listen to doctor’s advice, eat healthy, and regularly go to the gym,” he said.

At the age of ten, Keith heard a school teacher reading a newspaper article, saying the cure for diabetes is on the way.

He still hopes that day will come soon.

Do you have an interesting story for iNews? Please send it to our team at iNews@nh.org.au.

For decades now, coded data has been used to ensure hospitals can be reimbursed for their activity and better plan for services in the future.

Clinical coding usually occurs after the patient has been discharged from hospital, where information written in patient notes is translated into coded data and entered into hospital information systems.

It is important that hospitals code episodes of care accurately to ensure the right resources to provide care for patients is received. For Northern Health, coding helps to fund our clinical services and equipment needs.

Medical Unit 4 at Northern Hospital Epping has been involved in a coding audit review process for over four years.

The process involves the whole team meeting with Patricia Savino, Health Information Manager (HIM), on a monthly basis and answering any clinician questions about documentation.

Northern Health’s regular audit is a great example of ensuring data is accurately reflecting the patient’s episode of care, and we are optimising our eligible Weighted Inlier Equivalent Separation (WIES) income. Medical Unit 4 has achieved 77.10 WIES YTD – that’s $372,624! This figure is expected to double for the remainder of the year.

Medical Unit 4 Consultant, Sandeep Sharma, says “our monthly meetings are a great opportunity for our Unit Clinicians to come together and discuss complex patients, and for our junior staff to see how clarification in documentation can lead to significant changes in funding.”

“We know it’s imperative for our junior medical staff to learn financial aspects of medicine, as we do not live in the world with unlimited resources,” Sandeep says.

Frances Barnett, Medical Director Oncology, has been interested to learn more about WIES optimisation and data quality improvements after Mary Kouvas (pictured above), Clinical Documentation Specialist (CDS), spoke at a Heads of Unit meeting.

Frances believes there is an opportunity for doctors to have a better understanding that documentation has both a clinical and revenue purpose. An example of this is the diagnosis of pneumonia treated with antibiotics.

“To me, this means a bacterial pneumonia, but a coder requires bacterial pneumonia to be specified rather than implied. If the documentation is done for both purposes the first time, it is more efficient for everyone,” Frances says.

“I have set up regular meetings for 2019 so that my junior medical staff can learn how the process works, thereby reducing the need for queries to be generated and answered.”

Another way of improving data is by being involved in the documentation improvement process on the ward. Mary Kouvas reviews concurrent medical records to ensure the documentation is written in a specific way the coders can translate into codes. This Clinical Documentation Improvement (CDI) program looks at improving documentation in real-time, to reduce re-work at a later date.

If you wish to get involved and reap the benefits, please email mary.kouvas@nh.org.au or call CDS on 8405 2038.

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On Tuesday, 26 February, Northern Health’s Strengthening Hospital Response to Family Violence Team will be running an “Accidental Counselling” workshop at Northern Centre for Health Education & Research.

Accidental counselling refers to situations where emotional support is given by one person to another, where the person giving support is not a trained counsellor.

In our workplace or personal life, we can cross paths with people, clients or customers who are sometimes upset, distressed, sad, hurt and lonely, or simply need someone to listen to them. If you’re not a trained counsellor, it may be difficult to manage these situations with confidence.

The practical and interactive workshop will help participants develop skills in effective listening, empathetic communication, positive body language, assisting others to consider new possibilities, asking the right questions, focussing others towards solutions, setting boundaries and restraining the urge to ‘fix’ anyone or solve another person’s problem.

The workshop will be run by Linda Wilson, a qualified, practicing counsellor in private practice and experienced facilitator. Linda has worked with thousands of people to help develop their personal and professional skills, and has over 20 years of experience within the business sector and private practice.

Natasha Knapic, Project Officer, Strengthening Hospital Response to Family Violence, says “the workshop is a great way for people to better understand what to say and do to help others who are struggling, whether it be in the workplace, at home or in the community, and will provide valuable tools and skills no matter what situation you find yourself in.”

For information about the workshop, course fees and to register, please complete the registration form below and send to the Strengthening Hospital Response to Family Violence Team by 11 February 2019.

Accidental Counsellor Registration Form

February is Northern Health’s month dedicated to healthy and smart eating, with a ‘4 Week Staff Smart Eating Challenge’.

The inspiration comes from the Dietitians Association of Australia Smart Eating Week, celebrated from 11 – 17 February.

Amy Castelli, Clinical Dietitian, said our dietitians have developed a 4 Week Smart Eating Calendar, with every day smart eating tips, and encourages all staff to participate and win a prize.

“The calendar has a small challenge for every day of the week and ties in with the Dietitians Association of Australia campaign and also links with Northern Health’s Healthy Choices Campaign. This also follows from the Rethink your drink display, located in the Craigieburn Centre foyer,” she said.

The Rethink your drink display, developed together with Cancer Council Australia, showcased how much sugar many popular drinks contain, raising awareness of the hidden sugar content in drinks and promoting healthy choices, for which the team received a lot of positive feedback, especially from parents.

While that campaign was targeted both at staff and visitors, the 4 week Smart Eating Challenge aims to help Northern Health staff make healthier choices day by day.

“This is a good time – the year has just started and everyone is still motivated to get back on track with their nutrition. The calendar we have developed in not a weight loss programme, it’s not a diet, just simple steps people can make every single day to become a little bit more balanced,” Amy added.

Dietitian, Cliona Twohig, added that the main reason the challenge is targeting staff is that we often look after our patients, but sometimes forget to look after themselves.

“In order to be able to take care of others, we need to be able to take care of our needs and stay healthy, taking care of our mind and body, and nutrition is a really good way to do that,” she said.

Cliona added that the challenges during the ‘smart eating’ month are really simple – it can be just having an extra piece of fruit or sitting down and enjoying your meal and not rushing it at your desk.

“Every challenge is actually designed to lead to a long-term change and that is something we’d recommend. Even if just two to three new habits develop, that is a step in the right direction,” she added.

There is no pass or fail in this challenge, and that is why everyone should participate. The goal is to improve your health score, and to develop new habits.

Join the challenge and share your new smart eating habits or a healthy lunch with us to win a $100 Coles Myer Gift Card.

Click here to find out more.

Do you have an interesting story for iNews? Please send it to our team at iNews@nh.org.au.