Each week in the lead up to Accreditation, Northern Health will focus on a different Standard. You will hear from the Chairs of each Standard Committee on what you need to know.

This week we spoke to Lisa Cox, Chief Nursing and Midwifery Officer, about Standard 5: Comprehensive Care.

What is this standard about?

Standard 5 is aimed at ensuring patients receive care that is based on their individual care needs and considers the whole person in that care. It also aims to ensure that each patient is assessed at the beginning and during their care for any risks of harm. These risks are then mitigated though interventions developed with the patient and family.

At Northern Health, this standard covers nine key areas:

• Assessment and developing a comprehensive care plan
• Providing comprehensive care at end of life
• Preventing falls and harm from falls
• Preventing and managing pressure injuries
• Nutrition and hydration
• Preventing delirium and managing cognitive impairment
• Predicting, preventing and managing self-harm and suicide
• Predicting preventing and managing aggression and violence
• Minimising restrictive practices – restraint and seclusion

What are the top 5 ways staff can be prepared for Accreditation against this Standard?

All patients on admission need to be assessed using the admission form and risk assessments.  A care plan is then developed based on this initial assessment. It is important that all staff providing clinical care review the plan of care each day to understand each patient’s individual care requirements, identified risk(s) and ensure strategies are in place to minimise patient harm. There are specific harms that are identified in this standard and they are:

• Pressure injuries
• Falls
• Poor nutrition
• Cognitive impairment
• Self-harm and suicide risk
• Unpredictable behaviour

The plan of care developed for each patient must consider these potential risks and ensure that they are protected from harm. More importantly the care plan needs to be developed with the patient ensuring decisions made about their care is shared.

What are the top 5 questions staff needs to be able to answer about this Standard?

• What is your patient’s/consumer’s specific goal for the day, what matters to them?
• What does your patient/consumer want to achieve by, being in hospital or using the community (Hospital without Walls) service?
• What is your patient’s/consumer’s risk(s)?
• What interventions and plans do you have in place to minimise harm from these identified risks?
• Does the patient/consumer and/or their family/carer/nominated support person understand their risks?

To learn more about Standard 5, please see the Intranet.

#WeAreNorthern

Meet Dr Eric Daniel, Colorectal Surgeon, Northern Health

Q: What is your coffee order?

A: Long macchiato.

Q: Tell us about your role at Northern Health?

A: I’m a Colorectal Surgeon which is a sub-speciality dealing with bowel cancer, inflammatory bowel disease, pelvic floor dysfunction and proctology. I finished medical school in 2006 and my post graduate training in 2017 and started as a consultant in 2018 at Northern Health.

The Colorectal Unit is a part of the Division of General Surgery, and we work closely with the Gastroenterology Unit, stomal therapy, nursing staff and Allied Health.  It is a busy unit for our junior medical staff, but I think our unit culture makes it a favourable rotation. Well, I hope it does!

 

Q: If you weren’t a surgeon, what would you have been instead?

A: Either a failed writer or a terrible lawyer. In both cases, still living with my parents.

 

Q: What is your biggest achievement till date (both professionally and personally)?

A: Professionally, I feel my biggest achievement was getting through training. It’s a terrible toll your family has to pay. Personally, being lucky enough to have two children.

 

Q: What is on your bucket list for 2024?

A: Ah…. Probably getting away for the weekend for my 10-year wedding anniversary. Actually, this is quite a good reminder to book something!

Northern Health is committed to delivering patient-centred care. Partnering with consumers is central to ensuring that our patients and their carers are at the core of all the work we do.

Standard 2, known as the Partnering with Consumers Standard, is about fostering a collaborative relationship between healthcare providers and those we serve. This means involving consumers in the planning, design, delivery, and evaluation of our services. It’s also about empowering patients to be active participants in their own care, giving them a say in decisions that affect them.

Today, we’re excited to share the story of Carol Burnett. Carol is not only a retired nurse, teacher, educator and manager, but also a dedicated volunteer at Northern Health since 2019. She’s currently a valuable member of our Consumer Participation team, where she continues to make a difference in shaping our approach to patient-centred care.

Q: Tell us about your professional background and some of the roles you’ve had throughout your career?

A: I have had a range of careers, starting as a nurse in 1965. I gave up nursing to raise my two children and during that time studied to become a teacher/librarian. I taught for a while and then moved into adult education, and finally management. One of my roles was CEO of Volunteering Victoria – the peak body for volunteers – and I was a manager at The University of Melbourne for 10 years and La Trobe University for 15 years.

Q: What is your relationship to Northern Health and how did this begin?

A: I started as a Volunteer in 2019 and was a guide for a while, before moving to various admin tasks. I then commenced driving patients to their outpatient appointments. COVID struck and the driving program had to cease. When we were allowed to resume, I started driving at the Bundoora Centre and I do this two days a week.  I also participate in the Standard 2 Committee.

Q: Why do you think it’s important to be involved in Consumer Participation and in what capacity do you contribute to the team?

A: Volunteering has been a big part of my life for over 40 years, and I have been on numerous committees. As for taking part in Consumer Participation, I felt that I had the skills and the willingness to volunteer my time. I have always believed that it is more important to be part of the solution, than be the person that complains about issues within the health service. Consumer Participation allows people to do exactly that – be part of the solution and give feedback from a different perspective.

Q: You provide valuable insights to Northern Health because of your lived experience. What does it mean to have ‘lived experience’ and how do the insights you share make a difference to the health service?

A: There is a definition that lived experience refers to the first-hand involvement or direct experiences and choices of a given person, and the knowledge that they gain from it, as opposed to the knowledge gained from second-hand or mediated source. This fits with what I believe, and decisions made by Northern Health about consumers should always include the consumer’s viewpoint, which can often be different than those making the decisions. The National Safety and Quality Health Service (NSQHS) has set standards which Northern Health has adopted, and I believe that if you have a standard, you need to be proactive in addressing the issues. Being part of the Standard 2 Committee enables me as a consumer to be proactive.

Q: Tell us something not many people know about you?

A: When I was sixteen – a very long time ago – I lied about my age so that I could be a dancer at a St Kilda nightclub. My “career” only lasted for three weeks, as my brother saw me and told the manager my real age.

Q: Is there anything else you would like to add?

A: What I find interesting is that the past can have an influence on what we do today. My great aunt was a nurse at the Launceston General Hospital in 1908 and was involved in an incident that impacted on the patient’s wellbeing. My book on the subject has just been published, and the hierarchy of the day shows the huge gap between the way hospitals are run today and the respect and rights given to consumers.

A new test, similar to COVID-19 rapid antigen tests, could detect a common infection in expecting mothers within minutes, potentially saving the lives of 150,000 newborns around the world every year.

Group B Streptococcus (GBS) bacteria is carried by one in five pregnant women, and GBS infection can cause serious complications, leading to preterm births, stillbirths and neonatal deaths. The good news is the infection, once detected, is easily treatable with standard antibiotics.

RMIT University is part of a consortium that has just won $3 million in funding in the latest Cooperative Research Centres Projects (CRC-P) round for StrepSure®, a sensor technology that’s anticipated to be able to identify GBS bacteria within minutes.

Northern Health is delighted to partner with RMIT, EXSEN Biotech and Atomo Diagnostics for this important trial.

RMIT has already filed a provisional patent application to protect the key intellectual property underpinning the GBS sensor technology. Within the next three years, the RAT-like technology will undergo large-scale clinical trials and be taken to regulators in Australia, the United States and the United Kingdom.

Associate Professor Prahlad Ho, Chair of Northern Health Research Executive Committee and Divisional Director of Diagnostic Services, said Northern Health was proud and excited to be the clinical partner in the project, which will help improve clinical outcomes for babies.

“As one of the busiest healthcare providers in the region, Northern Health is committed to providing the best care for its large volume of clinically and ethnically diverse populations through its research collaborations and partnerships,” he said.

“Northern Health’s clinical partnership, led by Professor Lisa Hui and the Northern Pathology team, will enable the clinical testing of the diagnostic sensor being developed, thereby making it available for wider and equitable use in the community.”

Pictured left to right: Professor Shekhar Kumta, Professor of Surgery, Northern Health, Mr Thomas Hanly, CEO, NexSen, Mr Mark Muzzin,Chairman, NexSen, Associate Professor Prahalad Ho, Chair of Northern Health Research Executive Committee and Divisional Director of Diagnostic Services) and Professor Vipul Bansal, Founding Director, Sir Ian Potter NanoBioSensing Facility, RMIT University.

February marks Ovarian Cancer Awareness month and is dedicated to raising awareness and providing support for those affected by ovarian cancer.

Ovarian cancer is a malignant tumour that grows in one or both ovaries and is the ninth most common cancer in Australia. According to Cancer Council Australia, it is estimated that each year, about 1,720 Australians are diagnosed with ovarian cancer.

While over 80 per cent of people diagnosed are over the age of 50, ovarian cancer can occur at any age and it can be difficult to diagnose in its early stages, as symptoms can often be non-specific or similar to those of other diseases.

“Unfortunately, at present, it is difficult to detect ovarian cancer early as symptoms tend not to develop until the cancer is more advanced. Symptoms can be vague and include persistent abdominal pain and bloating. If you experience any persistent new concerns, you should see your doctor in a timely manner,” said Dr Frances Barnett, Medical Oncologist, Northern Health.

Although further research is needed to fully comprehend the origins of ovarian cancer, currently, there are no targeted tests, screening procedures, or preventative measures available to mitigate the risk of ovarian cancer in women.

“Ovarian cancer is not as common as many other cancers including breast and bowel cancer. Some people with hereditary cancer syndromes such as BRCA (BReast CAncer gene), are at higher risk of ovarian cancer when compared to the average person, and these women are frequently advised to have their ovaries removed after completing their family to reduce their risk,’ said Dr Barnett.

Even though the only way to really prevent ovarian cancer is to remove your ovaries, this is not necessary for most women. According to Dr Barnett, “More important is general cancer prevention which can be done by eating well, exercising regularly, maintaining a healthy weight, not smoking, moderating alcohol consumption, and having recommended screening tests for certain cancers (cervical cancer, breast cancer, bowel cancer, and lung cancer, for those who smoke).”

Ovarian cancer is usually diagnosed by a combination of preliminary tests performed by a doctor, including a pelvic exam, radiological tests, blood tests and ultimately, a surgical biopsy.

For more information on ovarian cancer, visit the Cancer Council website.

Featured in the image: Dr Frances Barnett, Medical Oncologist.

In the lead up to organisation wide Short Notice Accreditation, each week Northern Health will be focusing on a different Standard. You will hear from the Chairs of each Standard Committee on what you need to know.

This week we spoke to Vinod Chellaram, Director of Pharmacy, about Standard 4: Medication Safety

“Everyone has a role to play in medication safety at Northern Health,” Vinod said.

“The patient is the central focus in medication management and all clinicians are responsible for working collaboratively to ensure the patient receives safe and effective care. The patient/carer is always involved in shared decision making throughout the process of medication management including prescribing and administration of medications and medication counselling,” he added.

What is this standard about?

The Medication Safety Standard aims to ensure that clinicians safely prescribe, dispense and administer appropriate medicines. It also aims to ensure that consumers are informed about medicines, and understand their own medicine needs and risks.

At Northern Health, this standard looks like….

We work together collaboratively when prescribing, administering and dispensing medications and provide information to patients to ensure the patient is kept safe and medication errors are minimised during their inpatient stay. We also ensure patients are discharged safely and continue to stay well in the community.

When administering medications, we follow the 7 rights of medication administration (RIGHT patient, RIGHT drug, RIGHT dose, RIGHT route, RIGHT time, RIGHT documentation, RIGHT reason). We have a strong reporting culture, reporting medication incidents and we learn about the trends in medication errors and work together to improve medication safety across the organisation. The patient is the central focus of care and they are a key component of shared decision making and are involved in the decisions around medication treatment throughout their stay.

What are the top 6 ways staff can be prepared for Accreditation against this Standard?

1. Ensure the patient is involved in all aspects of medication management and ensure they are provided with information in a way they understand
2. Perform a Best Possible Medication History and Medication Reconciliation at admission to reduce the risk of medication related errors including comprehensive allergy/adverse drug reaction documentation
3. Know the Medication Safety Improvement projects in your area, reflect on what you are most proud of
4. Keep medication rooms tidy, and ensure all medications are stored appropriately (e.g. locked in the medication room, schedule 8 safe, WOW medicine drawers)
5. Be involved in education sessions on medication safety including in services and presentations and learning packages on the LMS portal (e.g. Medication Safety Training, Safe Medication Administration – Get It Right!)
6. Familiarise yourself with workflows to support safe prescribing, administration and dispensing practices.

What are the top 5 questions staff needs to be able to answer about this Standard?

1. What types of medication related incidents keep you up at night and what has your area done to reduce the risk of these?
2. How do you involve the patient/carer in decisions about their medications?
3. How do you store medications safely and in accordance with legislative requirements in your area?
4. How do you report a medication incident or new allergy/Adverse Drug Reaction? How do you know what types of medication incidents are reported in your area?
5. What are the high risk medicines at Northern Health and what are some strategies used to reduce the risk of medication errors with these medicine classes?

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

Medication Safety is something you practice every day, we should all be proud of the work we do to improve medication safety and remember to highlight this and be proud when speaking to the assessors.

To learn more about Standard 4, please click here.

#WeAreNorthern

Meet Anne Bright, Project Manager, Northern Imaging Victoria.

What is your coffee order?

I have never developed a taste for coffee. Terrible stuff! I generally order an Earl Grey tea if out with friends, but my current favourite at home is Black Rose tea from the Tea Centre.

Tell us about your Northern Health journey? (When you started, your roles here etc.)

I joined Northern Health in April 2023 as a Project Manager to bring imaging in-house under Northern Imaging Victoria. I continue in that role drawing upon my past experience as a Chief Radiographer to help grow and build the service. The current projects are bringing imaging in-house at Kilmore District Hospital, commissioning of PET, transition of point of care devices from the old PACS to the new, and development of services at Broadmeadows and our community sites, with much more on the horizon.

What do you like to do after work?

Listen to music and non-fiction audiobooks. I like walking with my husband, enjoying the sun and breeze or visiting art galleries. When time permits, I enjoy baking or working on a craft project.

What are some things people don’t know about you?

I lived in Belfast for a little over a year before the end of The Troubles. I have a small collection of pre-decommission murals taken on a long walk through the streets of the Falls and Shankill. Those were streets I had been warned to avoid when I first arrived due to the unrest, but by the time I was leaving I knew when to speak with the locals and when to leave some things alone. It was a year of great growth. One painting, seen at Christmas, stands out in my mind. On the side of a large building on the lower Falls Road was the virgin and child, juxtaposed by a large armed checkpoint immediately in front. I was declined the opportunity to take the photograph by my friends, lest we be arrested.

Where is a favourite place you’ve travelled and why?

That’s difficult to answer. There are so many places that are wonderful. One memory that I cherish is my visit to the island of Murano where I was privileged to be taken into the glass works of Mazzega Murano and was able to watch and speak with the glass master at work. Although there’s plenty of opportunity to watch the glass makers, being permitted into the foundry is a rare privilege. The day I was there they were crafting pink glass bowls that surround the globes for a chandelier. It gave me a different perspective on glassblowing from the limited experience I had when I lived in Sydney.

A new paediatric service has launched this week at Kilmore District Hospital, as part of Northern Health’s commitment to providing better connected care, and ensuring we are meeting our communities needs now, and into the future.

The newly established service provides support to young children who experience developmental and behavioural issues. This includes children experiencing speech delay, concerns of autism, concerns of ADHD (Attention Deficit Hyperactive Disorder) and significant levels of anxiety, particularly post-COVID.

Many of these children are eligible for NDIS funding, and the team at Kilmore is focused on recognising and treating concerns before they commence school and getting them linked with the most appropriate services early.

The clinic operates four days a week and is staffed by two community fellows and a paediatric consultant, supported by onsite nursing and administrative support. The clinicians also provide outreach clinics to local maternal child health nursing and community health centres. These clinics accept referrals from, not only GPs, but also maternal child health nurses and school nurses, enabling greater access to care.

“By servicing the Mitchell Shire region and in particular Kilmore itself, we wanted to focus on some of the most vulnerable families and young children who, at the moment, are facing long wait times to be seen,” said Dr David Tran, Divisional Director, Women’s and Children’s Services.

“It is a fantastic, and really exciting new service in a region where there is a huge need. Hopefully this will streamline services and enable some of these patients to get the care that they need faster, and closer to home.”

Dr Daniel Tsen, General Paediatrician, looks forward to its positive impact in the local community.

“It is fantastic that paediatric services are more accessible for community in Mitchell Shire region. This allows us to deliver better paediatric care by working closely with families locally,” he said.

“Through clinics at Kilmore District Hospital and community outreach centres, paediatric community fellows will also gain invaluable experiences in community medicine, consolidating their professional development as future paediatricians.”

Cooper was the very first patient to access this new service on Tuesday, 13 February 2024.

Cooper’s mum, Jordy, is excited to see the progress he will make under the care of the paediatric team at Kilmore District Hospital.

“It’s really good that we now have local access to these health services, not only for ourselves, but also for our children, and not have to travel far away, or be on a massive waitlist,” said Jordy.

Dr Tran also spoke of the other benefits of having a paediatric team onsite at Kilmore District Hospital.

“The other benefit of having the clinics here is that we will also have paediatricians on site, who can help support other services like the Urgent Care Centre. That’s something we’d be really keen to explore,” he said.

Dr Daniel Tsen with Jordy and Cooper

 

Featured image: Jennifer Gilham, Divisional Director, Community Hospitals, Dr David Tran, Divisional Director, Women’s and Children’s Services, Dr Daniel Tsen, General Paediatrician, James Walker, Outpatient Administration Coordinator, Paediatrics, and Jennifer Grech, Team Leader, Kilmore District Hospital Outpatients