Builder appointed for Stage 2 Expansion Project at Northern Hospital

The Minister for Health has approved Kane Constructions as the main works builder for the Stage 2 Expansion Project at Northern Hospital. Kane have extensive experience in building public hospital infrastructure.

This next stage will increase the tower from three to seven floors, including three 32-bed wards accommodating 96 acute in-patient beds and three new operating theatres. The seventh floor will include shell space for future expansion.

Works are expected to commence almost immediately with an anticipated completion date of late February 2021.

Staying Well

In health care, we know we need to do things differently as our population grows and demand for health services continues. Our new “Staying Well” initiatives will commence in the second half of the year – where we will reach out to patients in the community to support them further outside hospital.

In the future, this will extend to further involvement in population health and support across our community.

I’m pleased that we’ve been able to recruit Professor Don Campbell as Clinical Services Director, Staying Well Program, commencing in August. Don is an innovator in the health sector, establishing a number of ground breaking programs including most recently the ‘Monash Watch’ program for patients with complex needs.  He has also been involved in simulation flow modeling tools, to understand the movement of patients through hospitals – including Royal Children’s Hospital, Royal Melbourne Hospital & Royal Adelaide Hospital.

Flu Vaccination

Our flu vaccination team have provided over 16,000 vaccinations to the public in just over a month, compared to 11,000 vaccinations in three months last year, and to date 602 patients have been vaccinated.

When we look at our staff, 79% of staff have received the vaccination, with our target being 90%. I encourage you all to participate for your own health, your family and the protection of our patients.

Although the flu season has not yet been officially declared, we all know winter is here!

I hope you have a good week ahead.

Siva Sivarajah

Chief Executive

The education evening on ‘Osteoarthritis – Joint Management with General Practice’, is an example of how Northern Health is working collaboratively with the General Practitioner (GP) for the best patient outcome. It was initiated by our Orthopaedic Department and developed and coordinated through the Primary Care Liaison Unit.

Seventeen GP’s attended the event, which sought to provide a forum for GP education regarding best practice non-surgical management of hip and knee osteoarthritis (exercise and medication).

Karen Overall’s role as Primary Care Liaison, is to provide the expertise of Northern Health’s medical specialists to present the most up-to-date and relevant medical development for the GP. A role that is of increasing importance in Northern Health’s mission to keep our community well in their own homes.

“An important aspect of the upskilling is to know at what point to refer to Northern Health and what is required in the referrals for triage,” says Karen.

“Patients are triaged according to the information we receive, so it’s really important to educate the GP on what is required on a referral to our service.”

Juliette Gentle, Director of Orthopaedic Surgery at Northern Health states “The key messages were optimising non-operative management of hip and knee arthritis in the community, promoting resources for GP’s and their patients and highlighting programs available for referral.”

“There is irrefutable research evidence (at least 44 randomised controlled trials) to support the assertion that structured, targeted exercise therapy improves pain management and function, regardless of the severity of radiographic findings or pain severity,” claims Tom Collins, Clinical Leader Physiotherapy – Advanced Practice at Northern Health.

“What patients are often not told, is that 10 percent of patients are unsatisfied with their knee replacement surgery outcomes at one year, and 20 percent have no clinically meaningful improvement in pain or function,” he adds.

Speakers included Anton Harms – Advanced Practice Musculoskeletal Physiotherapist, Akilan Velayudhan – Anaesthetic Consultant and Pain Specialist and Juliette Gentle.

Anton Harms says “Over my time at Northern Health, I have witnessed remarkable improvements in many patients’ osteoarthritis knee pain through specific exercise and weight control improvements, that I would not have thought possible if I had not witnessed it.”

“The aim of the GP session was to try and convey this to them and in particular, to inform them about the GLA:D program for hip and knee osteoarthritis.”

The GLA:D program developed in Denmark, provides the minimally effective dosage of exercise for knee and hip arthritis. This consists of two one hour exercise sessions per week for six weeks.

A patient of the GLA:D program at DPV Community Health, Epping, Pamela Horton, can attest to the effectiveness of it. “I did not want to get surgery, so I was willing to try anything.”

“I think it was the best thing ever for me,” she continues.

“Because of the program, I’m actually walking really well and I’m not going for the operation.”

Anton says, “As the primary point of contact, the GP’s have a critical role in advocating for and arranging rehabilitation before considering referral to the Orthopaedic Department.”

“Pain and disability are a massive problem, in particular in our community. It just so happens that we have the perfect group of collaborative, passionate, skilled team members (Juliette, Anton, Briana, Wanda, Akilan and Jake from the pain team) to make this model of care work,” Tom says.

Featured image left to right: Anton Harms, Juliette Gentle and Karen Overall.

Our Inpatient Palliative Care Unit at Epping Gardens recently kicked-off their Comprehensive Unit-based Safety Program (CUSP) meetings.

Dr Alison Giles, Palliative Care Physician and Head of Unit, sees the CUSP as a great problem-solving and team building opportunity.

“CUSP meetings are a great opportunity to get together as a team and problem solve at a grassroots level. We also see it as an opportunity to think about our safety and ensure high quality care for our patients,” she said.

CUSP is a key component of Northern Hospital’s HRO transformation, providing a clinical method for improving patient safety through improved teamwork, communication and fostering clinical best practice.

Initially developed by Johns Hopkins Medicine, CUSP is a methodology establishing clinical teams as centres of local knowledge and shared clinical expertise. As a collaborative network, CUSP meetings focus on clinical communication and awareness of unique patient risks by identifying system defects and potential localised interventions across a range of disciplines.

“It’s a great way to team build because prior to this, we didn’t have an opportunity to gather across multiple disciplines. The team will meet regularly – doctors, nurses, allied health, pharmacy, ward clerks, volunteers, managers – everyone together to brainstorm and problem solve,” Alison added.

Dr Jaclyn Yoong, Palliative Care Consultant/Medical Oncologist, said these meetings can help the team discuss data and results relevant to their patients.

“I think CUSP is a valuable exercise because there are a couple of things that are important from a quality and safety issue, that may not be necessarily transferable between sites. For example, our patient population is different than the acute population. Using these meetings to flag things which are relevant to our specific setting, both geographically and clinically is good,” she said.

Clare McCarthy, Project Manager, said this is Northern Health’s fifth CUSP and there will be more in the future.

“We are currently supporting Respiratory and Neurology/Stroke (Ward 18), Med3/Unit B, Respiratory Outpatients and Unit 1 Broadmeadows CUSPs – and the ICU CUSP is starting next month. Our CUSPs are emerging as effective communities of practice, they’re embracing the method, and their preliminary outcomes are indicating a heightened awareness of safety culture,” she said.

Consistent with international data, Australian research indicates that about one in 10 hospital patients experience a ‘complication of care’, with half of these considered ‘avoidable’. Each episode of patient care occurs in a modern, complex and high-risk environment and involves thousands of people and moving parts.

Avoidable complications arise largely because of failings in communication and culture, rather than individual clinical incompetence or other failings in the chain of medical care.

CUSPs are there to enhance communication across disciplines, increase teamwork and improve patient safety.

Westmeadows local, Natalia O’Keeffe, knows the Neonatal Unit at Northern Hospital very well after her premature twin boys, Liam and Logan, spent over two months in the nursery.

After being born at just 32 weeks during an emergency caesarean after Natalia’s placenta ruptured, the twins were transferred to Northern Hospital a week after they were born.

Liam spent 69 days in hospital, while Logan spent 59.

Born on 22 March 2018 at only 1.3 kg and 1.4 kg, the proud mum was excited to share the news recently of an exciting milestone – their first birthday.

“They’re doing amazing – they’re hitting their points, they’ve just been signed off by the physio today. They’re happy and healthy!”

“They’re crawling and starting to say a few words – they’ve come out of hospital with no complications at all,” she says.

Liam was born first as he was the healthier baby, followed shortly after by Logan.

As they were born prematurely, throughout their stay in hospital they suffered a number of complications. Natalia tells us they wouldn’t feed properly, developed temperatures and caught colds very easily.

“Liam wasn’t drinking or swallowing properly, and when he swallowed milk, it went into his lungs and caused a lung infection,” she says.

“They were on antibiotics, which could have caused hearing problems, but they had a hearing test just last week and passed!”

As Natalia had her other son Lachlan at home, she couldn’t be with her newborns all the time and would come in at night with her husband. She says the nurses made all the difference to her experience, as they consistently kept her informed of their progress.

“The nurses would call me every four hours to provide me with updates which was really great,” she says.

Natalia says staff went above and beyond for her and her sons – “They were in hospital on Mother’s Day and, because I couldn’t be there with them, the nurses printed their footprints on a Mother’s Day card for me. They gave it to me when I came in – that was really special – I have the card stored away and will keep it forever,” she says.

Natalia says her overall experience with the hospital was fantastic – “you get nurses that really know what they’re doing, and you click with them and become friends.”

“The staff were amazing – all so positive and helpful. They also gave you your space when you needed it so you can bond with your babies, which was really nice,” she adds.

“I want to say thank you so much to the nurses, because they’ve come out healthy. I really appreciate the time and care they put into them – you can see the benefits at the end of it.”

“Also, thank you to the volunteers who cuddled them when we weren’t there!”

In this week’s Get to know: Q&A with…we chat with John Cozzolino, Team Leader at Payroll Services.

What is your coffee order?

As a born Neapolitan, I can’t go past an espresso using the flip coffee pot.

What does a typical work day look like for you?

My day starts early, at 3 am. I’ve been passionate about health and fitness from a young age, so I’m off to the local 24 hour fitness centre for an hour session, then back home to take the dog for a run.

I typically start work at 7.30 am. My role is deadline driven, so I have to organise my time and prioritise workload efficiently and effectively. Also, tackling any new challenges the day may bring is part of the usual day.

Tell us about your Northern Health journey? 

My journey at Northern Health started in October 2001. Prior to this, I was working for the Royal Children’s Hospital for twelve years.

As a resident of the north, I was looking for something closer to home and applied for a role in the Human Resources Department.

My role is partly payroll related, where I aid in maintaining the payroll master file and at the same time, work closely with the Melbourne Health Payroll Department.

When I arrived in 2001, Northern Health had 2,400 employees. Today, we have approximately 5,200 employees. The growth has been incredible and exciting for Northern Health.

Now, after 18 plus years, we begin another amazing, new journey of having payroll services in-house from mid July 2019. Exciting times!

Can you tell us a bit about your career before starting at Northern?

After completing accounting studies, I applied for a payroll position at the Royal Children’s Hospital. I spent twelve years there and my first role was as a Payroll Administrator. I then successfully moved into a team leader/manager role. I was also lucky enough to be seconded to North West Hospital, formerly Mount Royal, as Payroll Manager for nine months. In October 2001, I decided to move on and begin employment with Northern Health in the Human Resources Department.

What is your greatest achievement or favourite memory since working here?

There have been many tasks to be proud of over the years, and would’ve only been achieved by working and collaborating as a team with my colleagues.

On a personal note, commitment to Northern Health for 18 years is my biggest achievement.

How would you describe Northern Health in one sentence?

Playing a vital role in providing care for the growing demand of acute illness and injury.

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

When it comes to music, I’m a fan of pop and dance music and have a love for classical and listening to solo piano. Mum wasn’t a fan of classical music, so dad would drag me along to concerts from an early age – which I agreed because I knew gelati was on the cards after the concert.

From the age of nine, I wasn’t a fan of some Italian home meals like pasta e piselli (peas), pasta e fagioli (beans), pasta e broccoli.

Pasta was with everything! Give me a meat pie, sausage role or hot dog anytime.

Ask me if I love those meals now – absolutely!

What do you like to do after work?

I’m an early starter, so not much happens after work during the week. I touch base with mum over the phone, prep dinner and dedicate time to my pets. I’m a crazy sports fan, so I catch up on sports, both with AFL (Collingwood) and my home town Napoli football club.

Do you have a bucket list item? Something you would love to do?

My dad wanted to travel the Glacier Express train through the Alps together.

He became terminally ill, so we never had the chance to take the trip.

This one is on my list!

Who would you nominate next for a staff profile and why?

Roger Nicholls. Roger employed me back in 2001 and was my mentor for 13 years. As the Director of Corporate Governance, Roger continues to play a major role for Northern Health.

Welcome to winter!

The hospital has been busier than ever in the last few weeks, consistently seeing over 300 presentations to the emergency department each day.

While the flu season is yet to be declared, the hospital is seeing high numbers of confirmed influenza cases. Almost 20,000 cases of flu have been reported so far this year compared to 2,500 in the same period in 2018. Many of these patients are very unwell. Having looked after a number of them myself in the last few weeks, it serves as a timely reminder as to the importance of protecting ourselves and our families from the flu.

We all know that the best way to protect ourselves from flu is by being vaccinated. It’s excellent to see that the large majority of staff have had their fluvax, but we still have a way to go to reach our target of 90% vaccination. For staff who are unable or unwilling to have the fluvax, to protect them from exposure to flu, they will be required to wear a mask to reduce their risk of contracting it.

While this might seem like a drastic move, minimising the transmission of flu amongst our staff is a high priority for Northern Health.

As someone who diligently had their fluvax on the first day of our vaccination campaign, it was a shock for me to find myself with a high fever and a cough four weeks later. I had been around several patients who had been unwell with flu but had always carefully used a gown, gloves and a mask, as well as religiously using Avagard to clean my hands. Just like I would isolate a patient while waiting for their flu swab result to return, I isolated myself to protect my patients and team in case I was contagious.

While vaccination is the best protection, it isn’t perfect and so it is vital that we use all of the infection prevention measures available to us.

As caring healthcare workers, when we find ourselves unwell, we often don’t want to take enough time off to recover for fear that we are increasing the workload for our colleagues, but this is really the best possible thing we can do so as not to infect our friends and co-workers.

Finally, when it’s really busy and everyone is under the pump, it’s easy to forget to be kind to each other. Working together as a unified team is the only way we will all get through what is shaping up to be a busy and challenging winter.

Take care of yourselves,

Dr Katharine See

Director, Respiratory Medicine

La Trobe University’s Professor of Digital Health, James Boyd, held a lecture at Northern Health on digital data, health informatics and different ways we can use information to improve patient outcomes and the way a health service works.

“Health and care systems are complex with many interactions and linkages. No single part of the health system provides a complete picture. It is the whole system and the way that different parts interact which provides a complete picture of the ‘patient pathway’. Using ‘joined up’ information that covers the whole healthcare system allows clinicians to practice knowing the full context of their patients and their outcomes,” Professor Boyd explained.

Professor Boyd added care can be personalised rather than generic, founders can focus resources on interventions of proven value, while consumers can get access to solutions and information in ways that are commonplace in other aspects of their lives.

Over the last 10-15 years, technology has provided apps, wearables and the Internet, which has changed not just the way we live – these technology developments have also changed the way we deliver health services.

“Combining skills, knowledge and expertise around digital health, data linkage and health informatics, allows us to collect more information, electronically join-up points of care and to develop new ways of looking at healthcare services. This interaction between technology and healthcare allows us to monitor, manage and improve the efficiency of healthcare delivery and patient outcomes,” he added.

Professor Boyd is certain digital health is the future of health.

Professor Boyd has been appointed as the inaugural Chair in Digital Health at La Trobe University. He has a strong research background and is an international expert in data linkage and data governance and will lead La Trobe’s digital health strategy, course development and high-impact research on this important topic.

To learn more, see the video below:

Recently, the first ‘In-Situ Simulation’ was held in the Emergency Department as part of a Code Trauma Scenario.

Code Trauma is an activation sequence that provides a staff and service response to a potentially major trauma patient in the Emergency Department, that meets the Code Trauma criteria including abnormal vital signs, specific injuries and/or special circumstances.

Simulation is part of a hospital-wide initiative run by the newly formed In-Situ Simulation Clinical Community alongside support from the High Reliability Organisation (HRO) Team at Northern Health. Simulation has been acknowledged as an important part of training in healthcare, with Northern Health having a dedicated simulation centre at the Northern Centre for Health Education and Research.

How In-Situ Simulation differs to regular simulation, is that it occurs in patient care units with scenarios involving healthcare professionals in their actual working environment. It is a tool that allows hospitals to target areas of known risk before they affect a patient, test systems to identify areas of needed system improvement and encourages translation of previous quality recommendations into practice and re-assessment.

The scenario involved a patient (simulation manikin) presenting with a closed head injury and closed left femoral fracture. The quality objectives of the scenario were to examine the response to Code Trauma and any barriers to implementation, as well as the process and barriers for early CT imaging of a trauma patient.

Dr Nancy Sadka, Emergency Physician and lead for In-Situ Simulation at Northern Health says, “If you tried to set up simulation in the simulation lab, people will do things differently to what they would normally do in their workplace. The best way to test the system is in that same environment.”

“Many times, we have areas of risk that we have already identified. These areas of risk have had analysis and recommendations, but if we don’t test to see if those recommendations are being translated into practice, then we don’t know if we’ve had any impact and if anything will change in the future,” Dr Sadka continues.

The simulation was attended by staff from multidisciplinary areas and will help to improve system quality through education and ensure our systems support the right clinical decision-making for the patient.

“We’ve done this first simulation now, we’ve made a simulation team from multidisciplinary areas, with the view to develop this program, aiming now for two monthly, then monthly, and then the sky is the limit!” Dr Sadka says.

“We would like to be doing this weekly if we could because we really feel it will make a difference to the quality of our patient care as well as improve our processes.”