One of the latest and highly specialised cancer treatment options available, known as SIRT (Selective Internal Radiation Therapy), was successfully performed at Northern Health on 13 October. Only a relatively small number of hospitals offer this treatment in Australia.

Says Dr Terry Kok, Interventional Radiologist, “Our patient was diagnosed with liver cancer that was not suitable for surgical treatment and we were asked to provide minimally invasive treatment for his tumour. SIRT, also known as Y90 radioembolisation, was chosen to provide the best chance of curative treatment.”

The complex procedure involved the combined Radiology and Nuclear Medicine teams including Nuclear Medicine Physician, Dr Anthony Hannah, supported by specialist nurses and technicians working closely together to plan and administer the treatment.

It also involved expert input from specialist colleagues in Hepatobiliary Surgery, Gastroenterology-Hepatology and Oncology through our cancer multidisciplinary team.

“We were very grateful to have the support of two experts, Dr Mark Goodwin (Interventional Radiologist from Austin Health) and Dr Yung Kao (Nuclear Medicine Physician from Royal Melbourne Hospital) to guide us through the first SIRT procedure at Northern Health,” says Terry.

SIR-Spheres are tiny radioactive ‘beads’, one-third the width of a human hair. The microspheres are injected directly to the liver tumours using the tumour’s own blood supply. The microspheres, light enough to be carried by the blood flow, yet too large to pass through the small blood vessels, become permanently trapped in the small blood vessels that are in and around the tumours.

They then emit high doses of radiation to the tumour cells to destroy them. This targeted nature of the procedure, enables doctors to deliver up to 40 times more radiation to the liver tumours than would be possible using normal radiation therapy, while sparing the surrounding healthy liver tissue.

“The procedure went very smoothly due to the meticulous planning put in by the IR and Nuclear Medicine teams and our patient made an uneventful recovery after a short overnight stay in hospital. The treatment will take effect over the coming weeks and he will be followed-up by his surgical team under the care of Mr Russell Hodgson, HPB Surgeon,” says Terry.

“The establishment of a SIRT treatment program at Northern Health has been the product of over two years of hard work as part of a greater aim to establish an Interventional Oncology centre of excellence for our patients. We offer a comprehensive and holistic service to patients with cancer, covering a wide range of procedures from biopsies and vascular access for chemotherapy, to minimally invasive treatments such as tumour ablation, chemoembolisation and most recently, SIRT radioembolisation,” he explains.

“Patients who would have previously had to be referred to other health services for some of these specialised treatments, are now able to benefit from comprehensive and ongoing care at Northern Health by their doctors, nurses and healthcare professionals who know them best.”

“Associate Professor Wanda Stelmach and Dr John Ferguson (current and former Chief Medical Officers) have provided invaluable support over the years in our endeavours and this achievement is something that Northern Health can be proud of,” he adds.

Chief Medical Officer, Wanda Stelmach, congratulated the team for their dedication and persistence to set up this service which supports the care of our community.

“I have heard from a number of sources how well the procedure went and the collegiate atmosphere that allowed everyone to contribute to the success of the procedure – truly a multidisciplinary effort! Well done to everyone! I look forward working with you to support your to aim to establish an Interventional Oncology Centre, ” she said.

Featured image shows Dr Terry Kok, Dr Mark Goodwin and Dr David Burrows, performing angiography before delivery of radioactive Y90 SIR-Spheres to the tumour. In the background is Maryann Chetcuti RN.

Northern Health has received formal notification from the Australian Council on Healthcare Standards (ACHS) that we have met all actions within the National Safety and Quality Health Service (NSQHS) Standards.

Northern Health was acknowledged for the progress it has made since the last assessment and the commencement of its strategic journey towards a ‘High Reliability Organisation’.

“This is a fantastic achievement and is a direct reflection on the quality of the care that our staff provide to our patients and our broader consumers every day. We can all be proud of this affirmation of the quality of services we provide to our community,” said Siva Sivarajah, Chief Executive.

Northern Health was congratulated on the continued focus on collection and evaluation of key performance measures, throughout the pandemic-affected clinical and non-clinical operations of the health service. The assessors acknowledged that the previous 12 months have been particularly challenging for both the health service and staff individually.

Assessors reported that staff were well informed and engaged on governance, their processes, and outcomes, and readily discussed their current improvement work.

Maree Glynn, Director of Clinical Practice Improvement, said this is a fantastic achievement.

“I would like to thank everyone for being so adaptable. Our staff were able to adapt to our ever-changing environment and were ready for parts of the Accreditation to be undertaken remotely,” she said.

“To achieve an Accreditation result with no recommendations, nothing that we have to correct, is a wonderful achievement,” she added.

“Some of the feedback from surveyors included compliments like ‘care is the best it can be at Northern Health’ or ‘can-do attitude comes across in everything that you do’ etc.”, which is great feedback we should all be proud of,” Maree added.

The assessors were impressed that staff were consistently focused on patient and staff safety, quality of care, and experience. They also noted our commitment to a values-based culture, respecting choices, improving services and outcomes for all consumers, and acknowledged extensive positive feedback from consumers and volunteers.

Dr Bill Shearer, Executive Director, Quality, Safety and Transformation, thanked Maree Glynn, Marisa Argetto, Standard Chairs and Clinical Improvement Committees, for the amazing effort they have put into preparing us for Accreditation.

“You did so much work in the lead up to the Accreditation. This is probably the first hybrid survey that has been successfully completed. Thank you to all our staff and a huge congratulations to all,” he said.

Jennifer Williams AM, Board Chair, said “On behalf of the board, I express my appreciation to all staff on this significant achievement.”

The statistics are sobering – 1 in 7 women are diagnosed with breast cancer in their lifetime.

So far this year, over 3,000 Australians passed away from breast cancer including 36 males and 3,102 females. That’s nine Australians a day dying from the disease.

What they also make clear, as Cheryl Murray, Breast Care Nurse Consultant (BCN) points out is, “breast cancer doesn’t stop for a pandemic.”

Says Cheryl, “I want to acknowledge it’s been a tough year and taking care of yourself has never been more important.”

October, Australia’s Breast Cancer Awareness Month, provides an opportunity for us all to focus on breast cancer and its impact on those affected by the disease in our community.

Breast cancer remains the most common cancer among Australian women (excluding non-melanoma skin cancer). Survival rates continue to improve in Australia with 89 out of every 100 women diagnosed with invasive breast cancer now surviving five or more years beyond diagnosis.

Take the time this month to find out what you need to know about breast awareness and share this important information with your family, friends and colleagues.

As Cheryl eloquently puts it, “Get to know your lemons!”

Featured image shows Cheryl Murray, Breast Care Nurse Consultant (BCN) .

Our COVID Ward nurses on Ward 22 have received a generous donation of work shoes from footwear company Skechers.

As part of Skechers October campaign – ‘Skechers Supports Essential Workers’ – 48 shoes from their work range, were donated to nurses on Ward 22.

Kaitlin Themistoklis, COVID Ward Registered Nurse, thanked Skechers for their new foot gear.

“It feels great to receive the shoes, we really appreciate it. Thank you to Skechers for supporting our hard work and thank you for helping us to continue working hard,” she said.

Rebecca Foggie, COVID Ward Registered Nurse, said, “We are very thankful for Skechers for providing us with the shoes. It is great to have some support on board and we really appreciate it.”

Amy Wilson, COVID Ward Clerk, said it was great that nurses were being supported and recognised for their commitment to providing great patient care.

“Thank you for supporting our feet. A big thanks to Skechers, we really appreciate it. It’s the small things that mean a lot,” she said.

The Skechers work range is designed to support workers that are on their feet for long hours and feature slip resistant traction outsoles, water and stain resistant uppers and air-cooled memory foam insoles.

Daniela Jovanovic, Head of Marketing Skechers ANZ, said the Skechers Supports Essential Workers campaign was to support nurses who are doing long shifts and are on their feet all day due to the impacts of COVID-19.

“This is our way of saying thank you to the workers helping keep our communities safe during these unprecedented times,” she said.

Featured image: Kaitlin Themistoklis, Registered Nurse; Amy Wilson, Ward Clerk and Rebecca Foggie, Registered Nurse

As part of a Department of Health requirement, on 1 November 2021, Northern Hospital Epping, Broadmeadows Hospital, Bundoora Centre and Craigieburn Centre will be changing our internal Emergency Code phone number from 444 to the new number 2222.

Across Australia, 51 different phone numbers are used to initiate an in-hospital emergency code across different health services. It is widely acknowledged that having one in-hospital emergency number improves staff awareness and reduces the likelihood of a time delay. Standardising the in-hospital emergency number to 2222 across all Victorian hospitals will enhance recall and improve patient safety.

While Northern Health is transitioning on 1 November 2021, it is anticipated that all other health services will have transitioned by the end of 2021.

At Northern Health, 2222 will replace the existing internal emergency number for all codes currently managed by calling 444. There will be no changes to other sites who currently contact 000 such as Palliative Care at Heritage Epping Gardens.

“All Victorian hospitals are required to move to the new internal emergency code number 2222 by the end of 2021. For our staff that work across different health services, this change will mean that you will only have to remember one phone number regardless of what hospital you work at,” Jason Amos, Manager – Emergency Management explained.

“This consistent approach will ultimately result in a reduction in delay of emergency code notifications to our Emergency Response Teams,” he added.

The official Go-Live date of the new Emergency Code phone number is 1 November 2021. However, in August 2021, there was over 2,200 calls made to 444 at Northern Health – so, to ensure patient safety, as we become accustomed to the new 2222 number, the existing 444 number will remain operational for a minimum six month period ending May 2022.

During October, staff will see the new emergency code phone number promoted on the Intranet and screensavers, within staff areas such as nursing stations, office spaces, staff huddles, LMS training packages and organisational procedures. A resource package will also be available, for all managers, to provide the basic steps and resource material, including posters, stickers and checklists.

For further information, please click here or email Jason Amos, Manager – Emergency Management at jason.amos@nh.org.au.

During COVID Peak, our Speech Pathology team has been fielding questions for advice on vocal fatigue and strain related to communication with N95 masks.

Elissa Thomson, Senior Speech Pathologist at Broadmeadows Hospital, explains, “Just like other muscles in our body, overuse or rapidly increased load can lead to straining our vocal chords, particularly when wearing N95 face masks and shields for long periods of time.”

“Emotional factors, such as stress and anxiety, as well as other health and lifestyle factors, such as reflux, smoking, and viral infections, can also contribute to voice problems.”

“It is important to consider your voice use outside of work responsibilities. In busy times or between consecutive shifts, be mindful of moderating your voice use and taking regular voice rest,” she adds.

She has the following advice to protect the health of your vocal chords.

“Try and rest your voice during breaks throughout your day. Incorporate short vocal exercises such as lip or tongue trills or vocal straw exercises to warm up or cool down your voice,” says Elissa.

“Minimise any background noise while speaking, e.g. music, loud conversations, open windows to busy roads.”

“Be mindful of your breathing whilst talking. Ensure you take regular deep breaths from your diaphragm. This will help to slow down your talking and reduce time speaking on residual air. Also move the voice around through different pitch ranges and use inflections where possible.”

“For healthy voice projection, ensure you have deep breathing to support and focus on the sound resonating in the front of your face, rather than back in your throat. For more information, see here.”

Elissa says that after a period of disuse such as annual leave, we are susceptible to vocal strain. She suggests trying a series of vocal straw exercises in the days leading up to your return to work to help voice reconditioning.

Elissa points out that, “good posture is important for good voicing, so be mindful of your posture.”

Lastly, Elissa advises staying well hydrated by drinking plenty of water throughout the day and avoiding excessive amounts of caffeine, menthol-based lozenges, as these have a drying effect on the vocal folds, and maintaining a healthy lifestyle, with good sleep, a balanced diet and regular exercise.

Featured image shows Elissa Thomson, demonstrating vocal straw exercises.

October marks National Telehealth Awareness Month.

This year’s themes are promotion and awareness of telehealth and virtual care for consumers, and addressing digital inequity and digital literacy.

As part of our response to COVID-19, Northern Health introduced telehealth as a strategy to support patients attending our Specialist Clinics (Outpatients). Now, telehealth is used right across our health service.

Earlier this year, a Telehealth Hub was launched – a new, redesigned and dedicated space where clinicians can conduct video or phone call appointments with patients.

Meggan Barratt, Speech Pathologist, works in Community Therapy Services at Broadmeadows Hospital. She sees clients who have a range of communication, cognitive and swallowing difficulties due to stroke, progressive neurological disorders such as Parkinson’s Disease, cancer, respiratory conditions and brain injuries.

When Meggan was first introduced to telehealth appointments, she said she was nervous and excited to use telehealth with her clients.

“I wondered how my patients would respond to completing their therapy and reviews over video or phone call. I was particularly excited about using video telehealth, as it meant no masks for our clients with communication impairments, which makes therapy much easier,” Meggan said.

“I’ve had a really positive experience providing client care over telehealth. I have received some great feedback from clients and clinicians regarding the ease and accessibility of the video telehealth platform. The video call quality is generally really clear, making it feel like we are in person.”

The implementation of telehealth has meant Meggan has been able to continue seeing her patients for block therapy during COVID-19 restrictions and lockdowns, which has ensured her patients continue to progress with their goals.

“I have a fond memory of using video telehealth with a client who had significant communication impairment. Her daughter assisted us by setting up the video call and helped to facilitate the sessions on the other end of the video when needed,” Meggan said.

“One of this client’s goals was to be able to say her daughter’s name, which was achieved through video telehealth. Video telehealth enabled me to provide the appropriate auditory and visual cues required for this form of therapy. It was lovely to see this client’s and her daughter’s response to saying her daughter’s name accurately for the first time.”

Laura is a Northern Health patient and has been participating in weekly therapy over telehealth since August with Aneta Boskovska, Speech Pathologist. Laura was referred to our speech pathology team by Austin Health, for communication assessment and management, after a sudden collapse at 33 weeks pregnant left her diagnosed with right cerebellar hemangioblastoma, requiring craniotomy and resection of cerebellar lesion and an emergency C-section.

Laura uses telehealth for communication therapy, targeting difficultly pronouncing longer words due to the movement of her muscles and cognitive communication deficits such as generating ideas, planning, problem solving and organising.

Her goals have been to optimise speech in day-to-day activities, build confidence to communicate and maintain social relationships, build independence in complex communication tasks such as email writing, phone calls and planning and aiming to return to work as a teacher.

“So far, telehealth has been great, I can’t fault it. It means I still get to do my therapy during lockdown, which is good as I haven’t missed out,” Laura said.

“It’s been easy to log on to and the process has been seamless.”

Laura said saving travel time, undertaking therapy in the comfort of her own home and reducing the risk of COVID-19 exposure has been some of the many benefits of using telehealth.

“I would recommend it. It’s been easy to use. I’ve got no complaints about it. I think my family and friends would enjoy using it as well,” she said.

Tracey Webster, Telehealth Coordinator, said, “Telehealth allows patients to be able to see clinicians and patients can share images and photographs. For patients that are hard of hearing, it allows them to lip read. Telehealth allows clinicians to have the patient, a family member, an interpreter, GP or Allied Health staff in the call together,” she said.

“When patients see their clinician via telehealth, they can save money on petrol, parking, and public transportation. Even better, they don’t waste time travelling or risk running into a traffic jam that makes them late for their appointment.”

Featured image: Speech Pathologist, Aneta Boskovska, conducting a telehealth appointment with Laura

Northern Health’s Virtual Emergency Department (ED) has now partnered with Ambulance Victoria, allowing paramedics to use the Virtual ED service from a patient’s home and receive emergency medical advice and care.

Amanda Thornton A/Regional Improvement Lead, Ambulance Victoria said this partnership will help connect patients with the services that best meet their health needs.

“Our aim is to minimise patients’ and paramedics exposure to COVID-19, by spending less time at the hospital, and keeping care at home or closer to home. We are essentially going to bring the Emergency Department to their home,” she said.

The new partnership means that once paramedics arrive on scene, they can determine if the patient would be suitable for Virtual Emergency and, once confirmed, a dedicated pathway is set up for paramedics to access the service. The Virtual ED and Ambulance Victoria partnership will cover the north-eastern hospital catchment area.

“The paramedics are really excited to engage with Northern Hospital Epping and the ED physicians. To be able to use the technology to support our work is a great change that we are bringing to Ambulance Victoria, and will have a greater impact on the wider community, making us more available to more cases,” Amanda added.

Dr Loren Sher, Emergency Physician, said the team is very excited to launch this collaboration.

“Amanda and I have been working on this for a while, as we see the potential to really work as a team to provide care for patients in the community. The Virtual ED’s aim has always been for patients to have access to specialist healthcare from home. This way, we can provide coordinated help, whilst making sure patients don’t have to sit and wait in busy ED waiting rooms,” Dr Sher explained.

Currently, Northern Health’s Virtual ED sees close to 90 patients a day, showing a significant increase since the recent wave of COVID-19 started.

“We are rapidly onboarding new doctors to meet that need and collaborating with GPs and specialist ED physicians, so that we can continue to provide excellent healthcare,” Loren added.

For Northern Health, this is another step towards bringing care to patients, keeping them well at home and making sure they can readily access emergency care.

Virtual ED is open 8 am – 11.30 pm, every day, including weekends. Interpreters are available. Patients with COVID-19 can access the service 24/7. To connect to the Virtual ED, please head to nh.org.au/ed.

Featured image: Amanda Thornton and Dr Loren Sher