Who could have imagined that only six months ago that we would be hosting Research Week 2020 as a purely virtual event as we continue to transition a large proportion of our services towards digital health via telehealth, in-hospital monitoring and home-based healthcare solutions?

It will be our inspired researchers who will lead the way on our journey to a ‘new normal’ – while new treatments and a potential vaccine will likely dominate headlines, it is the new ways of doing many of the things we have taken for granted that is already advancing healthcare, delivery and consumer-led experience.

The events during Research Week 2020 have been organised in a very different way with virtual presentations, posters, guest speakers and workshops. They will highlight the quality of research occurring across the spectrum that are being driven by an increasing number of our Northern Health staff. Highlighted is the increasing volume of projects being conducted with our academic partners; Melbourne, La Trobe, RMIT and Swinburne Universities.

We are privileged to have an exciting range of speakers at Research Week 2020. They will encourage us to reflect upon our current practices and challenge us to explore how we can rise above the increasing demands we will continue to face.

Research at Northern Health is not just about Research Week, and here are just a few of our highlights during the year:

• Associate Professor Lisa Hui was awarded a $1.28m Medical Research Future Fund (MRFF) investigator grant for her project ‘closing the critical knowledge gaps in perinatal genomics’
• Our Low Risk Human Research Ethics Committee celebrated its first-year anniversary
•  RedCAP now live as a tool for our researchers: https://redcap.nh.org.au/
• Research Grand Rounds are now well established occurring weekly on Tuesday
• Two new PhD scholarships were awarded to Natali Cvetanovska and Dr Julie Wang, and $50,000 worth of Small Research Grants were awarded to researchers thanks to the generosity of the Northern Health Foundation and our community donors
• Participation in a number of COVID-19 research activities and clinical trials under the stewardship of Associate Professor Craig Aboltins and Dr Angaj Ghosh. These include ASCOT, CHARTER, SPRINT-SARI and participating in our first phase I study evaluating a protection device for our clinical staff caring for unwell patients in ICU

Congratulations and thank you to all who have contributed to research at Northern Health in 2020. The future is unknown but by reviewing and evaluating what we do, and how we do it, we will have the opportunity to change things for the better and to continue to deliver trusted care in partnership with our community.

Professor Peter Brooks AM,  Research Lead – Northern Health.

When the first COVID-19 wave hit, learning and education was one of many processes that had to be quickly changed and adapted to the new reality. The education leads across the organisation were facing the same challenge – how to keep the education going – and with the roll out of MS Teams, things have become more streamlined.

Bec Gilbert, Manager Organisational Capability, explained that this is online learning’s big moment and education and training is about to be revamped just as much as the industries that are moving to remote working.

“From cancelled face-to-face sessions to physical distancing and limited opportunities for practical competency assessments, the COVID-19 pandemic has forced Northern Health educators and trainers across all disciplines to review our current practices. This reality has forced a crash course for online learning plans and technology use for every one of us. Video conferencing platforms such as Microsoft Teams are being used heavily, as is our Learning Management System – myLearning,” she said.

Molly Galea, Allied Health Education Lead, explained that a lot of allied health education is about bringing different professional groups together and then putting the education into practise.

“Education for us is putting all the knowledge and experience in one room, sharing that and asking questions, with the aimed outcome of people going away motivated to try something they have learned at the session. Our challenge is creating a space where people can learn from each other, as an important part of education is to keep the knowledge moving around the organisation,” Molly said.

“Initially, there was a lot of training relating to adapting to a COVID-19 environment – like Telehealth, PPE training, looking for signs of family violence etc. Now, that has been incorporated in every day work and people are starting to ask for our regular training, which is a good sign,” she said.

Education leaders across the organisation, Leah Hansen, Keith Amarakone, Talin Gochian and Rachael Coutts, all agree that teams had to quickly adapt, and the movement to online education has had both it’s positive sides, as well as the challenges, like teaching practical skills.

“If we don’t deliver on some of the content for nursing education, then we don’t have the workforce for next year and we don’t have certified staff that are able to practice in the areas really important in pandemic times. Coming up with innovative ideas to deliver education is an absolute requirement,” Leah said.

“The adaptability, flexibility and the willingness to come along and fix problems and share ideas, from everyone involved in the process, has just been amazing. If we didn’t have the pandemic pushing us, this would have been a two year project, but we built it within a week, we found a solution and just went with it,” Rachael said.

Featured image: top row – Penny Remston, Clinical School Coordinator, Nursing and Midwifery; middle row – Kerryn Asbury, Clinical Nurse Educator (left), Talin Gochian, Allied Health Clinical School Coordinator (right); front row: Bec Gilbert, Manager Organisational Capability (left) and Nichita Gavrilescu, Senior Medical Registrar (right).

Dr Kristen Pearson is thrilled to see a hybrid car up for grabs in this year’s Northern Health Foundation Raffle. Dr Pearson is a Geriatrician and member of Northern Health’s Environmental Sustainability Committee, as well as a volunteer with Doctors for the Environment.

“I am delighted that Northern Health Foundation is offering a hybrid car as this year’s raffle prize! Firstly, the raffle supports Northern Health’s work on being safe, kind and together with our community. Secondly, the hybrid car has much lower fuel consumption and emissions than a regular car.”

“We all know that to protect our planet and our health, it is essential to cut carbon emissions and air pollution from motor vehicles. We can do this by driving less – taking public transport, walking or riding – and by driving electric or hybrid cars like this Corolla,” she said.

Dr Pearson says, as the owner of a Toyota Corolla Hybrid herself, she can personally recommend driving one.

“It is quiet and very comfortable to drive! My sons also enjoy driving it when they get a chance.”

Northern Health continues to reduce our environmental impact thanks to a number of initiatives throughout the organisation.

Our Environmental Sustainability Committee, chaired by Chief Financial Officer, Basil Ireland, is always looking for ways to reduce our impact on the environment by reducing waste, increasing recycling and looking into renewable energy.

To reduce petrol consumption, Northern Health has started replacing our fleet cars with hybrid technology vehicles.

“Northern Health has a big fleet of cars, so it is important to manage this carefully. The plan is to replace ageing cars with new Corolla Hybrids, which will reduce our emissions. So far, 18 cars in the fleet are hybrid. So when I drive out for a home visit or to visit an aged care facility, I’m happy to be driving a hybrid!” Dr Pearson said.

Telehealth is another part of the solution – and has grown strongly since face-to-face visits have been restricted by COVID-19.

“Telehealth can be a great alternative to clinic or home visits – we can minimise car travel, reduce time commuting or waiting, and improve patient satisfaction,” Dr Pearson said.

“So buy your raffle tickets now and good luck for being the winner of the Corolla Hybrid!”

To purchase Northern Health Foundation Major Raffle tickets, please click here. If you purchase your tickets before midnight Wednesday, 23 September, you will go into the Early Bird draw to be in the running to win a $500 Coles Myer Gift Card.

Two warm patient experience stories are coming from our Broadmeadows Hospital, where both patients and staff have been working hard to make the hospital experience and recovery as quick and pleasant as possible.

Elinor Fonovic was admitted to the Rehabilitation Ward on Unit 2 at Broadmeadows Hospital from Northern Hospital Epping 412 days ago, after being diagnosed with Guillain Barre Syndrome, a disease involving rapid onset muscle weakness.

Belinda Nash, Nurse Unit Manager, explained Elinor was not able to move her arms or legs when she was admitted and embarked on her rehab stay.

“It was through tenacity and hard work, on both Elinor’s and the rehabilitation multidisciplinary team’s efforts, which has resulted in Elinor being able to walk, use a telephone, and now follow others on Instagram who have recovered from the same disorder, and assist in her own activities of daily living (ADL’s). Whilst progressing with her physical rehabilitation, the rehab team have successfully gained a sizeable NDIS package and temporary accommodation for Elinor to begin a new chapter in her life with newfound independence in a safe environment and with the carers she needs. Congratulations to the rehab team on another complex and successful discharge,” she said.

Elinor speaks fondly of her memories of the first day when she arrived, meeting the admitting nurse, and is very grateful to the team and their assistance during her hospitalisation.

“I was at Northern Health for 14 months – it began to feel like home. I had many physio and OT treatments and the staff were incredibly supportive, especially my physio team. Everyone was friendly and professional. While I was there, I lost my father and the team was wonderfully supportive during my grief. I can’t talk highly enough about my physio team,” she said.

Belinda highlighted that Elinor’s stay proved to be rewarding for all staff working on the unit that have contributed to Elinor’s journey, through therapy to regain function.

“The team has been able to gain an insight to the challenges of NDIS and the functionality of this scheme that enables people to get back into the community. Furthermore, the team have honed their skills in accessing NDIS, which has meant they did succeed in a sizeable budget that enables Elinor to go to a serviced apartment with carers whilst her home is modified,” she said.

 

The second story also comes from Unit 2, where patient, Rita, stayed post a stroke. During her stay, she felt disconnected from family due to the current visiting policy, being in the ward since July. Although Rita could see her family via Facetime, she felt it’s not the same as personal visits.

Last week, she celebrated her birthday whilst on the unit and the team organised a ‘window visit’. The unit has a day room with a huge a glass door, and therapists and nurses have been using this to allow family to see their loved ones, and communicating via phone on either side and still maintaining COVID-19 safety.

Rita said this “improved her mood and can’t wait to go home and have another celebration”. She was lucky on that day that the speech therapist upgraded her meals to include cake as, due to her stroke, she had to have texture modified meals. It was a great birthday present!

Belinda added: “This form of virtual visiting helps bolster family and patients mood during COVID-19. Rita and her family were grateful for this visit on her birthday. Staff spirits are also elevated during these visits as they can provide some comfort to their patients who cannot receive visits currently and have not seen family for weeks”.

 Featured image: Elinor with Unit 2 staff and her care team at Broadmeadows Hospital

As part of Nursing in the Community Week, we celebrate our community nurses, who give special meaning to the phrase “frontline heroes”.

GEM@Home has been operating since March 2015. Mathew Wood, Manager Transition Services, TCP, GEM@Home, and GEM@Resi says, “We provide interdisciplinary aged care and rehabilitation services after an illness or injury to older people and their families. Patients are visited in their home on a daily basis while on the program, and may be seen by one or multiple staff from the team.”

“The program aims to reduce time spent in hospital and provide care in their home, which research has shown can assist people in their recovery,” adds Mathew.

Ingrid Montano, GEM@Home Nurse, says, “The support that we provide patients and their families to remain safely at home is many times affirmed to be invaluable.”

“Working as a nurse within the GEM@Home team can be both challenging and rewarding. There are many hours spent driving, getting lost, looking for a new address and lunch on the run. However, it’s all worth it, when your patients say that they will miss your visits as the program ends,” says Ingrid.

“Many patients say ‘Come visit when you are in the area to have a cuppa with me,’” she adds.

Ingrid has been a nurse for 14 years and says, “Early in my training, I identified community nursing as a dream job for me. I joined GEM@Home full time in 2016 after being a casual nurse for eight years. I experienced many different workplaces and gained varied skills until I had the opportunity to settle into my ideal job.”

“An average day for a nurse in the GEM@Home program is rarely ever the same. We can plan our day meticulously in the morning; however, there are times when we are required to deviate from that plan. On many occasions, we have received phone calls when a patient feels unwell, requires reviewing, needs some extra education or support for the day,” says Ingrid.

“Patients often comment on the positive effect the support and reassurance they have received from the nursing staff on the program,” said Matthew.

Says Anne Marie Fabri, Associate Director, Community Programs, “Often we are caring for people who are socially isolated and vulnerable, and our care is what makes the difference.”

Featured image shows GEM@Home nurses, Grisel Zalewski on the left and Ingrid Montano on the right.

Today, the World Health Organisation is commemorating World Patient Safety Day. The COVID-19 pandemic has unveiled the huge challenges and risks health workers are facing globally, and that is why the World Patient Safety Day 2020 theme is ‘Health Worker Safety: A Priority for Patient Safety’, with the official slogan “Safe health workers, Safe patients”.

Our High Reliability Organisation (HRO) transformation puts patient safety at the centre of everything we do. To help increase patient safety, as well as to work on developing and implementing HRO quality and safety projects, the ‘HRO Champions Network’ was formed a year ago.

The group is co-chaired by Paula Kuder, Nurse Unit Manager, Renal Services, and Nicholas Romeo, Head Respiratory Scientist, and has ten staff members from various campuses and departments, from finance to physiotherapy. Jeff Vasquez, Access Manager from Broadmeadows Hospital, says the team shares the passion for patient safety, but also patient experience.

“The network is about staff leading and creating projects, and taking the HRO principles back to their departments. Some of the projects we are working on are new ways of delivering staff education and streamlining the processes, in line with COVID-19 requirements. Also, we are working on ideas that were planned for our Hack Weekend, and numerous operation projects on how we can work more efficiently. The group is also supporting the Staying Well initiative,” Paula explained.

Prior to these system-wide initiatives, the group feels quality was seen as a individual practitioner and ward-based system improvement, while HRO looks at the whole system and how to join initiatives and processes to improve processes and quality for all.

“This way of looking at services and how we improve has a direct effect on patient safety,” added Molly Galea, Allied Health Education lead.

The members have shared different interpretations of what ‘Safe health worker, Safe patient’ means to them.

For Nicholas, keeping staff in respiratory departments safe is essential as the team understands that staying healthy and minimising risks is essential for being able to help patients.  Jay Lakmal, Finance Manager and also a member of the committee gave a financial perspective:

“When staff feel safe, we can see how it reflects in our activity. There are less personal leave rates and this improves our overall activities, and it is one of the contributing factors to our operational efficiency,” he explained.

Molly touched on the recent ‘Conversations on Mental Wellness’ week, adding that she feels proud of how the organisation has responded to the need for staff emotional safety.

“As an organisation, we are going through a huge change and disruption, as well as uncertainty, that is why it is important that all of us, all colleagues, look after each other’s emotional wellbeing”.

Steve Ferguson, Physiotherapist, added that when a patient and the health worker feel safe, there is facilitation of communication and collaboration between them, and also between the health worker and the colleagues.

“The concept of safe health worker is key for facilitating those conversations,” he added.

The HRO Champions Network welcomes new members, as well as new HRO projects. To get in touch, please email hrochampionnetwork@nh.org.au

 

 

 

Featured image: Nicholas Romeo, Kirstin Tirant (back) and Paula Kuder (front).

 

This week as part of Nursing in the Community Week, we celebrate our community nurses, who give special meaning to the phrase “frontline heroes”.

Community nursing is a very broad description of many roles undertaken by nurses outside of the hospital setting. “The work community nurses do is not unlike the work of nurses in a ward; it includes highly technical procedures such as those done by nurses in Hospital In The Home (HITH) program or in Wound Clinic, and expert assessments such as those done by Clinical Nurse Consultants working in the Hospital Admission Risk Program (HARP),” says Johanna Hayes, Operations Director, Community Programs.

HARP provides services for people with chronic diseases and complex needs who need assistance with keeping safe and well at home. Specifically, they look at patients with chronic cardiac disease, chronic respiratory disease, diabetes, older patients with complex needs and patients with complex psychosocial needs or dementia.

The HARP team includes a specialist team of highly skilled care-coordinators from Nursing and Occupational Therapy backgrounds, Heart Failure and Respiratory Clinical Nurse Consultants, Physiotherapists, Social Workers, Geriatricians, Psychologists, Diabetes Nurse Educators and a Health Coach.

Julie Tran, Registered Nurse Care Coordinator HARP, says the program, “Provides disease specific education, care coordination, health coaching, allied health therapies and medical review.”

The program involves the patient, their carer, their GP, hospital staff and other community organisations to develop and implement a care plan that maximises health outcomes, maintains the person in their residence of choice and reduces preventable hospital admissions.

Recent data has shown that as a result of the HARP program, unplanned admissions had been reduced by 69 per cent and, in a 6 month period post-intervention, hospital admissions in these patients reduced by 54 per cent.

Julie says her move to community nursing was prompted “after working in the emergency department for a number of years and seeing first-hand the complex medical and social issues that lead to hospital presentations.”

Julie says each client is unique and the issues that arise are varied. “Prior to COVID-19, my day consisted of phone calls and home visits, during which I could monitor chronic disease management and provide education, liaise with local GPs and other health professionals, speak with and organise community support services, and ultimately advocate for the holistic needs of the client.”

“My day looks a bit different during COVID-19 as home visits require more planning and clients become more vulnerable due to social isolation, financial stressors and lockdown restrictions,” says Julie.

“Despite this, the HARP goals remain the same: helping clients to meet their physical, social and emotional needs in order to prevent avoidable hospital admissions,” she adds.

“Working in community nursing is a great way to practice holistic, person-centred care,” says Anne Marie Fabri, Associate Director, Community Programs.

“Working in someone’s own home, with their family or supports around them, helps remind us that our patients are people, members of their own community, and that we need to work with them to meet their goals,” she says.

Julie agrees. “I really enjoy community nursing because of the opportunities to develop positive health care relationships with clients. The barriers to building rapport in the acute hospital setting have less impact in the community, as we are now in their environment and we have more time to listen to their needs.”

“Ultimately, a simple phone call or a home visit is appreciated by our clients and personally rewarding for me,” says Julie.

Featured image shows Julina Shariff, another member of the HARP team, pictured with her client Andrew Carrigan. Says Andrew, “Julina did everything for me. I can’t thank her enough. She deserves a medal!”

The COVID-19 pandemic has made spending time with loved ones challenging for everybody, especially those being cared for in hospitals and aged care facilities.

John Wakim, Recreation Officer at Bundoora Centre, has created a new program to help families stay connected to their hospitalised loved ones during this difficult time.

He initiated the program, ‘Staying in touch with loved ones’ in July this year, using Skype video calls whilst current visiting restrictions are in place.

“With visitor restrictions in place, families aren’t able to visit for safety reasons. But even if they can’t physically be with their loved one in hospital, our recreation service is working hard to ensure they can still be connected,” he said.

“This program was made possible with the help of Northern Health Foundation, from an approved grant for new equipment for Bundoora Recreational Therapy. Part of the grant was to purchase tablets for our clients on the wards,” he added.

John is very passionate about this new program and helping families in our community stay in touch.

“Video calls help keep patients engaged and a part of their loved ones’ lives. They can still see their grandchildren, have that morning coffee with their friends and be virtually present for memorable moments like birthdays,” John said.

“It allows patients to remain physically distant, but emotionally present and can help patients cope with this pandemic.”

The wards collect contact details of patients and families who would like to participate. John calls the family first to assist them with any technical issues, ensuring they have the required technology and internet connection at home. Once organised, John will go to see the patient and facilitate the call for them.

For patients recovering, John says maintaining a social connection with loved ones can enhance their overall wellbeing.

“To see their loved ones, it improves their mood and they are reassured that their loved ones are OK – because patients are worried about their families too, along with their families being worried about them.”

John has been working closely with the Nurse Unit Managers and their staff at Bundoora Centre to get this up and running and the program has proven very popular already, receiving fantastic feedback from appreciative families.

Barbara (pictured above) and her son Michael are extremely grateful for this service.

“It’s the only opportunity I’ve been able to see my mother, so I’ve found the calls extremely useful and beneficial,” Michael explained.

“It’s a wonderful service because it’s really catering for the needs of families. Families are finding it very difficult at the moment so it really helps – to be able to see someone in their environment and look at their face – you can pick up on how they’re going,” he said.

“John does a wonderful job in organising it and makes sure you understand how to use the technology. My mother has commented on what a highly valuable member of the team he is,” Michael added.

John facilitates approximately 10 video calls a day and there is currently a waitlist due to the popularity of the program.

“We’ve been very busy because families are missing their loved ones, so they are very grateful and it’s been really positive. We are also now providing this service in the Kath Atkinson Wing (KAW) where patient stays can be a bit longer,” John said.

Even when visiting restrictions are lifted, John says he hopes to continue this program in future to help families that, for various reasons, may not be able to visit.

Featured Image: Patient, Barbara video calling her son Michael. Patchwork quilt generously donated by North of the Yarra Quilters Guild.