At the beginning of the year, Northern Health became part of the North Eastern Public Health Unit (NEPHU), a team of healthcare workers focusing on the North Eastern region to help manage the COVID-19 outbreak response. Austin Health has been appointed as the lead health service, in collaboration with Northern Health and Eastern Health.

Dr Christian McGrath, Clinical Lead NEPHU @ Northern, explained the idea for a localised health unit came about last year due to an increase in COVID-19 cases and the need for more contact tracers to support the Department of Health.

“At some stage, it got quite busy and demand was high – then the decision was made to form these local public health units, and decentralise public health into local regions. It’s much easier to manage 15 or 20 post codes as a public health unit, than thousands across the state. At the moment, all we can focus on is COVID-19, but the idea is that one day, those local public health units will start developing into units responsible for other health issues and communicable diseases in the region, like measles, environmental health issues, as well as play a role in health promotion,” Dr McGrath said.

For Dr McGrath, working locally has numerous benefits for getting things done quickly and efficiently, and improving local health outcomes.

“Having these health units attached to health services, like we are here, means there are a lot of relationships that can develop and the units can really improve local health outcomes. Our North Eastern Public Health Unit roughly covers a catchment area of 1.8 million people. Our teams operationally work integrated with the Austin and Eastern Health teams, and there is probably 300 staff across NEPHU working on this program at the moment,” he added.

Samantha Soggee, Operations Lead NEPHU, explains how the unit works to contact trace and reduce transmissions in the north-east catchments.

“At the moment, we are in the super surge and the volume of cases is high. Northern, Austin and Eastern Health work together by joining into one team and we function out of pods – like ‘confirmed case pod’, ‘primary close contact pod’, ‘exposure site pod’, and each of those pods will have a team leader and an overarching operations lead across all of the pods,” she said.

“Once there is a confirmed case in the catchment, the team would pick that up on the dashboard and interview the case, generate all the exposure sites, all primary close contacts, and then the designated pods will follow up. For example, the ‘exposure sites pod’ will follow up with the businesses, close them down if needed, advise on cleaning etc,” she added.

For both Samantha and Christian, this new role meant a lot of learning on the job and adapting processes and procedures to make the response more efficient.

“Our COVID response unit started in April this year, and that is when things started to ramp up. It was really the baptism of fire, as the City of Whittlesea outbreak started at that time, and it has been go-go-go since,” Dr McGrath said.

“It’s no secret that a lot of COVID-19 cases are in the northern suburbs. For example, the NEPHU team conducted 300 case interviews one day last week, and that is an amazing effort, considering the total case number for Victoria that day was around 500. If we are concerned about a case, we join the efforts from ED, pathology and our contact tracers to get the results quickly, and that is the main benefit of working locally,” he added.

The team works seven days a week, and also works closely with metro and our regional public health unit partners and the Department of Health, to manage outbreaks.

“Over the months, it has been streamlined what information is being collected, in terms of information from cases. Previously, we would contact trace everywhere a case would go, but now we are contact tracing sensitive settings and exposure sites around that, usually workplaces and homes. We are trying to suppress COVID-19, while the vaccination rates are going up,” Samantha added.

The team is welcoming new members – if you have some free time, enjoy working from home and are interested in contact tracing, please contact Lara Madden on: Lara.Madden@nh.org.au.

Our dedicated junior doctors received a special delivery of care packages as part of R U OK? Day from the Junior Medical Staff Association (JMSA) Welfare team, to show their thanks for their incredible work during the COVID-19 pandemic.

The R U OK? Day Care Packages filled with goodies were delivered to all junior doctors; interns, residents and registrars at Northern Hospital Epping, Broadmeadows Hospital and Bundoora Centre.

Dr Natina Monteleone, JMSA Representative, said the Welfare team recognised that this was a challenging time for all our Doctors, and wanted to show their appreciation to the junior doctor community at Northern Health.

“We wanted to support each other through it. We are unable to meet in our usual way or partake in our usual get togethers,” Natina said.

“These packages are a symbol of unity and support and hopefully brought some joy to the doctors across the Northern Health workforce. These packages were provided in recognition of R U OK? Day, which was created as a way to starting a conversation with those around us.”

“We hope this has created some opportunity for open and supportive discussion about these really challenging times and that the conversations continue after R U OK? Day.”

In the care packages, staff received R U OK? Day phone wallets and pamphlets, Beyond Blue fridge magnets, wrist bands and wallet cards, coffee cups, chocolates, pens, coffee vouchers, hand sanitiser, note books, hackey sacks and stress balls.

“Many of the items were donated by local organisations that recognised the hard work and sacrifice of our staff, and wanted to show their support and thanks,” Natina said.

“Many of these organisations provide ongoing support to our Doctors and we wanted to get that message out that we are not alone in all of this and there are services there that can help.”

“We also graciously received funding from the CMO, Divisional Directors, Senior Medical Staff Association and Northern Health, with which we purchased additional coffee cups, vanilla scented candles, hacky sacks and linen bags.”

The JMSA Welfare team hoped the care packages helped to “brighten the day” for our colleagues.

“We also hope they serve as a reminder that we are all facing these challenges together, we can support each other through it and that there are services out there that can help.”

Featured image: Broadmeadows Hospital doctors with the R U OK? Day Care Packages

 

 

 

 

 

 

 

 

This week, Northern Health launched a new outpatient service to treat patients with COVID-19 in the community.

The ‘Sotrovimab Clinic’ is located at Entry 5 of Northern Hospital Epping.

In the clinic, staff administer Sotrovimab, a novel monoclonal antibody treatment, intravenously to patients in the community who are unwell with COVID-19.

Northern Health is one of only a couple of sites across Victoria that are administering this therapy in an outpatient setting.

Professor Don Campbell, Director Staying Well Program, said,  “We are very pleased to have the Sotrovimab infusion centre established here at Northern Health.”

“Vulnerable communities who haven’t yet been able to access vaccination are particularly at risk from COVID-19,” he explained.

“The Sotrovimab treatment involves a single intravenous infusion of a monoclonal antibody directed against the Protein S Spike of the SARS CoV2 (COVID-19) virus. If it is administered early to eligible patients, it has the potential to reduce risk of severe illness and admission to hospital by over 80 per cent,” he explained.

The laboratory-made proteins are designed to mimic the natural antibodies produced by the immune system when defending itself against diseases.

The monoclonal antibodies bind to the virus to stop it from entering host cells, and also help to fight off already infected cells. A complete treatment cycle requires only one dose.

“We want to treat members of our community who are at risk – so we can help keep them safe at home,” Don said.

Madelaine Flynn, Director of Infection Prevention, explained the new clinic is being well received by patients.

“At present, the clinic can administer this treatment to 15 patients per day Monday to Friday,” she said.

“So far, the clinic is going great – we have already had many patients come through and receive this treatment.”

We look forward to the clinic increasing capacity and treating more COVID-19 patients in our community.

Northern Health has a support program in place for people who have tested positive to COVID-19 in our catchment area.

Our COVID Monitor Program provides best practice care for people whom have tested positive for COVID-19, and ensures other health care needs are met whilst in the program.

The telephone-monitoring program also helps to prevent unnecessary hospital admissions of mild COVID-19 cases and ensures isolation protocols are followed to limit community spread.

Patients complete a daily self-check survey to let a Northern Health staff member know how they are feeling and if they have any other symptoms. Staff will then contact patients based on their symptoms and if they need assistance with staying at home and isolating for 14 days.

The program runs seven days a week, and provides patients with health advice if symptoms worsen and how to get food and essential items during isolation. Support is also available for families with children and interpreters are on hand.

The program is supporting over 1,200 people, with increasing daily demand. Patients are allocated to Northern Health by the North Eastern Public Health Unit (NEPHU).

Johanna Hayes, Divisional Director of Hospital Without Walls, said the program had seen an increase in patients from 20 to over 1,200 in the past three weeks.

“Last year, the COVID Monitor Program saw 900 patients over a three month period, which at that time was the highest in Australia. In the past three weeks, we have gone from 20 patients to now over 1,200 patients,” she said.

“We have an IT system in the background, so patients are sent a text message every day and then we can monitor their symptoms remotely. Our staff can make contact with our patients if we can see their COVID-19 symptoms starting to deteriorate.”

“A lot of the symptoms of concern are shortness of breath and chest pain, but there are also a lot of people who are highly anxious and worried. If you can walk in the shoes of the people who have got COVID-19, you’ll understand that it is a very stressful time for families, individuals, and the community.”

“We also work closely with the Northern Health Virtual Emergency Department. Patients can have a telehealth appointment with an Emergency Department clinician. We continue to improve and innovate the care for people at home.”

Staff from across the health service are assisting with the program, working at Bundoora Centre or from home.

“We have pulled lots of people from so many different areas. I am very grateful to people who have put their hands up. People come from clinical backgrounds, with nursing, allied health, medical and research expertise. We also have people who are providing valuable support such as interpreting, care coordination and finance.”

“We also have some retired health professionals volunteering their time and have been able to share their knowledge and wisdom with us and our patients.”

Henni Wade, Manager Volunteer Services, said Northern Health volunteers were preparing to assist with the program.

“We are hoping the volunteers can assist with deliveries of food and other supplies if normal avenues are not available. We are putting procedures in place to ensure this support can be offered in a safe way,” Henni said.

“We have about 14 volunteers who have offered to assist and they are eagerly awaiting to be assigned a job. They are raring to go and can’t wait to feel like they have a sense of purpose in helping the hospital’s approach to caring for our community.”

Requests for Northern Health volunteers to assist with deliveries of essential items can be sent to volunteer@nh.org.au.

Featured image: Nicky Tully and Sue Hull at the COVID Monitor Program

Northern Health patients now have more fresh and healthy meal varieties as our kitchen staff go live with cooking fresh vegetables in their new state of the art industrial kitchen, with three new steamers utilised for this purpose.

Our food services department transitioned into the new kitchen in February, which was one of the first areas to open as part of the Stage 2 of the Northern Hospital Expansion Project.

Tina Smith, ISS Catering Manager, said her team received feedback from patient surveys about what they would like to see on the menu in regards to fresh and healthier meal options.

“For the patients, it means better quality vegetables and more variety and patient satisfaction. The chefs are very excited to be cooking fresh vegetables in our modern kitchen,” Tina said.

“The new kitchen was designed as a hybrid to cook some fresh items. It has taken a lot of group work to get us to this point and we are very proud to provide excellent services to the patients.”

Saj Amerasinghe, ISS Key Account Manager, said the ISS Food Service team was in consultation with Dietetics and Speech Pathology to enhance patient meals at lunch and dinner times.

“This is a great partnership for Northern Health to working towards patient satisfaction in the patient journey,” Saj said.

“I would personally like to thank the Food Services team, Greg Warman, Director of Support Services, the Dietetics team and Speech Pathology for all the support throughout and making this project a success. This is what we exactly mean by at ISS, we connect people and places to make the world better.”

Hayley Collins, Grade 3 Dietitian, said, “Dietetics and Speech Pathology worked closely with the Food Service team to develop a new fresh vegetable menu, add items and build recipes into the menu management system Delegate, update the default menu with these changes, as well as add in nutrition and allergen information,” she said.

“The Speech Pathology team have been instrumental in ensuring the vegetables meet international standards for consistency.”

Greg Warman said the team had been working towards these enhancements since the new kitchen opened.

Featured image: ISS team member preparing meals

Northern Health Allied Health students and graduates have access to an Interprofessional Passport, designed for students and early career clinicians across all professions including allied health, nursing and medical.

The passport is a learner-led and clinically-based suite for interprofessional learning activities. It has been designed to help students and early career clinicians better understand their role, the role of others and how to work collaboratively in a team to deliver safe and trusted care to our community.

Talin Gochian, Interprofessional Educator – Allied Health, highlighted the importance of interprofessional practice.

“Today’s patients have increasingly complex needs. In order for us to fully address the spectrum of their needs, we are required to work together interprofessionally,” Talin said.

“When done successfully, interprofessional practice helps to improve the patient experience, improve health outcomes and reduces related costs.”

“At Northern Health, we are committed to educating students and early career clinicians not only about their profession, but how to work effectively in interprofessional teams.”

When asked about what made a great team, Talin said it was a multitude of factors.

“If we look at the most successful teams on the sporting field, in a survivor challenge or in a hospital, there are a few essential elements which make theses teams – communication, a common goal, understanding each others roles and responsibilities and mutual respect,” she said.

“The Interprofessional Passport helps to inform the importance of these elements, transforming clinicians beyond professional to interprofessional practitioners.”

Peter Brack, Associate Director – Education, Allied Health and Interprofessional Programs, said working within collaborative teams had shown to have a positive impact on the mental health and wellbeing of team members.

“As a health service, we are going through an extraordinarily challenging time and now, more than ever, we need to rely on those around us. We hope that participation in the Interprofessional Passport will help our students and early career professionals make connections with others and reflect on the importance of our teams in supporting our patients and each other,” Peter said.

The resource is being launched initially with new graduates and students from Allied Health, but is planned to be rolled out with other disciplines from early 2022. The Interprofessional Passport is also available on the Intranet.

Anyone with questions can contact Peter at peter.brack@nh.org.au.

Northern Health staff are constantly adapting the way we conduct ward rounds to meet new and changing circumstances constantly. With the implementation of our Electronic Medical Record (EMR), the primary function and purpose of the ward rounds will not change with the EMR, but the tools our staff use to access and document information will be different.

Currently, we may refer to various paper forms, such as medication chart, plan of care, and observation chart for decision making. One of the benefits that the EMR will  bring is a more streamlined process of information retrieval. Other than holding information from all treating clinicians, data recorded on some devices will also be fed into the EMR. The patient data will be presented in a summary screen that displays the most important information about the patient. In cases where our clinicians would like more in-depth information on the patient, they will have the ability to drill down into the details about the patient’s condition and treatment by using the system.

“Being able to access the EMR in real-time as we discuss the long-stay patients in the virtual LOS Round will be very useful, as viewing the most current information will allow us to understand more about what needs to be achieved in order for the patients to be safely discharged,” says Lorinda McPherson, Manager, Acute to Community Coordination Team.

While this change will bring significant benefits in terms of accuracy and breadth of information, as well as legibility, there will be significant adjustments that will take time and practice for us to feel comfortable using the EMR. Patient data documentation will no longer be on paper forms, especially for our wards. Instead, we will have a workstation on wheels (WOW) or a laptop on a trolly to take to the patient’s bedside to enter information. However, with this change, we will need to practice to work out the best way to enter information, view the electronic record and make eye contact with the patient and our team.

Catherine O’Connell, EMR Clinical Documentation Analyst, says from her previous experience in using WOW at the bedside at Monash Health, the transition was beneficial for both the patient and the clinicians, but it will take some time and patience to get used to.

“I found small tips such as letting the patient know what I was doing and placing the WOW to the side and not directly between the patient and I were very helpful in the transition. Once you get used to documenting in real-time, you will never want to go back as overall, the benefits greatly outweigh the inconveniences,” says Catherine.

To help our staff to become more comfortable with the EMR, the EMR team will provide training in how to use the EMR, with practice opportunities such as walkthroughs to familiarise with the equipment and technology, as well as the practicalities of moving around the space and paying attention to our body language.

Dr Richard King, Executive Physician, says the LOS Round was successful despite lockdown. “We would not have been able to carry out the LOS Round during lockdown without the help of digital technology. It was extremely successful and I would like to thank the nursing staff and registrars for their support in making this possible.”

“It was exciting to see how technology had enabled us to conduct virtual ward rounds. We were able to involve key clinicians who may be working from home due to the current COVID-19 situation. I believe with the introduction of the EMR, this could contribute positively to improving our future ward rounds,” says Laura Hughes, Project Manager, Project Management Office and HRO Transformation Unit.

Featured image (left to right): Dr Sandra Brown, Divisional Director, Sub Acute and Aged Care, EMR Medical Accountable Leader; Dr Richard King, Executive Physician and Lorinda McPherson, Manager, Acute to Community Coordination Team

The community is encouraged to put lymphoma in the limelight during September, as part of Lymphoma Awareness Month.

Yesterday also marked World Lymphoma Awareness Day, which is celebrated every year on 15 September to raise awareness of cancers of the lymphatic system.

According to Lymphoma Australia – a charity dedicated to supporting lymphoma patients, carers and health professionals – there is a new lymphoma diagnosis every two hours in Australia. However, lymphoma is currently classed as a low priority cancer in Australia. Lymphoma Australia aims to improve community awareness to assist in early diagnosis and access to the best possible treatment.

As part of Lymphoma Awareness Month, the community is encouraged to show their support by wearing the colour lime for someone with lymphoma, share a fact to help raise awareness, take on a challenge and share #Lime4Lymphoma.

Naveeni Natkunarajah, Ward 3 Nurse Unit Manager, says lymphoma is the sixth most common cancer in the country.

“It is also the most common blood cancer affecting the lymphatic system – white blood cells – and can affect all age groups,” says Naveeni.

“Over the last 12 months, Northern Health has treated 274 inpatient admissions for various types of lymphoma.”

“There are 80 different sub types of lymphoma that are classified according to the rate of growth – with a new diagnosis every two hours and lives lost every six hours. Northern Health Cancer Services are going lime this September to put lymphoma in the limelight and support people who are experiencing this life changing illness. The monies raised will help patients and families who have been touched by lymphoma and assist in funding for specialist lymphoma care nurses.”

Northern Health’s Haematology Service under Cancer Services is expanding, says Naveeni, with a Haematology Specialist Outpatient Clinic Service and Day Oncology Treatment Centre, which now incorporates the NOAH@Home program, offering oncology and haematology treatment at home, together with Ward 3 for inpatient diagnostic investigation, diagnosis and treatment.

“We provide an inpatient consultation liaison with our Clinical Nurse Consultants, inpatient nursing treatment education, inpatient chemotherapy administration, together with discharge planning advice and resources for support. We have an on-call symptom review contact for patients to call following discharge with any questions, queries and support,” says Naveeni.

Featured image (left to right): Ward 3 Chemotherapy Trained Nurses Sarita Rai, Samantha Hewa Inaththappulige and Hashika Dharmatileka