This week is Health Information Management Awareness Week, to honour and celebrate health information management (HIM) professionals and to raise awareness of the profession and the contribution that the health information workforce makes towards healthcare.

COVID-19 has highlighted the important role Health Information Services play in the health service’s response to the management and preparation for the pandemic.

“When the planning for this pandemic started, the Health Information Services (HIS) team’s first task was to look at their business continuity planning from the medical records perspective and ensure that they are able to continue this essential service,” explained Terri Fiorenza, Director Health Information Services.

Our Health Information Services include a number of different areas: general medical records, IPM, corporate records management, communication (reception and switch board) across all campuses, data sets reporting, coding, ward clerk workforce, ED clerical workforce, CPF and forms.

The HIS team has seen a number of changes in the last couple of weeks, from split teams on various locations at all campuses and part of the team working home, to changes in their usual reporting and coding.

“From the coding perspective, there have been new codes for COVID-19 patients. From the ward clerk perspective, we have been involved with assisting with the setup of the Fever Clinic and we provide clerical resources to that area as well. The clerks had to learn how to do the donning and doffing of PPE and that was quite new for them,” she said.

With the development of telehealth and patients moving to a new model of care, the HIS team have also looked at developing electronic and paper based forms which suit and match the telehealth environment.

Terri sees the biggest changes for the HIS team being the splitting into two teams and adapting to the new communication channels with staff members who work from home through MS Teams.

“Even with the challenges, the feedback has been good and the team keeps coming up with ideas, being engaged in the whole process from the start,” she said.

Terri has been at Northern Health for 23 years, and in her current role for 12 years and sees these times as an unprecedented event.

“This is definitely a once in a career situation we are experiencing. We have to think outside of the box and prepare for multiple scenarios. We have had to rely on technology more, work differently and had to explore working from home options for staff that don’t necessarily need to be on site,” she explained.

To mark HIM Awareness Week, our HIMs have shared why they chose this profession and what they enjoy most in their role. Please see the video below to find out:

 

Featured image (left to right): Shani Radford, David Mangano, Donna Trimble, Sonia Mastrilli, Raelene Hunter, Sandra Louws, Terri Fiorenza

In celebrating International Nurses Day this week, we share a story about one of our nurses, Stephanie Gray, who has a special connection with Northern Health.

Not only does her mother and sister also work as nurses at Northern Hospital, but she was delivered by Debra Bourne, our Chief Nursing and Midwifery Officer.

“I was introducing graduate nurses in our lecture theatre and saw Steph at the back. I was the midwife for Steph and I was present at her birth and delivered her 24 years ago. It was an incredibly special moment to see her there,” Debra said.

Stephanie has been a Northern nurse since 2016. When she started her graduate year, she saw Debra as the Director of Nursing at the time.

“Our connection started in my country town, with Debra remembering my mum and the delivery. I now work in ED and the Neonatal Unit and I can say Debra is now my boss,” Steph said smiling.

While explaining the role of nursing during a pandemic, Debra said, “I am very proud of our nurses. This pandemic has demonstrated that nurses have the ability to step up, step into areas they usually don’t work in and develop new models of care, while keeping the humanity of patient care.”

“Many of our nurses are undertaking additional training and education to provide the best possible care for our patients, including over 300 nurses completing the education packages in respiratory care,” Debra added.

Thousands of nurses are undergoing special training to help fight the COVID-19 crisis. The skills they’re developing will not just save lives now, but have them better prepared for years to come. https://t.co/5zYfOfohG3 @LouisaCheatley #7NEWS pic.twitter.com/Jb0wgo6x3f

— 7NEWS Melbourne (@7NewsMelbourne) May 12, 2020

This year, the World Health Organization (WHO) has designated 2020 as the International Year of the Nurse and Midwife.

Under the theme ‘Caring Together’, over the last few months, Northern Health has been showcasing the importance of nursing, in a series titled ‘Postcard to my Younger Self’, featuring senior nursing staff from Judy Sonneveld, Monica Dowling, Gavin Fahey, Luma Gashi to Valeria Konova-Tscholakow and Nazih Beydoun. The ‘postcards’ reflect the influence of our senior nursing  staff and takes the form of advice to their younger self.

Today on the anniversary of Florence Nightingale’s birth, we surprised our nursing staff with live music, symbolic gifts, a special guard of honour and live music at all our centres. Georgia Pitts, a former music therapist at our Children’s Ward,  performed for nursing staff at both Northern Hospital and Craigieburn Centre. Miia Leslie, also a music therapists performed for staff at Broadmeadows Hospital and Paula Martinez for staff at Bundoora Centre.

Debra Bourne, Chief Nursing and Midwifery Officer said “It was great to welcome nursing staff coming in for their morning shift and let them know how special they are. I am very proud of our nurses and midwives and their achievements,” she said.

Here are some videos and photos of our celebrations.

A video where we paid a special tribute to all nurses around the world:

 

Our Emergency Department staff, join the celebration:

 

Georgia Pitts serenading staff coming in for their morning shift.

Before the COVID-19 pandemic started, Northern Health’s accreditation due date was scheduled for today, 11 May.

On 25 March, the Australian Commission for Quality and Safety ceased all accreditation in response to the coronavirus pandemic.

Maree Glynn, Director of Clinical Practice Improvement, explained the Commission understood the health services would be fully immersed preparing for the pandemic.

“The National Standards describe the minimum standard of care expected for any patient. Organisations often see and prepare for accreditation as an event,” she explained.

Dr Bill Shearer, Executive Director Quality and Safety, added that “event” is about showing that we do our daily work well – every day.

“Our goal is to be accreditation ready any time. That means that at Northern Health, quality and safety is our continuous work, and working towards a standard is part of our everyday role. We prove this to ourselves, and at accreditation, by regularly measuring our performance, auditing our practice, and making sure we are following procedures and best evidence practice,” he said.

The other way we monitor quality and safety is our reactive side. That includes learning from clinical incidents, adverse events and feedback to improve our care.

“The work of getting the organisation ready for accreditation, as well as the work of the clinical improvement committees has continued regardless of the pandemic. From the accreditation team point of view, we will be very ready once accreditation comes back. Once the decision is made, and the timeline is determined, we will probably get about five to six months to re-prepare,” Maree explained.

“The uncertainty is also an exciting opportunity to make Northern Health Ready Anytime – whether for accreditation or COVID-19,” Dr Shearer added.

Our approach to quality and safety is also built on the High Reliability Organisation transformation work we are doing.

“Our response to COVID-19, which has been an incredible effort, and really breaking barriers will be excellent to showcase once we have accreditation. If we take Standard 3, one of our big standards, which is preventing infection, our COVID-19 response is a case study of a resilient and learning organisation that has concentrated on things like hand hygiene, immunisations, screening, isolating patients, preventing the spread of virus and infection. Resilience means that an organisation can respond to new and unexpected challenges, and COVID-19 was exactly that,” Maree explained.

“It’s about responding to unexpected challenges quickly, effectively and with the minimal disruption of the organisation. Our response to COVID-19 is an example of how we are doing that well,” Dr Shearer added.

While some of our staff are very busy now, others have some down time so Maree is encouraging everyone to keep up with mandatory training, appraisals and things we always find hard to do and usually leave for the last minute.

“We need to make sure we continue to do audits where we can and do the improvement work where we need to. From an accreditation point of view, we already almost met every action that was required, so we should be positive and proud of what we have achieved and we need to keep up that work to be ready anytime,” she added.

Featured image (left to right): Maree Glynn and Marisa Argetto, Administrative Assistant and PROMPT Administrator, Quality & Service Improvement 

To celebrate the International Year of the Nurse and Midwife, we asked a selection of staff who exemplify the key qualities of a nurse/midwife to write a ‘postcard to their younger self’ and offer insight and advice. Monica Dowling, Nurse Donation Specialist and ICU Liaison Nurse Consultant, had this to say to her younger self:

The day your nursing becomes routine for you is the day you need to challenge yourself with something new. Being uncomfortable in your role means you are learning something – embrace every opportunity.

Starting out in nursing many years ago in Ireland, career progression came with age not expertise. Coming to Australia in 1987 blew that myth right out of the water. Look around you – nursing is the mecca for opportunity.

Believe in yourself – yes a bedside nurse can become an Associate Nurse Unit Manager and progress to Nurse Unit Manager, District Nurse, Director of Nursing, Nurse Recruitment Project Manager, ICU Liaison and Nurse Organ Donation Nurse Specialist!

Are you good enough for the role? Make yourself good enough with the right training/courses/Grad Dips. Remember you owe it to yourself and to those who work with you to be the best at what you undertake. Yes it is scary, yes it is uncomfortable, yes you doubt yourself and yes you make mistakes.

But one day it all falls into place and you become comfortable and confident again. Enjoy the feeling for a while (seven years was my limit in any role) and consider the next challenge – new organisation, new role, new focus, new people.  

40 years on and I still love nursing and I continue to be excited by the opportunities it provides!

Amanda Cox is Northern Health’s COVID-19 registrar, but she and her team usually say this is a, “job without a job description,” with  the role constantly evolving over the last 10 weeks.

“It’s been everything from measuring chairs 1.5 metres apart on the day we opened our Fever Clinic, to moving from calling each patient with their results to creating a texting system. We also developed policies and procedures and provide clinical support and education to clinicians about testing and management of patients,” she said.

Amanda is a Physician Trainee, and this is her second year at Northern Health. Before COVID-19 started, she was doing two weeks relief and was then brought into the COVID-19 team to help Infectious Diseases for a, “couple of days,” – that became 10 weeks and counting.

“A lot has changed now in my day-to-day work, everyday there’s a new problem to be solved but it wouldn’t be possible without a huge focus on team work. There have been so many faces that can have contributed to our COVID-19 response, and it’s been great to meet the people involved.”

“Having a sense of humour also helps, especially in situations when you’ve just written a whole protocol, issued to all staff, only for it to be changed a few hours later,” she explained.

With a personal interest in Endocrinology, Amanda was due to sit her clinical exam at the end of this year, but that has been delayed until next year.

“We are all personally and professionally affected by this pandemic in one way or the other,” she added.

Amanda feels she only realised she was drawn to medicine when she studied  Biomedicine at Melbourne University, enjoying the more clinical aspects and decided to apply for medicine. She then studied Medicine in Sydney, worked and travelled in Ireland before moving back home to Melbourne in 2019.

As this is a very unusual time for everyone, Amanda says to take every day at a time.

“My secret to success is chocolate, wine and a bit of healthy couch time to unwind occasionally. We also have to appreciate the silver lining, as this is an opportunity for change and to also take a moment to slow down and smell the roses during isolation. While a pandemic is frightening, we still need to keep our spirits high and it’s been wonderful to see great sense of camaraderie, kindness and can-do attitude across the hospital and that has really lifted spirits. It’s been great to work in a place that is supportive and where we can still share a laugh about the absurdity of the situation we have found ourselves in sometimes” she added.

“There is no workplace that has been untouched by this pandemic and every industry will change from this, hopefully for the better” she added.

The COVIDSafe app helps find close contacts of COVID-19 cases and will speed up the current manual process of finding people who have been in close contact with someone with COVID-19.

The Commonwealth has said that widespread use of the app is a precondition of relaxing some of the physical distancing restrictions currently in place.

While the COVIDSafe app is completely voluntary, Northern Health staff are encouraged to download the app to help keep our community safe.

Over the last week, the entire COVID-19 Incident Management Team have downloaded the COVIDSafe App to their mobile phones.

“The app helps the Department of Health to quickly contact people who may have been exposed to COVID-19, and inform you if you have a risk of infection. It will help monitor possible outbreaks in the community, as restrictions are gradually relaxed,” said Dr Christian McGrath, Clinical Lead, COVID-19 Response.

He believes that the app is completely safe to use.

“The app itself doesn’t collect data about yourself or where you are going. What it does is identify when you’ve been moving within 1.5 metres of someone else who has the app on their phone.”

The information is encrypted and that encrypted identifier is stored securely on your phone. Not even you can access it. The contact information stored on people’s mobiles is deleted on a 21-day rolling cycle.

“When the Department of Health has a confirmed case, they seek permission from that person to download the data. This will provide a phone log of people you’ve been in the vicinity of and inform them that they are now a close contact and recommend quarantine. That way they can clamp down really early on outbreaks and not have to rely on people’s memories,” Dr McGrath said.

You can learn more and download the app here.

Photo: Members of the COVID-19 Incident Management Team who have all downloaded the COVIDSafe app.

The International Day of the Midwife was first celebrated on 5 May 1991, and has been observed worldwide since. We spoke to Debra Bourne, Chief Nursing and Midwifery Officer at Northern Health on the significance of this day and her views on midwifery. Debra commenced her nursing career in metro health services within intensive care departments. Later on, she moved to rural health and held a variety of nursing roles, from renal dialysis unit, operating suite, emergency nursing and then midwifery where she worked for 20 years. Debra was endorsed as one of the first rural and remote Nurse Practitioners (NP) in Victoria. Her career then progressed further and led to health service management roles in operations, quality and service development. Debra joined Northern Health in 2016.

What is the significance of today?

In essence, most people have had some touch point with a midwife. Whatever country you are born in, there is a high probability that there was midwifery care. Midwives play such an important role – and not only just for the actual birth but also for the important role they play in the pregnancy and post natal period. Research clearly demonstrates that midwifery care is pivotal to mother and baby’s wellbeing. If a woman and her family receive midwifery care throughout the whole episode, it results in better outcomes for mother and baby. The word ‘midwife’ is about standing with and being there for women. Midwives see the family as a whole unit and are truly focused on holistic care.

As I said before, we do know that women and babies that have good midwifery care, have better outcomes.

Why did you choose midwifery?

I commenced work in a small rural hospital 30 years ago and they were delivering babies. There was just one ward and maternity was a part of it. You could spend one shift working in the Emergency Department, scrub in for an emergency theatre case and assist in birthing. I recognised quickly that I needed to become a midwife to meet that community’s needs.

I started midwifery when I was in my twenties and just loved it. I loved it right from the start. In the country, I was providing care for women and their families that I knew – it had a real community feel. You looked after them right from the start and when they had their babies, you saw them afterwards, and then you saw those babies grow up. Being present when a woman gives birth is a privilege and witnessing her strength and power in birth is incredibly special.

What was your most memorable delivery?

It’s hard to mention just one and often the ones that were most memorable are often the ones that were more challenging. I can also remember the birth of one of the staff members here at Northern. Her name is Steph Gray, who is working in the Neonatal Unit and Short Stay Unit and is a delightful young woman (nothing to do with me). Besides making me feel incredibly old, it was extremely special to see her on her orientation day as a grad nurse.

But being a midwife is not only about being part of a birth. One of the most significant memories is assisting a woman to breastfeed. Breastfeeding for some can be very challenging and it takes patience, skill and perseverance. Midwives play such an important role here and there is nothing that gives me more job satisfaction than helping a women to overcome breastfeeding challenges.

To be with a woman who is birthing, is giving a little bit of yourself to that moment. If you are with the mother for eight to 10 hours or even sometimes 12 hours, you are with and connected to that woman – not only physically (on your feet and moving around) but also emotionally. You cannot lose focus and lose that connection to not only create trust, but to ensure the safety of the woman and her baby. Emotionally, this can be hard work. So you can finish an entire shift on your feet being connected to and being there for one woman and it can take a little bit out of you.

What are some of the rewards of being a midwife?

One of the rewards of being a midwife are the midwives you work with. Midwives are always about the team work, not only with their fellow midwives, but also with the obstetrics team. This is why I like this job – I’m fortunate to be the Chief Nursing and Midwifery Officer at Northern Health and play a small part in leading this wonderful and highly skilled group of midwives here. They are a very caring and close knit group.

At Northern Health it is not just the midwifery team – here it is the obstetrics team, our doctors, our neonatal team – it’s a close knit team and that is one of the joys of being here as a midwife.

Any final messages to staff and the community?

It is important that we acknowledge the importance of the role of the midwife and the role they play in improving maternal and newborn health. They truly make a difference – they connect and be with women at such an important time of their life. I would like to sincerely thank them on this special day.

Featured Image: Debra Bourne (centre) with midwifery staff