If the COVID-19 pandemic has taught us anything, it’s the importance and value of technology.

The success of Northern Health’s Victorian Virtual Emergency Department (VVED) has highlighted the opportunity to engage and deliver healthcare through virtual platforms.

Dr David Langsford, Head of Medical Obstetrics and Nephrologist at Northern Health, had an idea to provide a virtual service for GPs to directly access hospital-based specialist expertise, to discuss complex patient management in the community.

The newly established Medical Community Virtual Consult (MCVC) service enables GPs to book an appointment with dedicated internal medicine specialists that is conducted through HealthDirect. The GP can attend the appointment with or without the patient and their family, to discuss medical issues, investigations, results and plans.

“The aim of the MCVC service is to foster reliable communication between primary care and medical specialists. We believe this will help both GPs and specialists provide good and prompt care with their patients, avoiding duplication and waiting times for appointments,” David said.

“Internationally, versions of this idea have been successful at reducing the need for referrals for primary care to specialist outpatient clinics and emergency departments. Once established, for some disciplines, 50 to 70 per cent of contemplated referrals from primary care are avoided, and patients can continue to have good care delivered by their GP, knowing that they have access to and support by Northern Health. Over time, this will help to reduce outpatient clinic waiting lists.”

David trialled the service during COVID-19 outbreaks over the past two years. He then submitted his idea in the February 2022 round of The Big Ideas Campaign. He has worked alongside the High Reliability Organisation (HRO) and VVED teams to roll out this new and exciting service, which went live last week.

The service currently offers 20-minute appointments with GPs to discuss complex patient cases. The MCVC service provides Medicare Benefits Schedule (MBS) billable times for GPs to access the service, initially from 12.30 pm to 3.30 pm, Monday to Friday. At present, Podiatry and Pharmacy departments are assisting physicians in the virtual service, utilising the opportunity to case conference and network with community partners.

“GPs are already reporting that they have found the service helpful and intend to make more use of the service. We have also made the service available to the VVED as a once only virtual hot clinic to follow up with patients that need some extra assistance after a VVED visit,” David said.

There are plans to expand the service to incorporate more specialities and disciplines in 2023, with the possibility of also offering the service in catchments outside Northern Health.

“At present, MCVC is providing only internal medicine advice and support for GPs, but as we demonstrate that this approach can work to aid GPs and specialities to collaborate more efficiently in patient care, there will be more opportunities for other specialities to be involved,” David said.

“There has already been interest expressed from GPs outside our catchment, both metropolitan and rural. Once we’re established, growing to support a larger primary care community might be possible.”

MCVC can be accessed here.

Featured image: Steph Castagnini and Dr Vinita Rane on screen.

This week is Trans Awareness Week – an opportunity for transgender people and their allies to educate the community about who transgender people are, share stories and experiences, and advance advocacy around the issues of prejudice, discrimination and violence that may affect the transgender community.

Observed from 13 November to 19 November, the week also leads up to Transgender Day of Remembrance on 20 November, which memorialises victims of transphobic violence.

Transgender is an umbrella term used to describe people whose gender identity is different to the sex that was assigned to them at birth. Transgender people may identify as straight, gay, bisexual or another sexual orientation.

Other transgender terms used to describe people include Non-Binary – someone who doesn’t identify as a man or woman, Gender Fluid – someone who alters between female and male, Gender Queer – a person who does not identify to conventional gender distinctions, but identifies with neither, both, or a combination of male and female genders, and Agender – not having, or a lack of gender identity.

Sistagirl and Brothaboy are terms used by Aboriginal communities to describe transgender people and their relationships. Cisgender describes a person whose gender identity is aligned with their sex assigned at birth. If at any time you’re unsure of a person’s gender identity, ask for their gender pronouns e.g. she, her, him, his, they, them etc. which are used instead of a noun to refer to a person. Introducing yourself with your pronouns also provides a safe space for transgender people.

Lee Pattison is a transman, a consumer representative on Northern Health’s Rainbow Working Group, and a former Northern Health employee. Dr Siân Cole is a registered Clinical and Health Psychologist working on our acute medical wards. Assigned female at birth, Lee began his medical transition in 2010. He and Siân have been together for more than 14 years.

“I came out to my own family as a lesbian when I was 17. That wasn’t easy for them but coming out as trans in my thirties was even more difficult. The support provided by Siân and her family was, and continues to be, incredibly important to my surviving and thriving,” said Lee.

When one partner transitions in a relationship, it can significantly impact the other person’s sense of identity.

“We met as lesbians and had always been seen as a queer couple. When Lee started being perceived as male, it was strange to no longer be recognised,” said Siân.

A recent Australian study found that 41 per cent of transgender people who needed emergency care did not attend the emergency department because they were transgender. This is one of the factors contributing to poorer health outcomes for trans and gender diverse people.

Private Lives 3 – an Australian survey of the health and wellbeing of LGBTIQ people – reported in 2020 that more than half of survey participants reported high or very high levels of psychological distress. This is four times higher than that of the general population.

Electra Ulrich, Co-Chair of the Northern Health Rainbow Working Group, said transgender people experienced poorer health outcomes due to stigma and discrimination.

“Working to reduce discrimination, educating ourselves and being an ally, can all help create the change that will be needed to reduce this disparity in health outcomes for trans folk,” she said.

“There are many ways in which we can educate ourselves. To provide safer care for the trans community at Northern Health, we can use the patient’s chosen name – even if it is different to their name on their Medicare card, don’t assume someone’s pronouns – we can introduce ourselves with our pronouns to sign post to the person that we understand this. I may say, ‘my name is Electra and my pronouns are she/her.’”

“It is also important to only ask clinically relevant questions. For example, unless it is clinically relevant, don’t ask a trans person if they’ve had surgery or take hormones. And most importantly, if you make a mistake, acknowledge this, apologise, and move on. This can also let the person know that you didn’t do this intentionally, and that is important to providing safe care.”

Lee, who is currently working on an EMR Diversity and Inclusion Project, says, “We can only be more inclusive and responsive to the needs of Rainbow patients with exposure, education and tools.”

What can you do?

Watch Trans 101 published by Melbourne’s own Minus18.

Watch TransHub Talks: Healthcare Experiences published by NSW ACON Health.

Read the studies referenced in this article

Continue exploring for reliable information about how to use inclusive language and be an ally to people who identify as part of the LGBTQIA+ Rainbow.

If you would like to be a part of Northern Health’s Rainbow Working Group, you can email rainbowgroup@nh.org.au

Featured image: Lee and Siân. 

Throughout 2021-22, Northern Health Foundation has been fundraising for new ophthalmology equipment for Broadmeadows Hospital. The campaign contributed to the purchase of new, state-of-the-art equipment for patients in our northern community with cataracts – a cloudy film covering the lens of the eye, causing loss of vision or even blindness.

As our community grows and ages, so does our equipment. The time has come to retire ophthalmology equipment at Broadmeadows Hospital to make way for the latest models. With demand for cataract surgery increasing, the need for more efficient equipment became evident.

Thanks to the support of our donors, this specialised equipment can now be purchased, enabling our patients to access a better quality of care within their community. Not only will the new equipment allow for quicker turnover of patients and reduce waiting periods, but the equipment will last for years to come.

Tracey Wyllie, Director of Operations – Peri Operative Services, said, “I would like to acknowledge the hard work of the Foundation to ensure we can deliver this equipment to the team at the Surgical Centre. I’m sure the team will be excited to be trialing options, with the understanding that one of them will soon be procured. This is one of those pieces of work that will see the patient, the medical team and the nursing staff all benefit. Very exciting!”

The Foundation raised over $230,000 to contribute to this cause, so this state-of-the-art equipment could be purchased.

Linda Romano, Divisional Director Nursing, Surgical Services and Access, said, “It is really exciting to hear, that with the $230,000 funds raised from the Foundation and $229,000 innovation fund, we can now progress this important equipment replacement.”

“Knowing this is a reality, will bring much excitement to our nursing and medical staff. The positive impact this will have on our staff and patients is enormous. Thank you again to the Foundation for their support.”

Pina Di Donato, Executive Director Public Affairs and Foundation, was thrilled by the outcome, saying, “Fulfilling a promise is what rewards us most. We made a commitment to bring the latest ophthalmology equipment to Broadmeadows Hospital, and we are delighted to see that commitment realised. We are thrilled that our fundraising efforts have made a significant contribution to purchasing this equipment. Our community deserves access to the best possible care. That is what we, as a health service, strive for.”

We thank our donors who continue to support Northern Health and Northern Health Foundation in our vision to build a healthier community.

Featured image: Dr Suheb Ahmed.

Northern Health’s Electronic Medical Record (EMR) will be integrated with our current electrocardiogram (ECG) records when we go live in September 2023.

An ECG records the electrical signals in the heart and is commonly used by patients who experience chest pain, heart palpitations, and rapid pulse, in order for the clinicians to detect or determine whether there are irregular heart rhythms, blocked or narrowed arteries in the heart that might be causing chest pain or potential of a heart attack.

Currently, at Northern Health, ECGs can be initiated by nurses or doctors, how and when these studies are reviewed is dependent on the patient’s clinical condition or where the patient is located. For example, in ICU, patients undergo regular ECGs in the mornings. The results are stored in the Philips monitors and are reviewed by consultants on the morning ward round. Generally, the ECGs are then printed and stored in the patient’s chart.

When the EMR is implemented, clinicians will be able to use Mortara Carts or Philips Bedside monitors to order and perform a 12 Lead ECG in the system. The image of the record will be sent to the archive and integrated with the patient’s record in the EMR. From there, our cardiologists will be able to enter their final interpretation and sign the order off. Doctors will also be able to view the results in ‘Results Review’ at their convenience. This will be a paperless process.

At the front and centre of designing this workflow, is Nader Elshehabi, EMR Benefits and Clinical Analyst. Coming from a medical background, Nader has worked as a practising doctor trained in Cardiology, and then as a Cerner consultant for many years. Before joining Northern Health’s EMR team, he helped implement EMRs in several hospitals overseas.

“Digitising the ECG workflow helps clinicians get instant access to current and all previous ECGs at the point of care. For example, cardiologists from Epping can immediately see and report on ECGs performed in other sites. They can also compare current ECGs with previous studies. This helps the care team make more informed clinical decisions, much faster,” says Nader.

The workflow was validated on 29 September 2022, with a live demonstration conducted by Nader at Northern Hospital’s ICU ward. To ensure patient safety and quality of care at Northern Health, inpatient settings at all sites will have full ECG integration to minimise clinical risks.

“Nurses and midwives will be able to perform an ECG and transmit it immediately so it can be interpreted by multiple teams from anywhere inside the hospital or remotely.  This streamlined workflow will remove time-intensive steps that nurses undertake to ensure ECG results get to the right team at the right time for review, resulting in safe and timely care for our patients”, says Vanessa Reid, Chief Nursing Informatics Officer.

“Integrating ECGs into the EMR is a key step to getting this crucial piece of clinical information to the right people in a timely manner and reduces reliance on “informal” means of data transmission such as private messaging applications. I cannot overstate the amount of work done by the team to get this working. I am confident it will play an important role in supporting clinical processes across the entire organisation,” says Dr Sing Tan, Deputy Chief Medical Informatics Officer.

“One ECG reviewed and reported on time can make a big difference in patient care. I’m so grateful we have this technology, and I hope this work supports our frontline clinicians in providing the best possible care for our patients,” Nader concludes. ​

Featured image: Nader Elshehabi, EMR Benefits and Clinical Analyst.  

 

This is a significant time to be working in the mental health sector, as we declare our commitment to the ambitious reform agenda, set out by the Mental Health Royal Commission.

Last week, the Aged Persons Mental Health Services at Bundoora Centre transitioned to Northern Health, and we officially welcomed staff from the Kath Atkinson Wing (KAW), Aged Mental Health Unit and the Aged Psychiatry Assessment and Treatment Team (APATT).

Collectively, Northern Health is now the third largest mental health service in Victoria.

Today, we speak to Dr Gary Ennis, Director of Nursing, Mental Health Division.

Gary, let’s start with your coffee order?

Latte please!

Tell us about your role as Director of Nursing of Mental Health and what it entails?

The Director of Nursing for Mental Health works with Northern Health’s Chief Nursing and Midwifery Officer to ensure there is professional oversight of mental health nursing. This includes mental health nursing education, professional development and research.

Mental health nurses work in a variety of specialist areas including emergency, community and bed-based services. There is a well-established mental health nursing structure across Northern Health, and part of my role is to think about ways to strengthen and build on the great work already being undertaken.

Tell us what you were doing prior to this role?

I have been a mental health nurse for all of my career. I won’t say for how long, but if I say cathode-ray TV, those in the know will understand!

Although I am new to Northern Health, I have previously worked at both Broadmeadows Hospital and Northern Hospital Epping in the mental health program. Before coming to Northern Health, I worked at Eastern Health as the Director of Mental Health Nursing, and before that, at the Royal Melbourne Hospital as a senior nurse.

What does a typical day look like for you?

I start my day at Northern Hospital Epping, but as mental health services are spread across all of our catchment area, it is not unusual to finish offsite. Sometimes my day involves more meetings than I would like, but I get many opportunities to chat with staff and see the great work they do.

I also work closely with the Area Senior Nurses at the Northern Area Mental Health Service, Northwest Area Mental Health Service and the Aged Mental Health program.

What excites you about your role?

The opportunity to make a difference for mental health nurses and support the fantastic work they do every day.

Mental health nursing requires a particular skill set. There are many opportunities to try something new in nursing. Creating pathways for nurses to start their mental health nursing career is an important part of my job.

In addition, the opportunity to support mental health nursing research and professional development opportunities is an exciting part of this role.

What are some of the challenges of this role?

We are a large service, and getting around to all sites to meet with nurses can be a challenge. Building and sustaining connections that ensure mental health nurses feel engaged and supported professionally will be an important part of this role. In addition, the Royal Commission into Mental Health has provided us with many opportunities to look at the way in which we do our work. Nursing will have a key role in shaping how we implement the recommendations in a meaningful way.

Lastly, what would people be most surprised to know about you?

I came from Dublin in 2003 planning to see Ireland win the Rugby World Cup and I was intending to return home after 12 months. Neither happened!

 

Recently, there have been a number of cyber-attacks on prominent service providers – from telcos to health insurance providers.

These breaches resulted in personal data including names, addresses, dates of birth, phone numbers, and email addresses of millions of users being exposed.

Ironically, many of them happened during Cyber Security Awareness Month.

The sobering fact is that there may be more. The Australian Cyber Security Centre received 67,500 reports in the 2020-21 financial year – up 13 per cent from the previous year. That is roughly one report every eight minutes.

Our Chief Information Officer, David Calvo, tells us that as a sector reliant on technology, we are just as vulnerable to cyber-attacks.

“Hospitals are increasingly reliant on computer systems to store and manage patient records, schedule appointments, and communicate with patients and other healthcare providers,” said David.

“However, these systems are also vulnerable to cyber-attacks that could jeopardise the confidentiality, integrity, and availability of patient data. A breach could result in the disclosure of sensitive patient information, the disruption of hospital operations and the loss of patient trust.”

“We all play a role in preventing this from happening and awareness is the best way for staff to understand how to protect their patients’ information from being accessed or stolen,” David said.

Northern Health provides a cyber security training module with this in mind, found here. The training module gets updated regularly to ensure Northern Health keeps up to date with the latest threats, like scams or phishing attacks. Phishing starts with a fraudulent email or other communication that is designed to lure a person into clicking on a link or giving personal information. The message is made to look as though it comes from a trusted sender.

The training helps our staff to understand how to protect themselves and our health service from online threats. It also helps to raise awareness of the importance of cyber security in the workplace.

The Information and Communication Technology (ICT) team is working in conjunction with the Department of Health to run a phishing awareness campaign that will commence in the coming months, to educate our staff on how to identify emails that could create a security breach.

Registrations are now open to staff for the Speaking Up for Safety (SUFS) program.

The SUFS program is a series of one-hour workshops designed to equip staff with the skills and confidence to escalate concerns around patient and/or staff safety with assertiveness and respect. The program aims to build and normalise a culture where we feel comfortable to check on each other, and to welcome being checked on, with the aim of preventing unintended harm.

Bianca Fazzari, People Experience Business Partner, People and Culture, said, “creating a culture of safety where staff feel empowered and comfortable to raise concerns is essential at Northern Health. The Safety CODE (Checks, Options, Demands, Elevates) is a proactive tool that enables staff to speak up before mistakes happen to prevent unintended harm to patients and/or staff.”

Working in partnership with the Cognitive Institute to deliver an evidence-based model that enables staff to raise safety concerns, Northern Health will roll out Speaking Up for Safety workshops. These workshops will enable staff to explore ethical considerations that may impact them as they consider the decision to speak up for safety, as well as improve confidence, skills and develop a common language, using the Safety CODE to speak up for safety with collegiate communication as a first approach.

The workshops will be delivered face-to-face across Northern Hospital Epping, Broadmeadows Hospital, Bundoora Centre and Craigieburn Centre over the next 12-18 months by 15 Northern Health employees who have been accredited to deliver the program.

“We strongly encourage all staff to attend the workshops so that we can build a culture where everybody feels comfortable to speak up for safety. Doing so is critical to the delivery of quality patient care and a positive employee experience,” Bianca said.

For registrations and further information on the program, please visit the Intranet.

Featured image: Some of the Northern Health SUFS trainers.

Tomorrow is International Pathology Day (IPD). The day was first marked in Sydney 10 years ago, and has continued to grow in popularity within the international pathology and medical community.

As part of the celebration, Royal College of Pathologists Australasia is revisiting milestones in pathology from the last decade. You can find more information here.

Pathology plays a critical role in healthcare and is a medical specialty in its own right. It is something all doctors and nurses rely on to determine the cause and nature of diseases by examining and testing body tissues and bodily fluids (e.g. blood, urine). Pathology also helps in preventing diseases, and almost 1,000 pathology tests are performed every minute in Australia.

The importance of pathology became even more clear during the COVID-19 pandemic, following a massive increase in swab collection sites and testing capacity. Victoria reached 92,262 tests per day in December 2021, and Northern Pathology Victoria (NPV) performed 2,136 tests in a 24-hour period.

“Bringing pathology in-house has greatly improved the quality of care we can offer. This was evident in the excellent PCR turnaround times during the early periods of the pandemic,” said A/Prof. Prahlad Ho, Divisional Director-Cancer Services and Specialist Clinics, Program Director-Diagnostic Services.

Pathology also plays a critical role in advancing medicine and improving patient outcomes, as both a diagnostic service and by supporting clinical research.

NPV collects samples from pregnant women at Northern Health for the whole-of-state Generation Victoria research project, which aims to create a large group dataset for future discovery and interventional research. Our scientists have also presented at national scientific meetings, such as the Australasian Association for Clinical Biochemistry (Rachelle Liwayan on using a web application to assist clinicians in screening for primary aldosteronism) and Australian Society of Microbiology (Mikayla Kingston on a case of Echinococcus and H. pylori).

In addition, NPV supports the various cancer clinical trials running at Northern Health.

To further support our community, NPV opened a new collection centre at Mill Park in June 2022. The Epping Collection Centre is also open on Sunday mornings from 9 am to 1 pm.

NPV will have a table in the Northern Hospital Epping front foyer tomorrow morning, where you can meet the team while helping yourself to some tasty treats!