Lockdown was a difficult time for many of our patients, but for some Dialysis at Home patients, these last seven months brought significant changes and improvement to their life and care.

Paula Kuder, Nurse Unit Manager Dialysis at Home, explained most of their patients had home treatments set up prior to the pandemic, and the team had set up remote monitoring for these patients.

“We have continuous contact with our patients and, through our programs, we can see everything that is happening with their dialysis at home. All our patients were safely looked after during the pandemic and were able to safely isolate at home,” she explained.

A number of renal patients hadn’t considered Dialysis at Home before the pandemic, but were now more open to switching to a home setting.

One of these patients is Asiasiga Esekia, who is only 29 years old, and has been coming to hospital three times a week for the last two years. She was struggling to balance family life with two kids, a full time job and dialysis at hospital. Before the pandemic, she was anxious to have dialysis at home, but the pandemic was a chance for her to change her mind.

“During the lockdown, she completed her home dialysis training and was able to transition to full home dialysis. She really thrived through the lockdown and was able to put a positive spin on her situation,” Paula said.

“I started the home option two weeks ago and I already feel that I have the control of my life back. I am now there for my two kids, especially for my daughter who goes to school. Before, I had to come to hospital and spend hours here, now I hook up the machine in the evening and sleep through my dialysis. That allows me to have the family time that we need. I would recommend home dialysis to all patients, especially young ones – you will have your whole day back,” Asiasiga added.

Another patient is Jaspreet Greewal, who had been on home dialysis for the last three and a half years, and was looking forward to potentially getting a kidney transplant this year. During the lockdown, she was worried that her transplant might get delayed.

Then, her phone rang in the middle of the night.

“I didn’t even answer, thinking it was my family from overseas. Then they called my husband, and told us about the transplant. It was amazing! I had my transplant in August and everything is going well now. I didn’t expect the call, as I thought all transplants are cancelled due to COVID-19,” Jaspreet said.

Paula explained Northern Health patients are affiliated with other hospitals like Royal Melbourne and Monash Health and participate in the shared care model.

“Jaspreet was our patient through the whole journey and had her transplant at Monash Health. Once the procedure was done, our doctors took over the care post surgery. She is now on immunosuppressants which makes her even more vulnerable, not just to COVID-19, but to things like flu and similar. It was very brave of her to undergo this procedure in these times,” she said.

“One of our nephrologists volunteered his time to come to our offices every Tuesday and Thursday to enable patients to have a face to face review, outside the main campus. As well, the rest of the medical and extended renal team has rallied together to support us. That was great support for all our patients. We started with 25 patients having home dialysis to now 37 patients,” Paula added.

Paula is hoping to see this model of care implemented in other specialities, not just in the renal space. The team considers themselves lucky just to have a unit dedicated to training patients, especially away from the main hospital building.

“The Home Dialysis Awareness Program is much more sustainable for patients, and it links with our Staying Well Program, which is focused on looking after patients in the community. This models allows us to really get to know our patients, and that is what patient-centred care is all about,” she added.

Featured Image: Asiasiga Esekia (back), Jaspreet Greewal (middle), Paula Kuder (front)

Long standing Northern Health Foundation supporter, Rino Minniti, is walking over 11km to fundraise for cancer services at Northern Health.

On Sunday 6 December, Epping local Rino will walk from Northern Hospital in Epping all the way to PANCH in Preston – an impressive distance of 11.3km.

Cancer is a cause very dear to Rino who is walking in memory of his brothers who battled the disease. He is especially motivated to raise funds for cancer patients as Rino himself also fought cancer and has experienced firsthand its challenges. He is grateful for the exceptional care he received at Northern Health, as well as the care provided to his brother.

“I was motivated to do this because I had cancer myself. I’d like to give back and raise awareness of bowel cancer and try to raise money for people to have a better life,” Rino said.

Rino anticipates the walk will take him approximately two hours and 45 minutes and is looking forward to raising funds for this important cause. He and his wife Josie have been dedicated fundraisers for over 20 years, passionate about improving the lives of cancer patients in our community.

Melissa Gwynne, Day Oncology Nurse Unit Manager, expressed her appreciation for Rino and Josie for their wonderful support over the years.

“Rino and Josie are an inspiration and I am extremely thankful for all the fundraising they do for our cancer patients at Northern Health,” she said.

“I wish Rino all the best in his Walk for Cancer and I’m very confident he will achieve his goal. I’ll be cheering from the side lines!” Melissa added.

To support Rino and Northern Health cancer patients, please click here to donate.​

A new collaborative project in the Short Stay Unit (SSU) is improving the pathway for patients to get the right care, at the right time.

The Toxicology HDU (High Dependency Unit)/SPECTRE Cubicle Project is aimed at reducing the length of time in the main Emergency Departments for patients presenting with sedation, whether it be from an overdose or recreational substance use, whilst ensuring safer care.

This project has been developed in conjunction with the SPECTRE Unit. SPECTRE is Northern Health’s new specialty unit that focuses on the care of patients with a problem pertaining to one or more of the following: Substance Dependence, Psychiatry/Mental Health, Envenomation, Clinical Toxicology, Recreational Substances.

The Cubicle Project commenced on 10 November and is based within the Clinical Decisions Unit (CDU) in SSU – with two fully monitored beds dedicated to caring for this cohort of patients, with a goal to elevate patient experience and contribute to better health outcomes.

Dr Joe Rotella, Northern Health’s first clinical toxicologist, explains the new service will help to provide more individualised, safer patient care. Joe is an emergency physician and one of only 10 toxicologists in Victoria.

“At Northern Health, we see a large proportion of patients for whom drugs, alcohol and mental health are the reason for their presentation. We’ve had a multidisciplinary Toxicology Special Interest Group for over a year now, and the evolution of that has been to create a formal unit called SPECTRE,” Joe said.

Previously, if patients were to present to the Emergency Department (ED) intoxicated or having overdosed, they were required to stay in ED before they could go anywhere else – whether that be home, onto a ward or to ICU.

That’s where Nicole Higginson, Clinical Nurse Specialist, stepped in with the Toxicology HDU/SPECTRE Cubicle Project.

“The Toxicology High Dependency Cubicles created within CDU is a unique project allowing for a safe and suitable environment for this cohort of patients. They will assist the flow from the Emergency Department whilst also decreasing the pressure on ward beds, as these patients no longer have to wait in ED for a bed,” Nicole said.

This is the first project of its kind in any Australian hospital and the team are excited for the new education opportunities and increase of skills, to ensure the best care for these patients.

Patients will benefit from quicker access to services such as social work, mental health and alcohol and other drugs (AOD) services, which will present opportunities to reduce length of stay. Patients will also have access to one to one nursing, rather than two to one in the ED.

“Being in hospital can be an anxiety-provoking experience for patients, so we have an opportunity to reduce the time they actually have to be in hospital, and also an opportunity to link them in with the right services they need,” Joe said.

Luma Gashi, Nurse Unit Manager for SSU/CDU, said, “This project has created a change to our nursing care, as our nurses have been specially trained to care for this cohort of patients. From education and support from Nicole, Joe and the education team, we are now able to take better care of these patients.”

“Our nurses have learnt new skills and have more experience, so I’m excited about the project as it will be an overall better experience for patients.”

The project is already growing as the team have recently received confirmation for funding of a new registrar to come on board next year. They will add to the utility of these cubicles by providing direct care alongside the SSU team to any patient who presents in need of care.

Featured Image: Nicole Higginson and Dr Joe Rotella 

In the last week of July, Unit 1 staff from Broadmeadows Hospital were redeployed to the new Ward 15 at Northern Hospital Epping – to look after COVID-19 positive and suspected COVID-19 patients.

Minu Manuel started her Nurse Unit Manager role at Unit 1 just the week before. She didn’t get much time to enjoy her new role, as the COVID-19 numbers were rising.

“It was a very short notice for our staff and a big change, but the staff turned up for work the next day and embraced it. Some of them hadn’t been at the Epping campus for years, so working in this new environment was very brave of them. The months from July onwards were very challenging times for any health care worker,” she said.

Unit 1 at Broadmeadows Hospital is a surgical and medical ward, and the staff are used to overnight stays of surgical patients. The move to Ward 15 for them meant adapting to wearing PPE at all times, making sure they adhere to all COVID-19 precautions, upskilling in different patient conditions and procedures quickly, and adapting the care according to infection prevention principles.

“The first thing staff had to learn is how to be in the N95 mask all day, and in full PPE. Another big challenge was getting to know how the Epping campus works, as surgical and medical teams are different here, and just getting accustomed to a new environment,” she said.

Minu says her team received huge support from the access team, being a fast-moving ward, and also working closely with NUMs of surgical division and Linda Romano, Divisional Director.

“I have been extremely pleased and thankful for all the hard work and resilience from the Ward 15 staff. It was certainly a big change for most. However, despite their initial reservations, they were all committed to providing high quality and compassionate care to our community during such challenging times. Their contribution assisted greatly in Northern Health’s COVID-19 pandemic response, and for this, I will be forever grateful,” Linda said.

The team and Minu also highlighted the support from multiple departments – “We had Grant Taylor, Director of Nursing and Operations for Broadmeadows Hospital supporting us the whole way through this redeployment and guiding me as the new NUM. We also had huge support from nursing education and infection prevention, who were with us on the ward. In the moments of high stress, staff were given the opportunity for TREAT sessions and EAP, and many staff have taken advantage of it. Now that it has been four months working on Ward 15, the team has adapted to the change and knows the system,” she said.

Grant Taylor said he is exceptionally proud of the Unit 1 team.

“The team have demonstrated the Northern Health value of together, both in supporting each other, as well as their colleagues at Epping during what was a very challenging time for Northern Health and the state of Victoria as a whole,” he said.

Richard Ram, NUM for Ward 15 and 16 added: “The team from Ward 15, during the second wave of COVID-19, has shown the values of Northern Health, and this has resonated daily in their operations. Great team comradery from the Broadmeadows team whilst at Epping”.

November is Lung Cancer Awareness month, an important initiative to raise awareness of the condition and break one common misconception – that lung cancer only affects smokers.

Dr Katharine See, Head of Respiratory, explains lung cancer doesn’t just affect smokers: one in five people with lung cancer have never smoked.

“Lung cancer affects both men and women, and statistics show twice as many women die of lung cancer each year than of breast cancer, and three times as many men die of lung cancer than of prostate cancer. During the pandemic, the number of new diagnosis of cancer has dropped about 27 per cent, so it’s really important that people don’t delay acting on their symptoms,” she said.

Dr See explains Northern Health has a fantastic multidisciplinary lung cancer service. In a single clinic, patients can be seen by the respiratory specialists, medical oncologists, radiation oncologists and thoracic surgeons, all in one location.

“And we are also incredibly lucky to have someone like Alison Hirth, Lung Mass Nurse Coordinator, who can coordinate patient care and is a key resource for patients during a very stressful time. Having a single point of contact gives patients some control over their diagnosis and treatment,” Dr See added.

“Once a patient is referred to Northern Health, establishing a diagnosis of lung cancer involves a number of investigations in an optimal time frame, across multiple health services. Patients with limited social support, new to the health system, with low health literacy and culturally and linguistically diverse patients particularly benefit from a central point of contact when all these tests need to be coordinated,” Alison said.

The COVID-19 pandemic has brought some challenges in running a multidisciplinary clinic, such as being able to meet as a team to discuss patient results and care.

“In April, the lung cancer multidisciplinary meeting moved online. We are now running a completely virtual meeting and it has been a really positive addition to the service, as we can virtually look at patient’s pathology slides, review patient’s images with radiologists in real time, and so on. We have high attendance from all departments, which means patients are getting just as good quality care as they were before the pandemic,” Dr See added.

The team is still seeing some patients face to face, while others, who have follow up of nodules (or spots on the lungs), can have imaging and tests done, and then a telehealth consultation, which reduces the need to come to hospital.

The new EBUS machine, for which the Northern Heath Foundation has been fundraising during the year, will be available at Northern Health next year and will significantly improve care for lung cancer patients.

“This machine is particularly used for cancer patients, with a camera test that allows us to not only diagnose, but also stage the cancer all in one minimally invasive procedure. Staging is particularly important as determines the type of treatment most suited for each individual patient,” Dr See added.

Early diagnosis of lung cancer is challenging, as patients often don’t have symptoms at the early stage of their disease.

Katharine and Alison agree that the earlier the team can make the diagnosis and commence treatment, the better the outcome for the patient.

If you have symptoms such as an unexplained cough that doesn’t go away, or you are coughing blood, losing weight without trying, experience chest and or shoulder pain, night sweats or unexplained shortness of breath, please don’t delay seeking medical help.

Featured image (left to right): Dr Krishna Bhagwat, Thoracic surgeon; Dr Bassem Dawood, Consultant Respiratory Medicine; Dr Terry Kok, Consultant Interventional Radiologist; Alison Hirth, Lung Mass Nurse Coordinator; Dr Katherine See, Director of Respiratory Medicine;  Dr Simon Knight, Director of Thoracic Surgery and Dr Frances Barnett, Director of Medical Oncology.

The MDM team also includes specialists in Nuclear Medicine, Pathology, Radiation Oncology, Pleural Medicine specialist and the Cancer MDM team.

 

The Northern Hospital Expansion Project is making great head way, with Stage 2 works on track to be completed in mid-2021.

Stage 2 will increase the tower from three to seven floors, providing space for improved facilities and extra room to meet future needs. Among the features of the new development will be three 32-bed wards accommodating 96 acute inpatient beds, three new operating theatres including one hybrid theatre, increased recovery capacity, satellite pharmacy, kitchen and expanded back-of-house services.

Once completed, the building will have the capacity to treat 10,000 more patients every year at Northern Health.

Meet the dedicated team who are working together on the project!

In collaboration with the Victorian Health & Human Services Building Authority (VHHSBA), staff from Northern Health are working alongside builders, Kane Construction and consultant project managers, Johnstaff, to bring this project to fruition. Karen Green, Director of Capital Development, manages the project from our end, working through any issues that arise due to Northern Health requirements and managing them back through Johnstaff and VHHSBA.

Kushani Dissanayake and Ashley Shea, Project Managers of Capital Development, manage the interface between Northern Health, Kane and the design team (external consultants such as architects and services and structural engineers) while also being responsible for the project’s furniture, fittings and equipment procurement. Anton Frischmidt, Associate Director of Procurement, supports the capital project team by managing all tenders for the project. He guides the process of procuring and delivering all furniture and fitouts, in line with the project procurement plan and construction timeline.

Alex Jovanovski, Project Coordinator, Engineering Department, assists the capital development team in advising and overseeing shutdown of services to ensure the live hospital can still operate, while Kane Construction integrate new services or upgrade existing services. Kyle Pearson, Interface Manager from Kane Construction, oversees the construction timetable and liaises with Kushani around works that will impact on the hospital.

A key milestone for the project was the official opening of the new Central Sterilising Services Department (CSSD) which has included the closure of our current CSSD with all operations transferred to the new space in late October.

In January 2021, Wards 19, 20 and 21, the new kitchen, satellite pharmacy, Transit Lounge and front of house reception and waiting areas are also set for practical completion and handover from Kane Construction. Practical Completion of the new Recovery is set for mid-2021.

The significance of the project at Northern Health was recognised by the Victorian State Government during COVID-19 and was nominated as one of only nine critical state health projects that were granted exemption from Stage 4 workforce restrictions. Kane have managed the construction project while ensuring strict compliance with a COVID Safe Plan which was endorsed by Worksafe Victoria as of a very high standard.

“One achievement we are really proud of is the delivery of Ward 15 (our old ICU). Capital Development were asked if it could be made operational within 36 hours, which was made possible with the assistance of Engineering, Support Services, Supply/Procurement and Ward 16,” said Karen Green, Director of Capital Development.

“Our team has developed some really good working partnerships with the Kane Construction site team and Northern Health Engineering, Supply/Procurement and clinical teams.”

Featured Image (left to right): 

Front: Ashley Shea, Project Manager, Capital Development – Northern Health; Kushani Dissanayake, Project Manager, Capital Development – Northern Health and Karen Green, Director, Capital Development – Northern Health 

Back: Carl Naidoo, Project Manager – Kane Construction; Will Gullifer, Senior Project Manager – Kane Construction; Alex Jovanovski, Projects Coordinator, Engineering and Building Services – Northern Health and Kyle Pearson, Contract Administrator – Kane Construction 

Our Northern Oncology and Haematology (NOAH) department within the Day Oncology Unit has recently launched a new at-home service for cancer patients – NOAH@Home. 

NOAH@Home provides oncology and haematology patients the opportunity to receive certain chemotherapy or supportive treatments in the comfort of their own homes.

The new service launched on 9 November and has been very well received by patients already. Henry (pictured below) was one of the first patients to utilise this new service and was grateful to be able to receive treatment in comfort.

Kaylene Probst, NOAH@Home Liaison Nurse, explained the innovative service will improve convenience for patients and benefit them in a number of ways.

“The program means patients no longer have to travel for appointments, there will be less stress on family who have to take time off work to bring their loved ones in for treatment, less worry about coming into a hospital during COVID-19, and patients are more relaxed in their homes,” she said.

Our Day Oncology nurses will now be on the road six days a week to administer treatment to patients out in the community. Over the past two months, oncology staff have been working hard behind the scenes to develop the program, purchasing new equipment, including a car, and undertaking additional training from our Hospital in the Home staff.

“We are very excited to be able to offer a program like this, as it enables for a greater use of our nursing skills and gives patients the opportunity to decide where they would prefer to have their treatment,” Kaylene said.

“This past eight weeks has been a whirlwind of activity and hard work on behalf of all those involved, and it’s been a pleasure to be involved and to be able to pull this all together – ready to start a new chapter for Cancer Services and the Day Oncology Unit at Northern Health.”

Thirty-four smart wireless glucometers have been rolled out in nine wards at Northern Health, as part of the new Northern Inpatient Diabetes Service (NIDS).

Richard Nasra, from the HRO/Project Management office, explained the new glucometers are an electronic system automatically linking patient blood glucose measurements with patient data in iPM.

“When a patient’s blood glucose is measured at the bedside, the result is automatically and wirelessly logged into a software package for the Endocrinology team to review. The software automatically alerts the Endocrinology team when a patient logs a high (hyper) or low (hypo) blood glucose measurement and indicates the ward and bed where the patient is located in the hospital, enabling the Endocrinology team to proactively identify, review and manage these patients. The new meters are currently installed on Wards 3, 4, 5, 6, 13, 14, 15, 16 and 18 at Northern Hospital, with the view to roll out across the rest of sites next year,” he explained.

High and low blood sugar levels are associated with hospital acquired complications (HACs), and having an ability to proactively identify patients at risk early and treat them is not only expected to reduce the number of patients who have complications, but also has a financial impact on the hospital too. Reducing HACs is part of our HRO Trusted Care initiatives.

“This is a broad, concerted effort around how we can reduce the implications of HACs for patients, and this is one component of that. The idea is that this will form part of an early intervention/proactive hypo and hyperglycaemia diabetes service across the hospital, and reduce the number of inpatients that suffer avoidable hospital acquired complications and infections due to fluctuating blood glucose levels,” Richard added.

Dr Suresh Varadarajan, Head of Endocrinology Services and the NIDS, explained the service started in February this year and works to identify the prevalence of diabetes at Northern Health.

“We work to identify how many inpatients on a certain day, excluding certain wards, have diabetes on a given day. Unfortunately, patients in our catchment have the highest prevalence of diabetes in Victoria,” he said.

Dr Mervyn Kyi, Endocrinologist and Clinical Lead for the NIDS, says this project is an early intervention and proactive approach to inpatient diabetes care.

“From my PhD studies, we know that patients with diabetes have worse outcomes at hospitals, and early intervention for these patients can improve outcomes. The NIDS service is now running for six wards in the hospital, and we have a multidisciplinary team of clinicians who go around proactively managing people with diabetes, and optimise their care,” he explained.

The NIDS team assesses people with diabetes, and can prescribe insulin and make changes to diabetes management.

“We then review as needed, help facilitate discharge and follow up after discharge. Our rapid access clinic, which runs once a week, enables discharged patients to be seen quickly. The new glucometers enable remote glucose surveillance and help identify people with diabetes. In addition, they facilitate data capture, enabling detailed clinical research. The glucose data then allows benchmarking against other hospitals,” Dr Kyi added.

After implementation of the Electronic Medical Records (EMR) system, the glucose measurements will be automatically uploaded into the EMR, which means our nursing staff won’t need to manually enter them.

Every year, 14 November marks World Diabetes Day. In Australia, statistics show that 280 Australians develop diabetes every day, with one person every five minutes.

Featured image (left to right): Patient Karen with Dr Suresh Varadarajan, Richard Nasra and Dr Mervyn Kyi holding the new glucometers.