Category Awards - Winners
Category 1: Safety in Health
Care
South Western Sydney Area Health Service
“Toxic Drug Monitoring”
Contact: Helene Rickard
Phone: 9828 4088
Patients with rheumatic diseases such as rheumatoid arthritis
are frequently required to take potentially toxic medications
such as methotrexate for prolonged periods of time as outpatients.
Up to 30% of patients on methotrexate will experience an
adverse event at some time during their treatment. This project
was established to increase the safety of patients by improving monitoring
processes and patient compliance. The team developed standard monitoring
protocols for each medication. These allowed the establishment
of a system to monitor the expected follow-up date for
each patient and any abnormal pathology results. Educational
material was designed and a nurse-driven education program
implemented. Fifteen months after implementation 121 reversible
adverse events have been recorded. Patient and carer education
has increased and there has been no irreversible toxicity.
Provision of a standardised monitoring and education program
for patients on long-term potentially toxic medications detects
adverse events early and should reduce the likelihood of
irreversible toxicity occurring.
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Category 2: Effectiveness of Health Care
NSW Health in conjunction with AHS SWISH Co-ordinators
“Statewide Infant Screening Hearing Program (SWISH)”
Contact: Dr Lis Murphy
Phone: 9391 9475
If not treated early, significant permanent bilateral hearing loss in children
has severe detrimental effects on speech and language development. Children
with late identified hearing loss demonstrate long term negative effects
on social, educational, economic and employment prospects. This project successfully
developed and implemented a statewide population-based newborn hearing
screening program to identify and intervene early with babies born with significant
permanent bilateral hearing loss. In the first 18 months of the program, 92
babies have been identified. Average age of diagnosis has decreased from 18
months to 1.6 months and average age of commencing hearing aid intervention
has decreased from 22 months to 3.8 months.
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Category 3: Appropriateness of Services
New England Area Health Service
“Innovation in PD Catheter Insertion”
Contact: Kim McNamara
Phone: 6767 7049
Patients nearing End Stage Renal Disease (ESRD) selecting peritoneal Dialysis
(PD) as their therapy option, require a PD catheter to be permanently inserted.
Patients usually have a hospital admission of 2-4 days consisting of a
scheduled surgical procedure, trip to theatre, general anaesthetic and a post
operative period. This exposed vulnerable patients to risks and potential complications
as well as exacerbating the decline of their kidney function and hence
increasing the need for urgent dialysis post operatively. These risks prompted
the investigation of other options for PD catheter insertion. By using a multidisciplinary
collaborative approach collaborative Tamworth Base Hospital took up the challenge
to change PD catheter insertion practice. Patients now have their catheters
implanted under local anesthetic as a short “Day Only” admission
with Tamworth becoming the first site in the Australasian area to undertake
this procedure, and has since become the training provider to other sites in
Australia.
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Category
4: Consumer Participation – Joint Winners
South East Sydney Area Health Service
“Satellite
Sexual Health Youth Project”
Contact:
Vickie Knight
Phone: 9382 7462
Sexual Health
Services in South East Health were faced with a challenge.
The Area had the highest rate of new Chlamydia infections
in NSW and those most affected, the 15-24 age group, were
under utilising existing sexual health services – including a specific
clinic for young people. The Satellite Sexual Health Youth
Project was established in March 2003. It enlisted young people
(consumers) to identify why their peers weren’t accessing
the service and to develop and help implement solutions. Consumer
feedback was used to make the service more ‘youth friendly’.
Peer educator-driven outreach activities distributed information
about sexually transmissible infections (STIs) and services,
and clinical sexual health services were integrated with
established youth services to take the service directly
to the community. As a result the number of new young people
accessing the sexual health service and calls to the sexual
health information line have significantly increased.
South Western Sydney Area Health Service
“Community
Participation Framework”
Contact:
Alice Wood
Phone: 9828 5778
In 2001, SWSAHS embarked
on a journey to develop a more structured and coordinated
approach to involving the community in health service planning
and decision-making. The need was identified through interviews
and questionnaires with consumers, community, health service
managers and staff, and a ‘stocktake’/audit of community participation
activity. Throughout 2001-04 community representatives and
staff worked together to develop the SWSAHS Community Participation
Framework. This provided information vital to implementing
sustainable participation within the health service. The
Framework is a strong commitment from SWSAHS to its community
that the philosophy of participation will underpin everything
it does. It means working ‘with’, rather than ‘doing
to’, people. Already on this journey, significant community
participation is evident and continues to grow. Numbers of
community representatives involved in SWSAHS have increased,
and the range of activities they participate in continues
to expand. Staff feedback demonstrates greater understanding
and recognition of the community’s invaluable contribution.
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Category
5: Access to Services
Western Sydney Area Health Service
“Don’t
Knock…it’s a NOF”
Contact:
Rosio Cordova
Phone: 9845 6295
Patients with fracture of the neck of femur (NOF)
should have early surgery (within 24 to 36 hours) once a
medical assessment has been made. Analysis of data for the
period January 2002 to June 2003 indicated that only 42%
of patients presenting with fractured neck of femur to Westmead
Hospital were going to theatre within 24 hours. In order
to improve the rate of NOF fracture patients going to theatre,
a multidisciplinary team comprised of orthopaedic surgeons,
nurses, anaesthetists and administrators was formed. The
use of various quality tools assisted the team to identify
the priority areas requiring attention. After the implementation
of a number of cross-departmental strategies surrounding
accessibility and assessment, the rate of patients going
to theatre within 24 hours increased by 70% after seven months
of project implementation.
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Category 6: Efficiency of Service to Consumers
Central Coast Area Health Service
“Calling all Nurses”
Contact: Lynne Bickerstaff
Phone: 4393 8076
In response to increased casualisation of the nursing workforce,
Central Coast Health (CCH), in conjunction with a commercial
partner, is harnessing the power of the internet and the
ubiquity of mobile phones to dramatically reduce administration
effort and ensure that the most preferred, most qualified
and most willing staff are matched to demanding and varied
work assignments. The system, dubbed “Cascom”,
intelligently matches specialist nursing casuals to specialist work assignments
in most need using the Internet & two-way SMS text messaging as communications
media. A “yes” reply to an SMS work request, confirms shifts,
updates rosters, feeds payroll systems and importantly, allows managers to
focus on more strategic staffing issues such as training, recruitment and
retention. Since implementation, the system has reduced administration effort
by 86%; increased casual utilisation by 20%; reduced telecommunication costs
by 29% and reduced overtime by up to 42%.
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Category 7: Competence
Hunter Area Health Service
“Improving Care with Dementia Mapping”
Contact: Carol Penning
Phone: 4924 6313
A pilot study (March – September 2003) was undertaken at John Hunter
and Rankin Park Hospitals as part of a collaborative nursing partnership between
Hunter Health Care Network, HAHS and Calvary Centre for Research, Learning
and Development Cessnock. The aim of the project was to improve the acute hospital
care of cognitively impaired older patients. Ten HAHS nurses were trained in
a Person-Centred Approach (PCA) and Dementia Care Mapping (DCM). DCM is an
observational tool, which provides a means of quantifying and qualifying the
well-being and occupational diversity of people with dementia. DCM was implemented
in an acute and sub-acute care setting and evaluation and feedback undertaken
to improve the care of patients with a diagnosis of dementia, delirium or confusion.
Equipped with practice-based evidence – the DCM data, the nurses changed
routines and procedures in their hospital wards and effected significant
improvement in the physical and emotional health and safety of their patients.
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Category 8: Information
Management
Macquarie Area Health Service
“Integrated
Safety Improvement System (ISIS) Project”
Contact:
Alison Attenborough
Phone: 6841 2329
An improved system to facilitate clinical governance
was identified as a key issue for the Macquarie Area Health
Service in late 2002. Existing systems for complaints and clinical
incident management across the Area were ad hoc and managed
in isolation by individual departments and facilities. To identify
barriers and implement systems improvement, a multidisciplinary
team was convened at the pilot site, Dubbo Base Hospital (DBH),
with a Guidance Team, led by the Chief Executive Officer. At
DBH there was identified underreporting of incidents compared
to a similar sized rural health facility and data indicating
that complaints handling was well below state-wide benchmarks.
Over the course of the project a number of interventions were
trailed and tested through a series of PDSA (plan, do, study,
act) cycles and subsequently implemented resulting in improved
reporting of incidents and achievement of state-wide benchmarks
for complaints handling. Further to this, the project has enhanced
the system for clinical governance and has prepared the Macquarie
Area Health Service for the implementation of the integrated
system of incident management, in line with the direction of
NSW Health.
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Category 9: Continuity of Care
Northern Rivers Area Health Service
“Women’s Referral and Access Project”
Contact: Kerry Leitch
Phone: 6620 7596
As part of a rural integrated care trial for women dependent
on illicit drugs a case management model was developed, implemented and evaluated
in the Northern Rivers Area, NSW. The trial aimed to improve the quality of
life, including the health and social circumstances, of drug
dependent women. Development of the WRAP case management
model was informed by the findings of a comprehensive area-wide
needs assessment conducted with both drug dependent women
and service providers. Qualitative and quantitative measures
were utilised in a quasi-experimental longitudinal design
with assessments occurring at baseline (recruitment), 3 and
6 months to evaluate the model’s effectiveness. Findings show that
WRAP case management had a positive impact on women’s lives, particularly
in relation to psychological wellbeing and reduced drug use. Remaining in
case management beyond 3 months and up to 6 months appears to confer further
benefits in these areas.
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Category 10: Education and Training
South Western Sydney Area Health Service
“Certificate III in Aged Care Work”
Contact: Nicole McGreal
Phone: 9722 8248
In 2002, a collegial opportunity became apparent to develop a Nursing Vocational
Education and Training (VET) program for secondary school students within the
Bankstown District. A collaborative approach was adopted between Bankstown
Health Service (BHS) and the Department of Education and Training (DET) to
develop and implement a Nursing pilot program that aims to address the identified
needs of all stakeholders. Bankstown Health Service is currently delivering
a 3 unit Higher School Certificate (HSC) subject called a Certificate III in
Aged Care Work - Nursing Assistant course over years 11 and 12. At the successful
completion of this course, students will matriculate with their HSC, a Board
of Studies and an Australian Qualifications Framework (AQF) accredited Nursing
Assistant qualification. For those students who wish to pursue further nursing
studies, it is anticipated that this opportunity will offer them a wonderful
and insightful beginning to their nursing careers.
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