2004/05 ANNUAL REPORT

icare that we deliver the best care possible

Better Health for Our Community icare that our diabetes unit is world class AUDITOR GENERAL’S REPORT FOR THE YEAR ENDED 30 JUNE 2005

FINANCIALS ANNUAL ANNUAL REPORT REPORT 2004/05 2004/05 SOUTHERN SOUTHERN HEALTH HEALTH PAGE PAGE 73 3 SOUTHERN HEALTH

Corporate Offi ce 246 Clayton Road, Clayton Phone 03 9594 6666 Email [email protected]

SITES

CASEY HOSPITAL CRANBOURNE INTEGRATED GREATER DANDENONG 52 Kangan Drive, Berwick CARE CENTRE COMMUNITY HEALTH SERVICE Phone 03 8768 1200 140–154 Sladen Street, Cranbourne Springvale: Phone 03 5990 6789 55 Buckingham Avenue, Springvale DANDENONG HOSPITAL Phone 03 8558 9000 CARDINIA CASEY COMMUNITY HEALTH David Street, Dandenong Dandenong: Phone 03 9554 1000 Berwick: 229 Thomas Street, Dandenong 28 Parkhill Drive, Berwick Phone 03 8792 2200 MONASH MEDICAL CENTRE CLAYTON Phone 03 8768 5100 Dandenong: 246 Clayton Road, Clayton Cockatoo: David Street, Dandenong Phone 03 9594 6666 McBride Street, Cockatoo Phone 03 9554 8270 Phone 03 5968 8146 MONASH MEDICAL PARKDALE COMMUNITY CENTRE MOORABBIN Cranbourne: 140–154 Sladen Street, Cranbourne REHABILITATION CENTRE Centre Road, East Bentleigh Phone 03 5990 6789 335 Nepean Highway, Parkdale Phone 03 9928 8111 Doveton: 97 Power Road, Doveton Phone 03 8587 0170 KINGSTON CENTRE Phone 03 9791 5700 Cnr of Heatherton and Warrigal Road, Pakenham: Cheltenham Cnr Deveney St and Princes Hwy Phone 03 92651000 Phone 03 5941 0500

PAGE 4 SOUTHERN HEALTH ANNUAL REPORT 2004/05 TABLE OF CONTENTS

ABOUT SOUTHERN HEALTH 2 Southern Health offers healthcare services to more than 750,000 people. Read about where and how these services are provided to our community. OUR VISION, PURPOSE AND VALUES 2 These are at the heart of the service we provide. FROM THE CHAIR OF THE BOARD 4 Our Chair, Peter Maloney, recaps on a successful year at the head of the Board. FROM THE CHIEF EXECUTIVE 5 Linda Sorrell leads a team of more than 10,000 people. Read about her Southern Health highlights this year. OUR BOARD 7 At Southern Health we are very fortunate, and proud, to have such a diverse and high calibre Board. HIGHLIGHTS – OUR BUSY YEAR 8 Read about some of this year’s achievements that we’re proud of. CLINICAL AND CORPORATE GOVERNANCE 10 A clinical governance framework helps us to provide safe and effective care. ACHIEVING OUR GOALS 12 We have six strategic goals that guide us in the delivery of our services. ACCESSIBLE SERVICES 12 SAFE AND EFFECTIVE CARE 14 APPROPRIATE SERVICES AND CONFIGURATION 17 COLLABORATION AND ENGAGEMENT 20 FINANCIAL ACCOUNTABILITY 22 DEVELOPMENT OF OUR PEOPLE 24 SOUTHERN HEALTH – AT A GLANCE 26 Some quick facts, fi gures and statistics about our service. THE SOUTHERN HEALTH EXECUTIVE AND SENIOR MANAGEMENT TEAM 27 There are more than 300 people that lead the Southern Health team. Here we list the top management level of our organisation. LEGISLATIVE FRAMEWORK OF SOUTHERN HEALTH 30 Here we detail some of the legislative requirements we have fulfi lled this year. BOARD COMMITTEES 32 Details of the six committees that oversee some of the work we do at Southern Health. FREEDOM OF INFORMATION 33 This year we had more than 1200 requests for information. SOUTHERN HEALTH SERVICES 34 A comprehensive list of our almost 200 services. FINANCIAL SUMMARY 37 The breakdown of our facts and fi gures. COMPLIANCE INDEX – DISCLOSURE REQUIREMENTS 39 OUR FINANCIAL STATEMENTS 41

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 1 ABOUT SOUTHERN HEALTH

Southern Health is the largest metropolitan health service in Victoria. We OUR VISION, PURPOSE provide comprehensive primary, secondary and tertiary health care services AND VALUES to people living in the south-eastern suburbs of metropolitan Melbourne. Our Vision at Southern Health We provide services to an area in excess of 2,800 square kilometres with a is to provide “Better Health population of over 750,000. The primary catchment area includes the cities for Our Community” of Cardinia, Casey, Greater Dandenong, Kingston and Monash. We also We will be an Australian leader in provide specialist services to a rural catchment including Gippsland. improving the health and wellbeing Our services are provided from a number of hospitals and of our community. community health services: Our Purpose is to plan and deliver • Monash Medical Centre Clayton; safe, effective and people-focussed • Monash Medical Centre Moorabbin; health care and services that • Dandenong Hospital; anticipate and respond to our community’s health needs by: • Casey Hospital; • Kingston Centre; • Collaborating with our partners; • Cardinia Casey Community Health Service • Maximising the use of all Berwick, Cranbourne, Doveton, Cockatoo and Pakenham; available resources; • Greater Dandenong Community Health Service • Working together to realise Dandenong and Springvale; people’s potential; and, • Primary Care Services; and • Fostering knowledge-based practice • Mental Health Services. and continuous improvement. The Southern Health team, of almost 10,000, comprises health and OUR VALUES administrative professionals across a wide range of disciplines. This year we treated more than 133,000 patients in our hospitals, which is 8,000 more At the heart of our service are our than last year. More than 104,000 people presented to our Emergency values. The Southern Health values Departments and we provided in excess of 680,000 episodes of care. Our spell “icare” because caring is the beddays exceed 600,000 which is a steady increase on previous years. foundation of our service. At Southern Health we will work together with: Integrity - by acting fairly, honestly and openly; Compassion - as we interact with dignity and empathy; Accountability - to take ownership and responsibility for performance; Respect - as we value difference and individual worth; and Excellence - as we aim for and recognise innovation, quality and professionalism.

PAGE 2 SOUTHERN HEALTH ANNUAL REPORT 2004/05 icare that our emergency department is quick to respond

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 3 FROM THE CHAIR OF THE BOARD

During my two-year term as Chair of Southern Health is fortunate to Southern Health Board of Directors, I enjoy excellent partnerships with its have been privileged to work among a community groups such as the Primary truly committed team both on the Board Care Partnership, which is made up of a and in the staff of the organisation. broad range of local health and welfare services, and the Community Advisory The board has played a signifi cant role Committee that comprises local in setting the fi nancial agenda for the community advocates. Southern Health organisation and, under the excellent also works closely with tertiary institutions leadership of Linda Sorrell, has evolved to such as Monash and Deakin Universities. become a more collaborative, responsive The ongoing support of Southern Health’s and innovative health care provider. volunteer population is also to be This past year has seen much renewal commended. The auxiliaries provide and vigour in an organisation that is solid support raising more than $70,000. committed to managing change for the I’d also like to acknowledge the effective future direction of their service. working relationship that the organisation and its management has with the One of the most signifi cant events Department of Human Services. for Southern Health this year has been the development and implementation This has been my fi nal year serving on of its Strategic Plan 2004 - 2007. This the board of Southern Health and I am is a comprehensive plan for the thankful to have worked alongside such organisation and provides a clear a high calibre and committed team. I’d direction for the services that Southern like to extend my thanks to my fellow Health delivers to its community. The board members and to the Chief plan incorporates the six strategic goals Executive, Linda Sorrell, who, in her fi rst of: Safe and Effective Care; Appropriate full year at Southern Health, has led her Services and Confi guration; Accessible team to a signifi cant end-of-year result. Services; Collaboration and Engagement; I have been encouraged most by the Financial Accountability; and excellent people who work at all levels Development of Our People. of the organisation – including clinicians The development of Casey Hospital and and management. The staff at Southern the major redevelopment at Dandenong Health shine through their expertise and Hospital refl ects that the Government commitment to their work. I’m confi dent has confi dence in the way that Southern that over the next fi ve years Southern Health can manage resources and Health will become more recognised for provide services for the vast community the services it provides and that it will that it serves. continue to be more effective in the way it delivers these services and the way The organisation has substantially that it is managed. reduced the defi cit of last fi nancial year and the commitment, and hard work of management and staff is providing a solid foundation for the challenges in the coming year. Peter Maloney Chair

PAGE 4 SOUTHERN HEALTH ANNUAL REPORT 2004/05 FROM OUR CHIEF EXECUTIVE

It has been a busy and successful year We’ve also commenced, or started for us at Southern Health. I’m delighted planning for, signifi cant major works to be moving into my second year as this year, including: Chief Executive and very proud of the • a $13 million redevelopment of team that has produced the results you’ll Dandenong Hospital which has read about in this report. resulted in a new and expanded This year we treated more than intensive care unit, a new rehabilitation 133,000 patients in our hospitals and ward, two new medical/surgical wards provided in excess of 680,000 episodes and two new operating theatres; of care. More than 104,000 patients • the Government-funded $19 million were treated in our emergency expansion of our radiotherapy departments. Our surgical teams services at Monash Medical Centre performed almost 30,000 operations and Moorabbin; and we celebrated more than 6,400 births. • a $10 million upgrade for our Some specifi c highlights are: Emergency Department at • The completion of our new Monash Medical Centre Clayton. 229-bed hospital at Casey. These achievements have happened • Our Mental Health Program alongside the care and commitment As a result of our Strategic Planning commissioned a 25-bed inpatient unit we provide to our community every day. process we have moved towards at Casey Hospital and co-located one Southern Health would not be in a becoming a values-driven organisation. of the Adult Continuing Care teams and position to provide this quality of care This means we will ensure that we’re all a Child and Adolescent Community without the dedicated team of almost working towards the same goals and Mental Health team to that site. 10,000 that I am privileged to work with. that our patients and clients are receiving • Our Rehabilitation & Aged Services I’d like to offi cially thank Peter Maloney a consistent level of service from Program (RASP) developed the for his time as Chair of our board. One of motivated and caring staff. Our Values Sub Acute 2020 project to look at Peter’s principal objectives was to ensure of Integrity, Compassion, Accountability, redesigning their care processes to that we move back to a sound fi nancial Respect and Excellence underpin the ensure that we deliver the right care, position, while maintaining the quality of way we deliver our services, the way in the right place at the right time. our care. Peter fi rmly believes that this is we treat our patients and clients and The project successfully established a fundamental requirement in order for the way we treat each other. an access unit for referrals and us to control our destiny and manage our I am enthused about the opportunities co-ordination of admissions into activities. As a result of his clear direction ahead of us and I fi rmly believe we have the program. The Rehabilitation in and collaboration, our fi nancial an outstanding team of professionals the Home program was expanded performance has improved considerably. that will help us to deliver better health in January and now provides one of for our community. the largest “at home” programs in I’m delighted to welcome our new Chair, Victoria. In just six months, the number Professor Pauline Nugent, who has been of patients treated has increased by a director on our board for almost four more than 50 per cent with many years. Pauline has served with energy expressing their sincere appreciation and vigour on our board, and is currently the Chair of the Quality Committee. of this innovative service. Linda Sorrell Chief Executive

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 5 icare that our radiologists can see things fi rst

PAGE 6 SOUTHERN HEALTH ANNUAL REPORT 2004/05 OUR BOARD

MR PETER MALONEY, CHAIR MS PATRICIA O’ROURKE MS KATHY GRIGG, CHAIR AUDIT COMMITTEE Peter Maloney has held a number of Patricia O’Rourke is the Clinical Director senior executive roles with fi nancial and of Medicine and Emergency Services at Kathy Grigg is a Fellow of the Australian commercial responsibility in Australia and St Vincent’s Hospital where she provides Institute of Company Directors and internationally with the WMC Group of strategic and operational support to the Australian Society of Certifi ed Practising Companies, Santos Limited and F H CEO, and manages 510 staff and a Accountants. She has extensive Faulding. Peter was educated at the budget of $50 million. She is a member of international executive experience in the University of Melbourne (B.Com), the the Nurses Board of Victoria and the wool industry, including serving as Chief University of Rochester (MBA) and the Royal College of Nursing, Australia Financial Offi cer and in operational Harvard Business School where he (from 1/7/04). management positions with The completed the Advanced Management Woolmark Company and the Australian Program. He is currently Chief Financial PROFESSOR PAULINE NUGENT Wool Corporation. She is a director of Offi cer of two listed mining investment CoINVEST Ltd, the Grape and Wine Pauline Nugent is Head of the School companies, Lion Selection Group Limited Research and Development Corporation of Nursing and Chair of Nursing and AuSelect Limited, and a director of and serves on the Clinical Research and Development at Deakin University. Indophil Resources NL. Ethics Committee of the Melbourne She has 25 years’ experience in nursing, Health Research Directorate. specialising in critical care practice. MR DAVID COWLISHAW She is immediate past President of the PROFESSOR EDWARD BYRNE David Cowlishaw retired from the National Australian Council of Deans of Nursing, Australia Bank in 2001 following an and the Australian Vice Chancellor’s Edward Byrne is the Dean of Medicine extensive and varied career, which began Committee representative on the Nursing and Health Sciences at Monash in Western Australia in 1962. Senior Australian Health Workforce Advisory University. He has had an active career in appointments included: District Manager Committee. She has been on the clinical neurology and basic neurological Metropolitan Melbourne, Head of Credit Victorian State Nurse Recruitment and research. Previously he was the Founding Victoria and Tasmania, secondment to Retention Committee and is a member Director of the Centre for Neuroscience an associate Merchant Bank in Indonesia of the National Nursing and Nursing and Professor of Experimental Neurology as Company Secretary, General Manager Education Taskforce. at the University of Melbourne and Head of the Bank’s US operations based in of Neurosciences at St. Vincent’s Hospital New York, Managing Director National MR COLIN WISE for almost 20 years. He is a Board Australia Trustees. David is currently Member of Cochlear Pty Ltd, Colin is a Fellow of the Australian Institute Chair of Crisis Support Servicesm a Neurosciences Australia, Neurosciences of Company Directors and a legal and non-profi t telephone counselling service, Victoria, Baker Heart Research Institute business consultant. He is the Non- and Chair of the Dandenong and Macfarlane Burnet Institute. He is the Executive Chairman of the ASX listed St Development Board. Editor-in-Chief of the Internal Medicine Barbara Mines Limited. As a senior legal Journal (from 1/06/04). counsel and manager he has had MR NAIM MELHEM, signifi cant practical in-house experience MEMBER AUDIT COMMITTEE MR NEIL HEWITT, in Australia and internationally with a wide MEMBER AUDIT COMMITTEE Naim Melhem has extensive experience range of business, corporate in local Government as a Councillor with management, dispute resolution and Neil Hewitt was a partner of KPMG the City of Springvale and City of Greater litigation issues, including extensive from 1971-1998 and is now a company Dandenong. He served as Mayor of the experience in the management of director, with a particular interest in the City of Greater Dandenong in 1999-2000 complex governance, corporate and health industry. Presently a director of and was re-elected to Council in 2002. He business matters at board level. Colin has Turning Point Drug & Alcohol Service, has an extensive history of involvement served as General Counsel to the WMC Youth Substance Abuse Service, with local community organisations, Group of Companies (a major world National Ageing Research Institute, including the South Eastern Arabic minerals and energy resources group), International Diabetes Institute and Association, St Nicholas Orthodox subsequently as Counsel to the New York Schiavello Project Solutions. He has Church, Springvale Community Aid and fi rm of Howard, Smith & Levin LLP. He is a extensive professional skills in fi nancial Advice Bureau and Springvale Fellow of the Australasian Institute of management and strategy. Community Health Centre Board. Mining & Metallurgy.

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 7 HIGHLIGHTS FROM A BUSY YEAR AT SOUTHERN HEALTH

STRATEGIC PLAN 2004 – 2007 GREAT RESULTS IN KEY STATISTICS THE ESAS PROGRAM One of the most signifi cant business This year we treated more than events for Southern Health this year has We achieved some outstanding results 133,000 patients in our hospitals been the development of our Strategic in the Department of Human Services – and provided in excess of 680,000 Plan 2004 - 2007. This was an extensive established Elective Surgery Access episodes of care. process that involved input from our staff Service (ESAS) Program. and the community. More than 104,000 patients The Program was instigated to were treated in our emergency Our Plan provides a clear map for the manage patients who have waited departments. direction of Southern Health and the longer than clinically recommended We celebrated more than services we’re going to deliver to our for elective surgery. community for the next three years. One 6,400 births. Monash Medical Centre Moorabbin of the most important features of the Plan was designated as a centre to Our surgical teams performed is the incorporation of our new Vision, participate in this program and treat more than 29,900 operations. Purpose, Goals and Values. patients who require laparoscopic Our beddays exceeded 600,000 A summary of our Strategic Plan cholecystectomies, inguinal hernia which is a steady increase on can be found on our website at repairs and surgery for varicose veins. previous years. www.southernhealth.org.au We have treated 279 patients.

WE OPENED A NEW HOSPITAL DANDENONG REDEVELOPMENT The opening of our new 229-bed The redeveloped Intensive Care Unit at Casey Hospital in October 2004 was Dandenong Hospital was opened in June a signifi cant expansion of the care we this year. Under redevelopment for more can provide to one of the fastest-growing than six months, the ICU now has a total areas of Australia. of 14 Intensive Care Unit and High Dependency Unit beds. The hospital has successfully opened in stages, with elective surgery, The opening is an important milestone rehabilitation, palliative care, renal in our $34 million Dandenong Hospital dialysis, BreastScreen, mental health Stage 2 redevelopment. The fi rst level (both community and hospital-based of the building that includes the new services), maternity, special care nursery, expanded Intensive Care Unit also paediatrics, medical and emergency includes an Allied Health area. The departments now all open. second level is also nearly completed and will include a sub-acute ward and In addition, support services in a new home for medical interpreters. imaging, pathology and pharmacy are also operational. In its fi rst months of operation to 30 June 2005, Casey Hospital’s emergency department has seen 5358 cases.

PAGE 8 SOUTHERN HEALTH ANNUAL REPORT 2004/05 MONASH MEDICAL CENTRE PAEDIATRIC INTEGRATED CLAYTON EMERGENCY CANCER SERVICE DEPARTMENT UPGRADE The Children’s Cancer Centre at Monash We were delighted with the Government’s Medical Centre Clayton partnered with announcement of an allocated $10 million the Royal Children’s Hospital and Peter in the State Budget for the redevelopment MacCallum Cancer Centre to form the of our Emergency Department at Monash Statewide Paediatric Integrated Cancer Medical Centre Clayton. This Emergency Services (PICS). Department is one of the busiest in Funded by the Department of Human Victoria, treating more than 53,000 Services Children First Policy, PICS patients each year. aims to provide the best quality care, Reconfi guring and expanding the in the best facility, as close to home department will enable us to better as possible. Key objectives include manage the high demand for services the development of consistent and and streamline the way we manage our high quality approaches to treatment, emergency patients. A key feature of the with increasing involvement in clinical project will be an expanded children’s trials, and strengthened links to section. This major building project will regional centres. support better emergency care for patients, and a better environment for our WORLD HEALTH dedicated staff. ORGANISATION REGISTRATION This year Southern Health became EVENT-DRIVEN DISCHARGE a registered Health Promoting Health AFTER SURGERY Service with the World Health Our Surgery Program moved to event- Organisation (WHO). driven discharge, allowing the earlier The World Health Organisation is the discharge of patients who do not require United Nations’ specialised agency for a medical review prior to leaving hospital. health. WHO’s objective, as set out in This multidisciplinary team approach its constitution, is for all people to attain sees medical staff document discharge the highest possible level of health. criteria for each patient. A senior nurse A Health Promoting Health then ensures each patient meets the Service provides high quality criteria, and that all the discharge comprehensive medical and clinical arrangements have been made, services, and promotes health and allowing 90 per cent of patients to well being to patients, visitors, staff leave before 10am. This approach and to the community. has proven extremely popular with both patients and staff. There are currently only eight WHO registered Health Promoting Hospitals in Australia, including only one other Victorian hospital (Latrobe Regional Hospital).

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 9 CLINICAL AND CORPORATE GOVERNANCE

CLINICAL AND systems, identifying roles and ACCREDITATION CORPORATE GOVERNANCE responsibilities, and increasing consumer Our preparation for the Organisation participation.Clinical and corporate Our board of directors, whose members Wide Survey conducted by the Australian governance is about: have a variety of skills, backgrounds, Council on Health Care Standards and fi nancial, health, legal and • providing clear lines of accountability (ACHS) is well under way. This is a key community expertise, governs Southern and responsibility for quality of care event in the Evaluation and Quality Health. The board actively participates in Improvement Program (EQuIP) cycle • bringing together a comprehensive decision making at Southern Health and and happens in November 2005. program of quality improvement maintains contact with the operational initiatives and procedures to identify During this preparation phase, a Southern activities of the organisation through a and remedy poor performance Health Steering Committee has variety of reporting mechanisms and monitored the organisation’s progress committees. It is the directors • demonstrating strong leadership and together with the Quality Unit and responsibility to ensure that we have and the right culture. program Quality Coordinators, have an appropriate governance framework. In June 2005, we completed a review of worked to ensure that the organisation Working within a clinical governance governance structures and processes at is well placed to achieve a terrifi c result. framework is one of the ways in which we Southern Health. The review found we Survey teams from ACHS visit work areas aim to ensure we provide safe and can be proud of our systems to support and talk to staff looking for verifi cation of effective care. As we work towards our the delivery of care, but to further Southern Health’s quality activities. The vision of better health for our community, enhance our performance and surveyors will help ACHS to understand working within a governance framework accountability, the review made some how the organisation works towards means we have a system to ensure our recommendations for us to consider, achieving its quality and safety goals consumers will be provided with high such as: and its commitment to ongoing learning. quality and safe care and that we can demonstrate how this happens and the • reviewing key committees to results. It also means when we don’t strengthen clinical governance perform as well as we aim to, we have roles and responsibilities systems in place to identify and address • enhancing the use of data to problems and continually work towards inform decision making improving our service to you. • implementing a standard clinical In the past three years, we have made audit methodology signifi cant improvements to our clinical • using web-based incident reporting governance framework. Under a • increasing consumer and governance framework, our board has a community involvement in quality responsibility for ensuring we have improvement activities. systems that help us to monitor, evaluate and continuously improve the health care We are developing an implementation we deliver. Implementing a plan for these recommendations and we comprehensive governance framework look forward to strengthening our clinical for improving quality has seen us focus governance arrangements and improving on developing quality management consumer outcomes.

PAGE 10 SOUTHERN HEALTH ANNUAL REPORT 2004/05 icare that my mum gets better

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 11 ACHIEVING OUR GOALS ACCESSIBLE SERVICES

Southern Health has six strategic goals Southern Health will provide appropriate access to services that, along with our Vision, Purpose and within available resources and infrastructure. Values, help us to focus on the services that Specifi c strategies to realise this goal are to: we provide. These goals are outlined in our Strategic Plan 2004 – 2007, which is our • Provide access to available services; three-year ‘map’ to improve the care that • Improve access to elective and emergency services; we provide to our community. • Foster clinical innovation to improve access; and Our goals are: • Provide relevant information to consumers on their care. • Safe and Effective Care; ESAS ELECTIVE SURGERY ACCESS SERVICE (ESAS) • Appropriate Services and Confi guration; • Accessible Services; The ESAS program was established by the Department of Human Services in 2002 to manage patients who have waited • Collaboration and Engagement; longer than clinically recommended for elective surgery. • Financial Accountability; and Monash Medical Centre Moorabbin was designated as a • Development of Our People. participating health service, treating patients requiring particular Over the following pages we detail what we procedures such as hernia repair, varicose veins and gall have achieved under each of these goals. bladder removal. Under the clinical leadership of surgeon These achievements span the full breadth Professor Bruce Waxman and the head of Vascular Surgery of our sites and services. Dr Al Saunder, a total of 279 patients were treated. This is a great achievement. This success was supported by our staff in Outpatients, Theatre, Wards and Health Information Services.

CASEY HOSPITAL Elective surgical services established at Casey Hospital have reduced waiting times for patients awaiting Category 2 and Category 3 surgical procedures. In partnership with the City of Casey, sexual assault counselling services were also opened in Berwick and Cranbourne.

QUEUING EQUITY PROJECT AT MONASH MEDICAL CENTRE, CLAYTON The Queuing Equity Project aimed to decrease the average waiting time for surgery for patients on our Category 2 elective surgery waiting list. The Department of Human Services classify Category 2 as those conditions that are causing some pain, dysfunction or disability but not likely to deteriorate quickly or become an emergency. We successfully treated patients who had been waiting for the longest time. Adult and paediatric patients from all surgical groups were treated. Before the project started, the average waiting time for this category at Monash Medical Centre Clayton was 27 days higher than the target set by the Department of Human Services. At the end of the project the average waiting time had decreased by 46 days, to 19 days below the Department of Human Services’

PAGE 12 SOUTHERN HEALTH ANNUAL REPORT 2004/05 target. The number of Hospital pre-admission combined visit is Health and over a secure internet Initiated Postponements (of surgery) coordinated prior to day surgery. connection. The system also permits also reduced signifi cantly. viewing of the same set of images at This model of care has seen the Regional different geographical sites which better These achievements have set the Eye Service treat long-wait cataract facilitates reporting, on-call work and framework for sustainable change in surgery patients from rural and eliminates ‘lost’ fi lms. waiting list management at Monash metropolitan areas, signifi cantly reducing Medical Centre Clayton and Moorabbin. waiting times and waiting lists for surgery. Another benefi t is the reduction in costs associated with fi lm and chemicals, and We are delighted that the State GO WITH THE FLOW an increase in effi ciency in delivering Government has cited this approach as a images and reports to our clinicians. Go with the Flow was a project established template for other services wishing to this year at Monash Medical Centre, reduce waiting lists. The improved Radiology Information Clayton to reduce the time patients wait for System enhances handling of the patient inpatient endoscopy services, while MENTAL HEALTH TRIAGE database, including fi nancial reporting ensuring adequate preparation. and invoicing. We developed a new single referral point Improved processes and communication for people who want to access mental DIVERSITY IN EMERGENCY and a commitment from our staff has seen health services at Southern Health. This a signifi cant reduction in waiting times single telephone number replaces the This year, we established a project to from three to four months to three weeks. previous 11 which were across nine improve communication, and enhance the With a more timely diagnosis, treatment different sites. quality of care and treatment provided to can now begin earlier which means culturally and linguistically diverse (CALD) Launched in September 2004, this improved outcomes for our patients. patients in our emergency departments. consumer-friendly service brought together Child and Adolescent and Adult This included establishing a steering LENGTH OF STAY Mental Health Services. In the fi rst eight committee with wide representation, which Dr Bill Shearer, Medical Director of the months of operation, we recorded more consulted with patients through focus Critical Care Program, led a team project than 29,000 calls. groups and surveys. to reduce the length of stay among our New training packages, policies and long-stay patients. Relevant groups of PATIENT FLOW procedures were developed which were patients across each site and program A patient fl ow program, within our Mental aimed at improving care to CALD patients. were identifi ed with a target set of one Health Program, brought together This included developing a CALD intranet day reduction in average length of stay. consumers, frontline staff and managers site, language and cue cards, along with The project targeted improvements in to improve patient access to our services. staff education. patient fl ow and improved quality of care. The Length of Stay project complemented This program has improved care offered DIALYSIS EDUCATION other work we have underway which aim to mental health patients in our to improve patient fl ow such as the Emergency Departments, improved bed We developed a patient education video Patient Flow Collaborative, Quality management and individual case for future dialysis patients which is now Improvement Initiatives, and the efforts management across Southern Health, used Australia-wide. It informs patients of the Access Manager. and has helped patients get the care they about dialysis choices available. The video need when they need it. has been translated into Vietnamese, with REGIONAL EYE SERVICE other languages to follow. AT CRANBOURNE INTEGRATED RADIOLOGY SYSTEMS CARE CENTRE An innovative Picture Archive and An innovative approach to cataract Communication/Radiology Information surgery has been developed at the System (PACS/RIS) Project was Cranbourne Integrated Care Centre with commissioned this year. great success. Appropriate patients are This system allows soft copy reporting of selected and an initial consultation and radiology images both within Southern

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 13 SAFE AND EFFECTIVE CARE

Southern Health aims to provide risks of identifi cation errors. By working These are now implemented and safe and effective care for all patients, co-operatively, senior nurses were able accepted across all of our clinical units. clients and residents. This means that to reduce errors well below target rates. Development of further protocols and pathways is underway. we will plan and manage our services Falls prevention will be a focus for to ensure that we are providing the most the coming year, with a better use of EMERGENCY NURSING effective interventions and management the Incident Database helping to PRACTITIONER PROJECT for consumers. improve monitoring. Specifi c strategies to realise this This Department of Human Services - goal are to: SURGERY funded project aims to enhance the delivery of emergency health care within • Establish an organisational culture Our Surgery Program moved to event- Southern Health. Three emergency nurse that puts consumer wellbeing and driven discharge, allowing the earlier practitioners extended their practice to safety at the core of our services; discharge of patients who do not require a medical review prior to leaving hospital. include emergency department • Foster effective clinical governance; admission, discharge and referral, • Continually improve our services; and This multidisciplinary team approach sees supervised prescribing, advanced medical staff document discharge criteria • Ensure staff have appropriate training diagnostic requesting and interpretation for each patient. A senior nurse then to provide safe and effective care. and detailed patient examination and ensures each patient meets the criteria, assessment. This project was supported and that all the discharge arrangements CREDENTIALING through physician mentoring. have been made, allowing 90 per cent of Credentialing is how we confi rm that patients to leave before 10am. An evaluation covering 2004 until 2005 our patients are treated at Southern Health demonstrated increased effi ciency and This approach has proven extremely by a properly trained professional. patient satisfaction, contributing to more popular with both patients and staff. Credentialing is carried out for our rapid access to treatment and reduced doctors, nurses and clinical support SURGbase, a new data collection system, length of stay. staff, such as pharmacists and was introduced, which along with the physiotherapists. Southern Health has establishment of a Surgical Program THE SOUTHERN HEALTH HUMAN a working party to implement best Quality and Risk Management Committee, RESEARCH ETHICS COMMITTEES practice in credentialing as a result of signifi cantly improved monitoring and Reforms were implemented from early recommendations made by the Australian audit procedures. January 2004, which included the Council on Health Care Standards in 2003, Within the Neurosurgery Unit, one project restructuring of the Southern Health the introduction of the National Standard was the introduction of calf compression Human Research Ethics Committees for Credentialing and Defi ning the Scope devices, and the selective use of heparin (HREC) from four to three within Southern of Clinical Practice and Southern Health’s to reduce post-operative complications. Health. The purpose of the reform was to focus on Clinical Governance. Another project successfully reduced streamline applications to best serve the post-operative infections through the diverse range of research proposals MEDICINE introduction of a new antibiotic protocol submitted each year and to address the unbalanced workloads between previous The Medicine Program introduced an and by using special catheters. committees. The changes have been Incident Management Awareness implemented smoothly with the co- Campaign aimed at increasing access to EVIDENCE-BASED MEDICINE operation of all members, in particular the Incident Database, improving timely Working collaboratively with clinical the three Chairs. reporting of incidents and improving colleagues over a number of years, management of incident reporting within nine major evidence-based clinical In the fi nancial year of 2004/2005, the Program. This required both education protocols were established to increase 193 research proposals were reviewed and improved information technology and the effectiveness and safety of care by the HRECs for compliance with the with a cooperative effort resulted in for Southern Health patients. Among National Statement on Ethical Conduct signifi cantly better use of the system. these were protocols for head injury, in Research Involving Humans (1999) by the National Health and Medical Another project in Medicine targeted pulmonary embolus, renal colic, Research Council; the Health Records patient wristbands, to improve cervical spine trauma, fractures and Act 2001 (Vic); State and National identifi cation of patients and reduce the sub-arachnoid haemorrhage. privacy legislation.

PAGE 14 SOUTHERN HEALTH ANNUAL REPORT 2004/05 The majority of research applications infrastructure into new works and and will assist information sharing across were submitted in the following building refurbishment. the whole of Southern Health. disciplines; the Medicine Program Annual reporting of energy consumption (33%) (including General, Respiratory, CRITICAL CARE and minimisation initiatives are Gastroenterology, Emergency, Palliative provided to the Department of Human Our world-class Simulation Centre at Care and Radiology, Medical Oncology), Services. All major projects are evaluated Monash Medical Centre, Moorabbin Women’s and Children’s Program (20%) as an Environmental Sustainable provided in-house crisis teamwork training and Speciality Medicine (20%) (including Development. An energy audit has to many staff. A project at Casey Hospital Cardiology, Cardio-thoracic, Neurology, recently been undertaken at Clayton allowed staff to familiarise themselves with Neurosurgery and Renal). and Dandenong to evaluate future their new work environment and identify Approximately 40 per cent of research energy reduction opportunities. key training needs. A simulator was proposals submitted this fi nancial transported to Casey to assist with mock year involve clinical drug trials that OCCUPATIONAL HEALTH AND resuscitations in the hospital, which were are sponsored by pharmaceutical SAFETY AND RISK MANAGEMENT videotaped to facilitate debriefi ngs. companies or in collaboration with WITHIN PRIMARY CARE clinical trials groups. Our Primary Care program established an INCIDENT REPORTING, Component research groups at Southern Occupational Health and Safety (OH&S) MONITORING AND ANALYSIS Health include Prince Henry Institute of Advisory Committee with representatives AT RASP Medical Research, Monash University from each Primary Care Service, Human The Rehabilitation & Aged Services Institutes and Departments and Jean Resources, Quality Coordinator and Program (RASP) reviewed the way that it Hailes Foundation. To facilitate the Infection Control Unit. managed incident reporting, monitoring growing collaboration in research with This committee addressed all 42 and analysis. Firstly, the program Monash University, a Coordinated Review developed and launched a comprehensive of Research Ethics was implemented on reference areas in the Southern Health OH&S management manual and fl ow-chart which mapped the whole 1 January 2004. In this fi nancial year incident reporting process for patients, almost 20 per cent of research proposals developed appropriate action plans with time frames. residents and staff. This chart is on display submitted were reviewed under this in all RASP wards and departments. process and joint research funding is The committee also developed and estimated at $23 million. distributed a Primary Care OH&S resource As a result, a weekly reporting process folder to educate our Primary Care staff was established for all major incidents. RESEARCH GOVERNANCE on Safe and Effective Care priorities and This weekly report alerts senior managers to ensure that a proper investigation and HREC welcomes the national clinical trials issues at Southern Health. analysis takes place in a timely manner. register that the Australian Government, Our Primary Care program also through the National Health and Medical All incidents are also followed up at a Research Council, is establishing. developed a Risk Management Tool to facilitate an integrated management departmental level and data is analysed The register will make information and reported each month to the newly available to the public about trials being approach to addressing risks across established Risk Management Committee. carried out. This includes the types of the program’s 30 services, 800 staff trials (such as drug or other health care), and 19 sites. As a result of this process, a number of how to enrol, results including citations changes have been implemented such as of published results. It is noted that the The Tool has resulted in the development new signage on all ward doors which trials included in the register are not of an integrated action plan with helps prevent elderly people inadvertently merely restricted to medicines and timeframes and responsibilities clearly wandering. Since the introduction of the medical devices but all health and health articulated. The Risk Management Plan signage, the program has seen a care interventions. has also been scored against the reduction in this type of incident. mandatory Equip Accreditation standards ENVIRONMENTAL PERFORMANCE and OH&S Management Manual for Southern Health supports the reduction Southern Health. This plan will ensure in energy consumption and water usage minimum and consistent standards of by monitoring annual performance practice across our Primary Care services and implementing energy saving

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 15 icare that our anaesthetics are expertly managed

PAGE 16 SOUTHERN HEALTH ANNUAL REPORT 2004/05 APPROPRIATE SERVICES AND CONFIGURATION

Providing cost-effective services where The hospital was visited by the Governor REHABILITATION & AGED and when they are needed and aligned of Victoria John Landy AC, MBE and his SERVICES PROGRAM with the community’s health needs. wife Mrs Landy in June, who reported The Rehabilitation & Aged Services they were very impressed with the Specifi c strategies to realise this goal Program (RASP) signifi cantly expanded its facilities at Victoria’s newest hospital. are to: Rehabilitation in the Home (RITH) services. • Confi gure services to address the DANDENONG REDEVELOPMENT Patients are increasingly keen to receive health needs of our community; their care at home and RASP moved to The Minister for Health, the Hon. Bronwyn expand the “at home” options for patients • Implement agreed Metropolitan Pike, offi cially opened Dandenong requiring rehabilitation. Health Strategy (MHS) initiatives; Hospital’s Intensive Care Unit in June Following a consolidation of inpatient • Provide appropriate infrastructure 2005. The ICU was under redevelopment bed-based services in January, RITH and support services; and for more than six months and now has a expanded. In its fi rst six months of total of 14 Intensive Care Unit and High • Align Jessie McPherson Private operation activity increased by 50.5 per Dependency Unit beds. Hospital plans with Southern cent, with excellent feedback from patients. Health’s needs. The opening is an important milestone These changes were part of a larger Sub in the $34 million Dandenong Hospital Acute 2020 project which, in addition to CASEY HOSPITAL Stage 2 redevelopment. The fi rst level expanding RITH, aims to establish a RASP of the building that includes the new The opening of our new 229-bed Access Unit, review assessment and expanded Intensive Care Unit also Casey Hospital in October 2004 was access and transition and care planning. a signifi cant expansion of the care we includes an Allied Health area. The can provide to one of the fastest-growing second level is also nearly completed Aged Person’s Mental Health services areas of Australia. and will include a sub-acute ward and were also realigned in January with the a new home for medical interpreters. opening of Amaroo Assessment Unit at The hospital has successfully opened Dandenong Hospital, with relocation of The remainder of the Stage 2 project in stages, with elective surgery, clients from the Pinelodge Clinic. rehabilitation, palliative care, renal includes wards on Levels 3 and 4 and the theatre block. A new coffee shop will be dialysis, BreastScreen, mental health SUB ACUTE 2020 (both community and hospital-based located to the left of the main entrance of services), maternity, special care nursery, the hospital. The Sub Acute 2020 project is about paediatrics, medical and emergency looking to the future and redesigning our departments now all open. MONASH EMERGENCY UPGRADE care processes to ensure that we deliver the right care, in the right place at the right We were delighted with the Government’s In addition, support services in time. The aims of the project were to: imaging, pathology and pharmacy announcement of an allocated $10 million are also operational. in the State Budget for the redevelopment • establish an access unit for referrals of our Emergency Department at Monash and co-ordination of admissions In its fi rst months of operation to 30 June Medical Centre, Clayton. into the Rehabilitation & Aged 2005, Casey Hospital’s emergency Services Program; department has seen 5358 cases. This Emergency Department is one of the Approximately 40 per cent of which busiest in Victoria, treating more than • expand ambulatory services to provide have been children. We’ve also recorded 53,000 patients each year. patients with more options for care at 106 births. Reconfi guring and expanding the home or in their local community; Outpatients services have been department will enable us to better • implement best practice in care successfully established to ensure every manage the high demand for services planning and transition; and and streamline the way we manage patient is now seen and prepared prior to • implement best practice in referral, our emergency patients. A key feature hospital admission. This required the access and triage. input of many different health disciplines of the project will be an expanded in a collaborative approach to ensure the children’s section. The access unit was established in May this best model of care was offered, and This major building project will support year. The Rehabilitation in the Home appropriate staff recruited. better emergency care for patients, and a program was expanded in January and better environment for our dedicated staff. now provides one of the largest “at home”

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 17 programs in Victoria. In just six months, the MacCallum Cancer Centre, as one of Our specialists successfully operated number of patients treated has increased three fl agship childhood cancer centres. on an unborn baby while still in the womb by more than 50 per cent and patients to overcome a potentially devastating The new service is the result of a great often write to express their sincere condition. The surgical team removed deal of hard work and co-operative effort appreciation of this innovative service. a band of tissue which had become from several teams. tangled around the baby’s leg. Had The best practice projects in care The construction and fi t-out of a the surgery not been performed it is planning and transition, and referral, new Paediatric Day Oncology Unit likely that the baby would have had its access and triage have been supported at Monash Medical Centre Clayton foot amputated. by the employment of dedicated project was also announced. The redeveloped staff since early 2005 and are about to It is believed to be only the second time unit has been made possible by a very undergo pilot testing in many of the this procedure has been undertaken in generous donation from the Kids With inpatient wards. Each project has been Australia, and one of only a handful of Cancer Foundation. developed by a local “expert” working such operations in the world. Monash group and the Sub Acute 2020 projects Together these announcements are a very Medical Centre is uniquely placed to care are overseen by the Sub Acute 2020 exciting development, offering better care for such cases with expertise in the full Steering Group which enjoys multi- for Victorian children who need treatment range of tertiary services for both mothers disciplinary representation and is chaired for cancer. and babies. by the Executive Director of the We are very proud of Chris Kimber, Head Rehabilitation & Aged Services Program. SOUTHERN MELBOURNE INTEGRATED CANCER SERVICE of Paediatric Surgery, Paul Shekleton, from our Fetal Diagnostic Unit, and Fetal EARLY PSYCHOSIS PROGRAM In March, the Minister for Health, the Intervention specialist, Andrew Edwards A new service focused on assessing and Hon. Bronwyn Pike offi cially launched and the rest of the multidisciplinary team supporting young people who are at risk the Southern Melbourne Integrated involved in this signifi cant procedure. of, or experiencing, early psychosis was Cancer Service at Monash Medical launched to improve their care. This Centre, Moorabbin. This service will ACQUIRED BRAIN INJURY/ innovative program based at the provide better co-ordinated cancer SLOW TO RECOVER Dandenong Community Mental Health care for people living in the south and A review of Acquired Brain Injury/ Service required close co-operation east of Melbourne. Slow To Recover (ABI/STR) services between Southern Health, the Department The Minister also turned the fi rst sod to was completed in November 2004. A of Human Services and Peninsula Health. signal the beginning of construction of a number of recommendations aimed at This major service initiative aims to Radiotherapy Bunker which will see the improving services to these clients were reduce the impact of psychosis through expansion of radiotherapy treatment implemented with an additional $1 million early treatment and rehabilitation. It is services at Moorabbin. Department of Human Services funding. planned to extend the approach at Clayton and within Bayside. Working closely with Bayside Health, The ABI/STR program aims to be Peninsula Health and the Peter a world leader in its area, with PAEDIATRIC INTEGRATED MacCallum Cancer Service and with the continued emphasis on research CARE SERVICE strong support of the Victorian and evidence development. Government, together these new services The Premier, the Hon. Steve Bracks will greatly enhance the care we can offer SOUTH EASTERN CENTRE launched the Statewide Paediatric people with cancer. AGAINST SEXUAL ASSAULT Integrated Care Service at Monash (SECASA) Medical Centre, Clayton in March FIRST FOR SOUTHERN this year. HEALTH SURGEONS A new state-wide service for 12-17 year olds with an intellectual disability and Along with the Minister for Health, the Our Paediatric Surgery and Fetal sexually abusive behaviour was begun Hon. Bronwyn Pike, the Premier Diagnostic Unit achieved a Victorian fi rst in partnership with Berry Street and announced details of the centre, which in Fetal Surgery which gained extensive Statewide Forensic Services. will see Southern Health join with the national media coverage. Royal Children’s Hospital and the Peter

PAGE 18 SOUTHERN HEALTH ANNUAL REPORT 2004/05 icare that our nurses work together

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 19 COLLABORATION AND ENGAGEMENT

Southern Health is committed The centre was established through There is a broad body of research to involving relevant community, competitive federal funding from the currently taking place with collaboration consumers, funders, staff and other National Health and Medical Research between researchers and clinicians who external service providers in the Council. One of only seven awards work in our hospitals. This means planning of services and in decisions granted from an original fi eld of 88 researchers have access to hospitals that that impact them. applications, the Gait CCRE brings care for patients and clients with the together the Murdoch Children’s widest range of illnesses. Specifi c strategies to realise this Research Institute, Southern Health’s goal are to: As the major public hospital service Kingston Centre, Royal Children’s within the Monash Health Research • Develop and maintain effective Hospital and departments of La Trobe, Precinct, we are delighted to provide relationships and partnerships with Melbourne and Monash Universities. staff (including all operational areas); the major interface for trialing research The CCRE will be the only centre able to developments of the Monash Institute • Foster education and examine the walking process across the of Medical Research. research activities; entire life span. The expansion of this research facility • Develop and maintain effective Kingston Centre Parkinsons’ Program will be of great benefi t to the population relationships with external partners; was also recognised as a Centre that we serve, and the formalisation of • Build partnerships with our of Excellence by the US-based our collaborative efforts with research communities; and National Parkinson Foundation. This institutes at Monash will certainly assist • Improve the availability of information Foundation focuses on research, us to continue to attract the best on internal and external services. support, treatment and the care of clinicians available. patients with Parkinson’s Disease. CASEY HOSPITAL RESEARCH GRANT This recognition is a public seal of The opening of Casey Hospital was the approval in Parkinson research, support, Southern Health’s research profi le was fi rst hospital delivered under the and care and places the Kingston Centre boosted with the announcement by the Partnerships Victoria arrangement, a service on a list of esteemed Federal Minister of Education, Science collaboration between the public and organisations around the world. This and Training, Brendan Nelson, of a private sectors. Centre of Excellence is only the second $21.47 million grant to develop new in the southern hemisphere. and improved nuclear imaging tracers. More than 3,000 people from the local community attended the offi cial opening The grant was awarded to Professor MONASH INSTITUTE OF by the Premier, the Hon. Steve Bracks David Reutens, Director of Neurology MEDICAL RESEARCH and the Minister for Health, the Hon. and Professor of Neurosciences Bronwyn Pike. A great milestone was achieved with the and his research collaborators at the offi cial opening of the Monash Institute Co-operative Centre for Biomedical This community support has continued of Medical Research, adjacent to Monash Imaging Development. with many local services, community and Medical Centre Clayton, by the Premier business groups organising events to The major focus is on identifying and the Hon. Steve Bracks. raise funds for the hospital. developing new PET and SPECT tracers Medical research is vital if we are to for the diagnosis of neurological diseases GAIT CENTRE FOR CLINICAL continue to live longer and healthier and cancer. RESEARCH EXCELLENCE lives, so we are extremely pleased to It is a great boost for medical imaging at be playing our part. Federal Treasurer Peter Costello and Southern Health and Monash University. Dame Elisabeth Murdoch launched a $2 We have a strong history of conducting It was one of only 16 successful CRC million Gait Centre for Clinical Research clinical trials of new therapies that applications out of 80, and the only new Excellence (CCRE) in July 2005 that uses have revolutionised aspects of medical biomedical grant awarded. movie and computer game technology to care. Interaction and collaboration with help improve mobility for patients with world-class research organisations is SEADS GRANT cerebral palsy, Parkinson’s disease, a key strength to our hospitals. This We are very proud of our team at SEADS, osteoarthritis, stroke and sporting injuries. collaborative initiative with world-renowned the Drug and Alcohol Program within research partners will ensure we remain Primary Care, which received a grant at the forefront of developments.

PAGE 20 SOUTHERN HEALTH ANNUAL REPORT 2004/05 from the Alcohol Education and Research connection between these two groups, held on Friday, June 17 and involved 21 Foundation (AERF) for $125,000. an Africa Active Sudanese Youth Program specialist and general paediatricians, designed to engage this community and neonatologists and paediatric surgeons The submission to AERF was prepared promote mainstream youth services, a and psychiatrists from Monash Medical by our Cambodian, Laotian and Sudanese Women’s Group and a Centre. The Southern Health team Vietnamese team to seek funding for a mentoring project with the Dandenong presented short talks to more than 60 two-year project to develop an education Aboriginal Co-Op. healthcare colleagues who travelled from and prevention program (for alcohol and as far as New Zealand to attend the event drug awareness) within the Cambodian SIMULATION CENTRE held at Clayton. community, in particular young people and their families. Our world-class Simulation Centre, based The Program Update is an important at Monash Medical Centre, Moorabbin way that we remind general The project will work in partnership has provided specialist training to health paediatricians across Australia that with the Cambodian Association, professionals from throughout Australia Monash Medical Centre is a tertiary existing Cambodian health workers, and overseas. referral centre with expertise across and existing networks. Relationships the full breadth of paediatrics. with the Khmer speaking population One innovative project trained rural have been established over many years clinicians in their own environment in rural VOLUNTEER AND AUXILIARY and this project highlights Primary Care’s Victoria, as part of an 18-month effort SERVICES collaboration and engagement with conducted in conjunction with the Victorian our community. Trauma Foundation and the University of A total of $70,900 was donated to Melbourne. Six two-day courses were held Southern Health by the Central Council of LOCAL DRUG STRATEGY at hospitals throughout rural Victoria. Auxiliaries in May. The money was raised by six auxiliaries at Monash Medical SEADS also worked with Deakin SOUTH EAST CENTRE AGAINST Centre and Dandenong Hospital. A University to evaluate a local drug SEXUAL ASSAULT (SECASA) further $7,950 was raised by the Monash strategy and evaluate the effectiveness Kids, a support group which is dedicated of the service system. This evaluation SECASA moved to improve the to assisting the children at Monash involved some 250 users over a two-year information available to consumers on its Medical Centre. period and provided a strong evidence website. Many people are unable to attend base to inform future funding face-to-face counselling or information Volunteers at Monash worked a total submissions and a sustainable service. sessions, and the website provides a vital of 18,681 hours during the year. The link to key information and resources. reduced number of hours refl ected GREATER DANDENONG the closure of the volunteer program During the year, the site was overhauled COMMUNITY HEALTH SERVICE in the gift shop at Monash Medical and updated to cover gaps identifi ed by Centre Clayton. The Greater Dandenong Community clients and workers who use the site. A Health Service partnered with local promotional campaign saw some 10,000 The closure initiated a lot of change for general practitioners, Lendlease, advertising stickers distributed. the volunteers and new positions were Dandenong Plaza and Parkmore found for those who wanted to continue The site has proven extremely popular – Shopping Centres to offer community supporting the hospital. A special with tens of thousands of visits and members an opportunity to exercise function to thank the volunteers was held pages downloaded each month. The site in a safe and warm environment. in March. has been the recipient of both an The partnership allows more than 100 local Australian Crime and Violence Prevention An Appreciation Day was held for people to participate in regular weekly Award, and a Gold Award for Excellence volunteers in the Queens Hall at walks within the shopping centres. With in Crime and Violence Prevention from Parliament House in November to support to train volunteers, it is expected the Department of Justice. thank them for their commitment to the program will become self-sustaining the medical centre. UPDATE FOR GENERAL The Health Service has also been active PAEDIATRICIANS Long service badges were given to in other community collaborations 18 volunteers representing 165 years including an Older/Younger Persons The second annual Children’s Program of volunteer work for the hospital. Engagement Program to promote Update for General Paediatricians was

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 21 FINANCIAL ACCOUNTABILITY

We will focus on achieving fi nancial We established four separate teams to performance targets and maintaining identify initiatives and projects to improve adequate cash reserves by implementing our fi nancial performance. These teams identifi ed strategies and achieving the addressed revenue, cost savings, service key performance indicators. alignment and capital investment. Specifi c strategies to realise this An example of improved fi nancial goal are to: management was our fl eet review project. • Develop a fi nancially sustainable Fleet management was identifi ed as a organisation and a culture target to produce cost savings, achieve of accountability; operational effi ciencies and improve fi nancial management of the fl eet across • Develop systems to Southern Health. monitor performance; We established a designated business • Demonstrate effi cient use unit for fl eet management that is of resources; and responsible for the central administration • Develop fi nancial skills of managers. and ongoing management of all Southern Our objective is to meet our fi nancial Health vehicles including selection, performance and cash fl ow targets as disposal and acquisition. agreed with the Department of Human We identifi ed ineffi ciencies in our old Services. We have developed a number decentralised system so we purchased of strategies to improve our fi nancial fl eet administration software status and achieve these goals. (AutoManager) and car pool booking During the year 2004/05, we developed software (Pool Car Manager) to help us and implemented a strategy to identify improve the coordination of fl eet usage revenue enhancement and cost saving and to centralise the system. initiatives, and then to ensure that these initiatives were realised.

30000

25000

20000

15000

10000 $,000 OPERATING DEFICIT

5000

0 2004/2005 2003/2004 2002/2003 2001/2002 FINANCIAL YEAR

PAGE 22 SOUTHERN HEALTH ANNUAL REPORT 2004/05 icare that our pathologists deliver results

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 23 DEVELOPMENT OF OUR PEOPLE

Southern Health needs to ensure that range of disciplines. Features Healthy Opportunities integrates our staff have the skills and experience of the process were targeted employee and organisational health to do their jobs and that they are advertising campaigns, behavioural initiatives. It provides a framework to encouraged to reach their potential. selection techniques and a tailored coordinate established employee health induction program. and organisational health services, Specifi c strategies to realise this goal activities, products and policies and are to: The need to ensure that the right allows us to further develop these and staff with the right skills were recruited, • Develop a high performance future activities. organisation that engages and supports while not adversely impacting our people and teams and improves other sites and services, was also A recent success under this initiative working relationships; a key consideration. has been our Building Positive Attendance program which identifi ed An online E Recruitment system was • Establish a workforce planning strategy; underlying causes for absenteeism trialled during the year which showed • Implement a leadership training and and has instigated positive potential advantages in reducing development strategy; and management strategies to improve advertising and administrative costs and this in our workplace. • Develop a communication strategy. increasing the ability to screen candidates. This will be further trialled BACKSAFE WORKFORCE PLANNING in the year ahead. Southern Health has developed a A BackSafe project, which began in 1999 Workforce Plan as one of the key NURSING SUPPORT as a pilot nurse back injury prevention program, was extended to an supporting plans of our Strategic Plan A key focus of the Nursing Support Unit organisation-wide all-staff program. It was 2004 - 2007. has also been workforce planning. With progressively implemented site by site for the expansion of services at Casey, there Workforce planning is recognised staff who work with patients, and is now was a corresponding need to recruit nationally as crucial to improving health addressing the risks to Hotel Services additional suitably qualifi ed nurses, over care and meeting increased demand and non-patient care staff. It has and above the ongoing need to attract pressures. Representatives from across successfully targeted the most frequent and maintain our nursing workforce. the organisation have been co-operatively and costly manual handling injuries. working to develop our plan. This resulted in an additional 250 positions being created. To achieve our Vision of Better Health for STAFF GRADUATES Some 76 international nurses were Our Community we need the right number During the year 200 staff graduated from recruited during the past year. These of staff, with the right skills in the right place University of Ballarat courses. In nurses have brought not only their skills supported by the right infrastructure partnership with the University, Southern to Southern Health but have also delivering the right health services in an Health conducted several nationally- enhanced our culturally diverse nursing affordable and sustainable way. Our accredited education courses, with workforce. We anticipate an additional Workforce Plan is helping us to achieve this. students selected from across all sites, 27 international nurses will arrive in the programs and occupational groups. Issues to be addressed include the coming months. medical and technological advances that Courses included the Certifi cate 111 in Our innovations in nursing recruitment are improving diagnosis and treatment of Business Administration, undertaken by were recognised in a presentation at the illness and the training required to ensure 140 ward clerks and administrative International Congress of Nursing in that health professionals are equipped to support staff, many of whom had not Taipei, Taiwan, with wide acclaim for the meet these needs in the future. Other undertaken formal tertiary level education concept of a centralised nursing issues include the recruitment and before. The Certifi cate IV in Business was workforce unit. retention of staff and managing a better completed by 20 frontline supervisors, work-life balance for our employees. project managers and team leaders. HEALTHY OPPORTUNITIES Twenty-fi ve associate nurse unit CASEY HOSPITAL During 2005 we launched “Healthy managers and middle managers The commissioning of Casey Hospital was Opportunities”, an employee initiative that completed their Diploma of Business, a signifi cant challenge, requiring the will help us to deliver our strategic goals while a further 25, including nurse unit recruitment of some 700 staff across a by creating opportunities to develop our managers and senior managers, staff, both professionally and personally.

PAGE 24 SOUTHERN HEALTH ANNUAL REPORT 2004/05 undertook the Advanced Diploma Associate Professor Bruce Waxman, from third years of study, with a preceptor FastTrack of Business. the Surgery Program, Mr Amiroel Razif an appointed who will work with the student Orthopaedic Surgeon at Dandenong for the duration of the placement. It is very encouraging that so many of our Hospital and Lana Tutin, Associate Nurse colleagues have worked hard to both This model, which offers more Unit Manager from Operating Theatres at improve their knowledge, and enhance consistency and personalised teaching Casey Hospital all played their part in the contribution they can make to and support, is associated with higher what was a national effort. Southern Health. student satisfaction, improved education The Department of Human Services and more effi cient nurse recruitment STATE NURSING EXCELLENCE coordinated responses from over 800 and retention. Further refi nements AND COMMITMENT AWARDS health service staff wishing to volunteer are planned. their time, skills and expertise in response Several Southern Health nurses were to the Tsunami. OUR VOLUNTEERS among the recipients of State Nursing Excellence and Commitment Awards The selection process was onerous given We are fortunate at Southern Health presented at a ceremony held at the the number of respondents and their to enjoy a dedicated volunteer team. Victorian Arts Centre in December 2004. strong skills and backgrounds. Selections Our volunteers work across our entire were made based on skills, backgrounds, organisation from hospitals to community Clair Luca, from Monash Medical Centre language skills, previous experience and health services and play an integral Outpatients won the prestigious Jen team composition. support role to both our staff and patients. Rusden Memorial Prize for outstanding From delivering and tidying fl owers to clinical leadership, for her work Over 200 staff volunteered their playing with children and providing counselling and educating parents and services, and many more contributed comfort and support in palliative care, expectant parents with club foot babies. to the Red Cross Appeal – the fi gure the work of a Southern Health volunteer raised by Southern Health was more Other Southern Health recipients included is a valued and important one. We thank than $105,000. Nicole Kinnane (Moorabbin all of our volunteers for their commitment Chemotherapy Unit), Val Wilson to our service. NURSING EDUCATION (Education) and Brian O’Donnell, AND RESEARCH Margaret Meade and Paula Stephenson MERIT AND EQUITY AT (Nursing Support Unit). In addition to its core education function, SOUTHERN HEALTH Nursing Education and Research Southern Health’s Merit and Equity REHABILITATION & AGED delivered 30 courses and workshops to education package “Respect, Rights and SERVICES PROGRAM 1,600 nurses within all sites and responsibility” continues to be delivered programs at Southern Health. It also The Program implemented the “Have across the organisation. This package is supported 78 nurses undertaking post- Your Say!” strategy to improve the supported by the Discrimination and graduate studies. working environment for staff. Feedback Harassment Training undertaken by new received from staff was consolidated into Staff from the unit also presented widely Southern Health managers as part of the priority areas – to establish a reward and at local, national and international forums. Manager Orientation Program, held at recognition program and to establish a regular intervals during the year. Kingston Fitness Centre. Both of these UNDERGRADUATE In addition, Southern Health has revised were launched in July 2005. NURSE PROGRAMS its Bullying and Harassment policies and The coming year will see further Southern Health worked with both protocols to incorporate the new Code of implementation of priority areas arising Monash and Deakin Universities on Practice for the Prevention of Bullying and from the process. developing clinical supervision models Violence in the Workplace. that better support undergraduate nurses A Bullying and Harassment Committee TSUNAMI RELIEF and improve learning outcomes. was established to recommend Three Southern Health staff members In particular, undergraduate nurses interventions for Bullying and Harassment joined the 24-strong Victorian Tsunami undertook their clinical placements in a behaviours. A strategy and process has Relief team which took part in a two-week ‘home ward’ environment. This saw all been developed and will be rolled out tour of duty of Banda Aceh. students returning to the same ward within over the coming year. Southern Health during their second and

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 25 SOUTHERN HEALTH – AT A GLANCE

ACTIVITY

Admitted Patient Acute SubAcute Mental Health Total Separations Same Day 71,274 30 29 71,333 Multi Day 55,129 4,589 2,246 61,964 Total Separations 126,403 4,619 2,275 133,297 Emergency 46,865 205 860 47,930 Elective 66,635 3,616 678 70,929 Other inc Maternity 12,903 798 737 14,438 Total Separations 126,403 4,619 2,275 133,297 Public Separations 120,257 4,037 2,262 126,556 Total WIES 92,564 Separations per Available bed 116.61 9.95 7.29 133.85 Total Beds Days 333,468 176,142 99,603* 609,213 Available Beds 1,084 464 312 1,860

* Occupied Beddays. Souce: CMI Intranet Reports - Inpatient and Residential Statistic by Financial Class

Non Admitted Patients Acute SubAcute Mental Health Total Emergency Medicine Attendances 104,528 104,528 Outpatient Services - Occasions of Service 446,459 6,084 452,543 Other Services - Occasions of Service 11,760 4,227 111,443 127,430 Total Occasions of Service 562,747 10,311 111,443 684,501 Victorian Ambulatory Classifi cation System - Number of Encounters 130,202 130,202

ACCESS STAFF NUMBERS

2005 2004 2003 Staff 03/04 04/05 (fulltime equivalents)* 1 Elective Surgery Performance Category 1 proportion of patients admitted within 30 days (%) 100% 100% 100% Nursing 2989 3230 Category 2 proportion of patient admitted within 90 days (%) 59.0% 67.2% 66.9% Average waiting time of category 2 patients 176.3 205.9 176.7 Administration Clerical 924 992 Total Waiting List 7,760 7,453 7,483 2 Emergency Department Performance Medical & Support 1083 1197 2a Triage Performance Hotel & Allied 720 776 Category 1 patients receiving immediate attention 100% 100% 100% Senior Medical 107 110 Category 2 patients receiving attention within 10 minutes 88% 89% 84% Category 3 patients receiving attention within 30 minutes 81% 84% 72% Hosp/Residential 2b % of patients requiring admission who are admitted 78% 77% 79% Medical 561 619 within 12 hrs Sessional Medical 149 163 2c Ambulance Bypass 207 289 269 3 Average Available Beds 1,860 1,671 1,696 Sec.97 3 4 Critical Care 6536 7087 4a Number of Intensive Care Beds Total Average Open 21 21 21 * Total headcount for 04/05 = 10,696 Total Average Available 21 21 21 4b Number of Coronary Care Beds Total Average Open 33 33 33 Total Average Available 33 33 33

PAGE 26 SOUTHERN HEALTH ANNUAL REPORT 2004/05 THE SOUTHERN HEALTH EXECUTIVE AND SENIOR MANAGEMENT TEAM

SENIOR EXECUTIVE Specialty Program Ms Linda Sorrell Chief Executive Professor Julian Smith Medical Director Dr Syd Allen Chief Medical Offi cer Ms Marguerite Abbott Nursing Director and (until 13 February 2005) Dandenong and Cranbourne Dr Craig White Executive Director Clinical Services/ Site Director of Nursing Chief Medical Offi cer (until 14 January 2005) Ms Sharon Wood Chief Nursing Offi cer Ms Linda Balaam Nursing Director and Dandenong and Cranbourne Mr John Stanway Executive Director, Operations, Site Director of Nursing Clayton and Moorabbin Surgery Program Dr Lakshmi Sumithran Executive Director, Operations, Dandenong and Cranbourne A/Professor Bruce Waxman Medical Director Mr Peter Faulkner Executive Director, Operations, Ms Shirlee Graham Nursing Director and Casey Casey Hospital Hospital Director of Nursing Mr Greg Young Executive Director, Primary Care Mental Health Program A/ Professor Alex Cockram Executive Director Mental Health Prof Saji Damodaran Clinical Director Mr John Sutherland Executive Director, Dr Wendy Cross Senior Nurse Finance & Corporate Services Acute Allied Health Ms Christine Fitzherbert Executive Director, Human Resources Ms Sue Blake Director Mr Alan Lilly Executive Director, Rehabilitation & Aged Services Program Finance Dr John Morris Executive Director, Infrastructure Mr John O’Connor Chief Financial Controller Mr Michael Robinson Executive Director, Strategy & Information Services Innovation (until 25 February 2005) Dr Andrew Rothfi eld Chief Information Offi cer Mr Andrew Williamson Executive Director, Public Affairs (until 11 February 2005) Mr Phil Stone Acting Chief Information Offi cer OFFICE OF THE CHIEF EXECUTIVE Jessie McPherson Private Hospital Mr Peter Corrigan Internal Auditor Ms Wendy Cameron General Manager and Mr John Snowdon Corporate Counsel Director of Nursing Ms Elizabeth Murdoch Manager, Quality Diagnostic Imaging SOUTHERN HEALTH CORPORATE EXECUTIVE Dr John de Campo Director (until 31 March 2005) Dr Laurence Lau Director Rehabilitation & Aged Services Program Southern Cross Pathology Professor Barbara Workman Medical Director Dr Syd Allen Executive Director Ms Jill Peterkin Nursing Director and Kingston Site (until 28 February 2005) Director of Nursing Dr Craig White Executive Director Medicine Program Monash Medical Centre Moorabbin A/Professor Richard King Medical Director Andrew Freeman Operations/Business Ms Sharon Wood Nursing Director Manager (until 8 April 2005) Women’s & Children’s Program Chris McCarthy Acting Moorabbin Site Dr Caroline Clarke Medical Director Director of Nursing Ms Helen Gillies Nursing Director Nursing Education and Research Critical Care Program Dr Michael Wilson Director (until 21 March 2005) Dr Bill Shearer Medical Director Professor Wendy Cross Director Ms Kym Forrest Nursing Director and Clayton Site Director of Nursing

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 27 ORGANISATIONAL STRUCTURE: ROLES & RESPONSIBILITIES

EXECUTIVE DIRECTOR EXECUTIVE DIRECTOR EXECUTIVE DIRECTOR CLINICAL SERVICES OPERATIONS MONASH HUMAN RESOURCES & CHIEF MEDICAL OFFICER MEDICAL CENTRE – CLAYTON & MOORABBIN - Recruitment & Retention - Imaging - Performance Management - Cardiology Business Unit - Pathology - Employee Relations - Disaster Planning - Library - EEO - Human Research & Ethics EXECUTIVE DIRECTOR - OHS / WorkCover - HMO Offi ce OPERATIONS DANDENONG & CRANBOURNE - Remuneration & Rewards - Health Information Services - Organisational Development - Infection Control EXECUTIVE DIRECTOR - Leadership & Management Programs OPERATIONS CASEY HOSPITAL - Pharmacy - Training & Development EXECUTIVE DIRECTOR - HR Management Information EXECUTIVE DIRECTOR PRIMARY CARE CLINICAL SERVICES & CHIEF NURSING OFFICER - SEADS CLINICAL PROGRAMS MEDICAL DIRECTORS - Cardinia Casey CHS - Allied Health - Greater Dandenong CHS - Medicine - Nursing Support - Regional Ambulatory Services - Critical Care - Nursing Education & Research - Specialty EXECUTIVE DIRECTOR EXECUTIVE DIRECTOR - Women’s & Children’s INFRASTRUCTURE REHABILITATION & AGED - Surgery SERVICES PROGRAM - Engineering - Sub-Acute Inpatient - Health Technology Services CLINICAL PROGRAMS NURSING DIRECTORS - Sub-Acute Ambulatory - Capital Works - Aged Persons Mental Health - Medicine EXECUTIVE DIRECTOR FINANCE - Critical Care - Residential Care & CORPORATE SERVICES - MonARC - Specialty - Contract Services - Women’s & Children’s - Materials Management EXECUTIVE DIRECTOR - Surgery MENTAL HEALTH - Finance - Child & Adolescent Mental Health EXECUTIVE DIRECTOR STRATEGY - Southern Adult Mental Health PERFORMANCE & PLANNING - Southern Mental Health Evaluation & Research Centre - Clinical Information Management - Quality - Projects & Planning

PAGE 28 SOUTHERN HEALTH ANNUAL REPORT 2004/05 ORGANISATIONAL STRUCTURE PAGE 29 PAGE

Board SOUTHERN HEALTH Chief Executive Offi ce of the Chief Executive - Corporate Counsel Internal Audit - Executive Director Patient Access & Demand Strategies - Executive Director Public Affairs - Chief Information Offi cer & Fundraising

Executive Executive Executive Executive Executive Executive Executive Executive Executive Executive Executive Executive Director Director Director Director Director Director Director Director Director Director Director Director ANNUAL REPORT 2004/05 Clinical Clinical Rehabilitation Mental Health Operations Operations Operations Primary Care Infrastructure Finance & Strategy Human Services & Services & & Aged Monash Dandenong & Casey Hospital Corporate Performance & Resources Chief Medical Chief Nursing Services Medical Centre Cranbourne Services Planning Offi cer Offi cer Program – Clayton & Moorabbin

Clinical Clinical Site & Program Programs Programs Business Medical Nursing Managers Directors Directors

Operational responsibility Professional responsibility for fi nancial matters LEGISLATIVE FRAMEWORK OF SOUTHERN HEALTH

By Government Gazette Notice dated • To develop plans, strategies and ADVISORY COMMITTEES 1 July 2000, the Governor in Council, on budgets to ensure accountable and The Board must also appoint at least one the recommendation of the Minister for effi cient provision of health services by Community Advisory Committee and Health, established Southern Health as Southern Health and the long term must appoint a Primary Care and a metropolitan health service. fi nancial viability of Southern Health. Population Health Advisory Committee Southern Health acquired all the assets • To establish and maintain effective under the Act. and liabilities of the former Southern systems to ensure that the health Health Care Network save for those asset services provided meet the needs of STRATEGIC PLAN and liabilities associated with the former the community served by Southern Pursuant to the Act, the Board must, at Sandringham Hospital campus and the Health and that the views of users of the direction of the Minister, prepare and Berwickwide Community Health Centre. health services are taken into account. submit a strategic plan for the operation Metropolitan health care networks • To ensure effective and accountable of Southern Health. of which the Southern Health Care systems are in place to monitor and Network was one, were disaggregated improve the quality and effectiveness NATIONAL COMPETITION POLICY on 1 July 2000. of health services provided by Southern Health. Southern Health continues to comply with Southern Health is incorporated as a the Victorian Government’s Competitive • To ensure that any problems identifi ed metropolitan health service under the Neutrality Policy. In addition, the Victorian with the quality and effectiveness of provisions of the Health Services Act Government’s Competitive Neutrality health services are addressed in a 1988 as amended. pricing principles for all relevant business timely manner and that Southern Health activities have been applied by Southern strives to continuously improve quality BOARD OF DIRECTORS Health from July 1, 1998. and foster innovation. The Board of Directors of Southern Health • To develop arrangements with other DIRECTIONS OF THE is appointed by the Governor in Council health care agencies and health service MINISTER FOR FINANCE on the recommendation of the Minister for providers to enable effective and Health in accordance with the Act. All the information described in the effi cient service delivery and continuity directions of the Minister Part 9.1.3(iv) The Minister is required under the of care. exists and is available to the relevant Act to ensure that the Board includes • To establish the organisation structure Minister, Member of Parliament of the at least one person who is able to refl ect including the management structure of public upon request. the perspectives of users of health Southern Health. services and that men and women are VICTORIAN INDUSTRY adequately represented. • To appoint a person to fi ll a vacancy in the position of Chief Executive. PARTICIPATION POLICY The functions of the Board of Southern Health complies with the intent Southern Health are: • To establish a Finance Committee, an Audit Committee and a Quality of the Victorian Industry Participation • To monitor the performance Committee and other committees to Policy Act 2003, which requires wherever of Southern Health. assist it in carrying out its functions. possible local industry participation in supplies, taking into consideration the • To oversee the management of • To facilitate health research and principle of value for money and Southern Health by its Chief Executive. education and any other functions transparent tendering processes. • To monitor the performance of the conferred on the Board by or under Chief Executive. the Act. THE WHISTLEBLOWERS • To develop strategic plans for the PROTECTION ACT operation of Southern Health. We have had no applications or disclosures made under the Whistleblower’s Protection Act 2001 during the 2004/05 fi nancial year.

PAGE 30 SOUTHERN HEALTH ANNUAL REPORT 2004/05 icare that your feedback is heard

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 31 ASSET MANAGEMENT BOARD COMMITTEES

BUILDING STANDARDS AUDIT COMMITTEE AND CONDITION ASSESSMENTS The role of the Audit Committee is to Since Southern Health was formed in 1995, the condition of our buildings have advise the Board of Directors on audit been assessed through site inspections and existing condition reviews matters and matters relating to the undertaken by architects and consultant engineers in support of Master Planning fi nancial, accounting and legislative for redevelopments. In addition, during 1998-99, fi re audits and qualitative risk compliance and the operational assessments were undertaken by consultant fi re engineers for every residential effectiveness and effi ciency of Southern site to establish compliance with the updated requirements of the Department of Health. The Committee also advises Human Services’ Fire Risk Management Engineering Guidelines. the Board on the level of business risk or exposure to which Southern Health Recommendations from the fi re audit and risk assessments have been actioned might be subject. through a series of projects developed in association with the Department of Human Services, to achieve a high degree of fi re safety. All bed-based facilities FINANCE COMMITTEE are audited on a three-yearly cycle. The initial fi re risk assessments are reviewed as part of a three year fi re re-audit cycle. Monash Medical Centre, Clayton, The role of the Finance Committee is Dandenong Hospital, Monash Medical Centre, Moorabbin, and our Community to advise the Board of Directors on Health Services at Yarraman, Mooraleigh, Middle South and Doveton and the matters relating to the use of fi nancial Western Port Drug and Alcohol Unit were last audited in 2005. Kingston Centre resources by Southern Health. was re-audited in 2004 and is due for the next re-audit in 2007. QUALITY COMMITTEE ESSENTIAL SERVICES MAINTENANCE The goal of all quality activities is to Southern Health buildings constructed after July 1994 have been designed to ensure that patients/clients receive the conform to the Building Act 1993 and its Regulations, as well as to meet other best possible care and that their safety, statutory regulations that relate to health and safety matters, and have been and that of staff, is protected. The Quality issued with occupancy permits. Committee advises the Board of Directors on the service standards achieved by all Southern Health Buildings constructed prior to July 1994 were not subject to the areas of Southern Health’s operations; issue of occupancy permits. However, regardless of the age of each building, on appropriate reporting of achievement Southern Health has adopted a policy to maintain essential services, as far as is against standards and indicators; on practical, in accordance with Part 11 of the Building Regulations 1994. structures and systems to support and Compliance involves ensuring that all essential services called up by the improve service quality; and on measures regulations are being maintained to fulfi l their purpose, as well as keeping records to monitor and assure quality. of maintenance checks, completing an Annual Essential Services Report, and retaining records and reports on the premises for inspection by the Municipal COMMUNITY ADVISORY Building Surveyor or the Chief Fire Offi cer at any time on request. COMMITTEE Essential Services Reports (Form 10s) are prepared annually for properties owned The Community Advisory Committee by Southern Health to confi rm that all of the essential services are operating at the will be an enabler of community required level of performance. participation by assisting the Board to appropriately integrate consumer and community views at all levels of its operation. The Committee will have the responsibility to advise on governance, policy and strategy in relation to community participation and its impact on health service outcomes.

PAGE 32 SOUTHERN HEALTH ANNUAL REPORT 2004/05 FREEDOM OF INFORMATION

PRIMARY CARE & POPULATION HEALTH ADVISORY COMMITTEE FREEDOM OF INFORMATION FIGURES CALCULATED FROM 1 JULY 2004 TO 30 JUNE 2005 The Primary Care and Population Health Advisory Committee’s primary role will Number of requests 1234 be to provide strategic advice to the Access in full 1101 Southern Health Board on the interaction with relevant external service providers. Access in part 20 This Committee will recommend the Access denied in full 3 creation of structures and processes to enable health services to develop over Other 110 time. These services need to more Plus (cancelled - no application fee paid) 127 closely respond to the health needs and expectations of people who live in, Exemptions cited 30 work in and visit the Cities of Monash, 24A = 1 Cardinia, Casey, Greater Dandenong 25A(1) = 1 and Kingston. 33(1) = 10 This Committee and the Community 35(1)(a) = 2 Advisory Committee will coordinate 35(1)(b) = 16 strategies through common representation, a single secretariat and Average decision time (days) 31.2 the use of an issues-based approach. Fees and charges $51,375.00 Fees collected $35,327.60 FUNDRAISING AND DEVELOPMENT STEERING COMMITTEE Fees waived $16,047.40 In recognition of the potential growth in donations and fundraising income for the organisation, the Southern Health Board has established a Fundraising and INITIAL DECISION MAKERS Development Steering Committee, Therese Canestra Manager, Specialty Services HIS comprising members of both the Board Else O’Halloran Manager, Medical Record and Executive Team. The Committee is Services, Clayton developing a fundraising growth strategy, Assoc. Prof. Saji Damodaran Director of Mental Health Services to include the introduction of a number of Lorna Knight Medical Records Clerk (FOI Unit) new initiatives, programs and policies. The Steering Committee plays an Jan Cremer Medical Records Clerk (FOI Unit) important role in guiding and overseeing the strategic direction in INTERNAL REVIEWER the organisation’s fundraising initiatives. Therese Canestra Manager, Specialty Services HIS John Snowdon Corporate Counsel

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 33 SOUTHERN HEALTH SERVICES

PRIMARY CARE SERVICES South East Alcohol & Drug Service Crisis Assessment (SEADS) Acquired Brain Injury Support Services Eating Disorders Women’s Health (community-based) Aged and Disability Support Emergency Psychiatric Service Youth Health Aged Care Assessment Service Ethnic Mental Health AIDS Prevention Programs MEDICINE PROGRAM Gender Dysphoria Co-ordination Alcohol and Drug Acute Medical Care Unit Lifeskills Team Allied Health & Rehabilitation Acute Medical Unit for the Aged Mobile Assessment, Support & Treatment Birthing Support Clinical Haematology Mother & Baby Inpatient Unit Children’s Early Intervention Clinical Immunology Primary Mental Health Team Community Aged Care Packages Clinical Nutrition Sexual & Relationship Clinic (SARC) Community Nursing Dermatology Specialist Clinics Counselling and Casework Diabetes Telepsychiatry Chronic & Complex Care Needs Diabetes Education Women’s Mental Health Consultant Emergency Medicine Dental REHABILITATION AND AGED CARE Diabetes Education Endocrinology SERVICES PROGRAM (RASP) Domestic Violence Support Gastroenterology Acute Rehabilitation (Inpatient & Outpatient) Dual Diagnosis Service General Medicine Aged Care Residential Services Financial Counselling Infectious Diseases & (High & Low Care) Clinical Epidemiology Health Information and Referral Aged Rehabilitation Medical Oncology Health Promotion & Education Aged Persons Mental Health Service Palliative Care Hospital In The Home Case Management & Service Respiratory Medicine Housing Co-ordination Program Rheumatology Immunisation Chronic Pain Clinic Outpatients Vascular Medicine & Hypertension Liver Clinic Cognitive Memory and Dementia Service Medical MENTAL HEALTH PROGRAM Community Access Service Men’s Health Adolescent Recovery Centre – High Community Rehabilitation Centres Dependency Day Program Mental Health Falls & Balances Clinic Adult Inpatient Psychiatry Service Needle and Syringe Exchange Program Geriatric Evaluation and Management Adult Mental Health Community Teams Optometry Interim Care Services Child & Adolescent Mental Health (Inpatient & Home-based) Post Acute Care Community Teams Movement Disorders Services Problem Gambling Counselling Child & Adolescent Inpatient Unit Rehabilitation in the Home Sexual Health Community Care Units Southern Continence Service Consultation Liaison Psychiatry – Child, Adolescent & Adult

PAGE 34 SOUTHERN HEALTH ANNUAL REPORT 2004/05 SPECIALTY PROGRAM Newborn Services Dental Cardiac Catheterisation Obstetric & Gynaecological Ultrasound Orthopaedic Surgery Cardiology Paediatric Cardiology Maxillofacial Surgery Cardiothoracic Surgery Paediatric Dental Plastic & Reconstructive Surgery Paediatric Endocrinology Coronary Care CRITICAL CARE PROGRAM Echocardiography Paediatric ENT Anaesthesia Nephrology Paediatric Gastroenterology Intensive Care Neurology Paediatric Intensive Care Operating Theatres Neurosurgery Paediatric Nephrology CLINICAL SUPPORT AND Renal Surgery Paediatric Neurology INTERFACE SERVICES Stroke Paediatric Neurosurgery Aboriginal Liaison (Koori Health Unit) Paediatric Oncology/Haematology WOMEN’S AND CHILDREN’S Aids for Disabled People HEALTH PROGRAM Paediatric Ophthalmology Audiology Adolescent Medicine Paediatric Orthopaedics Chaplaincy & Pastoral Care Service Birth Centre Team Paediatric Plastic & Maxillofacial Diagnostic Imaging Breast Surgery Paediatric Respiratory Dietetic Services BreastScreen Paediatric Rheumatology Health Information Services Contraceptive Counselling Paediatric Surgery Hospital In The Home Delivery Suite Play Education Interpreter Services Dental Pregnancy Care Library Developmental Disabilities Prenatal Education Occupational Therapy Foetal Diagnostic Reproductive Biology Oncology Day Centre General Gynaecology Reproductive Medicine Services Orthotics General Obstetrics Special Care Nursery Outpatient Department General Paediatrics Spina Bifi da Service Pathology Genetic Services Thalassaemia Medical Therapy Pharmacy Growth & Development SURGERY PROGRAM Physiotherapy Gynaecological Oncology Vascular Surgery & Transplant Podiatry Lactation Consultant Gastrointestinal Surgery Post- Acute Care Project Maternal Foetal Medicine General Surgery Social Work Maternity ENT Surgery South Eastern Centre Against Menstrual & Menopause Ophthalmology Sexual Assault Midwifery Care Unit (Clayton) Orthoptics Speech Pathology Midwives in Partnership Team Urology Stomal Therapy (Dandenong)

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 35 icare that our meals are nutritious

PAGE 36 SOUTHERN HEALTH ANNUAL REPORT 2004/05 ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 36 SUMMARY OF FINANCIAL PERFORMANCE

The 2004/2005 fi nancial year was a year of consolidation and signifi cantly improved fi nancial performance. It was also a year of expansion for Southern Health with Casey Hospital being commissioned during the year. Southern Health achieved an annual turnover of $725.5 million during 2004/2005 which was a 12.55 per cent increase, compared to the previous fi nancial year. The net result from ordinary activities for the 2004-2005 fi nancial year was a defi cit of $2.8 million which was $22.6 million favourable to the budget of $25.4 million. This result was a $23 million improvement on the 2003-2004 result. This result highlights the signifi cant improvement in fi nancial performance achieved by Southern Health. This improvement is attributable to increases in funding, better utilisation of resources and cost containment. The break up of the respective operational segments are summarised below:

2005 2004

Health Service Agreements Operations $9.2M Defi cit $25.6M Defi cit Business Unit Operations $0.5M Defi cit $1.1M Surplus Special Purpose Funds $2.5M Surplus $3.2M Surplus Recurrent Capital $5.1M Surplus $4.7M Surplus Depreciation & Other Capital Income $0.7M Defi cit $9.2M Defi cit

Net Result from Ordinary Activities $2.8M Defi cit $25.8M Defi cit

In line with the improved fi nancial performance Southern Health recorded an increase of $13.3 million in cash holdings, $8.9 million from operations and $4.4 million for investing and fi nancing activities. The closing cash balance for the organisation was $34.6 million. The summary of the fi nancial results of the organisation for the previous fi ve fi nancial years is on page 38. The major factors affecting the organisations fi nancial performance in 2004/2005 were: 1. Cost Containment Strategies There was a major focus on the management of costs, while continuing to respond to increased demand for services. Expenditure increased by 8.6 per cent in the 2004-2005 fi nancial year, compared to 2003-2004. This refl ected the commissioning of Casey Hospital combined with annual increases in salaries and wages and medical consumable costs. 2. Revenue Improvements In the same period, total revenue increased by 12.5 per cent from $644.9 million to $725.5 million. This refl ected the impact of funding for the commissioning and operation of Casey Hospital, increases in patient fee revenue and capital purpose Income.

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 37 SUMMARY OF FINANCIAL RESULTS 2004/05

2004/05 2003/04 2002/03 2001/02 2000/01 $’000 $’000 $’000 $’000 $’000

Total Expenses 728,333 670,705 636,306 588,775 526,648 Total Revenue 725,511 644,899 623,811 579,657 525,912

Operating Surplus (Defi cit) (2,822) (25,806) (12,495) (9,118) (736) Retained Surplus (48,746) (44,502) (16,351) (2,922) 6,196 (Accumulated Defi cit) Total Assets 619,511 503,454 523,866 507,761 504,315 Total Liabilities 255,003 152,592 152,869 151,429 139,995 Net Assets 364,508 350,862 370,997 356,332 364,320

TOTAL EQUITY 364,508 350,862 370,997 356,332 364,320

REVENUE INDICATORS CONSULTANTS

Average Collection Days 2005 2004 SOUTHERN HEALTH CONSULTANT FEES FOR INPATIENT FINANCIAL YEAR 2004/05 Private 53 51 Peter O’Callaghan Transport Accident Commission (TAC) 87 290 Consulting 100,150 Victoria Workcover Authority (VWA) 58 128 Keogh Consulting Psychiatric 19 32 Pty Ltd 119,648 Nursing Home 21 24 SMS Consulting Group Limited 122,150 Health Issues Centre 153,000

Accounts receivable < 30 31-60 61-90 91-120 2004/05 2003/04 Total Expense 2,041,371 ageing analysis days days days days Total number of INPATIENT $’000 $’000 $’000 $’000 $’000 $’000 consultants 82 TAC 17 10 5 22 54 76 Private 2,372 1,269 589 956 5,186 5,005 WorkCover 34 32 42 81 189 359 Psychiatric 36 4 3 43 34 Nursing Home 135 28 2 165 177

2,594 1,343 636 1,064 5,637 5,651

PAGE 38 SOUTHERN HEALTH ANNUAL REPORT 2004/05 SOUTHERN HEALTH WORKCOVER STATISTICS 2001/02 TO 2004/05

2004/05 2003/04 2002/03 2001/02

Number of Standard Claims 164 155 170 179 Claims per $ million of remuneration 0.396 0.392 0.447 0.487 Claims costs per $ million of remuneration 1.433 1.438 1.526 1.703

Remuneration combines wages, superannuation and fringe benefi ts

COMPLIANCE INDEX - DISCLOSURE REQUIREMENTS

The Annual Report of the entity is prepared in accordance 9.1.3 (ii) (d) Major changes or factors affecting with the Financial Management Act 1994 and the Directions achievement of objectives 2-26, 37-38 of the Minister for Finance. This index has been prepared to 9.1.3 (ii) (e) Events subsequent to facilitate identifi cation of compliance with statutory disclosure balance date; 2-26, 37-38 and other requirements. 9.1.3 (ii) (f) Consultancies > $100,000 - Full details of each consultancy; 38 REPORT OF OPERATIONS 9.1.3 (ii) (g) Consultancies < $100,000 Clause Disclosure Page - Number and total cost of consulting agreements; 38 Charter & purpose 9.1.3 (ii) (h) A statement on occupational health 9.1.3 (i) (a) Manner of establishment and and safety matters, including relevant Minister; 3, 30 performance indicators and how they affect outputs; 39 9.1.3 (i) (b) Objectives, functions, powers and duties; 3, 30 9.1.3 (ii) (i) Extent of compliance with Building Act 1993; 32 9.1.3 (i) (c) Services provided and community served; 3 9.1.3 (ii) (j) Application and operation of FOI Act 1982 33 Management & structure 9.1.3 (ii) (k) Summary of the application of 9.1.3 (i) (d) (i) Names of governing board the Whistleblower’s Protection members, audit committee and Act 2001, including disclosures chief executive offi cer; 7 required by the Act; 30 9.1.3 (i) (d) (ii) Names of senior offi ce holders 9.1.3 (ii) (l) A statement that information listed and brief description of each offi ce; 27 in FRD 22 is available on request; 30 9.1.3 (i) (d) (iii) Chart setting out organisational 9.1.3 (ii) (m) A compliance index; 39-40 structure; 29 9.1.3 (ii) (n) Summary of the entity’s 9.1.3 (i) (e) Workforce data and application of environmental performance; 15 merit & equity principles. 25-26 9.1.3 (ii) (o) Progress in implementation and compliance with National Financial & other information Competition Policy; 30 9.1.3 (ii) (a) Summary of fi nancial results; 37-38 9.1.3 (ii) (p) Disclosure of contracts 9.1.3 (ii) (b) Summary of signifi cant changes in commenced or completed under fi nancial position; 37-38 the Victorian Industry Participation 9.1.3 (ii) (c) Operational and budgetary objectives Policy Act 2003. 30 for the year and performance against those objectives; 2-26, 37-38

ANNUAL REPORT 2004/05 SOUTHERN HEALTH PAGE 39 SERVICE ACTIVITY AND EFFICIENCY MEASURES FINANCIAL STATEMENTS

Preparation 9.2.2 (ii) (a) Statement of preparation on an Liabilities accrual basis 45 9.2.3 (iii) (b) (i) Overdrafts N/A 9.2.2 (ii) (b) Statement of compliance with 9.2.3 (iii) (b) (ii) Bank loans, bills payable, Australian Accounting Standards promissory notes, debentures and associated pronouncements 45 and other loans N/A 9.2.2 (ii) (c) Statement of compliance with 9.2.3 (iii) (b) (iii) Trade and other creditors 60 accounting policies issued by the 9.2.3 (iii) (b) (iv) Finance lease liabilities 60-61, 66 Minister for Finance 45 9.2.3 (iii) (b) (v) Provisions, including Statement of fi nancial operations employee entitlements 61 9.2.2 (i) (a) A statement of fi nancial operations Equity for the year 42 9.2.3 (iii) (c) (i) Capital 43, 62 9.2.3 (ii) (a) Operating revenue by class 48-54 9.2.3 (iii) (c) (ii) Issued capital N/A 9.2.3 (ii) (b) Investment income by class 48-54 9.2.3 (iii) (d) Reserves and transfers to and 9.2.3 (ii) (c) Other material revenue by class from reserves 43, 62 including sale of non-goods assets and contributions of assets 48-54 Statement of Cash Flows 9.2.3 (ii) (d) Material revenues arising from 9.2.2 (i) (c) A statement of cash fl ows for the year 44 exchanges of goods or services 48-54 9.2.3 (ii) (e) Depreciation, amortisation or Notes to the fi nancial statements diminution in value 55 9.2.2 (i) (d) Ex-gratia payments N/A 9.2.3 (ii) (f) Bad and doubtful debts 51-52, 56 9.2.2 (i) (d) Amounts written off 51-52,56 9.2.3 (ii) (g) Financing costs 55 9.2.3 (iv) (a) Charges against assets N/A 9.2.3 (ii) (h) Net increment or decrement on 9.2.3 (iv) (b) Contingent liabilities 70 the revaluation of each category 9.2.3 (iv) (c) Commitments for expenditure 66 of assets 59-60 9.2.3 (iv) (d) Government grants received or 9.2.3 (ii) (i) Auditor-General’s fees 70 receivable and source 48-49 Statement of fi nancial position 9.2.3 (iv) (e) Employee superannuation funds 67 9.2.2 (i) (b) A statement of fi nancial position 9.2.3 (iv) (f) Assets received without adequate as at 30 June 2005 43 consideration 54 9.4.2 Transactions with responsible Assets persons and their related parties 67-69 9.2.3 (iii) (a) (i) Cash at bank or in hand 55 9.2.3 (iii) (a) (ii) Inventories by class 57 9.2.3 (iii) (a) (iii) Receivables, including trade debtors, loans and other debtors 56 9.2.3 (iii) (a) (iv) Other assets, including prepayments 43 9.2.3 (M) (a) (v) Investments by class 57 9.2.3 (iii) (a) (vi) Property, plant & equipment 58-60

PAGE 40 SOUTHERN HEALTH ANNUAL REPORT 2004/05