MEDTECH Issue WHY WE NEED IT NOW MORE THAN EVER

WINTER 2020

TECHNOLOGY MEDTECH iSSUE WHY WE NEED IT NOW MORE THAN EVER

DiGiTAL HEALTH iNFECTiON CONTROL TECH VS PANDEMiC Transforming Australian Covid-19: Risk assessment AI, telehealth, pathology,

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CONTENTS

TECHNOLOGY ISSUE

Turning to tech in the pandemic: TECHNOLOGY case study series

14 18 20 22 The use of technology in Building holistic models Medtech leading the way in Mobilising local medical health care is now more of care on a fragmented pandemic collaboration manufacturing in a pandemic important than ever foundation

case study series case study series

23 24 56 62 Juiced TV Wound care delivered by AI’s role in modern-day A new paradigm in medical telehealth health care image analysis

CLINICAL SERVICES DESIGN IN HEALTH INFECTION CONTROL

26 46 29 37 Frontiers in orthopaedic Health on the other side of Lab design fit for phenome Reshaping risk with COVID-19 surgery the COVID-19 pandemic researchers

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4 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au REVOLUTIONARY

RAPID INFUSION TECHNOLOGY

NEXT-GENERATION

STERILISATION SOLUTIONS

Life-saving innovation. Cutting edge light-technology. Next-generation sterilisation. All that, plus so much more.

1300 246 0349 | www.mediquip.com.au CONTENTS

REGULARS

LEADERSHIP A DAY IN THE LIFE

8 Editor’s Welcome Jane Allman

18, 59 Contributing Editor Amy Sarcevic 32 40 Digitalisation in the Year of the Royal Australian Navy officer, Nurse Lieutenant Commander Thomas Miller, a Nurse 10 Educator The Rounds Breaking news and AGED CARE latest medical research

44 Pharmacy Kristin Michaels CEO, SHP

48 66 68 Food safety Fall-detection tech gets Fall-prevention technology Andrew Thomson helps seniors stand tall Think ST Solutions smart

SAFETY IN CONVERSATION

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Advertising Manager: Nicky Stanley Welcome to our 0401 576 863 [email protected] Advertising Sales: technology issue Nikki Edwards +61 2 9168 5516 [email protected] his issue we focus on technology, and communicate in times of social distancing Kerrie Robinson all the ways it is innovating our health are just some examples. +61 2 9168 5517 T system. [email protected] Harnessed in the right way, technology can PUBLISHED BY In the midst of a global pandemic, life as we propel health care into places we could Westwick-Farrow Media know it has been hurriedly digitalised, with only have imagined in science fiction. A.B.N. 22 152 305 336 remote working, learning and health care Robots assisting surgeons and taking blood being critical to keep elements of society for analysis, AI-facilitated diagnostics, operating while parts of the country face telehealth, 3D-printed organs — these lockdown measures. technologies are happening now in the Access to innovative technologies has healthcare space. shaped our response to the pandemic, Get stuck in to this issue’s features and find out enabling us to do things that would how technology is revolutionising health care, www.wfmedia.com.au not have been possible in earlier times. particularly in these unprecedented times. Virtual medical appointments, digital Head Office health records and ways to connect and Keep safe, Unit 7, 6-8 Byfield Street, North Ryde Locked Bag 2226 North Ryde BC NSW 1670 AUSTRALIA ph: +61 2 9168 2500

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NOTICE: All material published in this magazine is published in good faith and every care is taken to accurately relay information provided to us. Readers are advised by the publishers to ensure that all necessary safety devices and precautions are installed and safe working procedures adopted before the use of any equipment found or purchased through the information Want to contribute? we provide. Further, all performance criteria was provided by the We welcome articles and research reports from health professionals across representative company concerned and any dispute should be referred to them. Information indicating that products are made in Australia or Australia for review for the quarterly print publication and our daily web page. New Zealand is supplied by the source company. Westwick-Farrow Pty If you have a story you think would be of interest, please send an email to Ltd does not quantify the amount of local content or the accuracy of . the statement made by the source. [email protected]

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THE WORLD’S MOST ADVANCED DRINKING WATER SYSTEM The Rounds Updates in health care

Subiaco hospital uses wearables to A prototype of an reduce workplace injury automated blood drawing WA’s St John of God Subiaco Hospital has introduced wearable and testing device. devices in a bid to reduce workplace injuries. Developed by global safety science company Soter Analytics, the wearable technology captures and measures hazardous movements and coaches workers using real-time feedback and in-app training. The device continually assesses body movements and alerts the wearer when they are moving in an unsafe way. This awareness allows the user to alter their posture, ultimately reducing the risk of injury. St John of God Subiaco Hospital Manual Task Consultant Shane O’Brien said the hospital jumped at the opportunity to pilot SoterSpine. “Many roles at our hospital require manual handling. Moving a patient or bed incorrectly, or lifting a heavy object the wrong way can lead to ongoing issues. “The SoterSpine has been successful in supporting caregivers in a variety of roles, including nursing, engineering, cleaning and

maintenance. Chauhan. Image Unnati credit: “It has even been useful in ensuring the safety of injured staff returning to work,” he said. Happy with the benefits that the technology is bringing, the hospital Robot successfully samples blood is now working with Soter Analytics to develop their latest project, A team of biomedical engineers has created a blood-sampling robot the SoterShoulder. Similar to SoterSpine, SoterShoulder is a solution that performed as well or better than people in a human clinical that identifies and trains workers to avoid movements that commonly trial. The automated blood drawing and testing device includes lead to shoulder injuries. an ultrasound-image-guided robot that draws blood from veins, a module that handles samples and a centrifuge-based blood analyser. Soter Analytics CEO Matthew Hart said, “We are particularly excited to have the opportunity to work with St John of God Subiaco Hospital In the future, the device could be used in procedures such as to develop our SoterShoulder. IV catheterisation, central venous access, dialysis and placing arterial lines. “The results and feedback have been very positive. Piloting this device in a hospital setting has allowed us to better understand Results using the device — published in the journal Technology — movements that can lead to injury.” were comparable to or exceeded clinical standards, with an overall success rate of 87% for the 31 participants whose blood was drawn. Both solutions aim to build awareness and encourage caregivers to For the 25 people whose veins were easy to access, the success rate change their manual-handling technique through real-time feedback was 97%. from the device. Over time, this awareness and self-correction can lead to long-term changes in movement, reducing workplace injury. Venipuncture is claimed to be the world’s most common clinical procedure, yet clinicians fail in 27% of patients without visible veins, 40% of patients without palpable veins and 60% of emaciated patients. Repeated failures to start an IV line increase the chance of phlebitis, thrombosis and infections, and may require targeting large veins in the body or arteries. As a result, venipuncture is among the leading causes of injury to patients and clinicians. Difficulty accessing veins can increase procedure time by up to an hour, requiring more staff and increasing costs. “A device like ours could help clinicians get blood samples quickly, safely and reliably, preventing unnecessary complications and pain in patients from multiple needle insertion attempts,” said lead author Josh Leipheimer, from the Yarmush lab at Rutgers St John of God University–New Brunswick. Subiaco Hospital caregivers Rosie Next steps include refining the device to improve success rates in Cook and Shane patients with difficult veins to access. Data from this study will be O’Brien wearing the used to enhance artificial intelligence in the robot to improve its SoterSpine device. performance.

10 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

Targeting triple-negative breast The Rounds tumours Updates in health care University of Queensland researchers may have found a way to improve treatment of triple-negative breast cancer. The researchers found that triple-negative breast tumours with the highest energy usage respond best to chemotherapy because the ‘recycling stations’ that deal with metabolic by-products, called proteasomes, also make cancer more ‘visible’ to the immune system. Conducted in collaboration with the University of Adelaide and published in the journal Life Science Alliance, the discovery could improve treatment responses to the aggressive cancer. “Previous research has indicated that inhibiting proteasomes could be effective in triple-negative breast cancer, but we have found the opposite to be true,” Dr Jodi Saunus said. “If we can figure out how to boost the activity of tumour proteasomes, we could improve the effectiveness of 3D device prints skin for burn wounds chemotherapy and potentially increase the prospects for A handheld 3D printer that deposits sheets of skin to cover large burn immunotherapy.” wounds has been developed by a team of researchers from the University Dr Saunus’s research team analysed the molecular features of 3500 of Toronto Engineering and Sunnybrook Hospital. The device covers breast tumours over two years to make this finding. wounds with a uniform sheet of biomaterial, depositing ‘bio ink’ that can Chemotherapy has been the predominant treatment for accelerate the healing process. triple-negative breast cancer, but research now suggests that The bio ink is composed of mesenchymal stroma cells (MSCs) — stem immunotherapy may also work. cells that differentiate into specialised cell types. The MSC material Triple-negative breast cancer is one of the most severe breast promotes skin regeneration and reduces scarring. cancers because it tends to grow and spread quickly, with many The project — led by PhD candidate Richard Cheng under the supervision patients experiencing relapse in the lungs, liver or brain. of Professor Axel Guenther (and in close collaboration with Ross Tilley Because the cancer is negative for the three receptors commonly Burn Centre Director Dr Marc Jeschke and his team at Sunnybrook found in breast cancer cells — oestrogen, progesterone Hospital) — has reported success in treating full-thickness wounds, as and HER2 receptors — hormone therapies are reported in the journal Biofabrication. ineffective and treatment usually involves surgery, “Previously, we proved that we could deposit cells onto a burn, but there radiotherapy and cytotoxic chemotherapy, which wasn’t any proof that there were any wound-healing benefits — now we’ve produce unfavourable side effects. demonstrated that,” Professor Guenther said. The team is now working on the next phase of the The current method of care for burns is autologous skin grafting, which research, which it hopes will lead to the requires transplantation of healthy skin from other parts of the body onto development of experimental the wound. But large, full-body burns pose a challenge. ‘cancer vaccines’ that can “With big burns, you don’t have sufficient healthy skin available, which help the immune system could lead to patient deaths,” Jeschke explained. fight the cancer if it spreads to the brain. “Once it’s used in an operating room, I think this printer will be a game changer in saving lives. With a device like this, it could change the entirety of how we practice burn and trauma care.” Studio ©stock.adobe.com/au/Africa

Australian wound-healing tech ignites NASA attention A team of Australian scientists from Southern Cross University is communication back to earth can often have a 10-minute delay and pioneering a technology that could heal wounds in days rather than this is such a simple treatment to apply,” Dr Craig said. weeks without using stitches. The team’s research has caught the “We really are over the moon to win this part of the competition. To attention of NASA. have NASA support and promote our product is amazing. We’ve had a The wound-dressing technology, known as Rapid Repair, changes lot of support from CSIRO to progress our product to market.” the way molecules repair, enabling skin to heal more quickly and Dr Craig said a pilot study at Southern Cross University Health Clinic potentially removing the need for stitches, staples or glue. showed promising clinical outcomes. Project leader Dr Rosemary Craig, working with biomedical researcher “During our clinical trial on skin cancer wounds we were Dr Nedeljka Rosic and business consultant Gerard able to remove patients’ stitches after just one day. Criss, recently presented the technology to a These trials are showing this novel dressing works on panel at NASA’s Ignite the Night iTech Event — an all skin types, including on aged skin and people with online competition series that platforms scientific diabetes, and can minimise scarring,” Dr Craig said. advances and innovative space ideas. The team “Future trials plan to heal cuts and wounds without won the round and secured a place in the using stitches at all. August semifinals. “It is simple and painless to apply, using a non- Dr Craig first came across the idea while invasive device with a long shelf life. The potential recovering from a surgical procedure, when impact of this technology is enormous as it not she developed a device that appeared only increases the rate of repair but significantly to heal full thickness skin cuts in a much changes the way wound healing is understood.” shorter timeframe than normal.

“The panel of NASA scientists said they Rapid Repair research team leader Dr Rosemary thought our rapid-healing product would be Craig (centre), with business consultant Gerard very useful and valuable in space, especially as Criss and biomedical researcher Dr Nedeljka Rosic. Credit: © Southern Cross University.

12 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

Technology

The use of technology in health care is now more important than ever — digitising Australia’s health system

Jane Allman

Australia needs a well- he Australian Digital Health Agency T(the Agency) — established in 2016 to designed digital health system lead the development of the strategy and in order to transform health its implementation — has been tasked with evolving digital health to meet the needs care. Benefits should include of modern Australia and it is now critical to better patient experience, ensure this happens quickly. The Agency is quality care and improved working with healthcare providers, industry peak bodies, government departments and health outcomes. The rollout vendors to facilitate digital health integration The strategy is the product of detailed in the health system and deliver the key of National Digital Health consultation and co-production with initiatives. Strategy initiatives — with patients, consumers and carers — and The Australian Government’s National Digital the healthcare professionals, industry, the Australian Digital Health Health Strategy was devised to digitise the organisations and innovators who serve Agency at the helm — is Australian health system, making it safe, them. seamless and secure. realising Australia’s digital Delivering digital initiatives health future and COVID-19 is The strategy proposes seven priority To date, the process of delivering initiatives outcomes to be achieved by 2022: ensuring that it is fast-tracked. has been an integrated one, overseen by 1. Health information is available whenever the Agency’s measured and considered and wherever it’s needed. approach: roadmaps designed and adjusted; priorities agreed on; consultation 2. Health information can be exchanged sought from relevant parties on prioritised securely. initiatives, leading to implementation plans 3. Commonly understood, high-quality data in consultation with peak body organisations can be used with confidence. such as the Australian Medical Association, Australasian College for Emergency 4. Availability and access to prescriptions and Medicine and Australian College of Nursing. medicines information. The overall aim is to achieve interoperability, 5. Digital models of care that improve connection and integration between digital accessibility, quality, safety and efficiency. systems and sources of information to facilitate fast and user-friendly access to 6. Workforce confidence in use of digital health technologies to deliver health and centrally located health information. care. My Health Record 7. A thriving digital health industry delivering According to the Agency, as at the end world-class innovation. of February 2020 more than 22 million

14 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Technology ©stock.adobe.com/au/everythingpossible

Australians have a My Health Record — an E-prescribing and medicines Australia each year due to medicine-related integrated clinical information platform management problems, half of which are preventable. For allowing patients and associated healthcare example, if a patient is taking ginseng and Many Australians will remember the days professionals to access health information is prescribed warfarin, the efficacy of the of handwritten scripts — when pharmacists securely online. Health professionals can blood-thinning agent may be reduced — had to decipher illegible scrawls to upload, view and share documents via a increasing the chance of blood clotting. If a determine what medication a patient patient’s My Health Record, which provides pharmacist has access to all the medicines had been prescribed. Unsurprisingly, a detailed picture with which to make a patient is taking, they are in a position this method resulted in a high rate of decisions, diagnose and provide treatment. to inform the patient of potential drug prescribing errors, with patients receiving Given the recent crisis events of flood, fire, incorrect doses or even the wrong interactions and advise on the best course drought and pandemic, patient access to medication. of action to get the most out of treatment. their health information is more critical than ever. Typed scripts have helped reduce the rate In the case of e-prescribing, the doctor, of error; however, electronic prescribing pharmacist and patient are all involved. A whole host of digital will take us another step forward in Relevant information is available and initiatives patient safety when it comes to medicines accessible, with safety at the heart of the management. A transition to e-prescribing initiative. While My Health Record is a well-recognised will provide an alternative to paper scripts. digital health initiative — with tens of Medicines management has been identified thousands of healthcare practitioners, In addition to eliminating the problem of as a priority area to be rolled out across all public and private hospitals, community lost scripts and repeats, digitally stored states and territories across the country, pharmacies and other healthcare providers prescribing information will create an incorporating medicines safety, real-time connected to the system — it is just one of integrated record of what medications prescription monitoring and a single drug several tools that have been launched. There patients are taking, aimed at reducing catalogue. Western Australia and Tasmania is also a series of test-bed projects underway. adverse drug interactions and allowing have already made progress in this area, A range of systems and technologies are patients to get the most out of their with Tasmania using real-time reporting being trialled that, when rolled out, are set to treatment. This is known as the Pharmacist and recording of controlled drugs, and deliver a positive impact when it comes to Shared Medicines List and its aim is to the Fiona Stanley Hospital in Western digital health. address the 250,000 hospital admissions in Australia adopting the Automated Pharmacy

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 15 Technology

“Improving health outcomes for all Australians is our key priority and co-designing our solutions with consumers is a vital part of our work.”

The Agency is running a nationwide train- the-trainer program via the Australian Library and Information Association (ALIA) that will train library staff to help users navigate and understand digital health initiatives such as My Health Record. Many Australians use public libraries as trusted sources of health and wellness initiative, which promotes evidence-based hospitals and health services as a professional information. In addition to information about use of medicines in a safe, high-quality and development guide for nursing and midwifery. healthy living, health conditions, treatment cost-effective manner. This is part of the National Digital Health plans, therapies and medicines, training Workforce and Education Roadmap, will allow library staff to provide support Electronic referrals and information on My Health Record and In Victoria, an eReferral Program has developed by the Agency in collaboration with the Digital Health CRC. help community members access digital enabled secure messaging and exchange of resources. clinical information, timelines and roles and Digital literacy and responsibilities among health professionals. The Agency has also engaged the Good The initiative has already been implemented community engagement Things Foundation to provide grants to in four Victorian health services and will An important part of the Agency’s mandate is community organisations to build the be developed to form a framework for building community engagement, ensuring understanding and skills that will allow sector-wide use. eReferral and booking that digital systems are usable and providing Australians to realise the benefits of our capabilities, as well as secure messaging community digital health education to evolving digital health system. maximise uptake. and discharge summary capabilities are all These are just some of the many digital being implemented across Australia. All of “Community engagement is vital for digital initiatives and new technologies that will be these initiatives will work together to improve systems to be successful. Improving health integrated into the digital health landscape efficiencies in the health system, allowing outcomes for all Australians is our key over the coming years. It is an exciting time delivery of quality health care. priority and co-designing our solutions with for the health sector and patients and health Bringing nurses, midwives and consumers is a vital part of our work,” Agency professionals alike are sure to benefit from the Acting Chief Operating Officer Rupert Lee said. digital transformation. specialists along for the ride GPs and hospital-based GPs are currently well serviced by My Health Record, and the Agency wants to bring more nurses and midwives onto the digital system, as well as specialists working across all fields of health care. The newly created Australasian Institute of Digital Health — in collaboration with the Agency as part of the National Digital Health Strategy’s commitment to building health workforce capability in digital health — has conducted a professional development ©stock.adobe.com/au/WavebreakmediaMicro program to identify the digital health skills nurses and midwives need to further improve the quality, safety and efficiency of the care they deliver. Nurses and midwives across Australia have been consulted on the specific digital health skills they need, what is practical and relevant for them, and how a draft digital health capability framework could be used in

16 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

TECHNOLOGY

Building holistic models of care on a fragmented foundation Amy Sarcevic

alerie has just had a medical check-up In turn, Valerie is empowered to become an “We know that data is the foundation for the Von her toilet seat at home — her second ‘active partner’ in her own holistic wellbeing, future of the health system. So, it is important one that day. spotting the early signs of cancer and we get this right.” diabetes before any major symptoms present. Her urine stream was filmed by an in- In a clinical context, data is often spread built camera and monitored for glucose. However, many health devices and apps we across various technologies — pathology, Meanwhile, sensors checked her stools for use are not integrated in this way — neither diagnostic imaging, dispensing and electronic colour and consistency. with the EHR, nor with one another. In fact, medical record systems — with staff having to they often have different data formats and log in and out of each system to get the full It may seem quirky at first glance, but this protocols, which stops them from doing so. patient picture. RPM (remote patient monitoring) technology forms part of a wider, utopic vision of modern This robs them of their potential to enable In an everyday context, 52% of smartphone health care and ‘precision health’ in Australia. new, more holistic models of care, said Luke users collect their own health information, via Baxby of Deloitte. A vision centred around the concept of the 165,000 health and fitness applications wellness rather than illness; value instead of “The system is being inundated with new available for download.1 This signifies a lot of volume. and emerging technologies from a growing disparate health data which, pulled together, ecosystem of vendors — it can be difficult to could be vital for early diagnoses. Valerie’s smart toilet may be integrated with navigate,” Baxby said. her electronic health record (EHR), which As well as a missed opportunity to prevent means her doctor could see all the data it “It stops discrete pieces of data being rather than cure illness, this ‘fragmentation’ collects. Valerie could also see it herself when brought together to generate improved issue can be dangerous, with valuable data she logs in to her online patient portal. health insights. lost between machines or interfaces.

18 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au TECHNOLOGY

“We need to start thinking about the end game upfront and coming up with functional designs that can be flexible to rapid changes in the healthcare environment.”

“The hospital of the future will be different to the one we recognise today. Some may not even have walls,” he said, acknowledging the growing momentum behind virtual hospitals. “The health sector is in a constant state of flux, with rapidly evolving innovation, an ageing population, and shifting patient and consumer expectations. “Planning and budgeting for health care in this context will be a real challenge; and health capital planners will find themselves grappling with an ongoing dilemma: invest in more of the same or in something altogether different?” Bromley said the key to handling this moving target is to consider a range of asset and non- asset solutions and invest in flexible buildings. “Technology must be able to adapt to emerging megatrends, whether it’s a totally new innovation or an existing one that has been retrofitted. We need to start thinking ©stock.adobe.com/au/WrightStudio about the end game upfront and coming up with functional designs that can be flexible to rapid changes in the healthcare environment,” It can result in inaccurate diagnoses and significant opportunity to improve health he said. treatment, and, in turn, medication-related system performance.” Despite the time and investment it could take harm — a problem that already causes However, coming up with an overarching to iron out fragmentation, experts believe it is 400,000 annual hospital admissions every vision of health care isn’t easy, particularly worth all the effort. year; costing $1.4 billion in taxpayer spend.2 when the sector itself is fragmented. “Imagine how streamlined your processes To overcome fragmentation, Baxby said “With multiple lines of accountability and will be if you have a united system, working healthcare leaders must first develop a clear incentives across the care continuum, towards a common goal — and the vision of how they want their services to look developing a coherent vision that supports the technologies to support it,” Baxby concluded. — and then work with vendors to innovate government’s digital health strategy is not a accordingly. trivial task,” Baxby said. “What’s critical is that technology is Luke Baxby is a Partner at Deloitte “If we are starting with the vision first, then considered in the context of the overall health Access Economics; Isaac Bromley is we need to break down the siloes that exist in system. Director of Infrastructure Advisory at policy, clinical governance, procurement and “It is not a technology-first strategy. But a professions. New funding and business models Ernst Young. health-first strategy,” he said. may need to be considered here, along with more collaborative decision-making.” “Planned well, new technologies can References enhance the flow, exchange and An additional challenge is the ‘moving target’ 1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6057658/ interpretation of patient information across of modern-day healthcare infrastructure 2. https://ajp.com.au/news/psa-releases-new-report-on- the healthcare system. This creates a delivery, explained Isaac Bromley of EY. medicine-safety/

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 19 Technology

Medtech leading the way in pandemic collaboration

Ian Burgess, Medical Technology Association of Australia CEO ©stock.adobe.com/au/Gecko Studio ©stock.adobe.com/au/Gecko

The declaration of COVID-19 invasive ventilators available in Australia’s ICUs worked to source overseas supplies of would fall significantly short of the numbers PPE and connect local manufacturers as a pandemic by the World required. This need led to an intensive effort with the Department of Industry taskforce Health Organization in to produce a large number of ventilators in a on manufacturing, as well as providing short period of time. guidance to local businesses wishing to March 2020 has impacted retool to produce PPE. on the Australian healthcare In what is being compared to a wartime effort, a consortium of companies has been The efforts undertaken so far represent a landscape in a number of brought together, in an unprecedented significant change in our contemporary significant and lasting ways. collaboration involving government, clinicians understanding of our domestic and manufacturers, many of whom would manufacturing capacity and demonstrate an ordinarily be competitors. untapped potential for more home-grown medtech, a potential we may never have Bringing together a diverse range of locally realised without the unprecedented threat of produced components and expertise, from hen the first Australian case of a global pandemic. printed circuit board assemblies produced by COVID-19 was diagnosed on 25 W a family-owned business in Western Sydney, Whilst we must remain vigilant and there January 2020, it set in motion a course to Melbourne-based Australian precision will likely be further outbreaks over the of events that would ultimately lead to engineering capabilities, to home-grown coming months, as of June 2020, it appears an extraordinary collaboration between advanced machine tool production, 2000 that the worst-case scenario is unlikely to government and the medical technology invasive ventilators will be made available for eventuate. However, in what has come to industry as our healthcare institutions set the Australian stockpile by the end of July. be known as the ‘Australia Model’ there are about preparing for an anticipated influx of many lessons to be learned. The Australian COVID-19 cases. Working with Pathology Technology Australia industry collaboration strategy is increasingly (PTA), MTAA and others swiftly worked to The Medical Technology Association of being recognised as one of the best provide an exhaustive audit of COVID-19- Australia (MTAA) led the development and responses globally, with the effort starting related testing platforms that were ready implementation of the framework and to be replicated around the world as the to go, including nucleic acid testing (NAT) working group structure that underpinned global leadership of multinational firms begin encompassing RNA extraction and detection a unique partnership between the to acknowledge what has been achieved systems, and lab-based serology testing. The Commonwealth departments of health and through their Australian operations. industry’s ability to collaborate on this meant industry and the medical technology industry that we were quickly able to establish that The tangible outcomes of the Australia to ensure the supply of critically important the existing accredited pathology laboratory Model of government and industry medical equipment. Four key workstreams infrastructure was sufficiently equipped to collaboration have demonstrated the sit under this structure: ventilators, personal enable the increased testing that would be role that medtech can play in pandemic protective equipment (PPE), testing kits and required. It also quickly identified a number planning and what can be achieved when other intensive-care unit (ICU) equipment. of critical components that would need to government and industry come together in a Through this collaboration, the medtech be sourced immediately in order to fulfil the genuinely cooperative effort. As an industry, industry successfully secured this essential increased demand, many of which were able we look forward to what we can continue medical equipment, not only through the to be sourced locally. to achieve together in order to strengthen global supply chain but through a number of not only Australia’s preparedness for future The PPE workstream stepped up quickly innovative local partnerships that were able pandemics, but our healthcare system as a to address what would become a critical to ramp up Australian manufacturing in a whole. area of need, working with the state health remarkably short period of time. departments to establish their projected Reference A study published in the Medical Journal requirements for critical PPE supplies, of Australia1 in March 2020 found that, in including masks, gowns, eye protection, 1. https://www.mja.com.au/system/files/ a maximal surge scenario, the number of gloves and hand sanitiser. The group issues/212_10/mja250596.pdf.

20 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au What’s the new normal in health care? Changes post-COVID-19 and beyond

Visit www.sas.com/au/new-normal-in-healthcare to learn more case Factory operations had to be completely changed but study Malmet achieved higher efficiencies than ever before.

Mobilising local medical manufacturing in a pandemic

An Aussie-made medical manufacturer is using technology to get gold-standard infection control equipment in the hands of health workers during the COVID-19 crisis.

s coronavirus shockwaves reverberated the hospital floor, and everywhere in between. Being an Australian-made medical Athrough the Australian health sector in Moving quickly enabled Malmet to connect manufacturer meant that Malmet was uniquely March this year, healthcare providers quickly with clients in new and diverse ways. positioned to draw together and expand on enacted management plans that would allow its network of other Australian manufacturers Firstly, Malmet harnessed digital traffic via care of infected patients in isolation. and medical equipment suppliers in the face targeted online advertising, which resulted in of new demands. Online networking via social increased visibility to health providers looking This meant that demand for medical media platforms quickly expanded influence to source and secure much-needed washer equipment such as blanket warmers and in this area. washer disinfectors effectively doubled as disinfectors, warming cabinets and medical new wards and clinics were set up to care for supplies. Traffic through Malmet’s website “Health providers were sourcing additional affected patients, with equipment that could increased by over 260% within two months, supplies such as hand sanitiser — so if certain remain quarantined with patients to prevent which meant Malmet was able to effectively products weren’t on our production scope, we cross-infection. Attention quickly turned connect with facilities needing to upgrade or could use our network and assist hospitals more toward securing medical supplies and local add to their dirty utility equipment inventory. efficiently,” Kirkup said. medical manufacturers, such as Malmet, faced “This led to an unprecedented demand, It’s difficult for Malmet to quantify the gains unprecedented demands. all whilst having to dramatically change from its digital strategy in the midst of the “At the same time, Malmet’s traditional methods factory operations due to social distancing pandemic, but the team is in agreement about of supporting clients to access infection- requirements. Our customer relationship the results in terms of communication and control equipment and servicing were cut off management (CRM) software allowed us to efficiency on the ground. manage the inefficiencies to a point where we overnight,” said Paul Haddad, Malmet NSW/ACT “Overall, our efficiency is greater, our network Business Development Manager. could have a turnaround time of days rather than weeks, when and where required,” Malmet is expanding, we are connecting with clients “So much of what we do to connect with clients CEO Peter Kirkup said. through a range of digital platforms, and our is built around face-to-face contact to ensure long-term projects are to schedule,” Kirkup said. a high level of support. But social distancing “Then there were those facilities undertaking planned upgrades and capital works projects,” “Adapting our approach and leveraging existing forced us to cancel site visits, tradeshows and technology in new ways has meant we can conferences. And suddenly we had to achieve Haddad said, “which is where the importance of videoconferencing came in. Hospitals and remain on course. Although we’re looking more than ever, without our usual ways of forward to connecting in person again, we’ll do connecting with clients and supporting them.” aged-care providers were relying on us to keep projects on time, and we managed to get some whatever’s needed to continue playing our part The solution was found in leveraging multiple major projects across the line with minimal in keeping frontline workers and patients safe.” existing technology streams as part of a disruptions to schedule — engineering infection Malmet coordinated strategy from the factory floor to control from the living room!” www.malmet.com.au

22 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au case study Juiced TV uiced TV — the TV show made by kids in J hospital for kids in hospital — has been operating at Queensland Children’s Hospital Coming to for five years, bringing fun, laughter and interactive entertainment to young hospital guests and their families. you live from The initiative — made possible with the support of Juiced TV’s Founding Partner Queensland Children’s Hospital Foundation, Major Partner QSuper, as well as the support of Children’s Children’s Health Queensland — aims to reduce the isolation felt by kids in hospital and help to normalise the hospital environment. Hospital As an in-hospital service, the initiative allows the kids to take the reins and get involved with anchoring programs, interviewing special guests, taking part in workshops and helping explain parts of the hospital experience to their peers who watch from Sysoev ©stock.adobe.com/au/Alexei their bedside entertainment system. The pandemic problem bringing laughter, energy and smiles back admitted and the broader hospital With COVID-19 came precautions and into hospital wards, while still ensuring the community to join the experience. Patients restrictions that put Juiced TV’s operations health and safety of patients and healthcare can watch the live episodes, have their and impact on hold. Social distancing and workers. say about program content and film their visitor restrictions meant that the crew could own questions or messages for the special “We’ve created a customised live streaming no longer film on-site, with kids unable to guests, to be included in the broadcast. platform that allows us to connect multiple participate in the hands-on experiences patients with a special guest from anywhere “These unprecedented times have called for provided by the initiative. in the world, while being able to include our a shake-up of our regular Juiced TV program With an unquestionable need to prioritise graphics, music and pre-produced content and we’re really excited to be able to safety, the Juiced TV team turned to to ensure the production quality of each introduce a virtual solution to reignite some technology — to allow the interaction and episode is on par with our usual program,” fun into the hospital journey for the kids,” connection between the kids to continue, Forbes said. Forbes said. virtually — by launching Juiced TV Live. The live show is hosted by patients in real “Kids in hospital already feel a bit isolated Juiced TV Founder and Managing Director time and broadcast through Facebook, because they’re not at home with their Pip Forbes said going virtual was key to which allows patients who are not currently family and friends, but the COVID-19 social restrictions have meant face-to-face visits have had to be limited, making a hospital stay even more lonely. Through Juiced TV Live, we want to change that.” The program is co-streamed across the bedside patient entertainment systems within the Queensland Children’s Hospital, with the team hoping to expand and connect the hospital community across Australia. The first episode of Juiced TV Live was hosted by Katie from the Queensland Children’s Hospital, with a surprise virtual visit from one of Australia’s most notable actresses turned Hollywood superstar, Margot Robbie. To date, 50 patients have participated in the virtual visits, which have featured other high-profile guests like Chris Hemsworth and Dean Lewis. The episodes are continuing to be streamed by more and more users each week, reaching a total of over 30,000 views A virtual visit from Chris Hemsworth has been a highlight on Juiced TV Live. since the first live stream.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 23 SPONSORED CONTENT

Wound care delivered by telehealth

Megan Jordan, Clinical Nurse Specialist Wound Management

chronic leg ulcer and repeated treatment fading. She was becoming despondent that particularly painful. Initially the donor site A failures left Jan feeling despondent and her wound would ever heal and her level of wound was healing well with paraff in mesh sceptical that the wound would ever heal… confidence in new products was dwindling, gauze dressing; however, three weeks into as well as her willingness to allow yet another Jan’s care, the donor site wound broke down. After three months in hospital and a third clinician to make a wound-care plan. attempt at a split skin graft (SSG) to her Treatment plan chronic right leg ulcer, 70-year-old Jan After identifying that the third SSG was was transferred to her regional Victorian nonviable, Jan was referred to the Local An open discussion was held with Jan to town hospital for ongoing wound care Health District Wound Management Clinical identify her goals. Jan was hopeful that her and rehabilitation. She lived alone and was Nurse Specialist (CNS). Due to geographical wound would heal despite her comorbidities supported with her activities of daily living by distance and COVID 19 travel restrictions, and previous failed SSGs. An emphasis community nursing care. face-to-face reviews were not possible so was placed on appropriate wound hygiene, weekly telehealth reviews were conducted. deterrence of bioburden and exudate With a long history of wound care, Jan and the reduction. The nursing team providing the community nursing team identified that “every Wound characteristics wound care worked closely and diligently dressing type” had been used to try and heal On first referral to the Wound Management with the CNS and escalated any concerns. her wounds. Jan’s medical history included CNS the wound bed was 70% slough, 30% The Wound Management CNS provided atrial fibrillation, cardiac arrest, chronic kidney granulation, with maceration to the wound videoconference education to the nursing disease, defibrillator, hypothyroidism and edges and peri wound. A large amount of staff on each dressing product and wound lymphoedema. serous exudate and hyperkeratosis to the peri hygiene. wound and surrounding skin was evident and The ulcer was a long-standing wound of Wound hygiene was addressed with thorough the edges were nonadvancing. approximately 12 years with two previous wound-bed cleansing with a polyhexanide failed SSGs — unfortunately the third SSG Jan’s pain was 5/10 using a numerical-rated (PHMB) solution, mechanical debridement also failed. Jan’s hope for wound healing was pain scale and dressing changes were of non-viable tissue from the wound bed

24 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au CASE STUDY ©stock.adobe.com/au/Africa Studio ©stock.adobe.com/au/Africa

By the next dressing change the wound had improved, with several islands of epithelial tissue, reduced maceration and a boost to Jan’s confidence in both the product, the CNS and nursing staff , and a glimmer of hope for wound healing. With Jan’s new-found healing and reduced pain came improved compliance with “Despite many elevating her legs and wearing her prescribed stockings. The Zorflex continued to be changed years of failed every four to five days and the Impervia Neosorb changed every one to two days. wound healing, Three weeks into the wound-care plan the donor site deteriorated, with a 4 x 4 cm serous reduced hope and filled blister developing at the proximal area of the donor site. This blister self-deroofed leaving trust in wound an open wound that was painful and worrying for Jan. Initially a hydrocolloid dressing was used care, Jan’s wounds over the donor site wound breakdown; however, this was soon changed to Zorflex and Impervia showed signifi cant Neosorb as the level of exudate was too great. The frequency of change for the donor site healing with a wound dressings was also every four to five days. Zorflex was used on the donor site to comprehensive promote epithelial migration. and consistent Outcomes Weekly progress reviews saw increases in plan.” epithelial tissue over the wound bed at each dressing change. After six weeks, the level of exudate had reduced significantly, maceration had resolved, epithelial tissue covered approximately 50% of the wound bed and Jan finally saw some light at the end of the tunnel. and hyperkeratotic skin from the peri wound reduced by staff encouraging Jan to elevate Jan’s donor site wound also progressed well, and surrounding skin. The skin integrity was her legs and by cutting the Zorflex to the size with 100% of the site epithelised within three supported with regular skin cleansing and of the wound bed without any overlapping weeks of using Zorflex and Impervia Neosorb. moisturising. onto the peri wound area. Once exudate levels reduced at the donor site the Impervia Neosorb was stepped down to The chronic wound bioburden and non- The Zorflex was initially left in situ for three Osmocel® Hydroporous Foam. advancing wound edges were managed with days, with the Impervia Neosorb changed a topical antimicrobial primary dressing. The daily. The level of exudate was managed One week prior to Jan’s discharge, a telehealth exudate level was controlled with appropriate well with the Impervia Neosorb and did not meeting was held to agree upon the ongoing super-absorbent secondary dressings require daily changes; however, Jan found wound-care plan. and reduced by Jan performing lower-leg comfort in having it changed daily and Despite many years of failed wound healing, exercises, elevating her legs throughout the was able to closely monitor her leg for any reduced hope and trust in wound care, Jan’s day and wearing lymphoedema compression deterioration. wounds showed significant healing with a stockings. She had previously ceased wearing When nursing staff attempted to remove comprehensive and consistent plan. The her stockings due to poorly controlled the Zorflex after three days, they found it person-centred team approach also gave exudate leaking through and increased pain was adhered to the wound bed. The patient the opportunity for Jan to be an active part to the wound area. become concerned about this and lost of her wound care and the team were able Zorflex®, an antimicrobial, conductive confidence in the product and wound-care to develop their knowledge and skill set. The and odour adsorbing primary dressing, plan. Reassurance was given to the patient combination of products, nursing care and was used and to assist in transepithelial and the nursing staff , and it was agreed Jan’s active participation in improving venous potential. Impervia® Neosorb was used as the to extend the frequency of changing the return through leg elevation, exercises and secondary dressing to manage the exudate Zorflex to every four to five days, with the compliance to wearing her lymphedema levels and reduce maceration. Initially the Zorflex soaked in saline for 15 minutes prior to compression stockings finally turned healing in maceration continued; however, this was removal to allow it to be lifted away with ease. a positive direction.

For more information www.sentrymedical.com.au

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 25 CLINICAL SERVICES

Frontiers in orthopaedic surgery — a discussion with Dr John O’Donnell Orthopaedic surgeon Dr John O’Donnell is one of the earliest developers of arthroscopic FAI (femoroacetabular impingement) surgery, recently performing his 10,000th hip arthroscopy procedure — a reported world first for any surgeon performing this procedure.

Dr O’Donnell, how did your 10,000th For example, if we were to use more invasive How important is technology in hip arthroscopy compare with the open surgery we would need large incisions improving surgical procedures and (with associated large scars) and would need to first? cut muscles and dislocate the hip. This would outcomes for patients? When I performed my first hip arthroscopy significantly increase the risks of surgery and Technology is critical in improving in 1992, we only had knee arthroscopy prolong recovery time. outcomes for patients. The surgery we instruments, which were quite limited, and perform today would not be possible relatively rudimentary knowledge of the Can you tell us about the patient that without the improved materials, arthroscopic anatomy of the hip. Now we represented your 10,000th procedure, instrumentation and diagnostic imaging have sophisticated instruments that allow us Catherine Norris? that new technologies have delivered. to perform far more complex procedures. Catherine is an active lady who works as a Improved CT and MRI scanning has We also have a greater understanding of social worker in NSW. Over time her activities allowed us to ‘virtually see’ the side of the the damage and problems that can be were severely limited by pain in her hip and hip and determine likely causes of hip pain. identified within the hip and how we can groin so she had to largely stop exercising. She This allows more accurate diagnosis and repair much of that damage. Understanding had been prescribed conservative treatments potential non-surgical treatments in many why these problems occur means we can — painkillers, anti-inflammatories and cases. address underlying issues to minimise the physiotherapy — but these had not provided risk of symptoms recurring in the future. The long-term relief. Greatly improved optics in arthroscopes surgery is far more complex than the simple and digital imaging have allowed us to see debridement operations we used to do. Catherine was very keen to get relief from her with far greater clarity within the hip and pain and regain her previous level of activity, as to perform far more complex arthroscopic How does the AMIS procedure she aims to walk the Camino del Santiago trail surgery. in Spain. compare with the procedures you How do you see orthopaedic performed earlier in your career? She came to Melbourne, believing that surgery provided the best possibility of pain relief and procedures changing in the future? AMIS is a method of performing anterior the chance to realise her goals. approach total hip replacement. The main No doubt orthopaedic procedures will change in ways we won’t be able difference between it and most other What impact does the AMIS methods of performing hip replacement is to predict. It is likely that truly robotic that it avoids cutting muscles and minimises procedure have on patients’ lifestyles procedures will be developed, especially the risks of cutting major nerves, so I find post surgery? for joint replacement surgery. the patients recover significantly more It is important not to confuse AMIS — a method It is also likely that some of the image- quickly than those where I used different for performing hip replacement — with hip guidance systems used in joint approaches. arthroscopy, which is a method that uses replacement now will be adapted to telescopes and very fine instruments inserted improve the accuracy of arthroscopic What are the advantages of through very small incisions for identifying procedures. minimally invasive surgery compared pathology within the hip and repairing it. Both with procedures used in the past? have the potential to relieve pain and restore Virtual reality will allow better teaching function. In many patients, hip arthroscopy can of techniques than the current, relatively ‘Minimally invasive surgery’ is a rather broad restore a normally functioning hip and allow a crude machines, so surgeons will be better description. It may be used to describe return to all (even elite-level) activity. trained before operating on patients than arthroscopic (or keyhole) surgery, or it may they currently are. be used to describe open surgery performed Hip replacement is used for more severely through smaller incisions. Arthroscopic damaged, arthritic hips that are beyond repair. It And we are all looking forward to surgery has the great advantage of is a very reliable way to relieve pain and greatly better biological, and perhaps genetic, minimising damage to unaffected tissues. improve function. treatments to restore damaged joints.

26 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au your ICU Medical account manager or call 1300 428 652.

ICU Medical Inc. 1300 428 652 SPONSOREDxxxxxxxxxxxxxxxxx CONTENT

Have you been introduced to the unique MicroPurity™ technology of the Zip HydroTap®? Only Zip HydroTap technology transforms water at the touch of a button into a form you’ll instantly love.

id you know that water pipes, in many cases, can guidelines stipulate that drinking water should not Dbe up to or more than 70 years old? So, it is no contain any more than that. surprise that researchers from Macquarie University For decades, Zip Water has been perfecting its have detected traces of copper and lead contaminants MicroPurity water filtration technology to bring you in domestic water samples from kitchen taps across delicious, crystal clear, pure-tasting water at the touch New South Wales. of a button. The groundbreaking 0.2-micron filtration Many consumers don’t understand the importance of system reduces contaminants as little as 1/5000th of a water filtration in their homes and off ice spaces. It is millimetre, ensuring that the water delivered from Zip therefore up to professionals in the industry to educate Water appliances is as delicious as it is healthy. consumers about the risks associated with prolonged By expertly reducing sediment and volatile organic consumption of these contaminants and the long- compounds, lead and parasitic micro-organisms term eff ects they have on brain development and liver — such as cryptosporidium and giardia, which are function. greater than 0.2 microns — Zip Water helps safeguard ‘My results show that there is quite a significant your customers and their families. concentration of lead and copper in the drinking water As a longstanding leading Australian manufacturer, Zip that is coming out of people’s kitchen taps into their Water prides itself on innovation and commitment to morning cup of tea,’ says lead author of the study, PhD national and international standards. researcher Paul Harvey1. All of its filtration products meet strict performance The team tested 212 ‘first drawn’ samples from kitchen guidelines, and are independently tested by National taps that were taken after the water had been sitting Sanitation Foundation (NSF) International and in a tap for a nine-hour stagnation period — similar to approved under the Watermark Certification Scheme. what happens when you run the tap in the morning to make your morning cuppa. All samples contained By selecting genuine Zip Water MicroPurity filtration, copper, while lead was present in 56% of the dwellings you can be sure that you will be offering your tested. customers peace of mind with a product that will perform, and the assurance that you are installing Notably, 8% of the lead samples contained higher an approved water filter that meets the highest of than 10 micrograms of lead per litre, where Australian standards. Zip MicroPurity Filter

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28 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Design in Health

Lab design fit for phenome researchers

The Australian National Phenome Centre (ANPC) — designed by Hames Sharley — is located within the research and education precinct of Perth’s Fiona Stanley Hospital (FSH). Hames Sharley designed the Harry Perkins Institute of Medical Research at FSH, which was completed in 2013, and was invited to return to the building to reimagine an existing laboratory — to be operated by Murdoch University.

eported to be the only one of its kind Rin Australia, the centre will provide a state-of-the-art facility for researchers to analyse the molecular, physical and biochemical characteristics of biological tissue and fluids, with the aim of predicting the genetic, environmental and lifestyle interactions causing disease. It is hoped that the research will also allow the development of personalised treatments. Hames Sharley’s design for this specialist research laboratory occupies 1400 m2 of PC2 laboratory space, office space and data visualisation facilities, and can accommodate up to 60 researchers. The laboratory is said to house the largest collection of mass spectrometers in the Southern Hemisphere, combined with several nuclear magnetic

Images: Douglas Mark Black

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 29 Design in Health

travel routes for the instruments — some of which weigh up to two tonnes — was a key consideration. “We liaised closely with the manufacturers of the instruments, together with our builders and engineers, to plan transportation of equipment and, upon arrival, to ensure our configuration evenly distributed weight across the floor plate,” Edwards said. The new design also incorporates a long corridor that serves as a viewing gallery from which visitors can safely observe researchers at work. Given the significant interest and profile of the research being undertaken at the ANPC, this visibility is another welcome feature of the thoughtful design. ANPC Senior Operations Manager Sze How Bong summarised the response to Hames “Researchers Sharley’s design as overwhelmingly positive. “The facility’s functionality and architectural are relishing the integrity have surpassed our expectations,” he said. resonance spectroscopy instruments and opportunity to “We’re exceedingly grateful for Hames advanced data modelling equipment. Sharley’s well-considered approach, which converse in their has resulted in an outstanding laboratory Deployed to analyse samples, these that continues to impress our team and our instruments emit a significant amount of heat workplace without aligned networks of researchers, both locally and noise that often precludes researchers and internationally.” from prolonged laboratory access due to the shouting — a rare uncomfortable conditions. Hames Sharley Director James Edwards said occurrence in this the design team rose to the challenge by prototyping a laboratory furniture system type of research for on-site testing with actual instruments, which allowed modifications and important facility.” refinements. “The final design comprises moveable benches, upon which the large and heavy instruments are located,” he explained. A central fixed spine of bespoke cabinetry houses electrical and gas distribution services and allows easy connection to the instruments. Additionally, the spine contains an exhaust system that extracts hot air from the instruments before it enters the lab. Traditionally, the loud pumps associated with these instruments are positioned on the laboratory floor. “To insulate the noise, the central spine of the cabinetry incorporates acoustic enclosures for the pumps — essentially forming a barrier between the noise and the researchers,” Edwards said. The result? Researchers are relishing the opportunity to converse in their workplace without shouting — a rare occurrence in this type of research facility. Another welcome outcome of the design is the reduction in energy consumption thanks to the extraction of hot air at its source, which minimises the need for air conditioning. Likewise, waste reduction was top of mind as Edwards and his team redeployed some of the existing lab’s glass splashbacks to be incorporated into a new dividing wall. Because the laboratory sits within an existing building, the team had to be mindful of minimising disruption to nearby offices and other neighbouring facilities. Planning

30 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

Leadership

information quickly. Health information systems

Kim Photography Selby and software should be designed to facilitate curation of information to provide healthcare workers with information relevant to their role. It is hoped that, moving forward, machine learning can be employed to filter large volumes of data to grow the knowledge base to help nurses and midwives carry out their work. Less time spent on chasing patient information means more time to plan care with patients. Nurses and midwives spend 40% of their time documenting. Documenting patient information and procedures undertaken acts as a record of care, but Kate explained that the design of e-systems should also enable nurses to work dynamically, including forecasting goals for the patient such as expectations of care. Electronic documentation incorporated into a connected information system needs to engineer out duplication and allow a flow of accessible, searchable information across transitions of care. Training considerations Kate said that when designing digital training programs for nurses and midwives it is important not to wassume familiarity with digital interfaces. “While some may find systems intuitive, others may not, but it is important to provide the required training to ensure that everyone has the ability and support to adapt to this new way of working. “For some nurses and midwives in clinical Digitisation roles, the digital aspects of the job may be confronting — clinical strengths and in the Year of the Nurse expertise don’t necessarily translate to digital Jane Allman competency, so a respectful, supportive approach will be needed to bridge skill gaps,” she said. Kate Renzenbrink, Chief Nursing and Midwifery Information Training nurses in the use of digital tools will Officer at Bendigo Health, is encouraging nurses and midwives need to go beyond the orientation session — peer-to-peer elbow support is needed as well to lead the digital transition and use informatics to improve as on-demand availability of a whole range of patient care. learning tools, which meet the needs of busy nurses and midwives 24/7.

igitisation of Australian health care is “Electronic patient records are one such tool Another important consideration that Kate Dtransforming how patients are navigated to overcome barriers presented by multiple highlighted is disaster recovery and what through the system and is changing the systems and sources of information.” happens in the event of a system outage. working lives of doctors, nurses, midwives and Ironically, in these situations newer nurses may With the explosion of health technologies and allied health professionals. not have experience of documenting on paper, information platforms that are available, it’s so knowledge of older, more static systems will Kate Renzenbrink is currently working at an exciting time for the nursing profession to still be needed. Bendigo Health to support the implementation shape how the digital environment is built, to of the electronic patient record and to ensure get the best outcomes for patients in their care. Nursing informatics leaders the nursing and midwifery workforce has the Kate underscored the importance of health informatics skills to meet the challenges Overcoming fragmentation developing the next generation of digitally of contemporary practice. Kate explained that the aim of electronic competent nurses and midwives. system design is to mitigate fragmentation She spoke to Hospital + Healthcare about the in systems and information flows. Hospitals “Digital health needs to be incorporated into all exciting space of health informatics and digital operate multiple systems, but continuity of care subjects of undergraduate and postgraduate health. is needed. This can be achieved by connecting courses. Nurse informatics, however, is an emerging nursing speciality, revolving around “Patient care and safety is a critical part of the information to the patient. In this patient- the core components of gathering and sharing role of nurses and midwives. Digital health centred approach, a patient’s health information patient data,” she explained. is about collecting, accessing and sharing goes with them in the form of the EMR. patient information and overcoming barriers “It’s an integral part of contemporary practice to continuity of care. What we’re aiming for is a Curation: a solution to and there are huge opportunities for nurses to flow of information through the health system information overload lead the way in digital health. We need nurses that stays secure and private but supports the Confronted with an abundance of information, and midwives who are happy speaking health IT best possible care. nurses need to be able to access relevant and clinical languages.”

32 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

RURAL MEDICINE Rural GP training in the Burdekin Images courtesy of JCU

Burdekin-based doctor Michael McLaughlin was a medical student at James Cook University (JCU) when he discovered a love of working in rural and remote communities.

rowing up in Central Queensland, but I also found big-city hospitals weren’t “Or you might do a skin check on someone G Dr McLaughlin had always been the most supportive; they could be a bit and take them through their melanoma attached to the regions, but it was his rural overwhelming. journey. You’re then doing their skin checks placements in Cooktown, Innisfail and on three to six months after you have cleared Thursday Island that cemented his plan to “I found working in the smaller hospitals them of cancer. It’s that continuation where specialise as a rural generalist. friendlier and they gave me broader you get to see them as the whole person. experiences.” “These experiences were all really positive “When I worked in tertiary hospitals you might and made me commit to the rural generalist Having completed his training as a rural GP, see someone for a moment, or you might pathway. They really made me want to pursue a Dr McLaughlin has nothing but praise for see them in that acute admission, but you career in rural medicine.” the pathway he chose and JCU’s GP Training never see them again — you never know what Program. happens to them.” During his intern and residency years at the Cairns Hospital, Dr McLaughlin also discovered “The last two years finishing my training in the Even if a doctor doesn’t plan to settle in the a love of general surgery, which he was able Burdekin at Ayr Hospital and working in the regions long term, Dr McLaughlin believes rural to incorporate as an advanced skill in his community of GPs has been brilliant. I’ve had and remote training is highly beneficial. specialist training. broad experience both procedurally as well as in general and emergency medicine, and “It makes you a better doctor. You are very “When I was in medical school and a junior ward-based work. aware of those accidents and mistakes you doctor I really enjoyed procedural medicine, make — you can’t hide from them. You have to “JCU has embedded its culture and mission learn from them because they are facing you to develop rural medicine and rural health at the shops or the markets or the local club, services and produces a lot of rural so you can’t run away.” generalist trainees. As for the lifestyle for doctors in the regions, “At Ayr Hospital all the doctors but one Dr McLaughlin says it’s second to none. graduated from JCU, and all of them have trained up here, with a few stints in other “I did my advanced skill in Brisbane and I places.” probably wasted about an hour and a half on the commute each day. Here I live across the The scope of practice and continuity of care road from the hospital so I’ve got a lot of extra Dr McLaughlin can offer his patients as a rural time. I’ve got into gardening and I now grow GP has been a major drawcard. my own fruit and vegetables. “There are lots of little moments when you get “The beach is only 15 minutes away so you to follow patients. Where you may have started can take the dog down and throw the frisbee their antenatal care, assist in their caesarean around and there are a lot of opportunities to and see them through postnatal. go fishing and hiking as well. It’s great.”

34 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSORED CONTENT ©stock.adobe.com/au/pathdoc

Cognitive overload, medical errors and clinical communication strategy Chief Nursing Offi cer Rhonda Collins examines strategies to simplify communication and oﬄ oad clinicians’ burden of retrieving, retaining and recording information.

ach year, in Australia, medical errors result in as many as 18,000 3. Germane cognitive load is the eff ort expended to make sense of new Eunnecessary deaths, and more than 50,000 people become disabled information. If you receive a lab value with no context and have to each year.1 Communication problems and cognitive overload have retrieve past values and other information to understand the complete been associated with medical errors, which hospitals can address with a picture, your germane cognitive load is heavy. communication strategy that helps reduce the cognitive load of healthcare workers. What problems need solving to help reduce cognitive load and overload? What is the connection between cognitive Clinicians often have to solve complex problems without full context, overload and medical errors? or have to split attention between multiple sources of information and Hospital-based health workers are constantly segmenting what is pay attention to too many things concurrently. Clinicians also struggle important and urgent. When you receive too many pieces of information to communicate with each other, hindered by barriers such as multiple at once, you become overloaded and have diff iculty segmenting. This can standards, conflicting protocols and disparate communication tools. This is lead to mistakes. You are also constantly splitting your attention among a drain on working memory. multiple sources. This can lead to cognitive overload and may leave you The pervasive need for redundant documentation is another problem. unable to focus on a critical patient care task. When you have to write the same information three or four times in three How do you explain cognitive load in the clinical or four diff erent places — while also juggling information for four to six environment? diff erent patients — you’re likely to make a mistake. A clinician responsible for several patients encounters a constant influx of Nuisance notifications pose another challenge — perhaps a nurse doesn’t information that must be cognitively processed — an ongoing act of sense- need to receive a patient’s vital signs every ten minutes if a patient is stable. making and learning. Learning theory identifies three types of cognitive load: How can hospitals solve these challenges? A hospital using a single clinical communication and collaboration (CC&C) 1. Intrinsic cognitive load is the cognitive eff ort expended to complete a platform can address cognitive overload. Hospitals need to off load problem or task. For clinicians, intrinsic load is aff ected by stress factors clinicians’ need to retrieve, retain and record information, and make it easier that diminish working memory and can be compounded by larger, to communicate. A comprehensive CC&C platform, such as Vocera®, can deeper emotions such as shame, guilt or grief. make all the diff erence.

2. Extrinsic cognitive load is the cognitive eff ort the environment demands. Reference If you’re bombarded with information and you can’t control how it’s 1. Saul N Weingart, Ross McL Wilson, Robert W Gibberd, Bernadette Harrison. Epidemiology of coming at you, you can have a heavy extrinsic load. medical error. BMJ; 320: 774–7.

» For more information visit https://www.vocera.com/au/cno-perspective-2020

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 35 SPONSORED CONTENT

The importance of surface cleaning

healthcare associated infection can dramatically improve the frequency and include digital and printable resources to A (HAI) is an infection occurring in a quality of decontamination12,13. Improved help you run a similar initiative within your patient during the process of care in a environmental hygiene can reduce the organisation. We also have a limited number hospital or other health care facility which number of people acquiring harmful of Clinell Bells available. If you need any extra was not present or incubating at the time microorganisms14. support or materials, please contact your of admission1. HAIs can be classed as a GAMA Healthcare Sales Manager or email In response to the current pandemic, potentially preventable adverse event [email protected]. healthcare facilities have introduced rather than an unpredictable complication initiatives to raise awareness of the need and it is possible to significantly reduce to decontaminate surfaces regularly. It’s the rate of HAIs through eff ective infection challenging to keep environmental hygiene References: prevention and control2. Each year, there are top-of-mind when there are so many other 1. WHO. Clean Care is Safer Care 2020. approximately 165,000 HAIs reported within commitments competing for time. That’s 2. NHMRC 2019 :10. Australian acute healthcare facilities3. This where these initiatives come in. Emergency 3. Mitchell et al. doi: 10.1016/j.idh.2017.07.001. makes HAIs the most common complication staff from one UK hospital began making aff ecting patients within the hospital setting. 4. Mitchell et al. J Hosp Infect.2015:91:211-217. hourly announcements of ‘Clinell time’. Once 5. Otter et al. J Hosp Infect. 2016;92(3):235-250. Pathogens can persist in the environment an hour, the staff decontaminate their working 6. Otter et al Infect Control Hosp Epidemiol. 2011;32(7):687- 4 for days, weeks and months posing areas. At the same time, other hospitals have 699. an ongoing risk for transmission and started their ‘when you hear the bell, it’s time 7. Weber et al. Curr Opin Infect Dis. 2013;26(4):338-344. acquisition. Contaminated surfaces are an for Clinell’ campaign, with the shared goal of 8. Ikonen et al. BMC Infect Dis. 2018;18(1):1-7. important route for viruses with pandemic getting all the staff involved in environmental 9. Holbrook et al. New Eng J Med. doi:10.1056/NEJMc1210001 potential5. We know that touchable hygiene, making surfaces safer and protecting surfaces in our environment can harbour patients from HAIs. 10. Alfaraj et al. Am J Infect Control. 2018;46(2):165-168. harmful microorganisms6 including drug- 11. Memish et al. Am J Infect Control. 2014;42(12):1266-1269. resistant organisms7, cold & flu viruses8 and Running your own initiatives 12. Reese et al. Infect Control Hosp Epidemiol. 2019;40(7):798- coronaviruses9-11. It’s more important than GAMA Healthcare Australia would like to 800. ever to clean and disinfect the right way. support similar initiatives in your facility. We 13. Zimmerman et al. J Infect Prev. 2018;19(6):294-299. Well executed educational interventions have “Clinell Time” packs available which 14. Garvey et al. Antimicrob Resist Infect Control. 2018;7(1).

» For more information visit www.gamahealthcare.com.au

36 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Infection control

Reshaping risk with COVID-19

Dr Jan Gralton and Professor Anne Duggan, Australian Commission on Safety and Quality in Health Care

he rapid increase in coronavirus cases Australia’s relatively successful response T across the globe has sharpened the to COVID-19 since the outbreak began has healthcare sector’s focus on risk assessment highlighted the value of readily available and mitigation, with constructive outcomes information to enable health service in Australia. organisations to respond quickly and effectively. It is clear a risk-management A silver lining from the first wave of severe approach is critical to minimise transmission acute respiratory syndrome coronavirus of the infection. 2 (SARS-CoV-2), which causes COVID-19 disease, has been the demonstration of our health service organisations’ preparedness Framework for the future to respond. The National Safety and Quality Health Service (NSQHS) Standards provide a robust Since January, guidance for safe and high- foundation for continuing to provide high- quality health care during the pandemic quality care and addressing risks to patient has been rapidly developed by a range safety. of organisations, including the Australian Commission on Safety and Quality in Health The NSQHS Clinical Governance Standard1 Care (the Commission). This evidence- requires health service organisations to identify based advice spans clinical management, and document organisational risks; use data health service planning and operation, and to support risk assessments; act to reduce infection prevention and control. risks; regularly review and act to improve the

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 37 Infection control

Table 1: Risk matrix for likelihood of exposure to COVID-19

Patient with no Patient with Patient with Patient with exposure to known exposure to Patient with exposure to known exposure to known COVID-19 case or suspected COVID-19 COVID-19 contact COVID-19 case contact COVID-19 case

Indirect patient contact (e.g. LOW LOW LOW MODERATE MODERATE cleaner, food services, admin)

Direct patient contact – LOW LOW LOW MODERATE HIGH procedure, no AGP

Direct patient contact – LOW LOW MODERATE HIGH VERY HIGH procedure, AGP or dental

effectiveness of their risk management system; Ongoing vigilance in managing infection for COVID-19, and training and education and plan for and manage internal and external risks in healthcare settings will remain requirements. emergencies and disasters. critical. This includes comprehensively • Business continuity. reviewing and updating policies and Complementing this, the NSQHS Preventing procedures such as: Protecting patients, healthcare workers and Controlling Healthcare-Associated and the whole community from harm Infection Standard1 provides the framework • Screening of patients, visitors and staff for is paramount. Undertaking strong for identifying, assessing and mitigating signs and symptoms of COVID-19 infection, management and mitigation of infection infection risks related to COVID-19. and managing their access to health risks will ensure the safety and quality of care service facilities. This risk-assessment approach can be is maintained during the COVID-19 pandemic applied at an individual service level or • Management of healthcare workers with and help avert a potential second wave organisational level and, ideally, is integrated acute respiratory illness and requiring them resurgence of the disease. with routine corporate and clinical risk- not to attend work, and encouraging them management processes. Reporting on to seek medical care and COVID-19 testing, References COVID-19 risks and mitigation strategies if appropriate. 1. Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service should be incorporated into an organisation’s • Management of patients with respiratory Standards. 2nd ed. Sydney: ACSQHC; 2017. clinical governance monitoring and reporting symptoms. processes. In addition to the NSQHS 2. Australian Guidelines for the Prevention and Control of Standards, the processes described in AS/ • Staff and contractor understanding of Infection in Healthcare, Canberra: National Health and NZO ISO 31000:2019 Risk Management infection control and prevention practices Medical Research Council, 2019. Principles and Guidelines should inform development of a COVID-19 risk- management plan. Risk assessment matrix The principles for prevention and control of any infectious agent are applicable in healthcare settings responding to the risks associated with COVID-19. To promote the provision of safe health care, health service organisations should apply standard and transmission-based precautions that are consistent with the current Australian Guidelines for the Prevention and Control of Infections in Healthcare.2 For COVID-19, combined Contact and Droplet Precautions in addition to Standard Precautions are required. Where aerosol-generating procedures (AGPs) are performed, Airborne precautions are required in addition to Standard and Contact precautions. Dr Jan Gralton is the Senior Advisor Conjoint Professor Anne Duggan is Table 1 outlines how to assess the level of risk of transmission of COVID-19 based on to the Healthcare-Associated a Clinical Director at the ACSQHC. the probability of exposure to infectious Infections and Infection Prevention Professor Duggan is a highly respected material and the level of contact with that and Control program at the ACSQHC. gastroenterologist with significant material. These risks will be mitigated if She has previously worked in the operating and leadership experience in staff are fully compliant with Standard, Healthcare-Associated Infections a range of healthcare settings. She is Contact and Droplet precautions (or program at the NSW Clinical passionate about improving healthcare Standard, Contact and Airborne precautions Excellence Commission and led the services through sharing knowledge if aerosol-generating procedures are being undertaken), cough etiquette and NSW CAUTI prevention project. and collaborating across all aspects of respiratory hygiene, and physical distancing, Dr Gralton completed her PhD in 2012 the health system. Professor Duggan except when unavoidable during physical on the transmission and infection leads the development of the Australian examination and care. control of respiratory viruses and Atlas of Healthcare Variation series maintains her research interest in and the Commission’s COVID-19 Rapid Time to act these topic areas. Response Unit. With COVID-19 far from over, the adage it will be a marathon rather than a sprint rings true.

38 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSORED CONTENT

The S-Monovette® is the revolution in blood collection.

The S-Monovette is an innovative enclosed prior to blood collection. This creates a a holder. The needle is of a compact, low blood collection system that allows the user to fresh vacuum and ensures a precise fi lling profi le design, which reduces the chance of draw blood from the patient using the syringe or volume, ensuring a correct dilution ratio. haematoma by allowing for a reduced angle vacuum method, uniting the advantages of both The reduced vacuum pressure in the of puncture and eliminates the possibility of techniques in a single product. S-Monovette drastically reduces the rate needle stick injury caused by assembly of When used as a syringe, the phlebotomist of haemolysis and vein collapse, meaning the needle and holder. The compact design has full control over the speed at which the increased sample quality and reduced also results in approximately one sixth of blood is drawn into the tube. This is particularly costs associated with repeat collections. the sharps volume caused by using a pre- useful for patients with fragile veins, such as Furthermore, unlike pre-evacuated tubes, evacuated system, giving signifi cant cost the very young or elderly, where the use of the the S-Monovette does not have to hold a savings. aspiration technique prevents even the most vacuum for many months after manufacture, If you would like a visit from one of our fragile veins from collapsing. When the tube which allows the membrane stopper to Sales Representatives to demonstrate this has been fi lled, the plunger is simply snapped be thinner and more easily penetrated by system, please contact us on toll free off to leave a primary sample tube which can the needle sheath. This minimises the 1800 803 308. be centrifuged and is compatible with all major movement of the needle in the vein when analysers. attaching the tube, ensuring optimum The S-Monovette can also be used as an patient comfort. evacuated tube by drawing the plunger fully The S-Monovette needle is ready to use Sarstedt Australia down and snapping it off immediately so that there is no need for assembly to www.sarstedt.com

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 39 www.LabOnline.com.au | www.LifeScientist.com.au LAB+LIFE SCIENTIST - April/May 2014 | 1 A DAY IN THE LIFE

A Day in the Life of Royal Australian Navy officer, Lieutenant Commander Thomas Miller a Nurse Educator

Lieutenant Commander Thomas Miller is the Nurse Educator in the Royal Australian Navy. His career has seen him deployed around the world including Fiji, Papua New Guinea, East-Timor, Afghanistan and Iraq, and most recently to Operation Bushfire Assist, helping locals amidst the emergency at home. His work ensures that nursing staff are trained and supported to become expert military clinicians.

09:00 I make my way through 10:30 The rest of my morning is spent on some micro- the hospital and touch base with clinical skills with members. I explain how we do things a everyone throughout the morning, little differently in a military setting, teaching them some to ensure they are getting the most tips and tricks to apply when they are deployed. For out of their clinical duty. It’s important example, it might be a technical explanation of how to 05:30 I start each that our nursing officers have as run a specific infusion on a patient, and then putting that day with a run much experience as possible in an into a military context where the resources are different. before work. emergency setting, preparing them I use my 12 years of experience as a military nurse to for high-pressure situations. I want provide context and ensure our workforce come out to ensure that when our staff deploy, the very best that they can be. My focus is on teamwork they have the best possible clinical and building trust. In my experience, what’s been most experience to provide to the ADF and important is knowing that I have people around me the civilians we may look after. looking out for me so I can look after others. 10:30 09:00 05:30 07:00

HMAS Adelaide’s embarked senior nursing officer, Lieutenant Commander Thomas Miller, RAN, in the treatment room during 07:00 My work begins at the Royal North Operation Bushfire Assist. Shore Hospital. Our staff are trained here to ensure we advance and maintain their skills in a major trauma centre. Today I’m responsible for around 40 clinicians. They are highly qualified nurses and medics. It is my job to help enhance their professional capability and mentor them for military experience. They will have unique opportunities and exposure to areas of the Australian Defence Force (ADF), whether that is going to sea or getting an idea of tactical and operational areas of focus. It’s a lot to learn and I help ready them to be top of their game! In the emergency department, I brief my team and the hospital educators on the floor about what I expect of my members that day. They work throughout all areas of the hospital, including resuscitation, intensive care, acute care, mental health and paediatric emergency. It’s my responsibility to make sure everyone is Navy. Australian Royal Sawtell, Thomas ABIS Credit: informed and comfortable in their daily tasks.

40 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au A DAY IN THE LIFE

Embarked Nursing Officer Royal Australian Navy officer Lieutenant HMAS Adelaide, Lieutenant Thomas Miller conducts checks on the Commander Thomas Miller trauma station at the Hamid Karzai provides medical assistance International Airport military hospital in to a local from the town Kabul, Afghanistan. of Towamba, NSW, during Operation Bushfire Assist 2020. Credit: ABIS Thomas Sawtell, Royal Australian Navy. Australian Royal Sawtell, Thomas ABIS Credit: Navy Operation. Australian Royal CPL Chris Beeren, Credit:

13:00 After lunch I head back to base, HMAS Penguin. I prepare for clinical simulation training with the Maritime Operational Health Unit and other fleet-based nurses. This involves training within a controlled environment, where we can replicate medical emergencies and scenarios to best train our clinicians for real events, to maintain preparedness. We spend the afternoon replicating medical emergencies within 17:00 I head home our simulations centre, which looks like a mock-up military hospital. It’s a controlled for some R&R. environment that replicates the real environment we may go into in the future, putting theory into practice as close as possible. I’ve been in positions where my training and skills have led to actions that have relieved great distress, and I wouldn’t have had the same opportunities were I not in the ADF, so it’s really useful to be able to explain these unique types of scenarios in the Unit. 17:00 13:00 15:00 16:00 19:00

15:00 I take some calls with staff that are 16:00 I have some members that 19:00 Tonight I’m meeting placed with ambulance services. Today, some are fully qualified nursing officers, some of my team for a social are placed with helicopter retrieval teams. I’m but are upskilling in Masters dinner* in Mosman. There is no a firm believer that people need a safe mentor Programs. I spend an hour with other organisation in the world that won’t judge them and will support them them catching up, making sure that has the same mateship in making the correct decisions. It’s good for they are supported. The Navy really and support as the ADF. I’ve them to have someone to call to make sure invests in people, and I get great made some brilliant friends. they’re making the right decision, to guide and satisfaction from hearing about what *Adhering to current physical prepare them for deployment. they’re learning in their specialist distancing rules. areas. They’re exceptionally qualified I need to be able to hand over my nurse clinicians. educator role at short notice and be ready for deployment. Most recently this was on Operation Bushfire Assist, when overnight I found myself on a ship sailing to the outlying towns of southern NSW, where no-one was able to get in or out. That deployment meant a A Day in the Life is a regular column opening the door into the life of a lot to me because it was close to home. I have person working in their field of health care. If you would like to share a the ability to care for people in their day of day in your working life, please write to: [email protected]. need, possibly even on the worst day of their life, and being in the military adds another dimension to that.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 41 safety Reimagining WHS practices and management in

Australian health care ©stock.adobe.com/au/turgaygundogdu How COVID-19 is defining the rise and need to digitally transform traditional WHS practices

Alastair Brooke, Founder/Director, Safety Evolved

he COVID-19 pandemic and responses regulations, it’s important to understand that 1. A commitment to evolving safety practice Trequired to mitigate its impacts have WHS risk in this environment is shared by with a message that starts and ends with the transformed the operations of almost all employees and employers. While employers Board. industries. As traditional operations have rapidly have an obligation under law to ensure they 2. Fit-for-purpose software covering the value changed, it has shone the spotlight on how comply with regulations, the consequences chain of WHS — designed to be changed by organisations maintain a safe work environment of breaching these obligations can be business users, not software developers. and manage compliance with changing catastrophic for an organisation — as we’ve regulations. seen in the media. 3. Effective system integration to connect WHS systems to core business systems. The hospital and healthcare sectors are at the While robust policies and practices are essential forefront of navigating this challenge, and sadly, to delivering against that goal, they are but the 4. Real-time reporting to allow for speedy, it is frontline healthcare workers who have the tip of the iceberg. Careless or deficient safety informed, proactive and targeted decision- greatest exposure risk. But beyond this, there practices are indefensible and where incidents making. are further risks in our heightened state of occur, the onus is on the organisation to provide operations that may impact workplace health evidence that an effective WHS policy is in 5. Change management to shift thinking and and safety, like fatigue and anxiety. place and operating as planned. culture (from reactive to proactive). At the same time, we are in the midst of a In a changing environment, if this is a 6. An engaged workforce that is consulted, digital transformation in hospitals and health manual process, this is a huge task. Leading supported and enabled to collaborate on care from the way in which we manage patient organisations are leveraging digital systems to evolving practice. information and records, to how care and manage this requirement, as well as providing 7. Expert advice in WHS to provide assurance treatments are delivered. We must ask the a rich source of data and business intelligence on compliance and better practice. question, why is it our safe work processes on WHS performance to better target initiatives remain largely manual, reactive and largely and be more proactive to mitigate these risks Leading hospital and healthcare organisations unchanged in the past decade? and provide better safety outcomes. will need to quickly invest in developing these seven factors in order to navigate the current Safe Work Australia CEO Michelle Baxter put it Frontline WHS entitlements: crisis and those to come. even more succinctly: “How work is done will involve more humans interacting with more more with less machines and technology and … is going to The mixed success of recent digital healthcare bring new and unexpected challenges and also rollouts suggests that success requires more opportunities.” than just software. Well-integrated systems are needed to prevent time-consuming work and The question is, if work is changing, do our work duplication, and ensure effective management health and safety (WHS) systems also need of changes. This ensures adoption and a to change or are the existing systems robust change in thinking and culture within healthcare enough to cope with the powerful forces of workplaces without compromising the ability of change and disruption? workers to do their job. COVID-19 has resulted in the need for rapid Digital tools and associated procedural changes change and strengthening of hygiene and should allow under-pressure workers to have safety practices. As we progress past this less to do while achieving more from a safety initial response, it’s clear further change will perspective. There are no silver bullets, but a be required as regulations continue to adapt collaborative process will evolve practice over to the new normal. Successful organisations time. will be those who can successfully change *Alastair Brooke is the Founder/ faster and better, and be safer than before. An evolution in safety thinking Director of Safety Evolved, an This will only be possible by leveraging digital and practice innovative digital enterprise that tools and techniques to re-imagine traditional WHS is a complex area with stakeholders from has created what is claimed to be WHS practices to become more automated, the frontline to the Board. Systems integration in Australia’s first dedicated WHS connected, proactive and collaborative. health care is similarly complex. systems integration business. Safety Shared compliance Safety Evolved has discovered that an Evolved provides robust digital While the onus is on employers and health ecosystem of capabilities is needed to deliver solutions to transform and improve leaders to ensure necessary precautions are successful outcomes. The ‘Essential Seven’ traditional WHS practice. taken to comply with Safe Work Australia’s turnkey solutions are:

42 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSORED CONTENT

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 43 PHARMACY ©stock.adobe.com/au/Miverva Studio

preparations continued, The Society of Hospital Pharmacists of Australia (SHPA) conducted a series of weekly online surveys to quantify information about medicine demand and supply. An early disconnect was evident when SHPA members reported that 80% of propofol orders, a drug essential to the intubation of ICU patients, were not being supplied in full in mid-April, although this has since improved gradually. Other medicines, such as key neuromuscular blocker cisatracurium, remained difficult to obtain across the April/ May period, with 63% of orders reported as either unable to be placed or on back order. Regional, rural and remote hospitals faced a particularly difficult challenge as their orders were less likely to be provided in full, and interruptions to transport and logistics made delivery more uncertain. Given that 43% of the hospitals who advised they were treating COVID-19 patients were in regional, rural and Lessons remote locations, these combined challenges could have had a much worse impact. While there is no reason to believe these shortages came to impact on care in any way, learnt the fact they remained prevalent indicates greater efforts are needed to safeguard from medicines crunch Australia’s medicine supply in case of a pandemic. The experience of preparing for amid coronavirus a surge in COVID-19 patients also highlights the need for strategic medicine reserves to contain medicines for standard medical use, Kristin Michaels, CEO The Society of Hospital Pharmacists of Australia rather than only medicines for unusual events, such as vaccines. Greater information about strategic reserves at federal and jurisdictional levels, and how to access them if required, s we stand in mid-June 2020 it is not yet intubation was not flagged. For our members, would also prove beneficial to hospitals, clear if we have sidestepped the worst this has resulted in extreme concern as A rather than seeking to address systemic of the coronavirus pandemic. Our growing hospitals aimed to increase ICU bed capacity problems on a unilateral basis. optimism suits the human condition, and is by up to 250%. bolstered by the assumption that any future The interruption to medicine supply was cases will benefit from the rapid preparations In the Australian medicines market, public also felt in community pharmacy settings of the last few months, through which the and private hospitals were put under when the community swarmed pharmacies threat of acute COVID-19 cases drove laser- significant pressure as they ramped up their to get their frequently used medicines for focus on readying Australia’s healthcare requirements for medicines such as propofol asthma, heart disease and other chronic system in response. and neuromuscular blockers needed to treat conditions. An unexpected spike in demand thousands of additional patients. As only 2% for hydroxychloroquine resulted in significant From the outset of this pivot, hospitals of the international market for medicines, inconvenience for long-term patients with and the important roles of healthcare Australia does not command huge attention autoimmune conditions such as rheumatoid professionals have certainly been recognised, for key manufacturers that are mainly based arthritis. These complications reflect the while an increased interest in some areas in Asia and Europe — areas facing their own unusual policy and regulation environment of health care such as personal protective severe pandemic challenges. for medicines in Australia, where the key equipment (PPE) and access to ventilators paradigm for discussion of medicines is have burst onto the scene. However, other Over recent decades, Australian hospitals typically related to their trade terms. essential factors such as access to medicines have grown increasingly reliant on ‘just-in- have been slow to catch up. time’ supply — often multiple orders weekly — As the immediate threat of COVID-19 appears of key medicines. As soon as larger orders to to recede it is important to rebuff dismissive Counterintuitively, when urgent decisions support a greater number of beds started to reflection; coronavirus was in no way were made regarding expanding ICU appear, manufacturers halted them. ‘unprecedented’. Instead, we should use our beds and importing ventilators, the need shared recent experience as an opportunity for specific medicines that make patients To help clarify the implications for planned to learn and build future preparedness plans unconscious and comfortable during ICU bed capacity as national COVID-19 that truly cover every contingency.

44 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Clorox Ad.pdf 1 25/3/20 2:15:37 PM Health on the other side of the COVID-19 pandemic

here is no doubt that the COVID-19 “Another driving force for change in healthcare Repurposed shopping centres Tpandemic has accelerated the digital access is the increased use of diagnostics, As the retail industry continues to transition transformation of healthcare systems in testing and screening. These can now be online, shopping centre infrastructure in Australia and throughout the world. In the face carried out in almost any location and through certain parts of the world is emptying and of forced lockdowns and social distancing extended hours to meet patient needs and becoming vacant. Horne explained that directives, healthcare providers have had to increase convenience. healthcare organisations see this as an rapidly shift to digitally accessible health care “As we move forward with new approaches to opportunity to transform these spaces into — any fence sitters have been firmly pushed to care facilities. the digital side. care, new needs for infrastructure and service, and the disruption by new players, ‘new doors’ “Repurposed healthcare centres are especially Before COVID-19 gripped the globe, the into health care are starting to open and useful for diagnostics and imaging, outpatient landscape of patient care was already become more prevalent. Analytics can inform surgery, primary care and treatment of minor changing, with traditional health systems locations (both virtual and physical) that are injuries,” Horne said. gradually shifting to digital platforms. Online good candidates for care site expansion.” health consultations, electronic records and “Malls and shopping centres make ideal remote monitoring of post-surgical patients Where we might go for health locations for health care because they’re were already becoming more accepted by care in the future designed for large crowds and are often in the patients and healthcare providers. Pharmacies centre of communities, with transportation infrastructure and ample parking already in For some time, general practitioners have With customer convenience at the forefront, place.” been the main gateway to health care, but this many pharmacies are taking on primary framework is changing as new access points interactions with patients. Pharmacies are Horne explained that in the Nordic countries, to health care open up in the digital landscape. growing to extend the services they provide planners are looking to purpose-build health to customers, such as vaccination and asthma malls in new subdivision areas to promote New approaches to healthcare clinics, and chronic disease monitoring. community mix and movement, and in an delivery effort to prevent health issues associated with Horne explained that this trend is also Greg Horne, Principal Health Analytics social isolation. extending to some supermarket chains, who Strategist at SAS, explained that we approach are employing dieticians to give advice in “The vision is that these facilities will encourage health care differently now than in generations stores. Retailers such as Walmart are taking wellness using AI and analytic technology, past. this further by providing access to primary coupled with access to primary care and other “With the rise in outpatient surgical procedures care physicians in addition to the eye care and health services,” he said. and the recognition that outcomes are audiology services they have offered for many improved in the home with monitoring and years. Similarly, many supermarkets in the UK Virtual care good physical therapy, the need for long have in-house pharmacies, allowing customers Virtual health has become critical during the hospital stays and the beds associated with to fill scripts or seek health advice from a extended periods of social isolation as a result them is disappearing,” he said. pharmacist as part of their grocery shop. of the coronavirus pandemic, allowing patients

46 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au CLINICAL SERVICES ©stock.adobe.com/au/ipopba ©stock.adobe.com/au/ipopba

Analytics can help determine who might be linked to a patient — such as family, friends and neighbours, but also employer rosters, passenger manifests and school rosters. Machine learning can help automate that effort by building analytical models that reflect real- world data and conditions. Intelligent alerting: Once the contact tracing team has identified a patient’s links and network, it can begin the task of automatically notifying people in that network via text/SMS messages or emails. Based on the likelihood of close, extended contact, such as a work colleague, they may be notified to get a health assessment. Public health insights: When assessing a patient’s network, public officials can rely on analytical insights from the data to fill in some of the gaps to answer questions such as: Who should be tested? Who is most likely to spread the virus? How do I find missing or unknown to consult with their health providers without • missing or unexpected linkages in contact linkages? Which communities are at greatest the need to fill waiting rooms and risk exposure data; risk? Is social distancing working? to the virus. Patients and their doctors are • who should be tested; becoming more comfortable with virtual Advanced analytical modelling tools help face-to-face calls and we have seen a shift • where the virus is spreading; and health officials and governments answer the from telehealth for remote and rural settings to critical questions needed to implement smart wider adoption. • which communities are at greatest risk. public health policies. With data visualisation abilities, users can perform deeper As part of the virtual care model, wearable People who are unknowingly exposed to an investigations of contacts and data to uncover technology will play an increasingly important infected individual might carry on with their hidden patterns and share them across various role, particularly as regulation and payment lives, unaware that they, too, could be infected health agencies. models catch up with the potential of the and further spread the disease. This is precisely technology. where modern technology — such as analytics Once links have been determined, alerts can and machine learning — can play a pivotal role. be generated. These alerts can convey health Improved access to health technology will risk warnings and can be customised for each enable patients with mobility challenges to Advanced analytics and data visualisation recipient, such as directing them to obtain a see their physicians more regularly without allows public health officials and investigators COVID-19 test at a the challenge of travel, which may mean that to quickly identify (with their consent) people specific facility or to people are able to stay in their homes longer, who have been exposed to COVID-19 so they self-quarantine for a before transitioning to a care facility. Patients can self-isolate, seek treatment if needed and specific number of with complex conditions can be monitored impede the spread of infection. There are four days. They can be and cared for in a similar way to that in an areas where analytics can help. sent via automated aged-care facility. Contact transaction databases with entity channels, such as Contact tracing and protecting resolution: These databases hold contact text/SMS messages tracing data and enable entity resolution that and emails. health can link multiple records in multiple databases Contact tracing has entered the digital era to the same person. and will play an important role in helping communities move out of lockdown. Increased Data management solutions can establish awareness is a valuable tool that enables and display linkages between patients, their Greg Horne is the SAS Global Principal epidemiologists and healthcare officials to contacts and the places they might frequent for Health and is based out of Toronto, respond faster when instituting containment to narrow and focus the efforts of contact Canada. He is considered a thought measures and issuing public alerts to tracing resources. leader in the future of health care and COVID-19 hot spots. Enriched contact tracing data: Analytics the introduction of patient-focused Contact tracing can be enhanced by using and machine learning give health officials technology. data visualisation and analytics to understand: important insights into each patient’s network.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 47 FOOD SAFETY

©stock.adobe.com/au/romaset ©stock.adobe.com/au/romaset This type of system collects temperature data of equipment such as coldrooms, freezers, refrigerators, deli cases and dishwashers at set intervals using sensors. This reduces the likelihood of delays or inconsistent temperature measurement and recording using manual methods by kitchen employees. Digital technology that uploads monitoring data automatically, remotely or to the cloud can be analysed immediately for any discrepancies, such as missed checks or out-of-range readings. Consistency: Today’s technology ensures consistent recording of temperatures to satisfy internal reporting requirements and those of food regulatory agencies. Efficiency: Temperature-monitoring devices have low power consumption. Flexibility: Current temperature-measuring devices provide flexibility: whether it’s a fixed- Food safety location device in a coldroom or a convenient handheld measuring device for measuring The benefits of digital cooked food, information can be stored internally or through a wireless connection to monitoring technology external storage on a designated computer on the premises or in the cloud. Andrew Thomson, Think ST Solutions Responsiveness: When the temperature- measuring sensor picks up a change in environmental conditions leading to unsafe ood safety in hospitals and residential aged impacts on productivity and takes up valuable conditions, key kitchen or maintenance Fcare requires a higher level of attention time that could be better spent elsewhere. employees are alerted immediately. They can and priority by senior management and boards In addition, following up on incomplete then respond by transferring food or dishes to of directors. Many clients who fall into the records or processes can be time-intensive for appropriate storage areas and investigate the vulnerable populations category are at a higher managers. Paper records need to be stored, problem as well as throwing away food that risk of developing a foodborne illness. analysed and prepared for the regulator does not meet safety and quality standards. at audit, adding to overheads and further Supports traceability of food In Australia, all hospitals and residential aged- impacting on productivity. Audit trail: care operations have a legal requirement under products and provides a complete recorded the Australia New Zealand Food Standards Collecting food safety data and stockpiling history. Code to develop Hazard Analysis Critical the paper logs for compliance purposes is Proper temperature management is of critical Control Point (HACCP)-based food safety simply not sufficient in preventing a food importance for all hospital and residential programs. Facilities are required to maintain the safety incident from occurring. It does require aged-care facilities. Careful monitoring of effectiveness, suitability and adequacy of the studying the data for improving processes and temperatures in many areas around the food safety program and constantly seek ways practices and developing a better system. kitchen, coldrooms and fridges is essential to improve their policies, procedures, practices We know there is an increasing number of for maintaining high standards of food safety. and operations. When these requirements were hospitals and residential aged-care kitchen Modern cooking equipment has built-in data first introduced more than 15 years ago, they operations that have received poor audit collection technology to assist in this regard. were designed as a paper-based data collection outcomes, with auditors identifying inadequate and record management system. Managers with responsibility for food safety monitoring and recording of food and oversight should welcome the multiple benefits Records are routinely audited by food regulatory equipment temperatures and other incomplete of this type of digital data technology as they authorities to ensure they follow food safety paper-based records. will be able to view the current state of their standards and comply with the Food Act Replacing the paperwork with digital kitchen operations in a live state. Reviewing to produce safe and suitable food. A key technology — using handheld devices that digital data allows the manager and other component of a food safety program is for record critical information and wireless key personnel to spot trends over time and kitchen operations to: record food temperatures sensors that automatically monitor change processes or procedures to improve from the point of receiving food supplies to final coldrooms and freezer units — will provide performance. cooking temperatures; monitor refrigeration and food-handling employees with more time, freezer temperatures; monitor temperatures There are too many risks and limitations with enabling them to be more productive while of food and equipment before service; paper logs — it’s an old-fashioned and inefficient food safety is being monitored. enact cleaning and sanitising procedures way of performing a monitoring activity. It also for equipment; and monitor temperatures in Digital records are immediately available. Here impedes business activity in so many ways. dishwashing machines. are the benefits. In addition to assisting the bottom line, Kitchens are fast-paced environments. Accuracy: A digital system removes human investing in a temperature-monitoring system Employees that prepare, cook and serve error and ensures food safety program will take the risk out of uncertainty and provide meals have an extremely heavy workload. The compliance by using modern digital data- kitchen operations with the confidence and constant need for completing daily paper logging equipment providing time, date stamps assurance needed to manage food safety checklists to ensure client safety significantly and temperature data. compliance and risk.

48 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au For Excellence in IV Therapy, Choose a Specialist Partner with ICU Medical, an innovative company 100% focused on helping you deliver IV therapy excellence Since IV therapy is our only business, meeting your needs with quality products and consistent supply is our only concern. We bring you intuitive, patient-centric IV products and services that provide meaningful clinical differentiation, consistent innovation, and superior value throughout your facility. IV Consumables & Needlefree Connectors IV THERAPY

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©2019 ICU Medical Inc. 1300 428 652 | www.icumed.com SPONSORED CONTENT The risk of infection via surfaces and the new coronavirus any people are concerned about the risk of SARS-CoV-2 (the virus Part of the issue when Mthat causes COVID-19) transmissibility via contaminated surfaces. researching in this field, is not Although many viral pathogens cannot live for long outside a human to destroy surfaces or adversely or animal host, some viruses can and do survive for prolonged periods aff ect staff or medical equipment on contaminated surfaces. Based on current information, SARS-CoV-2 with unnecessarily strong Dr Greg sits somewhere in the middle of the risk zone for surface survival and disinfectants such as highly Whiteley transmission. concentrated chlorine solutions. At Whiteley Corporation we are Whiteley Corporation has conducted a huge number of disinfectant tests constantly looking into novel solutions that overcome known risks such as against a wide array of infectious viruses and other microorganisms over the microbial resistance and biofilm contamination, while maintaining the best past 40 years. We have a long history of disinfectant and cleaning product possible level of materials compatibility. research especially through collaborative research programs, including virucidal testing. This knowledge frames the important factors to note about Research funded by Whiteley Corporation has shown that once on surfaces, COVID-19 with respect to cleaning processes and the use of disinfectants. superbugs can be transmitted to many other surfaces via contaminated hands and fingers. It is therefore essential that appropriate hand hygiene This collaborative work is ongoing, looking at an array of diff erent applied with a TGA-approved alcohol-based hand rub be used after touching any microbiology and infection risk factors. The $6 million project and IMCRC potentially contaminated surface. These products are also part of the Grant through the School of Medical Science at the University of Sydney is Whiteley research framework and manufacturing capacity. a current example of Whiteley Corporation exploring improved hygiene and safe disinfectants through world best practice research and development. Following the simple guidelines of washing your hands regularly and Once a breakthrough is made, products can then be commercialised, cleaning all high-touch surfaces regularly will reduce the risk of cross registered and manufactured through the TGA-licensed Whiteley facility at infection from infectious microorganisms including superbugs and the Tomago in the Hunter Region, NSW. coronavirus.

» For more information please visit www.whiteley.com.au Featured Products Keep up with the latest industry innovations

Non-slip patient socks Canola spread Haines Medical SallySock Non-slip socks are portion- single-patient-use non-slip socks designed control pack to improve patient safety and confidence in getting up out of bed and walking as To meet the ongoing part of their recovery. health demands of patients in hospitals SallySock Non-Slip socks are designed and aged care, to minimise the chance of slipping on Peerless Foods dry floors. The socks are designed for offers Vegan Vita- comfort, superior grip and with a loose fit lite Canola Spread around the ankle to assist with circulation. Portion Control Packs (PCPs). The single-use socks are claimed to significantly reduce the bacteria spread from patients walking Vita-lite Canola Spread is a around the hospital. cholesterol-free, dairy-free, vegan, halal spread with no artificial colours or flavours. The socks are available in three sizes: medium, large and X-large. With low saturated fat and salt, Vita-lite Features: designed for increased comfort and to prevent twisting Canola Spread is recommended by dietitians and turning of the sock; loose ankle opening to assist with blood who encourage the reduction of saturated circulation around the ankle; heel to toe slip-resistant grips so the fats and salt as part of a healthy diet. As entire foot is covered; single patient use; $2 per pair; latex-free and the product caters to a range of dietary made from 88% polyester/12% spandex with PVC grips; different colour requirements, there is no need to stock a grips to identify sock size. range of portion-control packs. Haines Medical Australia Peerless Holdings www.hainesmedical.com.au www.peerlessfoodservice.com.au

50 HOSPITAL + HEALTHCARE hospitalhealth.com.au SUMMERWINTER 2020 2020 hospitalhealth.com.au HOSPITAL + HEALTHCARE 1

Featured Products

Medical cart Ultraviolet C panel PC germicidal The HID-2334 Medical Cart technology Panel PC from Avalue UV Solutionz’ High Energy Technology is an all-in-one, Germicidal UVC Germicidal 23.8″ panel PC designed for Technology is used for mobile carts. applications including killing Using the Intel 7th Generation airborne and surface pathogens platform to balance such as viruses — including performance and features, the coronavirus (COVID-19) — bacteria HID-2334 is designed to help and moulds that live, replicate and professional healthcare workers move through buildings via heating, carry out daily tasks. ventilation and air-conditioning (HVAC) systems. Built-in hot swappable batteries and a four-slot charging bay enable an uninterrupted power supply. UVC or germicidal light (254 nm) can inactivate viruses, with 99% reduction of typical viruses and bacteria in a Tekdis one-minute timeframe and spores like C. difficile in five minutes. www.tekdis.com.au When installed in an HVAC system, the product can destroy airborne and surface pathogens quickly and effectively, preventing them from growing and multiplying while also sterilising the air. UVC Germicidal Technology also improves your indoor air quality by reducing volatile organic compounds from sources such as paints, carpets, renovations and outside-introduced smells. Healthcare Forced air applications include: air-conditioned offices and information commercial buildings; hospitals and healthcare facilities; laboratories terminal and research facilities; schools and universities; veterinary facilities; refrigeration-induced and force-draft evaporators; and ventilation/ The HIT-507 is a medical- recirculation systems used in food technology and manufacturing grade healthcare information preparation areas, and agriculture manufacturing preparation areas. terminal that offers equipment builders an easily integrated AMT Group Australasia HMI for rapid product www.amtintlgroup.com.au development. Featuring an Intel Celeron J3455 quad-core processor and 7″ display with 10-point projected capacitive (P-CAP) touch control, the HIT-507 is a high- NATA testing performance device that has been designed to enable reliable services design and cost-effective project implementation. Airepure Australia’s To optimise the utilisation of control panels for sophisticated NATA-certified on-site medical equipment, the HIT-507 features multiple I/O ports technicians can replace for integrating additional peripherals according to usage HEPA filters within existing requirements. This eliminates the need to install extra modules or hospital pharmaceutical customise the design during manufacturing. cleanroom installations and perform relevant testing With the ability to support both Windows 10 IoT (64 bit) and and certification to meet Android 8.0 operating systems, the HIT-507 can be easily Australian Standards, state integrated with existing hospital information systems and healthcare regulation and TGA infrastructure. requirements. The HIT-507 supports two assembly configurations, VESA HEPA filters can be replaced and tested mounting and open-frame installation, enabling flexible within sterile, positive pressure aseptic pharmacy cleanrooms, deployment in a variety of medical equipment. Compliant with cytotoxic pharmacy cleanrooms (HEPA exhaust filtration IEC 60601 safety standards for medical devices, the terminal is systems), pass through boxes and hatches, air showers, designed to not only ensure safe operation of medical equipment pharmaceutical isolators, laminar flow cabinets and safety but also minimise the time-to-market by ensuring compliance cabinets — including biological safety cabinets, cytotoxic drug with healthcare regulations. safety cabinets and fume cabinets. The compact and open-frame design makes it suitable for Airepure Australia is a national air filtration company providing installing in bedhead units to function as bedhead terminals. professional, on-site NATA accredited testing and certification Healthcare staff can use the terminals to access medical records services to help organisations meet and maintain Australian and hospital information systems, retrieve laboratory results, standards for controlled environments, and ensure the monitor patient vital signs and document treatment observations. conformance, ongoing safety and operating efficiency of Supporting both wired and wireless communication, patients contamination control equipment. can use the terminals to request assistance or manage their environment, such as adjusting the bed height and room lighting. Airepure Australia Pty Ltd www.airepure.com.au Advantech Australia Pty Ltd www.advantech.net.au

52 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Featured Products

Validated cleaning Uniform supplies methods: training, Infectious Clothing Company equipment and supplies scrubs and corporate uniforms to the support medical and healthcare Steam Australia provides industry, catering training, equipment and to individuals, small ongoing support for the practices and entire hospital, healthcare and hospital teams. aged-care industries across In cases where teams Australia and New Zealand. need a new uniform, The Steam Australia recommends Infectious Clothing Company validated cleaning methods can provide guidance on brands, alongside tried and tested products such styles and colours to ease customers as steam and microfibre. through the process of choosing a good-looking, functional uniform. Novel cleaning methodologies can be implemented for task- specific or facility-wide cleaning for infection prevention and In addition to an online customer portal allowing control in settings including: infectious and terminal cleans; web-based ordering, customers can attend theatres; kitchen and food service; emergency facilities; high- the walk-in retail shop and fitting space; the touch points and common areas; and waiting rooms. warehousing facility for large corporate clients; or the onsite, customised uniform assistance and Reported benefits by hospitals include: significant long- business branding support. term cost savings; statistically significant reduction in hospital-acquired infections; reduced environmental Infectious Clothing stocks the following brands: impacts; increased cleaning efficacy, both visually and Dickies Medical, WonderWink, Zoe & Chloe, microbiologically; reduced cleaning times; and increased BizCare, Medline, BizCollection, City Collection, staff morale. JB’s Wear, ChefWorks, Skechers and New Balance. Steam Australia Infectious Clothing Company Pty LTD www.steamaustralia.com.au www.infectious.com.au

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 53 SPONSOREDxxxxxxxxxxxxxxxxx CONTENT

Lumary launches new software functionality for the aged care sector ©stock.adobe.com/au/Rido

The feature has been built Integral to the reforms are placing clients achieve consumer satisfaction and business at the center of their servicing system, success,” said Mercorella. for HCP providers, helping providing them with more choice and control, So what HCP features does the Lumary CM and structuring the system to support the them to improve compliance, platform assist with? clients and their families. This reiterates business effi ciency and the need for a technology solution that is • Meet HCP compliance requirements provide better care. consumer-centric. This is where the Lumary seamlessly CM platform, with HCP-specific functionality, • Manages organisational requirements & assists aged care providers. financial systems delaide-based HealthTech company, “Our product allows providers a complete • Streamlines daily tasks A Lumary, has launched new functionality view of their client, streamlines their within its healthcare platform product, workforces’ daily tasks, provides trackable • Creates trackable data, anytime, anywhere Lumary CM, specifically designed for data, meaningful insights, and engages Home Care Package (HCP) Providers. This with clients transparently. This means more • Builds meaningful data insights which feature, which has been co-designed with collaborative care, whilst managing your means better quality care HCP care providers, is an extension of their organisational needs and financial processes. • Allows transparent engagement with clients healthcare platform and increases Lumary’s It also allows the management of both HCP specialisation within the aged care industry, and NDIS in one platform for those providers • Allows more collaborative care: improved helping to provide better care to the ageing that work in both domains,” said Lumary CEO, client and carer engagement population of Australia. Joseph Mercorella. • Supports the ageing community to live In recent years there has been an increase Additionally, businesses will need to ensure independently and take control of their at- in the focus on the aged sector and how they are able to lower costs and optimize home healthcare and lifestyle services. care is delivered. Current reforms in this business outcomes whilst improving revenue. “With consumer-directed care being the area, as well as the call for technological and And the only way providers are going to be imperative it is crucial providers in the HCP business model transformation, means that able to do this is by leveraging a technology space ensure they have a technology solution care providers are under pressure to focus system that allows them to do this whilst that maintains compliance, off ers a complete on client care and satisfaction. However, keeping the client centre focussed. client experience, assists with increasing this will only be achieved through the use loyalty and customer retention, and ultimately “This is where we really stand out in the of technology that takes the burden of provides better care,” concluded Mercorella. administration off of the provider, whilst market. We have spent hundreds of hours giving them a complete and accurate view of with HCP providers building a solution that For more information or to request a demo each of their clients. we know will hit all the right marks in order to please go to www.lumary.com.au.

For more information www.lumary.com.au

54 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSORED CONTENT

Lumary launches new software functionality for the aged care sector ©stock.adobe.com/au/Rido

The feature has been built Integral to the reforms are placing clients achieve consumer satisfaction and business at the center of their servicing system, success,” said Mercorella. for HCP providers, helping providing them with more choice and control, So what HCP features does the Lumary CM and structuring the system to support the them to improve compliance, platform assist with? Australia’s leading Healthcare Platform clients and their families. This reiterates business effi ciency and the need for a technology solution that is • Meet HCP compliance requirements provide better care. consumer-centric. This is where the Lumary seamlessly now supports HCP Service Delivery CM platform, with HCP-specific functionality, • Manages organisational requirements & assists aged care providers. financial systems delaide-based HealthTech company, “Our product allows providers a complete • Streamlines daily tasks A Lumary, has launched new functionality view of their client, streamlines their At the heart of our platform is Lumary Care Management, a secure software solution within its healthcare platform product, workforces’ daily tasks, provides trackable • Creates trackable data, anytime, anywhere Lumary CM, specifically designed for data, meaningful insights, and engages for disability and aged care providers. We bring together best-in-class technology Home Care Package (HCP) Providers. This with clients transparently. This means more • Builds meaningful data insights which feature, which has been co-designed with collaborative care, whilst managing your means better quality care partners to support your organisation’s operational needs as you manage NDIS and HCP care providers, is an extension of their organisational needs and financial processes. • Allows transparent engagement with clients HCP services in one application. Facilitate collaborative care, maintain regulatory healthcare platform and increases Lumary’s It also allows the management of both HCP specialisation within the aged care industry, and NDIS in one platform for those providers • Allows more collaborative care: improved compliance and provide better wellbeing for your community with Lumary. helping to provide better care to the ageing that work in both domains,” said Lumary CEO, client and carer engagement population of Australia. Joseph Mercorella. • Supports the ageing community to live In recent years there has been an increase Additionally, businesses will need to ensure independently and take control of their at- in the focus on the aged sector and how they are able to lower costs and optimize home healthcare and lifestyle services. Do things differently. Together, we can positively impact the healthcare sector. care is delivered. Current reforms in this business outcomes whilst improving revenue. “With consumer-directed care being the area, as well as the call for technological and And the only way providers are going to be imperative it is crucial providers in the HCP business model transformation, means that able to do this is by leveraging a technology space ensure they have a technology solution care providers are under pressure to focus system that allows them to do this whilst that maintains compliance, off ers a complete on client care and satisfaction. However, keeping the client centre focussed. client experience, assists with increasing this will only be achieved through the use loyalty and customer retention, and ultimately “This is where we really stand out in the of technology that takes the burden of provides better care,” concluded Mercorella. administration off of the provider, whilst market. We have spent hundreds of hours giving them a complete and accurate view of with HCP providers building a solution that For more information or to request a demo each of their clients. we know will hit all the right marks in order to please go to www.lumary.com.au. www.lumary.com.au » @LumaryAU For more information www.lumary.com.au TECHNOLOGY

digital medical records. Not to mention, as a AI’s role result of the current pandemic, the healthcare sector has gone digital with a surge in in modern-day health care telehealth appointments — no doubt there Mark Jobbins* will be increased demand for similar offerings post-COVID-19. With the impacts of COVID-19 being felt across the globe, In order to keep up with increasing and shifting healthcare demands, both from the global healthcare sector has turned to technology to patients and the wider industry, technology, aid and accelerate innovation in the hope of combatting like AI and data analytics, is being used to support high-quality, sustainable healthcare the pandemic. services. However, for AI and data analytics to continue improving healthcare operations, data he Australian Government has launched when more staff are needed in hospitals, for management and analysis skills must become Tthe COVIDSafe app to help digitally example, during flu season. a crucial part of medical training. Staff must trace people who have come into contact have an understanding of best practices Clinical with confirmed COVID-19 cases. Once the Minimising clinical disparity: when applying AI to health care; for example, variation is a huge industry concern as it information is collected, artificial intelligence sufficient and accurate data is crucial to leads to wasted supplies and impacts patient (AI) will examine and analyse the data, success. Furthermore, datasets must be outcomes. Improving clinic variation requires allowing the industry to better manage specific, accurate and sufficient enough to assessing massive amounts of data, which is exposure to the virus. be free from bias — after all, an incorrect where AI can help. When supported by a solid AI-driven decision could have deadly There are countless other examples of AI IT infrastructure and significant computing consequences. and data analytics being applied in the fight power, AI can process this data at speed to against COVID-19. What’s important to note reduce clinical disparity. Clearly, AI creates a variety of healthcare is this shift towards AI and data-led solutions benefits, everything from advancing Paige.AI is an isn’t unique to the current pandemic. Using AI to fight cancer: diagnosis accuracy to speeding up drug organisation focused on improving clinical development. Implementing AI-driven Historically, technologies like AI have been diagnosis and treatment in oncology through solutions for health care still entails AI-related used to help reduce patient waiting times, the use of AI. Traditionally, manual analysis is and clinical data challenges. However, with support the development of custom-made used for most pathologic diagnoses to treat data being a catalyst for innovation, AI has medicines and reduce clinical disparity. Big cancer; however, AI can be used to examine the power to create real change within data has also been used to manage previous complex data faster and more accurately, our healthcare system and solve current worldwide health issues like the Ebola bringing us closer to a cure. problems. outbreak. Here are just a few examples of From a patient perspective, expectations other ways AI is changing health care for the Pure Storage Inc of the healthcare sector have never been better: info.purestorage.com higher. Patients expect health services and Putting technology at the heart of health practitioners to assist them to be more healthcare operations: Healthcare staff are informed, manage their health and provide *Mark Jobbins is VP and Field Chief often under the microscope — from both a prompt, appropriate and individualised help funding and performance perspective. To when required. On top of this, patients have Technology Officer, Asia Pacific and better manage demand, the industry is using increased expectations around data security, Japan, Pure Storage. historical data combined with AI to predict communication channels and access to ©stock.adobe.com/au/Have a nice day a nice ©stock.adobe.com/au/Have

56 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSOREDxxxxxxxxxxxxxxxxx CONTENT

Microdial Flowmeter A smoother transition to room air

orking in partnership with neonatologists, BPR Medical has W designed a special range of Microdial flowmeters that provide Neonatal ICU and Special Care Baby Units with the precision and control needed to eff ectively treat premature babies with medical oxygen. Innovation in the treatment of oxygen dependency in infants Premature babies with Respiratory Distress Syndrome (RDS), may receive mechanical ventilation as a lifesaving intervention. This ventilation can cause damage to the lungs, leading to a chronic lung disease, often referred to as bronchopulmonary dysplasia (BPD). An infant with BPD will often need to be weaned off oxygen over several weeks or months — with the level of eff ectiveness depending on the controlled gradual reduction in levels of “fraction of inspired oxygen”

(FiO2 ).

To enable controlled adjustments of FiO2 levels, BPR Microdial flowmeters feature a Microflow™ dial control that enables precise and reversible mini step changes in the oxygen flow. This dial technology delivers oxygen flow rates in gradual steps of as little as 10 cc per minute (Table 1). With advanced technologies, Microdial flowmeters ensure reliability Microdial flowmeters are available in two models; a paediatric version and superior performance. A built in pressure regulator ensures with flow rates of 0–3 lpm and a neonatal version with flow rates of 0–1 the oxygen flow remains consistent, irrespective of varying supply lpm. These two models allow minute changes of FiO2 levels, facilitating pressure. Furthermore, gas quality is assured by a dual filtration system a smoother transition to room air. (Table 2). which includes a 40 micron pre-filter and a 5 micron internal filter.

» For more information call us on 1800 050 999 or email [email protected] or visit www.boc.com.au/healthcare

Details given in this document are believed to be correct at the time of printing. While proper care has been taken in the preparation, no liability for injury or damage resulting from it use can be accepted. © BOC Limited 2019.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 57 SPONSORED CONTENT internal mailrooms: a thing of the past

Nadine Bucher, Bing Technologies

Healthcare providers may ask themselves if it’s possible to digitise communication, reduce costs and provide more patient-centred care. The answer lies in modernising and transforming healthcare administration processes, to allow facilities to provide a high level of care in a way that is cost-eff ective.

ommunication with patients is a vital However, there are shortfalls in the amount Hospitals were previously unable to outsource Ccomponent of the care process, with the of information that can be cost-eff ectively this function due to data privacy concerns provision of accurate and timely information provided to patients. Hospital clinics have and a lack of comprehensive functionality to being critical. been searching for ways to enhance SMS accommodate the volume, frequency and content, to allow inclusion of information such automated delivery requirements of hospitals. Traditionally, outsourced mailroom solutions as clinic location maps and patient admission have only been a way to solve bulk mail runs, questionnaires. Bing’s EasyPost Mailroom solution allows and hospital volumes, though large as a whole, hospitals to outsource all their outbound are small when prepared daily clinic by clinic. The strength of healthcare providers lies in postal mail and enhance their digital delivery Bing’s innovative and unique technology can providing high-quality care that meets the capabilities. Letters can be delivered via post, resolve these issues by providing a complete needs of patients and improves their wellbeing fax, email or SMS, with the recipient able outsourced mailroom solution for any volume — not diverting valuable resources to manual to open and view all document content on of mail, with automated omni-channel delivery mailroom functions. their device. If recipients do not access their management. An element of patient communication that electronically delivered correspondence within a specified timeframe, letters are automatically What about the disruption is important to providers is proof of receipt, with real-time visibility that provides assurance redirected as hard copy mail to ensure patient period? that patients have received, opened and read receipt. Although upgrading or implementing a the information about their appointment. Enhancements to Bing’s digital delivery options new system can be disruptive — impacting If patients appear to have not received this further improve a hospital’s internal process productivity and hindering flexibility in the short information, an ability for staff to automatically by using extracted custom data, such as term — innovative patient communication trigger communication via alternative channels appointment date and time, to trigger flow-on solutions off er agility, swift delivery of is an important feature. automated communications via any delivery information and enhance process eff iciencies channel. Virtual mailbox access is also available, for the longer term. Without automated omni-channel solutions, the task of dealing with undelivered or unread allowing patients and carers to individually A major concern for hospitals is lost digital communication reverts to the time- manage their preferred delivery method. For productivity due to patients not attending consuming process of printing, folding and example, a patient might prefer to receive their appointments, which has a significant lodging mail. postal mail, and the carer, an SMS. impact on a hospital’s ability to provide eff icient Bing’s EasyPost Mailroom solution allows outpatient services and results in clinical Although hospitals are driven to digitise to hospitals to achieve full outsourcing of their and administrative staff being underutilised. expedite delivery of patient communication outbound correspondence. Staff can securely Reduced revenue opportunities and extended and make cost savings, an aged population send any volume of postal mail, email, fax and patient waiting lists are another consequence with potentially limited access to technology SMS on demand with just a few mouse clicks. of no-shows. means that the provision of postal mail remains a necessity. The EasyPost Mailroom is a virtual printer driver meaning implementation and adaptation within Patient communication: Clinics must facilitate the manual requirement problems and solutions hospitals is quick and simple, requiring minimal of printing, enveloping and addressing patient IT engagement. As paper-based communication has letters, which are collected and processed for been an added trigger to patients missing lodgement via internal mailrooms. This process If you would like an obligation-free consultation appointments, many hospitals have opted results in double-handling and lengthy delays, to determine the value Bing can deliver, it would to send patient communications via SMS. which can impact non-attendance rates. be great to hear from you!

For more information bingmail.com.au

58 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au TECHNOLOGY ©stock.adobe.com/au/greenbutterfly ©stock.adobe.com/au/greenbutterfly

Artificial intelligence on the COVID-19 frontline and beyond

Amy Sarcevic

Professor Megan Coffee’s here is limited data at hand to help them They say adversity is often the catalyst for make this decision. change and COVID-19 has been no exception. colleagues at a New York T “Age, gender and comorbidities alone are not At the start of the coronavirus outbreak in hospital became doctors to enough to predict who will develop severe Wuhan, Professor Coffee and her colleague, save lives. Now — besieged symptoms,” said Professor Coffee. Anasse Bari, Professor of Computer Science with a fresh onslaught of “For clinicians this has been a real challenge, at New York University, set out to create an throughout the pandemic, in terms of AI-powered decision support tool to help ambulance arrivals — they deciding the right treatment options. clinicians in this context. are learning ‘on the fly’ how “Pilots need to know where they are flying; Learning from historical clinical data about to predict which COVID-19 and doctors directing care do, too. Yet former coronavirus patients, the AI tool can doctors have had to plan patient care — predict which COVID-19 patients will develop patients will need mechanical learning as they go along, who is most at risk severe respiratory illness, before any major ventilators. of deteriorating in their clinical condition.” symptoms present.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 59 TECHNOLOGY

“By flagging severe cases early, it can lower “My general theory about AI is that it exists to emergency visits, help hospitals decide which “Whether or serve as an extension to human intelligence, cases to monitor and, in turn, save human not as a replacement,” he said. lives,” Professor Bari said. not COVID-19 “We have reached a point in science where, This predictive analytical technology is one will prompt a as AI experts, we can admit (with empirical of many ways AI has proven useful in the evidence) that the way a computer thinks is trenches of COVID-19 health care. revolution of AI fundamentally different to how humans think. An AI platform has helped to track the “This is why I believe human judgment and propagation of the virus, by algorithmically in healthcare is creativity is needed more than ever in the 1 analysing alternative data sources. still unknown, but applicability of specialised AI. A computer vision algorithm, coupled with “An AI system will advise and make predictive analytics, has predicted which one thing we can suggestions. The human will have to make the geographical areas would be most vulnerable final decision — either following the AI or, at in a disease outbreak.2 times, correcting it, so the AI becomes more be sure of is that intelligent. In drug development, AI has come up with potential vaccine candidates, far quicker than it has fostered its “An AI system is in a constant learning humans have been able to.3 process, and humans make it possible to evolution.” advance this learning, by providing feedback Meanwhile, AI-powered drones have been and new training data. used to deliver medical supplies and food throughout the pandemic.4 “That is exactly the vision we have for AI in “One important reason for this is that we need health care.” But although AI has formed a major part to be extra sure that the technology works.” of the COVID-19 response, experts aren’t Whether or not COVID-19 will prompt a sure if this crisis will be the tipping point for Uncertainty about how a data-fed AI machine revolution of AI in health care is still unknown, widespread AI usage. Before that can occur, comes up with its prediction — also known but one thing we can be sure of is that it has cultural attitudes and norms within the as the ‘blackbox problem’ — is of particular fostered its evolution. healthcare industry may need to change, they concern, highlights Google Health Clinician say. Scientist Dr Martin Seneviratne. References 1. https://ij-healthgeographics.biomedcentral.com/ “At present, AI is mainly just used in “Health care is an industry in which people are articles/10.1186/s12942-020-00202-8 used to asking ‘why?’ and understanding the visual detection. For example, cancer on 2. https://www.bruegel.org/2020/03/artificial-intelligence-in- mammogram films, photos of skin lesions, exact mechanisms which underpin any given the-fight-against-covid-19/ tuberculosis chest X-Rays or signs of diabetes area of practice,” he said. 3. https://www.bbc.com/news/technology-52120747 on retinal exams,” Professor Coffee said. “But then again, there are many medications 4. https://www.weforum.org/agenda/2020/05/medical- “This is a shame because AI could play the (take lithium) where we might not understand delivery-drones-coronavirus-africa-us/ role of master diagnostician, help doctors the full mechanism of action. But it has been identify possible causes of an illness or shown to be safe and effective for many patients. predict more severe patient outcomes. Not Anasse Bari: The Courant Institute just in pandemics, but in everyday clinical “We should have the same approach for of Mathematical Sciences, Computer cases.” digital therapeutics — study the logic behind Science Department, New York Professor Coffee said there are a number of them for sure, but also build empirical University; Megan Coffee: The possible reasons why clinicians and medical evidence to show they are safe and effective.” Grossman School of Medicine, New procurers may be hesitating over AI. Professor Bari said clarity in terms of AI’s role York University; Martin Seneviratne: “Doctors still carry beepers. We aren’t always in health care may also be needed before Clinician Scientist, Google Health. the earliest adopters of technology,” she said. widespread uptake occurs. ©stock.adobe.com/au/zapp2photo

60 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SPONSORED CONTENT © Stock.Adobe.com/au/WavebreakmediaMicro Is poor connectivity aﬀ ecting your productivity?

he need for wireless connectivity for hospital staff is a necessity. administrators and patients alike. This hospital’s management made T With diff erent sizes of facilities and locations, Powertec can advise the decision to ensure a failover phone system is in place in case of an government bodies on the most cost-eff ective wireless connectivity emergency and to improve workplace health and safety. solutions. Powertec has over 90,000 installations in Australia and New Zealand, The Challenge • Implement a direct link between the hospital’s telephone system including large companies, government departments, small to medium- and the 4G cellular network. sized businesses, farms, aged-care facilities, hospitals and individual consumers. Below is a case study by Powertec which details the • Provide a solution with the capability to off er 48 simultaneous capabilities of their cellular signal booster, Cel-Fi GO. phone calls. The introduction of Session Initiation Protocol (SIP) in Australia has • Provide both voice and text options for 40 simultaneous users. created a greater need for failover phone systems. In case of an emergency power failure, SIP (the non-copper communications installed Product used as part of the NBN rollout) has less reliability than the previous copper- • Matrix GENX VoIP (Voice Over Internet Protocol) 3G/4G Gateway based ISDN service. • Matrix-GENX-VoIP-3G_4G-Gateway-510x510 Matrix Gateways act as a back-up for any business, they ensure phone calls can continue to be sent and received if existing phone lines are Business Benefi ts down. Additionally, the Matrix failover phone system also allows for Workplace health and safety has been dramatically improved now broadcasting text messages. This is achieved via innovative call routing that a failover phone system is in place, it has minimised many risks. technology, which enables a direct link between a telephone system and Continuous voice service is now available to all staff and patients the cellular mobile network. in the hospital and up to 48 simultaneous calls can be made at any To put it simply, Matrix Gateways can give a landline handset the ability time, which was considered suff icient for the almost 1900 active staff to operate as a mobile phone on the 3G/4G network. Failover phone members. systems are suitable for a multitude of industries including mining, government, schools, universities as well as hospitals and aged care. The Solution Below is a great case study of a recent Matrix failover phone system By installing redundant pairs of Matrix Gateways, the hospital will installation. now have another connection method via banks of SIM cards for the Optus, Telstra and Vodafone networks. Case study: Failover phone system for a hospital This multicarrier solution means the failover phone system has access Business needs to numerous cellular towers to automatically switch over to in the This Queensland hospital is heavily dependent on reliable connectivity event of a power or landline failure. Both voice and text capabilities in order to have a clear communication channel to reach doctors, have been enabled as part of the redirect.

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hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 611 machine learning

A new paradigm in medical image analysis Professor Gustavo Carneiro*

The main goal of computer- few decades ago, the first attempts to A predict outcomes were based on CAD aided diagnosis (CAD) systems that would take medical images systems in medical image and directly produce outcomes using hand- designed image features and rudimentary analysis is the prediction classification models. These first attempts of clinically relevant produced unremarkable prediction outcomes (eg, diagnosis, accuracy for a few reasons, including lack of computational power, and few medical prognosis, pathology) images available for modelling and testing directly from medical the systems. images. The prediction Furthermore, hand-designed features were developed based on conversations with of ejection fraction from clinicians or on standard image processing echocardiography images or tools, so in mathematical terms, they were not optimally designed for improving breast cancer probability from the prediction of clinical outcomes and mammograms are examples consequently the classification results were of CAD systems. sub-optimal. One important breakthrough in the late 80s was the development of an effective image segmentation tool, called active contour model, by Dr Kass and colleagues.1 This tool enabled the development of viable CAD systems to segment organs from medical images and allowed researchers to revisit the problem of designing CAD systems to Machine learning predict clinically relevant outcomes using The ’90s witnessed remarkable features extracted not only from medical breakthroughs in machine learning — a images, but also from segmentation maps. process where computer algorithms use Such classification based on images and datasets containing a large collection of segmentation maps has dominated the field observations (eg, images) and outcomes until today. (eg, diagnosis) to automatically build an optimal mathematical model that can take Despite a strong push for the development previously unseen observations and predict of effective hand-designed image features outcomes. and more accurate segmentation methods, the prediction accuracy never reached Machine learning penetrated the field of clinically acceptable levels. medical image analysis in the late ’90s,

when researchers implemented models The second point above was particularly 2. since the annotations were not part of that could segment medical images worrying because a lot of the segmentation clinical protocols, they contained noise and predict clinically relevant outcomes annotations were not part of the manual that inevitably biased the methods. using large datasets containing images image analysis protocol, so clinicians and relevant annotations (ie, diagnosis or needed to be hired and taught how to It is also interesting to note that the segmentations). These machine-learning- produce such annotations. classification paradigm mentioned above, based CAD systems showed promising based on images and segmentation maps, results, but there were a few issues: This process had two major problems: remained virtually unaltered during this period. • the methods relied on hand-designed 1. given that it was an expensive annotation features, so results were still sub-optimal; and process, datasets were never large Deep learning • the models needed large, manually enough to allow for the modelling of Meanwhile, deep learning — a particular annotated datasets. robust methods; and type of machine learning model formed

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 63 machine learning

As mentioned above, the annotation of “Deep learning models are highly complex medical image analysis was an expensive and unreliable process, so many researchers models that tend to require datasets studied ways to enable the development of deep learning models without using any that are orders of magnitude larger than other annotation than the ones already previous machine learning models.” available from the database. Deep learning and decision explanation Since 2012, with deep learning, researchers have been trying a strategy using only images and outcomes from hospital databases — the same strategy as that adopted by the first methods developed decades ago. The problem is that this approach requires the system to figure out how to explain the decisions made. For example, if the system says there is a 90% probability of malignancy in a mammogram, it should highlight/delineate the region with a suspicious lesion, but the databases from hospitals typically won’t contain that information. This is the current challenge — we can use the hospital databases (containing images and clinical outcomes) without any additional annotation, but the system needs to be ‘smart’ to explain the decisions (by, for example, segmenting image regions). The field of medical image analysis is currently working on the development of CAD systems modelled with extremely large datasets (containing hundreds of thousands of patients) that follow this new paradigm. Preliminary results show that these systems can not only produce accurate clinically relevant outcomes, but can explain the decisions for reaching a particular outcome.3-5 We believe that in the near future, these CAD systems will also be able to automatically discover new imaging biomarkers associated with clinically relevant outcomes, possibly having a profound impact in medicine.

*Gustavo Carneiro is a professor at the School of Computer Science at The University of Adelaide and Director

©stock.adobe.com/au/romaset ©stock.adobe.com/au/romaset of Medical Machine Learning at the Australian Institute for Machine Learning. by a hierarchical structure of classification later on, the whole of society). He and his layers — was being studied by now world- colleagues successfully developed a deep References famous researchers, such as Professors learning model that produced the best 1. Kass, Michael, Andrew Witkin, and Demetri Terzopoulos. Geoff Hinton, Yann LeCun, Yoshua Bengio classification result (by a large margin) in a “Snakes: Active contour models.” International journal of and Jürgen Schmidhuber. benchmark computer vision problem.2 Such computer vision 1.4 (1988): 321-331. Deep learning models have been developed a breakthrough was enabled by the use of a 2. Krizhevsky, Alex, Ilya Sutskever, and Geoffrey E. Hinton. incessantly since the late ’80s, but there large dataset (one million images) and more “Imagenet classification with deep convolutional neural networks.” Advances in neural information processing were always some roadblocks that did not adequate computational power based on systems. 2012. allow their effective use by the scientific graphics processing units. 3. Carneiro, G., Pu, L. Z. C. T., Singh, R., & Burt, A. community: lack of computational power; The relevance of deep learning models for small annotated datasets; ineffective (2020). Deep Learning Uncertainty and Confidence medical image analysis was that it would Calibration for the Five-class Polyp Classification from modelling of deep learning classifiers, etc. allow the development of models that could Colonoscopy. Medical Image Analysis, 101653. The main trade-off is that deep learning automatically learn optimal features and 4. Maicas, G., Bradley, A. P., Nascimento, J. C., Reid, I., & models are highly complex models that classifiers to produce a specific output, Carneiro, G. (2019). Pre and post-hoc diagnosis and tend to require datasets that are orders of allowing the models to be mathematically interpretation of malignancy from breast DCE-MRI. magnitude larger than previous machine optimal for predicting clinical outcomes. Medical Image Analysis, 58, 101562. learning models. 5. Gale, W., Oakden-Rayner, L., Carneiro, G., Palmer, L. J., & Despite success in various classification Bradley, A. P. (2019, April). Producing Radiologist-Quality In 2012, Professor Hinton had a major problems, deep learning required even Reports for Interpretable Deep Learning. In 2019 IEEE breakthrough that practically affected larger annotated datasets than previous 16th International Symposium on Biomedical Imaging the whole scientific community (and machine-learning-based CAD systems. (ISBI 2019) (pp. 1275-1279). IEEE.

64 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Free subscription

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AHHB_subs ad_A4.indd 1 31/10/19 2:22:48 PM Aged care

Fall-detection tech gets smart

report by the Australian Institute of A Health and Welfare (AIHW) shows that more than 100,000 people aged over 65 were hospitalised due to a fall in 2016–17, with injuries to the hip and thigh (22%) and head (26%) being the most common fall-related injuries. The Australian & New Zealand Falls Prevention Society has outlined that falls represent a major health issue, with the incidence and cost to the health system set to increase as the population ages. To help address this problem, an Australian company has created an artificial intelligence (AI) device that can detect if someone suffers a fall in the home, hospital or aged-care facility. Similar in size to a small portable speaker, the HomeGuardian.ai device uses sensors to monitor the interaction of objects and people within its surroundings and alerts carers or family members if a fall occurs — the development team spent more than one year teaching the device to recognise objects such as furniture and people, along with the ability to identify abnormal behaviours. HomeGuardian.ai Co-founder and CEO Kane Sajdak said the device’s ability to track objects without saving or sending images or video will revolutionise the aged-care, disability and hospital sectors.

66 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au Aged care

Q&A with Co-Founder and CTO of HomeGuardian.ai Adam Carroll

What led you to pursue AI technology to assist people at risk of falls? The idea came from my wife, who is an aged-care nurse. She often discussed the challenges associated with monitoring large numbers of patients, emphasising how long a round of checks could take, as well as what could happen in the time away from each patient. Once the team began chatting with friends and family, we realised everyone had an experience — whether it be a mother falling in the middle of the night and left on the ground for hours helpless, or a partner susceptible to fainting due to an ongoing medical condition. From there, we identified a need for a device that was minimally invasive, but had enhanced monitoring precision — to be in the corner of a user’s home “The device knows it is normal for an object without the need for them to interact. it recognises as a person to lay on a bed, but it also knows it’s not normal for that What is involved in teaching AI to recognise objects and same object to lay on the bedroom floor or bathroom tiles. identify abnormal behaviours? In its simplest form, AI is developed by feeding imagery and video content into the “It takes less than two seconds for the computer so it begins to recognise behaviour and activity. In this instance, we shared device to recognise someone may be at thousands of images including people or objects on the ground and a dog jumping off risk and immediately sends a notification to furniture — all aspects that could be involved in a fall or perceived as a fall. From there, their emergency contact, be it a neighbour, we teach the AI to identify what is a fall and what is not. Through the education process, loved one or nurse in an aged-care facility the technology begins to understand the difference between a pet and human, and so or hospital. on. The device then has the capability to continue to recognise habits and behaviour in Sajdak explained that an alert can also be the household and can adapt to its surroundings. escalated to other people if the primary contact fails to respond within a designated What was the main challenge you faced in developing the period. technology? To maintain security and privacy, our AI processes everything within the device — “Everything we have developed focuses on we do not transmit information to the internet for processing like other AI products. getting help to the user as soon as possible. Conducting this type of processing on the device is very difficult as one of the main “Falls cost Australian governments more challenges is ensuring we are processing high levels of data as quickly as possible. The than $3 billion in hospital admissions each second is making sure we’re doing it securely on the device to maintain the privacy and year and it’s directly related to how long dignity of its user. people are on the floor. The sooner you get to them, the better their chance of avoiding In what other applications might the technology be used? major issues or complications. AI has endless possibilities and opportunities to fit into everyday life. Our team are continuously testing the device’s capabilities and have a continued focus on developing “On top of this, many elderly people go the technology to identify further dangers and risks. This could include the detection from living independently in their own of weapons in a school classroom, monitor the existence of drowning in a pool or home into an aged-care facility as a direct supervising newborns to detect indications of SIDS (Sudden Infant Death Syndrome). result of a traumatic incident such as a fall,” At its core, HomeGuardian.ai aims to develop technology that can detect risks beyond he said. what is humanly possible and most importantly, save lives. To ensure the technology would enable better care for those using it, as well as How do you see the technology coming into its own in the face provide staff efficiency gains for care of the COVID-19 crisis? providers, HomeGuardian.ai worked with HomeGuardian can put families and care workers at ease in this chaotic time. With the aged-care groups and Southern Cross strict visitation restrictions put in place on aged-care facilities, hospitals and homes, University. families can have peace of mind knowing their elderly relatives can be monitored Sajdak said that aged-care homes, hospitals without additional physical contact and interaction. The device can not only safeguard and childcare centres can link the devices our elderly population but also dramatically reduce the risk of infection and provide to an alerting dashboard, allowing staff to relief to overworked and under-resourced medical staff. respond where and when they are needed. Are there plans to develop any associated technologies to “It’s akin to having a staff member assist the healthcare sector? monitoring each room 24/7. At this time, HomeGuardian is the best artificial intelligence-based fall detection product “This device is the perfect union of cutting- on the market, combating a very real problem for our older generation. Naturally, as edge technology and practical application. research and implementation continues, the extent of its capabilities will broaden, and It will allow people to live independently for we endeavour to offer further tech to assist the healthcare sector in future years as the longer, provide care providers with the best device becomes a staple in homes and facilities. incident detection technology in the world and, crucially, save lives.”

Fall-prevention technology helps seniors stand tall

ach year, one-third of people over StandingTall is an app that offers individually establish integrated processes and pathways E 65 years of age experience a major fall, tailored exercises to older Australians so that to deliver StandingTall to older people in the and half of those will fall again in the same they are able to exercise independently at future. Their model will improve access to a year. This makes falls the leading cause of home. Developed using the latest insights home-based, individualised exercise program hospitalisation among older people. in geriatric and translational neuroscience, appropriate for preventing falls in older the app employs mobile (tablet) technology people, including those living in regional and Research shows that people can lessen their to deliver an effective method for improving remote areas. likelihood of falls by completing two hours of balance and reducing fall risk. balance exercises each week for a six-month Among the StandingTall features are more period. On top of gaining and retaining Despite the national physical activity than 2000 different balance exercises tailored independence, older Australians who do guidelines, many older Australians do not get to certain abilities, a calendar to schedule these exercises are less likely to incur the the recommended 150 minutes of weekly exercise sessions and a goal-setting feature expensive healthcare-related costs associated exercise. StandingTall helps people achieve to keep users motivated. The app also keeps a with falls. this by providing safe balance training record of the user’s training so they can track programs that guide users through a series their progress. of movements within the time interval of their To qualify to trial the app, people must be choice. aged 65 years or older and live independently Neuroscience Research Australia (NeuRA) in the Sydney metropolitan area, Melbourne, researcher Associate Professor Kim Delbaere Mid-North Coast or Northern NSW. The app is and her team designed the app alongside The of particular relevance to those who have had Project Factory. The team hopes to make the a fall in the last six months or have current app available to the general public once trials concerns about falling. — taking place in NSW, Victoria and Northern The researchers ask that only participants England (UK) — are complete. without progressive neurological conditions Associate Professor Delbaere is working with — such as Parkinson’s disease, Multiple community groups and allied health service Sclerosis or dementia — apply. At present, providers in community settings, hospitals, researchers have replaced all face-to-face rehabilitation centres and retirement villages assessments and home-visits with remote throughout NSW. This will enable the team to methods, such as telehealth.

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hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 69 NURSING & MIDWIFERY AWARDS

HESTA announces 2020 Nursing & Midwifery Awards winners

ESTA has announced the winners of the 2020 HESTA Australian HNursing & Midwifery Awards, celebrating leadership and professional Tania Green, Cassandra Nest, excellence to improve patient outcomes. HESTA Nurse of the Year 2020 HESTA Midwife of the Year 2020 Each year, HESTA announces three winners — Nurse of the Year, Midwife of the Year and Outstanding Organisation — who this year will each receive $10,000 to be put towards further education or professional Ms Green said she will use the prize money to explore other national development. and international cleft services to establish networking, create HESTA CEO Debby Blakey said this year’s winners, who were announced educational opportunities and benchmark Monash Health’s cleft care via video broadcast due to COVID-19 restrictions, all exemplified the to further improve service delivery for families. reasons why 2020 was named International Year of the Nurse and Midwife. Midwife of the Year “Our 2020 winners have demonstrated extraordinary leadership in their respective fields, and I am humbled by their hard work and dedication to 2020 Midwife of the Year is Cassandra Nest from Gold Coast Hospital delivering quality health care,” Blakey said. and Health Service and Griffith University — recognised for her dedication to improving the delivery of culturally safe, quality maternity “The sector has faced unprecedented challenges this year — first care to more Aboriginal and Torres Strait Islander people on the Gold with devastating bushfires and storms, and now with the coronavirus Coast, particularly through the implementation of the Waijungbah outbreak — and never has the critical role health workers play in caring for Jarjums Service. Australians been more apparent. Ms Nest, who is a proud Ngunnawal woman and the first Aboriginal “HESTA is proud of our longstanding, trusted partnership with the health woman to join the midwifery group practice at Gold Coast University services sector and we are privileged to play a part in recognising the Hospital (GCUH), said she was grateful and honoured to be named as incredible contribution nurses and midwives make across Australia.” the 2020 Midwife of the Year. “Midwifery is my calling, it is what I was meant to be doing. This is more Nurse of the Year than just a job to me, this is my life, and the lives of my community,” she 2020 Nurse of the Year is Tania Green, Clinical Nurse Coordinator for said. Monash Health’s Cleft and Craniofacial Unit. Green is recognised for her work to improve care for patients with cleft and craniofacial conditions “I am these women, the women are my family, my culture, their babies and their families, supporting more than 500 patients. are our future ancestors and I am a part of the community whose experiences I am dedicated to improving.” Green said she was surprised and delighted to have been announced as the 2020 Nurse of the Year, which she said would help put a spotlight on Ms Nest was instrumental in setting up GCUH’s Waijungbah Jarjums the Monash Children’s Hospital cleft team, and their patients and families. Service, an innovative maternity health service that provides care and support to Aboriginal and Torres Strait Islander families, with care “Nursing is more than just a job for me, it is a part of who I am,” she said. delivered by First Peoples midwives and nurses. She was also the first “Cleft lip and palate is the most common congenital deformity and we Aboriginal woman to complete the Bachelor of Midwifery at Griffith support over 500 patients in our service.” University, where she now mentors and supports Aboriginal and Torres Strait Islander midwifery students. Ms Green has been instrumental in improving awareness of the treatment and care required for cleft-affected babies, including developing protocols Ms Nest said she wants to help increase the number of First Peoples that have increased the education and confidence of staff involved in their midwives, with the prize money to go towards a scholarship that care, and working with the special care nursery and neonatal staff. includes mentorship for a Griffith University midwifery student. “The Monash Health values are truly represented in the cleft team, who “In order to improve the experiences of First Peoples women and provide integrity, compassion, accountability, respect and excellence to families they need to be provided with culturally safe care,” she said. patients and colleagues alike.” “Increasing the amount of First Peoples midwives not only provides Green’s efforts have seen her set up antenatal consultations for parents the women and families they care for with access to innate cultural expecting a baby with a cleft lip and/or palate, reducing the number of knowledges, it contributes to the cultural safety of the whole workforce hospital visits families need. This saves families time and eases financial as First Peoples midwives advocate for culturally safe care and can pressures for those needing to travel from regional or remote areas. encourage others to do the same. “I have the best job in Monash Health and the opportunity to work with “As a recipient of scholarships whilst studying at Griffith University, the expert health professionals that make up the multidisciplinary team I understand the immense impact that a scholarship can have on is exciting, but it’s our cleft patients and families that make my work so the completion of the midwifery degree by taking away some of the rewarding, and I look forward to continually striving to develop the best financial stress that comes with being a university student and not cleft service,” she said. being able to work whilst studying.”

70 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au SoundEar®3 makes the noise visible ©stock.adobe.com/au/splendens

Ovarian Cancer Australia nurses Fiona and Di

Outstanding Organisation Ovarian Cancer Australia is recognised for its research, advocacy and support for women affected by ovarian cancer, especially its work to reduce the prevalence of ovarian cancer and improve early detection and survival rates. Ovarian Cancer Australia CEO Jane Hill said the organisation has helped more than 10,000 Australian families with their ovarian cancer experiences, with a key focus on providing tailored support to ensure no woman with ovarian cancer walks alone. “Many women who are diagnosed with ovarian cancer often say how isolating it is living with the disease,” Hill said. “I am proud that our team can be here for women during these times to ensure they are fully supported and empowered with knowledge and information to help them through all stages of their journey.” Six specialist cancer nurses form part of the team supporting women through their cancer experience. An Ovarian Cancer Support Nurse has overseen the development of ‘the resilience kit’, which gives women access to much-needed, reliable information, and the organisation’s network for younger women diagnosed with ovarian cancer is led by an Ovarian Cancer Support Nurse, who connects younger women with experts on a wide range of topics. “Every day our team strives towards our vision to save lives and that no woman with ovarian cancer walks alone,” Hill said. “Our highly qualified ovarian cancer oncology nurses do an outstanding job providing support information and referral for the 5000 Australian women living with ovarian cancer.” • All studies show: noise visualization Helps! Ovarian Cancer Australia’s advocacy efforts have resulted in a $20 million • Accurate measurements from 30 dB boost for ovarian cancer research, as well as the development of a • Reduce noise levels national case management program that aims to improve the wellbeing – In the intensive care unit and treatment for women with ovarian cancer. – In neonatology Ovarian Cancer Australia has developed prevention and early detection – In the operating room programs for women at high risk of developing ovarian cancer and has developed a National Action Plan to coordinate research efforts to – In the patient’s room improve survival rates. The organisation is also supporting Australia’s first – In the hallway and in the lounge areas research project on how an ovarian cancer diagnosis impacts a woman’s • Increased concentration for staff male partner. • Faster recovery for patients Ms Hill said Ovarian Cancer Australia will use the prize money to fund the • Automatic noise reports Staff Wellness Program to provide staff with debriefings, presentations by • Warning by email / SMS clinical psychologists and wellness activities. “By supporting the OCA team, we can ensure they are fully equipped to continue our vital work supporting women impacted by ovarian cancer, Contact: www.soundsafety.com.au particularly during this difficult time as we support staff wellbeing and prevent burnout,” Hill said.

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 71 IN CONVERSATION

In Conversation... Dr Harrison Steel

In Conversation provides a glimpse into the life of an ‘outlier’ — an exceptional person going above and beyond to improve outcomes in their field. Oxford University scientist and John Monash Foundation scholar Dr Harrison Steel has been directly involved in two significant projects that have impacted the COVID-19 health crisis. One is his research as part of a team of scientists at Oxford University that has evolved into a form of rapid testing for COVID-19. The other is OxVent, a project devised to answer the demands of the current global ventilator shortage.

Harrison Steel is the 2016 Roden Cutler NSW John Monash Scholar.

72 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au DR HARRISON STEEL

Tell us about your experience working on the frontline of COVID-19. It has been a very busy time. Once the severity of the ongoing pandemic became clear, there was a worldwide realisation

that fighting and eventually overcoming ©stock.adobe.com/au/sdecoret the virus would require a huge scientific and engineering effort. Many departments and research groups at Oxford immediately switched focus to working on this challenge, and I am glad to have been able to contribute my expertise.

What did you study at university that allowed you to be selected and involved in the medical frontline of a pandemic? As an undergraduate I studied Mechanical Engineering and Science at the University of Sydney and worked in many industries including space science (at NASA Ames), quantum computing (at the University of researchers have been generous to lend Seeing our technology progress rapidly Sydney) and particle physics (at DESY). I their time and expertise to help on many was very rewarding, with a personal was then awarded a Monash scholarship different fronts, and likewise they have been highlight for me being the Queen to go to the University of Oxford, where quick to consult and include colleagues that lending use of her personal helicopter to I completed a PhD (here called a D.Phil) can provide other skills and expertise. transport circuit boards I had designed in Engineering, focusing on robotics and across the country. biotechnology. Can you tell us more about the two In the subsequent weeks the evolving My work focused on developing new projects you were/are involved pandemic situation in the UK thankfully biotechnologies for medicine and industry, with? did not reach the ‘worst-case’ predicted and I also founded a spin-out venture scenarios. This was great news for that produces open-source robotic Most of my time in the past two months us, and the British people as a whole, technologies. I now hold a fellowship at the has been spent working on the OxVent as it meant that the NHS would (for University of Oxford, where my research ventilator project. This project was the most part) be able to cope with spans fields from synthetic biology to initiated by a PhD student in a biomedical the pandemic whilst remaining within experimental robotics to evolution. engineering group here at the University of capacity. However, this also meant that Oxford. A team quickly assembled to drive OxVent (and the majority of the other Were you selected from a group of this project, for which I have been leading Ventilator Challenge projects) would the electrical engineering effort. In the other talented Oxford scientists to likely not be required for the domestic space of three days we rapidly produced fight against COVID-19; pre-existing participate in these projects? What a prototype of our ventilator technology, commercial ventilators would cover was this process like? which we presented to the UK cabinet this need. Upon receiving this news office as part of their Ventilator Challenge. The past few months have been frantic — we immediately began reaching out OxVent was selected as one of the few across the university, projects have been to our international networks, as many novel ventilator designs to be funded in accelerated to address many facets of the countries (particularly in the developing this competition, and we set to work on international response to COVID-19. In many world) have very limited access to building, testing, and clinically validating cases these projects may have started with these life-saving technologies, and our system. a few academic researchers or students, are still far from reaching the peak of who then brought colleagues with expertise The government ordered more than their domestic pandemic. We are now in related fields, quickly building large 5000 OxVent units, with initial deliveries working on several fronts to get OxVent interdisciplinary teams. scheduled within the month. Meeting this units deployed where they are most deadline would require a round-the-clock needed. I was already working in a laboratory that effort from our team. At this point we were specialises in developing novel ‘biosensors’ very fortunate to be paired up with medical — their work quickly transitioned into the device manufacturers Smith & Nephew, who project on rapid COVID-19 diagnostics. My provided decades of experience in product experience in building new biotechnologies development, manufacturing and logistics. led to me being contacted to help on the A large part of our team travelled up to their OxVent project. manufacturing plant in Hull and worked The collaborative atmosphere at Oxford has in partnership with their engineering and enabled widespread cooperation on many manufacturing experts to refine our system Read the full of these projects. A time of crisis is not a and complete the rigorous testing required story online. time for overly aggressive competition — for regulatory approval of the device. ©stock.adobe.com/au/Mongkolchon ©stock.adobe.com/au/Mongkolchon

hospitalhealth.com.au WINTER 2020 HOSPITAL + HEALTHCARE 73 Seniors adventure Out & the world, virtually About

ormally our Out & About feature bring people together in a shared experience Nshowcases an event that is happening out and sense of purpose. in the world. This issue — with events across “After taking part in our sessions, we’ve found Australia being postponed or cancelled — we that residents feel more connected to each are turning the concept on its head and looking other and their care team, and are more likely at how some of Australia’s seniors are getting to share memories and stories.” out and about virtually. SilVR Adventures provides access to its A Melbourne-based start-up has brought the library of continuously updated VR content world to seniors isolated in aged-care homes via curated especially for seniors. The programs a virtual reality (VR) headset. are developed to cover three key experience Specialising in group VR therapy and social areas: reminiscence therapy, world travel engagement among the elderly, SilVR and family bonding, so even visiting family Adventures began services in 2019 with guided members can share an experience with their communal VR sessions that encourage social loved one. interaction for groups of seniors in care homes “It’s amazing to see the impact our group across Victoria. VR sessions have had with participants, and As a result of ongoing lockdowns due to fantastic that our partners are working to the COVID-19 pandemic, the company has improve the wellbeing of their residents by introduced a self-service subscription solution embracing new technology,” Pudsey said. that allows aged-care facilities to run as many sessions as desired for an unlimited number of What participants say residents, while adhering to social distancing. “That was so overwhelming, to go from sitting here and now we can go anywhere. I can’t “Our goal is to increase the happiness of even begin to think of where I want to go. How care-home residents and tackle the isolation can you make that decision when you say you many feel on a daily basis, especially during this can take us wherever we want to go? That was difficult period,” SilVR Adventures CEO Colin magnificent.” — Maree, 85 Pudsey said. “I forget everything in the last 50 years. What I “We can transport residents to a treasured talk to my wife about, everything I forget. But I’ll memory from their youth, or even create new never forget you. I’ll never forget this. I’ll never memories of adventure and wonder. But the forget today. This was amazing. Thank you.” — greatest feature of our sessions is that they Mario, 88

74 HOSPITAL + HEALTHCARE WINTER 2020 hospitalhealth.com.au

When you hear the bell it’s time for

Protect staff and patients Clean and disinfect touchable surfaces to stop the spread of infection.

Running your own initiatives It can be challenging to keep environmental hygiene top-of-mind when there are so many other commitments competing for time. Clinell Time is a way to remind staff and get them all involved in environmental hygiene, making surfaces safer and protecting patients. When the bell is rung, everyone decontaminates their working area.

If you would like to recieve a Clinell Time pack, please call us on 03 9769 6600, or email [email protected].

@Clinell_Aus #Clinelltime @GAMA_Healthcare_Australia #Clinelltime GHA200196

GAMA Healthcare Australia Pty Ltd., Suite 1, 33-37 Duerdin Street, Notting Hill, VIC 3168, Australia. T: +61 (0)3 9769 6600 E: [email protected] www.gamahealthcare.com.au