Epworth HealthCare Annual Report 2019-20

Our living history: Epworth HealthCare Annual Report 2019-20

Our living history: 100 years of care Acknowledgement of Country Contents Epworth HealthCare acknowledges the peoples of the Kulin Nations, the Traditional Custodians of the land upon which we work and care for our patients. We honour the unique and continued spiritual connection that Australian Aboriginal and Torres Strait Islander peoples have to land, 01 waters and culture. About us______ii

About us Epworth was established in 1920 by the Conference Epworth HealthCare is Victoria’s largest not-for-profit (organising body) of the Methodist Church. It was the 02 private hospital group, renowned for excellence in idea of the Reverend William Palamountain, a Methodist From the President______6 diagnosis, treatment, care and rehabilitation. Epworth is an innovator, embracing the latest in evidence-based medicine, minister at Long Gully in Bendigo. His drive and passion pioneering treatments and services for our patients. inspired leading doctors and many generous benefactors to support him. A mansion on Richmond Hill was bought. Our vision: Caring for people. Innovating for a healthy The name ‘Epworth’ was chosen, as it was the birthplace of 03 community. John Wesley, the founder of the Methodist Church. From the Group Chief Executive___ 8 Our purpose: Every patient matters. We strive to improve health outcomes and experience through compassion, Epworth opened as an intermediate hospital, regarded collaboration, learning and innovation. then as a hospital for people ineligible or not wishing to be treated at public hospitals, but unable to afford 04 Our values: Respect, excellence, community, compassion, Connected Care______17 integrity, accountability. the private hospitals, which were considered expensive. Despite economic depressions and World War II, Epworth Our history: This year we mark 100 years of care. Epworth succeeded as a not-for-profit private hospital. In 1980, it was founded by a Methodist minister in 1920 as a 25-bed was incorporated under its own Act of Parliament. community intermediate hospital in Richmond, for those 05 on moderate incomes. Today, our care is world-class, our Empowered People______49 technology is state-of-the art and our ethos is to always put patients first.

About this report Commonly used terms 06 Innovative Practice______87 This Annual Report details achievements and highlights Throughout this report we use these acronyms: of the 2019-20 financial year and reflects back on our 100 years of care (1920-2020). This special centenary edition Š DHHS – Department of Health and Human Services (our final printed version) follows the pillars of the Epworth Š EMF – Epworth Medical Foundation Š ICU HealthCare Strategic Plan 2018-22—Connected Care, – Intensive Care Unit 07 Empowered People, Innovative Practice and Sustainability. Š PPE – Personal Protective Equipment Sustainability______105 Š VMO – Visiting Medical Officer Historical information is sourced from Epworth: A tradition of care 1920-2010 by Janette Bomford.

This report is available online at epworth.org.au. ii Epworth HealthCare Annual Report 100 Years of Care 1 100 years of care Our hospitals

Epworth Brighton—a rehabilitation Epworth Camberwell—is home to Epworth Cliveden—a 28-bed boutique Epworth Freemasons—operates on two Epworth Eastern—a 223-bed hospital Epworth Eastern Kew—a hospital on a hospital supporting people to rebuild rehabilitation and mental health services, hospital specialising in cosmetic, plastic sites in East Melbourne (Albert Street in Melbourne’s eastern suburbs is newly refurbished site, which began their strength, restore their confidence as well as a specialist sleep studies unit. The and reconstructive surgery, gynaecology, and Victoria Parade). These two hospitals currently being redeveloped. Epworth operating in September 2019 to ensure and reclaim their independence. Epworth rehabilitation service provides inpatient and pain management, breast surgery and comprise 224 overnight beds, 44 postnatal Eastern provides specialty cardiology and minimal disruption to Epworth Eastern Brighton provides rehabilitation for a outpatient therapy for a variety of conditions, maxillofacial surgery. suites, nine delivery suites, a special care cardiothoracic services, and has state- patients and medical staff, while our range of needs, including orthopaedic including orthopaedics, chronic diseases nursery, 10 operating theatres, a day of-the-art digital operating theatres, redevelopment progresses. It features surgery and musculoskeletal injuries, such as heart failure and cancer; chronic procedure centre and an eight-bed critical including a da Vinci robotic system. three theatres, a procedural room and ageing, pulmonary conditions, falls and pain, and neurological conditions including care unit (CCU). Specialising in women’s Specialties include orthopaedic care, with a day surgery unit. We provide patients balance concerns and also neurological Parkinson’s disease and stroke. The mental health, Epworth Freemasons runs one of particular expertise in knee, hip and upper with services including general surgery, conditions, such as stroke, multiple health service, known as Epworth Clinic, Victoria’s best maternity hospitals. The and lower limb, comprehensive oncology urology, plastic surgery, ear nose sclerosis (MS) and Parkinson’s disease. provides a variety of inpatient and outpatient hospital also focuses on men’s health services and an 18 chair renal dialysis and throat (ENT), oral maxillofacial, programs to support a range of mental with the E.J. Whitten Foundation Prostate unit. Vascular, urology and plastic and orthopaedics, gynaecology, colorectal, health needs, including a dedicated aged Cancer Research Centre onsite. It offers reconstructive surgery services are also endoscopy and vascular care. psychiatry service. comprehensive cancer care and a full available. range of surgical services, including robotic assisted surgery.

Specialist centres

Epworth Geelong—a 171-bed acute hospital Epworth Hawthorn—is a boutique surgical Epworth Richmond—an acute 700-bed Epworth Specialist Centre Lilydale— Epworth Transitional Living Centre (TLC)— featuring an emergency department (ED), centre specialising in orthopaedics, plastic hospital with emergency care, a 26-bed specialists provide the local community located in Thornbury, the centre provides nine-bed ICU, eight-bed complex care unit, surgery, urology, oral faciomaxillary, ICU and a 39-bed cardiac unit. Specialties with access to a range of medical, accommodation for people with brain two operating theatres, two endoscopy general surgery, vascular, gynaecology include cardiac care, neurosciences, radiology, surgical and allied health injuries, to help residents integrate into rooms, catheter laboratory, day oncology and assisted reproductive services via orthopaedics, cancer, ENT, general services, before and after surgery. the local community by supporting them unit, renal dialysis unit, birthing suites Monash IVF. Epworth Hawthorn also medicine and surgery. A dedicated to relearn everyday living skills in a real and special care nursery. Specialties houses our renowned multi-trauma paediatrics emergency and ward care is life setting. include cardiology, oncology, neurology, orthopaedic rehabilitation service, available to children and adolescents. The neurosurgery, gastroenterology, colorectal supporting people who have sustained hospital also offers rehabilitation services, surgery, orthopaedics, urology, vascular traumatic orthopaedic injury, minor brain specialising in orthopaedic and surgery, obstetrics and gynaecology (O&G), injuries, amputation, complex wounds and neurological rehabilitation with a focus on and rehabilitation. burns following an accident or injury. acquired and traumatic brain injuries.

4 Epworth HealthCare Annual Report 100 Years of Care 5 From the President

While the Summit program and its We are indeed fortunate to have such Recently, Christiaan has contributed his Epworth has come a long way since 1920 when the projects are currently on hold, we have a loyal group of generous donors. This wisdom and guidance to the Voluntary identified six key strategic projects looking philanthropy has led to the purchase Assisted Dying Committee, and has hospital was founded with a philanthropic gift to provide at new ways to deliver care. They include of the latest medical equipment, chaired the Epworth Research and the highest possible standard of care to patients. investigating ways to respond to specialist upgrading of facilities and expansion Advisory Committee. We are fortunate care needs in remote areas of Victoria and of services to help our patients. One that he has agreed to continue in that role. In its first year, Epworth had five employees and beds for 25 patients. Today, Epworth using Artificial Intelligence (AI) to improve of the most amazing examples of this Serving for nine years, Robert Macmillan is Victoria’s largest not-for-profit private hospital group, with more than 7,100 staff, clinical practice and care delivery. I am was the purchase and renovation of has been invaluable as an expert member 2,600 doctors and 264 volunteers. Its hallmark throughout these years has been a excited to see how we can further this a unit near Epworth Richmond–the of the Finance Committee throughout commitment to provide compassionate care. work and continue improving care for Hope and Tony Saba Family House. his term and as chair of that committee our community. Thanks to philanthropy, we can provide for several years. As Deputy President, accommodation for patients’ families from Robert has been a great support to me for Strategic plan update regional and interstate locations, who are the past three years. On behalf of myself At the end of 2019, we had many plans Research continues to grow Training and education experiencing financial distress. and the rest of the Board, I warmly thank for the future, with intentions to focus We have always known that our centenary Laura, Christiaan and Robert for their on developing strategic projects and new This year, I am once again particularly At Epworth, continuous education is year would give us a moment to reflect This year, our pro bono work ranged generous and important contribution. innovations, as well as celebrating the proud of the research undertaken across something we value greatly. Our highly- on the past, but it has also given us from enabling a young woman from Papua remarkable 100-year history of Epworth. all our sites. Our five-year research trained staff deliver expert care to impetus to look to the future, to ensure New Guinea (PNG) to walk without pain, Thank you also to our Group Executive strategy focuses on ensuring findings are patients. Our education teams are kept Epworth continues to be a leader for the to assisting the people of Samoa following for providing strong leadership through This year, 2020, is our centenary year. translated to improve patient care and busy ensuring Epworth employees and next 100 years. a devastating measles outbreak. This work tough times and to all our employees, It was meant to be a year of celebration. provide tangible patient outcomes. doctors are always learning. is only possible with the support of our doctors, volunteers and supporters who Instead, it has been a year where we have We know the general health of people in our community and partners—together we’re make a difference. Every day. all been tested by a global pandemic. Highlights this year include: A new simulation lab at Epworth community can improve and we are looking bringing about positive change in a wide In March 2020, we rapidly refocused Freemasons enables our clinicians to take for opportunities to contribute to this. range of areas. Ms Maryjane Crabtree our efforts to contribute to the statewide Š our involvement in the BRACE trial, a hands-on approach to learning, with the response, caring for our Victorian which investigates whether healthcare lab mimicking a real clinical environment. We are seeing a need for additional Thank you community and ensuring our patients, workers can be protected against mental healthcare services and a employees and doctors were safe. the severity of COVID-19 by having Epworth employees have an opportunity community preference for different As Epworth has grown, the constants the Bacillus Calmette-Guerin (BCG) to further their skills and knowledge options of care, either in the hospital have remained—compassionate, Instead of recollecting past achievements, vaccine, previously used to protect through our unique scholarship program. or at home. individualised and evidence-based our thoughts at this time have evolved into against tuberculosis (TB). This trial is Each year, we fund further education, care. We look forward to continuing this pride for the way our people have handled being supported by the Bill and Melinda upskilling, conference attendance or study We are also partnering more with our legacy, building more pathways to care this crisis. Our partnerships with other Gates Foundation tours, so staff can learn the latest, most consumers, providing opportunities for for patients and ensuring our employees organisations have been strengthened, Š a researcher at Epworth receiving effective and innovative ways of caring for them to have a stronger voice in shaping develop to their fulles 0t potential. as we have worked with our state a $2.1 million National Health and patients. our services and how we deliver the care government and colleagues, in both Medical Research Council (NHMRC) we provide. Thank you to my fellow Epworth Board public and private health, to deliver the grant to investigate brain stimulation Epworth also supports our Visiting members for their ongoing commitment best care to patients. In many instances, therapies for mental health disorders Medical Officers (VMOs). Epworth Community kindness and dedication. In particular, I thank three our people have gone above and beyond, Š participation in two Australian- developed an inaugural Epworth Summit directors leaving our Board in November at a time when our community has felt led international clinical trials on 2020 VMO Leadership Program and Once again, our generous donors and 2020. Laura Anderson has served for great distress. individualising the approach to treating selected 24 of our brightest medical community have shown great support six years, and we are grateful for the bowel and rectal cancers. talent to take part. Before the program for Epworth. This year, the Epworth expertise and broad experience she has was paused, due to the pandemic, this Kindness Movement was formed after contributed. Revd Emeritus Professor group was scheduled to travel to Harvard our community wanted to show its Christiaan Mostert has been on our Board in the USA, to participate in an incredible appreciation during the pandemic. for nine years, and in addition, was the opportunity to learn from others in various Our employees and doctors have enjoyed long-time chair of our Human Research medical fields and expand their expertise. treats, food and hot drinks, all donated and Ethics Committee (HREC), a very by our extremely supportive community. exacting and time-consuming role. 6 Epworth HealthCare Annual Report 100 Years of Care 7 From the Group Chief Executive

Epworth executives and staff played a key The establishment of Staff and VMO Clinics Looking forward Our centenary year will certainly go down as one to role in assisting this response, supported at multiple Epworth sites was another by hospital ‘cluster’ groups (public and important part of the COVID-19 response. While 2020 has been incredibly challenging, remember. In February, the first of many planned private), aligned by geographic location. Our staff and doctors underwent intensive Epworth will emerge from the pandemic celebrations took place with multiple events across Associate Professor Luis Prado, in his role training in PPE protocols, so important in stronger and even more committed to as Chief Medical Officer, worked tirelessly controlling COVID-19. innovation, research and our patients. Epworth sites on our centenary day, 27 February 2020. to ensure Epworth kept its patients, staff The day finished with a memorable celebration dinner at the Melbourne Town Hall and doctors safe. Support for our nurses Safety and wellbeing Thank you to Epworth Board President, where significant Epworth figures (past and present) were honoured at an event and infection control procedures was Maryjane Crabtree and the members of featuring a keynote speech by the Hon. Lord Mayor Sally Capp. critical and Executive Director Clinical Safety has always been a priority at the Epworth Board for your leadership Services and Chief Nursing Officer Paula Epworth. Our ‘Speaking up for Safety’ and support of the organisation in 2020. Stephenson and her team assisted contact program is an important part of our I would also like to acknowledge the tracing, while providing Personal Protective culture, encouraging and supporting Group Executive for their hard work and Little did we know how the year would Assisted by site-based Executive General Reduced surgical volume and patient Equipment (PPE) expertise and advice. staff to speak up for patient safety. The contribution during such a unique and unfold; 2020 has given new meaning to Managers and the Hospital and Group admission numbers in the last quarter These initiatives would not have worked challenges of the year also renewed our challenging year. This year, we farewelled words such as ‘unprecedented’, ‘furlough’ Executive teams, the One Epworth of FY20 impacted on our activity this year, without the support of Epworth doctors, focus on mental health and wellbeing. Liz Camilleri after 30 years of service to and ‘pivot’. It has created significant approach is critical in assisting further with only ED presentations increasing nurses, allied health and support staff, We produced a range of new resources Epworth but we have been very fortunate changes in how we all live, including growth in the clinical services Epworth year on year. who have been both flexible and selfless in for employees, aligned with the values to appoint Cameron Fuller to the Executive wearing masks, physical distancing and provides to the Victorian community, on assisting our community. and behaviours of Epworth. Maree Feery, Director Finance role. Danny Gravell was being home before curfew. a financially sustainable basis. A variety In the last 12 months, Epworth has Executive Director People & Culture and appointed to the role of Chief Information of strategies and initiatives are being provided care to patients throughout The model of private and public hospitals Epworth People & Culture teams have Officer, bringing expertise to Epworth from Despite the many other challenges, developed as we continue to explore Victoria, resulting in: working in close collaboration is likely done a great job supporting employees outside the health sector. the resilience of Epworth employees, new ways of working, while building to continue to develop in the future and throughout the year. doctors and supporters has enabled the partnerships across the sector. This Š more than 191,000 patient admissions, Epworth is well-positioned to benefit from I also extend my heartfelt thanks to all organisation to continue caring for our includes working closely with the public a 5.4% decrease on last year its role in 2020, supporting the pandemic This year, we introduced online training in Epworth employees, doctors, volunteers patients with compassion and in a safe sector in Victoria to capitalise on the close Š surgical procedures numbering more response. Commonwealth Government diversity and inclusion to improve education and partners who continue to provide environment. The settings for this care collaborations made during the pandemic. than 116,000, a 9.4% decrease support in the form of a Comprehensive and understanding of the importance of their care and support to benefit our have varied, involving Epworth nurses Š more than 61,000 same day procedures, Funding Agreement enabled Epworth, and acceptance and respect for every member patients, their families and carers. and other staff assisting activities such as From April 2020, Epworth joined the a 9.7% decrease the private hospital sector, to mobilise in of our community. contact tracing. I am incredibly proud of the statewide pandemic response, with Š a 3% increase in ED presentations April to provide staffing, expertise and bed Victorians have entrusted Epworth with role Epworth has played in the statewide Epworth Geelong assisting the Barwon Š 7,300 ICU bed days, a dramatic decrease capacity to support the pandemic response. Turning 100 their care for the last 100 years and we are pandemic response. regional response. At the same time, from the previous year (9,800 bed days). honoured to continue this tradition. elective surgery across Victoria was greatly Education and reskilling For 100 years, Epworth has provided Financial year 2020 (pre-COVID) was reduced to ensure private and public COVID-19 response outstanding care to the Victorian Dr Lachlan Henderson already busy and challenging, with a focus hospitals had the capacity to respond to Clinical education has been more community. Across a range of medical, on improvement under a ‘One Epworth’ rising numbers of COVID-19 patients. The While the COVID-19 response has been important than ever over the past 12 surgical, obstetric, rehabilitation and operating model. The appointment of pandemic has also resulted in new ways incredibly challenging, the emergence of months. In particular, expertise and mental health specialties, Epworth Nicole Waldron as Chief Operating Officer- of working for many, with our patients, a stronger partnership between private training in the critical area of infection continues to research new and better Hospitals in late 2019 has been significant employees and doctors using digital and public health services and state prevention and control was prominent ways to diagnose and treat generations of in standardising the approach across our technology to stay safe and connected. government bodies has been a significant across all Epworth sites. Early in the patients, from newborns to the elderly. 11 hospital sites, which was particularly Epworth used this period to accelerate step forward. The formation of a Private pandemic response, Epworth established valuable during the pandemic. our digital strategy, with patients and Hospital CEO group and a statewide an internal contact tracing team, noting Our success is consistently enabled by clinical staff benefitting from telehealth Pandemic Response Committee were that COVID-19 testing, tracing and isolation the philanthropy of our generous donors consultations and technology enabling initiatives that assisted a coordinated was extremely important to control the and partners. Thank you to Scott Bulger, corporate staff to work from home. response to the pandemic. spread of the virus. Executive Director, Epworth Medical Foundation & Brand and to all in the Epworth community for their generosity and support. 8 Epworth HealthCare Annual Report 100 Years of Care 9 Epworth highlights

4,552 2,771 7,184 264 191,042 40,892 116,691 7,384 Children treated Births Employees Volunteers Patient admissions Emergency presentations Procedures undertaken ICU bed days

Year at a glance Our top specialties in 2019-20 across all sites Emergency Department care Patient admissions across Children treated (across Epworth Richmond and all Epworth hospitals The COVID-19 pandemic has had a Primary specialty Episodes of care Bed days Epworth Geelong) dramatic effect on our hospitals. There were large decreases in patient activity, Medical oncology 21,270 40,809 Year Emergency presentations Year Total patient admissions Year Total children treated as we joined the Victorian statewide response to preserve hospital capacity. General surgery 18,368 40,378 2019-20 40,892 2019-20 191,042 2019-20 4,552

Compared to last year, Epworth Gynaecology 2018-19 39,708 2018-19 201,846 2018-19 4,871 Richmond Emergency Department 16,549 32,300 had a very different last quarter, General medicine 2017-18 2017-18 2017-18 with a 23% decrease in the number 16,078 47,969 38,139 186,593 4,898 of presentations, due to pandemic 3% increase in emergency presentations 5.4% decrease in patients admitted in the 6.5% decrease in number of children restrictions introduced in Melbourne. Gastroenterology 15,041 19,610 compared to last year. last year. treated in the last year. Epworth Geelong experienced an 18% decrease. However, overall ED Orthopaedic surgery 14,269 49,363 presentations increased slightly. Urology 13,149 20,301 Surgical procedures undertaken Same day procedures Critical care Year Procedures undertaken Year Same day procedures Year ICU bed days Clinical haematology 9,920 21,509 2019-20 116,691 2019-20 61,404 2019-20 7,384 Rehabilitation 7,963 67,013 2018-19 128,720 2018-19 68,053 2018-19 9,848 Plastic surgery 7,685 13,107 2017-18 117,757 2017-18 61,074 2017-18 9,001 Nephrology 7,534 8,788 9.4% decrease in procedures undertaken 9.7% decrease of same day procedures 25% decrease in ICU bed days in the last year. in the last year. in the last year. Cardiology 6,963 21,781 Psychiatry 3,982 17,643

10 Epworth HealthCare Annual Report 100 Years of Care 11 Looking ahead

Epworth HealthCare We will continue Strategic Plan 2018–22 developing the following priority Our patients remain at the centre of all we do. Our strategic plan is underpinned areas next year: by four pillars—Connected Care, Empowered People, Innovative Practice and Sustainability. Adapting and responding to a changed environment prompted a refresh of the Strategic Plan this year, which saw a focus on priority areas. Our focus areas include building closer partnerships Connected Care Empowered People with government, revenue diversification and growth, and exploring different ways Š Partnering with consumers Š Safety and wellbeing (see page 59) of working. (see page 19 for more) Š Diversity and inclusion (see page 60) Š VMO engagement Š Workplace flexibility for employees 1980s first mission and values formulated

In 1986, staff formulated its mission and values, which included a series of commitments based on care for patients and members of the Epworth community, and striving for excellence in all aspects of the hospital’s work.

A new logo was adopted in 1995 (pictured above) to coincide with the redevelopment program and to reflect a modern image. The circle represents totality; the figure within the circle represents the people, both care givers and receivers; the outstretched arms form a cross, which symbolises the Uniting Church, with which Epworth has affiliations and the body is Innovative Practice Sustainability encircled by the lower case ‘e’, which represents Epworth and Š Innovative projects such as telehealth Š ‘One Epworth’, maximising the benefits the focused care the hospital is committed to providing. (see page 42), Hospital in the Home and of our scale, to ensure sustainability expanding our mental health services and improve operational efficiencies In 2005, as Epworth Richmond celebrated its 85th anniversary, to support our community Š Use of more digital platforms to better a new theme was adopted: ‘Epworth: Excellence, Everywhere, serve our patients, employees and community. Every Day’ and ‘Team Epworth’ was introduced, which was an initiative to involve all staff and to reward excellence.

12 Epworth HealthCare Annual Report 100 Years of Care 13 Artefacts over the years

As part of our centenary These precious treasures celebrations, a number of include a traditional Epworth historical items at Epworth nurse’s cloak, hat, badge and were pictorially catalogued, egg cup, reminiscent of a enabling us to reflect back bygone time and evoking upon the last 100 years. fond memories for many.

14 Epworth HealthCare Annual Report 100 Years of Care 15 04 Connected Care Our patients

We are committed to partnering with our patients and doctors to provide high quality care that is tailored to the choices of our patients.

28 July 1920

In his reports in the Spectator, the Reverend Palamountain stressed that the “wards must be bright and colourful. Our patients must have the best.”

16 Epworth HealthCare Annual Report 17 Our patients

“The Epworth Partnering with When we refer to ‘consumers’, we mean people who use, potentially Consumers Strategy empowers will use, or have previously used us to ask… and to be heard.” Epworth services. The term includes families, carers and patients, or more Epworth HealthCare Diana Dundon Chair, Epworth Consumer Advisory Committee broadly people and communities. Partnering with Consumers Strategy

Our patients come from varying Other countries of origin are: Patient satisfaction The survey asks patients a wide range Key results: Partnering with consumers backgrounds. In 2019-20, we had more of questions about their hospital stay than 191,000 admissions to Epworth Š England We regularly survey our patients at Epworth, including the overall quality 87.5% The aim of our Partnering with hospitals and more than 40,800 Š Italy to gain feedback on their experiences, of care, the care received from doctors overall mean patient experience score Consumers Strategy is to provide a presentations to our EDs. The majority Š United Kingdom which allows us to continually improve and nurses and the discharge process. voice to members of the community we of patients (77.5%) were born in Australia. Š China our services. serve. This strategy was approved by the Š New Zealand Epworth improved across most survey 90.6% Epworth Group Executive in October 2019 mean satisfaction score of nurses Š India In January 2020, we moved our patient sections, compared to 2018-19. Pleasingly, and developed in consultation with our Š Greece experience survey from a paper-based our overall patient experience score Consumer Advisory Committee (CAC). format to an electronic option, leading to continues to improve each year. 89.8% We encourage our consumers to be Our patients are generally aged 65-74 2,321 more responses than last year. This mean satisfaction score of doctors actively involved in making decisions years, with a large number of people also survey, which is conducted independently about their care and treatment, including aged 55-64 years and 75-84 years. by Insync/Press Ganey, is now sent to all how we plan and deliver our services. patients with an email address. 91.6% would recommend Epworth to family and friends.

18 Epworth HealthCare Annual Report Connected Care 19 5C activities

The strategy is built around our ‘five Cs’:

1. Clear communication – to ensure consumers can understand and act upon the information we provide. 2. Compassionate care – we encourage employees to show sensitivity to understand other people’s situation and demonstrate willingness to help and find solutions. 3. Cultural responsiveness – see activities on page 58. 4. Coordinated care – working together, Patient numbers to ensure the health needs of our patients are met at the right time and by the right By February 1931, the hospital had a record of 123 person, involving general practitioners patients on one day and the next month, when the (GPs) and patient families in our new children’s ward opened, the daily average peaked communications. 5. Capacity building – we’re continually at 139. Another balcony had been glassed-in and enhancing the knowledge and skills Epworth was now a 140-bed hospital, the largest by of our workforce, patients, caregivers far of its type in Victoria. and community. This includes: Each successive year was the busiest ever, rising from − a Consumer Advisor Register – a daily average of 208 patients in 1940 to almost 217 we currently have 20 consumer in 1943, with a peak of 237 patients treated on one advisors on our register − health literacy training was provided day. Given that Epworth was a 200-bed hospital, to selected employees and several its facilities were obviously strained to the limit and consumer advisors many patients had to be refused admission. in May 2020. By August 1949 a total of 12,421 babies had been born at Epworth but despite the baby boom, the daily patient average had fallen from a peak of 216 in 1943 to 158 in 1950 because of the shortage of nurses and the forced reduction of bed numbers.

20 Epworth HealthCare Annual Report Connected Care 21

Continual improvement Pressure injuries Epworth clinical services Vital link between mental Mental health provider health and acute care for the AFL in clinical care A pressure injury is a localised injury to ulcers (full thickness skin tissue loss A Victorian first: neuropsychiatry service To keep our patients safe and able to return the skin and/or underlying tissue, which with exposed bone, tendon or muscle) With mental health expertise well- Epworth has partnered with the AFL to to their daily lives as soon as possible, we occurs as a result of pressure or pressure and unspecified decubitus ulcer and Epworth has established Victoria’s first established at Epworth Camberwell, become a preferred provider of mental monitor key clinical indicators. Our aim is in combination with friction. pressure areas. private neuropsychiatry assessment and the team wanted to ensure the availability health services for AFL players and their to perform better than benchmarks and to management service, in partnership with of clinical mental health interventions families. Dr Ranjit Menon, a specialist in continually improve our care. Epworth recorded fewer pressure injuries The Australian Commission on Safety the neuropsychiatry unit at the Royal for all Epworth patients. sports psychiatry and part of the Epworth in patients during their admission and Quality in Healthcare (ACSQHC) Melbourne Hospital (RMH). Rehabilitation, Mental Health and Chronic Avoidable harm compared with industry benchmarks. sets a target of 10 for hospital-acquired A new role, Epworth Clinic Consultant Pain Clinical Institute, has taken on this complications (which includes pressure Neuropsychiatry is a sub-specialty, Liaison (CL) Psychiatric Nurse, specialist role. We have established a taskforce to identify Hospital-acquired complications (HAC) injuries, falls and infections). Epworth dedicated to the assessment and was established, with Julia Segal and implement opportunities for continual include the diagnoses of stage III ulcers was well below this target, achieving treatment of patients presenting with commencing in July 2019. This signals a strengthening of our improvement. (full thickness skin tissue loss), stage IV an average rate of 1.3. complex symptoms that cover both existing partnership arrangements, as psychiatric disorders and neurological This role provides expert mental health we already work with the AFL in sports In the past 18 months, Epworth has: symptoms or disorders. care to acute medical and surgical patients, medicine and concussion and Epworth Major HACs Rate ACSQHC Rate 2018 admitted to hospital, with pre-existing or remains an ongoing sponsor of the Š strengthened the process staff use All private patients who need inpatient emerging mental health concerns that AFL Doctors Association and the AFL to check and confirm patient details assessment and management were need to be supported. Physiotherapists Association. prior to surgery 4 admitted to the statewide service offered Š aligned surgical check lists to support 4.0 4.0 4.0 by the RMH. Now, the neuropsychiatry The CL nurse works closely with a patient, Expansion in mental health services, the checking process prior to surgery unit, located at Epworth Richmond and their acute medical team and consultant to provide greater support to our Š established an auditing program 2.5 administered as part of our mental health liaison psychiatrists to coordinate and community, is one of the strategic to monitor our checking and 2 2.1 2.3 2.3 2.3 service at Epworth Clinic, provides a new administer clinically appropriate care, priorities at Epworth. confirmation process pathway for people who are privately from immediate support at the bedside, Š introduced awareness signs, such 1.6 insured, compensable or self-funded, to arranging a referral to a mental health as ‘Stop the Block’, to remind staff reducing the burden on public waitlists. program when they are discharged. that further confirmation of patient or Falls procedure is required prior to surgery. Patients are treated by Dr Andrew Evans, Another focus of this role is to educate our Preventing falls for our inpatients remains an important focus. The number of falls a neurologist at Epworth Richmond, who acute nurses and build their knowledge Influenza at Epworth was lower than industry benchmarks. Epworth strives for zero falls, with works with the neuropsychiatry team at the and skills in mental healthcare and a bench of fewer than four per month. Patient falls with serious harm (fracture/head RMH. Our neuropsychiatrists work as part management strategies, to better support At 15 July 2020, 72% (4,516) of Epworth injury/death) at Epworth hospitals were no higher than 2.5 per 10,000 bed days. of a multidisciplinary team, to develop a patients at Epworth. staff were vaccinated against influenza, treatment plan and support our patients. compared to 63% vaccinated (4,275) in 2019. While this service is offered at Epworth Additional staff were due to be vaccinated in Major HACs Rate ACSQHC Rate 2018 Richmond, the CL nurse provides phone the remaining weeks of July 2020. support across all Epworth locations. In- person assessments are also available for To address any misinformation about 10 patients at Epworth Freemasons and all the benefits of vaccination, a local 10.0 10.0 10.0 10.0 10.0 Epworth Rehabilitation sites. vaccination champion program was implemented this year. This new initiative, supported by the EMF, funded 22 nurses 2.1 to undertake the University of South 0 1.2 1.8 0.3 1.1 Australia Immunisation course.

22 Epworth HealthCare Annual Report Connected Care 23 Getting our patients moving Janelle and Steve Overall with baby Archie.

Our patients have a number of common questions about moving safely in hospital and after their discharge. To answer some of these queries, our Allied Health team developed a series of videos, called ‘Getting moving’, to guide, support and empower patients to start becoming more mobile.

Rather than specific exercises, these videos demonstrate basic movements that might be taken for granted when patients are well. These include: how get in and out of a car after surgery, how to use a walker and crutches, knee and hip exercises and how to cough after abdominal surgery.

The videos, available through our bedside Point of Care system and online, are designed to give patients confidence to move around our wards. Easy to understand instructions focus on preventing falls and returning to usual strength and stamina. With online access, these videos are also designed to support carers.

This project, supported by the EMF, includes printed brochures and a QR code, enabling patients or carers to scan the code and access the link at home.

1,000th baby arrives “When I was in labour, the midwife told us there was a good chance that Archie Epworth Geelong welcomed the hospital’s could be baby 1,000 at the hospital,” 1,000th baby into the world in May 2020. Janelle said.

Lara couple, Janelle and Steve Overall’s Epworth Geelong Executive General son Archie was delivered, weighing 3.6kg Manager Luke Edwards is proud of (eight pounds 13-ounces). the milestone.

“Delivering our 1,000th baby here at Epworth Geelong is testament to the passion and dedication of our midwives, obstetricians and pediatricians; providing first-class care to local families,”

Epworth Geelong Executive General Manager Luke Edwards

24 Epworth HealthCare Annual Report Connected Care 25 Caring for the carers “His wife was looking for some support, Led by a psychologist and a social Cardiology: success Interventional cardiology Minimally invasive procedures increase but there were only support groups where worker each month, the sessions are Sometimes a great new initiative is born the patient went along too. She needed to part educational and part bonding, to continues to build Our work in interventional cardiology As predicted, our procedures for out of personal experience. talk openly about how she was feeling and give participants an opportunity for open Cardiac surgery peaked in 1995, continues to save lives. Percutaneous Transcatheter Aortic Valve Implantation she couldn’t do that if he was there. We discussion and support. with heart operations accounting Coronary Interventions (PCI), a procedure (TAVI) have increased. This minimally Jo Goodridge, Executive General couldn’t find anything in Victoria to provide for 50% of all surgery in the state. involving pushing a wire and balloon down invasive procedure, which replaces open Manager, Epworth Rehabilitation, the carer with support.” “Usually our patients with Parkinson’s an artery and then dilating the artery, was heart surgery for a diseased aortic valve, proposed a support group for the carers are men in their 70s, much older than Over the years, treatments for the heart first introduced at Epworth in 1982. reduces complications and Epworth has of people with Parkinson’s disease - Jo’s team discussed the idea of a group my brother. But, the similarities amongst have continued to advance. In 1981, Epworth taken a leading role in these procedures. as her brother, Wayne, has lived with specifically for carers of Parkinson’s carers are greater than the differences.” CEO, Peter Wilson (then called Epworth In 2019: early onset Parkinson’s for more than patients, to complement the Parkinsons’ Manager), invited Dr Graeme Sloman to Since 2010, Epworth has performed: a decade and his family were looking program at Epworth Rehabilitation. With carers generating topics to cover, establish a cardiac unit with cardiac surgery Š 999 PCI (or angioplasty and stent) cases for a support network. sessions have included guest speakers and intensive care. The first bypass surgery were performed, compared to 980 in Š 578 TAVI cases, including: “Part of our strategy is community about the progression of the disease, how was performed at Epworth Richmond 2018 − 131 in 2019 “The diagnosis has been devastating focused and this initiative really aligned finances are affected, mood changes and later that year by Mr George Westlake − 652 at Epworth Richmond − 64 in in the first six months of 2020. for our family. We try to focus on what with that,” Jo said. treatment options. and Professor Brian Buxton. − 255 at Epworth Eastern he can do, rather than what he can’t. − 92 at Epworth Geelong TAVI is used for older patients (the He’s a vibrant, active and sociable man, “The formation of the group was all With positive feedback from participants, In 2019: average age is 82 years) who are deemed but he can’t do all the things he used consumer led and we came up with the the Epworth Rehabilitation team is now Patient mortality rates, following stent as high risk or unsuitable for surgery. to do,” Jo said. values and rules of the group.” looking at establishing carers’ support Š 795 cardiac surgeries cases were procedures, was 0.5%, comparing Data from Epworth, combined with data groups for other conditions. performed across Epworth Richmond favourably against the Victorian from The Alfred and Cabrini Health, gives and Epworth Eastern, compared to 798 benchmark of 1.69%. a clear view of the long-term quality of life the previous year. changes in these patients.

“The diagnosis has been devastating for our Survival rates for family. We try to focus on what he can do, cardiac surgery are rather than what he can’t. He’s a vibrant, high, with a 1.01% active and sociable man, but he can’t do mortality rate in the all the things he used to do.” past year, lower than

Jo Goodridge, Executive General Manager, Epworth Rehabilitation, the national average.

26 Epworth HealthCare Annual Report Connected Care 27 A patient recovers in our cardiac ward at Epworth Eastern.

Expertise benefits cardiac patients New probe revolutionising cardiac care

Epworth is one of the few hospital groups Epworth cardiac surgeons are now using to perform the Ross procedure, with only the MiraQ Cardiac Ultrasound for coronary a handful of surgeons in Australia trained artery bypass grafts (CABG), thanks to the to perform the five-hour operation. This generosity of donors and the EMF. procedure involves the replacement of a diseased aortic valve with a pulmonary “The MiraQ is a hand-held ultrasound valve and the replacement of the probe designed to assess blood flow pulmonary valve with a homograft. The in newly constructed bypass grafts,” goal is long-term durability of the two Professor Silvana Marasco, Epworth valves, along with a reduction in the use cardiothoracic surgeon said. of anticoagulation therapy in younger patients. The benefit of this particular ultrasound is that it provides the team with immediate After 20 years, specialist cardiothoracic feedback on the quality of the surgery surgeon Peter Skillington, Deputy Director and the quickest and most accurate of the Cardiac Sciences Clinical Institute assessment of success, all while the at Epworth, has a 99.8% survival rate patient is still in the operating room. (0.2% mortality rate) using this procedure. It requires no artificial material or warfarin “We really had no other way of reliably and is used on patients who are under assessing graft patency in the past and we 60 years of age. relied on the surgeon’s visualisation of the graft,” Prof Marasco explained. Ross procedures during the past three years: “This has revolutionised our ability to check our grafts prior to chest closure. If there is Š 2019 - 22 any problem identified with the graft it can Š 2018 - 21 be revised immediately, avoiding potentially Š 2017 - 15 catastrophic complications in the post operative period.” Robotic surgery continues to be widely practiced at Epworth, including robotic- assisted cardiac surgery performed by a team led by cardiothoracic surgeon, Aubrey Almeida. Since 2004, 495 procedures have been performed at Epworth and robots were used in 47 valve repairs in 2019.

28 Epworth HealthCare Annual Report Connected Care 29 Hope and Tony Saba Family House Sonia was cared for at Epworth Richmond and was able to have her father Bui nearby, staying Philanthropy has funded the purchase at the Hope and Tony Saba Family House. and renovation of a unit near Epworth Richmond. The Hope and Tony Saba Family House is used to support patient families from regional Victoria, interstate and as far away as PNG. Use of the accommodation helps ease the financial burden on patients and their families.

To date, the Hope and Tony Saba Family House has provided a home away from home for 15 families, including Sonia Paua’s father Bui, while Sonia underwent pro bono surgery (read Sonia’s story on page 114). By staying at the house, Bui was able to be at Sonia’s side until the final minutes before her surgery and during her recovery.

Cardiac care 1980s Guests at the house are predominantly families of oncology patients, with two By 1980, Epworth had eight specialist units and Peter Wilson families staying up to a month to support (Epworth Manager 1975-1985) was convinced the next steps their family member during treatment. should be establishing a first-rate intensive care unit (ICU) The EMF is grateful to our donors followed by a cardiac unit to perform open-heart surgery. who supported the purchase and redevelopment of the house. In particular, Dr Graeme Sloman, who was a world authority in the field thank you to the Saba family, who have of cardiology and based at the RMH, was very supportive in directly assisted Epworth to provide support to patients and their families encouraging a cardiology unit at Epworth. His decision to move during the most difficult of times. to Epworth in November 1980 was crucial to the unit’s success and a huge boost to our reputation. He became the first Medical Director at Epworth and set up the cardiology unit. His presence, and the initiatives the hospital was undertaking, attracted other highly regarded doctors to Epworth.

The coronary care ward was opened on 24 August 1981 and the first open heart surgery at Epworth was performed by Mr George Westlake on 8 September 1981.

30 Epworth HealthCare Annual Report Connected Care 31 Mental health

A passport to wellness There are also daily planners to help “It is important to recognise suicide Food Services receives national awards Five-star food rating structure the day. When your mental is often perceived as an answer to an and recovery health deteriorates, something as simple underlying problem causing significant The food served to Epworth patients Our Food Services team at Epworth In the last year, Epworth developed a Mental as showering can become difficult. emotional distress,” Kim Miles, Education regularly receives praise. This year, we Eastern achieved a five-star rating in Health Passport that encourages patients Manager said. also won a number of national industry its 2019 Food Safety Assessment. This to become experts in their conditions and “It’s about achieving small goals, taking accolades. assessment evaluates the performance empower them towards recovery. time to document your mood and reflect “If we can recognise this and empathise of food safety practices, with a five- on how to respond to different events,” with the situation, we can start to identify Epworth Richmond Food Services won star rating representing a grading of The passport, a portfolio of comprehensive Natalie said. helpful solutions using a collaborative, two national prizes in the Institute for ‘excellent’, incorporating best practice. information, includes a recovery action recovery-focused approach.” Hospitality in Healthcare (IHHC) awards in plan, preferences about care, triggers “Keeping a mood calendar, self-rating August 2019, after winning a state award. that exacerbate their illness, dietician your mood from 1-10, enables patients “At Epworth Clinic, we work with our information on the impacts of food and their carers to form a clear picture of patients to empower them to identify their The awards won are in the categories of: on mood and advice from exercise what’s going on. We can track how things warning signs and seek support using psychologists on movement and mood. are going and establish any impacts from strategies that keep them safe, both in Š Project of the Year Award – new medications and other treatments hospital and at home. Room Service Suzie Hooper, Director of Clinical and Site or interventions over several weeks, to Š Leadership Award – Food Services Services at Epworth Camberwell, said her identify any improvements, even if it’s “Scenario-based activities and role- Manager Noeleen Xerri. team wanted a tool that could remain with marginal.” play help workshop participants build the patient beyond Epworth Clinic. With confidence by developing a tangible The national winners were also eligible nothing available in Australia, the team This project engaged inpatients to use understanding of the signs to look for and for the major prize, the Rosemary Pirie created their own kit. the passport, supported by mental health practicing techniques to identify warning Excellence Award. This was also won by nurses who have undertaken special signs. This can de-escalate a potential Epworth Richmond Room Service Project. Associate Nurse Unit Manager Natalie training in the role of a recovery coach. suicide situation and keep someone safe. Nardella from Epworth Camberwell, led This ensures each patient is able to gain Epworth Richmond Room Service is the working party tasked with creating a maximum benefit from this integrated “We recognise that we don’t have to agree the largest room service kitchen in useful patient resource that focuses on approach to their care and recovery. or disagree with someone, we can still sit a healthcare setting in the western recovery goals, not medical goals. with them and support them with what hemisphere. The kitchen produces The development and implementation of they are going through.” more than 3,000 meals per day for 700 “Patients identify impacts to their life the passport is part of a research study, inpatients and hundreds more for day caused by their mental health and currently underway at Epworth Clinic. Suicide is the leading cause of death patients. With 32 theatre operating rooms establish goals to achieve. Goals may for Australians aged between 15 and 44. at the hospital, the service also caters for include returning to work, improving Reinforcing skills to prevent suicide For every death by suicide, it is estimated surgeons’ meals daily. parenting skills or managing their that as many as 30 people attempt to anxiety,” Natalie said. To support our patients being treated for end their lives. mental health issues, over 70 staff within “If a patient returns to hospital, the Epworth Clinic participated in a new If you, or anyone you know, are passport accompanies them so they don’t Suicide Prevention Workshop. experiencing a mental health crisis, have to retell their story everywhere they please call Lifeline on 13 11 14. go. That in itself can be traumatising and Developed by the Mental Health Education For immediate emergencies, dial 000. triggering for people. It’s designed to be Department, the sessions reinforce a consumer-focused complementary existing techniques, teach new skills and communication tool that sits alongside build confidence to detect any warning information their care team may already signs. Our team also developed a program have received.” that focuses on role-play.

32 Epworth HealthCare Annual Report Connected Care 33 Epworth milestones

Past and current staff members of the As well as celebrating Unique service praised Hospital in the Home team. our centenary year, The Transitional Living Centre (TLC) at “After discharge, a number of ABI patients several key services had Epworth passed accreditation with flying were returning to hospital. Since the colours this year, while also marking 30 opening of the TLC, we’ve had over 500 milestones of their own. years of service. people call the TLC home,” Jeremy said.

The TLC provides residential and “Some residents come straight from the community rehabilitation for adults who hospital ward, others from care facilities have an Acquired Brain Injury (ABI). The or from home. Many of our residents first community-based facility of its type are several years post-injury but were in Victoria, the TLC helps patients build not coping at home. At the TLC, they independence and practise everyday living practise skills like cooking, memory skills, so they are eventually able to return strategies, time management, budgeting to normal activities. or parenting.”

Community Rehabilitation Manager Residents, aged 18-70, stay an average Jeremy Buckmaster says the TLC, which of six to nine months at the centre, which comprises a four-bedroom house and includes five TAC/WorkCover-funded three units, was set up to help ABI patients beds and two funded by the Department Two decades of care for you at home It is a clinical unit of the hospital, with its They also look after complex wounds with who couldn’t manage by themselves at of Health and Human Services (DHHS). own medical, nursing and administrative negative pressure dressings. home, after hospital discharge. Another unit has been purchased this year, Our Hospital in the Home (HIH) service staff, with full access to the technology increasing the available beds to eight. celebrated a major milestone in February and support services from Epworth. Today our HIH service attends to 10,000 of this year, 20 years of caring for patients patients annually, expanding to provide a: A successful accreditation review of the at home. HIH nurses administer a wide variety TLC was undertaken by the DHHS in of intravenous therapies, including Š 24 hour on-call service October 2019. Head of the HIH Unit, Associate Professor antibiotics, antivirals, colloid fluids, Š team of four doctors, 12 nurses and Michael Montalto, brought his knowledge steroids, blood products and a unit receptionist and experience of HIH care to Epworth chemotherapy. Š fleet of seven cars. Residents develop independence at our in 2000. Transitional Living Centre. “The unit started with three part-time nurses and myself, visiting patients at home, where we often put in long hours and were on call overnight,” A/Prof Montalto said.

HIH provides acute home care for patients, who would otherwise need treatment in a traditional hospital bed.

34 Epworth HealthCare Annual Report Connected Care 35 Staff members, past and present, gathered Voluntary Assisted Dying – empowering Dying with Dignity is an organisation of to share stories about the dialysis unit over patients to choose 150 volunteers. They support Epworth the past 30 years. patients by assessing their capacity and Victorians were able to access Voluntary signing their final declaration as voluntary Assisted Dying (VAD) at Epworth from witnesses in hospital and doctors’ rooms, 19 June 2019, following a decision by the including during the pandemic. Board that the Voluntary Assisted Dying Act was consistent with our strategic Connected Care pillar. At Epworth, holistic empowering patient-centred care recognises the importance of patient choice and autonomy.

A working group, comprising Professor Emeritus John Catford (former Executive Director, Academic and Medical Services), A/Prof and Chief Medical Officer Luis Prado and Executive Sponsor VAD and Director of Clinical and Site Services, First Australian private dialysis In April 2019, the unit became a Epworth Camberwell, Suzie Hooper, was unit turns 30 standalone unit and now boasts new, established to support the development state-of-the-art dialysis equipment of information, resources, procedures and The Dialysis Unit at Epworth celebrated its and modern and comfortable chairs, protocols around services that could be 30-year anniversary in October 2019. located in a light and bright space offered to patients on request. at Epworth Richmond. Prior to 1989, haemodialysis was only Within our hospitals, it was clearly available at major public hospitals in Our patient numbers have steadily communicated that doctors and staff who large cities across Australia–a great increased over time, now averaging 25 conscientiously objected would not be disadvantage to patients requiring dialysis patients per day. asked to participate. in smaller towns. A legacy has been created by the original It was important to ensure continuity of In 1989, Professor Gavin Becker was Epworth unit, with many other private care, which provided comfort to patients, First private hospital to admit time asked to examine the possibility of dialysis units subsequently opened was supported by a consistent approach establishing the first private dialysis unit following our success. across all sites. Eliza Armstrong, critical patients - 1990s in Australia. Several private insurance Voluntary Assisted Dying Coordinator, and Epworth had been accredited to receive time critical companies eagerly supported this local support teams work closely together medical patients by ambulance during the 1994-95 initiative. Epworth was asked to host this to ensure patients are seen promptly. They financial year. In 1996, the ED was accredited by the project, taking several months to develop work closely with VAD accredited doctors a four-bed unit in the paediatric ward. and undertake education campaigns Australasian College of Emergency Medicine for across all shifts to manage patients. advanced vocational training of emergency medicine The unit started with three staff members, Further support is provided by four of our specialists – the first private hospital in Australia to each working one day a week. Pastoral Care staff, who have specialised receive this recognition. in voluntary assisted dying processes.

36 Epworth HealthCare Annual Report Connected Care 37 Care in times of a pandemic

Private and public sectors collaborate Epworth Geelong Professor of Surgery, Technology helping support public health When the COVID-19 Professor Glenn Guest said the crucial As part of the collaboration between partnership between Epworth Geelong Our Information Technology (IT) team pandemic was declared in Epworth Geelong and Barwon Health, and Barwon Health has been invaluable. has also been involved in enabling public March 2020, the immediate the ‘Surgical Unit 3’ at University Hospital health efforts by Epworth in response Geelong was relocated to Epworth Geelong “Through the partnership with Barwon to COVID-19. Activities include working aim of Epworth was to keep from 30 March 2020. This move ensured Health, patients who were diagnosed with our public hospital partners and our patients, staff, doctors essential colorectal surgeries, for both with colon cancer received treatment in a staff, across multiple business units, to public and private patients, could continue timely manner, meaning that there were develop processes for referral pathways, and community safe. within Geelong throughout the pandemic. no poor outcomes related to delays in revised administrative and billing treatment. We also continued to manage functions and the secure exchange of From 30 March to 15 May 2020, 160 time- diagnostic colonoscopies and screening clinical information to ensure seamless critical cases were successfully performed colonoscopies and, while these diagnostics transitions of care. Statewide pandemic response Our critical care educators collaborated Regional response at Epworth Geelong. were at a lower level than normal, we are to develop training programs across the hopeful that few cancers will have been The technical solutions deployed varied As part of our responsibility to our organisation. Epworth Geelong contributed as During this period: missed or delayed in their diagnosis.” in complexity and included changes to community, Epworth joined the statewide part of the first Victorian regional existing systems or new solutions to pandemic response. We signed an Pandemic modelling indicated a shortage cluster response planning team. The Š 18 cancer operations were performed University Hospital Surgical Unit 3 will support specific hospital networks, such agreement with the Victorian State of critical care trained nurses to meet collaboration between all health services, Š Two cases of bowel cancer were remain at Epworth Geelong for the as Alfred Health. The agility and flexibility Government to ensure there was hospital the anticipated demand. Some of our private and public, in the south west detected via colonoscopy. duration of the DHHS agreement, which of our IT team during this phase were capacity for potential Victorian patients, programs were specifically designed to region, has ensured a coordinated surge sees the state’s healthcare system critical elements to the success of this should there be a surge in infections. support critical care certificated nurses capacity plan was in place, to manage working as one. arrangement. Epworth Group Chief Executive Dr Lachlan (CCRNs) to manage critically unwell inpatient units, ICUs and EDs in the event Henderson was nominated as Victoria’s COVID-19 patients. of an outbreak. private hospital representative on the State Pandemic Response Committee, chaired Each Epworth site developed workforce Epworth Geelong converted six empty by the DHHS Secretary Kym Peake. surge models of care. Our educators shells within its ICU into patient beds. “ Experience from around the world revealed were integral in identifying the skills A number of philanthropic trusts from Dedicated wards and operating theatres and competencies required for various the Geelong region, supported the there was morbidity and mortality, not only were designated for the response, with all workforce groups, as nursing care was conversion of three shells into ICU directly from COVID-19, but as collateral Epworth hospitals joining in geographical customised to safely and skilfully care beds and the EMF, made an additional clusters to assist our public hospital for COVID-19 patients. Training programs contribution, to convert an additional impact, when a hospital became overwhelmed colleagues during this crisis. involved interactive virtual classrooms, three shells into High Dependency Unit and could no longer provide the normal face-to-face sessions, clinical simulation beds. The investment of over $500,000 All Epworth ICUs planned for an and bedside mentoring. ensured Epworth Geelong has access essential surgery that was needed.” anticipated surge of patients, ensuring to specialised equipment, including Epworth Geelong Executive General Manager Luke Edwards we have appropriate facilities, PPE, Epworth Richmond developed a course to ventilators and monitors to care for our equipment and staffing models to upskill nurses to manage a sudden influx high acuity patients. safely care for COVID-19 patients, of critically ill people. Several hundred while continuing to treat elective staff completed this training, including surgery patients. theatre and ward staff.

Planning for COVID-19 introduced many A number of retired ICU nurses challenges, including the need to quickly volunteered their services to support any upskill staff to work within a critical care potential surge requirements. Many VMOs environment, in particular ICU. also volunteered to assist, for which we are incredibly thankful.

38 Epworth HealthCare Annual Report Connected Care 39 Our internal tracing team met virtually. Safety considerations and Most non-urgent elective surgery was infection control cancelled across public and private hospitals, ensuring that PPE was preserved. In line with the DHHS guidelines, we put security and screening measures in place Urgent elective surgery cases continued, 1.5 m across all entrance points. Members of with additional screening required for the public, with any symptoms, were asked patients, with questions asked via phone, not to visit and overall visitor numbers prior to their surgery and again on were restricted, to minimise the chance presentation. As elective surgery increased of community transmission within our from April, outstanding cases were hospitals. While this was difficult for our prioritised according to clinical need. patients, it was necessary to put their health and safety first. Our staff supported patients, Communication materials for our Social distancing as we proactively encouraged families to use community and employees focused on It’s for everyone’s health video conferencing applications to connect necessary social (physical) distancing Tracing from inside our hospitals Epworth was well-prepared. By 30 June to minimise further risk of transmission with their loved ones. measures and good hygiene practices. 2020, 36 nurses across Epworth sites were and to identify any breaches in infection With potential outbreaks a possibility within trained to interview those with a confirmed control. PI2281_QUA_0320 With high demand for PPE, such as We communicated with our community on our hospitals, an in-house contact tracing infection, quickly identify people they had masks, gloves and isolation gowns, each change via our website, social media, team was established in early April 2020, to been in close contact with and offer any The tracers, who participated in a 24/7 we monitored our supplies closely and in our hospitals using posters and signage, manage the tracing of any COVID-19 cases required support to assist contacts to self- on-call roster, in addition to their primary ensured our healthcare workers received cards on meal trays and through our Point related to our patients, staff or doctors. isolate and limit the spread of infection. nursing roles, conducted more than 170 intensive training on how to don and doff of Care bedside system (POC). Visitor investigative interviews with patients, staff 访客 protective equipment. restriction posters were translated into This service and its procedures and Our internal contact tracers also and doctors. This service played a vital role 探病规定 Chinese, Vietnamese and Italian. protocols were developed quickly to ensure investigated the circumstances of infection, in minimising transmission at Epworth.

为了维护所有病患,工作和医务人员的持续安全, 所有进入医院的访客需要接受体温检测. 探访时段限早上10时半-12时半或下午5-7时. 禁止进入 > Contact tracers in the community They then attempted to call everyone 每名住院病患一天仅限两名（2）访客， 且只限 如在您过去的14天内, 无论是从海外归国或到 探访一次。访客仅限家属或住院患者之监护人 过国内的其他城市. Dear Patient identified as a close contact, asking them 或家庭照护成员。访客年龄限于16岁以上 如果您有以下任何症状: > When the DHHS called for contact to self-isolate. The team also carried 产科部病人在住院期间仅限 Your safety is our priority. NP2615_QUA_0420 一（1）名指定的访客（仅限伴侣或亲属） 发烧 > Due to COVID-19, strict visitor tracers, many of our dedicated staff out welfare and emotional checks on 新冠病毒患者或等待测试结 咳嗽 restrictions are now in place. 果者在住院期间，禁有访客探病 volunteered (pictured left). Epworth impacted people. > 新冠病毒患者或新冠病毒康复者或 喉咙痛 Please advise your loved ones and potential visitors to had a team of 65 staff who relocated 居家隔离期间者，一概禁止探访 check our website prior to visiting at www.epworth.org.au > 如有特殊情况，该部门的医务人员将慎重考虑 呼吸急促, 呼吸困难或⽓喘 to the department’s city offices, Working in a dynamic and rapidly 与衡量病患的安全为首，而实施适当的探病规定 We recognise that staying in contact is important and encourage this as much as possible via other 头痛 as part of a team of almost 200. changing environment, the team had 我们理解，这对您和您家人而言是一段很艰 means such as phone, FaceTime and Skype. 难的时期和处境，为了给予病患持续的支持 其他呼吸道 to be flexible and responsive. Helping 与关怀，且让病患和家人保持联系，我们鼓励 感染的症状 Thank you for understanding. 采用其他联系方式如电话，脸书和Skype。 The project objectives were containment flatten the curve, through speedy contact epworth.org.au epworth.org.au 更新: 2020年5月20日, 星期三下午5时 NP2615_QUA_0420 to reduce the health burden and prepare tracing, has been a rewarding experience health services. for all involved.

Epworth people from multiple sites, including enrolled nurses, associate unit managers, business development staff and hospital coordinators contacted individuals who were confirmed as having COVID-19 about their movements.

40 Epworth HealthCare Annual Report Connected Care 41 Pastoral Care Worker Claire Davies provided Pastoral Care steps in “We’ve been trying to support families emotional support. with phone calls and let them know they Our Pastoral Care team has been have a listening ear when needed. balancing the needs of patients and families with strict physical distancing “We’ve also found ways of adapting for regulations. those facing end of life. It’s distressing for patients, families and staff and being able Pastoral Care Worker Claire Davies to work creatively, with all three groups, says there has been some anxiety in these unprecedented circumstances during this time. has been really meaningful.”

“There is a lot of loneliness from patients, as they are not receiving visitors as they would normally and they are feeling isolated,” Claire said.

Telehealth sessions for mental health Services move to telehealth brought on by COVID-19,” said Dr Graham In a two-week period, the Epworth Clinic Wong, Epworth Medical Director of Mental team transitioned all mental health (March-30 June 2020): Flexibility and agility have become Health and Psychiatry, Epworth Clinic. programs and services to a telehealth 1,527 sessions in total, including: the standard, as we responded to the phone and video conferencing model, COVID-19 pandemic. A host of services, “With this in mind, it was imperative ahead of many other mental health including mental health, rehabilitation, for us to adjust our services so people service providers. 718 day program sessions maternity and oncology used telehealth to could safely continue to receive mental

connect with patients. healthcare, while adhering to the social Following one-on-one consultations and distancing guidelines.” testing with inpatients, our programs were 260 Mental health was a focus, with Epworth conducted with people attending online individual one-on-one sessions associated with day sessions Clinic acting quickly to ensure treatment Developing a service for telehealth delivery therapeutic group programs in their rooms options would still be available for required teamwork, so the team worked via personal devices. Day programs were vulnerable members of our community. alongside IT, our Project Management the final service to move to telehealth. 69 private practice sessions Office and health contracts staff.

With physical distancing guidelines all but Patients have expressed appreciation for putting a stop to traditional one-on-one “It was important that we understood continued access to our mental health 480 psychiatric consultations, inpatient group how an online service model would programs, without any compromise to inpatient sessions therapies and outpatient day programs, provide appropriate clinical intervention their health or safety. the mental health team at Epworth Clinic for our patients. It would need to meet set up telehealth sessions, so clients government and health fund needs, have could be treated from home. the right resources and administrative processes, and give staff and patients “One in five Australians already experience an opportunity for feedback,” Dr Wong a mental health condition. There are also explained. heightened feelings of depression, anxiety and stress amongst the community,

42 Epworth HealthCare Annual Report Connected Care 43 COVID-19: our employee response

Staff at the frontline in our Staff & VMO Clinic, with Chief Medical Officer A/Prof Pandemic preparation - training These programs were designed to ensure Luis Prado at back left. nursing employees had the skills required The pandemic brought many challenges. to work in ICU, and involved interactive We took stock of our facilities, virtual classrooms, face-to-face sessions, equipment and staffing models to clinical simulation and bedside mentoring. ensure we could safely care for both Each of our hospitals developed workforce COVID-19 and other patients. surge models of care.

With a shortage of trained critical care The team at Epworth Richmond ICU nurses to meet expected demand, we developed a short face-to-face course, to implemented training programs. upskill nurses in other areas, starting with coronary care and theatre staff. Training was tailored to allow for multiple surge scenarios to be accommodated and saw the upskill program training completed by:

Š 20 CCU nurses Š 52 Post-Anaesthesia Care Unit (PACU) nurses Š 100 ward nurses.

Following the declaration of a Our people and VMOs well supported The service was expanded to include PPE training – protecting our people Many employees attended multiple pandemic, our hospitals moved into all staff from Melbourne Pathology at sessions to improve their confidence full preparation mode to support the By April 2020, we had established walk-in Epworth Richmond, Epworth Medical Our Education teams have been a critical in handling a suspected or COVID-19 needs of the Victorian community and Staff and VMO Support Clinics at three Imaging (EMI) and Slade Pharmacy part of supporting our response to the positive patient. employees volunteered to help in any Epworth sites to provide COVID-19 swab in late April. pandemic, learning to think innovatively. way they could. testing. The service was managed by our The need for physical distancing own nurses and doctors in redeployment Until July 2020: At Epworth, a new role was introduced challenged the usual way of providing Our employees and VMOs began adapting roles. We also set up a dedicated group- in March 2020 - dedicated PPE spotters. essential clinical education to our their practice, learning new skills and wide phone hotline, available every day, Š we performed 6,146 tests on staff This role was performed by trained staff people, with some sessions run educating themselves in how to safely and an email enquiry service that provided and patients. who helped ensure correct procedures for virtually or via video. manage this pandemic together. Former clinical advice, employment information the safety of employees and patients in ICU employees also put their hands up and directions for additional support. COVID-19 patient areas. to return to the bedside, should they be needed. During this time, the priority was Mock COVID-19 isolation rooms were to ensure the safety of our frontline created and hundreds of employees healthcare workers and to deliver a underwent intensive training to ensure convenient and accessible means of our people donned and doffed correctly in-house testing, clinical support, to avoid infection. wellbeing advice and counselling.

44 Epworth HealthCare Annual Report Connected Care 45 Centenary celebrations

Turning 100 was a major It was a night of milestone for Epworth and acknowledging our past, we celebrated with past and celebrating our achievements present staff, doctors, donors, and pledging our commitment volunteers and partners at to excellence in patient care, Melbourne Town Hall. into the future.

46 Epworth HealthCare Annual Report Connected Care 47 05 Empowered People Our people

Many staff members remain at Epworth for decades, while some 7,184 333 Empowered People, a core pillar spent their entire working lives there. Nurses and most of the employees directly employed doctors of the Epworth HealthCare Strategic Plan 2018–2022, is about enabling domestic and office staff lived at the hospital until the 1960s. our people and teams to be their Some patients remained at Epworth for months or years. 3,862 2,600+ best and make a difference to our nurses and midwives VMOs All these factors contributed to the sense of family and concern patient experience. The past 12 months (54% of our workforce) has been an extraordinary period of for each other that is still apparent at Epworth today. change and we have continued to see 709 264 high performing teams working closely allied health employees volunteers together, supporting one another and rapidly adapting to new ways Our employees have an average length of service of six years. of working during uncertain times.

48 Epworth HealthCare Annual Report 100 Years of Care 49 Title

Our Board

Epworth Foundation is a body corporate Ms Maryjane Crabtree Robert Macmillan Ms Laura Anderson Professor Paul Dougas (President) BA, LLB, FAICD (Deputy President) LLB, B Com, F Fin, FCIT, BMath, BLit BE, MEngSc, FAICD, Professorial Fellow established under the Epworth Foundation Act GAICD Melb Uni, Harvard OPM24 1980 (Vic) that principally operates under the Appointed to Epworth Board of Chairman of SVI Global Pty Ltd, Management in 2012 and President since Appointed to the Board in 2011 and Deputy OneGlobalVenture Pty Ltd, LaunchVic Professor Dougas has had an extensive registered business name Epworth HealthCare. November 2017. A retired lawyer and President since 2017. Beginning his career and the Foundation for the Advancement career in business and consulting executive partner, Ms Crabtree specialised as a lawyer, Mr Macmillan then moved of Science and Technology and Chair of engineering with 15 years as CEO of Our Board of Management consists of 10 in occupational health and safety, product into senior roles at Foster’s Group Limited, Judges of the World EY Entrepreneur Sinclair Knight Merz. Prof Dougas was and environmental liability, class actions Pacific Brands Limited, BlueScope Steel Of The Year™ Oceania, Ms Anderson is appointed to the University of Melbourne members. and risk management, before retiring Limited, Grill'd Pty Ltd and Australian also on the Board of the Defence Science School of Engineering to connect with to focus on non-executive director and Pharmaceuticals Industries Ltd. He has Institute, the National Basketball League industry and introduce leadership and committee positions. Ms Crabtree is extensive financial, commercial, business and the Defence Council Victoria. management into the engineering also on the Boards of Racing Analytical development and legal experience at programs. Prof Dougas is a Fellow of the Services Laboratory and Rugby Victoria, executive and Board level. AICD and has served on the Boards of is a member of Chief Executive Women, listed, private and not for profit companies. and sits on the Ethics Committee of the Australian Institute of Health and Welfare.

50 Epworth HealthCare Annual Report Empowered People 51 TitleOur Board continued

Associate Professor Dr Lachlan Henderson Ms Janet Matton The Reverend Emeritus Ms Wendy Thorpe Reverend Sue Withers MBBS, FRACGP, MHSM, GAICD, Cert AM BBus, GAICD BA, BBus, Grad Dip Applied Finance & DipTeach, BTh, GradDipPsych Nerina Harley Sports Med Professor Christiaan Investment, GAICD, FFin, Harvard AMP AM MBBS, MD, FRACP, FJFIM, FCICM, Ms Matton has extensive experience in the 172 An ordained minister of the Uniting PGDipEcho, AFRACMA Mostert Dr Henderson is the Group Chief IT industry and in business management. BA, BD, MA, PhD Church of Australia, Rev. Sue Withers Associate Professor Harley is the Chair Executive Epworth HealthCare and a She spent 34 years with IBM, including Ms Thorpe is Chair of Online Education is currently Secretary of the Ministry of the Group Medical Advisory Council medical practitioner who has 30 years time as vice president of operations and Revd Dr Mostert is an Emeritus Professor Services, a Non-executive Director of Placements Committee within the Synod (GMAC) and the Specialist Accreditation of experience in the healthcare industry. 12 years holding key roles in Southeast of the University of Divinity (Melbourne) Tower Ltd, Ausgrid, People’s Choice of Victoria and Tasmania. She is also Committee at Epworth. She is also a He joined Epworth in January 2017 and Asia, the United States, Japan, China and and was a minister of the Presbyterian Credit Union and Very Special Kids and a Co-Director of the unit responsible for Director of Intensive Care Council and was previously CEO St John of God (SJoG) Europe. Named the 2010 Victorian Telstra Church of Australia and then the Uniting member of Chief Executive Women. She overseeing relationships between Uniting Epworth ICUs at Epworth Freemasons and Subiaco Hospital. Dr Henderson a Board Business Woman of the Year, Ms Matton Church in Australia for almost 50 years. previously served as a Director of AMP Church- associated hospitals, schools Epworth Geelong. A/Prof Harley works Member of Cricket Australia. is also Chair of the Eastern Community He was engaged in parish ministry in Bank, a member of Council at Swinburne and agencies (Uniting). Sue is a past with the DHHS as a member of the Patient Legal Centre and ACMI and on the Boards Tasmania, missionary service in South University and as a Director of AXA Moderator (2003-2006) and has had other Measurement and Reporting Committee *Previously Vice President, of Better Care Victoria and pitt&sherry Korea, and theological and ministerial Business Services in India. Ms Thorpe management roles associated with the and the Expert Working Group; Critical Dr Henderson was appointed President (engineers). She is also a member of Chief education in Sydney (nine years) and had an extensive executive career leading Synod (Victoria & Tasmania) of the Uniting Care Clinical Network, Safer Care Victoria, of the Australian Private Hospitals Executive Women. Melbourne (17 years). His work has technology and operations within large, Church of Australia. Sue was Senior and internationally as a consultant with Association in October 2020. been published in books and journals listed financial services companies. This Chaplain at Methodist Ladies College from the World Health Organisation (WHO). and he continues his teaching, research included senior executive roles at AXA 1997-2003 following an early career in A/Prof Harley is a physician specialising in and writing, though officially retired in (CIO and COO), ANZ (General Manager, secondary teaching. nephrology and intensive care. December 2012. He was ordained an Institutional Technology) and AMP (Group Anglican priest in 2016. Executive, Operations).

52 Epworth HealthCare Annual Report Empowered People 53 Title Our Executives

Epworth HealthCare is led Ms Maree Feery Mr Danny Gravell Associate Professor by a Group Executive team Executive Director, People & Culture Chief Information Officer Dr Luis Prado Chief Medical Officer and Executive Maree joined Epworth as Human Danny commenced his role at Epworth in of eight, who bring a wealth Director Academic and Medical Services Resources Manager at Epworth April 2020, following more than 25 years of of experience and expertise Richmond with over 20 years extensive experience in leadership roles: spanning For more than 20 years, Luis has held a to our private hospital group. leadership experience in public and technology, product management, number of senior medical administrator private health before becoming Executive marketing, eCommerce and organisation- roles across Queensland Health and in Director in 2012. Prior to Epworth, her wide transformation, most recently at the private healthcare sector. He has roles included national human resources business supplies company WINC. also served as a medical officer with the manager at Healthscope, and director Australian Regular Army. With more than of organisational development at 30 years as a practising GP, Luis joined Melbourne Health. Epworth in 2016.

Dr Lachlan Henderson Mr Scott Bulger Ms Liz Camilleri Adjunct Professor Mrs Nicole Waldron Group Chief Executive Epworth Executive Director, Epworth Medical Executive Director Finance and Chief Operating Officer – Hospitals HealthCare Foundation and Brand Commercial Services Paula Stephenson Executive Director, Clinical Services With an extensive background in and Chief Nursing Officer A medical practitioner, Lachlan has 30 With extensive senior leadership Liz joined Epworth as a pay clerk in 1990 healthcare management across the years of experience in the health industry experience in development, advancement, and during her career was promoted to With more than 30 years experience in public and private sectors, Nicole joined and joined Epworth in January 2017. marketing and media across both payroll manager, hospitality services healthcare sector, Paula has a wealth Epworth in February 2011 and was Lachlan’s focus is on driving patient the private and not-for-profit sectors, manager at Epworth Richmond and of clinical, education, leadership and appointed as Executive Director Epworth care, doctor and staff satisfaction, Scott joined Epworth in 2012. Prior to became the inaugural business manager management experience. She has Richmond in March 2014, as Executive and business outcomes in a changing Epworth, Scott was Pro-Vice Chancellor, of the greenfield Epworth Eastern in 2004. held senior operational and strategic Director, Epworth Freemasons and healthcare landscape. Development and External Relations at She was appointed Executive Director, management positions in major Epworth Richmond in May 2018 and Bond University. Finance in 2009 and the expanded position metropolitan public health services, Chief Operating Officer – Hospitals in in 2017. Liz left Epworth after 30 years a not-for-profit medical professional November 2019. in August 2020. Her replacement is Mr association and a multi-national Big Cameron Fuller. Four consulting firm. Paula started at Epworth in June 2018.

54 Epworth HealthCare Annual Report Empowered People 55 Our Hospital Executive General Managers

As Epworth grew in size and complexity, In order to achieve our strategic goals “ Epworth has grown by more than 30% over the last five years: significant growth for the need to benefit from this scale, while as a more unified hospital group, collaborating effectively across our the new role of Chief Operating Officer – any organisation. We have dedicated, passionate and experienced Executive General hospitals, became critical. In November Hospitals was created and Nicole Waldron Managers leading our hospitals. While leading their respective hospital teams, and in 2019, we reshaped our operating model to was appointed to this role. Nicole’s ensure Epworth is best placed to face the remit covers strategic and operational partnership with other Epworth leaders, each Executive General Manager is focused challenges that lie ahead. leadership, management and alignment on ensuring our patients receive the best care and that staff and doctors are supported of our hospitals and services. and empowered to provide care.” Mrs Nicole Waldron, Chief Operating Officer – Hospitals

Mr Simon Benedict Mr Luke Edwards Ms Allison Evans Ms Jo Goodridge Ms Kerry May Epworth Freemasons (Clarendon Street, Epworth Geelong and EMI Epworth Richmond Rehabilitation and *Mental Health (Brighton, Epworth Eastern (Box Hill, Kew and Ekera) Victoria Parade and Cliveden) Richmond, Camberwell, Hawthorn, “In 2021, Epworth Geelong will celebrate “At Epworth Richmond, our dedicated Transitional Living Centre) “Through our community partnerships, “We launched into a new and exciting era five years of service to the greater Geelong teams look forward to continuing to we have commenced a significant of exceptional patient care and clinical region. Since our opening in 2016, we have provide exceptional health services to “It is our role to help people lead expansion and redevelopment that will innovation at Epworth Freemasons, become a vital part of the community by the community and take pride in the a fulfilling life at home and in the deliver additional healthcare services to with the completion of our $100 million introducing new services and delivering difference they make for every patient community, whether they are living our region. Our new facilities will also redevelopment. Beyond the bricks and exceptional care for patients and their and family. The opening of the state- with a mental illness, recovering from support us to continue to attract and mortar, our people remain committed families. This year, our dedicated team of-the art La Trobe Financial Cardiac a physical injury or managing a long- retain highly skilled and experienced to finding new and better ways to care, will continue to grow the range of services Catheterisation Unit this year will see term chronic illness. We will continue doctors, nurses and clinicians, to while taking into account each patient’s available in Geelong to support the health us continue to be at the forefront of the to research, work collaboratively and provide world-class care and the best individual needs.” of our local region.” latest technologies and the provision of deliver rehabilitation and mental health experience possible for our patients and excellence in clinical care.” programs both in hospital and in the their families.” community, to achieve the best possible outcomes for our patients.”

*A permanent appointment to the new Executive General Manager Mental Health position will be made shortly.

56 Epworth HealthCare Annual Report Empowered People 57 Our culture

Keeping our workforce engaged and part Health, safety and wellbeing During the year: A group of employees represented Epworth of a positive, safe, healthy and values-based in our first ever Midsummar Pride March culture is integral to both our patient and We continued to embed a safety culture, Š 1,821 employees completed Speaking in February 2020. people experience. including enhanced safety leadership, Up for Safety training. awareness, capability and accountability In November 2019, 65% of our people to ensure everyone stays well and returns The program is built on respect, mutual completed an Epworth-wide employee home safely at the end of each day. support and the underlying message that experience survey. we are all doing our best in a fast-paced, Our aim is to ensure everyone is committed rapidly changing workplace. Survey results showed: to safety expectations at Epworth and has the knowledge and skills to perform their Cultural awareness Š 77% of employees were ‘engaged’ roles safely. During 2020, this included – a strong result a renewed focus on mental health and In May 2020, we launched online Cultural Š Key strengths included safety, pride in wellbeing. To further enhance safety and Awareness programs for the Indigenous, Epworth and growth and development wellbeing, we introduced a respect and Torres Strait Islander and LGBTIQA+ opportunities. kindness campaign that aligns with our communities. This training is mandatory Š Improvements were needed in managing values and behaviours. for all employees. To date: change, building trust in leadership, recognition and work processes. Speaking Up for Safety Š 3,541 employees have completed the LGBTIQA+ training Continuous improvement opportunities are Speaking Up for Safety face-to-face Š 3,950 employees have completed the always sought, and this year, we rolled out training continued throughout the year, Aboriginal and Torres Strait Islander Diversity and inclusion Within this program, we delivered a series an enhanced performance development including during COVID-19 restrictions, training of events including: International Women’s system across Epworth. where smaller groups were trained while Š The remaining 45% will complete While Epworth has a strong culture, Day, a number of Future Women’s Forums, maintaining physical distancing. training by the end of November 2020. grounded in both patient and employee Men’s Health breakfast, Pride March and experience, this is being strengthened with Harmony Day. Developed by the Cognitive Institute, a renewed focus on diversity and inclusion. Speaking Up for Safety training is In our recent employee experience survey, We’ve also been working towards Rainbow mandatory for all employees and VMOs. Epworth was highly rated for having a Tick Accreditation and developing a It builds on a culture of safety, where culture of inclusion. Reconciliation Action Plan (RAP) to improve all employees and VMOs feel safe and support for Aboriginal and Torres Strait supported to speak up for patient safety. We know that a workplace that genuinely Islander patients and employees. This is enabled by developing insights and values diversity and inclusion enables skills to respectfully raise issues with team greater employee engagement and Our aim is to ensure everyone, from members when they are concerned. empowerment, increases productivity patients to employees, doctors and and performance, boosts innovation and volunteers, feels they belong at Epworth. strengthens connection with patients and the community.

58 Epworth HealthCare Annual Report Empowered People 59 Reconciliation admission. As at 30 June 2020, 84% of our These art installations are one way we staff involved in the patient administration seek to respectfully create a welcoming This message was included in our Epworth HealthCare operates hospitals process had completed the e-learn. environment for First Nations Australians Aboriginal and Torres Strait Islanders on the traditional lands of the Wurundjeri, in our hospitals. Wadawurrung and Boon Wurrung peoples In May 2020, we continued enhancing of the Kulin Nations and acknowledges cultural competency within our While building our organisation’s cultural “ I’m a Wotjobaluk man, their continuing connection to the land. organisation, with the introduction of online consciousness within our hospitals, we education on the history of Aboriginal have also sought to build our engagement an Aboriginal man from Our reconciliation journey began in 2019, and Torres Strait Islander people and with other organisations committed to Western Victoria on my ahead of a formally endorsed RAP, thanks the contemporary experience of First supporting Aboriginal and Torres Strait to the commitment and passion of our Nations Australians in our community Islander healthcare professionals. dad’s side. I’m quite proud people and donors. With the support of the and workplaces. With a target of 100% Epworth is an organisation member of the to work at Epworth and I Board of Management, Group Executive completion by end of 2020, more than half Australian Indigenous Doctors Association and our Diversity and Inclusion Committee, of our workforce completed the online (AIDA). We sponsored two AIDA members am also very proud of my Epworth’s Reflect Reconciliation Action education within six months. in 2019 - a medical student and junior Aboriginal heritage. Plan will be launched in late 2020 and medical officer selected by AIDA - to attend implemented in 2021. In 2019, with the generous support their annual conference in Darwin. The fact that Epworth has of donors, we acquired artwork from a cultural awareness package In January 2020, we launched an “Asking Aboriginal artists connected to the lands the Question” protocol, online training upon which Epworth cares for its patients. is really important to me (e-learn) module and posters to reinforce Acquisitions made through the 2019 as an Aboriginal person, the importance to staff and patients of Koorie Art Show and through The Torch This artwork by Dixon Patten (Aboriginal name Bitja), but also important for staff recording Aboriginal and Torres Strait are now on display in Epworth hospitals in depicts Aboriginal and Torres Strait Islanders connection to Islander origin information on patient Melbourne and Geelong. Country and community. This artwork was designed for and for our patient care.” Epworth HealthCare’s Reflect Reconciliation Action Plan commencing in December 2020. Dr Glenn Harrison, Emergency physician at Epworth Geelong

60 Epworth HealthCare Annual Report Empowered People 61 Celebrating our women

Gender equality At our breakfast for 400 Epworth Future Women’s Forums Celebrating women at our International employees, Daisy Pearce, a pioneer Women's Day breakfast, where footballer Most of our employees are female (78%). of women’s football in Australia, Our Future Women’s Forum included two and midwife Daisy Pearce was the practicing midwife and mother, symposia events in July and October 2019 keynote speaker. Women were well-represented in was the keynote speaker. on the topics “The lies we tell ourselves” promotions, being awarded: and “Financial empowerment: challenging Events had additional significance as your money story.” we celebrated the centenary of Epworth 83% and the World Health Organisation’s Guest speakers were Julia May, co- of all promotions Year of the Nurse and Midwife. founder and director, Visibility Co. and

Victoria Devine, Founder of She’s on 62% When Epworth opened its doors in 1920, the Money podcast and co-founder and of manager promotions and the hospital was run by five women. Director, Zella. Both events were attended 65% of new manager roles Nursing staff were entirely women, until by more than 250 of our people, both in male nurses were accepted into nursing person and via video conference. schools in the 1970s. Today, women are 85% well represented in all areas at Epworth, The Future Women’s Forum initiative, of non-manager promotions including senior positions. Half of launched at International Women’s Day Epworth’s Group Executive and two-thirds 2019, was designed to support Epworth International Women’s Day of our Board are women. women to flourish and take advantage of every opportunity in their careers and The many achievements of our lives. Both events were sponsored by outstanding women were celebrated at Conquest Advisory and the EMF. events around our sites for International Women’s Day (IWD) in March 2020. A breakfast event, morning teas and activities were held to recognise the remarkable contribution of the more than 6,700 female employees, VMOs and 1920s-50s: Epworth a place of women volunteers who work across Epworth. As with other hospitals, until recent times, Epworth was By 1950, nurses were in short supply because of poor pay and predominantly the workplace of women. A hospital was a place working conditions. The war had also demonstrated that where women, could assume responsibilities and roles not women could be employed in many occupations other than the readily available to their contemporaries. The matron managed traditional ones of nursing and teaching. The post-war trend to the hospital on a day-to-day basis and the nursing staff consisted marry young also contributed to the shortage. Studies showed entirely of women until male nurses were accepted into nursing that the most frequent reason for leaving the nursing profession schools in the 1970s. Nursing has undergone many changes in was marriage, although about half returned to the work force in the past century. Nursing was considered a vocation demanding the late 1950s and the 1960s. a special commitment, which also involved self-sacrifice in terms of low salaries, antisocial working hours and poor working and living conditions.

62 Epworth HealthCare Annual Report Empowered People 63 Celebrating our nurses and midwives

International Midwives’ Day, 5 May 2020 “ Nurses: A Voice to Lead – Nursing the International Nurses Day, 12 May 2020

We celebrated International Day of the World to Health” was the theme of In the year that the WHO declared 2020 Midwife and thanked our dedicated International Nurses Day this year. the Year of the Nurse and the Midwife, midwives at Epworth Freemasons there has been much to acknowledge and Epworth Geelong. These talented about the nursing profession. and dedicated professionals are key in reassuring and supporting our expectant The value of our nurses has been clearly parents to have a positive experience at a defined during the COVID-19 pandemic. major milestone in their lives. Epworth nurses have adapted quickly to many changes - following new guidelines, Paula Stephenson, Executive Director undergoing intensive training on PPE and Clinical Services and Chief Nursing comforting our patients in times when Officer, says our midwives play a key role many were not able to have visitors. Ethel Gray: in helping women bring a newborn into the world. Due to COVID-19, our planned events First matron - integral to hospital’s success were postponed. However, we still The appointment of a suitable matron was vital to the hospital’s success. “Our midwives are outstanding, not just acknowledged the diversity of the nursing The Spectator informed readers that: ‘We shall have a godly, skilful well-educated, but all passionate about profession across all levels of healthcare woman as matron, and our young women will find scope in the hospital their work and the women they care for. and in education, research, management Each of them will tell you what a privilege and executive leadership. for lives of usefulness as nurses, for which they will be able to train’. The it is to have this role and they are all so sub-committee to appoint the matron met on 25 July 1919. It considered invested in making sure women having Our nurses: two approaches that had been made to it and Dr Wilkinson’s personal babies are well supported,” Paula said. recommendation of Ethel Gray. He knew her well and stated that if she 3,084 could be secured, it would be unnecessary to look any further. A member of Registered Nurses (RN) a well-known Methodist family, Ethel Gray had trained and worked at the

Melbourne Hospital except for a short time when she was matron at the 120 Queen’s Memorial Infectious Diseases Hospital, Fairfield. She then went graduate RNs to Perth and was matron of Perth Public Hospital for two years, before joining the Australian Army Nursing Service during the war. She had served 390 in England and France with great distinction and was expected back in Enrolled Nurses (EN) and Australia before Christmas 1919. Ethel Gray accepted the position of matron on a salary of £200 and The 33 Spectator, in announcing her appointment, noted her distinguished war graduate ENs service and that her competence ‘will win the hearts of all who come under her care’. She took charge of the hospital on 1 June 1920. Although only 164 cm tall, Matron Gray had ‘great constitutional stamina and a forceful, sometimes domineering personality’. She was a staunch Methodist and dedicated to the nursing profession. A firm disciplinarian with a strong sense of duty, she was also compassionate to her patients and staff.

64 Epworth HealthCare Annual Report Empowered People 65 Our new graduate nurses and midwives Investing in our leaders Senior talent programs aim to ensure Our Nurse Unit Manager (NUM) Talent undergo orientation. we have strong capability in critical Program was shortlisted for the 2019 Epworth’s significant investment in roles across our organisation, as well as Australian Human Resources Institute leadership development programs creating a strong pipeline of talent. (AHRI) Marshall Goldsmith Talent continues to attract extensive interest Management Award. This program, from our employees and draws external In 2019, a targeted talent program was delivered in partnership with Development talent to Epworth. These programs created for Perioperative Services, Dimensions International, has helped focus on enhancing leadership and attracting and retaining talent in us exceed our goal of filling 50% of NUM management skills, which leads to Perioperative Nursing for Epworth in roles internally. Introduced in 2015, the exceptional patient experience and future 2020 and beyond. Ten employees are program was part of a broader strategy career opportunities. undertaking an Associate Director Clinical focused on empowerment, recognition Services Talent Program, delivered and developing our critical NUM roles. In 2019, 20 employees joined our through a group coaching method to Motivated Associate NUMs were identified Operational Leaders Program and 40 focus on the key practical skills and and exposed to the real challenges and employees took part in our Frontline competencies required in perioperative the essential behaviours required to Leaders Program. Upon completion, services. Participants include current operate as confident and capable NUMs. participants receive a Diploma in and emerging talent with the potential to Leadership and Management or progress to this level in the future. a Certificate IV in Leadership and Management from Swinburne University.

Nurse and midwife graduates – largest A special graduation ceremony was held Registered Midwife Graduate of the Year: Some of our graduating nurses and ever cohort at Richmond Town Hall in January 2020. midwives at Richmond Town Hall. Abigail Hyndman was named overall Š Epworth Freemasons – Megan Stewart During 2019, 167 nurses and midwives Epworth HealthCare Graduate of the Year completed their graduate program and for her dedication to excellence and safety Welcome new graduates first year of employment with Epworth, and emerging leadership qualities. our largest intake of graduates in our 100- At the beginning of 2020, we welcomed year history. Congratulations to our Enrolled Nurse, 114 graduate nurses and midwives Registered Nurse and Registered to Epworth, as they completed their Midwife winners: orientation and began their 12-month journey with us. “ This year has taken Enrolled Nurse Graduate of the Year:

me to the depths of my Š Epworth Freemasons – Alycia Bradby human capacity, tested Š Epworth Eastern – Belinda Paine

my courage, highlighted Registered Nurse Graduate of the Year: my vulnerability and Š Epworth Rehabilitation and Mental extracted every possible Health – Jessica Luu emotion from my body… Š Epworth Eastern – Abigail Hyndman Š Epworth Freemasons – Peyton Lawson and I loved it.” Š Epworth Richmond – Stephanie Harper Melanie Desmond, Graduate Nurse Š Epworth Geelong – Alanna Murnane

66 Epworth HealthCare Annual Report Empowered People 67 Scholarship winner Hannah Riches is furthering her skills in training others. Scholarship program Undertaking her Masters in Health On completion, Hannah will be equipped Administration saw Nicky blend her to plan and create engaging education Our scholarship program continues existing clinical experience with advanced sessions, conduct assessments and to offer extraordinary development learning in leadership, management and facilitate learning in the workplace to opportunities, with employees able to business disciplines. This opportunity support her colleagues. Hannah has apply for a range of activities, to support enables Nicky to put her learning into already played a vital role in the roll-out education and development or take part in practice at work, better lead her team of PPE spotter training in response to innovative new projects. and ultimately assist in ensuring patients COVID-19, including a session specifically receive the best care. for our Environmental Services team, who In 2019, scholarships were: had no previous PPE experience. Hannah Riches, recipient of the Medtronic Š awarded to more than 150 employees scholarship is completing her Certificate Our scholarship program will continue Š valued at over $790,000. IV in Training and Assessment, which in 2020-21, with thanks to the generosity will help her fulfil important aspects of of our donors and sponsors through the For Nicky Pearson, Nurse Unit Manager her role as Clinical Nurse Specialist at EMF. at Epworth Richmond, receiving the Epworth Geelong. Advantage Salary Packaging scholarship allowed her to return to study.

A scholarship to Nicky Pearson is allowing Group Chief Executive Dr Lachlan her to further her studies. Henderson congratulates EpWORTHY winner Julia McKinnon.

EpWORTHY awards launched In February 2020, our new employee recognition award program, the Group Chief Executive EpWORTHY awards was launched.

This program recognises the unique and worthy contributions of Epworth staff.

More than 200 employees have received awards. This initiative gives our people the opportunity to nominate a colleague, a direct report, or a manager for an award. Employees can nominate under three categories: safety and wellbeing first, living our values, and contributing to our strategic pillars.

68 Epworth HealthCare Annual Report Empowered People 69 TitleClinicalOur volunteers education

Hospital volunteers:

86 40 42 12 9 60 15 264 Epworth Richmond Epworth Eastern Epworth Geelong Epworth Freemasons Epworth Rehabilitation Auxiliary volunteers Consumer advisors Total

Our 189 hospital New volunteer programs volunteers, aged from We introduced several new initiatives 18 to their 80s, help us this year: to improve our patient Š ED support – Epworth Geelong experience. welcomed volunteers to its ED team. These volunteers provided extra Our 60 EMF Heartbeat and auxiliary support and comfort to patients and volunteers help raise funds to support their families by delivering beverages, our patients by selling raffle tickets, providing warm blankets or simply handcrafted goods and knitted items. by sitting and chatting Š Chinese speaking concierges – this The recent addition of the consumer Key achievements Friends and centenary initiative was developed to assist advisory register to the volunteer patients and visitors at Epworth program has seen an additional 15 In the past 12 months, we have raised the Our volunteers were a central part of Eastern, who may have difficulty Volunteers through the years consumer volunteers welcomed. profile of the Epworth Volunteer Program our centenary celebrations. Some made communicating or interpreting This team volunteers recognise the across our hospitals and have enjoyed gorgeous gifts for our littlest patients admission information in English Volunteers have been vital to Epworth since its earliest days. To celebrate importance of having a consumer voice national recognition. (pictured above). Š Ambassador Program – this initiative the International Year of the Volunteer in 2001, a lemon scented gum was to improve our services. was designed to provide leadership planted at the Erin Street entrance to honour the work of volunteers at We saw: Every baby born at Epworth Freemasons opportunities for volunteers on site and Our volunteer program was suspended in or Epworth Geelong, on 27 February 2020, advocate for the volunteer program in Epworth over the years. Volunteers were also presented with certificates mid-March 2020, due to visitor restrictions Š a 35% increase in volunteers from 2018 our 100th birthday, received a special the promotion of its services to patients and medallions bearing our logo and that of the International Year of implemented during the COVID-19 to 2019 box of handmade treasures. Volunteers and staff. the Volunteer. While an increasing number of volunteers were involved pandemic. We were unable to recruit Š the average turnover rate at Epworth is knitted, sewed and tied ribbons on in direct contact with patients, a substantial number continued to work further volunteers during this period. less than half the standard benchmark. booties, baby hats and teddies to ensure Instead, we concentrated on ensuring our each baby, who shared a birthday with behind the scenes freeing up specialist staff to focus on their primary volunteers felt supported and engaged, The renal dialysis volunteer car service Epworth, received these special gifts and roles. There were 34 people who had completed at least five years of despite not being on site to perform their at Epworth Eastern was a finalist in the keepsakes. voluntary service to Epworth in 2001. roles for a number of months. APHA Awards for Excellence 2019 in the category of Comprehensive Care.

70 Epworth HealthCare Annual Report Empowered People 71 2020 VMO Leadership Program

Chief Medical Officer A/Prof Luis Prado.

Far right: VMOs take part in a learning weekend as part of the VMO Leadership Program.

More than 160 of our The Summit program is a custom New ways to deliver care Our junior doctors The prestigious Clinical Supervisor of This is a collaborative initiative led by designed 12-month program, developed the Year award is given to a clinical AMS, with representatives from People & medical practitioners and delivered in collaboration with By February 2020, the Summit program In 2019-20 the Junior Workforce Team supervisor for their outstanding support, Culture, medical directors and members applied for entry to the Monash Business School and the Monash was in full swing, with six key projects accredited 299 junior doctors. education and advocacy to junior doctors from each hospital site. University Faculty of Medicine, Nursing and assigned to the 24 participants during an undertaking training in their specialty. inaugural Epworth Summit Health Sciences (MNHS) for our VMOs. intensive learning weekend in the Yarra Recognition As part of this work, AMS has initiated 2020 VMO Leadership Valley. All projects are aligned with the Dr Anastasia Chrysostomou, Consultant informal check-ins with each Junior Successful applicants have the opportunity strategic vision of Epworth and focus on The recently established Junior Doctor Nephrologist and Physician, Associate Medical Officer (JMO) to identify any early Program, with 24 successful for a week-long trip to the United States new ways of delivering care. of the Year Award has seen an annual Dean of Medicine received this award for concerns and to build awareness of the applicants selected in 2019. to study at the internationally renowned acknowledgement and recognition of her unwavering commitment, dedication multiple support structures available. Harvard Macy Institute, Boston (delayed The projects, currently on hold due outstanding patient care by Epworth’s and support in both the professional and The successful candidates represented due to COVID-19). Graduates of the Summit to the pandemic, cover areas such as junior doctors. Dr Chia Yuen Chong was personal development of junior doctors AMS has ensured JMOs were involved in every Epworth site and a wide range program will receive an Executive Graduate telehealth, improved patient experience named the 2019 Junior Doctor of the and medical students. the safe care of COVID-19 patients, as of clinical specialties, including Certificate of Business, with the potential and innovative clinical practices. Year for the high quality of care she has part of our medical teams working in the practitioners at different stages for extension into a Masters degree provided Epworth patients, with her strong New initiatives dedicated COVID-19 wards at Epworth. of their careers. if desired. focus on ensuring patient safety and her Specific education and thorough training exceptional clinical knowledge. Dr Chong The junior medical workforce team of were provided to junior doctors by our The program is funded through the EMF was nominated by multiple medical and Academic and Medical Services (AMS) Medical Education Team to ensure their and Epworth HealthCare. nursing staff and highly recommended to has established an Entitlement and ward readiness and safety. Epworth is receive this award. Wellbeing Steering Committee, to ensure proud of the contribution our JMOs have the development and wellbeing of junior made during our pandemic response. doctors across all Epworth sites.

72 Epworth HealthCare Annual Report Empowered People 73 The future of healthcare The evening culminated in the Our third VMO masterclass included the announcement of the 2019 Medical Leader announcement of Medical Leader Awards. Our second VMO Masterclass - ‘The Award winners. Our worthy winners were: Future of Healthcare’ was held in August 2019. More than 200 Epworth doctors and Š Consultant emeritus – VMOs gathered for thought-provoking Dr Graeme Sloman AO and insights from an expert panel including: Mr Michael Dobson Professor Chris Bain, Dr Fiona Kerr and Š Medical researcher of the year – Dr Lachlan Henderson, moderated by ABC Prof Paul Fitzgerald news anchor, Beverley O’Connor. Š Peter J Dohrmann award – Dr Matthew Read Group Chief Executive Dr Lachlan Š Junior doctor of the year – Henderson spoke about the trends we are Dr Chia Yuen Chong seeing in healthcare, noting that: Š Liz Morton award clinical supervisor of the year – Š the future patient will be actively Dr Anastasia Chrysostomou involved in managing their health and Š Prof Geoffrey Metz award wellbeing clinical tutor of the year – Š enhancing clinician experience A/Prof Indhresha Rasaratnam. will be facilitated by improving communications and ensuring digital Our first virtual masterclass was held clinical information is readily available in June 2020, with multi-award winning Š our large and diverse workforce needs social media expert, former clinician and modern and integrated technology, founder of Women in STEMM, Michelle Š forward-thinking organisations Gallaher, presenting on the power of are transitioning to a data-centric social media for medicine. Around 300 approach, viewing data as a strategic of our VMOs joined this event via video asset. conference or phone.

Our third VMO masterclass, in November Chief Medical Officer A/Prof 2019, featured ABC chair Ita Buttrose as Luis Prado, guest speaker Ita Buttrose, guest speaker. Professor Michelle Russell, Director of Executive Education, Monash Business More than 250 medical leaders gathered School and Epworth Group Chief Executive at the Park Hyatt to listen to Ita share Dr Lachlan Henderson. her ideas and experiences of leading transformational change, including personal moments that showcased society’s changing views on women in the workplace. She encouraged the audience to embrace change as an opportunity to learn and grow and advocated for women to strive for leadership.

74 Epworth HealthCare Annual Report Empowered People 75 Doctor celebrates three decades of care

Symposia While Epworth has turned As technology advanced, doctors had Our longest serving Emergency doctor, to learn with it. Dr Bob Poulton. We share our expertise by conducting Due to COVID-19, we had a hiatus 100, Dr Bob Poulton is Clinical Institute symposia, showcasing in symposia in 2020, with our first celebrating his 30th year “Medications haven’t changed a lot at the expertise and thought leadership of virtual symposium delivered by the all – it’s radiology that has brought the our leading specialists and experts. In Musculoskeletal Clinical Institute at Epworth. biggest changes. 2019, we presented four symposia, on: in July 2020. This event was a foot and In 1990, when Bob first began, there was ankle masterclass, covering the Achilles, just one doctor in Emergency on every shift “The new radiology testing that became Š Obstetrics and gynaecology, attended flat feet, gout and more. Around 300 GPs and two on the weekend. available was not something we did in our by 164 and featuring international guest and specialists attended. training, so we had to learn how to read speaker, Professor Richard Anderson “We had 30 patients a day on average, these new scans, which was difficult,” from the University of Edinburgh and All weekly Grand Rounds and cardiac nine beds and one resuscitation cubicle,” Bob said. 16 prominent local speakers breakfast events continued throughout Bob remembered. Š The inaugural neurological the pandemic as online Zoom events. As the years went by, presentation rehabilitation symposium, which In those days, the College of Emergency numbers tripled and care became attracted our largest symposia Medicine was not registered by Medicare and more complex. audience to date, a capacity audience the charge was the same as seeing a GP. of 300. This program featured eight “Today, we see more significant eminent local speakers, with the most “People used to come here with a sprained illnesses and up to 25% of patients popular sessions covering concussion ankle or minor worries. Only 10% of arrive by ambulance. and focal spasticity patients came by ambulance,” Bob said. Š Neurosciences – spine and spinal “We spend a lot more time with each disorders, with a 31% increase in “We were one of the first places to patient as many are now older and have registrations compared to the previous do urgent angiograms (to help detect a more complex history. It was unusual symposium in 2017. This year’s event clots and abnormal blood vessels) 30 years ago to have a patient over 80, featured 16 highly regarded local for people walking in.” but now that is common.” speakers Š Cardiac sciences, with the most valuable sessions voted as being ‘five things you don’t know about cholesterol and vascular disease’, ‘five drugs making a difference in cardiac failure’, and ‘five thing cardiologists need to Epworth Richmond Epworth Geelong know in neurology’. Emergency Department Emergency Department Š Custom-built building, that opened Š Servicing the Barwon community in 2016 seven days a week, 8am-midnight Š 35 cubicles and two resuscitation bays Š Part of a new hospital that opened Š Up to six doctors available during the in 2016 day and five in the evening. Š 20 private treatment spaces, including two resuscitation bays Š Piloted our first nurse practitioner at Epworth.

76 Epworth HealthCare Annual Report Empowered People 77 Foundation Day celebrations

A sense of excitement and 3AW broadcast live from pride permeated our 11 sites on Epworth Richmond, 27 February 2020 as Epworth interviewing Group Chief celebrated turning 100. Executive Dr Lachlan Henderson, Emergency Staff, wearing our special 100 Department Director year tops or caps, took selfies Associate Professor Ron at our custom photo booths Sultana, Epworth Freemasons and created a celebratory Nurse Unit Manager Colleen atmosphere for all, with O’Hara and volunteer BBQ lunch and gelato carts. Margaret McKelvie. Our patients received special mementoes, as did employees and doctors.

78 Epworth HealthCare Annual Report Empowered People 79 by 06 Innovative Practice

Over the years, the Our Australian firsts include: In 2019, a world-first was achieved when Epworth medical advances at  removal of a kidney through clinicians created a fully- Epworth have been a 2cm hole in a patient’s functioning jaw bone in a navel in 2010 single, minimally invasive extraordinary.  a new technique for procedure, using 3D printing operating on tumours technology. in adrenal glands  use of a clip device to minimise the risk of stroke in atrial fibrillation patients.

86 Epworth HealthCare Annual Report 100 Years of Care 87 Epworth research

We encourage our people Studies by Epworth Clinical Institutes include: Research and COVID-19 With very little known about the novel to continuously strive coronavirus to date, Epworth researchers “ The project helps us 61 26 15 15 While standard protocols have changed, have had opportunities to be involved in compare samples of people for scientific knowledge cancer services critical care cardiac sciences musculoskeletal opportunities for vital research have studies related to COVID-19. soared since the pandemic. who have been infected, to and new pathways for Epworth is a partner in four large studies 61 20 15 Professor Nik Zeps, Epworth Director of investigating the virus: understand why different treatment and care. rehabilitation, general internal medicine Research and Development, said there were mental health and surgery and people’s immune systems Research will ultimately improve fears a lot of research would stall due to Š a biobank study that looks at why the chronic pain gastroenterology the care of our patients, contribute lockdown restrictions. Instead, researchers virus affects some people differently respond in different ways to furthering scientific knowledge have found different ways to progress. Š the BRACE trial, which is investigating to this virus.” and deliver better outcomes. At 30 June 2020, 253 research studies Our research is conducted at seven of whether the BCG vaccine, previously were in progress, a significant increase our sites, with the majority at Epworth “Orthopaedics, perioperative, allied used to protect against TB, can protect It’s hoped the research will help identify Our research strategy also attracts and compared to the same time last year. The Richmond (169), followed by Epworth health and some nursing research all healthcare workers against COVID-19, markers in the blood and throat swabs cultivates the brightest talent and makes number of studies in the areas of cancer Freemasons (63) and Epworth Camberwell rely on elective surgery patients and our or reduce severity of the virus that can be used to predict whether a difference to all. and rehabilitation, mental health and (42). There are nine different types of elective surgery has been restricted,” Š ASCOT, which aims to generate clinical COVID-19 patients may have poorer chronic pain have doubled. Of our total studies, including: Prof Zeps explained. evidence about treatment for COVID-19 outcomes. It could be possible to target clinical studies this year: that can be applied to reduce mortality existing medications or develop new Š 105 clinical trials “These instances have necessitated the use or the need for mechanical ventilation drugs to use on different patients. Š 185 are investigator-initiated Š 55 observational studies of verbal and electronic consent. You can’t in hospitalised, but not yet critically Š 44 are commercially sponsored Š 27 research audits. put pen and paper in front of COVID-19 ill patients Š 24 are research collaborations. patients as that is a source of infection. Š elective surgery surveillance project, This really has challenged some of the testing 3,000 people for COVID-19 on the The research programs at Epworth span previous thinking we’ve had in ethics.” day of surgery in June and July, to guide a wide range of areas, from oncology future policy decisions and help improve to critical care and mental health. Other changes have included the need the care of patients who undergo surgery to monitor patients remotely, rather than in the future. observing in person, to ensure treatments Number of studies per Epworth site Number of studies per project type are being administered in the right way. Medical records are also being accessed 14 7 3 14 7 3 20 remotely to ensure those in trials meet 20 20 all criteria.

20 42 Dr Ron Sultana, Director of Emergency 42 169 169 Medicine explains his research project Epworth Richmond Clinical trial to Group Chief Executive Dr Lachlan Epworth Freemasons Observational study Henderson during Research Week. Epworth Camberwell Research audit 42 Epworth Eastern Case study Epworth Geelong 63 Interview or focus group Epworth Hawthorn Survey or questioinnaire Epworth Brighton Tissue bank 63 Research registry Other Laboratory research

88 Epworth HealthCare Annual Report Innovative Practice 89 Tuberculosis vaccine trial The BCG vaccine trial was conducted in parallel to the annual staff flu vaccination Epworth has partnered with Melbourne’s at Epworth, which commenced in late Murdoch Children’s Research Institute March 2020. Following commencement (MCRI) to study whether a vaccine, of the study, funding provided by the Bill normally used to protect against TB and Melinda Gates Foundation enabled can be used to boost immunity against the trial to expand to include healthcare COVID-19 in healthcare workers. workers who have already had their flu vaccination. While the BCG vaccine is designed to protect against TB, it also boosts Epworth has contributed 250 healthcare immunity to protect against other workers to the 3,000 Australian infections. Some studies have shown participant target. people who have had a BCG vaccine have fewer viral respiratory tract infections Biobank expansion than those without the vaccine. A $100,000 donation to Epworth could help Other studies have shown people who Melbourne researchers better understand have had a BCG vaccine and then get why COVID-19 affects people differently. a virus, have lower virus levels in their blood than those who haven’t received the The research project, led by Epworth vaccine. infectious diseases expert Dr James McMahon, is building a biobank of blood Dr Niki Tan, Epworth Anaesthetist and samples and throat swabs taken from Director of Critical Care Clinical Trials said COVID-19 patients admitted to Melbourne the purpose of this WHO-approved study hospitals during the pandemic. is to find out whether BCG vaccination protects against COVID-19, or reduces “The research project has been collecting the severity of the virus in Australian samples from COVID-19 patients admitted healthcare workers. to hospital since the pandemic began,” Dr McMahon said. “Half of the people in the study will be randomly allocated to receive the BCG Clinicians, researchers and scientists, vaccine and half will not receive the with expertise in infectious diseases, vaccine. Everyone will have a blood test immunology and virology perform detailed taken and be followed up for six months,” analyses on the samples. Dr Tan said.

90 Epworth HealthCare Annual Report Innovative Practice 91 Prof Paul Fitzgerlad (middle) with Steven Research Week 2019 Jane, Luis Prado, Kate Hoy, Carolyn Bell and Dr Lachlan Henderson.

We’re committed to Studies receiving grant funding included: Š funding has been awarded to haematologist Dr Costas Yannakou research that advances Š a clinical quality registry for ovarian and the MOCI team to identify ways the health and longevity cancer at Epworth, awarded to Epworth to treat lymphoma, using circulating Freemasons gynaecological oncologist tumour DNA (ctDNA) as a biomarker of of our patients and future Associate Professor Robert Rome. The response, in aggressive B-cell non- generations, with a focus National Gynae-Oncology Registry will Hodgkin lymphoma that will enable adopt a national approach. It will be better outcomes for patients on investing funds into important in evaluating the safety and Š a project led by Kirsten Gainsford to areas of greatest need and effectiveness of our treatments for investigate the effects of combining women with ovarian cancer, informing virtual reality and brain stimulation in with the highest potential new clinical trials and research aimed order to develop an effective, efficient to improve quality of life. at improving outcomes and accessible treatment for social Š ‘Don’t Soap the Bub’, a study cognitive impairment in schizophrenia Research Week 2019 (5-9 August 2019) investigating the role soap and Š a clinical services study, led by Stuart launched with the new Epworth detergent plays in the risk of some Shakespeare, to track consumers’ and Research Strategy 2019-23. babies developing food allergies later clinicians’ satisfaction, attitudes and in life, led by paediatrician Dr John understanding of the ‘Are you worried’ We announced 26 new projects to receive Ainsworth escalation process, a system for nearly $500,000 in research funding, Š a new project established by cardiologist identifying and reducing the risk of poor provided by supporters of the EMF. Associate Professor Tony Walton to outcomes for patients. Funding success – mental health boost This new grant will address ways to Moments of mindfulness test the long-term effects of TAVI on Š a range of other grants were also improve the clinical use of repetitive the quality of life of patients, capturing awarded across mental health and In May 2020, Professor Paul Fitzgerald TMS: through the development of a Epworth Clinic launched Moments of valuable local experience that can be rehabilitation, cardiac, education, (pictured above, middle) Epworth Centre more sophisticated version of treatment Mindfulness, during Mental Health Week used to improve care outcomes surgical and urology and analysing for Innovation in Mental Health Director, for treatment-resistant patients. It will in October 2019, a meditation resource to health systems. was awarded a NHMRC investigator grant. also help with the testing of a highly help people relax their body, quiet their accelerated version of repetitive TMS mind and focus on the present. This highly sought after $2.1 million grant therapy for patients who need a rapid Research Week by numbers: (over five years) funds brain stimulation clinical response, such as those with Available on CD, on Epworth Point of Care therapies for mental health disorders, substantial suicidal ideation. terminals and online through Spotify, $477,225 26 from concept to clinical application. iTunes and YouTube, the resource provides in grant funding distributed EMF grant recipients Prof Fitzgerald also aims to develop a new 16 meditation practices developed by Prof Fitzgerald and his team have been therapy using closed-loop transcranial, psychologists Dr Maddy Fernando and using transcranial magnetic stimulation alternating current stimulation, for use Patch Callahan from Epworth Clinic. 11 73 (TMS) to find better, more effective ways at home in a much broader spectrum of research symposia research posters to treat common psychiatric disorders like patients with major depressive disorder. Guided meditations include:

clinical depression, Alzheimer’s diease, 51 22 fibromyalgia and obsessive-compulsive Š Prof Fitzgerald is also the co-lead of Š five-minute mindful breathing research presentations nurse-led research posters disorder. a study looking at genotype-guided Š self-compassion practice versus standard psychotropic therapy Š gratitude practise While this non-invasive brain stimulation in moderately-to-severely depressed Š loving kindness meditation. 12 5 therapy is showing promise, there are patients. This study received $2.95 clinical specialties presentations Outstanding Research Poster Award some limitations. million from the Australian Federal Thanks to generous supporters of the winners Government as part of its mental EMF, this resource has been highly health and suicide prevention research successful, with the YouTube playlist support. listened to by more than 200,000 people.

92 Epworth HealthCare Annual Report Innovative Practice 93 A/Prof Rachel Wong.

New technology leading to “We take blood samples, which are New form of chemotherapy analysed at Johns Hopkin University in individual cancer care Baltimore, and use that information to Epworth Richmond is trialling a new form of spray- A new research study is examining DNA determine if we need to use intensive on chemotherapy, developed in Germany, in a bid in the blood of bowel cancer patients chemotherapy, or a less intensive to lessen side effects and slow cancer growth in to plan an individualised approach to chemotherapy, with the aim of improving oncology patients. treating cancer. outcomes and reducing the side effects for patients,” A/Prof Wong explained. This treatment, called Pressurised Intraperitoneal First IVF baby: 1984 From Epworth Eastern, Associate Aerosol Chemotherapy (PIPAC), uses an aerosol Professor Rachel Wong is leading the “With these studies, we look for residual spray to administer drugs directly to the tumour The Epworth-Monash Fertility Clinic achieved two DYNAMIC clinical trials research into early cancer in the bloodstream. If we find site, instead of injections into the bloodstream for world firsts in 1984. Professor Carl Wood announced stage rectal cancer and stage III bowel cancer DNA in the blood, those patients traditional chemotherapy. the first pregnancy from a donor ovum at a news cancer, as part of two Australian-led are given more intensive treatment. We international studies. know that chemotherapy is toxic so it is Associate Professor Craig Lynch, an Epworth conference at Epworth on 12 January 1983. A team hoped this study will help us decide who surgeon, said the therapy “goes in under pressure from Epworth and the Queen Victoria Medical Researchers are studying circulating needs it and how much they need. and soaks into the tumour nodule. That’s why it has a Centre worked on this development. The pregnancy tumour DNA (ctDNA) which is found in the significant effect.” was normal and the healthy baby boy was born at the bloodstream and comes from cancerous “If we detect no cancer cells in the cells and tumours. A previous study of sample, those patients may only need It is most relevant for gastric and colorectal Queen Victoria Medical Centre in November 1983. bowel cancer patients found people with three months of chemotherapy treatment, tumours. It is a palliative treatment, not a cure for At the same time, Dr Linda Mohr was developing a ctDNA in their blood after surgery have instead of six and only one drug, instead of peritoneal cancer. The trial, funded through the EMF, technique for freezing embryos in liquid nitrogen. A a very high chance of the cancer coming two,” A/Prof Wong said. involves patients with peritoneal cancer following woman had become pregnant after the implantation back, compared with those with no ctDNA. bowel cancer who did not respond to traditional The trial, which involves 500 participants chemotherapy. of an embryo that had been frozen, but developed This study aims to confirm whether in the rectal cancer trial and 1,000 in the an infection and miscarried at 24 weeks in 1983. the presence of ctDNA after surgery is colon cancer trial, is expected to run for Participants received three rounds of aerosol The world’s first baby born as a result of this frozen effective in determining the type and several years at hospitals in Australia chemotherapy during laparoscopic surgery under embryo technique, Zoe Leyland, was born on duration of chemotherapy the patient will and New Zealand. Epworth patients were anaesthetic, six weeks apart. need to prevent a reoccurrence. enrolled in the trials from December 2019. 28 March 1984. The procedure offered another The treatment provides patients with another option avenue of hope to infertile couples and meant that to intravenous chemotherapy, which often causes embryos could be stored for future implantation. nausea, vomiting and hair loss.

It is hoped the aerosol treatment could shrink tumours, allowing surgery to reduce the burden of disease and extend life.

94 Epworth HealthCare Annual Report Innovative Practice 95 The new simulation lab at Epworth Freemasons Research showed the busiest time for To ensure our cardiac rehabilitation patients requiring a nurse practitioner services could continue, the team was 10am-8pm, particularly on introduced the ‘Cardihab’ mobile app, with weekends. This includes patients with support from the EMF. Currently, Epworth Simulating the real world less serious illnesses and injuries, who is the only private hospital in Victoria using are cared for in a ‘fast track’ process. Cardihab - a digital and interactive exercise Students, newly graduated nurses, This typically includes patients with cuts, and education program that participants midwives and doctors at Epworth are sprains, fractures, soft tissue injuries, can safely complete at home. constantly building their skills and minor burns, eye irritations and minor knowledge. They can often be found paediatric issues. Suzie Hooper, Director of Clinical and Site practising their skills in our simulation Services, Epworth Camberwell said they labs, equipped with the latest technology. The nurse practitioner pilot has been have been able to tailor the app to our an outstanding success. In Michael’s rehab programs, providing content and A new simulation lab, opened in first month in the role, he treated activities developed by Epworth clinicians. September 2019, at the renovated 16% of the department’s presentations Epworth Freemasons, mimics a clinical between 10am-6pm, growing to 28% environment and provides a wealth of in the past year. “ Importantly, our patients education opportunities for employees. Positive results include: are not left alone The lab’s mannequins include a baby throughout the digital who can be ‘born’ and a high-fidelity Š fast track patients are discharged simulation mannequin who can mimic home or to the ward after an average program. They have critical distress, allowing staff to gain real of 61 minutes when seen by the weekly contact with our time feedback on their care, including nurse practitioner, resulting in a 42% measuring the depth of compressions and improvement in workflow cardiac rehabilitation heart rate. Š complex patients, requiring treatment nurse to check on their Further education advancing nursing care by emergency medical staff, can The high-tech equipment, funded by be discharged home or to the ward progress and can also donors to the EMF, enables employees to In July 2019, Epworth introduced its first 34 minutes sooner, with a nurse contact us at any time.” undertake all their core competencies and Road to developing the first private ICU: 1981 endorsed nurse practitioner, critical practitioner involved in their care. advanced life support training. care nurse Michael Hardie (pictured In 1981, Epworth introduced medical resident fellows and became the first above), who works at Epworth Geelong Surveys were sent to 174 patients The app has made cardiac rehabilitation The simulation lab also has a mannequin private, not-for-profit hospital in Victoria to have a fully equipped ICU and Emergency Department. over a three-month period (December more accessible to the wider community. for basic life support training, a crash trolley 2019-March 2020) and the respondents Patients unable to regularly travel to a team of resident medical fellows on duty around the clock. The medical (where staff can use a real defibrillator), Michael was involved in the establishment praised the initiative, with all rating the Epworth Camberwell to participate in catheter and cannula trainers and a fellows managed the ICU under the supervision of intensive care specialists, of this program, which involved the experience ‘very good’ or ‘good’. the in-person program are now able to paediatric resuscitation mannequin. attended emergencies in the hospital and performed other elective work comprehensive documentation of clinical participate, at a time that suits them. referred to them by accredited doctors. The role proved to be extremely governance and patient safety. Cardiac rehabilitation goes digital Environmental and food services staff also attractive to a wide range of highly qualified and experienced doctors. In practice their Safe Moves training in the “We were able to adjust our program to The COVID-19 pandemic impacted our lab to reduce personal injuries. the first nine months of operation, there were 200 admissions to the ICU. support the needs of the private system,” ability to deliver our cardiac rehabilitation By 1982, the hospital was receiving a steady stream of enquiries about this Michael said. program, which helps people recovering scheme from throughout Australia. from cardiac events learn to live a fulfilling Working closely with senior consultants life, reduce the risk of future cardiac in the ED, together, they formulated episodes and build a support network. a patient care plan.

96 Epworth HealthCare Annual Report Innovative Practice 97 Expanding Rehabilitation in the Home Patient Paul De Candia was urologist Associate Professor Laurence Harewood’s Rehabilitation in the Home (RITH), 1,000th robotic surgical case. an Epworth program, began in 2014, as a service for people who had hip or knee replacement surgery at Epworth Richmond and Epworth Eastern.

Over the past 12 months, the program has evolved from a physiotherapy-only service to a holistic home-based rehabilitation service, supported by a rehabilitation specialist, rehabilitation nurse and occupational therapist.

One of the contributing factors to this growth has been a new partnership formed between WorkSafe Victoria and Epworth Rehabilitation. We are now able Robotic surgery arrives: 2003 to offer an in-home rehabilitation service for people who have had workplace In late 2003, Epworth acquired a $3 million da accidents or injuries. Vinci robotic surgical system, a totally intuitive, minimally-invasive robot. The system provides This partnership has also expanded the case mix for RITH, adding neurology full colour 3D vision, up to 15 times magnification and trauma treatment, in addition and both intuitive and dextrous manipulation. Key 1,000th robot partnering “Robotic prostate surgery is minimally to orthopaedics. surgeons and operating theatre staff underwent invasive, blood loss is usually minor, blood Associate Professor Laurence Harewood transfusions are uncommon and post- extensive training in the use of the robot at two The addition of a rehabilitation physician has completed his 1,000th surgical case operative discomfort is minimal. Patients to our RITH service contributes to medical university hospitals in the United States of America. with robotic assistance at Epworth, surgical are normally discharged on the second oversight and, as the key liaison with acute Two of those who trained overseas were prominent technology he describes as a “game post-operative day. specialists, improves communication with urologists: Professor Anthony Costello, who was changer.” doctors to enhance patient care. The results, in terms of continence and also a director of the Prostate Cancer Foundation of His patient, Paul De Candia, had been the positive margin rate, which is an Undertaking rehabilitation at home can: Australia, and Mr Justin Peters. The early operations diagnosed with prostate cancer and indication of the possibility of leaving at Epworth were supervised by senior American travelled to Epworth from Tasmania cancer behind, are dramatically less.” Š reduce inpatient length of stay proctors. The first surgery, a radical prostatectomy, to have his prostate removed. A/Prof and decrease risk of complications Harewood performed a Robotic Radical The da Vinci robot is also used in kidney was performed in December 2003 and the first heart after surgery Prostatectomy, removing the cancerous and bladder surgery, and recently has Š help patients transition home easier, surgery was performed in March 2004 when cardiac prostate and joining the bladder and urethra been used in cardiac, gynaecological, alleviating worries or concerns with surgeons undertook a mitral valve repair. back together using the da Vinci robot. colorectal and thoracic surgery. a clinician visiting their home soon after discharge “Robotic surgery is enhanced keyhole Epworth performs a large number Š enable people to recover at home surgery, which allows me to have of robotic procedures, with a total and regain their place within their binocular vision, a three-dimensional of six da Vinci robots. community faster. view, magnification and greater precision.

98 Epworth HealthCare Annual Report Innovative Practice 99 Maternity goes digital Home-based sleep studies introduced “During the pandemic, we have some Senior Sleep Scientist, Natalie Swaby, people not wanting to come into hospital, demonstrates the portable device. Innovating the way we work has resulted Sleep studies, to assess and diagnose so this at-home service has been in Epworth Maternity delivering content obstructive sleep apnoea, are now more welcomed; we’ve been booked out every differently during the pandemic. accessible following the introduction night,” he said. of at-home sleep studies at Epworth Our maternity patients usually attend Camberwell and Epworth Geelong. Patients attend the clinic to get connected antenatal evening or weekend classes to the device and receive instructions on at either Epworth Freemasons or In August 2019, an at-home sleep service how to remove it the next morning. On Epworth Geelong, but physical distancing was introduced to complement the return to Epworth, the data is analysed, guidelines made this impossible. Our existing in-hospital service. with results sent to the referring doctor maternity team reoriented our content within 48 hours, as it would normally and these classes were moved online. Darrel Wicks, Sleep Unit Manager and occur if the test was completed on-site. Sleep Scientist, said two portable devices Knowing new parents are often anxious A breastfeeding service was provided via grandparents’ program, as they are not enabled seven people to be tested at home The at-home testing, which is a scaled and desperate for information, all usual telephone consultation or via Microsoft encouraged to look after babies during the each week, across both sites. down version of hospital testing, is classes were filmed, with these videos Teams, giving our mothers one-on-one pandemic. Feedback regarding our online restricted to those with suspected available on our website, enabling time with a lactation consultant after they resources has been consistently positive, “The in-hospital service runs across obstructive sleep apnoea and no other participants to digest the information left hospital. with patients feeling reassured. all our sites and, prior to COVID-19, we health complications. at their own pace. A live Q&A session, These new resources are not only useful were seeing 60 patients a week, testing via Zoom, with an Epworth midwife was With hospital tours cancelled, we provided during COVID-19. Our maternity units are for sleep apnoea, narcolepsy, nocturnal Planning is underway to expand the also offered. virtual tour videos, so patients could see planning to continue offering online options epilepsy and movement disorders. at-home service, enabling further the hospital before they gave birth. The to patients who can’t attend classes. partnerships with GPs. only class that was not available was our

Our expectant parents can now attend their antenatal information evenings from home. New blood donation technique in the face of HIV crisis: 1980s During the early 1980s, it took three months to determine if a person had HIV/AIDS, but blood could not be preserved for this length of time. HIV-affected blood had infiltrated the Red Cross Blood Bank and people were reluctant to use this source. A system was developed so that patients could donate their own blood prior to surgery. Kingsley Mills (Director of Orthopaedics and Medical Director of Care Centre One) got to know Jim Picken, a perfusionist at Epworth, and quizzed him about how he could help, given that they could not rely on the Blood Bank for blood supplies. Jim collected blood, which would otherwise be wasted down the sucker machine, and using a cell saving machine to separate the red blood cells, he then resuspended them in saline so that they could be given back to the patient. Kingsley recognised the value of this technology and by using it with the patient’s own stored blood, he could undertake complicated surgery without having to use donated blood.

100 Epworth HealthCare Annual Report Innovative Practice 101 Technology projects

During the year, we This project, which is part of our Digital In the past year, POC has been used: Cardiac technology upgrade MyRoster We expanded our reach by creating Vision and aligns to the Epworth more video content: upgraded technology and HealthCare Strategic Plan 2018–22, has Š by clinical staff more than seven Standardising and upgrading our cardiac The My Roster project, which involves a delivered new solutions involved consultation with a range of million times technology has remained a focus. transition from paper-based to electronic Epworth YouTube stakeholders from within our hospitals and Š by VMOs more than 100,000 times This work, including consolidating rostering of time and attendance, to improve patient care our wider community to ensure our new Š by patients for entertainment for cardiac imaging storage enabled continued across Epworth. Epworth Š 21.3k subscribers and efficiency across the website meets the needs of our audience. more than four million hours cardiologists at Epworth to access, Richmond and Epworth Medical Imaging Š 23.6 million impressions (519% Š by patients to order more than view and write cardiac diagnostic roll outs were completed, with Epworth increase from the previous year) organisation. The design focuses on creating a website one million meals. reports remotely. Freemasons implementation underway. Š 30.5k hours of video watched. that responds to the changing expectations Enabling a mobile workforce of our patients, clinicians, workforce, Meal management The relocation of Epworth Richmond Social media success Connecting with staff over social media has GPs and partners. With increased use Cath Lab will enable new integrated also been a focus, especially during the Throughout the pandemic, many non- of mobile devices, more of our information Delegate, a new meal management catheterisation systems at Epworth Using social media to connect and pandemic. We introduced regular videos clinical employees were required to work is available digitally. system, was launched at Epworth Richmond Cardiac Services. engage our community has been from our Group Chief Executive provided remotely. To enable this, IT: Camberwell to streamline the processes particularly important in the past year, to employees via SMS, with significant During Victoria’s pandemic restrictions, related to meal preparation and ordering. Behind the scenes support as people looked for trusted sources open rates. We launched an Epworth Team Š deployed Microsoft Office 365 and Teams our website was crucial in updating our Working with Food Services, IT implemented during the pandemic. Facebook page and an Epworth TikTok across Epworth, ensuring collaboration community about evolving public health the new system to improve the way: Each of our site redevelopments requires account to share staff-generated content and connectivity regardless of where measures, such as: IT support. This year, technology was and encourage connection across our staff were working Š patients order their meals, using critical to ensure the success of: 62,000 followers social media channels. Š upgraded remote access infrastructure Š visitor restrictions the POC screen at their bedside across Instagram, Facebook, Twitter capacity to cater for greater Š pre-surgery screening Š Food Services creates meals, Š Epworth Freemasons Day Oncology, and LinkedIn, During the April 2020-July 2020 requirements for remote access Š mandatory masks manages patient orders and keeps consulting suites and carpark lockdown, we saw more engagement Š piloted VPN technology, rolling this out Š physical distancing. track of supplies Š Epworth Freemasons/EMI PET 19.5 million people across our social media channels: reached in 2019-20, an increase of to more than 70 people for seamless and Š ingredients, diet codes and allergies CT installation 6% on the previous year. secure remote connectivity Point of Care platform strengthens are managed, keeping patients safe. Š Epworth Eastern site redevelopment 35% Š managed an increase of almost 250% in and the deployment of Epworth increase in our Facebook engagement remote system access from an average During the COVID-19 pandemic, with Delegate software is already in use at Eastern Kew. During Victoria’s lockdowns, our rate: comments increasing by 144% of 250 people per day to a peak of over visitor restrictions in place, our bedside Epworth Richmond and Epworth Geelong community was looking to us for support 700 per day. Point of Care (POC) system has provided and it will streamline meal management IT has also been important in the: and answers about the pandemic. a telehealth platform for patients at Epworth Camberwell. We successfully used social media 219% Website refreshed to communicate with their families, Š migration of approximately 100 to provide relevant, current and trusted increase in Epworth Maternity Group clinicians and allied health teams. This new system has paved the way applications and database servers information rapidly and we’ve built posts, with the group growing by 32% Following two years of development, the for a wider range of menu choices, from Windows 2008 to Windows 2016, communities such as the Epworth and engagement increasing 138% new website for Epworth was launched in Since POC was implemented five years with patients ordering one day in advance providing ongoing service and support Maternity Group, a safe place for February 2020. ago, usage has accelerated. Our bedside for set meal times. Š strengthening of our disaster recovery new and expecting mums to connect, technology provides clinicians with access capability, including the implementation ask questions and provide feedback. 2,000+ The website brings together multiple to critical information about each patient The Delegate software and new meal of a standby datacentre that can video views on Epworth Iso-Mums standalone sites adopting a One Epworth and their treatment. It is used by patients management systems will roll out at support critical technology services Mobile Midwife, our free educational Facebook live series approach. It has increased functional to access entertainment channels and other sites over coming months, enabling Š replacement of 30 network switches maternity videos, were also a popular capability, including a comprehensive to order their meals. our hospitals to use a consistent model and the upgrade of many WIFI access resource. From January-June 2020, search capacity, an up-to-date design to manage meals. points to provide better coverage, faster we saw a 405% increase in visitors and is mobile and tablet responsive. speeds and higher levels of security. to the site compared to the previous This program was completed with no six months. business disruption.

102 Epworth HealthCare Annual Report Innovative Practice 103 07 Sustainability

One of our strategic pillars is sustainability. It encompasses not only sound environmental and financial choices, but collaborations and partnerships that are mutually aligned and beneficial.

104 Epworth HealthCare Annual Report 100 Years of Care 105 Redevelopments

The new entrance at Epworth Freemasons. Redevelopment works continue at Epworth Eastern.

This year, we completed the The new features, which are fully integrated Epworth Freemasons Executive General Better connected cancer care New state-of-the-art scanner Epworth Eastern redevelopment into the existing buildings, include: Manager, Simon Benedict, said many progresses redevelopment of Epworth years of planning and construction have The relocation of the hospital’s DOU from a As part of the redevelopment of Epworth Freemasons, expanded Š Albert Street hospital entrance resulted in a direct impact on patient care stand-alone facility at the Victoria Parade Freemasons, donors to Epworth helped Work to expand Epworth Eastern, refurbishment to improve and experience, with internal and external site, into the new Grey Street building, has purchase a new state-of-the-art PET/CT including a new ED, additional operating cardiac care at Epworth patient access designs sympathetic to the original enabled us to deliver even better care to Scanner to support cancer patients theatres and three new clinical floors Richmond and made great Š a dedicated drop off and pick up heritage-listed hospital and neighbouring our patients. at diagnosis and throughout their care. has progressed, with completion expected area at the main entrance terrace buildings. in late 2021. progress on construction Š a redesigned and upgraded main The purpose-built space, named the Helen The PET/CT can reveal a tumour that at Epworth Eastern. reception area “Our new state-of-the-art operating Hains Day Oncology Unit, is filled with is not visible on other types of scans. Several months of excavation created Š a new Day Oncology Unit theatres, combined with the impressive natural light and is spacious for patient It can help with the detection of unknown three levels of basement car parking. Epworth Freemasons redevelopment Š onsite parking for more than robotics program ensure we will deliver comfort and privacy, while supporting our disease and map the spread of diagnosed In April 2020, the site’s main crane arrived 300 vehicles world-class clinical care,” Mr Benedict said. clinical teams in the care they provide cancer, to ensure the most appropriate and construction of the 14-storey East The $100 million redevelopment of Epworth Š new research facilities each day. A key investment for Epworth treatment is provided. Wing Tower commenced. Freemasons was completed in March Š an upgraded simulation and “Our team feels a sense of pride in our Freemasons, the new DOU directly links to 2020. The new facilities, within the historic education centre new-look hospital and rightly so. It’s their the existing inpatient oncology ward. PET/ CT scans are also routinely used More than 50 of our doctors were Clarendon Street site, allow the hospital to Š new consulting suites passion and professionalism that has in clinical trials. They provide the most relocated to new consulting suites at care for even more patients. Š four additional operating theatres helped make it possible. This new space enables us to provide accurate assessment of the patient’s Epworth Eastern Specialist Centre. (to complement the eight existing better individualised care for each patient disease and the impact of treatment. Purpose-built, the new facility enabled The new radiation oncology and day theatres at Clarendon Street) “Our new Day Oncology Unit (DOU) has and an easier access to radiotherapy, a decant strategy and refurbishment oncology units were completed first, with Š 12 additional inpatient beds made treatment days more comfortable, radiology, ICU and the inpatient unit, The addition of this technology ensures works to commence in a timely manner. patients accepted into new areas from Š a new pharmacy. in a light and spacious environment. We enabling smoother transitions for patients, patients will receive the gold standard September 2019. also know that it’s the people behind that our doctors and specialist nurses. in cancer care. care who ultimately make the difference.” The support of donors to the EMF has facilitated the purchase of extra medical equipment and furnishings.

106 Epworth HealthCare Annual Report Sustainability 107 Epworth Eastern staff enjoy an open day for The Epworth Eastern team was joined by the community at Epworth Eastern Kew. our partners and community representatives including City of Whitehorse Mayor, Cr Bill Bennett, Box Hill Institute CEO Vivienne King and Major Alwyn Robinson of The Salvation Army Box Hill to celebrate a sod turning ceremony.

Building healthy communities together Epworth Eastern Kew opens Sod turning ceremony with the Salvos The partnership facilitates the expansion of Epworth Eastern and allows BHI to To ensure our patients have the While construction is ongoing, we leased As part of the broader redevelopment of develop a state of the art nurse training best experience possible during the a former hospital in Kew to treat some of Epworth Eastern, we are building a new facility. BHI will become the sole construction phase, we launched our surgical patients. place of worship for The Salvation Army enrolled nursing training provider for the ‘Building healthy communities Box Hill on Whitehorse Road, Box Hill. Epworth Eastern, with opportunities together’ campaign. Staff acting Epworth Eastern Kew opened its doors for a new generation of patient care as brand advocates, wore branded following a Community Open Day in Following its opening, Epworth Eastern assistants, allied health assistants, t-shirts with the tagline, ‘Ask us about August 2019. More than 150 visitors will acquire the The Salvation Army Box theatre technicians and students from Epworth Eastern’s redevelopment’ enjoyed a tour of the facility and a Hill site at Nelson Road. other fields including food handling, and were given key information to barbecue lunch. environmental services, maintenance impart. The campaign was successful Both organisations are part of a unique and ward management. in reminding patients, families and the A number of specialties are delivered at landmark agreement, known as the Box broader community why this important this site, including general surgery, plastic Hill Health and Education Precinct, which redevelopment was taking place. surgery, maxillo-facial, orthopaedics, also includes Box Hill Institute (BHI). gynaecology /uro-gynaecology, urology, ENT, endoscopy, colorectal and vascular.

108 Epworth HealthCare Annual Report Sustainability 109 New world-class cardiac Refurbishment of maternity suites First private radiation oncology in the New private IVF day procedure unit catheterisation unit Barwon region The Maternity Unit at Epworth In October 2019, Epworth Eastern opened Epworth Richmond first opened a Freemasons has a proud history of helping The Barwon region’s first private radiation a new private IVF day procedure unit, fit for purpose, leading edge cardiac welcome approximately 3,000 babies each oncology facility, Icon Cancer Centre, operating alongside independent IVF catheterisation laboratory unit 30 years year. It has been refurbished in a number opened at Epworth Geelong in January specialists, Newlife IVF. ago. The establishment of the lab has of key areas. 2020, giving locals access to expert enabled over 50,000 cardiac patients to treatment close to home. Epworth Eastern Ekera, staffed by highly receive care in the past 10 years alone. The $2 million project saw the skilled and experienced patient services With continued demand for cardiac refurbishment of birth suites, postnatal The centre uses the latest technology staff, nurses and clinical personnel from services, there was a need for an extensive Facilities in 1920s-30s – problems rooms, new lobby area, reception and and techniques, previously unavailable Epworth Eastern, welcomed its first upgrade and refurbishment. nurses’ station. The Susan Harris in the region. These include Stereotactic patients in November 2019. It was reported (in the Annual Report of 1921) that the medical Learning Hub was also created, following Radiation Therapy – an advanced In March 2020, construction began to men had expressed the “greatest satisfaction” with the facilities a generous donation to the EMF. technique used to treat small tumours Treatment available includes fertility create the new La Trobe Financial Cardiac with well-defined edges, commonly testing, early fertility treatment, IVF provided at Epworth Hospital and in particular the up-to-date Catheterisation Unit, a state of the art The birth suites now feature a floral located in the brain, spine or lung. treatment (including egg retrieval, sperm (1) facility. It was made possible by operating theatre. The scrub up bowls were brass and oval in design across one wall, which was preparation, insemination, embryo La Trobe Financial and the EMF. shape. The Brasso to clean them was provided by the nursing chosen to help create a calm, nurturing This centre complements existing services development and embryo transfer) staff. No masks were worn and surgical gloves were placed in environment. The refresh of the postnatal at Epworth Geelong, including diagnostics, preimplantation genetic testing (PGT), The new unit will enable Epworth to rooms includes new colours, lighting and surgical and medical treatments and a egg and sperm freezing, and donor and a perforated brass glove box and plunged into the steriliser.(2) continue providing patients with the best soft furnishings. dedicated day oncology unit. surrogacy services. care and meet growing patient needs. The new hospital faced several problems, because it was not purpose-built. The first baby was born on 15 June, but the labour To minimise the impact on patients and Icon Cancer Centre already has radiation The La Trobe Financial Cardiac room was found to be unsatisfactory because the “patients in the their families, refurbishment works were oncology facilities at Epworth Richmond Catheterisation Unit includes three new carried out gradually. and Epworth Freemasons. maternity ward were distressed by sounds from the room”. cardiac catheterisation laboratories, (3) which will be integrated with the new A detached room with a duty room was recommended. These projects make up phase one Cardiac Diagnostic Services Unit to Another difficulty that soon became apparent was the lack of our maternity refurbishment, improve efficiency and patient care. This of a lift. The bulk of the work was surgical and the operating which was almost completed before unit will provide diagnostic services for COVID-19 restrictions led to pausing theatres were on the first floor. The nurses had to carry patients cardiovascular disease, including exercise hospital construction work. Phase two stress testing and electrophysiology downstairs after the operations. Another onerous task was refurbishment works, within other areas capabilities to observe heart rhythm and tending ‘White Rose’, the trade name of the boiler. The night of the unit, are being planned. activity. It will offer advanced monitoring, nurse was expected to stoke ‘White Rose’ at night, but it was mapping, and diagnostic and interventional not the most obliging of boilers. (Matron Gray was known to equipment to support cardiac care. dry her long hair in the boiler room). Each of the new expanded laboratories ensures that surgeons can perform all Sources: procedures, unrestricted by room size. (1) Annual Report, 1921 Each lab will be equipped with the latest (2) Gwen Summers and Marjorie Holding, Recollections, c. 1980, equipment and technologies, including new (3) Methodist Intermediate Hospital Committee, Minutes Book, x ray machines, CT scanning, ultrasound 15 June 1920. and cardiac imaging technology.

110 Epworth HealthCare Annual Report Sustainability 111 Our donors generously provided funds to help us respond to the pandemic.

Epworth Medical Foundation (EMF)

Each year, the generosity of our donors makes a big difference to the care we provide. This year, it was even more important in helping us respond to the pandemic.

COVID-19 and donor support

When the COVID -19 pandemic reached Australia, Epworth responded immediately. We rapidly created measures to protect and care for our patients and healthcare workers. We also reached out Philanthropy: Epworth began with to the Victorian community to help keep our community safe. benefactor Aaron Danks: 1919 Sir Aaron Danks (1861-1928) was the son of Anne Thanks to the generosity of our and John Danks. His father founded a hardware supporters, volunteers and donors, manufacturing business with his two brothers. After we were able to: they retired, Aaron Danks became a partner in the Š purchase more than $1.6 million business. From 1871 to 1900, the company expanded in critical and life-saving equipment from 35 to 200 employees. Aaron led the company including ventilators, ICU beds and after his father’s death in 1902, until his own death glidescopes to manage difficult airways and air respirators in 1928. He was a generous benefactor who financed Š purchase PPE to keep our staff safe the purchase of ‘Yalcowinna’ (in 1919) to establish Š expand telehealth services to ensure Epworth Hospital in Richmond. Active in many patients could continue to receive philanthropic pursuits, he was knighted in 1925. mental healthcare in their own homes Š expand the ICU at Epworth Geelong Sir Aaron’s widow, Jane, and their daughter, Annie, by 50% and fit out three new ICU continued to be generous supporters of Epworth. rooms. This included the purchase of new ceiling pendants, ventilators, ICU beds and high dependency unit beds, to ensure we can support our community during the pandemic.

112 Epworth HealthCare Annual Report Sustainability 113 Left: Sonia with her father, Bui and healthcare workers.

Right: Sonia with Professor Minoo Patel.

Partnerships Sonia said having the chance to be treated Since the operation, Sonia has regained Activities included: This year, the partnership: The partnership has enabled Epworth in Australia was “a dream come true.” an incredible 12cm in length. Sonia staff to access clinical research training Providing care beyond our borders has two further surgeries and extensive Š local businesses delivering food and Š funded 11 new priority initiatives from and Women in Leadership and Healthcare “Soon, I will be walking straight, without rehabilitation ahead of her, but she’s other perishables to our hospital sites mental health in new mothers to Improvement masterclasses. A Fellowship Sonia Paua, from PNG, has chronic a crutch, and I won’t be embarrassed excited at the prospect of walking with Š treats like Easter eggs, hot drinks and improving lung cancer care program, in areas such as data-driven osteomyelitis, an infection in the bone, anymore. My family will be really happy ease. muesli bars for employees and doctors Š attracted State Government investment health care improvement and community that has left her with poor mobility and and proud of me when I arrive home, Š promoting positive stories on our media in research systems and processes to and consumer involvement, is also offered. daily pain. standing up straight,” Sonia said. Epworth Kindness Movement channels, connecting our people to ensure more Victorians benefit from each other and to the community health data research and cutting-edge Advancing Women in Healthcare Epworth, in partnership with the Children The teenager requires multiple surgeries, The Epworth Kindness Movement was they serve. clinical trials Leadership First Foundation, is changing Sonia’s life the first was in February 2020 when formed during the COVID-19 pandemic, Š provided leadership and funding for the by providing pro bono surgery. she underwent a three-and-a-half hour after many loyal Epworth supporters, Monash Partners Academic Health inaugural national network (in women’s An Advancing Women in Healthcare operation to re-align her leg. This included donors and organisations contacted EMF Science Centre health) across centres, and Leadership initiative was established, “Sonia’s deformity is the result of the insertion of a cutting-edge device to with offers to support Epworth employees Š formed a strategic partnership with involving Monash Partners, State and surgeries in PNG when she was younger gradually lengthen and regenerate the and thank our frontline healthcare Epworth is a member of Monash the Monash Institute of Medical Federal governments and professional to remove the diseased bone and bone by millimetres workers. Partners, a partnership between leading Engineering to turn clinical problems colleges nationally. Through research related scarring and skin contracture,” each day. health services, teaching and research into real world solutions, expanding into and translational resources, programs said Professor Minoo Patel, Epworth With #kindnesspanedemic becoming organisations, focused on innovating for digital health, health service impact and tools for national implementation, orthopaedic surgeon. The procedures, Sonia’s hospital stay, a movement in the community, we better health. and workforce capacity building. this initiative will support women in Professor Patel’s fees, as well as the harnessed this sentiment to create the healthcare to attain their career goals “Unfortunately, this all happened while equipment and prosthesis were all Epworth Kindness Movement, giving Capacity building and enable a health system with greater she was still growing, so her limb is provided at no cost to Sonia’s family. employees and doctors some much leadership diversity. deformed both at the bone and the joint, needed support during a stressful time. This alliance brings strengthened national and it is shorter as well.” collaboration, shared learning and advanced research.

114 Epworth HealthCare Annual Report Sustainability 115 Collaborations On 30 April 2020, Epworth Group Chief Medical materials were packed up by staff Executive Dr Lachlan Henderson at Epworth Geelong. Working with government and announced Epworth had finalised a new public hospitals Private Hospital Funding Agreement Far left: medical supplies helped people in Samoa. (COVID-19) with the state of Victoria. The COVID-19 pandemic prompted It provided funding support to ensure our Epworth to work collaboratively with the hospital workforce and facilities were State Government and public hospital ready to assist in the statewide COVID-19 operators, to ensure Victorians received Hospital Response Plan. This was in urgent care. conjunction with the Commonwealth’s funding support for operational continuity of healthcare systems nationally.

Epworth established relationships to receive public patients from Barwon Health and the RMH. During the pandemic, Epworth also worked with Alfred Health, Eastern Health, Djerriwarrh Health and St Vincent’s Health to treat urgent and semi-urgent patients from the public elective surgery waiting list. Epworth was also available to treat public emergency patients presenting to Epworth Richmond and Epworth Geelong.

As part of the agreement, Epworth is prepared to care for:

Š COVID-19 patients within our EDs, medical wards and ICUs Š non-COVID public medical patients Helping our neighbours in Samoa A/Prof Hair organised several pallets of Epworth Group Director Procurement Š urgent/acute public surgical cases. medical items to be shipped to measles- and Supply, Melinda Tippett said Epworth The disastrous consequences of a infected patients to stem the spread of and our supply partners were pleased to The aim was to ensure equitable and measles outbreak on the small island the disease. This included thousands of coordinate the donations, which assisted coordinated clinical care was provided of Samoa in December 2019 prompted facemasks and gowns, hand sanitiser, and medical and nursing teams in Samoa. to patients in our community. Epworth Geelong gastroenterologist disposable cups and plates. Associate Professor Chris Hair to rally “We’re proud to have our medical Epworth medical supply distributors A/Prof Hair, a director of the Australia experts acting as global citizens for for help. and New Zealand Gastroenterology better health outcomes in a time of International Training Association crisis,” Melinda said. Samoa was in desperate need of medical (A.N.Z.G.I.T.A.) and regional leader for supplies, with the outbreak resulting in South Pacific programs, is passionate Epworth continues to donate medical and 4,500 measles cases in a country of just about supporting education and training operating equipment, and other materials, 200,000 people, exacerbated by a steep programs in the Pacific Islands. to aid hospitals, health services and decline in vaccination rates. communities in developing countries.

116 Epworth HealthCare Annual Report Sustainability 117 Environmental Reducing waste Waste and redevelopment Recycling sustainability We started a food waste reduction While great care was taken in creating We implemented single-use metal recycling Becoming more sustainable is essential program at Epworth Richmond in late appealing patient spaces in the new across three sites and from October 2019 to our operations, to protect the 2019, following a grant from the City of Epworth Freemasons redevelopment, the to 30 June 2020. We recycled more than environment and ensure resources Yarra and Sustainability Victoria, to trial a hospital’s sustainability was also a key a quarter of a tonne of metal comprising: are used responsibly. This year, we WasteMaster machine. component of its blueprint and is already introduced new initiatives to progress reaping rewards. Š 126.25kg single use steel items, our Epworth Environment Policy. With the use of a WasteMaster machine such as scissors from late 2019-30 June 2020: We found a new way to dispose of general Š 97kg aluminum (82kg suture packaging waste that didn’t involve using regular bins and 15kg oxygen mask clips) and 9.5kg Š 18 tonnes of food waste have been that cost $10 each to empty. diathermy cables. diverted from landfill Š 72% of food waste has been evaporated, Environmental Services and Patient Our Polyvinyl Chloride (PVC) recycling leaving a residue weighing 2.7 tonnes Transport Manager, Maria Stokes said when campaign prevented 8,056kg of PVC going to Š using this residue, 4,867kWh of green the new loading dock was being designed landfill. Instead, it was recycled by Epworth electricity was created at the Yarra the waste systems were also overhauled. through the Baxter Healthcare and the Vinyl Valley Water Anaerobic Digester in Council of Victoria PVC Recycling Program. Wollert “We decided to lease a compactor, This amount of PVC could be used to build Š the amount of green electricity fed back which was a game changer for our 10 playgrounds or 56.4km of garden hose into the grid powered the equivalent of hospital. Like a big corkscrew, it turns, and equates to a potential saving of more 356 homes for a day. grinds and compacts waste into a cube. than $6,034. The smaller space in landfill also means less money wasted on rubbish disposal,” Recycling at Epworth also extends to Ms Stokes said. uniforms, to keep as much textile waste out of landfill as possible. In the past six Epworth also saved cardboard removal months, we collected more than 121kg of “ We are being systematic and committed costs by using a baler. The cost of removing staff uniforms. These textiles are recycled each bin was reduced from $10 per bin, to and used to make products, such as carpet in our approach to environmental $5 for nearly a dozen bins. It is also a better underlay and gym equipment. sustainability and this is showing results.” use of labor.

Simon Mikedis, Group Sustainability Manager, Epworth HealthCare We are investigating options for disposing of food waste and co-mingled recycling at Epworth Freemasons.

Epworth Freemasons Executive General Manager, Simon Benedict said our new facilities were improving the way we work and helping reduce our environmental footprint.

“These initiatives have already saved us time and money. Innovation isn’t always about medical advancements; something as day-to-day as how we get rid of our rubbish can have a real impact.”

118 Epworth HealthCare Annual Report Sustainability 119 Staff initiatives: our sustainability win Water savings Three trailer loads of supplies were sent Greenhouse performance Š In the previous data, the energy to wildlife shelters. This included biscuits, consumption of our corporate office In 2019, Epworth Eastern recycled 1.376 Our reverse osmosis capture imitative bandages, sutures, bowl sets, kidney While our greenhouse emissions (at Pelaco) wasn’t included in our metric tonnes of PVC. That’s more than project diverts reject water produced dishes, dressings, gloves, IV solutions, decreased last year, this year’s results overall emissions and yet (with the 100kg per month. Two years ago, the in dialysis, saving water and funds at blankets, towels, catheters, syringes, were impacted by several significant inclusion) our emissions are almost hospital wasn’t recycling PVC at all. Epworth Geelong. Water for dialysis oxygen masks, steri-straps and breathing factors: identical to last year needs to be ultra-pure so for every litre circuits. Š LED replacement program results PVC is used in our fluid bags, oxygen produced, five litres is wasted. Instead, Š COVID-19 resulted in atypical results for Epworth Richmond and Epworth tubing and facemasks. It is a plastic that this water is now used to fill onsite tanks, Energy (e.g. elective surgery stoppages) and Eastern are not yet reflected in the makes up a significant percentage of our previously supplemented by millions of with lower patient bed days, emissions results below. general waste and goes straight to landfill. litres of water, for ongoing use in gardens LED lighting upgrades at the Pelaco intensity increased, as lights, heating The Sustainability Committee at Epworth and for flushing toilets. corporate office and Epworth Richmond, and cooling facilities were required Eastern prevents tonnes of PVC going to through the Victorian Energy Upgrades throughout our hospitals landfill. Instead, the rubbish is recycled into This year, Epworth Geelong was able to program, resulted in: Š the new tower at Epworth Freemasons items including garden hoses, play mats, save more than 4.7 million litres of water and the new facility at Epworth Eastern playground equipment and floor coverings. (and $16,000) through this initiative. Š 23% immediate reduced consumption Kew didn’t exist in 2018-19 and Š more than $180,000 in savings. accounted for 4,849MWh Social sustainability

In January 2020, we gathered expired and surplus supplies to assist injured and displaced wildlife affected by the Victorian Year CO2e (tonnes) Patient Bed Days (PD) Emissions Intensity (kg/PD) bushfires. 2019-20 60,228 502,936 120 2018-19 56,096 534,940 105 Being environmentally conscious brings multiple benefits. 2017-18 57,280 514,727 111

120 Epworth HealthCare Annual Report Sustainability 121

Epworth HealthCare Epworth Eastern Kew Epworth Hawthorn 89 Bridge Rd 209 Cotham Road 50 Burwood Road Richmond VIC 3121 Kew VIC 3101 Hawthorn VIC 3122 Phone 03 9426 6666 Phone 03 8807 7100 Phone 03 9415 5777

Epworth Brighton Epworth Freemasons Epworth Medical Imaging 85 Wilson Street 109 Albert Street Epworth Freemasons (Albert St) Brighton VIC 3186 East Melbourne VIC 3002 Epworth Freemasons Medical Centre Phone 03 9591 9200 Phone 03 9483 3833 Epworth Geelong Epworth Richmond Epworth Camberwell 320 Victoria Parade Phone 1800 699 729 888 Toorak Road East Melbourne VIC 3002 Camberwell VIC 3124 Phone 03 9418 8188 Epworth Pathology Phone 03 9809 2444 Epworth Camberwell Phone 0455 887 672 Epworth Geelong Epworth Eastern Phone 03 9890 0889 Epworth Cliveden 1 Epworth Place Epworth Freemasons Phone 03 9419 0074 29 Simpson Street Waurn Ponds VIC 3216 Epworth Geelong Phone 03 5271 7833 East Melbourne VIC 3002 Phone 03 5271 7777 Epworth Richmond Phone 03 9429 2222 Phone 03 9107 4500 Epworth Richmond Epworth Specialist Centre Lilydale Epworth Eastern 89 Bridge Road Suite 4, 355 Main Street 1 Arnold Street Richmond VIC 3121 Lilydale VIC 3140 Box Hill VIC 3128 Phone 03 9426 6666 Phone 03 9739 3666 Phone 03 8807 7100