West Cork Falls Prevention Service

HSE South

HSE Area HSE South

South Lee Community Speech & Language Therapy Title: Conversation Partner Scheme (CPS)

Summary  The Conversation Partner Scheme helps create conversational opportunities for people with aphasia (communication difficulties after a stroke). It is based on a model provided by Connect in the UK (www.ukconnect.org).  These clients may be isolated with little opportunity to have conversations outside of the speech and language therapy clinic. This scheme fits with the WHO social model of disability by giving clients with aphasia the opportunity to share their ideas and interests, thus improving their quality of life.

 The CPS brings together trained volunteers and people with aphasia who are isolated and who have little opportunity for conversation.  Volunteers are recruited, trained, supervised and supported. Those trained as volunteer conversation partners enter into an agreement to visit a partner with aphasia once a week over a six month period for one hour a week, with the aim of conversing with that person.  These conversations take place in the client’s home.

Project Lead Kate Dunn, Senior Speech & Language Therapist, City General Hospital, Infirmary Road, Cork [email protected]

Anne Tangney, SLT Manager, City General Hospital, Cork Senior Sponsor Gabrielle O’Keeffe, General Manager, South Lee Local Health Office, Cork HSE Area HSE South

Bantry General Hospital and West Cork PCCC

Title: West Cork Falls Prevention Service

Summary  Falls in older people are a major public health concern in terms of morbidity, mortality and costs to health and social services.  Considerable difficulties often arise, however, when attempting to deliver high quality medical care to older people living in rural, sparsely populated regions.  This project pioneered a service for the assessment and management of older patients at risk for falling in one of the most rural parts of Ireland.  Using a system that involves intimate cooperation between community and hospital services, high-risk patients are identified and referred for a one-stop, comprehensive falls risk assessment performed by a dedicated multidisciplinary team.  The most up-to-date international protocols and procedures are used to stratify risk and to identify evidence-based, targeted interventions that will significantly reduce the risk of falling and sustaining injuries.  This has allowed frail older patients to benefit from an evidence-based, high-quality service close to home in a rural setting where the delivery of healthcare services has traditionally proven difficult or impossible.

Project Lead Dr. Brian Carey, Consultant Geriatrician, Dept of Geriatric Medicine, Bantry General Hospital, Bantry, Co Cork Senior Sponsor [email protected] Ms. Eleanor O’Donovan, Hospital Manager, Bantry General Hospital HSE Area HSE South

Hospital, community and voluntary disability groups in the Cork Region Title: Informing families of their child’s disability

Summary  Following the launch of evidence-based Best Practice Guidelines for Informing Families of their Child’s Disability an interdisciplinary, cross-sectoral project was established to pilot the implementation of the guidelines on an integrated partnership basis in the Cork region.  The aim of the project was to improve the experiences of parents who are informed of their child’s diagnosis of disability and to improve support for professionals involved in the communication of the diagnosis.  The project was guided by a Steering Committee chaired by a parent of two children with disabilities, and was implemented across acute, community and disability service settings in the Cork region. Professionals from medical, nursing and allied health disciplines in a wide range of organisations participated in the project

Project Lead Alison Harnett, Informing Families Project Coordinator [email protected] Senior Sponsor Brian O’Donnell, Chief Executive, National Federation of Voluntary Bodies Steering Prof Jonathon Hourihane, Professor of Paediatrics, Cork Committee University Hospital, Cork. members Dr Brendan Murphy, Consultant Neonatologist, Cork University Maternity Hospital, Cork. Margo Fenton, A/Social Work Team Leader, Cork University Maternity Hospital, Cork. HSE Area HSE South

North Lee Speech and Language Department and North Lee Community Work Department PCCC Title: The Glen Early Language and Learning Pilot Project Summary  A joint initiative of the Health Service Executive (HSE) and Cork City Partnership, which was run on a pilot basis.  The pilot project comprised two parallel interventions which were designed in response to the need to pay more focussed attention to speech and language development among young children in The Glen, an area of socioeconomic deprivation in Cork City.  The first was a speech and language development programme for Junior Infant classes in the two primary schools, which was designed and implemented by the Speech and Language Therapy Service of the North Lee HSE-South in collaboration with the schools in the area.  The second programme involved five pre-schools .  The programme for pre-schools included two elements: a) providing the Hanen professional training programme Teacher Talk Series for pre-school staff b) developing an oral language programme, which was implemented by childcare workers in the preschools

Both elements of the project encouraged a community development approach, in that each partner involved, had an opportunity to consult on the development of the project

Project Lead Ronnie Dorney , Principal Community Worker, Ellis House, Ballyvolane, Commercial Park, Ballyvolane, Cork [email protected] Anne Horgan Speech and Language Therapy Manager, Eye, Ear & Throat Hospital, Western Road, Cork [email protected]

Deirdre Scully, Local Health Office Manager, North Lee, Senior Sponsor North Cork Aileen O’Neill, A/General Manager, North Lee, North Cork

HSE Area HSE South

Wexford General Hospital Title: Site Infection Surveillance Service

Summary  Wexford General Hospital (WGH) had no formal system of surgical site infection surveillance, unless the surgical site infection (SSI) was caused by an ‘’alert’’ organism such as Methicillin resistant Staphylococcus aureus (MRSA).  An internationally robust surgical site infection surveillance system (SSIS) was introduced into WGH in 2006.  On average most SSI’s occur between days 5 and 10 following a surgical procedure. Changing surgical practices with shorter length of stay contributed to the underestimation of the true SSI rate.  Accurate determination of SSI’s required the introduction of a system of post discharge surveillance. A post discharge surveillance system was commenced in WGH in January 2010.  In 2007 our crude SSI rate was 9.0%, in 2008 5.4% and in 2009 the rate is recorded at 4.4%.

Project Lead Eithne O’Sullivan, Surveillance Co coordinator, Surveillance Service, Dept of Infection Prevention & Control, Wexford General Hospital. [email protected]

Senior Sponsor Ms. Lily Byrnes, General Manager. Wexford General Hospital HSE WEST

1. HSE West

COPE Galway Community Catering

 COPE Galway Community Catering is a positive development dedicated to the provision of nutritional support for Galway’s older people. Our objective is to assist older people to live their life independently and in their own home if that is their wish.  Cope Galway Community Catering delivers approx 45,000 hot nutritious meals per annum to older people in the City & County. Our team of over 120 volunteers deliver to 14 city routes, and we have 2 vans bringing meals to 2 outer lying rural routes.  We operate from a state of the art facility in Ballybane which was supported by The Dormant accounts fund to equip, and is fully compliant with HACCAP standards. We have 9 part time employees including an executive Head Chef. A panel of approx 120 volunteers assist with food preparation and delivery.  Cope Galway Community Catering is a voluntary organisation, which receives funding from the HSE (33%), income from meal receipts (50%), fundraising (12%) and other grants (5%)  Our application for the HSE achievement award is based on our receipt of the EIQA Q mark in March 2010, at the highest possible level – Emerald.

Project Lead Geraldine Ryan Executive Chef /Mary Stout Coordinator [email protected] Senior Sponsor Jacquie Horan, CEO COPE,Galway HSE Area 2. HSE West Galway University Hospital

Title: The Galway University Hospital Regional Anaesthetic Facility

Summary  The facility that we have set up in the reception area of the major theatre suite in GUH allows for patients: o To have regional anaesthesia techniques (blocks) performed and by doing so decreases the number of general anaesthetic techniques. o Provide a service for the provision of acute and some chronic pain blocks to either acute post operative patients or patients presenting with painful problems. o Provide onsite teaching of junior doctors, Medical or Nursing students.

Project Lead Dr. John McDonnell, Consultant Anaesthetisit, Galway University [email protected] Senior Sponsor Dr Noel Flynn, Consultant Anaesthetist, Galway University Hospitals HSE Area 3. HSE West Roscommon PCCC

Title: When Nature Calls! Managing Incontinence in Roscommon.

Summary  Bladder and bowel problems can be distressing, unpleasant, socially disruptive as well as restricting employment, educational and leisure opportunities. A high quality and comprehensive continence service is, therefore, an essential part of healthcare.

 This project outlines the continence care model developed across County Roscommon which has significantly improved the continence care for children and adults with bladder and bowel problems.

 This was done by redesigning the way services are provided and delivered in all Primary Community and Continuing Care (PCCC) settings as well as private nursing homes across the county.

 Central to the project is the synergy database, an information management system which manages the data derived from clinical assessments.

 This system leads to the provision of regular home delivery of appropriate products to clients across County Roscommon, either direct to their own homes, residential care units or private nursing homes.

Project Lead Margaret Tiernan, Continence Advisor [email protected] Senior Sponsor Frank Murphy, Local Health Manager, Roscommon PCCC HSE Area 4. HSE West Mid Western Regional Hospital Limerick Title: Paediatric High Dependency Unit

Summary  The need for adequate centralised Paediatric Intensive Care Unit facilities is widely recognised and many studies support the view that centralised paediatric Intensive Care outcome is better than small facilities attached to adult intensive care units.  Prior to the establishment of the paediatric High Dependency Unit we had no purpose built facility with appropriate trained staff.  The establishment of the unit has led to the provision of high quality, seamless and comprehensive service organised to encompass the needs of critically ill child and his/her family.  We are now able to provide care with a workforce who is highly skilled and valued to maintain high standards of care through continued education, audit research and evidence based practice/guidelines.

Project Lead Dr Roy K Philip Lead Clinician for High Dependency Unit [email protected] Senior Sponsor Mr Mark Sparling Hospital Manager, Mid Western Regional Hospital Limerick HSE West

Occupational Therapy Splinting Clinic ( Primary Care)

5. Primary Care Occupational Therapy (OT) Splinting Clinic

 The clinic offers a weekly service to clients both paediatrics and adults that are based in the community that require splints for the upper limb.  The clinic was set up approximately three years ago as response to fellow community and hospital OT’s/Physiotherapists /GP’s/PHN’s requiring expert advice and follow up on hand conditions.  Initially the clinic was once a month but due to the demand was extended to once a week.  The clinic is based in Castlebar which is a central location for clients in Mayo.  instead of the usual route of the PC OT going directly to the client’s home to fabricate a splint they are seen in the clinic. Hence reducing travel expense, waiting lists and time for the rest of the PC OT team.

Project Lead : Helen Boyle, Senior Primary Care Occupational Therapist [email protected] Senior Sponsor: Eileen Kelly, Occupational Therapy Manager

HSE Dublin North East HSE Dublin North East

Community Services, Local Health Office – Dublin North Central

Men’s Health and Wellbeing Programme (MHWP).

 The Men’s Health and Wellbeing programme was developed by the Larkin Centre in partnership with Glasgow Celtic Football Club, the Health Service Executive and Pfizer Healthcare. The population focussed on were men (30 years plus) living in Dublin’s North Inner City.  This targeted area is characterised by high deprivation with many social factors that impact negatively on health.  The challenge for the MHWP was to devise a formula and programme that would meet the needs of this client group who were particularly difficult to engage.  The model chosen was based on the Well Man Programme established by Glasgow Celtic Football Club and was then tailored for the requirements for men of Dublin’s North Inner City.  The Programme ran for ten weeks and had the following elements: fitness and lifestyle, cookery, health education. The content was: Health Screening, Health Awareness, Cookery, Soccer.  The MHWP was effective in meeting the objectives of the programme and connecting with the local men. It is viewed as a very genuine and worthwhile example of best practice in how to effectively engage with men (Men’s Health and Wellbeing Evaluation Report – Centre for Men’s Health, Institute of Technology Carlow, May 2010)

Project Lead: Phil Dunne Development Officer PCCC [email protected] Mary Martin Manager of Services for Social Inclusion [email protected]. HSE Area HSE Dublin North East Mater Miserciordiae University Hospital

Title: Tracheostomy Grand Round (TGR)

Summary  The tracheostomy Grand Round was established on 11th March 2009 as a quality initiative to ensure standardising care, continued progress and rehabilitation of patients with a tracheostomy insitu post discharge from critical care.

 Prior to the establishment of the grand round, follow up of patients following discharge from critical care was not standardised on the peripheral wards.

 It is a committed team, which meets weekly incorporating all multidisciplinary team members working with the patient to ensure an integrated progressive management approach.

 The ultimate goal is the provision of a high quality standardised service for patients with tracheostomy throughout the hospital with the aim of weaning patients in a systematic way that reflects best practice.

Project Lead Ms Ailbhe Dunne Senior Speech and Language Therapist

Senior Sponsor Ms Una Cunningham Speech and Language Therapy Manager HSE Area HSE Dublin North East Mater Hospital CAMHS (Child and Adolescent Family Service/University College Dublin)

Title: Working Things Out Through SPHE

Summary  Is an innovative schools-based psycho educational Resource specifically designed to support SPHE Teachers in their youth mental health promotion work with students.  The Resource consists of 9 X Animated DVD-Based representative youth mental health stories, narrated by the young people themselves.  These stories are complimented by a specially- developed Teachers Resource book designed to provide structure lesson-plans for this work.

Contact email Project Lead: Mike Power [email protected] Senior Sponsor: Prof Carol Fitzpatrick, Child Psychiatry Dept. HSE Area HSE Dublin North East Physiotherapy Service LHO Dublin North Central

Title: Balance Matters for Older People

Summary  The Falls Management Exercise (FaME) programme is an evidence based programme which aims to improve older peoples balance and mobility, improve their confidence and prevent falls.

 The physiotherapy service ran a pilot programme in collaboration with the community in Marino in 2008. An audit was conducted of the outcome measures and this demonstrated significant improvement in peoples balance, mobility, level of confidence and coping abilities in the event of a fall. A focus group was conducted with positive feedback.

 The evaluation demonstrated that changing from individual one to one sessions on home visits to a group programme was an effective and efficient way to deliver physiotherapy for this client group.

 Working in partnership with a local community group worked well. We adopted this approach again in Ballymun and Millmount, working closely with statutory, voluntary and community groups to run successful FaME programmes in 2009 and 2010.

Contact email Project Lead: Aine O’Riordan Senior Physiotherapist/ Physio Manager [email protected]

Senior Sponsor: Gerry Reid A General Manager HSE Area HSE Dublin North East Beaumont Hospital

Title: 5. A “Respiratory Passport” for patients with Chronic Obstructive Pulmonary Disease (COPD).

Summary  Chronic Obstructive Pulmonary Disease is an umbrella term to describe a respiratory disease associated with airflow obstruction.  Approximately 440,000 people in Ireland have COPD. Currently it is projected to be the top cause of respiratory deaths in Ireland and the third highest cause of mortality in the world by 2020.  In an attempt to improve the quality of care delivery, the quality of life of COPD sufferers and to aspire to achieving the goals of the Health Transformation Programme, an information booklet called a “Respiratory Passport” incorporating an individualised self- management plan was developed lead by the applicant, who is working as a clinical nurse specialist within a MDT COPD outreach setting.

Contact email Project Lead: Niamh McCormack CNMII Senior Sponsor: [email protected] Brenda Deering Senior Physiotherpaist/ COPD Outreach Coordinator

HSE Dublin Mid Lenister

HSE Area HSE Dublin Mid Leinster Adelaide and Meath Hospital incorporating The National Children’s Hospital, Tallaght Title: Development of a Pilot Patient Self-Testing Project in a nurse-managed Anticoagulation Clinic

Summary  Warfarin is a frequently prescribed high risk medication, requiring ongoing monitoring of drug levels. This necessitates frequent hospital visits, to often overcrowded Anticoagulation clinics, causing inconvenience for patients which can lead to poor compliance with treatment.  We implemented a pilot home testing programme for 10 patients in February 2009.  Following development of guidelines and training we supplied a Point of Care testing device to patients.  These patients now perform INR testing at home on an agreed date and phone in to the Clinical team to receive warfarin dose instructions.  They attend clinic 3 monthly to facilitate quality control.  They are all very enthusiastic about the programme and delighted with the convenience provided by home testing.

Project Lead Teresa Connole CNM2 [email protected]

Senior Sponsor Senior Sponsor Bernadette Corrigan Assistant Director of Nursing

HSE Area HSE Dublin Mid Leinster St James’s Hospital

Title: Patient Advocacy Programme

Summary Broad Purpose of Hospital Quality Programme:  Development direct and promote a hospital programme to improve patient satisfaction.  Develop and create a framework which enables the local community to purposefully interact with the hospital and discuss, debate, feedback concerns, make contributions in relation to existing service provision/delivery methodologies and participate in the development of future services.  Achievement of the above was pursued within a quality paradigm incorporating the following: accreditation, patient advocacy, risk management, clinical audit and performance indicator.

Project Lead Carol Hickey Quality Manager Senior Sponsor Ian Carter Chief Executive Officer

HSE Area HSE Dublin Mid Leinster Our Lady’s Children’s Hospital Crumlin

Title: The ‘Anyone Can Eat’ tube weaning programme Summary  This is a new and very innovative service development. It is a three week inpatient intensive programme which aims to wean infants and children from their tube feeding to develop full oral eating and drinking skills by the end of the programme.  To ensure children are suitable for tube weaning ie medically stable, appropriate weight and have a safe swallow; prior to admission they attend appointments with the primary consultant, speech and language therapist, dietician and psychologist.  To date 21 children with a range of medical diagnoses have attended the programme. 20 of these have become full oral feeders by the end of the three weeks.

Contact email Project Lead Ms Cecila Butler Senior Speech & Language Therapist [email protected] Ms Carina Kelleher Senior Dietitician

Senior Sponsor Catherine Cunningham SLT Manager HSE Area HSE Dublin Mid Leinster Kildare West Wicklow School Support Team HSE Disability Services

Title: The Kildare West Wicklow School Support Team

Summary  The Disability Manager had identified a gap in services in respect of children with a diagnosis of Moderate Intellectual Impairment attending Mainstream Primary School.  These children received ‘Early Intervention Services’ until they began mainstream school however they did not qualify for Community Speech & Language Therapy intervention.  With the publication of the EPSEN Act (detailing the needs of therapy provision for children with intellectual impairment in mainstream school settings), and government policy promoting ‘integration’ in the Irish Education System, an increasing amount of parents began to choose mainstream education for their children with Intellectual Disability.  The Disability Manager identified this group of children as requiring intervention in a comprehensive way and sought both funding and personnel to work as a team, providing therapy in Mainstream schools for children with Intellectual Disability.  A Psychologist, Occupational Therapist and a Speech & Language Therapist were approached to be part of this innovative service, and in September 2006, the Kildare West Wicklow School Support Team was born

Key contact Project Lead: Ms Carol Cuffe Disability Services Manager, Cuffe [email protected]

Senior Sponsor: Mr Billy Quinn General Manager Kildare West Wicklow

HSE Area HSE Dublin Mid Leinster Cathedrals Primary Care Team Dublin South City, LHO Title: Key Working Model

Summary  Implementation of a key working model and person centred multidisciplinary care planning within a Primary Care Team (PCT), adopting a continuous quality improvement approach.  Identify best practice in this area and establish a model of key working that is transferable across primary care services.  To decrease and share the risks associated with the ongoing management of complex vulnerable clients with high needs and under users of services.

Key Contact Alma Joyce, OT Manager(acting) [email protected] Senior Sponsor Ellen O’Dea Primary Care Manager