Calvary Mater Newcastle
Review of Operations 2011 / 2012
HealingHospitality Stewardship Respect
HealingHospitality StewardshipRespect
Contents
Report from CEO 5
Department Reports 6
Activity and Statistical Information 35
Research 36
Financial report 2011/2012 47
Front Cover: Chief Occupational Therapist Andrew Wakeley and patient This page: ‘Madonna and Child’ stained glass window in foyer above chapel
Calvary Mater Newcastle • review of operations • 2011/2012 • 1 The Spirit of Calvary
We strive to excel in the spirit of ‘being for others’ Our mission identifies why we exist; To bring the healing ministry of Jesus to those who are sick, dying and in need through ‘being for others’: In the Spirit of Mary standing by her Son on Calvary Through the provision of quality, responsive and compassionate health, community and aged care services based on Gospel values, and In celebration of the rich heritage and story of The Sisters of the Little Company of Mary.
Our vision identifies what we are striving to become To be, and to be recognised as, a leader in strengthening and developing Catholic health at regional and national levels through the creation of integrated models of care where excellence and leadership are pursued by all to meet best the needs of the people and communities we serve.
Our values are visible in how we act and treat others As stewards of the rich heritage of care and compassion of the Little Company of Mary, we are guided by our values.
Hospitality Stewardship Demonstrates our response to the desire to be welcomed, Recognises that as individuals and as a community all we to feel wanted and to belong. It is our responsibility to have has been given to us as a gift. It is our responsibility extend this to all who come into contact with our services to manage these precious resources effectively for the by promoting connectedness and listening and responding future. We are responsible for: striving for excellence, openly. developing personal talents, material possessions, our environment, and handing on the mission of the Sisters of the Little Company of Mary. Healing Demonstrates our desire to respond to the whole person by caring for their spiritual, psychological and physical Respect well being. It is our responsibility to value and consider Recognises the value and dignity of every person who is the whole person and to promote healing through associated with our services. It is our responsibility to care reconnecting, reconciling and building relationships. for all with whom we come into contact with justice and compassion no matter what the circumstances, and we are prepared to stand up for what we believe and challenge behaviour which is contrary to our values.
2 • Calvary Mater Newcastle • review of operations • 2011/2012 Healing Stewardship Respect
Community Advisory Board (Ingrid Grenell and Susan Russell absent) Community Hospital Management Advisory Board Committee
Professor Brian English to end of December 2011 Greg Flint Chief Executive Officer Richard Anicich Alison Lee Assistant Director of Clinical Services (Medical) Teresa Brierley Ailsa Hawkins Director of Clinical Services (Nursing) Cathy-Lyn Burnard appointed March 2012 Lynne O’Brien Assistant Director of Clinical Services (Nursing) Kay Fordham appointed March 2012 Wayne Wells Director of Finance Susan Russell appointed March 2012 Kevin Mulligan Director of Mission Lee Shearer Heather Alexander Health Information Manager Cathy Tate Michael Hodgson Human Resources Manager Steven Tipper appointed March 2012 Ingrid Grenell Public Affairs and Communications Manager Greg Flint Chief Executive Officer Jeanette Upton Quality Manager to January 2012 Wayne Wells Director of Finance Di Dolan Acting Quality Manager from February 2012 Kevin Mulligan Director of Mission Ingrid Grenell Public Affairs and Communications Manager Walter Kmet National Director LCMHC Public Hospitals to December 2011 Brenda Ainsworth National Director LCMHC Public Hospitals from January 2012
Calvary Mater Newcastle • review of operations • 2011/2012 • 3 Bequests
Many of the hospital’s supporters have left a bequest to us in their will. Your bequest helps us to continue our work to provide care for patients. This is done in general medicine, oncology, research, alcohol and drug services, palliative care and to assist with the promotion of positive community attitudes toward the necessity and desire of quality health care. Your contribution will go on helping us through the 21st century. Your contribution can be a fixed amount or a percentage of your estate. You can nominate to assist in the general provision of our services or your bequest can be directed toward a specific unit, project or type of service.
How to Make a Bequest To assist in the preparation of a bequest may we advise the following wording: I, (name), given ($amount) free of all duties and testamentary expense to Calvary Mater Newcastle for the purpose of patient care/service development, and I direct that the receipt of the Chief Executive Officer shall be sufficient discharge of my executors for this bequest. If you would like more information about services provided at our hospital and how best your intended bequest could be used, please do not hesitate to contact our Chief Executive Officer. Chief Executive Officer Calvary Mater Newcastle Locked Bag 7 Hunter Region Mail Centre NSW 2310 Telephone 4014 4700
Calvary Mater Newcastle Auxiliary Member, Melita Cole.
4 • Calvary Mater Newcastle • review of operations • 2011/2012 Report from the Chief Executive Officer
It has been an extremely busy and in Medical Oncology which is a with the Hunter New England Local successful year for Calvary Mater unique concept in service delivery Health District Clinical Governance Newcastle in delivering health care and an extremely valuable role at Unit. Dr Aldrich will commence in services in conjunction with our role Calvary Mater Newcastle in delivering August, 2012 delineation and the targets and key medical oncology services. A significant milestone was reached performance indicators set by our The Community Advisory Board in January, 2012 with one of our long funder, the New South Wales Ministry (CAB) recruited four additional new serving staff members, Anne Grainger, of Health through the Hunter New community members this year which reaching a record fifty years of service. England Local Health District. now gives the CAB a broad cross This is an extraordinary achievement As part of the health reforms across section of skills and abilities. The and a function was held at Calvary New South Wales, a formal service CAB will be actively involved in a Mater Newcastle to acknowledge agreement between Calvary Mater number of Calvary Mater Newcastle and celebrate Anne’s dedicated and Newcastle and the Local Health functions and involvement in a significant service to the hospital. District was agreed to and signed number of the hospital committees. The hospital continues to receive which articulates the levels of service An exciting development for Calvary valuable support and advice from Little activity, targets and goals that Mater Newcastle is the proposed Company of Mary Health Care Board, Calvary Mater Newcastle is required development of the Hunter Water National Office, and the Local Health to achieve within the allocated land adjacent to the hospital. The District in continuing the hospital’s budget. land has been purchased by the role as a major cancer care facility as The organisation underwent an Local Health District and plans are well as significant community support. accreditation review by the Australian underway to develop the site as a This review contains many highlights Council on Healthcare Standards health precinct through a consortium which reflect the achievements and (ACHS) in November, 2011 and arrangement involving Little Company commitment of our hospital staff of was awarded ongoing accreditation of Mary Health Care, the Hunter New whom I am very proud to serve. I which recognises that Calvary Mater England Local Health District, Hunter would also like to take this opportunity Newcastle meets the corporate, Medical Research Institute and the to thank the very hardworking and clinical and quality standards set University of Newcastle. The Steering dedicated Auxiliary and volunteers by the ACHS. This is a significant Committee has developed tender for their generous contribution of achievement for our organisation and documents which will be advertised their time in assisting Calvary Mater demonstrates our commitment to to appoint a project director to Newcastle staff to deliver high level, providing excellence in care. progress a Master Plan for the site compassionate and quality care to our and at the same time, develop a The Medical Oncology Review community. Our staff, Auxiliary and Clinical Services Plan for Calvary was completed and Calvary Mater volunteers exemplify the values under Mater Newcastle. Newcastle has worked with the which we operate. Local Health District to develop a We are pleased to announce that I hope that you enjoy reading an five year action plan for the roll out an appointment has been made to overview of the year at Calvary Mater of the recommendations. An initial the position of Director of Medical Newcastle. enhancement was funding and Services at Calvary Mater Newcastle. commissioning of four additional Dr Rosemary Aldrich will bring with chemotherapy chairs which has her significant hospital experience Greg Flint assisted in reducing waiting times. and expertise in the areas of medical Chief Executive Officer The Port Waratah Coal Services and administration, public health, clinical Supporters of Cancer has generously governance, quality, safety and risk funded a Nurse Practitioner position and more recent experience working
Calvary Mater Newcastle • review of operations • 2011/2012 • 5 Department Reports
General Internal Medicine
The department saw 3,200 inpatients Dr Foy has completed an audit of the palliative stents, than the department which is similar to the previous year. remote service which is very pleasing of gastroenterology at John Hunter Congratulations to our staff for their in that it shows considerable growth Hospital. Well done to all involved. consistent efforts in meeting the over time, a spread of patients across The department was very pleased to challenges presented throughout the all three of the different settings, welcome Dr Annalise Philcox, General year. namely Mungindi general practice, Physician and Endocrinologist to the A total of 2,014 outpatient occasions Pius X Aboriginal medical service department this year. Annalise has of service were provided at the and the Moree clinic. Overall, in the made a substantial contribution to department’s outpatient clinics. In six years of the programme, 33% the coverage of our patients’ needs. addition, the external clinics continued of patients have been indigenous, In addition she will be conducting to be operated at Tomaree Polyclinic whilst the Bureau of Statistics lists the endocrine clinics for severe diabetics and Tamworth Hospital. These population of that area as being 22% at Moree. clinics provide a real service to those indigenous. Some other useful clinical Senior registrar numbers have communities as well as provide data has also come from the audit. been good this year with the three excellent training for our advanced The need for both gastroscopy and positions in advanced training in trainees in medicine. bronchoscopy for the department and general medicine being held by Drs Mater to Mungindi those referring to us has increased Withanage, Sellathurai and Oo, with a This programme had its busiest year this year. With some increased 4th advanced trainee to join us from ever despite the fact that two trips arrangements and the co-operation Sri Lanka soon. could not be completed because of of theatre staff, we have actually In addition, we have Dr Sudeshi the Queensland/Northern NSW floods been able to double the amount of Wijethilaka who is an advanced and on one occasion the team had to gastrointestinal endoscopy which was trainee in geriatric medicine and Dr have a patient evacuated by helicopter performed in the first half of 2012. Magnus Halland who is an advanced to see them. Nonetheless, there were The amount of palliative endoscopy trainee in gastroenterology, giving us a total of 186 occasions of service has also increased and the a total group of five, increasing to six provided. department has now inserted more
6 • Calvary Mater Newcastle • review of operations • 2011/2012 in the new financial year. would also like to thank the hospital’s this year. Dr Foy will be presenting volunteers who greatly assist us on the results of his audit of our remote This year the department embraced this day each year. programme and Dr Susan Miles will its biggest challenge yet in hosting present an audit of her work with the Royal Australiasian College The department’s research activities mental health patients. of Physicians (RACP) Clinical have now reached a level which is Examinations for 12 candidates. more consistent with our status as a This has been a challenging, very Whilst the number of candidates may teaching hospital in general medicine. busy and very productive year for the Department of General Internal not seem large, this was an enormous Dr Scott Twaddell presented a Medicine. undertaking, involving recruitment poster at the recent World Congress of approximately 40 patients to for Bronchology and Interventional participate in the exam and the Pulmonology and all three advanced very substantial infrastructure, trainees will be presenting papers at administrative work and supervision the Internal Medicine Society meeting required. RACP was most in Queenstown, New Zealand later complimentary about our work. We
Acute Aged Care
Calvary Mater Newcastle (CMN) cognition, nutrition and hydration management guidelines, pain has an acute aged care team and and self-care and skin integrity). assessment for people with dementia a very active aged care advisory and the development of an agitation This model of care has realised committee with multidisciplinary scale. improved care outcomes for patients representation from the acute care with delirium over the past two A one day education program was areas, emergency department, years with the introduction of the facilitated by the Acute to Age geriatric medicine, allied health and Confusion Assessment Method Related Care Service, Clinical Nurse mental health. The members have (CAM) sticker, the enablement care Specialist, Sue Southgate, and the been proactive in supporting and plan, patient specialling criteria and Discharge Facilitator, Sharon Lewis. implementing an enablement model ongoing staff education. The day was hosted by CMN in of care for older people during their March this year with 70 attendees acute phase of care with the aim The team continues to progress from acute care, aged care, of addressing the five enablement a number of projects including community and specialist palliative domains (mobility, continence, the management of aggression in care services. older persons, review of delirium
Calvary Mater Newcastle • review of operations • 2011/2012 • 7 Coronary Care Emergency Department
During the last year the The Emergency Department continues Resus4kids. Neat (National Emergency Coronary Care Unit continued to increase its activity with 32,095 Access Target) which commenced in to have a high patient patients being treated an additional April and our department is continually numbers admitting an average 1,466 patients from last financial year. striving towards the NEAT targets set of 57 patients per month for Admissions have also increased by by Federal Government. over 1,100 to 10,416. the year. Patients admitted New equipment for the Emergency with myocardial infarction The Emergency Short Stay Unit had Department also assisted in enhancing represented about 27% of 4,087 admissions, averaging 340 care for our paediatric patients. Money the total admissions. Those patients per month, an increase of was donated by the Auxiliary which patients requiring Coronary 1,616 admissions for this financial year. enabled us to buy a Neopuff, Broselow paediatric packs, overhead paediatric Angiography are stabilised With the enhancement of the heater and a compartmental pressure and then transferred to the Emergency Short Stay Unit, the units monitor for adults. These pieces of John Hunter Hospital or now have a full time clinical nurse equipment will enable the department unit manager, part time pharmacist, discharged to the private to ensure current and best practice for full time ward person, full time sector for further investigation all of our patients. physiotherapist and enhancement of and management. patient service clerk hours. The Emergency Department and In addition to the traditional Emergency Short Stay Unit continues The Emergency Department continues coronary care management, to have high staff retention, we to implement quality projects commend our staff for their continued the unit provides service throughout 2011/2012. These commitment to our service. to the other units of included SEPSIS KILLS, DETECT, Calvary Mater Newcastle performing cardioversions, transoesophageal echocardiography, pericardiocentesis and insertion of temporary pacing wires.
The Peter Curteis Education Grant continues to provide support for further education of junior medical and nursing staff and this year was awarded to RN Ruth Shaw from Coronary Care Unit. Ruth utilised the award to attend the 2012 Cardiac Society of Australia and New Zealand Annual Conference which was held in Brisbane in August 2012.
The Cardiology Department continues to provide inpatient and outpatient support services in ECG, exercise testing, echocardiography and trans-oesophageal echocardiography.
8 • Calvary Mater Newcastle • review of operations • 2011/2012 Alcohol and Drug Clinical Services Unit
The Alcohol and Drug Unit provides education for LMOs and health in a clinical audit of treatment assessment and compassionate professionals, school education outcomes for prescribed opioid treatment to people with alcohol and sessions, traffic offenders community dependence. Medical staff have drug problems and their families. program, nursing, psychology also been involved with the trial of a The multi-disciplinary unit functions and medical student placements. cannabinoid buccal spray (Sativex®) with six clinical staff to provide University related teaching (via for cannabis withdrawal with the medical, nursing, psychology and conjoint appointments) to nursing National Cannabis Prevention and counselling services. This includes and medical undergraduates and Information Centre. comprehensive outpatient services, the postgraduate Alcohol and Drug With the generosity of the consultation-liaison to inpatients of diploma/masters course continues. Physiotherapy Department an the hospital and inpatient withdrawal Staff have been involved with additional staff member will assist treatment for the most complex collaborative work with Drug and with administrative services at the patients. Alcohol Clinical Services (DACS) reception. The activity is high for a small HNELHD and the Ministry of Health. Next year the focus will be on unit with outpatient occasions of This includes monthly clinical review, activity based funding, consistency service between 350-500/month morbidity and mortality meetings, with elective admission access and and inpatient consultations of Quality in Treatment Committee, continuing to improve our services 80-130/month. With the introduction clinical supervision, staff recruitment to assist Emergency Department of activity based funding it has and research. and other areas of the hospital become a challenge to record all The clinical research has included with Alcohol and Drug treatment activity. It has become apparent that being one of the sites for a trial of an pathways for patients. many telephone, case review and Alcohol and Drug treatment outcome non-nursing C/L activities were not tool, with the aim of it eventually counted and systems for improving being implemented throughout NSW this are being implemented. Health, Alcohol and Drug services. Non clinical activities included The unit has also been involved
Calvary Mater Newcastle • review of operations • 2011/2012 • 9 Department of Consultation-Liaison Psychiatry
During 2011/2012, the Department The QUICATOUCH program was used Young Adult (AYA) service as part of of Consultation-Liaison Psychiatry for screening oncology outpatients for the Hunter and Northern NSW Youth consulted on 891 individual distress and pain and for monitoring Cancer Service, provides clinical inpatients, delivering over 1,876 progress (symptom scores) of services to oncology outpatients and occasions of service. Main referral patients attending the Psycho- inpatients aged 15-25 years. groups were: Department of Oncology service. QUICATOUCH The Department also operates a Clinical Toxicology (517 referrals), operated for over four years however, Suicide Prevention Program, a General Medicine (109), Emergency it was closed at the end of December clinical research unit funded from the Department (124 referrals), Oncology 2011 due to funding cessation. Burdekin initiative and administered (58 referrals) Palliative Care (57 During the last six months of 2011 by Research Manager, Sarah Hiles, referrals) and Surgery (18 referrals). this service provided 5,157 occasions through the Hunter New England of screening to 1,090 patients. The The Psycho-Oncology Service Mental Health Service. department was extremely active accepted referrals of over 320 in clinical, research, teaching and Student Placements individual patients and delivered community education. We commend nearly 1,000 occasions of service The Clinical Psychology Program: all who ran this worthwhile service to outpatients through the Psycho- Professional Doctorate level, Gillian namely Project Manager, Dr K Oncology Clinic. The Psycho- Maddock. Rogers, Ms K Gleeson and Ms K Oncology Service provided input Harris. School of Psychology: Research to the following oncology multi- Higher Degree (PhD), Dr Tharaka disciplinary teams: haematology, A new appointment of one part- Dassanayake. head and neck cancer, lung cancer time clinical psychologist, Karen and breast cancer. Matthews, to the Adolescent and
Service Number of Patients Seen Occasions of Service Consultation-Liaison Psychiatry Inpatients 891 1876 Palliative Care Inpatients 57 57 Psycho-Oncology Outpatients 322 974
10 • Calvary Mater Newcastle • review of operations • 2011/2012 Clinical Toxicology and Pharmacology
The Department of Clinical Toxicology and Pharmacology provides an inpatient service for the management of patients with deliberate, recreational, accidental or other self-poisoning and envenomation. For the management of deliberate self-poisoning, the department combines with the Department of Clinical Liaison Psychiatry as the 716 individual patient admissions, of The department has set up and runs Hunter Area Toxicology Service. whom 515 were new to the service. a website at http://www.wikitox.org. Clinicians in the department also This is an international collaboration manage patients with adverse drug Sixty-five patients had more than of toxicological information and reactions and complex medication one admission during the financial teaching resources. Through this issues and provide a consultative year. Of the admissions, 733 site the department runs a Diploma service to the Hunter New England were for deliberate self-harm. In of Clinical Toxicology degree course Local Health District in Clinical addition, there were 20 spider and which is internationally subscribed. Pharmacology. snake bites, 46 recreational drug overdoses, 9 iatrogenic poisonings, The Hunter Drug Information Professor Ian Whyte serves on the and 14 accidental overdoses. Service (HDIS) is the primary drug Quality Use of Medicines Committee information resource for health of the John Hunter Hospital and is The majority of the patients (98.06%) professionals within the Hunter chairman of both the Area Quality were admitted via the Emergency New England Local Health District Use of Medicines Committee and Department. Almost all (86.79%) providing current, clinically relevant the Clinical Trials Subcommittee were discharged from the Emergency and unbiased medicines and of the Hunter New England Human Short Stay Unit (ESSU) and only therapeutic information. Research Ethics Committee. 9.70% were discharged from the toxicology ward. For those whose Andrew Ward resigned in November Associate Professor Geoff Isbister whole hospital stay was in the ED or 2011 and Tiffany Bichard joined provides expertise to the Ethics ESSU, the median length of stay was the service in January. The service Committee of the New Children’s 13.8 hours. 5.21% were admitted to received 541 enquiries throughout Hospital, Westmead. As well as the Intensive Care Unit with a median 2011/12. Adverse drug reactions these activities, there is a substantial length of stay of 34.2 hours. remained the most common question commitment to undergraduate and and most (64%) of questions post graduate teaching and an Of the deliberate self-harm were patient related with 80% of ongoing active research program. patients, 92.5% received timely and responders using the information appropriate psychiatric assessment. Members of the department provided in patient management. 58.91% of patients were discharged published 21 articles in refereed The department continues to train directly home, while 36.24% were journals in 2011/12 and were pharmacy and medical students and transferred to a psychiatric hospital successful in grants worth more than other pharmacists from within the and there were three deaths (0.36%). $1.2 million. The clinicians in the Local Health District. The average number of admissions department also contribute to the per day was 2.25 and the median HDIS contracted with the National Poisons Information Centre length of stay for the deliberate self- Pharmaceutical Society of Australia roster and support the Hunter Drug harm patients was 14.9 hours. This to produce Non-Prescription Information Service which is part of length of stay is substantially less Medicines in the Pharmacy - A the department. than the length of stay for poisoning guide to advice and treatment. The In 2011/12 there were 825 at other hospitals in NSW and therapeutic drug monitoring service admissions to the Hunter Area Australia. for aminoglycosides has increased Toxicology Service. The average age to a district wide service but is still Dr Colin Page continues to give the of patients at admission was 35.9 restricted to aminoglycosides only. department his time by being on-call years and the proportion who were every Monday night from Brisbane. female was 61.09%. There were
Calvary Mater Newcastle • review of operations • 2011/2012 • 11 Oncology
Medical Oncology March 2012) and the opening of four to the team and is critical in assisting extra chemotherapy chairs at Calvary us to comply with the ever increasing The most significant event for Mater Newcastle with Kelly Randall complexity of clinical research. the unit was the release of the as the new Nursing Unit Manager. We welcome to our unit Leanna external review of medical oncology Attempts to obtain extra funding for Pugliese. Currently we have 14 actively services in February 2012. Of the 24 medical oncologists is still under recruiting clinical trials covering a recommendations made, 21 were consideration. accepted. The most significant being range of cancers and cancer stages recommendations no.1 – that the From a workload perspective we are including early and metastatic breast Hunter New England LHD Plan for still very busy having seen 1,288 new cancer, a variety of gastrointestinal recruitment of medical oncologists patients and 22,347 occasions of cancers, brain, prostate, head and across the region according to service in the 2011/2012 financial year. neck and gynaecological cancers. In benchmarks set by the Australian We continue to address waiting time addition, we have patients in 37 studies in the follow up phase and have five Medical Oncologist Workforce benchmarks. Four of our Advanced studies in various stages of ethics and Study conducted by the Medical Trainees will complete their training governance review. These studies will Oncology Group of Australia and at the end of 2012 (Drs Lindy Turner, activate by the end of the year or early recommendation no.19 – increase the Nick Zdenkowski, Maria Aslam and in the new year. number of funded chemotherapy chairs Nazeer Upanal). We wish them well in at Calvary Mater Newcastle from the their careers. As from this year medical The outsourcing of compounding current 12 to 16. oncology trainees will be interviewed chemotherapy drugs has been very statewide. successful. We will be looking at further Other recommendations related to improvements in educating, supervising currently unfunded positions and The Medical Oncology Clinical Trial and safely delivering oral chemotherapy improvement in internal processes Unit continues to expand. The unit drugs to our cancer patients. that were already underway. The now employs six full time and three immediate funding of approximately part time clinical trial co-ordinators Persisting challenges include meeting $1 million dollars through the Hunter and a part time administrative demand with existing workforce, New England Local Health District has officer. The recruitment of a clinical financial support from the Cancer allowed the appointment of a Medical trials pharmacist to assist in trials Institute of NSW for data managers Oncologist at Manning Rural Hospital management at pharmacy level for our and rural registrars, and the continued in Taree (Dr Ted Livshin who started in unit and for other trials units within the challenges in trying to meet waiting hospital has proved a valuable addition time benchmarks.
12 • Calvary Mater Newcastle • review of operations • 2011/2012 Radiation Oncology
As a five linear accelerator The removal of one linear High-dose rate brachytherapy department, Calvary Mater accelerator and the installation and for gynaecological cancers now Newcastle continues to be one of the commissioning of a new updated integrates MRI into 3-D volume- largest and most efficient radiation version was a labour intensive and based planning for better soft-tissue oncology departments in NSW. We multi-disciplinary team effort. The definition. The MRI installation was saw over 1,900 new patients with a process took over five months and a significant milestone event for our 17% increase in referrals from 2010 was completed by the end of June department not only by enhancing to 2011 and we performed the most 2012. Significant measures, such treatment planning but also by new treatment courses in NSW. as employment of extra staff, two fostering new proposals for multi- disciplinary cancer research. This steady increase in service extended-hour shifts and extra- demand was particularly challenging ordinary overtime were required Over the last year, the scope and over the past year as an ageing to treat patients on fewer linear complexity of Intensity Modulated linear accelerator was replaced. accelerators. Our waiting list for Radiotherapy Treatment (IMRT) has been expanded to include head Waiting lists for both chemotherapy treatment did increase over this and neck, prostate, cental nervous and radiotherapy remained period but this is now improving as system, soft tissue sarcomas and suboptimal and staffing deficits the new machine became operational pelvic cancers. persisted. We also faced the and we continued on with an challenge to provide our patients extended hours shift. IMRT is a complex form of highly with access to more complex, Closer collaboration between conformal dose delivery. For precise and diverse radiotherapy the departments of Diagnostic patients, this may translate into less side-effects and improved tumour treatments. Imaging and Radiation Oncology control. For our staff, this entails has continued over the last year. Many patients were referred to increased workload in contouring In 2011, the 3.0T MRI scanner was other centres to receive complex anatomical structures, planning installed at the hospital and close treatment in a more timely fashion complex dose distributions, ensuring proximity of the scanner to our or referred for treatments that the precise treatment delivery and department streamlines the planning hospital does not currently offer performing quality assurance (QA) such as stereotactic cranial and process for our patients and allows procedures. extra-cranial radiotherapy, prostate for service improvements. For brachytherapy and paediatric example to improve setup accuracy, We are now treating 15-20 patients per month with IMRT and focusing treatment under general anaesthesia. we have acquired a flat MRI table top the efficiency of the patient specific Thus the priority of the coming year for simulation, installed radiotherapy quality assurance processes to is to implement new technology, setup lasers in the MRI room and increase the number of treatments paramount to maintaining excellence are currently commissioning MRI to commence each week. Rapid in patient care, research and coil mounts for head and neck and Arc is another new form of education. prostate treatments. complex conformal treatment using dynamically collimated radiation beams rotating around the patient. This is currently being implemented and should be applied clinically by the end of the year. Rapid Arc has the potential to be more efficient than IMRT as it allows for faster delivery and increased patient throughput. Ensuring the accuracy of dose delivery during treatment of these highly conformal techniques has led to the rapid evolution of image- guided radiotherapy (IGRT). As well as electronic portal imaging dosimetry (EPID), we have commissioned and implemented newer imaging modalities on the linear accelerators to ensure daily
Calvary Mater Newcastle • review of operations • 2011/2012 • 13 setup accuracy such as kV on-board has worked at the hospital for over particularly focusing on MRI based imaging and cone beam CT scans. 26 years, Karl’s contribution has radiotherapy and IGRT. We had 30 been very much appreciated within publications last year. Associate Increasing precision of radiation the department. Professor Jim Denham continues delivery by on-treatment imaging is to lead his prostate research group time-consuming and best practice Expansion of training commitments with multi-centre clinical trials TROG is still under investigation. Over has continued. Of note, medical 96.01 and RADAR, consolidating the past year, our IGRT process in student attachments in oncology long-term results in prestigious treating localised prostate cancer at the hospital are longer and more publications. We continue our close has consolidated with most patients numerous reflecting the doubling association with clinical trials group having gold seeds implanted in of the numbers of 5th year medical TROG (Trans-Tasman Radiation the prostate to guide treatment students from the University of Oncology Group) who are onsite precision. Newcastle. The number of radiation at Calvary Mater Newcastle. We oncology registrar trainees also The priorities for implementation of welcomed Helen Nguyen who joined expanded to six with an additional new technology during 2012 have our group of three departmental advanced trainee from medical included Rapid Arc, 4-dimensional research co-ordinators. oncology or palliative care. Dr CT simulation accounting for Geetha Govindarajulu is completing The medical physics research respiratory motion, and stereotactic her clinical fellowship focussing on continues to grow in strength both cranial and spinal irradiation. The gynaecological cancers and palliative in publications and grant success following year we hope to see care. under the guidance of Associate the development of extra-cranial Professor Peter Greer for projects stereotactic radiotherapy for lung in IGRT, EPID dosimetry and MRI- nodules and liver metastases, Linear Accelerator projects. Peter respiratory gating and a prostate Medical Physics Greer is collaborating with Varian HDR brachytherapy program. Medical physics has continued in Switzerland to develop a new In July 2012, Dr Anne Capp to strengthen its links with the EPID imaging product. This year, Dr completed her term as Director University of Newcastle. The Brian King finished his 3 year post- of the Department and Dr Jane department has hosted five doctoral research on EPID dosimetry. Ludbrook has since been appointed undergraduate students who are Dr Henry Woodruff joined the group to the Director’s position. Dr Capp undertaking research projects as as a post-doctoral researcher from must be commended for her hard part of their course work or as the University of Sydney working in work and commitment to this role, a result of vacation scholarships EPID real-time dosimetry. Jidi Sun providing leadership in striving provided by the Commonwealth is a new PhD student working on for the implementation of new Government. Two physics registrar MRI-based planning. A/Prof Peter technology and in the planning of the positions continue. Stanwell joined the group as a MRI new department in Tamworth. Congratulations to radiation physicist with the aim to foster research in MRI-based radiotherapy We also welcomed a new Radiation oncology registrars, Drs Katherine and is linked to the University of Oncologist this year, Dr Jared Neville and Ekaterine Moseshvili who Newcastle. Martin who will be sub-specialising passed their phase 1 examinations in genito-urinary and gastro- in 2011 and to medical physicist, Over the past year, some of our intestinal tumour sites, and who Michael Barnes who obtained his senior staff have committed much has keen interest in research thus ACPSEM accreditation. Dr Mahsheed of their time to provide expert strengthening the department’s Sabet was awarded her PhD advice on the establishment of the research culture. under the supervision of Associate new linear accelerator department Professor Peter Greer in medical in Tamworth, which should be The numbers of radiation therapists physics and joined the clinical team operational in 2013. We must (RTs) are increasing to provide as a scientific assistant. thank the significant contribution extended hours on the linear of Chief Medical Physicist, Dr Kim accelerator to implement new The years 2011/2012 has seen Nitschke, Chief Radiation Therapist, technology. However, there is a steady growth in research Dr Karen Jovanovic, Radiation need to recruit more RTs and indeed activity in radiation oncology. We Therapist, Annette Skov, Information physicists, oncologists, nurses and participated in 23 open clinical trials Technology Ray Sheather and allied health staff in the near future and we remain one of the largest Dr Anne Capp. to continue this strategy. contributors of patients to radiation oncology clinical trials in Australia. Sadly, we said goodbye to Karl Stansfield, biomedical engineer, who In-house studies are progressing,
14 • Calvary Mater Newcastle • review of operations • 2011/2012 Haematology
The Hunter Haematology unit has had a busy year as the number of newly referred patients increases each year. In 2011/2012 over 900 new patients were reviewed and provided with treatment by the unit’s 3.9 Haematology staff specialists. Unfortunately this has resulted in an 11 week average new patient appointment waiting time. This is despite the clinical staff using a triage process that determines which patients should be treated first based on their clinical need. Patients with a non- threatening illness can wait up to 10 months for an appointment. The demand on inpatient beds for high dose chemotherapy and stem cell transplant has increased in the past year. Under Nursing Unit Managers (NUM), Wendy Johnson work practices, and a pathway to Medical Students from both the and Debbie Carr’s leadership, the the external link of EVI-Q, the state University of Newcastle and University staff in wards 5C (inpatient) and 5D based treatment guidelines of the of New England are taught in both (Day Ward) increased the throughput NSW Cancer Institute. The “Portal” the inpatient and outpatient setting, by co-ordination of patients by provides convenience and document as well as by provision of lectures pre-admission, early discharge control and has greatly facilitated and tutorials at the University of procedures and outpatient follow patient treatment and safety. Newcastle Callaghan Campus. up. The occupation of inpatient beds A number of our haematology staff Nursing and Allied Health is often in excess of 100%. Many play an indispensable role for the undergraduate students from treatments that other units administer wider Hunter New England Local University of Newcastle are trained in as inpatients are administered as Health District (HNELHD) by providing the inpatient ward. outpatient therapy at Calvary Mater their expertise for service planning Newcastle, to avoid treatment delays. The Staff Specialists contribute and delivery. These include: to Medical Registrar training and New national standards required HNELHD Transfusion Committee: Dr preparation for the Royal Australasian extensive review and revision of Sandra Deveridge. College of Physicians exams. stem cell apheresis, cryopreservation and transplant facilities and work HNELHD Cancer Network Leadership By senior staff reducing their hours to practices. After many weeks Committee: Wendy Johnson, NUM fractional appointments, Dr Sam Yuen preparation Calvary Mater Newcastle and Professor Philip Rowlings, was able to be employed permanently (CMN) was fully accredited for these Director in August 2011, as 0.8 FTE staff specialist to assist in managing the services by the National Association HNELHD Haematology Stream is department’s large clinical load. His for Testing and Accreditation. Cathie chaired by Professor Philip Rowlings appointment is part of succession Milton CNC (apheresis co-ordinator) and co-ordinated by Wendy Johnson and Geordie Zaunders (Stem Cell planning and unfortunately does Laboratory Manager) provided the At a state level staff have participated not contribute a significant staffing leadership to achieve the required in: increase. goals in a relatively short period of NSW BMT Network of the Agency The Mater Auxiliary provided funding time. for Clinical Innovation (ACI): Louisa for two new treatment chairs for the Dr Arno Enno led the initiative to Brown CNC, transplant co-ordinator stem cell apheresis area. The Ron develop a centralised “Haematology is co-Chair Poetscha fund enabled the purchase of several electric recliner chairs Portal” on the CMN Intranet. Via the NSW BMT NSW, Autologous for patient and carer comfort in the “Links” section on the CMN home Committee: Professor Philip Rowlings page, the haematology portal brings haematology ward. together treatment protocols, safe NSW Haemophilia Network: Dr Michael Seldon
Calvary Mater Newcastle • review of operations • 2011/2012 • 15 Surgical Oncology Palliative Care
The Department of Surgical The activity of the Department of latter half of 2012. Oncology and the Australia and New Palliative Care continues to grow. Providing care for the bereaved Zealand Breast Cancer Trials Group Over the last 24 months, there has is an important part of the clinical (ANZBCTG) co-ordinate national significant increase in referrals. activity of the palliative care service. and international collaboration in As a result, the department is Like all areas of palliative care, randomised clinical trials for women experiencing high occupancy this part of the service continues diagnosed with or at risk for breast rates of dedicated palliative care to experience increasing activity. cancer. This national activity is beds and increased numbers of An important innovation in the last an important resource for Calvary people admitted under palliative 12 months has been to hold four Mater Newcastle. The Department care services within the general annual Remembrance Services in the of Surgical Oncology and the Trials wards of the hospital. Like many hospital chapel. This has improved Co-ordination Department of the other palliative care services, the attendance and participation in the ANZBCTG are located in the NBN majority of people treated have morning tea that follows. Telethon Mater Institute on the cancer. However, the Calvary Mater Mater Campus. Professor Forbes Newcastle Palliative Care Service is Together with clinical activity, an is Director, Department of Surgical also seeing increasing numbers of important responsibility of palliative Oncology, and Director of Research people with non-malignant disease. care services is to engage in for the ANZBCTG. Recent statistics reveal that the teaching, educational and research service is remarkable for seeing the activities. The department is Current clinical trials encompass most respiratory patients of any actively engaged in teaching at prevention and treatment of all stages palliative care service in Australia. undergraduate, post-graduate of breast cancer. This collaboration levels, maintenance of professional involves more than 600 researchers, Some notable clinical projects standards and community forums. 80 institutions and 60 unique clinical undertaken within the department Two such initiatives include the trials in Australia and New Zealand. are highlighted. The common theme development of a spaced education With more than 1,000 investigators that underpins these is adoption program to improve exposure of 5th internationally through International and incorporation of the use of year medical students to the notion Breast Cancer Intervention Studies national palliative care indicators of a palliative approach and courses (IBIS, Cancer Research UK) London and quality measures. This was aimed at nurses working in acute UK; Breast International Group (BIG) highlighted by the development and care whilst caring for the dying. Brussels, Belgium; International installation of Palliative Care ARIA Breast Cancer Study Group (IBCSG) system. Incorporating evidenced- Lastly, the research activity of the Bern, Switzerland and Amhurst, USA; based systematic assessment department continues to grow. and the National Surgical Breast and tools into ARIA allows ease of There are now two research nurses Bowel Project (NSABP, Pittsburgh, communication amongst the multi- funded by the successful attraction USA). The ANZBCTG has launched disciplinary palliative care team and of competitive grant funding. The a new trial, APHINITY, to test a new allows for easy extraction of activity work undertaken by the department targeted agent called pertuzumab. data that will be used to inform the is focusing on improving the Other trials are investigating local department’s funding. evidence-base from which palliative treatment and new systemic care is practised from, the Other projects adopting the use approaches for all stages of breast identification of people with palliative of standardised tools include a cancer. The large international care needs and the approach offered redesign project undertaken under prevention trial, IBIS II, completed its to all dying Australians. the auspices of the NSW Ministry of recruitment phase in December 2011 Health to develop and trial a referral Grants and donations for year and results are anticipated in late tool to assist referrers understand 2011/2012: 2013. and assess the specific needs of Cancer Institute of NSW Primary The ANZBCTG supports the joint palliative care patients. A separate Health Care Grant $40,000 appointment of a Postgraduate project was the development of an Fellow in Breast Cancer Clinical evidence-based algorithm to improve Cancer Institute of NSW funding for Research, and recently a new Fellow the palliation of dyspnoea. a research nurse $100,000 was appointed to commence in early Over the last year, The Fig Tree Margaret Mitchell Grant $10,000 2013. Program initiated a redesign project. Lions Club of Jesmond donation In the 2012 Australia Day Honours, This included a review which has $5,000 Professor Forbes was awarded a informed the development of an Member of the Order of Australia alternative model which is based KO Surf classic donation $11,000 (AM), being recognised for service to on a four-week education program The 2011/2012 financial year has medicine in the field of breast cancer aiming to target the learning needs of seen numerous changes within the research, to the development of palliative care patients and families Department of Palliative Care. improved clinical practice standards around common but problematic and service to the community. symptoms. This will be trialled in the 2011 saw us welcome Kathryn
16 • Calvary Mater Newcastle • review of operations • 2011/2012 Day Hospice Programme
Bensley as the Aboriginal Health work at the hospice when it first studies (Octreotide for Bowel Education Officer in palliative care, opened in 1994. Megan, Cheryl, Obstruction) was completed in May this is a significant milestone, as Paul and Robyn have worked in 2012. her position is the first ever in NSW. the hospice, intermittentley, for the This year, a total of 116 patients Kathryn’s role is to inform Non- past ten years. Their professional agreed to receive information about Aboriginal staff about Aboriginal contribution to palliative care has clinical trial participation, 25 patients culture and what death and dying been greatly appreciated over the gave consent and went on to means to them. Kathryn also years and we wish them well in their participate in a clinical trial. provides support to dying people of new endeavours. Aboriginal descent and their families. The department remains actively In May, the ARIA database for involved in quality improvement Through Kathryn’s contacts, we palliative care was introduced. This projects, reviews and education, were fortunate enough to procure included the rollout of the outreach including: the services of local Aboriginal artist nursing staff using laptops when Colin Wightman, who produced visiting patients in their home. • Research and Statistics Working a number of paintings for display Party The research unit within the within the department. department remains involved in a • falls Working Party Throughout 2011/2012 we bid number of clinical trials with the • Medication Management Working farewell to many long-serving Palliative Care Clinical Studies Party palliative care staff members Collaborative (PaCCSC), Queensland including Clinical Nurse Consultant, University of Technology, • National Standards Assessment Yvonne Rohr, Registered Nurse Queensland IMET and more recently Program (NSAP) (RN) Lynne Stewart who retired. RN with GW Pharmaceuticals, as well as • palliative Care Review Committee Megan Kauter has relocated to the some smaller investigator initiated Medical Centre, RN Cheryl Pavey has studies. moved to the radiotherapy oncology We were open to recruitment for a clinic, RN Paul Collins has relocated total of 11 studies throughout the to Darwin and RN Robyn Cutcliffe financial year. The Methylphenidate has moved rurally for a lifestyle for Fatigue Study ran by Queensland change. IMET was completed in February Both Yvonne and Lynne commenced 2012 and the second of the PaCCSC
Calvary Mater Newcastle • review of operations • 2011/2012 • 17 Hunter and Northern NSW Youth Cancer Service
Calvary Mater Newcastle has a new Children’s Hospital. The service team of health professionals, service dedicated to adolescent provides consultation, advice and knowledgeable about cancer care and young adults (AYA) aged support to young patients, treated and adolescent health. The clinical between 15-25 years who have been either as public patients or in the nurse consultant, social worker diagnosed with cancer. private sector fostering collaboration and clinical psychologist are all between adult and paediatric cancer introduced to the patient and utilise The Hunter and Northern NSW services. the AYA Psycho-social Screening Youth Cancer Service (YCS) is Tool to provide a proactive rather based at Calvary Mater Newcastle. This team has proactively built than reactive health care service This service is the latest YCS strong relationships with medical delivery model. established within NSW/ACT as oncology, haematology, radiation part of the Youth Cancer Network oncology, surgery, palliative care Being an adolescent or young adult Project. The team comprises of four and rural cancer services as well is not easy at the best of times and health professionals with extensive as the other YCS within NSW and a cancer diagnosis can be very experience working with paediatric, ACT to maximise co-ordination of difficult for a young person to deal adolescent and young adult cancer care, psychosocial support, increase with as they transition through this patients. The YCS has a clinical health literacy and provide access to vulnerable time in their development. nurse consultant, social worker and financial assistance. Our team provides highly specialised, clinical psychologist based at Calvary nursing, medical and psychological Quality care for adolescent and Mater Newcastle and an adolescent support to young people who need young adult cancer patients requires oncologist located at John Hunter it. a dedicated multi-disciplinary
18 • Calvary Mater Newcastle • review of operations • 2011/2012 Oncology Nurse Practitioner Intensive Care Unit
The last 12 months have shown with the new service provided by Activity in the Intensive Care Unit a significant change to patient the Oncology Nurse Practitioner in continues to be high with 384 review with the introduction of on all categories including satisfaction admissions, of which 57% were treatment review and long term with time spent with them to ventilated. Average occupancy follow up clinics by the Oncology discuss treatment and any issues for the unit was 83% and average Nurse Practitioner, Gillian Blanchard. concerning their care, knowledge length of stay was 4.3 days. ICU 776 occasions of service have been of the Oncology Nurse Practitioner, continues to provide hospital undertaken for the period August communication, and overall wide services which include the 2011 – June 2012. satisfaction and preference. Many emergency medical response, patients also provided additional The change to the way patients have central line insertion and nutritional information and feedback indicating been reviewed has now become support for patients requiring TPN their overall satisfaction with the an accepted part of the oncology (in conjunction with the Dietetics service. service at Calvary Mater Newcastle. Department). This change seems to be very We would like to make The biggest impact on the ICU acceptable to patients who are acknowledgement to the Supporters this year has again been our role undergoing care. A quality activity of Cancer and Port Waratah Coal on the Rapid Response Team involving a patient satisfaction survey Services for their valuable support which provides the response to was undertaken of the patients seen and contribution to establishing the clinical emergencies throughout in the Day Treatment Review Clinic in Oncology Nurse Practitioner Service the hospital. There were 628 Rapid August- September 2011. The survey at Calvary Mater Newcastle. This Response Team calls this year, with service is highly valued by all who response rate was positive with a the 90 calls in June being twice the participation rate of 67.5%. use it and is a great asset to the monthly average. medical oncology service provided The preliminary results indicated by Calvary Mater Newcastle. The ICU continues to be an active that patients were strongly satisfied member of the ANZICS Clinical Trials Group participating in several multicentre, international research McGrath Breast Care Nurse projects. The 5th Point Prevalence Study This year has been challenging and I have taken a committee position Day has been completed; this trial rewarding seeing 270 new patients on the Hunter Breast Cancer Nurses provides data that further trials can as well as providing ongoing contact Group, sponsored by the Annual then be based on. The multicentre for previous patients, providing Lawler Partners Charity Breakfast trials CHEST (comparing saline much needed physical and emotional held at Wests each October. We to starch for fluid resuscitation) support to women and their families. provide complimentary education is now complete and we are days for Hunter Nurses working with Whilst providing care and support to awaiting publication of the results. breast cancer patients. patients is my main focus, another Nephro-Protect (determining if significant role is promoting breast We also provided nurses two supplemental protein protects awareness within the community educational scholarships for the kidney function) continues and we encouraging greater awareness of Breast Care Nurse Course. This year are about to commence ADRENAL the importance of early detection. we have provided sponsorships for (hydrocortisone in septic shock) Throughout the year I have given 20 nurses to attend conferences and and Transfuse trials. talks to the community regarding 180 nurses attended education days. breast awareness and also continued The research co-ordinators for Realising the community need to work closely with the Aboriginal these trials, Suzanna Vale and for further support, Debra Cook, cancer project officers based at Irene Bailey, have again been Breast Cancer Coordinator, social Waratah. complimented by the Trial Co- worker, Emma Sturgess and myself ordinators on the exemplary In October 2011 we celebrated Mini have developed an education and manner they have managed these Fields of Women Day in the hospital well-being program commencing projects at the hospital. foyer. A display featuring local in February next year. The twelve services for patients and families was week program is a partnership with In addition, we would like to a wonderful success with a morning the hospital and the Hunter Breast welcome senior intensivists Drs tea sponsored by our long-time Cancer Foundation. A productive Peter Saul and Ursula Beckmann to partner, Bakers Delight, Waratah. year indeed. our team.
Calvary Mater Newcastle • review of operations • 2011/2012 • 19 Melanoma Unit
It has been another busy year in Lyle, advanced trainee, working We also continue to see patients for the Melanoma Unit with a variety with Dr Van der Westhuizen. They consideration of new clinical trials. of challenges to face. We sadly both have shown a great interest Surgical management continues to said farewell to Professor Peter in melanoma management and be the main treatment modality for Hersey who has been a valued treatment of melanoma patients. They melanoma patients. A diathermy member of the Melanoma Unit for have been able to attend a number machine has been purchased by the of conferences and workshops on the last 28 years. He has worked unit and will be used to enable us to the new treatments for melanoma as as a clinician, seeing patients with attend to excisional biopsies and wide well as the Multi-Disciplinary Team high risk melanoma and patients excision of thin melanoma. These meeting at the Melanoma Institute of with metastatic melanoma as well procedures are attended under local Australia. as having his own laboratory as a anaesthetic here in the unit every translational researcher. The Hunter Melanoma Foundation two weeks by Dr Mike Reid. This Professor Hersey has taken up continues to support the Melanoma service continues to free up some of an appointment as Professor of Unit and is of great benefit to the the surgeons theatre time for wide Melanoma Biology at the University people of the Hunter region. The excision of thicker primary melanoma of Sydney. He has been a tireless Foundation has a new campaign or more involved surgery. called Check Mate. This campaign worker for the benefit of melanoma The Newcastle Permanent Charitable is aimed at getting men over 50 to patients and a world leader in Foundation has donated an check their own skin and to listen to melanoma research. He will be greatly ultrasound machine to the unit. This their wives in the hope of detecting missed by all. is a useful machine for the doctors melanoma early in this target and nurses and has been used to We welcome Dr Andre Van der population. Westhuizen to the Melanoma Unit. view lymph nodes pre-op’ or seroma Dr Van der Westhuizen comes from More than 50% of melanoma post operatively. deaths are in men aged over 50. South Africa and has been working The nursing staff have attended The message still needs to spread in medical oncology at Calvary Mater several conferences about melanoma that there is a 97% cure rate when Newcastle for two years and has now as well as conferences focussing melanoma is picked up early and joined the team of the Melanoma Unit. on wound care. Also beneficial are the best way of detection is self skin the workshops about new emerging Dr Van der Westhuizen sees examination and regular check-ups treatment drugs for melanoma with melanoma patients with high with GPs by everyone. international speakers. These have all risk melanoma and patients with The medical treatment of melanoma been useful and most informative for metastatic melanoma. Dr Van has shown great promise. This all in the Melanoma Unit. der Westhuizen’s experience as year has seen the registering of a medical oncologist, as well as Altogether it has been an interesting two new drugs for the treatment a geneticist brings great medical and busy year and we look forward to of metastatic melanoma with the skill and is very welcome. We are the year ahead. Therapeutic Goods Administration. fortunate to also have Dr Megan
20 • Calvary Mater Newcastle • review of operations • 2011/2012 Surgical Unit Clinical Ethics Committee
The 29 bed Surgical Unit provides Essentials of Care (EOC) has been Mrs Alison Lee Acting Director of a service for general and surgical successfully utilised for many Medical Services Calvary Mater oncology patients. projects in our unit but most Newcastle (CMN) as Acting recently changes regarding NHPPD The Surgical Unit provides care for Chairperson. were put into operation using EOC general and oncological surgical methodology. EOC is a practice patients. The Stomal Therapy Wound Mr Kevin Mulligan, Director of development approach that allows Management, Acute Pain Service Mission, CMN. nurses to celebrate the good care and the McGrath Breast Care Nurse they provide as well as identify Dr Aidan Foy, Associate Professor, are managed from the Surgical opportunities to improve care even General Medicine, CMN and Unit and all are very successful and further. The EOC program evaluates useful services bettering our patient Chairman, Medical Staff Council the person-centred nature of the care outcomes across the board. CMN. environment and is clinician driven We were most fortunate to be one with management support. Dr Tim Stanley, Staff Specialist, of the first units in the hospital to We received a substantial donation ICU, CMN; Executive member implement the award changes Nurse from the Newcastle Buses from its Medical Staff Council CMN. Hours Per Patient Day (NHPPD) in annual fundraiser the “Santa Bus”, November 2011. Recruitment of Dr John Cavenagh, Staff Specialist, which allowed the unit to purchase an additional full time equivalent nurses Entonox Machine for use on patients Palliative Care, CMN. has allowed review of our model of to provide pain relief during dressing care. Ms Elizabeth Milligan, Deputy changes. Director of Social Work, CMN.
Ms Maria McDonald, Nursing Representative, CNS, Haematology, The Clinical Ethics Committee CMN. Ms Mary Ringstad, Pastoral Care As a Catholic hospital Calvary participants. The wording is similar to Manager, CMN. Mater Newcastle (CMN) adheres to wording that is used by all Catholic Fr Barry Tunks Chaplain, CMN, the philosophy of Catholic social Hospitals throughout Australia, where Vicar General, Catholic Diocese of teaching. Clinical practice at CMN is specific research is undertaken which underpinned by the Code of Ethical may impact on the life of an unborn Maitland Newcastle. Standards for Catholic Health and child. Mr Wayne Dever Lawyer, MRM Aged Care Facilities in Australia by During 2011/2012 four Ethics Forums Lawyers, Mayfield. Catholic Health Australia (CHA). The were organised for CMN staff: relationship between the Hospital’s Mr Dennis Carroll Theologian, and Clinical Ethics Committee and Hunter Organ Donation After Cardiac Death - Ethicist, School of Theology and New England Human Research Dr Peter Saul and Ms Jennette Lacey Religious Studies, University of and Ethics Committee (HNEHREC) Dying with Dignity – Fr Kevin Newcastle. continues to be productive and McGovern beneficial for both organisations. Mrs Paula Watts, Community Close co-operation and monitoring Advance Care Planning – Dr Representative. of the application and approval Bernadette Tobin regime for research at CMN has been Life Before Death – Documentary on The appointment of Dr Rosemary maintained and has ensured that availability of pain relief at end of life Aldrich to the position of Director of the process remains very efficient Clinical Services (Medical) in August with minimum delays in the approval CMN developed a policy about 2012 means that Alison Lee will process. Organ Donation after Cardiac Death in line with NSW Ministry of Health vacate the position of Chairperson The Clinical Ethics Committee Guidelines. This policy has been in favour of Dr Aldrich. received approval for a Reproductive approved by Little Company of Mary Risk Statement to be included in the Health Care (LCMHC) for use on a The Clinical Ethics Committee Participant Information and Consent national basis. meets on the third Tuesday of each Form (PICF) in all applications month. for research involving human
Calvary Mater Newcastle • review of operations • 2011/2012 • 21 As a result of changes to the Nurses’ This has occurred due to: Human Resources Enterprise Agreement, nursing hours • a direct overseas recruitment drive per patient day (NHPPD) ratios now for nursing staff and Registrar/ Continued improvements have determine the number of nurses Medical Officers (as mentioned been made to the hospital’s staff required to provide direct clinical above); recruitment processes. With care to patients. This has resulted in assistance from the IT Department, the need to increase the number of • appropriately qualified candidates Convenors of Selection Committees nurses employed in wards throughout applying for positions vacant online can now view and manage electronic the hospital. at SEEK.com; and applications, expediting the selection process, minimising paper A number of strategies have • recommendations from recruitment consumption and eliminating the risk been implemented to ensure the agencies specialising in Health of lost and misplaced applications requirement for more nurses is met, Professionals. including the direct recruitment of and files. Much work has been achieved to qualified nurses from overseas. The progress the implementation of the Also, with direction from the HR Department interviewed many new Chris 21 payroll system which SEEK.com account manager, overseas nurses by telephone and is being rolled out across Little filtering questions have been placed assessed their suitability for work at Company of Mary Health Care. With in all online advertisements. The Calvary Mater Newcastle. filtering questions direct applicants staff covered by conditions equivalent to the hospital’s website for full After liaison with the Department to those of NSW public sector instructions on how to lodge of Immigration and Citizenship health employees, Calvary Mater applications that comply with the and AHPRA (the Australian Health Newcastle operates in one of the minimum requirements. The result Practitioner Regulation Agency), most complex payroll environments has been a drastic reduction in poor the hospital has so far recruited in Australia. Significant attention quality applications and unnecessary five Registered Nurses from the to detail has been applied to each correspondence with candidates United Kingdom and Ireland. The step of the implementation process during the selection process. We nurses have fitted in very well at the in order to avoid potential under/ welcome this change. hospital and their experience and over payment errors. With parallel skills have been warmly welcomed test runs expected soon to test the 1 July 2012 will signal the beginning by existing staff members. Staff reliability of the system, Chris 21 will of the new quinnquenium (the and management have supported be operational within the coming five-year period for which staff and assisted the nurses with their months. Well done to all staff involved specialists and Visiting Medical applications for permanent residency, in this pursuit. Officers (VMOs) are credentialled with one application already granted There were 12 Lost Time Injuries for specific responsibilities. The and others pending. Human Resources Department, (LTIs) in 2011/2012. This is a in collaboration with the Medical There has been a significant increase reduction in the number of LTIs that Administration Department, drafted in the number of overseas recruits occurred in 2010/2011 and less than and processed approximately 85 new appointed under sponsorship half the number of LTIs that occurred contracts and over 200 extension arrangements, 457 Temporary just five years ago. This result reflects of privilege letters to specialists Visas and permanent residency equally pleasing results achieved in and VMOs in the lead up to applications. this year’s Workplace Health, Safety commencement. & Injury Management (WHS&IM) audit which saw significant improvements in WHS&IM compliance across all “standards”.
22 • Calvary Mater Newcastle • review of operations • 2011/2012 Public Affairs and Communications
The Public Affairs and • Organisation and co-ordination of • Managed publicity for the Communications Unit has had Wig Week 2011, The Musical announcement of the new Oncology an interesting and busy year with Nurse Practitioner in conjunction • Production of the hospital’s involvement in a vast range of with Port Waratah Coal Services monthly newsletter Mater Matters hospital and community projects and and Supporters of Cancer and proactive co-ordination of events. The 2012 communications information inserts • Co-ordinated four Department plan has encouraged the exploration Managers’ Forums 2011/12 of Public Relations opportunities • Conducted a community focus both with staff and with our group on hand hygiene The Public Affairs and community. This process provided Communications Manager was • Hospital Hand Hygiene launch – us with the opportunity to conduct appointed to the Community Advisory Clean Hands Poster a SWOT analysis to gauge potential Board in September 2011 and will opportunities and to further • Clean Hands? Tattoo campaign be part of driving new initiatives consolidate the positioning of Calvary promoting hand washing to help in community engagement to Mater Newcastle within the hospital reduce hospital acquired infections consolidate partnerships with the wider community. and community. • Research, editing and co-ordination Our current involvement in many of six published articles in Hunter The Wig Service is a free volunteer internal health care projects, Lifestyle Magazine run service for hospital patients who lose their hair during cancer assistance with education/marketing • Involvement in the Heritage treatment. The service looked after tools and promotional events, has Committee to re-establish hospital approximately 220 patients this year seen the unit have an exceptionally artefacts to their original locations providing each patient with a new wig busy year. and compiled a work plan for future and professional fitting. We are pleased to have had the room naming The service has a high standard of opportunity to be involved and • Co-ordination of Hospice care and an outstanding reputation provide input to a number of hospital Community Arts Program activities and projects throughout within the community and has the year. We have provided expertise • Assistance with the organisation inspired some private hospitals to to many departments assisting with of the 2011 Celebration of Service found their own service for privately creative strategies, compliance to Awards insured patients. hospital brand and assistance with • Co-ordination and involvement The Wig Service is ably run by co-ordination to deadline. of hospital events – International volunteers Kim Rossi and Margaret We have enjoyed our involvement with Nurses Day, World’s Greatest Bottrill who were proud finalists in this staff and departments throughout the Shave, Dry July 2011, Multi-Cultural year’s Hunter New England Health year and the opportunity to assist in Health Week, Mini-Fields of Women, Achievement Awards. We thank both achieving successful outcomes for Look in our Backyard photography Kim and Margaret for their continued their projects and promotions. We are exhibition and Auxiliary AGM. support of this service, without pleased to have been involved in the • Management of all hospital media their time this service would not be following hospital activities: and promotional press releases possible. • Assistance with the development • Attended six guest speaking The service is further supported by of sponsorship and community engagements and ten cheque the friendly reception and booking fundraising opportunities with the handovers staff, Judy Young and Denise hospital Auxiliary Ashman, who co-ordinate the • Managed the onsite logistics for bookings for this important service. • Organisation of the Hair Ball 2011 two ABC Four Corners reports/ – marking ten years of fundraising productions - ‘The Miracles of This year staff dressed up to the with an end result of raising over Mary McKillop’ and the ‘Forced theme of “Mater, The Musical” with $750,000 during the lifespan of this Adoptions’ issue. And, filming for a many departments giving outstanding event national television commercial ‘What performances in dressing up and Matters’ for Xstrata Coal. singing for patients and staff.
Calvary Mater Newcastle • review of operations • 2011/2012 • 23 It was a significant occasion for the Donors The Harvey Family Bubble and Bling final Hair Ball marking ten years The Spinning Knitwits of community fundraising and The Kahibah Bowling Club and awareness with over 320 guests in Travelling Bowlers The hospital sincerely thanks Calvary attendance at The Civic Theatre, Heffron Employees and Families Mater Newcastle Auxiliary members Newcastle. for their ongoing dedication and Lake Macquarie Soccer Club support of our hospital. Their support The theme was Venetian Carnivale Newcastle Buses and the State enables us to buy hospital equipment and it raised $65,000 for cancer Transit Authority for patient care and comfort and patient care, comfort and research. for this we are most grateful to the The proceeds of the ball went to Beresfield Lioness Club members. assisting the fundraising effort in The KO Surf Classic providing new ‘up-to-the minute’ Calvary Mater Newcastle Auxiliary needed endoscopic and sterilising Charlestown Bowling Club members are appreciated by all equipment and a cancer research hospital staff and we see their Supporters of Cancer grant. fundraising work as being at the core Port Waratah Coal Services of our values and at the provision of We thank the Hair Ball Committee health care services at Calvary Mater and sponsors past and present. The Renee Spice and the Lambton Park Newcastle. We thank each and every Junction Hotel, The Jewellery Affair, Hotel member for their tireless work which Domayne Kotara, Southern Cross Mater Graduate Nurses is indeed outstanding. Ten, Glen Geary and The Good Guys Kotara, Gallerie Fine Jewellery and Jesmond Lions Club We take this opportunity to thank all of our community supporters who volunteer, Maggie Sulman, for her Hexham Bowling Club and Hexham each year have sponsored and made committed work within the Public Social Golf this event possible, enabling us to Affairs and Communications Unit. buy important hospital equipment to Adamstown Rosebud Junior Football Maggie is a volunteer of 20 years and make life easier for cancer patients. Club has a valuable all round knowledge of the hospital, its staff and community. A proud investment is also the grants Cessnock City Council awarded from ball proceeds to our Maggie gives two days each week Mater cancer researchers. Longriders Motorcycle Club to the unit and we thank her for her ongoing commitment. Maggie adds Fundraising and community donations Renae Perry Dance value to the service we provide. continue to be consistent for the UMFA Northern District Branch hospital especially in the areas of oncology and research. We thank Waratah Mayfield RSL Sub Branch the community and the following Hollie Davis donors for their significant donations, kindness and support. Chelle Van Photography
performing within or better than the closed and seven new actions were Quality ACHS rate. recommended.
Calvary Mater Newcastle (CMN) CMN hosted a three day site visit by The Clinical Education and Training staff are committed to ensuring that three ACHS surveyors from the 1-3 Institute accreditation survey was patients receive the best possible November 2011. The survey team conducted on the 8 March 2012. care by striving to continually improve was impressed with the number of CMN was awarded three years patient safety and the processes strategies that are in place to provide accreditation for Junior Medical associated with care delivery. To effective and efficient services and Officer training. During 2011 we were ensure that patients receive the best maximise the services offered within also awarded five years accreditation possible level of care we continue the available resources. for Basic Physician Training by the Royal Australian College of Physicians to monitor, report and benchmark The surveyors reported that there and five years accreditation for a number of indicators that flag the is a strong commitment to the advanced training in medical effectiveness of the care systems. delivery of quality care and services oncology. The Australasian College During 2011/12 CMN reported the throughout CMN and quality of Emergency Medicine, the Royal performance of over 59 clinical improvement is embedded in the Australian and New Zealand College indicators to the Australian Council values and practices. The eight of Radiologists and the Australasian on Healthcare Standards (ACHS) recommendations from Organisation and New Zealand College of and 50 indicators were reported as Wide Survey (Aug 2009) were
24 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Mater Newcastle Auxiliary ‘Cancer Carers’
‘The heart of a volunteer is not I would like to add a special thanks to • Special Occasion Lunches measured in size but by the Jo Pritchard for her tireless effort as • Fashion Parades depth of commitment to make a the Assistant Treasurer. difference in the life of others’. • Coach trips Fundraising success is the result of working as a team. These • Trivia Night The Auxiliary has well and truly results would not have been • Manning the Photo Exhibition at made that commitment this year possible without the assistance Charlestown Square through the values of hospitality, of the following people: healing, stewardship and respect. • Golf Day • Public Affairs and Communications It is with much pleasure that I present Department • Trading stalls at the hospital the Treasurer’s Report for the Ingrid Grenell and Amber Dale • Packing 4,679 kilos of lollies financial year ended 30 June 2012. • Finance Department We are so fortunate to have such This year we entered into a Lynda Evans and Katrina Thornton great Auxiliary members, who $300,000.00 partnership with • David Millington’s team enjoy what we do, what we are Xstrata Coal NSW to purchase Peter, Peter and Peter about and each others company. vital equipment for our operating theatres expediting surgery • Calvary Mater Newcastle staff The financial result for the year procedures for patients. Both ending 30th June 2012 is: • Mental Health staff parties contributed $150,000.00. GROSS INCOME • Kay Woods We are most grateful to Xstrata Coal FOR THE YEAR: $506,168.78 • Hospital volunteers NSW for their commitment as part of EXPENSES: $60,484.80 their Corporate Social Involvement • Our lolly packing friends who assist NET PROCEEDS Program “What Matters”. Like our with the packaging of lollies (known FOR THE YEAR: $445,683.98 Auxiliary, “People Matter to Xstrata”. as quality control experts for their During the year we have purchased self sacrifice in product testing) Well done team members. What a vital equipment for the care and • Continued support from the Bowling great result! comfort of cancer patients. Our Clubs, Muree Golf Club, our total expenditure on equipment families, friends and members of the for the year is $392,182.00, community To our CEO Greg Flint, we assure you with a further commitment of that we will continue with our best Activities this year included: $166,980.00 for equipment effort for the next financial year with orders that have been placed. • Catering at Bowls Days the same spirit as always “being for others”.
Anaesthetists also accredited relevant initiated a number of local projects NSW Ministry of Health benchmarks specialist training programs. including best practice mouth hygiene demonstrate that the hospital of ICU patients and tracheostomy acknowledged and resolved CMN strongly supports continuous care, a hospital wide approach. complaints in a more timely manner improvement methodology and when compared with other facilities. has participated in various NSW Promotion of a patient safety culture Ministry of Health initiatives, and participation in the broader To ensure CMN remains responsive including, the NSW Health Quality reporting and benchmarking activities to community and patient needs, we Systems Assessment, the ongoing of the Little Company of Mary Health continue to actively seek customer Between the Flags DETECT program, Care faculties continues. Five Root feedback by participating in the NSW improving the detection of the Cause Analysis (RCA) investigations Health inpatients, day-only inpatients, deteriorating patient, the REACH were commissioned during 2011/12 emergency non-admitted patients family/carer communication project, to investigate significant adverse and outpatient services satisfaction the Quality Systems Self-Assessment, events and the 12 recommendations surveys. Overall these patients scored the Emergency Department Sepsis have been implemented. our hospital care higher than the state Kills program and the Hand Hygiene average across all aspects of care. A CMN continues to recognise that program. CMN is also actively good result indeed. prompt response to customer participating in the LCMHC Palliative feedback is important. The Little and End of Life Care project and has Company of Mary Healthcare and
Calvary Mater Newcastle • review of operations • 2011/2012 • 25 presentation of information sessions to clinical and administrative staff. This outlines the details of newer requirements for data items, but also to discuss what ‘approved’ systems the various activity can be reported via to meet external reporting requirements and determining how to achieve this. Clinical Coding has also come into higher focus this year as the DRG data derived from the inpatient coding process is increasingly used to assist ABF discussions, and as a unit of measure for reporting hospital performance. It is imperative that we continue to attract and retain a skilled coding workforce, and that across the board the quality of clinical documentation which underpins the coding function continues to improve. Health Information Services Patient Services has been involved in and Information Technology devolving further administrative tasks related to patient movements in the iPM system to some wards, such as Incorporating the following March 2012, much to the delight of the transfer and discharge functions, departments and functions: Health our Surgeons, and the Aria system aimed at improving the timeliness of Information, Clinical Coding, introduced into Palliative Care bed availability data, which in turns Information Technology, Patient services, May 2012, as an extension assists patient flow. A number of Services (which includes Emergency of the already existing Aria Medical data capture and reporting processes Reception, Admission Office, Waiting Oncology/Haematology information have been reviewed and made more List Management, Main Reception, system. efficient, as well as changes to some Switchboard Services), Clinical Information Technology (IT) Disaster roles, which have enabled the most Information (Medical Records), and Recovery Planning (and ability) has effective rosters possible within the Medical Centre (Outpatient) Front been an increased focus as the resources across services. Office/Reception. hospital relies more and more on The frontline services have continued All areas have been extremely busy IT systems and integrity of data to welcome staff, patients and visitors this year supporting the growing to support nearly every aspect of alike, albeit in an increasingly busy complexity of services and systems the business. Maintaining an IT environment. Our staff take great across the hospital. Continuing infrastructure which can support the pride in their frontline work with our high patient activity levels, and the growing demand for storage of data patients and visitors. ongoing development of electronic and connectivity with wider services health record systems, have resulted will remain a challenge for this tightly In the Clinical Information Department in a number of significant challenges budgeted service. increased workloads have also for staff, many of which will continue been well accommodated. Priority Another significant area of change for some years to come in varying workloads have continued to flow and increased focus for our services ways and degrees. well generally, due to a dedicated and has been and will continue to be in flexible team approach by those staff The skill sets and dedication of staff the area of patient activity reporting, to their daily work. A high priority area in all areas is to be commended. due to the NSW Ministry of Health for management of this service is to Covering priority aspects of multiple implementation of Activity Based continue to work through the dilemma roles at times, being asked to Funding (ABF) models. If Calvary of how to move the hospital to overall take on new ways of doing things, Mater Newcastle is to receive its fair reliance on electronic documentation and adapting to an ever changing share of the available health budget and results, rather than requiring the environment, have become nearly it must be as well aligned as possible paper copies as well. The transitory second nature to many of our staff. to submit high quality data for all environment of electronic health aspects of activity. New computer systems implemented records (EHR) development, which during the year have included the The increased focus on non-inpatient is incremental and taking overall ProVation Endoscopy Information data collection and reporting has a number of years, has certainly System introduced into the theatres required the development and increased the complexity of access to clinical information.
26 • Calvary Mater Newcastle • review of operations • 2011/2012 Nutrition and Dietetics
Providing nutrition support for Nutrition Care Committee. To date rely on a feeding tube for nutrition patients at nutrition risk is core activities such as observational audits support. Meeting the costs is a business for dietetics. In 2011/2012 of the meal time environment, audits challenge for patients and we are the dietetics service was involved of nutrition screening and assessment thankful to the Port Waratah Coal in the care of over 2,350 inpatients practices and evaluation of the Services for donating $2,000 from its and 2,100 oncology outpatients, with hospital menu have been undertaken. employee donations program to aid nearly 8,300 occasions of service those experiencing financial hardship With the support of University combined. Each day there are during illness. Ongoing support from 40-55 hospitalised patients whose of Newcastle dietetic students, the hospital through the co-payment nutrition care is managed under a the department has been able to model remains a much valued part of dietician. The most common nutrition undertake needs assessments where the support we offer these patients. diagnoses being inadequate oral service gaps have been identified. The department is active in research intake (27%) and malnutrition (24%). Projects such as ‘continuing care for head and neck cancer patients and quality activities; an example being the collaboration with the The NSW Nutrition Care Policy was following radiation or chemo-radiation released in December 2012 with the Department of Psychiatry in the EAT (2011)’ and ‘an evaluation of current main objective to identify and support project, an NHMRC funded clinical dietetic services in the chemotherapy patients at risk of malnutrition. A psychology research study looking overnight treatment unit (2012)’ give strategic approach to provide a team at enhancing the counselling skills of us much needed information. base approach to nutrition care is dietitians in providing nutrition advice being put in place and co-ordinated Our staff continues to do a great for head and neck cancer patients to through the Calvary Mater Newcastle job advocating for patients whom achieve better outcomes.
Pharmacy
Throughout 2011/12 the Calvary Medication Safety initiatives and postgraduate students from University Mater Newcastle Pharmacy retained participates in the periodic audits of Newcastle. The introduction of its patient focus through quality associated with the National the University of Newcastle’s Masters activities aimed at both improving Medication Chart. in Pharmacy course has generated patient outcomes and contributing a large teaching commitment for all In 2011/12, Calvary Mater Newcastle to the most cost effective use of pharmacists and we are responsible Pharmacy has collaborated on a resources. This result is achieved for supervising students from both number of projects with the University through the commitment and years on a rotating basis. In addition, of Newcastle and NSW TAG. These teamwork demonstrated by all the pharmacy accepted student projects include: members of the Pharmacy. pharmacists from the University of The pharmacists are involved in: 1. Education of Junior Medical Sydney and Queensland University Officers with respect to how to this year. • Counselling patients/patient carers maximise the use of the admission about medications The outsourcing of targeted medication history form with the view chemotherapy commenced in August, • Working with clinicians to ensure of optimising patient care 2011. Its introduction, whilst freeing the quality use of medicines within 2. Participation in a pilot project up some pharmacy compounding the hospital aimed at improving prescription time, has resulted in an increased • Delivering medication-oriented talks writing. Pharmacists conduct regular workload with respect to clinical to specialist interest groups within tutorials with final year medical pharmacists’ management of the the community students on a ‘one on one’ basis. chemotherapy prescription writing Staff members actively participate The aim of this project is to determine process. the resources required to maintain in hospital, area wide and national The oncology and haematology this educational component on an committees, specialist clinical teams pharmacy staff continue to and numerous clinical trials. ongoing basis. work with Hunter New England The pharmacy maintains its The pharmacy continued its role in Information Technology Support and involvement in the National student education by supervising Development Department on the
Calvary Mater Newcastle • review of operations • 2011/2012 • 27 electronic chemotherapy chart (the ARIA project). The ARIA system Speech Pathology is proving beneficial to all users (doctors, nurses, pharmacists, clerical and administrative staff) The last year has been a particularly project this year has looked at the and is being rolled out into other busy one, with unprecedented referral process to speech pathology, hospital departments. numbers of inpatient referrals as resulting in more appropriate and well as some staff changes. The accurate referrals, and improved Four Calvary Mater Newcastle Calvary Mater Newcastle/University of workflow. We have also participated Hospital pharmacy technicians Newcastle Speech Pathology Student in the organisation of the HNELHD are currently undertaking a Unit continues to function well, with Speech Pathology Stroke Education Certificate 3 course In Hospital/ funding apparently continuing over Day. Health Services Pharmacy the next few years. Support. Grants from NSW State Revision of the Speech Pathology Current evidence is an important Tracheostomy Management policy, Training Authority were allocated focus for our department, and has as well as the development of to the technicians to facilitate this been well supported by participation some safe working practices, has undertaking. in the NSW Speech Pathology underpinned our involvement in the Evidence Based Practice Group. Calvary Mater Newcastle multidisciplinary tracheostomy team. Our department was responsible pharmacists attended a number The department has been heavily for organising the teleconference of SHPA courses this year to involved in the activity of this group, to enable local speech pathologists looking at tracheostomy education consolidate their knowledge in a to participate in the end of year and management across the hospital. range of pharmacy practice areas summation for this statewide group. and which they are able to apply to We are very grateful to the LHD Over the coming year, the department their clinical practice at the Calvary Library Service which helps us to is looking forward to developing Mater Newcastle. quickly source articles for this group’s a service to improve swallowing activities. The pharmacy remains committed outcomes for Radiation Oncology in its support for medical research In a recent initiative with medical patients, as well as continued involvement in the Head and Neck and is actively involved in more imaging, the department has now Cancer Support Group. We also than 50 trials. A Clinical Trials been able to record Modified Barium Swallow reports on CAP. This means hope to improve consistency of pharmacist position was approved that results are more readily available diet textures for dysphagic patients and successfully recruited in early to other clinicians to allow improved through further education of catering 2012. This person has already quality of care. Another important staff. made a positive impact on the management of clinical trials from a pharmacy perspective.
Physiotherapy
The Physiotherapy Department clients throughout the Local Health The Physiotherapy Department has been conducting a review of District and support to therapists is continuing to promote cancer lymphoedema services across Hunter throughout the region. services through presentation of lectures and tutorials to New England Local Network and Calvary Mater Newcastle in physiotherapy students at the provided a report to the Area Cancer conjunction with the University of University of Newcastle on the role of Network on the strategies needed Newcastle has established a full time ‘physiotherapy in cancer care’. to improve services for all clients student education unit in acute care needing lymphoedema management. with funds made available by the The department continues to support A priority list has now been developed Federal Government (HWA program). education within the hospital and to to be utilised, should funds become Funding has been approved for two patient support groups with assisting available. Calvary Mater Newcastle years and the unit has improved in programs such as the Leukaemia physiotherapy service continues to patient care and timeliness of Foundation Lymphoma Day and the provide lymphoedema services to services at the hospital. Breast Centre Support Group.
28 • Calvary Mater Newcastle • review of operations • 2011/2012 Occupational Therapy
Throughout the year, the and feedback is very positive. Gold Coast in August 2011, and the Occupational Therapy Department Whole Body National Symposium held The ‘Meditation Group’, for oncology has continued to provide a range of in Sydney during March 2012. patients and their carers has services across the hospital as well continued to meet weekly and has As a profession, occupational therapy as participating in quality activities constantly received positive feedback has now achieved full national AHPRA and student supervision. from all those who have participated. registration status. This came into The oncology loan pool has provided This group is facilitated jointly by effect on 1 July 2012. aids for daily living to many hospital occupational therapy and social work patients to help them and their and has been meeting weekly for Several undergraduate students families manage serious illnesses about 14 years, a long term resource completed clinical placements in the in their own home environment. for our patients which has been of Occupational Therapy Department Expansion of this service continues great value to many. throughout the year, and our staff to be a goal of the occupational have been participating in developing Staff have continued their therapy staff, especially in the area of learning modules for the occupational professional development throughout pressure care management. therapy program at the University of the year with attendance at Newcastle. The Auxiliary has been very conferences, in-services and local supportive of the loan pool and education days. Occupational Occupational Therapy Week was in June 2012 paid for six new therapy delegates attended both the celebrated in October 2011 with an wheelchairs. This equipment Australasian Allied Health and Nursing early morning breakfast and health donation is appreciated by patients SmartStrokes conference held at the promotion in the hospital foyer.
Calvary Mater Newcastle • review of operations • 2011/2012 • 29 Guest Speaker: • NSW Leukemia Foundation Annual Remembrance Service A highlight of this year was the inaugural Pastoral Care Week dinner, organised and sponsored by the local branch of our professional association Spiritual Care Australia, in which we hold two executive positions. The celebratory dinner was attended by 80 people from the pastoral care and wider community, with guest speaker Mr Peter Mitchell, author of ‘Compassionate Bastard’. The focus of the presentation was Peter’s reflections on the needs and experience of refugees, the personal Pastoral Care and professional choices in a constantly changing political context. Of recent concern has been our The last 12 months have presented Presentations in Educational capacity as a department to provide the Pastoral Care Department with forums. Workshops/seminars: a service to the many hundreds of many and varied opportunities to • Medical oncology forum psycho/ outpatients who receive treatment at engage the wider community in spiritual/social needs of patients/ the hospital each year. In September conversation about our work as families 2011 we initiated a monthly morning health care professionals in caring tea in the NBN Telethon Villa Units for people who are ill. This has been • Radiation oncology presentation on for residents to meet one another, both challenging and satisfying pastoral care services to have the opportunity to build a and has resulted in our work being • Presentation to the Emergency sense of community and to access acknowledged as being at the Department - End of Life Care in the support and care of pastoral care. forefront of pastoral care. ED; Self Care for nursing staff These morning teas have quickly Staff have been involved in specific • CUEHL Ethics Forum - End of Life established themselves as a vital part education programmes such as: Care of the residents feeling settled and • Clinical Pastoral Education connected as they begin and endure • Palliative Care Volunteers, NSW (Introductory and Basic Units) often long and at times difficult Conference – presentation Loss and -supervisor and presenter radiation therapy treatments, a long Grief way from home. • RN Certificate in Palliative Care - • Maitland Palliative Care Volunteers presenter An invitation to past participants of education session - Spiritual Care at bereavement support groups (five • Cert IV in the Palliative Approach - End of Life groups held from July 2010) to a presenter • Catholic Diocese of Maitland- gathering to reconnect, resulted in • PEPA education days - presenter Newcastle Secondary School stories of healing and transformation, Teachers’ Professional Development of new and varied challenges as their • New Graduate Nurses Education Day – presentation Pastoral Care in experience of life and grief continues. CMN - presenter the context of Australian Spirituality Deep gratitude was expressed by • University of Newcastle Medical many for the invaluable support the • Catholic Health Australia Students (yrs1-5) - specific units original group, of which they were Conference - presenter: Fewer palliative care members, provided. Clergy – Pastoral Care for the • University of Newcastle Future Media: Occupational Therapy Students • Diversity, Harmony and Respect •‘Behind the Curtain’ article in Hunter (yr 4) - Palliative Care Unit Public Forum, Palliative Care Week Lifestyle magazine MC and presentation ‘Dying at •Catholic Health Australia Webcast Home’ – the story of an elderly series: Mission in Focus - ‘Pastoral Chinese Australian Care as expression of Mission’
30 • Calvary Mater Newcastle • review of operations • 2011/2012 and other agencies to access bereavement resources in all clinical Social Work services. areas of the hospital. Social work staff have continued Social work staff continue to provide The members of the Social Work to provide representation of the assistance to the NSW Cancer Department continue to provide a department, allied health and the Council in the training of volunteers comprehensive social work service hospital on a range of committees working in the NSW Cancer Council to patients and their families/carers both within the hospital and with a Information Centre. range of community groups including: across all clinical areas. Funding for Social workers are actively Social Work in Aged Care, Social an Adolescent and Young Adult (AYA) involved in facilitating a range Workers in Emergency, HNE Stroke cancer service enabled us to recruit of group programmes within the Interest Group, Newcastle Domestic an additional Social Worker to work hospital including: Cancer Support Violence Committee, Haemophilia as part of this team. Group, Head and Neck Cancer Social Workers and Counsellors Support Group, Meditation Group, Social Work staff work with the group, Clinical Oncology National Bereavement Walking Group and medical, nursing, allied health Oncology group, COSA Neuro the Falls Management Programme. and support staff of the hospital Oncology Group and Cancer Council Support is also offered to the to provide a multidisciplinary Regional Advisory Committee. approach for patient care. Social Newcastle Mater Prostate Cancer workers in particular are responsible Staff have also contributed to a Support and Education Group and for attending to emotional and range of workshops and forums, by the Brain Tumour Support Group. participating in organising committees psychosocial needs of patients and The Head and Neck Cancer Support and presenting papers. Staff have carers/families. Social work staff Group, a joint initiative of social been active in the development and provide assessment, individual and work, speech pathology and dietetics updating of resources including: group programmes and services. commenced in October 2010. input in the development of patient These may include direct counselling The group would like to gratefully resources for those living with related to dealing with adjustment acknowledge the donation received malignant brain tumours, paediatric issues, trauma, grief and loss, the from the family of Stephen Raw to be guidelines in radiotherapy, resources provision of specialised meditation used for educational resources for to assist in the care of patients who and support group programs, this group. discharge planning, social support have suffered strokes, resources for services, advocacy with government patients who have a dementia, and
Calvary Mater Newcastle • review of operations • 2011/2012 • 31 Mission
Our mission is to bring the healing learn about Mary’s extraordinary life. significant people in the Hospital’s ministry of Jesus to all those who To coincide with the birthday of Mary history and the relocation of six are sick, dying and in need through Potter (22 November 1847), a Mass original foundation stones to the staff ‘being for others’. This is the reason was celebrated in the Mary Potter recreation area to be used as seating. why we exist and it is central to Chapel. This was followed by a staff Further heritage projects are planned all of our activity at Calvary Mater BBQ. for 2013. Newcastle. Mission provides us Since its foundation by the Sisters Mission integration is an important with the focus and direction so that of Mercy in 1921, the Hospital has component of life at Calvary Mater we are able to provide the range of become a significant landmark in Newcastle. The Orientation of new services that meet the needs of the the Newcastle region with a strong staff includes a mission and values community. All staff are witnesses to tradition of providing compassionate session that introduces the staff mission through their engagement care to the community. This tradition to Little Company of Mary Health with our patients, family members has continued following the transfer Care and our values. The session and visitors as well as through their of ownership to Little Company of includes a short DVD presentation relationships with their colleagues. Mary Health Care in 2006. Mission and an interactive segment which Thus mission is exemplified by the is an integral part of who we are and provides staff with the opportunity commitment and action of each staff to celebrate this, a series of projects to discuss the values and to ask member in living out our values of have been underway, which highlight questions. Over 90% of staff found Hospitality, Healing, Stewardship and various aspects of the Hospital’s the session to be educational and Respect. history and some of the people who informative. As respect is one of Venerable Mary Potter was the have played an important role in it. the cornerstone values of Little Foundress of Little Company of The projects include: Duplicating the Company of Mary Health Care, a Mary in 1877 and it is her legacy heritage display panels on level 3 on number of workshops have been held that LCM Health Care continues to the wall near the hospital’s southern with staff on Respectful Behaviours emulate. To help staff appreciate the entrance on level 2; ensuring the in the Workplace. The objective of significance of Mary Potter and her regular cleaning and maintenance of the workshops was to assist staff vision, philosophy and dedication, an the statues of Mary and Bernadette to develop a range of practical insight into her life story is provided in the Level 3 Garden; developing strategies which encourage them to all staff each Monday via email. a list for the naming of courtyards, to demonstrate our values to their Staff appreciate the opportunity to meeting rooms and gardens after colleagues in their work areas.
Volunteers It has been a challenging but that for the first time we have some have had an earlier experience of our rewarding year for our volunteers volunteers with particular skills hospital through an illness to a family who have worked extremely hard providing assistance in areas that member. So they just “want to give throughout the hospital and in the have previously not had this type back” because they had witnessed hospice. Volunteers hours including of support. For example we now the care given to their loved one by Cancer Council Volunteers, CMN have a volunteer with a ‘mechanical’ hospital staff. Auxiliary and CMN Volunteers totalled background who will be able to keep During Volunteer Week each of 16,500 this year! Some of our long our OT equipment in tip top condition. our volunteers was presented serving volunteers retired while others Also, for the first time under new with a Certificate of Appreciation needed to take lengthy leave due to regulations all of our volunteers are for contribution at Calvary Mater illness. However, others have stepped now required to attend mandatory Newcastle. into the breech. training every twelve months in Fire and Evacuation, Manual Handling and Our annual volunteer Christmas Recruitment commenced in CPR. party held on 9 December was an February for some new volunteers. occasion for us to say thank you to After a period of intensive training, It is always important that we all our volunteers for the wonderful particularly in the areas of grief, demonstrate to our volunteers just contribution they make to our hospital bereavement, communication and how much we appreciate their efforts. through their compassion and love boundaries, interviews were held They give up many hours of their time for our patients, families, carers and and an additional fifteen volunteers each week to care for our patients. staff. have been chosen to work across A common motivation for people the hospital. How fortunate we are wishing to volunteer is that many
32 • Calvary Mater Newcastle • review of operations • 2011/2012 Community Benefit
As our mission is to bring the healing ministry of Jesus to those who are sick, dying and in need through ‘Being for Others’. Thus, our Community Benefit Program is closely tied to the work begun by our founder Mary Potter in supporting those in the community who are identified as disadvantaged or most in need. Some of our activities this year included: Provided wigs to our patients who had lost their hair as a result of their cancer treatment. The wigs help to raise the patients’ self-esteem and self-confidence and allows patients freedom to be able to do many of the things that we take for granted including shopping, visiting friends and once more feeling part of society. Provided subsidised accommodation in McAuley Lodge Support Services and NBN Telethon Villas for patients from remote rural and regional areas who are required to come to Over the past 12 months, the as the Hair Ball and the Volunteer the hospital for prolonged cancer Support Services Team (group three Christmas Party. We also enjoy treatment. Without this assistance maintenance) has been responsible setting up, cooking and serving at many would be unable to make the for the following: staff BBQs. journey and their health would suffer Test, tag, repair and maintain all Support Services is responsible for further. Calvary Mater group three electrical the hospital car fleet. We attend to We established a relationship with appliances the administration and management Penola House which is a drop-in General repairs to patient oxygen, air duties of the fleet, general car centre for newly arrived Somali and and suction equipment care, flat batteries, transportation, Sudanese refugees. Penola House punctures and pick up and deliveries. is run by a Sister of Mercy and a Removal, relocation and disposal Dominican Sister. It is staffed by of all Calvary Mater Newcastle A highlight this year has been our volunteers who provide lessons redundant equipment involvement in halving the cost in English, computer literacy and associated with replacing hospital living skills to assist the refugees Going off site to test, tag and repair bed mattresses by organising to gain some kind of employment. palliative care outreach beds at purchasing of new covers instead Calvary Mater Newcastle applied Farragher’s Removalists Cardiff and in of purchasing new mattresses. Our for an Optus Grant on behalf patient’s homes. We pride ourselves team has been responsible for on this aspect of our personal home of Penola House to assist the fitting the new covers to the existing care support for our patients and children of the refugees deal with mattresses that can be re-covered. issues that they face in making staff. the transition to life in Australia. Our team has been kept very busy The maintenance team enjoys great We hope to assist the refugees in this year and they are an important relationships with the hospital’s 2013 by providing volunteer/work part of the day to day running of auxiliary and staff, and assists the experience opportunities in areas of Calvary Mater Newcastle. We enjoy efforts involved in holding events. We the hospital. the interaction with staff and patients set up for various hospital functions and the team takes great pride in the In respect of our patients who die throughout the year including work we do for the hospital, its staff, in poverty we provided a number of Celebration of Service, Auxiliary lollies visitors and patients. funerals for those patients who died and craft promotions, staff events, in our hospital. Daffodil Day, and off site events such
Calvary Mater Newcastle • review of operations • 2011/2012 • 33 Year in Review
34 • Calvary Mater Newcastle • review of operations • 2011/2012 Activity & Statistical Information
2011/12 2010/11 ADMITTED PATIENTS
Total Admissions (includes Same Day) 15456 14123 Same Day Admissions 5028 4298 Average Length of Stay of Admitted Patients 3.9 4.4 Bed Occupancy Rate 94% 93%
Number of Operations 3193 3206
EMERGENCY DEPARTMENT
Number of Attendances (includes admits) 32095 30627 Number of Admissions via Emergency 10416 9309
OUTPATIENT SERVICES 291431 275241 Major Categories Medicine 14946 13728 Surgery 18927 15726 Medical Oncology 37142 34385 Radiation Oncology 64608 64039 Haematology 16652 16658 Palliative Care 14801 14058 Allied Health 40930 41601 Other Services 83425 75046
Total Staff Employed 30 June 930 871
Calvary Mater Newcastle • review of operations • 2011/2012 • 35 Research
A Message from the Research Committee
Calvary Mater Newcastle (CMN) donations from family and friends The Committee would also like to Research Committee acts as of our patients, as well as specific welcome the following new members a representative of all CMN fundraising through the hospital’s and recognise their important researchers, providing a means of ‘Wig Week’, local support from the contributions to the committee: disseminating information and offering Coalfields Cancer Support Group, Prof Michael Nilsson, support for research activities. One and ongoing bequests established Director of HMRI. of the goals of the committee is to in the memory of Margaret Mitchell, showcase and promote the vast Jane Reid Harle and James Lawrie. Dr Jane Maguire, array of outstanding research being This has resulted in the awarding of School of Midwifery and Nursing, conducted by CMN staff. To this $140,634 in research and equipment Academic Nursing Representative end the committee has successfully grants for 2012. Ms Susan Goode, introduced a list of current research The Committee would like to thank Hunter Translational Cancer Research projects and researcher biographies the following members whose Unit (HTCRU) Representative on the hospital Intranet, and is valuable and much appreciated (newly created position) negotiating to do the same on the contributions came to an end during LCM internet website. 2011/2012: The main responsibility of the Professor Maree Gleeson, Committee is to oversee the annual Director of HMRI. awarding of research funding through the various CMN funding Dr Krystyna Cholowski, Dr Lisa Lincz schemes. These programs continue School of Midwifery and Nursing, Chairperson to be supported by generous Academic Nursing Representative
36 • Calvary Mater Newcastle • review of operations • 2011/2012 RESEARCH GRANTS “Development of a novel targeted therapy for the 3. D’Amico, A.V., Chen, M.-H., Crook, J., treatment of breast cancer” Armstrong, J.G., Malone, S., Steigler, A., Dunne, Calvary Mater Newcastle Research Committee M., Kantoff, P.W., Denham, J.W., Duration of Dr Kerrie Clover, Conjoint Prof Gregory Carter, (CMNRC) received 11 applications for funding in short-course androgen suppression therapy and Dr Ben Britton Psycho-Oncology 2012. Ten of these were requests for project grant the risk of death as a result of prostate cancer, funding (requesting a total of $256,912 from a pool “Calibrating commonly used questionnaires for (2011) Journal of Clinical Oncology, 29 (35), pp. of $147,000), and 2 were eligible for equipment depression and anxiety in oncology to enhance 4682-4687. funding (requesting a total of $15,108 from a pool of comparability and communication of outcomes” $43,000 from the Coalfields Cancer Support Group 4. D’Amico, A.V., Chen, M.-H., de Castro, M., Fund). A total of $125,562 in project and $15,108 in Margaret Mitchell Grant Fund (MM) Loffredo, M., Lamb, D.S., Steigler, A., Kantoff, equipment grants were awarded. Three projects were Katherine Clark, Ian Whyte, Naomi Byfieldt - P.W., Denham, J.W., Surrogate endpoints eligible for the James Lawrie Grant ($68,000); 1 was Palliative Care for prostate cancer-specific mortality after recommended for full funding, 2 for partial funding. radiotherapy and androgen suppression therapy “A pilot study of pyridostigmine in cancer patients with in men with localised or locally advanced prostate Overall, only 2 applications received full funding, while constipation and high anticholinergic loads”. cancer: An analysis of two randomised trials, 6 received partial funding as they were considered Jane Reid Harle Memorial Grant Scheme (JRH) (2012) The Lancet Oncology, 13 (2), pp. 189- to be either over budgeted or requests to fund items Cathie Milton - Haematology Nursing 195. that were not considered appropriate according to the Terms of Reference for the granting schemes. Only “Development, implementation and evaluation of 5. Denham, J.W., Lamb, D.S., Joseph, D., one Margaret Mitchell grant of $8,500 was awarded, a nurse led intervention model where Peripherally Matthews, J., Atkinson, C., Spry, N.A., and one grant that addressed all cancer types was Inserted Central Catheters (PICC) devices are used Duchesne, G., Ebert, M., Steigler, A., D’Este, funded equally from three separate schemes. instead of Central Venous Catheters in haematology C., Another form of subgroup to beware, (2011) patients in both the inpatient and outpatient setting at Radiotherapy and Oncology, 101 (3), pp. 525- Three applications were deemed unsuitable for Calvary Mater Newcastle” 526. funding, thus there remains $27,892 in the Coalfields equipment fund, $2,211 in the Wig Week, $11,516 in Dr Kerrie Clover, Conjoint Prof Gregory Carter, 6. Denham, J.W., Targeted therapies: An important the Jane Reid Harle, and $6211 in the James Lawrie Dr Ben Britton - Psycho-Oncology piece of the localized prostate cancer puzzle?, fund that was not awarded and will be held over for (2011) Nature Reviews Clinical Oncology, 8 (10), “Calibrating commonly used questionnaires for allocation in a future year for a suitable grant. pp. 573-574. depression and anxiety in oncology to enhance All grants were independently reviewed and ranked comparability and communication of outcomes” 7. Dowling J, Lambert J, Parker J, Salvado O, by three assessors, all of whom were external from Fripp J, Capp A, Wratten C, Denham JW., Greer James Lawrie Grant Fund (JL) the CMN Research Committee. In addition, the three PB, An Atlas-Based Electron Density Mapping Joel Parker Radiation - Oncology James Lawrie grant applications were also assessed Method for Magnetic Resonance Imaging (MRI)- Alone Treatment Planning and Adaptive MRI- by a Head and Neck Cancer specialist. None of the “Does a specific radiotherapy MRI reduce the amount Based Prostate Radiation Therapy, Int. J .Radiat. assessors were listed as investigators on any of the of normal tissues receiving unnecessary and harmful Oncol. Biol. Phys. 83(1): e5-e11, 2012 grant applications. All assessors agreed on the final doses of radiation through improved identification of rankings and determined the allocation of funds target volumes + organs at risk for radical head and 8. Dowling JA, Fripp J, Chandra S, Pluim against the individual bequest criteria. neck radiotherapy planning ?” JPW, Lambert J, Parker J, Denham J, Greer PB, Salvado O, Fast automatic multi-atlas The Research Committee would like to acknowledge Dr Kerrie Clover, Conjoint Prof Gregory Carter, segmentation of the prostate from 3D MR image and thank the assessors for their time and Dr Ben Britton – “Psycho-Oncology Calibrating Lecture Notes in Computer Science (including commitment to providing expert scientific reviews commonly used questionnaires for depression and subseries Lecture Notes in Artificial Intelligence and invaluable advice for funding distribution. anxiety in oncology to enhance comparability and and Lecture Notes in Bioinformatics) 6963 communication of outcomes” LNCS, pp. 10-21, 2011 Allison Fraser, Cathy Odelli - Nutrition and Successful Project and Equipment 9. ebert MA, Harrison KM, Howlett SJ, Cornes D, Dietetics Grants awarded for funding by CMNRC Bulsara M, Hamiton CS, Kron T, Joseph DJ, in 2012 “Retrospective review of prophylactic Percutaneous Denham JW, Dosimetric intercomparison for Coalfields Cancer Support Group (CCS) Endoscopic Gastrostomy (PEG) placement in patients multicenter clinical trials using a patient-based Madhu Garg, Dr Jayne Gilbert, Dr Jennette undergoing chemoradiation for head and neck anatomic pelvic phantom, Medical Physics, Sakoff - Medical Oncology cancer”. 38(9), 5167-5175, 2011.
“Cold Storage Equipment essential for smooth and 10. fuangrod T, O’Connor DJ, McCurdy BMC, Greer PB, Development of EPID-based real-time dose reliable operation of oncology laboratory research DEPARTMENTAL RESEARCH projects” dose verification for dynamic IMRT, Proceedings RADIATION ONCOLOGY and of World Academy of Science, Engineering and Cathie Milton - Haematology Nursing MEDICAL PHYSICS Technology 80: 609-612, 2011
“Development, implementation and evaluation of Journal Articles 11. Galvão, D.A., Taaffe, D.R., Cormie, P., Spry, a nurse led intervention model where Peripherally N., Chambers, S.K., Peddle-McIntyre, C., Inserted Central Catheters (PICC) devices are used 1. Chandra S, Dowling J, Shen K, Pluim J, Greer P, Baker, M., Denham, J., Joseph, D., Groom, G., instead of Central Venous Catheters in haematology Salvado O and Fripp J, Automatic Segmentation Newton, R.U., Efficacy and safety of a modular patients in both the inpatient and outpatient setting at of the Prostate in 3D Magnetic Resonance multi-modal exercise program in prostate cancer Calvary Mater Newcastle” Images using Case Specific Deformable patients with bone metastases: A randomized Models, IEEE Transactions on Medical Imaging controlled trial, (2011) BMC Cancer, 11, art. no. Wig Week Grant Fund (WW) (accepted), 2012 517, Judy Holland, Pauline Chiarelli – Physiotherapy 2. Chandra, S., Dowling, J., Kaikai Shen, Pluim, 12. Grand M, O’Brien P. Obstacles to participation “Testing a new intervention to reduce bladder and J., Greer, P., Salvado, O., Fripp, J., “Automatic in randomised cancer clinical trials: a systematic bowel problems following radiation therapy and Segmentation of the Prostate in 3D Magnetic review of the literature. J Med Imag Radiat hormone treatments for early prostate cancer” Resonance Images Using Case Specific Oncol. 56:31-39, 2012 Jennette Sakoff, Dr Jayne Gilbert - Medical Deformable Models,” Digital Image Computing 13. Gustafsson H, Vial P, Kuncic Z, Baldock C, Oncology Techniques and Applications (DICTA), 2011 International Conference on , vol., no., pp.7-12, Denham JW, Greer PB, Direct dose to water 6-8 Dec. 2011
Calvary Mater Newcastle • review of operations • 2011/2012 • 37 dosimetry for pre-treatment IMRT verification EPID in direct detection configuration, Phys.Med. Calvary Mater Newcastle - James Laurie Research using a modified EPID, Medical Physics, 38(11): Biol., 57: N295–N306, 2012 Grant. 6257-6264, 2011 Parker J, Wratten C, Tang C, Kumar M. 27. sethukavalan P, Cheung P, Tang CI, et al: Patient Does a specific radiotherapy MRI reduce the amount 14. Harrison K, Ebert MA, Kron T, Howlett costs associated with external beam radiotherapy of normal tissues receiving unnecessary and harmful SJ, Corned D, Hamilton CS, Denham JW, treatment for localized prostate cancer: the doses of radiation through improved identification of Design, manufacture, and evaluation of an benefits of hypofractionated over conventionally target volumes + organs at risk for radical head and anthropomorphic pelvic phantom purpose-built fractionated radiotherapy. Can J Urol 19:6165-9, neck radiotherapy planning? for radiotherapy dosimetric intercomparison, 2012 ($50,000) Medical Physics. 38, 5330 (2011) 28. singh J, Greer PB, White MA, Parker J, Tang Continuing Grants 15. Herschtal A, Kron T, Faroudi F, Eade T, Greer C, Capp A,, Wratten C, Denham JW, Treatment PB, Finding the optimal statistical model to related morbidity in prostate cancer: A NHMRC Project Grant describe target motion during radiotherapy comparison of 3DCRT with and without Image JW Denham, A Steigler delivery - a Bayesian approach Phys Med Biol, guidance using implanted fiducial markers, Int. J Optimal duration of neo-adjuvant androgen 57(9): 2743-2755, 2012 .Radiat. Oncol. Biol. Phys. (accepted), 2012 deprivation therapy in localised prostate cancer 2007-2011, $399,565 16. King BW, Clews L, Greer PB, Long-term two- 29. tang CI, Sethukavalan P, Cheung P, et dimensional stability of EPIDs used as part of al: A prospective study on pain score with NHMRC Project Grant regular linac quality assurance, Australas. Phys. transperineal prostatic gold seed fiducial JW Denham, D Joseph, G Duchesne, J Ball Eng. Sci. Med., 34(4): 459-466, 2011 implantation under local anesthetic alone. Can Value of androgen deprivation and bisphosphonate Urol Assoc J, 2012. http://dx.doi.org/10.5489/ therapy in patients treated by radiotherapy for limited 17. King B, Morf D, Greer PB, Development and cuaj.11225 prostate cancer testing of an improved dosimetry system using 2007-2011, $2,403,440 a backscatter shielded electronic portal imaging 30. wilcox, C., Kautto, A., Steigler, A., Denham, device, Medical Physics, 39(5): 2839-2847, J.W., Androgen deprivation therapy for prostate NHMRC Project Grant 2012. cancer does not increase cardiovascular mortality P. Greer, J. Denham, C. Baldock and Z. Kuncic in the long term , (2012) Oncology, 82 (1), pp. Investigation of a new imaging device for radiation 18. Quon H, Loblaw DA, Cheung PC, Holden L, Tang 56-58. therapy dose delivery verification C, et al: Intra-fraction Motion during Extreme 2009-2011, $393,411 Hypofractionated Radiotherapy of the Prostate using Pre- and Post-treatment Imaging. NHMRC Project Grant Clin Oncol (R Coll Radiol), 2012 doi:10.1016/j. Research Grants A. Fielding, B. Burmeister, P. Metcalfe, P. Greer, P. clon.2011.12.001 New Grants Evans and J. Trapp Improving patient outcomes of radiotherapy 19. rowshanfarzad P, Sabet M, O’Connor DJ, Greer NHMRC Project Grant treatments PB, Impact of the backscattered radiation from F Faroudi, A Herschtal, T Eade, T Kron, D Ball, PB 2009-2011, $356,375 the bunker structure on EPID dosimetry during Greer arc-IMRT, Journal of Applied Clinical Medical Optimising radiation therapy delivery for cancer NHMRC Enabling Grant Physics, (in press) 2012 patients using daily image guidance to maximize cure D. Ball, P. O’Brien, B. Burmeister, G. Duchesne, D. Joseph, J. Denham 20. rowshanfarzad P, Sabet M, O’Connor DJ, and reduce normal tissue side effects $494,436, (2012-2014) Clinical Trials Resources: Trans-Tasman Radiation McCowan PM, McCurdy BMC, Greer PB. Gantry Oncology Group angle determination during arc-IMRT: Evaluation NHMRC Project Grant 2006-2012 $1,765,000 of a simple EPID-based technique and two Baker A, Carter G, Wolfenden L, Wratten C, Britton B. commercial inclinometers. Journal of Applied Eating As Treatment (EAT):A stepped wedge, Cancer Australia Priority Driven Collaborative Cancer Clinical Medical Physics, (in press) 2012 randomised control trial of a health behaviour Research Grant Ebert MA, Joseph DJ, Haworth A, Denham JW, Spry 21. rowshanfarzad P, Sabet M, O’Connor DJ, Greer change intervention provided by dietitians to improve nutrition in head and neck cancer patient undergoing N, Bydder S, PB, Investigation of the sag in linac secondary Enhanced development of generic digital tools for collimator and MLC carriage during arc deliveries, radiotherapy. ($1,117,558) support of clinical trials and education in radiotherapy Phys. Med. Biol. 57: N209-N224, 2012 2009-2011, $585,750 22. rowshanfarzad P, Sabet M, O’Connor DJ, NHMRC Project Grant Ebert MA, Denham JW Prostate Cancer Foundation of Australia McCowan P, McCurdy BMC, Greer PB, Galvão DI; Newton R, Spry N, Taaffe D, Denham JW Detection and correction for EPID and gantry Assessment of rectal and urinary toxicity from the RADAR prostate radiotherapy trial – dosimetric Population-based exercise intervention for prostate sag during arc delivery using cine EPID imaging, cancer patients Medical Physics, 39(2): 623-635, 2012 constraints for novel symptom clustering, derivation of radiobiological parameters and assessment of patient 2009-2012, $476,024 23. rowshanfarzad P, Sabet M, O’Connor DJ, Greer localisation effects. Cancer Council NSW Project Grant PB, Improvement of Varian a-Si EPID dosimetry $315,224 (2011-2013) L. Ashman, N. Verills, J. Denham measurements using a lead-shielded support- Tetraspanin proteins in prostate cancer progression arm, Med. Dosim., 37: 145-151, 2012. ARC LIEF Grant PJ Keall, M Jackson, A Rozenfeld, M Barton, PB and prognosis 24. rowshanfarzad P, Sabet M, O’Connor DJ, Greer, PJ Vial, C Baldock, P Metcalfe, D Thwaites, Z 2009-2011, $341,000 Greer PB, Isocentre verification for stereotactic Kuncic, L Holloway, S Bose, E Eslick, S Downes. Cancer Council NSW Project Grant radiosurgery/radiotherapy: Review of principles An adaptable and dedicated linear accelerator for PB Greer, BMC McCurdy, C. Baldock, Z Kuncic, JW and techniques, J. Appl. Clin. Med. Phys. 12 (4): medical radiation research Denham 185-195, 2011 $600,000, (2012) Real-time dose monitoring for patient safety in 25. rowshanfarzad P, Sabet M, Barnes M, O’Connor Prostate Cancer Foundation Australia Young radiotherapy DJ, Greer PB. EPID based verification of the Investigator Grant 2010-2012, $360,000 MLC performance for dynamic IMRT and VMAT, J Dowling, PB Greer, O Salvado, P Stanwell Cancer Council NSW Project Grant Medical Physics, (accepted), 2012 Development of high precision MRI based prostate PB Greer, J Dowling, JW Denham, O Salvado, cancer radiation therapy 26. sabet M, Rowshanfarzad P, Vial P, Menk F, Does the initial treatment plan predict doses delivered $300,000, (2012-2014) Greer PB, Transit dosimetry in IMRT with an a-Si to normal tissues during prostate radiation therapy,
38 • Calvary Mater Newcastle • review of operations • 2011/2012 Cancer Council NSW, 11. rowshanfarzad P, Sabet M, O’Connor DJ, the University of Melbourne (Prof Terry O’Brien). The 2011-2013, $349,794 McCowan PM, McCurdy BMC, Greer PB, focus of this team has been the development of novel Detection and correction for EPID and gantry dynamin and clathrin inhibitors for the treatment Cancer Council NSW Project Grant sag during arc delivery using cine EPID imaging, of glioblastoma. This project has secured funding P Vial, Z Kuncic, PB Greer, C Baldock, L Holloway, 12th International Workshop on Electronic Patient from the Cancer Council NSW and of this year M Barton, Imaging, Sydney, Australia, 12-14 March, 2012. the NHMRC. Numerous small molecules are now A next generation detector for radiotherapy treatment undergoing animal orthotopic xenograft studies to verification with dual capability for simultaneous 12. sabet M, Rowshanfarzad P, Menk F, Greer determine efficacy. We have also recently discovered imaging and dosimetry, Cancer Council NSW, PB, A simple method for EPID transit dosimetry a group of small molecules that selectively kill ER+ve 2011-2013, $336,125 measurements, 12th International Workshop on breast cancer cell lines while having little to no effect Electronic Patient Imaging, Sydney, Australia, Conference Presentations on ER-ve breast cancer cell lines or on normal non- 12-14 March, 2012. cancerous breast cells. The mechanism controlling 1. Blake S, Vial P, Holloway L, Greer PB, Kuncic 13. van Eytven E, McCurdy BMC, van Beek, T, this effect is not known. Research funding was Z, Monte-Carlo modeling of optical photon Chytyk K, Greer P, Accurate patient dose recently secured from the HMRI to investigate this transport effects on electronic portal imaging reconstruction from on-treatment EPID images, phenomenon. These molecules are now undergoing device dosimetric response, 12th International 12th International Workshop on Electronic Patient animal xenograft studies in order to determine their in Workshop on Electronic Patient Imaging, Sydney, Imaging, Sydney, Australia, 12-14 March, 2012. vivo efficacy. Australia, 12-14 March, 2012. 14. p Vial, S Deshpande, S Blake, A McNamara, L In a recently completed a pharmacokinetic clinical 2. Denham J, 2011 European Multidisciplinary Holloway, P Greer, Z Kuncic, First experiments of trial in colorectal cancer patients at the Calvary Mater Cancer Congress – oral presentation in Proferred a prototype device for simultaneous imaging and Newcastle our team has identified telomere length as paper session – “Variations in androgen dose verification during radiotherapy, American a strong predictor of chemotherapy induced blood dependent clinical progression kinetics in locally Association of Physicists in Medicine Charlotte, toxicity. This biomarker discovery has now formed advanced prostate cancer. USA, July 28, 2012 [Oral Presentation], Medical the basis of a new clinical research project with 3. t Fuangrod, H Woodruff, E VanUytven, B Physics 39 (6), 4002 the University of Newcastle (Prof Manohar Garg), McCurdy, D O’Connor, P Greer, Simulations of to examine the role of nutraceuticals on telomere Conference Posters Real-Time Geometric and Dosimetic Verification biology in colorectal cancer patients. We have also System Using EPID, American Association of 15. McNamara A, Blake S, Kuncic Z, Vial P, Holloway established ourselves as the only research group Physicists in Medicine, Charlotte, USA, July 28, L, Greer PB, Evaluation of the performance of in Australia to conduct therapeutic drug monitoring 2012 [Oral Presentation], Medical Physics 39 (6), electronic portal imaging devices using Monte- (TDM) of the chemotherapeutic drug Mitotane used 3879 Carlo simulations, 12th International Workshop in the treatment of Adrenocorticol Carcinoma. We are on Electronic Patient Imaging, Sydney, Australia, also the only research group in Australia to conduct 4. fuangrod T, O’Connor DJ, Greer PB, 12-14 March, 2012. a surrogate measure test for dihydropyrimidine Synchronization of EPID and predicted images dehydrogenase (DPD) deficiency as a predictor of 5FU for a real-time treatment verification system for 16. Monville ME, Kuncic Z, Greer PB, EPID toxicity. radiation therapy, 12th International Workshop dose prediction for real-time dosimetry, 12th on Electronic Patient Imaging, Sydney, Australia, International Workshop on Electronic Patient The recent establishment of the University of 12-14 March, 2012. Imaging, Sydney, Australia, 12-14 March, 2012. Newcastle Cancer Priority Research Centre and the Cancer Institute Translational Cancer Research Unit 5. Greer PB, King B, Rowshanfarzad P, EPID based 17. s Blake, P Vial, L Holloway, A McNamara, has facilitated the expansion of our research efforts. linac QA for IMRT and VMAT, World Congress P Greer, Z Kuncic, Sensitivity Analysis of As a result Dr Matt Dun has now joined our team on Medical Physics and Biomedical Engineering, an Electronic Portal Imaging Device Monte and will proved expertise in the field of chemical Beijing, China, 20-26 May, 2012 Carlo Model to Variations in Optical Transport proteomics. Parameters, American Association of Physicists 6. B King and P Greer, A method for removing in Medicine Charlotte, USA, July 28, 2012, Publications arm backscatter from EPID images, American [Poster] Medical Physics 39 (6), 3650 Association of Physicists in Medicine, Charlotte, 1. de Bock CE, Garg MB, Scott N, Sakoff JA, USA, July 28, 2012 [Oral Presentation], Medical 18. B Whelan, S Kumar, J Dowling, J Lambert, K Scorgie FE, Ackland SP, Lincz LF. Association Physics 39 (6), 3911 Lim, O Salvado, J Begg, P Greer, S Vinod, L of thymidylate synthase enhancer region Holloway, Requirements for the Accuracy of polymorphisms with thymidylate synthase activity 7. King B and Greer PB, Dosimetry with new EPID- Electron Density Data Planning for MRI Based in vivo. Pharmacogenomics J. 2011. 11:307-314. Linac Designs, 12th International Workshop on Cervix Cancer Treatment Planning., American IF 5.435 Electronic Patient Imaging, Sydney, Australia, Association of Physicists in Medicine Charlotte, 12-14 March, 2012. 2. Garg MB and Ackland SP. Pyridoxine to protect USA, July 28, 2012 [Poster], Medical Physics 39 from oxaliplatin-induced neurotoxicity without 8. Kron T, Babington S, Dixon J, Ebert M, Faroudi (6), 3694 compromising antitumour effect. Cancer F, Frantzis J, Grand M, Greer P, Hall M, Haworth Chemother. Pharmacol. (2011) 67:963-966. IF A, Hilder B, Lin C, Martin A, Rolfo A, Verry H, 2.759 Assessment of cost/utility of image guided Medical Oncology radiation therapy (IGRT) in intermediate risk 3. Garg MB, Sakoff JA, Ackland SP. A simple HPLC Chief Hospital Scientist: Dr Jennette Sakoff, prostate cancer: The ANROTAT project, 12th method for plasma level monitoring of mitotane Hospital Scientists: Dr Jayne Gilbert International Workshop on Electronic patient and its two main metabolites in adrenocortical and Madhu Garg Imaging, Sydney, Australia, 12-14 March, 2012. cancer patients. J. Chromotography B. (2011) Technical Officer: Ms Alesia Ogrodnik 879:2201-2205. IF 2.971 9. McCowan PM, Rickey DW, Rowshanfarzad P, The research efforts of the Experimental Therapeutics Greer PB, McCurdy BMC, IMAT gantry angle 4. agrez MV, Garg MB, Dorahy DJ, Ackland SP. Group in Medical Oncology spans two main areas correction for cine-mode EPID images, 12th Synergistic anti-tumor effect of cisplatin when of oncology research (i) the development of small International Workshop on Electronic Patient combined with an anti-Src kinase integrin-based molecules for the treatment of cancer and (ii) Imaging, Sydney, Australia, 12-14 March, 2012. peptide. J Cancer Therapy, (2011) 2: 295-301. management of clinical toxicity. Our drug development 10. parker J, Australian Institute of Radiography, program has focussed on targeting brain and breast 5. agrez MV, Garg MB, Ackland SP. (2012) Novel Tasmanian Winter Education Weekend cancers. Targeting brain tumours is a collaborative anti-cancer peptides comprising three amino presentation (29th June 2012), High Precision project including researchers from the University acids. J Cancer Therapy (2012), In Press. of Newcastle (Prof Adam McCluskey), Children’s MRI Based Prostate Radiotherapy’ 6. tarleton M, Gilbert J, Sakoff JA and McCluskey Medical Research Centre (Dr Megan Chircop) and
Calvary Mater Newcastle • review of operations • 2011/2012 • 39 A. Synthesis and anticancer activity of a series medical oncology admissions for the management 2011 of norcantharidin analogues. Eur. J. Med. Chem. of breast cancer complications: An Australian Cuzick J, Dowsett M, Pineda S, Wale C, Salter J, (2012). IF = 3.35 In Press. institution’s experience. Quinn E, Zabaglo L, Mallon E, Green AR, Ellis IO, Asia-Pacific Journal of Clinical Oncology 2011;7:146- 7. Garg MB, Lincz LF, Adler K, Scorgie FE, Ackland Howell A, Buzdar AU, Forbes JF. Prognostic value 153. SP, and Sakoff JA. Predicting 5-fluorouracil of a combined estrogen receptor, progesterone toxicity in colorectal cancer patients from Zdenkowski N, Chen S, Van der Westhuizen A, receptor, Ki-67, and human epidermal growth peripheral blood cell telomere length – a Ackland S: Curative strategies for liver metastases factor receptor 2 immunohistochemical score and multivariate analysis. Br. J. Cancer. 2012. IF = from colorectal cancer: A Review. comparison with the genomic health recurrence score 4.9, Accepted. The Oncologist 2012;17(2):201-211. in early breast cancer. J Clin Oncol 2011; 29(32); 4273-4278. 8. tarleton M, Gilbert J, Sakoff JA and McCluskey Clinical Trials: A. Cytotoxic 2-phenyacrylnitriles, the importance Cuzick J, Sestak I, Baum M, Buzdar A, Howell PICNIC: A randomised, placebo controlled trial of of the cyanide moiety and discovery of potent A, Dowsett M, Forbes JF. 10-year analysis of the creon in the treatment of pancreatic unsufficiency broad spectrum cytotoxic agents. Eur. J. Med. ATAC trial: wrong conclusion? Reply. Lancet Oncol. in patients with locally advanced or metastatic Chem. 2012. IF = 3.35, Accepted. 2011;12(3): 217 (Letter). pancreatic cancer. Chief investigators: N Zdenkowski, 9. tarleton M, Dyson L, Gilbert J, Sakoff A Bonaventura, G Radvan. Dowsett M, Salter J, Zabaglo L, Mallon E, Howell A, JA and McCluskey A. Focused library of Buzdar AU, Forbes JF, Pineda S, Cuzick J. Predictive Conference Posters: 2-phenylacrylamides as broad spectrum algorithms for adjuvant therapy: TransATAC. Steroids cytotoxic agents. Bioorgan. Med. Chem. 2012. Hovey E, De Souza P, Marx G, Parente P, Rapke 2011; 76(8) S1: 777-780. IF = 3.1, Accepted. T, Hill A, Bonaventura A, Michele A, Craft P, Abdi Goldhirsch A, Wood WC, Coates AS, Gelber RD, E, Lloyd A: Modafinil for fatigue associated with Grants Thürlimann B, Senn H-J & Panel Members (Forbes docetaxel-based chemotherapy: randomized JF- Panellist). Strategies for subtypes – dealing with 1. Chircop M, Sakoff J, Jones N, McCluskey. controlled trial. the diversity of breast cancer: highlights of the St Dynamin as a new drug target for the treatment Upanal N, Ackland S, Bonaventura A, McElduff Gallen International Expert Consensus on the Primary of glioblastoma. NSW Cancer Council RG-11-03, P: Early rise in blood pressure to predict clinical Therapy of Early Breast Cancer 2011. Ann Oncol (2011-2013). $360,000 outcomes in metastatic colorectal cancer (mCRC) 2011; 22(8): 1736-1747. 2. McCluskey A, Robinson P, O’Brien T, Chircop patients treated with first-line Bevacizumab. Regan MM, Neven P, Giobbie-Hurder A, Goldhirsch M, Sakoff J. Development of pthaladyn-based Rachakonda K, George M, Janda M, Blanchard G: A, Ejlertsen B, Mauriac L, Forbes JF, Smith I, Láng I, dynamin I-selective inhibitors for treatment of Supportive care needs in advanced cancer patients Wardley A, Rabaglio M, Price KN, Gelber RD, Coates epilepsy. NHMRC DP1017063. (2011-2013) undergoing palliative treatment in rural and remove AS, Thürlimann B for the BIG 1-98 Collaborative $544,682 NSW, Australia. Group and the IBCSG. Assessment of letrozole and 3. Chircop M, Robinson P, McCluskey A, Sakoff tamoxifen alone and in sequence for postmenopausal JA. The role of clathrin in cell division. NHMRC women with steroid hormone receptor-positive breast APP1022218. (2012-2014). $629,685. SURGICAL ONCOLOGY cancer: the BIG 1-98 randomised clinical trial at 8.1 Professor John F Forbes years median follow-up. Lancet Oncol. 2011; 12(12); 4. Sakoff J, Gilbert J, McCluskey A. Development 1101-1108. of a novel targeted therapy for the treatment of Journal Articles Ring A, Sestak I, Baum M, Howell A, Buzdar A, breast cancer. Wig Week Grant. Calvary Mater 2012 Newcastle, (2012) $6,000. Dowsett M, Forbes JF, Cuzick J. Influence of Barrios C, Forbes JF, Jonat W, Conte P, Gradishar comorbidities and age on risk of death without 5. Garg M, Gilbert J, Sakoff JA (2012) Refrigeration W, Buzdar A, Gelmon K, Gnant M, Bonneterre J, recurrence: a retrospective analysis of the arimidex, equipment. Coalfields Equipment Grant Calvary Toi M, Hudis C, Robertson JFR. The sequential use tamoxifen alone or in combination trial. J Clin Oncol Mater Newcastle $8,383. of endocrine treatment for advanced breast cancer: 2011; 29(32); 4266-4272. where are we? (Review). Ann Oncol 2012; 23(6): 6. Ackland SP, Sakoff J, Garg M, Tacon L (2012). Stockler MR, Harvey VJ, Francis PA, Byrne MJ, 1378-1386. Mitotane pharmacodynamics in adrenocortical Ackland SP, Fitzharris B, Van Hazel G, Wilcken NRC, carcinoma. HMRI, $25,000. Bliss JM, Kilburn LS, Coleman RE, Forbes JF, Coates Grimison PS, Nowak AK, Gainford MC, Fong A, 7. Sakoff J, Gilbert J, McCluskey. Identification of a AS, Jones SE, Jassem J, Delozier T, Andersen J, Paksec L, Sourjina T, Zannino D, Gebski V, Simes RJ, novel target for the treatment of hormone positive Paridaens R, van de Velde CJH, Lonning PE, Morden Forbes JF, Coates A. Capecitabine Versus Classical breast cancer. (2012) HMRI, $30,000. J, Reise J, Cisar L, Menschik T, Coombes RC. Cyclophosphamide, Methotrexate, and Fluorauracil As Disease-related outcomes with long-term follow-up: First-Line Chemotherapy for Advanced Breast Cancer. Conference Presentations an updated analysis of the Intergroup Exemestane J Natl Cancer Inst 2011; 29(34): 4498-4504. Study. J Clin Oncol 2012; 30(7): 709-717. 1. Sakoff JA, Gilbert J, Tarleton M, Robertson MJ, Tang G, Cuzick J, Costantino JP, Dowsett M, Forbes and McCluskey A. Therapeutics Development Sestak I, Harvie M, Howell A, Forbes JF, Dowsett M, JF, Crager M, Mamounas EP, Shak S, Wolmark N. of a novel targeted therapy for the treatment of Cuzick. Weight change associated with anastrozole Risk of recurrence and chemotherapy benefit for (ER+ve) breast cancer. AACR/EORTC/NCI San and tamoxifen treatment in postmenopausal women patients with node-negative, estrogen receptor- Francisco, USA, Nov 2011. Abstract 127. with or at high risk of developing breast cancer. positive breast cancer: recurrence score alone and Breast Cancer Res Treat 2012; 134:727-734. 2. Sakoff JA, Garg MB, Lincz LF, Adler K, Scorgie integrated with pathologic and clinical factors. J Clin Oncol 2011; 29(33): 4365-4372. FE and Ackland SP. Predicting chemotherapy- Sestak I, Kealy R, Nikoloff M, Fontecha M, Forbes JF, induced toxicity in cancer patients from peripheral Howell A, Cuzick J. Relationships between CYP2D6 Toi M, Winer EP, Inamoto T, Benson JR, Forbes blood telomere length. EACR. European phenotype, breast cancer and hot flushes in women JF, Mitsumori M, Robertson JFR, Sasano H, von Association for Cancer Research. Barcelona, at high risk of breast cancer receiving prophylactic Minckwitz G, Yamauchi A, Klimberg VS. Identifying Spain, July 7-10th, 2012. tamoxifen: results from the IBIS-I trial. Brit.Jnl Ca gaps in the locoregional management of early 2012; 107(2): 230-233. 3. Garg, MB, Sakoff JA, Ackland SP. Mitotane breast cancer: highlights from the Kyoto Consensus Pharmacodynamics in Adrenocortical Cancer . Conference. Ann. Oncol. 2011;18(10): 2885-2892. HMRI Cancer Research Symposium (2011)
Articles:
Day F, Bull J, Lombard J, Stewart J: Changes in
40 • Calvary Mater Newcastle • review of operations • 2011/2012 CONFERENCE PRESENTATIONS Cancer Institute NSW (Research Scholar Judy Jobling) (ALLG), 10 sponsored by pharmaceutical companies Mammographic density as a biomarker for the efficacy and/or investigator initiated. 1 July to 31 December 2011 of treatment of endocrine therapies used to prevent Lecture Tour of China In addition to meeting requirements for the laboratory breast cancer events in randomised controlled clinical 3 x Presentations: “Optimizing endocrine treatment in components for the majority of the trials, the trials. early breast cancer” department also coordinates and actively contributes CI: Forbes JF 1-3 July – Guangzhou, Beijing and Shanghai, China tissue samples to the ALLG tissue bank. In 2011 – 2010 - 2013: $55,016 2012, the team was responsible for donating 186 Australia and New Zealand Breast Cancer Trials NBCF Collaborative Breast Cancer Research Grant samples from 28 tissue collections. This important Group Annual Scientific Meeting A single arm phase II study using magnetic resonance initiative ensures that researchers have access to Presentation: “IBIS-II Prevention, DCIS and Bone imaging (MRI) to assess postoperative radiotherapy quality tissue samples and treatment data from Substudy Status Report” omission in selected patients with early breast cancer patients enrolled in trials all around Australia and New Presentation: “ATAC 0501 LATER Status Report” (PROSPECT). Zealand. 20-23 July – Gold Coast, Qld CIs - Forbes JF, Mann GB (CIA), Skandarajah A, Rose Bone Marrow Stem Cell Transplant A, Chua B. Hunter Medical Research Institute Cancer Research Research Program Symposium 2011 – 2013 $200,000 Presentation: “ANZ Breast Cancer Trials Group: Philip Rowlings, Hong Zhang, Linda Bissett, University of Melbourne Current Research Program” Geordie Zaunders NHMRC Project Grant 4 November – Newcastle, NSW Cognitive effects of adding ovarian function The Hunter Haematology Unit continues to be a 1 January to 30 June 2012 suppression to adjuvant hormonal therapy in contributing member of the Centre for International Annual Women’s Health Update Meeting premenopausal breast cancer. Blood and Marrow Transplant Research (CIBMTR) 2 x Presentations: “Breast Cancer Preventive CI’s – Forbes JF, Phillips K (CIA), Francis P, Boyle F, based in Wisconsin USA. Patient transplant data Therapy” Bernhard J, Maruff P. are also reported to the Australian Bone Marrow 3 March – Melbourne, Victoria 2007-2011: $286,750 Transplant Recipients Registry (ABMTRR) as part of Australian BMT research and development. Professor University of Queensland 1st International Congress of Association of Breast Rowlings is a member of the Scientific Advisory NBCF Collaborative Breast Cancer Research Grant Surgeons in India (ABSICON 2012) Committee of Asia Pacific BMT Group (APBMT) as Novel strategies for prediction and control of Presentation: “Do specialist breast centres improve well as serving on a number of Research Working advanced breast cancer via nanoscaled epigenetic- breast healthcare” Committees of the CIBMTR. Presentation: “Endocrine therapies for breast cancer – based biosensors. best practice guidelines” CIs – Forbes JF, Trau M (CIA), Clark S, Brown M, Laboratory Research - The Hunter Haematology Research Group 18-20 May – Hyderabad, India Francis G, Dobrovic A, Scott R. 2008-2012: $5,000,000 (University of Newcastle Lisa Lincz, Fiona Scorgie, Linda Bissett, Angel component - $1,200,000) D’Crus and Anoop Enjeti
RESEARCH GRANTS The Haematology Research Laboratory conducts Competitive Research Grant funding supporting Haematology studies into haematological cancers and disorders Australian New Zealand Breast Cancer Trials Group of coagulation, with a primary interest in circulating projects (University of Newcastle - CIA Professor The Haematology Unit engages in both clinical and microparticles. The laboratory is linked to the John Forbes) laboratory based research. Clinicians and nurses are University of Newcastle and offers tuition and actively involved in research directed at improving scholarships to encourage students to enter this area NHMRC Project Grant 569213 (IBIS 2): A randomised patient care, while the department also supports of research. There are presently 3 PhD and 1 Master’s phase III trial of anastrozole for breast cancer dedicated laboratory and clinical trials teams. The student associated with the lab, and the welcome prevention in postmenopausal women at high risk. Staff Specialists are committed to providing quality addition of a new research assistant to the team this Chief Investigators: Forbes JF, Coates A, Boyle F, training to haematology registrars. Many of the staff year. In addition, researchers are responsible for the Mann G, Saunders C, Cuzick J. hold conjoint appointments with the University of processing of blood samples from CMN patients Total Awarded: 2009 – 2013 $1,635,000 Newcastle and engage in teaching undergraduate who participate in clinical trials and donate tissue to NHMRC Project Grant 510787 (LATER): Prevention medical students and supervising biomedical the ALLG Tissue Bank. The group maintains strong of late breast cancer (BC) events in postmenopausal student projects. The Unit is fortunate to have strong collaborations with researchers both nationally (School women with endocrine responsive BC. community support and is grateful for all the generous of Human Life Sciences, University of Tasmania) and Chief Investigators: Forbes JF, Mann G, Boyle F, donations received in 2011-12. locally with the departments of Neurology (JHH), Endocrinology (JHH), Molecular and Cytogenetics Green M, Coates A, Cuzick J. Haematology Clinical Trials Total Awarded: 2008 – 2012 $4,430,875 (HNEH), Toxicology (CMN), Medical Oncology (CMN), Clinical Trial Co-ordinators: Michele Gambrill, and the School of Biomedical Sciences and Pharmacy NHMRC Equipment Grant: Medilink Array digitising Tara Novak, Marguerite Hughes William (UoN). system. Whitbread-Brown Research Funding Chief Investigator: Prof John Forbes. Administrative Officer: Patricia Rozanski Total Awarded: 2012 $35,000 2012. Maitland Cancer Appeal, Grant for Leukaemia Over the past year the Haematology clinical trials Research for Hunter Haematology Research Group. P Cancer Institute NSW Infrastructure office has screened 344 patients (a 30% increase Rowlings, L Lincz $100,000 CI: Forbes JF, Boyle F, Ackland S, Coates A. from last year) of which we have recruited 84 new Total Awarded: 2009 – 2012 $640,000 participants to 13 currently enrolling trials. This 2012. U of Newcastle Near Miss Grant (for highly equates to a total of 121 participants currently entered ranked but unsuccessful NHMRC project grant Competitive Research Grant funding supporting onto trials with 38 participants in active treatment and applications) The genetic determinants of brain Australian New Zealand Breast Cancer Trials Group a further 83 participants in follow up. The open trials haemorrhage associated with stroke thrombolysis. C projects (other administering institutions or other cover a wide range of haematological conditions both Levi, J Attia, E Holliday, S Koblar, R Scott, J Sturm, J CIA’s) in acute and chronic diseases. Rosand, L Lincz (CIH) $20,000 BCRF Research Grant: ANZBCTG High Risk Bio-bank There were 23 open trials (including those open to 2012. CMN Jane Reid Harle and Coalfield’s Cancer CI: Forbes JF, Cuzick J. recruitment and those closed to recruitment but Support group grant schemes. Development, 2011 – 2012 US$225,000 with participants either on treatment or in follow up) implementation and evaluation of a nurse led Cancer Australia Infrastructure being managed in 2011/12, 13 administered by intervention model where Peripherally Inserted Central CI: Forbes JF the Australasian Leukaemia and Lymphoma Group Catheters (PICC) devices are used instead of Central 2010 - 2013: $1,401,490
Calvary Mater Newcastle • review of operations • 2011/2012 • 41 Venous Catheters in haematology patients in both Australia. Poster Presentation 2. yu-Ching Cheng, PhD1; Christopher D. Anderson, the inpatient and outpatient setting at Calvary Mater MD2,3,4; Silvia Bione, PhD5; Keith Keene, PhD6,7; T King, DE Joshua, M Seldon. Carfilzomib and Newcastle. Cathie Milton ($34,420) Jane M. Maguire PhD, RN8, 9; Michael Nalls, Dexamethasone Therapy in a Patient with Relapsed PhD10; Asif Rasheed, MBBS11; Marion Zeginigg, Conference Proceedings Refractory Multiple Myeloma: A Single Case Study. MSc12; John Attia, PhD, MD, FRCPC, FRACP8; HAA, Oct 30 – Nov 2, 2011. Sydney, Australia. Sanghee Hong, Chris Barker, John P Klein, Peter Ross Baker, FRACP, FRCPA13,14; Simona Barlera, Poster Presentation Shaw, Christopher Bredeson, Adla Angelina, MSc15; Alessandro Biffi, MD2,3,4; Ebony Bookman, Philip Rowlings, Jean-Yves Cahn, Mohamed Alireza Ardjmand, Charles E de Bock, Timothy PhD16; Thomas G. Brott, MD17; Robert D. Brown Kharfan-Dabaja, Mahmoud Aljurf, Jeffrey Szer, J Molloy, Simon Bone, Daniel Johnstone, Daniel Jr., MD18; Fang Chen, PhD7; Wei-Min Chen, William A Wood, Ibrahim Ahmed, David Gomez- Campbell, Kristy Shipman, Lisa F Lincz, Mark D PhD7,19; Emilio Ciusani, PhD20; John W. Cole, Almaguer, Yoshiko Atsuta and Marcelo C Pasquini. Spanevllo, Andrew Boyd, Gordon F Burns, Rick F MD21,22; Lynelle Cortellini, MSc2,3,4; John Danesh, Trends in Utilization of Total Body Irradiation Thorne. Fat1 Cadherin as a Novel Minimal Residual PhD23; Kimberly Doheny, PhD24; Luigi Ferrucci, (TBI) Prior to Hematopoietic Cell Transplantation Disease Marker in Acute Lymphoblastic Leukemia. MD, PhD25; Maria Grazia Franzosi, PhD15; (HCT) Worldwide. Biology of Blood and Marrow HAA, Oct 30 – Nov 2, 2011. Sydney, Australia. Oral Philippe Frossard, PhD, DSc11; Karen L. Furie, Transplantation, Volume 18, Issue 2, Supplement , Presentation MD, MPH3; Jonathan Golledge, MChir, FRACS26; Pages S336-S337, February 2012 Graeme J. Hankey, MD, FRACP, FRCP, Helen Crowther, Robert Lindeman, Joy Ho, Emily FRCPE27, 28; Dena Hernandez, MS10; Elizabeth Christopher A Barker, Sanghee Hong, John P Klein, Allen, Clare Waite, Stephen Matthews, Karl Jobburn, G. Holliday, PhD8; Fang-Chi Hsu, PhD29,30; Jim Peter Shaw, Christopher Bredeson, Adla Angelina, Juliana Teo, Samantha Day, Michael Seldon, David Jannes, PhD, BMBS BMBS FRACP31; Ayeesha Philip Rowlings, Jean-Yves Cahn, Mohamed Rosenfeld, Ian Kerridge. The Health of Adults Living Kamal, MD, FAHA, ABVN32; Muhammad Saleem Kharfan-Dabaja, Mahmoud Aljurf, Jeffrey Szer, William with a Clinically Significant Haemoglobinopathy in Khan, MSc33; Steven J. Kittner, MD21,22; Simon A Wood, Ibrahim Ahmed, David Gomez Almaguer, NSW, Australia. The Haemoglobinopathy Project. A. Koblar, PhD, BMBS FRACP31; Martin Lewis, Yoshiko Atsuta, Miguel Sanz, Gregory Hale, Mark HAA, Oct 30 – Nov 2, 2011. Sydney, Australia. Oral PhD31; Lisa Lincz, PhD8; Antonella Lisa, PhD5; Litzow, Marcelo C Pasquini Radiotherapeutic Presentation Mar Matarin, PhD34; Pablo Moscato, PhD35; Techniques in Allogeneic Hematopoietic Cell Josyf C. Mychaleckyj, DPhil 7,19; Eugenio A. Transplant (HCT), Biology of Blood and Marrow Victoria Milliken, Plerixafor- CMN’s Experience. Parati, MD20; Silvia Parolo5; Elizabeth Pugh, Transplantation, Volume 18, Issue 2, Supplement , ABC Symposium, July 2011 PhD24; Natalia S. Rost, MD2,3,4; Michael Schallert Page S351, February 2012 Victoria Milliken, Plerixafor - A single units MSc 12; Helena Schmidt, MD,PhD12; Rodney J. Nadine Berry, Philip Rowlings, Anoop Enjeti, experience with Plerixafor – a CXCR-4 inhibitor- in the Scott, PhD, PD, FRCPath, FHGSA8; Jonathan Victoria Cawich, Caitlin Valentin, Nicole Bain, Kerry hard to mobilise patient. HAA, Oct 30 – Nov 2, 2011. W. Sturm, PhD, MD36; Sunaina Yadav, MSc33; Fagan. Myeloma – Karyotype v’s iFISH and the Sydney, Australia. (Awarded Nursing Travel Grant Moazzam Zaidi, MBBS11; GARNET Collaborative Future. HAA Sydney, October 30th - November 2nd for best poster) Research Group37; Giorgio B. Boncoraglio, MD20; 8 2011 (poster presentation) Invited presentations/lectures Christopher Royce Levi, MD, FRACP, RACP ; James F. Meschia, MD17; Jonathan Rosand, Nadine Berry, Philip Rowlings, Anoop Enjeti, Lisa Lincz (Invited speaker), 34th Annual Meeting of MD, MSc2,3,4; Michele Sale, PhD6,7,38; Danish Kerry Fagan. The use of aCGH for the study of the Australasian Flow Cytometry Group, ‘Microparticle Saleheen, MBBS, PhD11,23,39; Reinhold Schmidt, plasma cell dyscrasia – The technical aspects. detection and enumeration’. Hobart, Tasmania, Aug MD12; Pankaj Sharma, MD PhD FRCP33; Bradford Australian Society of Cytogeneticists (ASoC), Port 23 – 26, 2011 Worrall, MD, MSc19,40; Braxton D. Mitchell, PhD1; Stephens, March 23 -25. (oral presentation) on behalf of the International Stroke Genetics Michael Seldon (Invited Speaker), Single Centre Consortium. Are myocardial infarction-associated Nadine Berry, Philip Rowlings, Anoop Enjeti, Experience of Six Years of Massive Transfusion single nucleotide polymorphisms associated with Kerry Fagan. Evaluation of myeloma by Protocol. ANZSBT/ASTH Combined Symposium: ischemic stroke? Stroke. 2012 Apr;43(4):980-6. oligonucleotide-based microarray analysis uncovers HAA, Oct 30 – Nov 2, 2011. Sydney, Australia. aberrations not detected by FISH analysis. Australian Epub Feb 23.(IF=5.85) Michael Seldon, Pathology Forum, “New Society of Cytogeneticists (ASoC), Port Stephens, 3. elizabeth G. Holliday1,2, Jane M. Maguire3,4,5, Coagulation and New Anticoagulants” NBN Telethon March 23 -25. (oral presentation and winner of the Tiffany-Jane Evans2,6, Simon Koblar7,8, Jim Telehealth Centre, JHH, 4 April 2012 Ed Krumins Young Scientist of the Year Award’) Jannes7,8, Jonathan W. Sturm5,9,10, Graeme Advisory Board Membership 11,12 11,13 Mohammad Alkhatatbeh, Lisa Lincz, Rick Thorne. J. Hankey , Ross Baker , Jonathan Golledge14,15, Mark W. Parsons4, Rainer In Vitro Modeling of Microparticle Production Cathie Milton, National advisory board on the Malik16, Mark McEvoy1,17, Erik Biros14, Martin D. Occurring in Diabetic Nephropathy. HAA, Oct 30 – development of guidelines for the admisistration of Lewis7,18, Lisa F. Lincz 6,17,19, Roseanne Peel1,17, Nov 2, 2011. Sydney, Australia. (Awarded ASTH Vidaza 17 17 best Poster Presentation) Christopher Oldmeadow , Wayne Smith , Pablo Debbie Carr, National advisory board on the Moscato20, Simona Barlera21, Steve Bevan22, Philip Rowlings, Michele Gambrill, Hong Zhang, development of guidelines for the administration of Joshua C. Bis23, Eric Boerwinkle24, Giorgio Sandra Deveridge, Arno Enno, Anoop Enjeti, Vidaza; National MDS advisory board B. Boncoraglio25, Thomas G. Brott26, Robert Sam Yuen, Mark Walsh, Jillian De Malmanche, D. Brown, Jr27, Yu-Ching Cheng28, John W. Philip Rowlings, ScientificA dvisory Board of the Asia Kerry Fagan. Chronic Myeloid Leukaemia in Chronic Cole29, Ioana Cotlarciuc30, William J. Devan31,32, Pacific Bone Marrow Transplant Group (APBMT) Phase in the Real World – Ten Years Experience in Myriam Fornage24, Karen L. Furie32, Sólveig the Hunter. HAA, Oct 30 – Nov 2, 2011. Sydney, Publications Grétarsdóttir33, Andreas Gschwendtner 16, Australia. Poster Presentation Mohammad Arfan Ikram34,35,36, W. T. Longstreth, 1. Charles E. de Bock, Alireza Ardjmand, Timothy Jr37,38,39, James F. Meschia26, Braxton D. Claudine Ho, Claire Weatherburn, Sam Yuen, Craig J. Molloy, Simon M. Bone, Daniel Johnstone, Mitchell28, Thomas H. Mosley40, Michael A. Nalls Sullivan, Ilona Cunningham. Bone Marrow Aspiration Daniel M. Campbell, Kristy L. Shipman, Trina 41, Eugenio A. Parati25, Bruce M. Psaty23,37,42,43, and Trephine with Methoxyflurane. HAA, Oct 30 – M. Yeadon, Jeff Holst, Mark D. Spanevello, Guy Pankaj Sharma30, Kari Stefansson33,44, Gudmar Nov 2, 2011. Sydney, Australia. Poster Presentation Nelmes, Daniel R. Catchpoole, Lisa F. Lincz, Thorleifsson33, Unnur Thorsteinsdottir33,44, Andrew W. Boyd, Gordon F. Burns, Rick F. Anita Chittaranjan-Shetty, Robert Lindeman, Joy Matthew Traylor 22, Benjamin F.J. Verhaaren34,36, Thorne . The Fat1 cadherin is over expressed Ho, Emily Allen, Clare Waite, Stephen Matthews, Kerri L. Wiggins23, Bradford B. Worrall45, The and an independent prognostic factor for Karl Jobburn, Juliana Teo, Samantha Day, Michael Australian Stroke Genetics Collaborative46, The survival in paired diagnosis-relapse samples of Seldon, David Rosenfeld, Ian Kerridge, Helen International Stroke Genetics Consortium46, precursor B-cell acute lymphoblastic leukemia. Crowther. Quality of Life in Parents of Children Living The Wellcome Trust Case Control Consortium2 Leukemia 2012 May;26(5):918-26. doi: 10.1038/ with a Clinically Significant Haemoglobinopathy in 46, Cathie Sudlow47, Peter M. Rothwell48, leu.2011.319. Epub 2011 Nov 25. ( IF = 6.9) NSW, Australia. HAA, Oct 30 – Nov 2, 2011. Sydney, Martin Farrall49,50, Martin Dichgans16, Jonathan
42 • Calvary Mater Newcastle • review of operations • 2011/2012 Rosand31,32, Hugh S. Markus22, Rodney J. • Sneesby,L, Satchell, R, Good,P, & Van Der in people with advanced cancer. Palliative Scott2,6,51*, Christopher Levi4*, John Attia1,2* Riet, P. Death and dying in Australia: Perceptions Medicine 2012 Common variants at 6p21.1 are associated of a Sudanese community. - Journal of • Clark K, Smith J, Currow DC. Do the trajectories with large artery atherosclerotic stroke. Nature Advanced Nursing. 2011, Vol 67(12): 2696-2702 of disturbed bowel habits differ over time in Genetics. Accepted June 2012. • Clark K, Hipwell A, Byfieldt N. Timing of palliative care? A consecutive cohort study. 4. Enjeti, AE and Seldon, M. “Microparticles: Role Cessation laxatives before Death. International European Journal of Palliative Care, 2011 in Haemostasis and Venous Thromboembolism” Journal of Palliative Nursing. 2012;18(7): 326 - in Pathophysiology and Clinical Aspects of 330 Venous Thromboembolism in Neonates, Renal Conference Presentations • Clark K, Smith J, Currow DC. The prevalence of Disease and Cancer Patients, ISBN 978-953- bowel disturbances reported in a Palliative Care International 51-0616-6, edited by Mohamed A. Abdelaal, Population. The Journal of Pain and Symptom 2012 • Clark K, Smith J, Currow D. Do the trajectories Management. 2012;43(6):993-1000 of disturbed bowel habits differ over time in 5. Chapman, K., M. Seldon, and R. Richards, • Clark K, Byfieldt N, Dawe M, Currow DC. a palliative Care population? 12th Annual Thrombotic microangiopathies, thrombotic Treating Constipation in Palliative Care: The Congress of the European Association of thrombocytopenic purpura, and ADAMTS-13. Impact of Other Factors Aside From Opioids. Palliative Care, May 2011 Semin Thromb Hemost, 2012. 38(1): p. 47-54. Am J Hosp Palliat Care. 2012; 29(2) :118 - 121 • Sneesby, L. Ethical and moral dilemmas in 6. freytes, C.O., M.J. Zhang, J. Carreras, L.J. [Epub ahead of print] End-of-life decision making: Is advanced care Burns, R.P. Gale, L. Isola, M.A. Perales, M. • sheehan C, Clark K, Lam L, Chye R. A Planning the answer? International Society of Seftel, J.M. Vose, A.M. Miller, J. Gibson, retrospective analysis of primary diagnosis, co Advanced care Planning and End of Life care T.G. Gross, P.A. Rowlings, D.J. Inwards, S. morbidities, anticholinergic load and other factors conference, 22nd – 23rd June 2011 Pavlovsky, R. Martino, D.I. Marks, G.A. Hale, on treatment for noisy respiratory secretions at S.M. Smith, H.C. Schouten, S. Slavin, T.R. National the end of life. Journal of Palliative Medicine. Klumpp, H.M. Lazarus, K. van Besien, and P.N. 2011 Nov;14(11):1211-6 Hari, Outcome of Lower-Intensity Allogeneic • 11th Australian Palliative Care Conference 2011, Cairns, Australia – 30th August – 2nd September Transplantation in Non-Hodgkin Lymphoma • Clark K, Currow DC. Assessing Constipation in 2011: after Autologous Transplantation Failure. Biol Palliative Care in a Gastroenterology Framework. Blood Marrow Transplant, 2011. Palliative Medicine, Published on line, July 2011 - Poster: Cameron-Taylor E, Byfieldt N. [Epub ahead of print] 7. iland, H., K. Bradstock, J. Seymour, M. Anti-Emetic Prescribing in the Mercy Hospice – Hertzberg, A. Grigg, K. Taylor, J. Catalano, Accepted articles Mechanism or Habit? P. Cannell, N. Horvath, S. Deveridge, P. • Clark K, Smith J, Lovell M, Currow DC. - Poster: Clark K, Gurigis A, Byfieldt N. The Browett, T. Brighton, L. Chong, F. Springall, J. Longitudinal Pain reports in a palliative care Impact of Constipation on Health Related Quality Ayling, A. Catalano, S. Supple, M. Collins, J. Di population. Accepted Journal of Palliative of Life for People with Advanced Cancer Iulio, and J. Reynolds, Results of the APML3 Medicine April 2012 trial incorporating all-trans-retinoic acid and - Sneesby L. Death & Dying: Views of a Sudanese idarubicin in both induction and consolidation • Currow DC, Fazekas B, Doogue M, Clark community living in Australia as initial therapy for patients with acute K, Rowett D Pharmacovigilance in hospice / - Clark K, Currow DC, Talley NJ, Lam L Dinning promyelocytic leukemia. Haematologica, 2012. palliative care. Rapid report of net clinical effect of P, Shelby-James T, Agar M, Davidson P, 97(2): p. 227-34. metoclopramide. Accepted Journal of Palliative Phillips J. A multi-site randomised controlled trial Medicine, June 2012 8. iland, H.J., K. Bradstock, S.G. Supple, A. comparing the severity of constipation symptoms Catalano, M. Collins, M. Hertzberg, P. Browett, • Clark K, Currow DC. Constipation in palliative experienced by palliative care patients receiving A. Grigg, F. Firkin, A. Hugman, J. Reynolds, J. Di care: what do we use as definitions and outcome usual care compared to those diagnosed Iulio, C. Tiley, K. Taylor, R. Filshie, M. Seldon, J. measures? Accepted Journal of Pain and and managed according to the underlying Taper, J. Szer, J. Moore, J. Bashford, and J.F. Symptom Management, March 2012 pathophysiology Seymour, All-trans-retinoic acid, idarubicin, and Invited presentations intravenous arsenic trioxide as initial therapy in • toh T, Clark K, Lam L, Shelby-James T. Currow acute promyelocytic leukemia (APML4). Blood, DC. The role of ondansetron in the management • PaCCSC Annual Meeting, Sydney, March 2012: 2012. of cholestatic or uraemic pruritus - a systematic review. Accepted Journal of Pain and Symptom - Byfieldt N. An audit of the cessation of laxatives 9. waller, A., A. Girgis, C. Johnson, C. Management, October 2012 to time of death Lecathelinais, D. Sibbritt, M. Seldon, T. Invited Contributions - Clark K. Preliminary Data Presentation: A Bonaventura, and D. Currow, Implications of multi-site cluster randomised controlled trial a needs assessment intervention for people • Clark K, Bensley K. End of life discussions comparing the severity of constipation symptoms with progressive cancer: impact on clinical around death and dying for Aboriginal and experienced by palliative care patients receiving assessment, response and service utilisation. Torres Strait Islanders. Check program for GPs. usual care compared to those diagnosed Psychooncology, 2012. 21(5): p. 550-7. September 2011 and managed according to the underlying • Clark K, Gurigus A, Currow DC. The palliative pathophysiology management of people with advanced PALLIATIVE CARE • Clark K. Evidence-based management oesophageal cancer. Cancer Forum 2012;35 of constipation. Queensland University of (3):175-179 Publications Technology Palliative Care Research Forum, Published Articles Published abstracts April 2012
• Good P, Sneesby L, Higgins I, Van Der Riet P. • Currow DC, Clark K, Cartmill J, Pather S, Conference Attendance Agar M, Craig S, Fazekas B, Quinn S, Hardy J. Medical officers in acute care settings: their views • International Society of Advanced care Planning A randomised double-blind placebo controlled on medically assisted nutrition and hydration at and End of Life care conference – London, 22nd trial in infusional subcutaneous octreotide in the the end of life. Journal of Palliative Care. 2011, – 23rd June 2011 – L. Sneesby Vol 27(4): 303-9 management of malignant bowel obstructions • 7th World Research Congress of the European
Calvary Mater Newcastle • review of operations • 2011/2012 • 43 Association of Palliative Care (EAPC) – palliative care patients receiving medications that Pharmacol Ther. 2011 Aug;90(2):243-5. Trondheim, Norway. 7th – 9th June 2012 – deliver an anticholinergic load and documented Clunas S, Berling I, Whyte I. Paracetamol in patents N.Byfieldt slow transit constipation with pre-existing liver disease. Aust Fam Physician. Grants Research Projects 2011 Aug;40(8):565
• Clark K, Whyte I, Byfieldt N. A pilot study • the impact of constipation on Health Related Berling I, Isbister GK, Calver L, Clunas S. Digital to explore the use of pyridostigmine in the Quality of Life (HR-QOL) for advanced cancer holter measurement of QT prolongation in ziprasidone management of constipation associated with patients (HR-QOL Study) overdose. Clin Toxicol (Phila). 2011 Aug;49(7):694-6. high anticholinergic load in palliative care. • self-reported evaluation of the adverse effects of CMN Margaret Mitchell grant for $10,000 to Shen F, Coulter CV, Isbister GK, Duffull SB. A dosing Dexamethasone (SEED Study) commence in 2012 regimen for immediate N-acetylcysteine treatment for acute paracetamol overdose. Clin Toxicol (Phila). 2011 • a needs assessment survey of Patients and their • Clark K. Establishment of a funding agreement Aug;49(7):643-7. primary Carers after being registered with the between Department of Palliative Care, CMN, Calvary Mater Newcastle Palliative Care Service and The University of Newcastle to improve Lane J, O’Leary MA, Isbister GK. Coagulant effects (NAT Project) capacity of palliative Care to support medical of black snake (Pseudechis spp.) venoms and in vitro efficacy of commercial antivenom. Toxicon. 2011 Sep student education in palliative care. Established • Dyspnoea Assessment Tool Review July 2011 for $250,000 over 2.5years 1;58(3):239-46. • peritron Validation Study • Clark K, Cameron-Taylor E, Gray J, Foster Casamento A, Isbister GK. Thrombotic M. Cancer Institute NSW primary health care for • rapid Pharmacovigilance in palliative care: A microangiopathy in two tiger snake envenomations. $40,000 over 12 months prospective observational study - understanding Anaesth Intensive Care. 2011 Nov;39(6):1124-7. the burden of adverse drug reactions and their Coulter CV, Farquhar S, McSherry C, Isbister GK, Clinical Trials impact on symptoms at end of life Duffull SB. Methanol and Ethylene Glycol Acute • a multi-site cluster randomised controlled trial Poisonings – Predictors of Mortality. Clin Toxicol comparing the severity of constipation symptoms (Phila). 2011 Dec;49(10):900-6. experienced by palliative care patients receiving General Internal usual care compared to those diagnosed Medicine Isbister GK, White J, Currie BJ, O’Leary MA, Brown and managed according to the underlying SG; for the ASP Investigators. Clinical effects and pathophysiology MACCS - Mater Acute Care Service treatment of envenoming by Hoplocephalus spp. snakes in Australia: Australian Snakebite Project (ASP- Conference Presentations • single Patient Multiple Cross-Over Trials To 12). Toxicon. 2011 Dec 1;58(8):634-40. Determine The Efficacy Of Pilocarpine In Relieving Australian Ambulatory Care Conference Melbourne, Calver L, Isbister GK. The Sedation Assessment Dry Mouth In Patients With Cancer Australia. July 2004 Tool to score acute behavioural disturbance in the • randomised control trial of megestrol acetate, Greenham J, Johnson W, Stokes B and McGettigan. emergency department. Emerg Med Australas 2011 dexamethasone and placebo in the management Use of a Warfarinised protocol enhances hospital in Dec;23(6):732-4011) of anorexia in patients with cancer the home anti-coagulation outcomes. Gulati A, Faed JM, Isbister GK, Duffull SB. • a Randomised, Double-Blind Multi-Site Practice Development Conference. Terrigal, NSW, Development and evaluation of a prototype of a novel Parallel Arm Controlled Trial to Assess Relief Australia. September 2004. clotting time test to monitor enoxaparin. Pharm Res. of Refractory Breathlessness Comparing Fixed 2012 Jan;29(1):225-35. Doses of Morphine, Oxycodone and Placebo Johnson W and Carr D. Hospital in the home care following autologous stem cell transplantation for Berling I, Anscombe M, Isbister GK. Intravenous • a randomised double blind placebo controlled lymphoma and multiple myeloma. paracetamol toxicity in a malnourished child. Clin trial of infusional subcutaneous octreotide in the Toxicol (Phila). 2012 Jan;50(1):74-6. management of malignant bowel obstruction in Greenham J, Johnson W, Stokes B and McGettigan. people with advanced cancer Use of a Warfarinised protocol enhances hospital in Isbister GK, Prior F, Kilham HA. Restricting cough and the home anti-coagulation outcomes. cold medicines in children. J Paediatr Child Health. • randomised double blind control trial of oral 2012 Feb;48(2):91-8. risperidone versus oral haloperidol versus oral National Medication Safety Breakthrough placebo with rescue subcutaneous midazolam Collaboration Sydney. 16th February 2005. Calver L, Dunlop A, Isbister GK. Individual patient assessment of methadone induced QT prolongation in the management of delirium in palliative care Use of a Warfarinised protocol enhances hospital in with digital holter recording. J Addict Med. 2012 inpatients the home anti-coagulation outcomes. Mar;6(1):92-3. • a randomised double-blind multi-site parallel arm controlled trial to assess relief of refractory Dassanayake TL, Jones AL, Michie PT, Carter GL, breathlessness comparing oral sertraline and Clinical Toxicology McElduff P, Stokes BJ, Whyte IM. Risk of road traffic placebo and Pharmacology accidents in patients discharged following treatment for psychotropic drug overdose: a self-controlled • a two-stage trial of antiemetic therapy in patients Journal Articles/ Publications case series study in Australia. CNS Drugs. 2012 Mar with cancer and nausea not related to anticancer 1;26(3):269-76. therapy Kumar VV, Isbister GK, Duffull SB. The effect of decontamination procedures on pharmacodynamics Van Gorp F, Duffull SB, Hackett LP, Isbister GK. study 1: A randomised open label study of of venlafaxine in overdose. Br J Clin Pharm 2011 Population pharmacokinetics and pharmacodynamics guideline–driven targeted antiemetic therapy Jul;72(1):125-32. of escitalopram in overdose and the effect of activated versus single agent antiemetic therapy charcoal. Br J Clin Pharmacol. 2012 Mar;73(3):402- Maduwage K., Hodgson WC, Konstantakopoulos N, 10. study 2: A randomised controlled double blind O’Leary MA, Gawarammana I, Isbister GK. The in vitro study of levomepromazine or ondansetron versus toxicity of venoms from South Asian Hump-nosed pit Isbister GK, Shahmy S, Mohamed F, Abeysinghe placebo with rescue antiemetics (best supportive vipers (Viperidae: Hypnale). J Venom Res. 2011;2:17- C, Karunathilake H, Ariaratnam A. A randomised care) in patients with refractory nausea 23. controlled trial of two infusion rates to decrease reactions to antivenom. PLoS One 2012;7(6):e38739. • Methylphenidate as a treatment for fatigue in Joy JP, Coulter CV, Duffull SB, Isbister GK. Prediction Epub 2012 Jun 18 advanced cancer patients of Torsades de Pointes from the QT interval: analysis of a case series of amisulpride overdoses. Clin Isbister GK, Fan HW. Spider bite. Lancet. 2011 Dec • a pilot study of pyridostigmine in constipated 10;378(9808):2039-47.
44 • Calvary Mater Newcastle • review of operations • 2011/2012 Isbister GK, Kumar VV. Indications for single-dose Animal, Plant and Microbial toxins, Vladivostok 2011 5. Hossein Hassanian-Moghaddam, Saeedeh activated charcoal administration in acute overdose. Sarjami, Ali-Asghar Kolahi, Gregory Carter. Research funding/ Grants Curr Opin Crit Care. 2011 Aug;17(4):351-7 Postcards in Persia: 12 month outcomes of a NHMRC Project Grant “Snakebite First Aid” van randomised controlled trial to reduce suicidal Isbister GK, Page CB. Early endoscopy or CT in Helden D, Isbister GK. 2012-2013. $192,450 behaviours after hospital treated deliberate caustic injuries: a re-evaluation of clinical practice. Clin (University of Newcastle). self-poisoning British Journal of Psychiatry 2011 Toxicol (Phila). 2011 Aug;49(7):641-2. 198(4): 309-316. http://bjp.rcpsych.org/cgi/ Hunter Medical Research Institute “First Aid for Conference Presentations content/abstract/198/4/309 cytotoxic snakebite” Van Helden D, Isbister GK. 2012 Isbister G. International Congress on Animal, Plant $25,000 6. Carter G, Britton B, Clover K, Rogers K, Adams and Microbial toxins, Vladivostok 2011: Invited C, McElduff P. Effectiveness of QUICATOUCH: NSW Health Drug and Alcohol Research Grants speaker: “Understanding the Effectiveness of a computerised touch screen evaluation for pain Program “The DORM II study: a post-implementation Antivenom Therapy”. and distress in ambulatory oncology patients safety study of droperidol for acute behavioural in Newcastle, Australia. Psycho-oncology First Isbister G. Australasian College for Emergency disturbance in the emergency department” Isbister published online: 21 July 2011, DOI: 10.1002/ Medicine: Annual Scientific Meeting 2011, Sydney: GK, Calver L, Miller M. 2011-2012 $18,190 pon.2020. Invited speaker: “Toxinology Update” NHMRC Project Grant: “Neurotoxicity after 7. page A, Taylor R, Gunnell D, Carter G, Morrell Isbister G. European Association of Poisons Centres acute anticholinesterase pesticide poisoning and S, Martin G. Effectiveness of Australian Youth and Clinical Toxicologists (EAPCCT) XXXII International envenomation.” Buckley NA, Senanayake N, Isbister Suicide Prevention Initiatives. B J Psychiatry Congress, London, 2012: Invited Lecture: “Spider G, Dawson A, Karalliedde L, de Silva J. 2012-2015. November 2011 199:423-429; doi:10.1192/bjp. Bite” $970,970. (UNSW) bp.111.093856 Isbister G. Envenomation. Paediatric Acute Care Margaret Mitchell Research Grant Scheme – Calvary 8. saha S, Scott J, Johnston A, Slade T, Varghese Conference, Coolum QLD, 2011 Mater Newcastle: $10,000 Clark K, Whyte I, Byfieldt D, Carter G, McGrath J. The association between N. A pilot study of pyridostigmine in cancer patients Allen GE, O’Leary MA, Brown SGA Buckley NA, delusional-like experiences and suicidal thoughts with constipation and high anticholinergic loads. Isbister GK for the ASP Investigators Clinical Effects and behavior: a large population-based study. 2011–2012 and Antivenom Dosing in Brown Snake (Pseudonaja Schizophrenia Research 132 (2011) 197–202. spp.) Envenoming - Australian Snakebite Project Clinical Trials 9. Hassanian-Moghaddam H, Carter G. Role of (ASP-14): European Association of Poisons Centres Randomised controlled trial of intravenous antivenom postcards in reducing suicidal behaviour. Authors and Clinical Toxicologists (EAPCCT) XXXII International versus placebo in the treatment of redback spider bite reply. (letter) Br J Psychiatry 2011; 199(4):342- Congress, London, 2012 343. A randomised controlled trial of factor replacement Allen GE, O’Leary MA, Brown SGA Buckley NA, therapy in snake bite coagulopathy. 10. white JH, Magin P, Attia J, Sturm J, Carter G, Isbister GK for the ASP Investigators Clinical Effects Pollack M. Trajectories of psychological distress and Antivenom Dosing in Brown Snake (Pseudonaja Does Fresh Frozen Plasma in Russells viper bite after stroke (accepted Annals of Family Medicine spp.) Envenoming - Australian Snakebite Project coagulopathy reduce the dose and duration of October 2011) (ASP-14): Australasian College for Emergency antivenom therapy? Medicine: Annual Scientific Meeting 2011, Sydney 11. white J, Gray K, Magin P, Attia J, Sturm J. A randomised controlled trial of sedation of acute Carter G. Exploring the experience of post stroke Whyte IM. Australian Society of Clinical Toxicology behavioural disturbance in the psychiatric setting: The fatigue in community dwelling stroke survivors: A and Pharmacology.Clinical Weekend, Sydney, Haloperidol OR Droperidol Trial (HORD). prospective qualitative study (accepted Disability Australia, April 28–9, 2012 “Too much insulin!” (Invited and Rehabilitation November 2011). lecture) 12. turner A, Hambridge J, White J, Carter G, Clover Isbister GK. Australian Society of Clinical Toxicology Consultation-Liaison K, Nelson L, Hackett M. Depression screening and Pharmacology.Clinical Weekend, Sydney, Psychiatry in stroke: A comparison of alternative measures Australia, April 28–9, 2012 Snake Envenoming. Publications in peer reviewed Journals with the SCID (Major Depressive Episode) as (Invited lecture) criterion standard. Stroke 2012;43:1000-1005, Conference Posters 1. Carter GL, Lewin TJ, Gianacas L, Clover K, (published online before print February 23 2012) Adams C. Caregiver satisfaction with out-patient Berling I, Whyte IM, Isbister GK. Oxycodone oncology services: Utility of the FAMCARE 13. alex J Mitchell, Nick Meader, Evan Davies, Kerrie overdose: A case series. European Association of instrument and development of the FAMCARE-6. Clover, Gregory Carter, Matthew J. Loscalzo, Poisons Centres and Clinical Toxicologists (EAPCCT) Supportive Care in Cancer 2011; 19 (4): 565- Wolfgang Linden, Luigi Grassi, Christoffer XXXII International Congress, London, 2012 572. Johansen, Linda Carlson, James Zabora. Meta-Analysis of Screening and Case Finding Isbister GK, Brown SGA for the ASP Investigators. 2. Britton B, Clover K, Bateman L, Odelli C, Tools for Depression in Cancer: Evidence based Bites in Australian snake handlers - Australian Wenham K, Zeman A, Carter G. Baseline Recommendations for Clinical Practice for the snakebite project (ASP-15). European Association of Depression Predicts Malnutrition in Head and DCC Consensus Group. Journal of Affective Poisons Centres and Clinical Toxicologists (EAPCCT) Neck Cancer Patients Undergoing Radiotherapy Disorders 2012 140: 149–160 (online May 2012, XXXII International Congress, London, 2012 Supportive Care in Cancer 2012, 20(2): 335- doi:10.1016/j.jad.2011.12.043) 342. Calver LA, Downes MA, Page CB, Chan B, Isbister 14. Dassanayake T, Jones AL, Michie PT, Carter, GK. Droperidol for sedation of Acute Behavioural 3. Dassanayake T, Michie P, Carter G, Jones A. McElduff P, Stokes BJ, Whyte I . Risk of road Disturbance. Society of Academic Emergency Effects of benzodiazepines, antidepressants traffic accidents in patients discharged following Medicine Annual Meeting, Chicago, 2012 and opioids on driving: a systematic review of treatment for psychotropic drug overdose: a epidemiological and experimental evidence. Drug Calver LA, Downes MA, Page CB, Chan B, Isbister self-controlled case series study in Australia. Safety 2011 34 (2): 125-156. GK. Safety of droperidol for sedation of Acute (accepted CNS Drugs January 2012) Behavioural Disturbance. Society of Academic 4. Jayasekera, Himali , Carter, Gregory and 15. Dassanayake T, Michie PT, Jones AL, Mallard Emergency Medicine Annual Meeting, Chicago, 2012 Clover, Kerrie. Comparison of the Composite T, Whyte IM, Carter GL. Cognitive impairment in International Diagnostic Interview (CIDI-Auto) O’Leary MA, Isbister GK. Venom-antivenom patients clinically recovered from central nervous with Clinical Diagnosis in a Suicidal Population, immunocomplex measurement in vitro and in system depressant drug overdose. Journal of Archives of Suicide Research, 2011. 15: 1, 43 – envenomed patients. International Congress on Clinical Psychopharmacology 32 (4): 503-510 55. DOI: 10.1080/13811118.2011.540208
Calvary Mater Newcastle • review of operations • 2011/2012 • 45 16. Maddock G R, Startup M, Carter G. Who do GPs 4. turner Alyna, Hambridge J, White J, Clover Nelson, L refer to the Better Outcomes in Mental Health Kerrie, Carter Gregory Leigh, Nelson Louise Jane, Working with Terminally Ill Patients Care ATAPS program? ANZJP 2012; 46(5): Alston M, Hackett M, ‘Depression screening Invited workshop (8 hours) for Clinical Psychology 435-444. (ANZJP February online first 2012). in stroke patients: A comparison of alternative Masters students at UNE measures’, International Journal of Stroke, Armidale, Semester 1 2012 17. Dassanayake TL, Carter GL, Jones Al, Mallard Adelaide, SA (2011) T, Whyte I M, Michie PT. Cognitive skills Successful grant applications underlying driving in patients discharged following 5. Hackett M, Carter Gregory Leigh, Crimmins D, 2011 Grant #W81XWH-11-2-0123. $2,500,000 self-poisoning with central nervous system Clarke T, Arblaster L, Billot L, Mysore J, Sturm USD over 5 years. ClinicalTrials.gov identifier: depressant drugs. (accepted Traffic Injury J, ‘imProving Outcomes after STroke (POST) NCT01473771 Prevention February 2012) clinical pilot trial results’, International Journal of Caring Letters for Military Suicide Prevention: A Stroke, Adelaide, SA (2011) 18. Carter G. Editorial: Young people, mental illness Randomized Controlled Trial (multicentre USA, and suicidal behaviours. Early Intervention 6. tharaka Dassanayake, Patricia Michie, Alison Germany). Supporting Agency: US Army Medical in Psychiatry 2012 6 (2): 113–114, (Article Jones, Gregory Carter, Trevor Mallard and Research and Materiel Command, U.S. Army Medical first published online : 17 April 2012, DOI: Ian Whyte. Cognitive impairment in patients Research Acquisition 10.1111/j.1751-7893.2012.00359.x) discharged following CNS-depressant drug Principal Investigator: David D Luxton, PhD National overdose, and its implications in driving. ASPR Centre for Telehealth and Technology, USA. See 19. Carter G. Invited Commentary on “Bergen H, et Dunedin December 2011. http://clinicaltrials.gov/ct2/show/NCT01473771 for al. How do methods of non-fatal self-harm relate more details. to eventual suicide?” (accepted Evidence Based 7. invited Workshop: Screening for distress in Mental Health April 2012) cancer: A practical and theoretical guide to what 2011 NHMRC project Grant Application: (Application really works. Mitchell A, Loscalzo M, Clarke K, ID: APP1021018). $1,112,000 over 3 years. 20. Maree L Hackett, Greg Carter, Denis Crimmins, Clover K. International Psycho-Oncology Society Eating as Treatment (EAT): a trial of dieticians Tracy Clarke, Lucy Arblaster, Laurent Billot, Academy, Antalya Turkey, Nov 2011. providing a psychological intervention to improve Jayanthi Mysore, Jonathan Sturm. imProving nutrition in Head and Neck cancer patients Outcomes after Stroke: results from the Other presentations: undergoing radiotherapy randomised clinical pilot trial (accepted Stroke Carter GL Chief Investigator: Amanda Baker CIA, Gregory Carter April 2012) Child and Adolescent Psychiatry. CIB et al. 21. Clover K, Kelly P, Rogers K, Britton B, Carter Invited Lecture in the Masters of International Public 2011 James Lawrie Research Grant – Calvary Mater G. Predictors of desire for help in oncology Health Course, University of Sydney. September Newcastle Hospital: Calibrating commonly used outpatients reporting pain or distress. (accepted 2011. questionnaires for depression and anxiety in oncology Psycho-Oncology July 2012) Suicide and Suicide Attempt. to enhance comparability and communication of 22. luckett T, Britton B Clover K, Rankin NM. Invited Lecture in the Masters of International Public outcomes. (RASCH study) Evidence for interventions to improve Health Course, University of Sydney. September CIs K Clover, G Carter, B Britton. AIs M King, S psychological outcomes in people with head and 2011. Lambert J Pallant. $17,367 over 1 year. neck cancer: A systematic review of the literature. Gianacas L & Nelson L Supportive Care in Cancer. 2011:19 (7); 871- Living Well with Lymphoma 881. Invited patient presentation, Leukaemia Foundation. 23. oultram S, Findlay N, Clover K, Cross L, Ponman September, 2011. L, Adams C. A comparison between patient Gianacas L self-report and radiation therapists’ ability to Women’s Cancers: Psychological Considerations identify anxiety and distress in head and neck Invited in-service presentation, Hunter Postgraduate cancer patients requiring immobilisation for Medical Institute. September 2011. radiation therapy. Journal of Radiotherapy in Practice. (Accepted Apr 2011, due for publication Gianacas L in June 2012 - Volume 11 Issue 2). doi:10.1017/ Introduction to Psycho-Oncology S1460396911000136. Invited lecture in Health Psychology 3500 Undergraduate Course, University of Newcastle. Conference Presentations March 2012. 1. Maddock Gillian Rebekah, Carter Gregory Leigh, Britton, B & Gianacas L Startup Michael Jonathan, ‘Do GPs observe Breaking Bad News, Communication Skills Training DoHA guidelines in making referrals to the Invited tutorials in Bachelor of Medicine Course (Year Better Outcomes in Mental Health Care, ATAPS 5), University of Newcastle. February - June 2012. program?’, 2011 PHC Research Conference Abstracts, Brisbane, QLD (2011) Britton, B Introduction to Oncology 2. white J, Magin P, Attia J, Sturm J, Carter G, Invited Lecture and Tutorials in Bachelor of Medical Pollack M. Exploring Post-stroke Mood Changes Radiation Science (Year 1), University of Newcastle. in Community-Dwelling Stroke Survivors: A September 2011 Longitudinal Cohort Study. Stroke Society of Australasia Conference, Adelaide, September Britton, B 2011. Communication, Boundaries and Self-Care Invited Lecture and Tutorials in Bachelor of Medical 3. turner Alyna, White J, Hambridge J, Clover Radiation Science (Year 3), University of Newcastle. Kerrie, Nelson Louise Jane, Mavratzakis Aimee October 2011 Lee, Carter Gregory Leigh, Hackett M, ‘Impact of routine electronic screening and feedback Britton, B on depression symptoms in stroke: A pilot Motivating Health Behaviour Change randomised controlled trial’, International Journal Invited to write a chapter in Masters of Clinical of Stroke, Adelaide, SA (2011) Medicine (MEDI6145), University of Newcastle, Semester 1 2012
46 • Calvary Mater Newcastle • review of operations • 2011/2012 Financial Report
Calvary Health Care (Newcastle) Limited ABN 75 081 149 126 Financial Report for the Year Ended 30 June 2012
Calvary Mater Newcastle • review of operations • 2011/2012 • 47 Calvary Health Care (Newcastle) Ltd
DIRECTORS' REPORT
The Board of Directors of Calvary Health Care (Newcastle) Ltd present their report on the Company for the financial year ended 30 June 2012.
Directors Calvary Health Care (Newcastle) Ltd Board of Directors is comprised of the same membership as the National Board of the Little Company of Mary Health Care Ltd, which is the ultimate parent entity.
The names of Directors in office at any time during or since the end of the year are detailed below.
Directors have been in office since the start of the financial year to the date of this report unless otherwise stated.
NAME QUALIFICATIONS AREAS OF SPECIFIC RESPONSIBILITY Hon John Watkins M.A., LLB, DipEd Chair Member, MEC Michael Roche BA (Accounting), Deputy Chair FCPA, MACS Member, ARC Chair, SDC Hon Gregory Crafter AO LLB Director Chair, MEC Rebecca Davies BEc, LLB (Hons), Director FAICD Member, ARC Member, PRC John Mackay AM BA, FAIM Director Chair, PRC Associate Professor Richard Matthews AM MBBS Director (Appointed 1 January 2012) Member, CGC (Appointed 8 February 2012) Professor Katherine McGrath MBBS, FRCPA, Director FAICD Member, PRC Member, SDC Chair, CGC (Appointed 8 February 2012) Professor Peter Ravenscroft AM MBBS (Qld), MD Director (Qld), FRACP, Member, MEC FFPMANZCA, Member, SDC FaChPM Member, CGC (Appointed 8 February 2012 Jane Tongs MBA, BBus, FCA, Director FCPA, MAICD Chair, ARC Brigid Tracey AM BN (Bachelor of Director Nursing), Grad Dip Member, ARC Nursing Member, MEC Administration Member, CGC (Appointed 8 February 2012) Philip Maloney B Com, LLB, Grad Company Secretary (Appointed 12 March 2012) Dip CSP, ACIS, MAICD David Bergman BCom, MEc, ACA, Alternate Company Secretary FFin Margaret Scott (formerly McGowen) BEc, FCA, FFin, Company Secretary (Resigned 25 September 2011) ACIS Key: ARC Audit & Risk Committee MEC Mission & Ethics Committee PRC Performance & Remuneration Committee SDC Strategy & Development Committee CGC Clinical Governance Committee
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48 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
DIRECTORS' REPORT
Principal activities The principal activities of the Company remain the ownership and operation of the Calvary Mater Newcastle hospital.
Significant changes in the state of affairs There were no significant changes in the state of affairs of the Company during the financial year.
Results A deficit of $0.004M was incurred for the financial year ended 30 June 2012 (2011: surplus $92.491M).
Management is actively reviewing operational performance to further improve this result.
Review of operations The Company continued to provide quality services in accordance with the mission vision and values of the organisation.
(a) Revenues The Company's revenue from operating activities totalled $151.003M (2011: $243.951M). Grants and subsidies from Government for hospital operations totalled $115.475M (2011: $210.456M). Grants and subsidies represent 76% (2011: 86%) of revenue from operating activities.
Revenue from operations for the year ended 30 June 2011 included $100.040M resources received free of charge - capital and revenue relating to the Public Private Partnership (PPP) arrangements and recognition of the NSW government funding of superannuation contributions for employees who are members of the defined benefit contribution schemes SASS and SSS.
(b) Expenses The Company's expense from operating activities totalled $157.921M (2011: $156.939M). Expenses on personnel costs represent 63% (2011: 58%) of total operating expense.
Staffing levels for clinical services have increased during the reporting period with total staff of 928 full time equivalents as at 30 June 2012 (2011: 871).
(c) Hospital activities The overall inpatient activity for the year was 15,442 separations, an increase of 9% on the year ended 30 June 2011. Non-inpatient activity for the hospital during the year was 313,048 occasions of service, an increase of 2% on the year ended 30 June 2011.
Future developments The Company plans to continue the integration and expansion of its current range of services in accordance with the mission, vision and values of the organisation.
Significant events after year end Set out below are the details of matters or circumstances which have arisen since the end of the financial year which significantly affected, or may significantly affect, the operations of the Company.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 49 Calvary Health Care (Newcastle) Ltd
DIRECTORS' REPORT
There is a substantial process of regulatory and policy change impacting on the health and related sectors. These changes arise from reviews undertaken by the Productivity Commission, potential revisions to legislation, health fund rebates eligibility changes and the impacts of the carbon tax. No provision has been included in the financial statements for the potential impacts of these changes due to the material uncertainty as to their timing and impact.
Report preparation The Company's financial statements have been prepared in accordance with Australian Accounting Standards - Reduced Disclosure Requirements.
Deed of access and indemnity - Directors Little Company of Mary Health Care Ltd has executed a Deed of Access & Indemnity which provides Directors with the right of access to records for seven years after they cease office and also indemnifies Directors (to the extent permitted by law) against liability incurred in the course of their duties as a Director of companies within the Little Company of Mary Health Care group.
Indemnification of officers Little Company of Mary Health Care Ltd paid a premium during the year in relation to a Directors & Officers Liability policy indemnifying the Directors and Officers of the Group for losses which the Director or Officer may become legally obligated to pay on account of any claim made against the Director or Officer during the policy period for a wrongful act committed during the policy period.
Rounding off The Company is an entity to which ASIC Class Order 98/100 applies. Accordingly, amounts in the financial statements and Directors' Report have been rounded off to the nearest thousand dollars, unless otherwise stated.
Proceedings on behalf of the Company No person has applied for leave of the Court to bring proceedings on behalf of the Company or intervene in any proceedings to which the Company is a party for the purpose of taking responsibility on behalf of the Company for all or any part of those proceedings.
The Company was not a party to any such proceedings during the year.
Company details The Company is incorporated as a company limited by guarantee. If the Company is wound up, the constitution states that each member is required to contribute a maximum of $100 towards meeting any outstanding obligations of the Company. As the Company only has one member, a total maximum of $100 is payable on a wind up.
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50 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Mater Newcastle • review of operations • 2011/2012 • 51 52 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Mater Newcastle • review of operations • 2011/2012 • 53 Calvary Health Care (Newcastle) Ltd
TABLE OF CONTENTS Page Statement of comprehensive income 8 Statement of financial position 9 Statement of cash flows 10 Statement of changes in equity 11 Notes to the financial statements 1 Statement of significant accounting policies 12 2 Revenue 18 3 Expenses 18 4 Cash 19 5 Trade and other receivables 19 6 Inventories 19 7 Other assets 19 8 Property, plant and equipment 19 9 Restricted assets 22 10 Trade and other payables 22 11 Bank overdraft and financing arrangements 23 12 Provisions 23 13 Commitments 25 14 Related parties 26 15 Financial risk management 27 16 Contingent liabilities and assets 27 17 Economic dependency and going concern 28 18 Events subsequent to balance date 28 19 Registered office and principal place of business 28 Independent Auditor's Report 29
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54 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
STATEMENT OF COMPREHENSIVE INCOME FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
Revenue from operations 151,003 243,951 Other revenues 6,914 5,479
Total revenues 2 157,917 249,430
Employee benefits expense 3 99,212 91,521 Depreciation expense 3 5,875 3,716 Finance costs 3 8 8 Supplies 20,848 27,668 Computer expenses 113 101 Consulting and legal costs 85 331 Contracted services 21,440 20,442 Insurance 208 202 LCMHC National Office shared service contributions 1,753 1,042 Loss on disposal of property, plant and equipment 3 258 4,563 Operating lease rental expenses 3 25 - Power, light and heat 101 22 Public relations 5 3 Repairs and maintenance 177 354 Subscriptions 79 59 Travel 1,009 853 Other expenses 6,725 6,054
Total expenses 157,921 156,939
Net profit / (loss) for the year (4) 92,491
Other comprehensive income - -
Total comprehensive income / (loss) for the year (4) 92,491
The Statement of Comprehensive Income is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 55 Calvary Health Care (Newcastle) Ltd
STATEMENT OF FINANCIAL POSITION AS AT 30 JUNE 2012
2012 2011 Note $ '000 $ '000
Current assets Cash and cash equivalents 4/9 45,745 41,922 Trade and other receivables 5 4,388 2,847 Inventories 6 1,110 2,295 Other current assets 7 160 174 Total current assets 51,403 47,238
Non-current assets Property, plant and equipment 8 127,910 128,925 Total non-current assets 127,910 128,925
Total assets 179,313 176,163
Current liabilities Trade and other payables 10 6,790 6,331 Provisions 12 30,576 28,062 Total current liabilities 37,366 34,393
Non-current liabilities Provisions 12 1,013 832 Total non-current liabilities 1,013 832
Total liabilities 38,379 35,225
NET ASSETS 140,934 140,938
Equity Retained earnings 140,934 140,938
TOTAL EQUITY 140,934 140,938
The Statement of Financial Position is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28.
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56 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 30 JUNE 2012 2012 2011 Note $ '000 $ '000
Cash flows from operating activities Receipts from customers 42,150 39,632 Payments to suppliers and employees (152,155) (143,585) Government grants received 125,778 121,426 GST recovered from the ATO 4,720 4,404 GST payments to ATO (13,756) (13,229) Interest received 2,204 2,091
Net cash provided by operating activities 8,941 10,739
Cash flows from investing activities Payment for property, plant and equipment (5,118) (2,739)
Net cash used in investing activities (5,118) (2,739)
Net increase in cash held 3,823 8,000
Cash at the beginning of the financial year 41,922 33,922
Cash at end of the financial year 45,745 41,922
Separate disclosure of operating and other cash at the end of the financial year: Operating cash 9,347 6,640 Special purpose, trust and other restricted cash 9 36,398 35,282
45,745 41,922
The Statement of Cash Flows is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 57 Calvary Health Care (Newcastle) Ltd
STATEMENT OF CHANGES IN EQUITY FOR THE YEAR ENDED 30 JUNE 2012
Retained earnings Total $ '000 $ '000
Balance 1 July 2010 48,447 48,447
Surplus for the year 92,491 92,491
Balance 30 June 2011 140,938 140,938
Balance 1 July 2011 140,938 140,938
Deficit for the year (4) (4)
Balance 30 June 2012 140,934 140,934
The Statement of Changes in Equity is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28.
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58 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
Note 1:Statement of significant accounting policies Calvary Health Care (Newcastle) Ltd is a Public Company limited by guarantee, incorporated and domiciled in Australia.
The financial statements are general purpose financial statements that have been prepared in accordance with Australian Accounting Standards, Australian Accounting Interpretations, other authoritative pronouncements of the Australian Accounting Standards Board and the Corporations Act 2001.
The financial statements have been prepared on an accruals basis and are based on historical costs, except for the revaluation of certain non-current assets and financial instruments.
The financial statements were authorised by the Board on 23 August 2012.
Standards affecting presentation and disclosure The following Standards were early adopted in the 30 June 2010 year. There has been no impact on the amounts disclosed in the financial statements arising from the early adoption as the standards related to disclosure only. AASB 1053 Application of Tiers of Australian Accounting Standards ; and AASB 2010-2 Amendments to Australian Accounting Standards arising from Reduced Disclosure Requirements.
Accounting policies (a) Revisions of accounting estimates Revisions to accounting estimates are recognised prospectively in current and future periods only.
(b) Rounding off The Company is an entity to which ASIC Class Order 98/100 applies. Accordingly, amounts in the financial statements and Directors' Report have been rounded off to the nearest thousand dollars, unless otherwise stated.
(c) Comparative figures Comparative figures have been adjusted to conform with changes in presentation for the current financial year as a result of changes in the mapping of the general ledger accounts.
(d) Taxation The Company is exempt from income tax under the current provisions of the Australian Income Tax Assessment Act (1997). Accordingly, there is no income tax expense or income tax payable.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 59 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
(e) Goods and services tax Revenues, expenses and assets are recognised net of the amount of goods and services tax (GST), except where the amount of GST incurred is not recoverable from the Australian Taxation Office (ATO). In these circumstances, the GST is recognised as part of the cost of acquisition of the asset or as part of the expense. Receivables and payables in the Statement of Financial Position are shown inclusive of GST.
The GST components of cash flows arising from operating, investing and financing activities which are recoverable from, or payable to, the ATO are classified as operating cash flows.
The net amount of GST recoverable from, or payable to, the ATO is included as a current asset or liability in the Statement of Financial Position.
(f) Revenue recognition Where applicable, revenues are recognised at the fair value of the consideration received net of the amount of goods and service tax (GST) payable to the ATO.
Rendering of services Patient fee income is recognised when the fee in respect of services provided is receivable. Accrued patient income represents an estimate of fees due from patients not billed at balance date. This estimate is calculated with reference to individual episode information and per diem rates.
Grants received Reciprocal grants Grants received on the condition that specified services be delivered, or conditions fulfilled, are considered reciprocal. Such grants are initially recognised as a liability and revenue is recognised as services are performed or conditions fulfilled.
Non-reciprocal grants Revenue is recognised when the grant is received or receivable.
Resources received free of charge Revenue is recognised when fair value can be reliably measured. Usage of resources is recognised as a corresponding expense.
Interest revenue Interest revenue is recognised as it accrues, taking into account the effective yield on the financial asset.
Donation revenue Donation revenue is recognised when received, at the fair value of the asset donated.
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60 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
(g) Finance costs Finance costs include interest and finance lease/hire purchase finance charges and are expensed as incurred. In the case of assets which are under construction (and prior to being ready to use), finance costs are capitalised and form part of the total construction cost of the asset in the Statement of Financial Position.
(h) Financial instruments If the Company has the positive intent and ability to hold debt securities to maturity, then they are classified as held-to-maturity. Held-to-maturity investments are measured at amortised cost using the effective interest method, less any impairment losses.
Recognition and initial measurement Financial instruments, incorporating financial assets and financial liabilities, are recognised when the Company becomes a party to the contractual provisions of the instrument.
Financial instruments are initially measured at fair value plus transaction costs where the instrument is not classified as at fair value through profit and loss. Transaction costs related to instruments classified as at fair value through profit or loss are expensed to profit or loss immediately. Financial instruments are classified and measured as set out below.
Derecognition Financial assets are derecognised where the contractual rights to receipt of cash flows expires or the asset is transferred to another party whereby the Company no longer has any significant continuing involvement in the risks and benefits associated with the asset. Financial liabilities are derecognised where the related obligations are either discharged, cancelled or expire. The difference between the carrying value of consideration paid, including the transfer of non cash assets or liabilities assumed, is recognised in profit or loss.
Classification and subsequent measurement Financial assets at fair value through profit or loss Financial assets are classified at fair value through profit or loss when they are held for trading for the purpose of short-term profit taking, where they are derivatives not held for hedging purposes, or designated as such to avoid an accounting mismatch or to enable performance evaluation where a group of financial assets is managed by key personnel on a fair value basis in accordance with a documented risk management or investment strategy. Realised and unrealised gains and losses arising from changes in fair value are included in profit or loss in the period in which they arise.
Loans and receivables Loans and receivables are non-derivative financial assets with fixed or determinable payments that are not quoted in an active market and are subsequently measured at amortised cost using the effective interest rate method.
Patient fees receivable are generally settled from Health Funds within 30 days and are carried at amounts due.
Other debtors to be settled within 30 days are carried at amounts due.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 61 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
Held-to-maturity investments Held-to-maturity investments are non-derivative financial assets that have fixed maturities and fixed or determinable payments, and it is the Company's intention to hold these investments to maturity. They are subsequently measured at amortised cost using the effective interest rate method.
Available-for-sale financial assets Available-for-sale financial assets are non-derivative financial assets that are either designated as such or that are not classified in any other categories. They comprise investments in the equity of other entities where there is neither a fixed maturity nor fixed or determinable payments. These assets are held at fair values with movements recorded directly to reserves. Financial liabilities Non-derivative financial liabilities (excluding financial guarantees) are subsequently measured at amortised cost using the effective interest rate method.
Trade accounts payable are normally settled within 30 days.
(i) Inventories Inventories are measured at the lower of cost and net realisable value.
The cost of manufactured products includes direct materials, direct labour and an appropriate portion of variable and fixed overheads. Overheads are applied on the basis of normal operating capacity. Costs are assigned on the basis of weighted average costs.
(j) Property, plant and equipment Property, plant and equipment are measured on a cost basis less depreciation and impairment losses.
Subsequent costs are included in the asset's carrying amount or recognised as a separate asset, as appropriate, only when it is probable that future economic benefits associated with the item will flow to the Company and the cost of the item can be measured reliably. All other repairs and maintenance are charged to profit and loss during the financial period in which they are incurred.
(k) Depreciation and amortisation Assets are depreciated or amortised using the straight-line method of depreciation to their estimated residual values, from the date of acquisition or, in respect of internally constructed assets, from the time an asset is completed and held ready for use. Leasehold improvements are depreciated over the shorter of either the unexpired period of the lease or the estimated useful lives of the improvements.
Depreciation and amortisation rates and methods and residual values are reviewed annually for appropriateness. When changes are made, adjustments are reflected prospectively in current and future periods only.
15
62 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
The depreciation/amortisation rates used for each class of asset are as follows: 2012 2011 Buildings 2.5% 2.5% Plant, equipment, fixtures and fittings 10.0% 10.0% Medical, surgical and office equipment 15.0% 15.0% Computer equipment 33.3% 33.3%
(l) Impairment of assets At each reporting date, the Company, a not-for-profit entity, reviews the carrying values of all assets to determine whether there is any indication that those assets have been impaired. If such an indication exists, the recoverable amount of the asset, being the higher of the asset's fair value less costs to sell and value in use, is compared to the asset's carrying value. Any excess of the asset's carrying value over the recoverable amount is expensed.
In the case of Property, Plant and Equipment, 'Value in Use' is taken to be the depreciated replacement cost of the asset.
(m) Leased assets Leases of plant and equipment under which the Company assumes substantially all the risks and benefits of ownership are classified as finance leases. Other leases are classified as operating leases.
Finance leases Finance leases are capitalised. A lease asset and a lease liability equal to the present value of the minimum lease payments are recorded at the inception of the lease. Capitalised lease assets are amortised on a straight line basis over the life of the asset. Lease liabilities are reduced by repayments of principal. The interest components of the lease payments are expensed.
Operating leases Payments made under operating leases are expensed in equal instalments over the accounting periods covered by the lease term.
(n) Employee benefits Provision is made for the Company's liability for employee benefits arising from services rendered by employees to balance date. Employee benefits, where the Company does not have an unconditional right to defer settlement for at least 12 months, have been classified as a current liability. Employee benefits payable later than one year have been classified as a non-current liability. Both the long-term current liabilities and non-current liabilities have been measured at the present value of the estimated future cash outflows to be made for those benefits.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 63 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
(o) Superannuation plan The Company contributes to various defined contribution and accumulation superannuation plans. Contributions are charged as an expense as incurred.
For defined contribution plans, contributions are expensed when employees have rendered services entitling them to the contributions.
(p) Key estimates and judgements The Directors evaluate estimates and judgements incorporated into the financial statements based on historical knowledge and best available current information. Estimates assume a reasonable expectation of future events and are based on current trends and economic data obtained both externally and within the Company and LCM Health Care group.
Key estimates - impairment The Company is a not-for-profit entity and assesses for asset impairment at each reporting date by evaluating conditions specific to the Company that may lead to the impairment of assets. Where an impairment trigger exists, the recoverable amount of the asset is determined. The recoverable amount is defined as the higher of its fair value (less costs to sell), and its ‘value in use’. As a not-for-profit entity, and where appropriate, value in use is calculated as the higher of the present value of future cash flows (inclusive of an appropriate assessment period and terminal value of the asset) or the asset's depreciated replacement cost. Key judgements - provision for impairment of receivables Current trade and term receivables are non interest bearing loans and generally on 30-day terms. Non-current trade and term receivables are assessed for recoverability based on the underlying terms of contract. A provision for impairment is recognised when there is objective evidence that an individual trade or term receivable is impaired.
Trade receivables Included in accounts receivable at 30 June 2012 is an amount of $0.888M (2011: $0.931M) which represents the net trade receivables believed to be recoverable by the Company after providing for an amount of $0.035M (2011:$0.035M) which is considered to prudently represent those receivables considered impaired. The Company reviews outstanding debts as the basis for impairment. All impairment calculations are based on a commercial assessment criteria, including segmentation, ageing, billing and collections procedures and prevailing trends.
The Directors do not believe, however, that the entire amount of the impairment provision is not recoverable. The provision represents 3.9% of trade receivables as at 30 June 2012. The 30 June 2011 provision amounted to 3.8 % of total trade receivables.
Other debtors Other debtors consist of related parties, government departments and the like. The Directors do not believe any of the amounts warrant impairment.
17
64 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
2 Revenue Operating activities Revenue from rendering of services 35,528 33,495 Recurrent grants received/receivable 113,053 108,259 Public Health Service capital grants 1,411 2,157 Resources received free of charge - capital - 93,280 Resources received free of charge - revenue 1,011 6,760 151,003 243,951
Non-operating activities Interest revenue 2,204 2,091 Donation revenue 1,293 1,522 Canteen takings and meals and accommodation 185 178 Government funded paid parental leave 156 - Other revenue 3,076 1,688 6,914 5,479 Total revenue 157,917 249,430
Resources received free of charge - capital and revenue During the 30 June 2011 year the Company recognised the fair value of the buildings, plant and equipment and minor equipment under the Public Private Partnership (PPP) arrangements as resources received free of charge - capital ($93.280M) and revenue ($5.724M). The remainder of the amount shown as resources received free of charge in 2011 and 2012 is recognition of the NSW governments funding of superannuation contributions for employees who are members of defined benefit contribution schemes.
3 Expenses Depreciation of: buildings 3,240 1,627 plant and equipment 2,635 2,089 Total depreciation expenses 5,875 3,716
Finance costs: interest and bank fees 8 8
Bad and doubtful debts 97 32
Employee benefits: Salaries and wages 88,151 81,490 Superannuation 6,789 6,324 Workcover 1,535 1,427 Long-term and post-employment benefits 2,737 2,280 99,212 91,521
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Calvary Mater Newcastle • review of operations • 2011/2012 • 65 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
Operating lease rental expense: Other parties 25 -
Loss on disposal of property, plant & equipment 258 4,563
4 Cash Current Cash at bank and on hand 20,745 16,922 Short-term term deposits 25,000 25,000 45,745 41,922
5 Trade and other receivables Current Trade receivables Receivables for patient fees 923 966 Less: Provision for impairment of receivables (35) (35) 888 931 Other receivables Grant receivable - Health / local Health division 374 - Other receivables 3,126 1,916 3,500 1,916 4,388 2,847
Movement in the impairment of receivables Balance at the beginning of the year (35) (37) Impairment losses recognised on receivables (97) (32) Amounts written off as uncollectable 97 34 Balance at the end of the year (35) (35)
6 Inventories Current - at cost Medical and surgical 341 381 Pharmacy 769 1,914 1,110 2,295
7 Other assets Current Prepayments 160 174
8 Property, plant and equipment Freehold land - at cost (a) 7,612 7,612
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66 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
Buildings - at cost (a) 130,007 129,786 Less: Accumulated depreciation (24,016) (20,776) 105,991 109,010
Plant and equipment - at cost 25,595 23,574 Less: Accumulated depreciation (11,778) (11,778) 13,817 11,796
Motor vehicles - at cost 490 554 Less: Accumulated depreciation - (47) 490 507
127,910 128,925
Asset audit Following a physical inspection throughout the financial year, plant and equipment with a cost of $0.450M (2011: $0.991M) and accumulated depreciation of $0.315M (2011: $0.856M) that could not be identified or located were scrapped. This resulted in a loss on disposal of $0.135M (2011: $0.135M).
Reconciliation of property, plant and equipment Reconciliations of the carrying amounts for each class of property, plant & equipment are set out below:
Freehold land (a) Carrying amount at beginning of year 7,612 7,007 Acquisitions / additions - 605 Carrying amount at end of year 7,612 7,612
Buildings (a) Carrying amount at beginning of year 109,010 25,280 Acquisitions / additions 221 89,584 Disposals - (4,227) Depreciation (3,240) (1,627) Carrying amount at end of year 105,991 109,010
Plant and equipment Carrying amount at beginning of year 11,796 4,114 Acquisitions / additions 4,879 5,693 Disposals (223) (171) Transfers in / (out) - 4,249 Depreciation (2,635) (2,089) Carrying amount at end of year 13,817 11,796
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Calvary Mater Newcastle • review of operations • 2011/2012 • 67 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
Motor Vehicles Carrying amount at beginning of year 507 535 Acquisitions / additions 532 795 Disposals (549) (823) Carrying amount at end of year 490 507
Assets under construction Carrying amount at beginning of year - 4,249 Reallocation - (4,249) Carrying amount at end of year - -
(a) Land and buildings In 2005/06 the NSW Health Administration Corporation entered into a contract with a private sector provider, Novacare Project Partnership, for financing, design, construction and commissioning of a new hospital facility, a mental health facility and refurbishment of existing buildings, and facilities management and delivery of ancillary non-clinical services on the Calvary Mater Newcastle hospital site until November 2033.
The official opening of the new facilities took place in August 2009. The legal documentation for the ongoing operation of the PPP arrangement, following finalisation of the construction phase of the PPP, was executed on 20 May 2011.
Hunter New England Local Health District (HNELHD) transferred control of the newly constructed general hospital facility through a sub-lease agreement to the Company. The terms and conditions of the use of the redeveloped facility are contained in a Head Lease between the parties to the PPP arrangement. The recognition of the assets is based on the fact that the Company, being an Affiliated Health Organisation which is outside the accounting control of either HNELHD or the NSW Health Department, recognises its funding (recurrent or capital) as grant income in the year of receipt.
Review of Interpretation 12 The applicability of Interpretation 12 Service Concession Arrangements to the activities of the Company in respect of the operation of the public hospital has been considered. Interpretation 12 mandates the accounting for certain public-to-private service concession arrangements.
The arrangements for the operation of the hospital are not within the scope of Interpretation 12 because the overall scope for decision making and control over the daily operations and the management of the hospital remains within the Company’s decision making framework. In addition, the Company retains significant residual value in the assets.
The Directors agree with this view and, therefore, believe it is appropriate the activities and assets of the Company be recorded on the Statement of Financial Position of the Company in order to present a true and fair set of accounts that comply with Australian Accounting Standards.
21
68 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
9 Restricted assets The Company holds assets which are restricted by externally imposed conditions, for example, in line with the 'Accounts and Audit Determination' of NSW Health in exercising its powers conferred by the Health Services Act 1997 (NSW) and grant and donor requirements.
The assets are only available for application in accordance with the terms of these restrictions.
Brief details of externally imposed conditions Category / Conditions Special Purpose / Conditions imposed by granting body 8,291 9,070 Charitable Trust / Trust Deed 23,543 21,219 Research grants / Conditions imposed by granting body 4,564 4,993 36,398 35,282 Disclosed in the Statement of Financial Position as: Cash at bank and on hand 11,398 10,282 Term deposits 25,000 25,000 36,398 35,282
10 Trade and other payables Current Trade payables 2,171 3,243 Grants / income received in advance 198 174 Deferred income 2 2 Other payables and accruals 4,419 2,912 6,790 6,331
Trade payable terms vary from 7 to 30 days generally. No interest is charged on trade payables.
Grants and other income received in advance relate to the component of grants received from Hunter New England Local Health District and University of Newcastle for work agreed to be performed under the terms of the grant next financial year 2012/13.
Deferred income comprises patient fees prepaid.
Other payables and accruals comprise salaries and wages and goods and services expenses incurred.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 69 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
11 Bank overdraft and financing arrangements The Company has access to the following lines of credit: Group pooling facility - bank (a) 2,000 2,000
Facilities not utilised at balance date: Group pooling facility - bank 2,000 2,000
(a) Group pooling facility - bank The LCM Health Care Group utilises a pooling facility with interest calculated daily and paid monthly on the Group balance. The security for this facility is provided jointly and severally by all the entities in the Group. This facility avoids the need for individual companies to have overdraft facilities in place.
12 Provisions Current Employee benefits: Annual leave 10,150 9,679 Long service leave 16,860 15,798 Accrued salary expenses 3,436 2,469 Other employee provisions 130 116 30,576 28,062 Non Current Employee benefits: Long service leave 1,013 832
Employee benefit provisions Employee benefit provisions are reported as current liabilities where the Company does not have an unconditional right to defer settlement for at least 12 months. Consequently, the current portion of the employee benefit provision includes both short-term benefits measured at nominal values and long-term benefits, measured at present value. Employee benefit provisions that are reported as non-current liabilities refer to long-term benefits of non vested long service leave that do not qualify for recognition as a current liability, and are measured at present value.
Funding of employee entitlements The NSW Health Department, via the Local Health District, has committed to providing annual funding to meet employee entitlements that become payable in that year in the course of providing services. These funds are part of the normal operating subsidies paid to the Company by Hunter New England Local Health District.
23
70 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
The Company has indemnification from the NSW Health Department for any accrued public hospital employee leave entitlements or any other employee entitlements such as redundancies payable by Calvary Health Care (Newcastle) Ltd which the Company is liable to pay at the time of, or becomes liable to pay as a consequence of, ceasing to conduct a public hospital in whole or part, as a public hospital listed in the Third Schedule of the Health Services Act or any successor Act subject to: - the Company being specified in the Third Schedule of the Health Services Act 1997 or any successor Act as the operator of the public hospital; - a transparent system being established to provide annual verification to the Area Health Service of the accrued recreation and long service leave entitlement in respect of each named public hospital employee as at 30 June each year; - real property and other substantial assets used to conduct the public hospital not being disposed of at any time without the full knowledge and agreement of the NSW Health Department; - the completion of a due diligence process should it be required in the event of wind up or cessation of operations whereby assets, or parts thereof, used to conduct the hospital are to be applied to offset liabilities properly incurred in operating the public hospital; and - the Company using its best endeavours to transfer all relevant employees together with the liability for the accrued entitlements for those employees as part of such transfer of operations, if at some future time the Company enters into an agreement to transfer part or all of the operations of the public hospital to a public health organisation (as defined in the Health Services Act) or to the State.
Superannuation plans The Company contributes to employee superannuation funds for all eligible employees based on various percentages of their gross salary, with a minimum contribution of 9% of gross salary. All employees are entitled to benefits on retirement, disability or death.
A small number of employees who commenced employment with the Company prior to 18 December 1992 are members of the defined benefit State Authority Superannuation Scheme (SASS). This scheme is managed by the State Super Authority and the Company has neither control nor responsibility for the scheme. The Company's only obligations are the payment of any employee salary sacrificed employer contributions and employee post-tax employee contributions. The NSW Treasury remits all other required employer contributions directly to the scheme. The Company accounts for the liability paid by NSW Treasury as having been extinguished resulting in the amount assumed being shown as part of the non-monetary revenue item described as Resources received free of charge.
The superannuation expense for the financial year is determined by using the formulae specified by the NSW Department of Health. The expense for certain superannuation schemes (ie Basic Benefit and First State Super) is calculated as a percentage of the employees' salary. For other superannuation schemes (ie State Superannuation Scheme and State Authorities Superannuation Scheme), the expense is calculated as a multiple of the employees' superannuation contributions.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 71 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 Note $ '000 $ '000
13 Commitments Operating lease commitments Future operating lease rentals not provided for in the financial statements and payable: Not later than one year 35 - Later than one year but not later than five years 64 - 99 -
The Company leases assets under operating leases. Leases generally provide the Company with a right of renewal at which time all terms are renegotiated.
Public private partnership (PPP) In 2005/06, the NSW Health Administration Corporation entered into a contract with a private sector provider, Novacare Project Partnership for financing, design, construction and commissioning of a new hospital facility, a mental health facility and refurbishment of existing buildings, and facilities management and delivery of ancillary non-clinical services on the site until November 2033.
Other expenditure commitments, totalling $7.247M (2011: $6.771M), for the provision of facilities management and delivery of other non-clinical services on the Calvary Mater Newcastle hospital site, were expended for the year ended 30 June 2012. As the Company is not contractually committed to the agreement, the expenditure commitment over the life of the service provision is contingent upon recurrent funding continuing to be received from the NSW Health Department, via Hunter New England Local Health District.
25
72 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
2012 2011 $ $
14 Related parties (a) Key management personnel From time to time Directors, executives and other key management personnel of the Company may be treated as patients. This service is provided on the same terms and conditions as those entered into by other employees or customers and are trivial or domestic in nature.
A payment, the details of which are confidential and not disclosed, was made by the Parent Entity, Little Company of Mary Health Care Ltd, in respect of a contract of insurance indemnifying all Officers against liability for any claims brought against a Director or Officer.
Non-Executive Directors' fees and National executive salaries are paid and are reported separately by the Parent Entity, Little Company of Mary Health Care Ltd. Remuneration for the Company's Executives is detailed below.
Compensation of executives Executives (aggregate) 781,656 845,340
Other related parties (b) Transactions Amounts included in income received during the year from LCM Health Care group companies: Supplier rebate income 1,095 - Recovery of salaries and wages (incl on-costs) - 1,231 Palliative care education - 3,875 Recovery for goods and services 1,000 210
Amounts included in expenditure during the year to LCM Health Care group companies: National Office shared service contribution 1,302,310 635,594 National IT shared service contribution - non-recurrent 169,565 178,692 National IT shared service contribution - recurrent 280,739 227,303 Payments for goods and services 14,132 109,397 Insurance premiums 65,467 71,977 Training costs 3,050 -
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Calvary Mater Newcastle • review of operations • 2011/2012 • 73 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
15 Financial risk management The Company's financial instruments consist mainly of deposits with banks, accounts receivable and accounts payable.
The Company does not have any derivative instruments at 30 June 2011 or 2012.
The Company's overall risk management strategy seeks to meet its financial targets whilst minimising potential adverse effects on financial performance.
Interest rate risk is managed with floating rate debt. As at 30 June 2012, the Company had no debt.
Carrying Amounts 2012 2011 $ '000 $ '000 Financial assets Loans and receivables 4,548 3,021 Available for sale 45,745 41,922 50,293 44,943
Financial liabilities At amortised cost 6,790 6,331
16 Contingent liabilities and assets Claims on managed fund On 1 July 1989 the NSW Government implemented a self insurance scheme known as the Treasury Managed Fund (TMF). Since that time, the Company has been a member of the TMF. The TMF will pay to or on behalf of the Company all sums which it shall become legally liable to pay by way of compensation or legal liability except for employment related, discrimination and harassment claims that do not have state-wide implications. Therefore, since 1 July 1989, apart from the exceptions noted above no contingent liabilities exist in respect of liability claims against the Company. A Solvency Fund (now called Pre-Managed Fund) Reserve was established by the NSW Government to deal with the insurance matters incurred before 1 July 1989 that were above the limit of insurance held or for matters that were incurred prior to 1 July 1989 that would have become verdicts against the State. The Pre- Managed Fund will respond to all claims against the Company.
Workers compensation hindsight adjustment The NSW Treasury Managed Fund normally calculates hindsight premiums each year. However, in relation to workers compensation, adjustments are delayed. The final hindsight adjustment for the 2005/06 fund year and an interim adjustment for the 2007/08 fund year were not calculated until 2011/12. As a result, the 2006/07 final and 2008/09 interim hindsight calculations will be paid in 2012/13.
It is not possible for the Company to reliably quantify the amount outstanding.
There are no other events identified and not brought to account which could be expected to have a material effect on the financial statements in the future.
27
74 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Health Care (Newcastle) Ltd
NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2012
17 Economic dependency and going concern The Company derives most of its income from the NSW Health Department, via Hunter New England Local Health District. A going concern basis for the preparation of the financial statements has been adopted as it is expected that sufficient funding from the NSW Health Department will continue.
An indemnification has also been obtained from the NSW Health Department in relation to employee entitlements refer to Note 12.
Of total revenue, 73% is derived from NSW Government funding, and 7% is derived from private patient revenue. Benefits are paid in accordance with agreements between the NSW Department of Health and the health funds.
The Company is one of a number of subsidiaries of the Parent Entity, Little Company of Mary Health Care Ltd. Whilst it is not envisaged the Company will need to rely on the Parent Entity for its economic dependency, the constitution of the Company has the provision required under s187 of the Corporations Act which expressly authorises the Company to act in the best interests of the Parent Entity, so that it is capable of providing economic assistance to the Parent Entity, provided the Company will not become insolvent as a result of giving such economic assistance.
The Parent Entity may, in turn, provide economic assistance to any of its subsidiaries including the Company, by withdrawing funds from any other of its subsidiaries, except for those moneys located in certain Special Purpose or Trust Fund Accounts, to provide such support as is necessary to enable the Parent Entity or subsidiary to pay its debts as and when they fall due, provided neither the Parent Entity or the Company will become insolvent as a result of the withdrawal.
The Directors currently believe that, collectively, the Parent Entity and its subsidiaries have sufficient cash resources to ensure the Company, the Parent Entity, and other subsidiaries of the Parent Entity will continue to trade as going concerns and they are unaware of any material uncertainties, events or conditions, which may cast significant doubt on this belief.
18 Events subsequent to balance date There has not arisen in the interval between the end of the financial year and the date of this report any item, transaction or event of a material and unusual nature likely, in the opinion of the Directors of the Company, to affect significantly the operations of the Company, the results of those operations, or the state of affairs of the Company in future financial years.
19 Registered office and principal place of business Calvary Health Care (Newcastle) Ltd is a company limited by guarantee, incorporated in Australia and operating in Waratah, NSW.
The Company's registered office is Level 18 68 Pitt St Sydney NSW 2000 and the principal place of business of the Company is Calvary Mater Newcastle Hospital Edith St Waratah NSW 2298.
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Calvary Mater Newcastle • review of operations • 2011/2012 • 75 76 • Calvary Mater Newcastle • review of operations • 2011/2012 Calvary Mater Newcastle • review of operations • 2011/2012 • 77 Palliative Care puppy “Daisy”
A service of the Sisters of the Little Company of Mary
Calvary Calvary Mater Newcaslte Mater Locked Bag 7 Hunter Region Mail Centre NSW 2310 Australia Newcastle T: 02 4921 1211 | W: www.mater.org.au