Melbourne Health Quality of Care Report 2011
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Melbourne Health Quality of Care Report 2011 1BTTJPOGPS $BSJOH"DIJFWJOH UIF&YUSBPSEJOBSZ Quality & safety information for our community The Melbourne Health Quality of Care Report is our report to the community, describing the way we measure and monitor the quality of care we provide and what we are doing to improve our services. Contents 2 Welcome 4 Melbourne Health at a glance 6 Improving our services 14 Keeping our patients safe 22 Keeping it professional 28 Keeping our patients at the heart of our healthcare 36 Care in the community 1 Welcome This Quality of Care Report is our In 2011, we welcomed 71 new opportunity to share highlights from a medical interns to The Royal selection of projects that are underway Melbourne Hospital, 115 nurses as across Melbourne Health to improve part of the Melbourne Health graduate patient services. These highlights nurse program, 23 graduate and include reducing waiting times in our 19 post graduate psychiatric nurses Outpatient clinics, developing ways with NorthWestern Mental Health and to keep patients mobile and adopting 13 Allied Health graduates. We see innovations in surgical techniques. these new recruits striving to become Our staff make incredible efforts leaders in their respective fields. every day to improve outcomes for Through embracing the organisation’s our community. vision – passion for caring and I believe our health care service is achieving the extraordinary – new and among the best in the world. We have existing staff provide care that meets achieved this standard by keeping our the medical, emotional and cultural patients at the heart of our healthcare needs of our community and bring and by involving consumers, carers strength, independence and dignity and the community as active partners to our patients and their families. in our decision making. Once you have read this report, please Our multidisciplinary approach to do not hesitate to let us know how we patient care and culture of person can improve our service and meet the centred care are supported by our needs of our patients. By listening to values of Respect, Caring, Integrity, you, we further make this dynamic Unity and Discovery. As a values health service one that belongs to our driven organisation we have become community. Your suggestions can also an employer of choice, reflected in help us improve this report so that it the number of new staff who joined meets your needs. Melbourne Health throughout We hope you enjoy reading our the year. Quality of Care Report. Robert Doyle Chairman Melbourne Health 2 This report describes the way we measure and monitor the quality of care we provide and what we are doing to improve our services. 3 Melbourne Health at a glance We manage beds across acute, sub- acute, outpatient and community settings. We also treat and care for many people from regional and rural Victoria and interstate through a number of specialist services. The Royal Melbourne Hospital - NorthWestern Mental Health provides North West Dialysis Service is one City Campus, on Grattan Street in a comprehensive, integrated range of of the largest providers of renal Parkville, is an acute tertiary hospital, services to people living with mental replacement therapies in Australia, offering a full range of general and illness in north-western Melbourne. providing care for more than a third of specialist medical and surgical A multidisciplinary workforce Victorian dialysis patients. The central services, as well as being a State Adult provides services from 27 sites, hub is located at The Royal Melbourne Trauma Service. It has 12 operating through four adult Area Mental Hospital - City Campus with links theatres, around 400 overnight beds Health Services (Inner West, Mid to six metropolitan satellite centres and 170 day procedure beds including West, North West and Northern), an (operating 80 dialysis beds and chairs) dialysis, as well as additional beds in aged persons’ mental health program and 23 regional satellite centres the community through our Hospital and a youth mental health service, in the north-western corridor of in the Home service. Orygen Youth Health. Services include Victoria. North West Dialysis Service crisis assessment and treatment, also provides training and technical The Royal Melbourne Hospital - Royal rehabilitation, community-based support for home-based dialysis Park Campus is on Poplar Road, treatment, ongoing case management, and pre-dialysis, and pre-transplant Parkville, near Melbourne Zoo. acute inpatient, residential and support and education. This campus provides specialist sub- specialist services. It also provides acute services, including aged care Our patients are diverse in terms of consultation and education to around and rehabilitation inpatient services, culture, language, age, ethnicity and one million people and a wide range assessment services, a community socio-economic status. For example, of health and welfare organisations. rehabilitation centre, outpatient day at The Royal Melbourne Hospital in Currently, NorthWestern Mental activity programs and clinics, and 2010/11, nearly half of our inpatients Health is funded to operate a total community outreach programs. The (41 per cent) were 65 years old or over. of 517 acute and residential beds. campus also manages about 160 beds More men were inpatients (53,300) across four residential facilities. compared to women (41,942), and half were born outside Australia. 4 There were 32,886 occasions of Melbourne Health catchments and services interpreting service, with 59 per cent provided by our in-house team of interpreters. We have interpreters in Italian, Greek, Arabic, Turkish, Vietnamese, Cantonese and Mandarin, which are the languages Whittlesea most often requested by our patients. Interpreting services are also arranged Hume for other languages and dialects Nillumbik as needed. An Auslan interpreting service is available for people who Melton Moreland Darebin have serious hearing impairments, Moonee Valley Brimbank and during the year, it was used 91 times. H Banyule Maribrynong RMH Inpatients: Admissions % from Total Melbourne Country of Birth 2010/11 Admissions Wyndham Hobsons Bay Australia 47,649 50% Italy 9,716 10% Greece 5,651 6% England 2,492 3% Lebanon 2,377 3% Legend Turkey 2,076 2% Former Yugoslav 1,754 2% NWDS Republic of NWMH (Adult Area Mental Health Service) Macedonia NWMH (Aged Persons’ Mental Health Service) Vietnam 1,440 2% NWMH (Youth Mental Health Service) New Zealand 1,293 1% NWMH - All programs NWMH Catchment Philippines 1,204 1% H Royal Melbourne Hospital India 1,196 1% RMH Primary Catchment Malta 1,145 1% RMH Secondary Catchment Croatia 982 1% Iraq 960 1% Data Source: Catchment Populations Egypt 944 1% - Provided by Melbourne Health (04/08/2009) - Population data originally from Service and Workforce Other 14,363 15% Planning, DHS (02/10/2008) Local Government Areas - ABS (2006) Total 95,242 100% Map prepared by: Service and Workforce Planning, Portfolio Services and Strategic Projects Division Department of Human Services. SEPTEMBER 2009 GDA_1994_VICGRID94 5 Improving our services During 2010/11 Melbourne Health completed 20 major improvement projects. These projects looked at how we can improve access to our services, make things safer for our patients, visitors and staff, reduce waiting times, and make our services more welcoming and inclusive. International and national collaborations, clinical research trials and embracing innovative ideas from our staff, all mean the quality of healthcare we deliver is equal with the best in the world. Here are a few highlights from our improvement projects last year. Improving access to emergency general surgery In February 2011, our Department of Specialist General Surgery successfully trialed a change in the model of care for the management of emergency general surgery patients. An on-call consultant provides in- appointment or didn’t respond to house cover between 8am and 6pm, Reducing waiting lists in our repeated attempts to contact them. seven days a week. Outpatients clinics The Outpatients Department This reduction of waiting lists will This consultant is also on call for three received funding from the Department translate into shorter waiting times nights a week, with the remaining four of Health to conduct an audit of for our patients, and we will continue nights covered by another consultant. waiting lists to identify patients who auditing regularly. We are also moving This has provided a more responsive no longer needed an appointment. to a patient-focused booking system, service and greater continuity of care Patients are often referred to a number where patients are notified that an for patients needing urgent surgery of health services for the same appointment is available and are and patients have been able to get condition and may be on a number asked to ring the hospital to confirm home quicker. of hospitals’ waiting lists. If these a suitable time. This means we can Since the introduction of the on-call patients are seen at another hospital, better meet our patients’ needs and consultant, the average length of stay and we are not notified, this prevents ensure that appointment times are for patients in hospital following an us from offering the appointment being used in the most efficient emergency admission dropped from time to someone else. and effective way. 5.8 days to 3.8 days (a reduction of From December 2010 to February 2 days); our 8-hour performance, 2011, we audited the Plastic, moving patients from the Emergency Urology, Neurology, Neurosurgery, Department to a ward within eight Orthopaedics, Dermatology, hours, has improved by nearly Colorectal, Head and Neck, 10 per cent; and we performed just Immunology and Cardiology over half of all emergency general outpatient waiting lists. We were surgery operations during regular able to remove 2904 names because hours (weekdays 7.30am to 5.30pm). they either no longer required an 6 We are constantly looking for ways to improve our services, and in the past year we completed 20 major improvement projects.