2005 – 2006 Annual Report

Getting better together Contents

04 Chairman’s report 26 Redevelopment, 05 Chief Executive Infrastructure and Officer’s report Commercial 06 Austin Health Board 30 Corporate 08 Organisational Development structure 34 Human Resources 09 Austin Health 36 Research Executive 40 Teaching and 10 Year at a glance Training 14 Acute Operations 44 Finance 20 Chief Medical Officer 46 Mandatory reporting 22 Ambulatory and 48 Senior staff Nursing Services 50 Our clinical services

Vision Overview Austin Health will be renowned for Austin Health is the major provider excellence and outstanding leadership of tertiary health services, health in health care, research and education. professional education and research in the north east of Melbourne. Values Austin Health is world-renowned for its research and specialist work in Integrity. We exercise honesty, candour cancer, liver transplantation, spinal and sincerity. cord injuries, neurology, endocrinology, Collaboration. We work in partnership mental health and rehabilitation. with others. Austin Health comprises Austin Hospital, Accountability. We are transparent, Heidelberg Repatriation Hospital and responsible and answerable. the Royal Talbot Rehabilitation Centre. Respect. We treat others with dignity, During 2005 – 06, Austin Health’s 6,400 consideration, equality and value. staff treated a record 82,153 inpatients and 146,185 outpatients. Excellence. We continually strive for excellence. Empathy. We are compassionate and empathetic. When teams of highly skilled and dedicated professionals work together, they achieve better outcomes for patients. Teamwork is the cornerstone of Austin Health’s success. Chairman’s report

The increasing mental health needs of The Board is pleased to note a strong the community are a major focus for health commitment to consolidate the various services, governments and, gratifyingly medical research activities at Austin Health now, for the broader community. The Board into a more collaborative structure that is pleased to support the proposal to will greatly enhance both the impact develop further mental health capacity of available resources and the outcome at the Heidelberg Repatriation Centre of research. The establishment of the site, which would include strengthening Austin Health node of the Howard Florey services for veterans’ mental health. Neuroscience Institute is a very welcome Volunteers again played a vital role development that will contribute in supporting our health service across to further strengthening the reputation the three facilities – Austin Hospital, of the organisation for outstanding Heidelberg Repatriation Hospital and medical research. Royal Talbot Rehabilitation Centre. The Board extends its thanks to the Their support in assisting our visitors, Minister for Health, the Honourable interacting with patients; and fundraising Bronwyn Pike MP and the Department enhances our service performance and of Human Services for their support the Board is very grateful to those who throughout the year. give their time so generously. Finally, I extend my personal thanks to my The development of the Olivia Newton fellow Board Directors for their contributions John Cancer Centre is one of the highest to the governance of Austin Health. priorities for Austin Health. The Board was delighted to receive a $10 million It is with pleasure that I present this annual contribution from the Commonwealth report outlining the significant achievements Government towards the medical research that have been accomplished in 2005 – 06. infrastructure of the new centre. Mr Tim Daly In our busiest year in the history of the The Board again expresses its sincere Chairman health service, record numbers of patients appreciation and thanks to Olivia Newton- were treated, performance against targets John for her continuing commitment to the improved and we finished the year with establishment of this new centre. a small operating surplus. This is an The Board also recognises and thanks the outstanding result for the health service. Appeal Committee, including its Chairman, Health care presents moments of great Mr Terry Campbell and the Public Appeal challenge and reward and we know the Chairman, Mr Andrew Demetriou, for their biggest issue faced by the health service contributions to the success of the into the future, will be meeting the ongoing fundraising appeal. demand for our services. This underlies The Board is pleased to report that the need for us to continue to refine the the management of health service was configuration of the health and aged care performed very capably. The Board sectors and their capacity to cope with the extends its appreciation and thanks ongoing demands of an ageing population, to Dr Brendan Murphy, his executive team with the availability of an expanding range and staff throughout Austin Health for their of treatment options for patients. tremendous contributions. The Board has begun work developing The Board is confident that Austin Health a new strategic plan to address this is well positioned to continue to provide demand while ensuring patient care, outstanding health care to the people service delivery, efficiency and quality of Melbourne’s north east. remain priorities.

0/05 Chief Executive Officer’s report

While tackling this emergency demand, The first Austin HealthSMART project Austin Health also enthusiastically took will be implemented in July 2006. up the challenge of the government’s The implementation of a new payroll additional investment in elective surgery system with 6,500 employees running during 2005 – 06. We treated 7,853 a 24/7 service under many different and elective surgery patients, a nine per cent complex award conditions, is an extremely increase on the previous year and have challenging undertaking. Information reduced our total waiting list by 22 per technology and payroll implementations cent. Part of the success in elective have a history of being problematic but surgery has been due to the short stay we are confident the system will launch surgery unit at the Heidelberg Repatriation successfully thanks to our superb team, Hospital. This unit has been very efficient led by Mr Leslie Bell. and we are exploring ways of sustaining It is perhaps self evident that our 6,500 this model after the opening of the new staff are our most prized asset. I have surgical facilities at the Austin Hospital. continued to meet staff groups across Despite the costs associated with the new the health service and have repeatedly activity, we managed to finish the year with been amazed at the loyalty and commitment a small operating surplus. We received shown in all areas and in all occupations. new activity funding and showed that We are all proud to be working in a additional elective work can be done very premier health service, looking after not efficiently at Austin Health. Financial only the very important community of performance is always a challenge in north eastern Melbourne but also, for the public health sector and I am grateful many of our services, the whole of Victoria Since moving into the new Austin Hospital to the many staff who have worked so and beyond. Tower in May 2005, an unrelenting surge hard to control costs. I thank my Board, the Executive, in demand has tested our people and The Olivia Newton-John Cancer Centre the Planning and Resources Committee, our processes. I am proud to report that (ONJCC) is moving closer towards the many other managers and the large Austin Health has again risen to the becoming a reality. The Appeal continues number of clinical and support staff who challenge and delivered world-class health to grow and this year the Australian continue to make Austin Health a world- care to a record number of patients, Government allocated $10 million towards class health service. with care and compassion, in a financially the research aspects of the ONJCC in responsible manner. the May 2005 Budget and we are working At the heart of this unprecedented hard towards securing significant additional increase in demand was a 16 per cent government support. Fundraising staff growth in Emergency Department have been busy the last few months Dr Brendan Murphy attendances, occurring immediately after working on the major fundraiser for the Chief Executive Officer the spacious new Emergency Department appeal, ROCKINC, to occur in July 2006. opened. We now see 133 emergency The relationship with our new neighbour patients a day. In turn, this additional and partner, Mercy Hospital for Women, pressure on the Emergency Department has blossomed with many joint services translated to the whole health service, working well together. Austin Health is as admissions rose in line with presentations. providing a number of clinical and non- Despite this increased demand pressure, clinical supports to the Mercy, including we managed to maintain and even medical specialist services, pathology, improve our performance on access meals and security services. The Mercy indicators and, most notably, had only has largely taken over the provision of 10 patients who waited 24 hours for gynaecology services on campus and an inpatient bed during 2005 – 06. together we will be reviewing the growing area of paediatrics. We are even sharing a multi-faith chapel, opened several months ago in a moving ceremony by representatives of a large number of diverse faiths.

Austin Health 2005/06 Annual Report Austin Health Board

The Board oversaw the busiest year in the history of the health service where record numbers of patients were treated, performance against targets improved and a small operating surplus was achieved by year’s end.

Mr Tim Daly Maddocks lawyers until July 2004, Mr Stephen Kerr B Bus, CPA, FAICD specialising in occupational health BA BSW Dip Crim and safety and employment law. Tim was appointed Chairman of the Board Joanna is also an accredited mediator. Stephen was appointed to the board in in 2003. He is a member of the Finance She is a graduate member of the March 2006 and is a member of the Audit and Audit Committees and is the Chair Australian Institute of Company Directors Committee and the Primary Care and of the Remuneration Committee and the and is a member of the Australian Human Population Health Advisory Committee. Primary Care and Population Health Resources Institute Occupational Health Stephen is a Director of Atkinson Kerr and Advisory Committee. and Safety and Risk Management Associates which specialises in planning Tim has 38 years experience in public Committee and the Industrial Relations and review of rural and Indigenous health sector management, including in health Society of Victoria. Joanna sits on the and community services. His past services policy and planning, and in Board of Melbourne Citymission and employment includes lecturer in welfare a range of other government functions. lectures in occupational health and studies at Monash Gippsland, Manager He was Chief General Manager of the safety and employment law for Monash of the Victorian Correctional Health Service former Health Department of Victoria University law faculty’s postgraduate and Executive Officer to the Minister for from 1988 to 1992 and subsequently program. Health (Marie Tehan). He is part time held senior executive appointments in Executive Director of the Church and the Departments of Justice and Finance. Professor Colin Johnston Charitable Private Hospitals Association Tim has been Chairman of the Board of and is the Vice President of the North AO, MBBS, MD (Hon), FRACP, FAHA the Metropolitan Ambulance Service since Richmond Community Health Service. May 2000. Colin is Chair of the Board’s Quality Committee. He is a Senior Principal Ms Joe Manton Research Fellow at the Baker Medical Ms Joanna Betteridge PGDWA, Fellow Williamson Community Research Institute, Honorary Professor Leadership Program, accredited Access Auditor BA, LLM of Medicine at Monash University, and Joanna joined the Board in 2003 and Emeritus Professor at The University of Joe chairs the Board’s Community is a member of the Audit, Quality and Melbourne, where he is one of the world’s Advisory Committee and is a member Remuneration Committees. Joanna leading cardiovascular researchers. In late of the Remuneration Committee. She has practices as a legal consultant in the 1999 he retired after 13 years from the had an extensive career in health and employment and occupational health position of Professor of Medicine and community services. Joe is a Director of and safety areas of law. Prior to starting Head of The University of Melbourne’s Access Audits Australia, providing disability her own business, she was a partner Clinical School at the then Austin and access advice, training, publications and in the Workplace Services Group at Repatriation Medical Centre. consultancy services to the government, community and corporate sectors.

0/07 The Board from top left to bottom right: Mr Tim Daly, Ms Barbara Hingston, Ms Joe Manton, Mr Robert Webster, Mr Stephen Kerr, Ms Joanna Betteridge, Professor David Scott, Ms Josie Rizza, Professor Colin Johnston.

Joe has been instrumental in establishing Professor David Scott Josie has served on the Victorian Eye and developing a range of community MB BS MD MS FRACS and Ear Hospital Board and chaired the services within the region. She regularly Audit and Finance Committee on behalf presents on disability access and is also David joined the Board in 2005 and of the Board. She was also appointed experienced in community engagement previously held the positions of Executive to the Board of Tweedle Child and Family strategy. Director, Royal Australasian College Health Service. of Surgeons, Head of Vascular and Ms Barbara Hingston Transplant Surgery at Monash Medical Mr Sam Spadafora Centre, and Professor and Chair of BA (Admin), BSW Monash University Department of BA Hons, Grad Dip Social Work Barbara joined the Board in 2005 and Medicine. He is a member of the Finance Sam served on the Austin Health Board brings a wealth of experience in public Committee and the Quality Committee. from 1 July 2005 until 31 August 2005 sector and non-government corporate David previously served on the Board of when he resigned to take up an governance, policy development, the Victorian Ministerial Council on Medical appointment as a ministerial adviser management, finance, human resources, Workforce Management and on the to the Minister for Transport. Sam was health service issues and planning, and Medical Training Review Panel for the on the Community Advisory Committee community representation. She is a Commonwealth Department of Health and the Primary Care and Population member of the Quality Committee and and Ageing. Health Advisory Committee. the Community Advisory Committee. David also chaired the Royal Australasian Mr Robert Webster Barbara is a program manager and College of Surgeons International counsellor with the Maroondah Community Humanitarian Surgical Aid Program MBA, FCPA Health Centre, Eastern Access Community and was medical director for East Timor Robert chairs the Audit Committee and Health. She is currently a member of AusAid Specialist Surgical Program. is a member of the Finance Committee. Mackillop Family Services Victoria and A Fellow of both the Australian Property has served on a number of community Ms Josie Rizza Institute and the Royal Institution of and government boards in the Australian Chartered Surveyors, Robert is program Capital Territory and Queensland, including BA (Econ) CPA leader of property postgraduate studies the Dental Board of Queensland. Josie joined the Board of Austin Health in at RMIT University’s School of Property, Past roles include Executive Director 2005, with expertise in finance, corporate Construction and Project Management. Mercy Health Care Australia and Deputy governance and risk management. He is also Vice-President of the Victorian Executive Director, Australian Heritage Josie chairs the Finance Committee and branch of the RSL. Commission. is a member of the Remuneration Committee.

Austin Health 2005/06 Annual Report Organisational structure

Board

Chief Executive Officer Dr Brendan Murphy

Chief Medical Officer Research Ethics Unit Medical Education Unit Dr Mark Garwood HMO Services Unit Pharmacy Biological Research Laboratory

Executive Director Medical & Emergency CSU Cancer Spinal Acute Operations Specialty CSU & Outpatients CSU Surgical CSU Access & Demand Mr Mark Petty Anaesthesia, Perioperative & Intensive Care CSU

Executive Director Mental Health CSU Nursing Resources Aged & Residential Care CSU NCASA Ambulatory and Royal Talbot Rehab Centre Pastoral Care Nursing Services Hospital/Primary Care Liaison Child Care Centre Home & Ambulatory Services Ms Ann Maree Allied Health Keenan Nursing Education

Executive Director Employment Services Occupational Health & Safety Payroll Security & Car Parking Human Resources Learning & Organisational Mr John Richardson Development Employee Relations

Executive Director Finance Retail Finance Supply Mr Ian Broadway Mail & Transport

Executive Director Health Information Services Corporate Communications Board Secretariat Information Technology Veteran Liaison & Internet/Intranet Corporate Strategy, Risk Red Cross Centre Development & Clinical Governance Patient Representative Health Sciences Library Clinical Photography Mr Chris O’Gorman Fundraising

Executive Director Laboratory Medicine Environment Services Radiology Medical Engineering Redevelopment, Nuclear Med & PET & Physics Infrastructure Stericlean Engineering & Buildings & Commercial Commercial Services Communications AR/M Project Infrastructure Mr John Breguet Food Services

Executive Support Medical Divisions Corporate Counsel Staff Chair Chair, Division of Medicine, Professor Jeffery Zajac Ms Claudia Hirst Dr Fergus Kerr Chair, Division of Surgery, Professor Chris Christophi Chair, Division of Psychiatry, Professor Graham Burrows

0/09 Austin Health Executive

Chief Executive Director Executive Director Executive Director Executive Director Chief Medical Officer Executive Officer Ambulatory and Acute Operations Corporate Redevelopment, Dr Mark Garwood Nursing Services Development Infrastructure and Dr Brendan Murphy Mr Mark Petty Commercial Ms Ann Maree Mr Chris O’Gorman Keenan Executive Director Mr John Breguet Finance Executive Director Mr Ian Broadway Human Resources Mr John Richardson

Austin Health 2005/06 Annual Report Year at a glance

Hospital inpatients treated Operating result

100,000 2.00

80,000 82,153 0.25 0.95 77,463 73,986 60,000 72,260 -0.30 -1.20 -1.50 40,000

-3.25 20,000

-4.70 0 -5.00 $ Millions Number of patients 2002–03 2003–04 2004–05 2005–06 2002–03 2003–04 2004–05 2005–06 A six per cent increase in the number of Austin Health achieved a modest operating inpatients treated this year is consistent with surplus for the year despite record demand recent trends. Most of the increase came from growth in emergency presentations and increased growing emergency demand in our primary elective surgery. This was a very good result. and secondary catchment areas in keeping with the growth in patient numbers attending the Emergency Department.

Emergency Department attendances Percentage of emergency patients admitted to a ward within eight hours 60,000 75%

68% 69% 45,000 65% 48,485 63% 50% 41,825 39,670 39,925 30,000

25% 15,000 centage admitted 0 0% Attendances Per 2002–03 2003–04 2004–05 2005–06 2002–03 2003–04 2004–05 2005–06 The Emergency Department in the new Austin Almost 70 per cent of patients requiring an Hospital Tower experienced an unprecedented inpatient bed were transferred to a ward within 16 per cent increase in attendances to 48,485 eight hours of arriving at the Emergency in 2005 – 06, the equivalent of 133 attendances Department. This is a tribute to swift assessment every day. Despite this increase, the admission in the Emergency Department, quick and efficient rate to inpatient wards decreased. movement to wards, and systems and processes that maximise bed availability for new patients.

10/11 Percentage of time spent on hospital Elective surgery patients waiting bypass at 30 June 2006 2.0% 3,000

2,832 1.5% 1.7% 2,417 2,472 1.6% 1.6% 2,000 1.3% 1.0% 1,874

1,000 0.5%

00.0% 0 Number of patients Per cent of time 2002–03 2003–04 2004–05 2005–06 2002–03 2003–04 2004–05 2005–06 Despite record numbers of people attending the The number of people ready and waiting for Emergency Department in 2005 – 06, ambulance elective surgery fell to the lowest level in seven access was virtually always available. This was years. Despite record emergency demand, more achieved through a range of innovations in patient than 7,850 elective patients were treated this management and flow through the Emergency year, an increase of nine per cent from 2004 – 05. Department, in the wards, and in transfers to sub-acute and residential care in the community.

Average length of stay for acute Elective surgery – Hospital initiated patients (excluding same-day patients) postponements (HIPs) 8 25.0

7.5 7.4 20.0 23.2 6 6.6 21.2 20.5 6.0 15.0 4 14.8 10.0

2 5.0

0 0.0 Number of HIPs per 1,000 admissions Days 2002–03 2003–04 2004–05 2005–06 2002–03 2003–04 2004–05 2005–06 Continual, safe reduction in the length of time Better planning and scheduling enabled Austin patients occupy a ward bed enables Austin Health to substantially reduce the number and Health to meet growing demand and ensures rate of postponements/cancellations of elective that patients can return to the community with surgery in 2005 – 06. This was achieved despite minimal delay. the enormous pressures on operating theatre time from increased emergency surgical demand.

Austin Health 2005/06 Annual Report Out of the 11,379 patients admitted to a ward from the Emergency Department, only 10 had to wait more than 24 hours, compared with 176 last year, a drop of 94 per cent. “They’re a team of angels. I couldn’t be in better hands.” Donald Drysdale, inpatient Ward 6 West. Clinical Services Acute Operations

Cardiac arrests have reduced four-fold since the implementation of the Medical Emergency Team.

Surgical The redevelopment of the Endoscopy Specialty A concerted effort to reduce the number and Day Surgery complex is well underway The Cardiac Catheterisation Laboratory of elective surgery patients on the waiting and aims to combine the endoscopy moved from the Harold Stokes Building list was undertaken with the assistance services at the Austin Hospital and the to two new laboratories in 5 North of of additional state government funding. Heidelberg Repatriation Hospital into the Austin Hospital Tower in February. In total, 7,853 elective patients were a new theatre day surgery precinct by The laboratories feature two new flat treated – a significant increase from the June 2007. Planning sessions have been bed panel detectors which offer accurate 7,210 patients treated the previous year. held and project leaders from each site imaging of microscopic blood vessels As a result the number of people waiting have been designated to successfully plan and the ability to treat patients for cardiac for elective surgery was reduced from and implement the move. intervention within one day – a benefit to 2,418 to 1,874. Improved theatre use, The Surgical Clinical Services Unit patients and clinicians. The new location targeting long-waiting patients and obtained funding to develop an intestinal also enables co-location with the increased auditing of waiting list patients, transplantation pilot, and consequently Cardiology Diagnostic Laboratory, the assisted in achieving this result. the Small Bowel Intestinal Transplant Coronary Care Unit and the Cardiac Ward. The Surgical Clinical Services Unit introduced Project is in the planning phase. A new community facility for residents a triage process for colonoscopy in an effort As a result of a decrease in the number of of the Bowen Centre is currently under to reduce the time patients wait for this available donor livers, the Surgical Clinical construction and will be complete in 2007. procedure. From January 2003 to January Services Unit performed 36 liver transplants The facility will be managed by Disability 2005 there was a steady climb from 295 during 2005 – 06 – a reduction from the Services and aims to provide assistance to 700 patients awaiting colonoscopy. 41 transplants performed in 2004 – 05. to allow more independent living in the The triage process reviewed those patients community. Staff took residents on a tour on the list to see who was still in need of of the new site in June. colonoscopy and resulted in a significant decrease in the number of patients awaiting this procedure. As a result, the number of patients waiting declined from 710 in April 2005 to 350 in April 2006.

14/15 The new state-of-the-art cardiac catheterisation laboratories opened on level 5 of the Austin Hospital Tower providing an all-in-one cardiac diagnostic centre for ultrasound, ECG, pacemaker and catheterisation procedures.

The Department of Human Services • A review of cardiac surgery with funded Austin Health to undertake Dr Clive Wellington and Mr Richard a Remote Patient Monitoring project. Bunton participating as external reviewers. This project is a randomised control trial The final report and priority implementation of 160 patients which will monitor 80 plan was completed in June 2006. of the participants via computers in their • A review of the ophthalmology service homes. The aim of the project, which with Professor Hugh Taylor from the went live in June with the first group Royal Victorian Eye and Ear Hospital of eight congestive heart failure and participating as external reviewer. chronic obstructive pulmonary disease The review confirmed that the complete patients enrolled, is to avoid an acute range of ophthalmology services, exacerbation of the patients’ illness including retinal procedures, provided at through early intervention. Patients Austin Health facilities was appropriate receive training in using the system and led to the purchase of a new to measure their physiological signs vitrectomy machine. and undertake a daily questionnaire. The clinical team views this information • A review of respiratory medicine. using a web browser. The review supported the establishment of a home sleep study service and new The Specialty Services Clinical Services respiratory and sleep outpatient clinic Unit conducted a number of services to meet increased patient demand. reviews including: • A review of neurosurgery with renowned neurosurgeon Professor Michael Fearnside from Westmead Hospital participating as an external reviewer. The review resulted in the introduction of additional theatre sessions, additional surgeon sessions and consolidation of outpatient clinics.

Austin Health 2005/06 Annual Report Clinical Services Acute Operations

Emergency and Medical A working party was established to The intensive care unit liaison nurse A 16 per cent increase in attendances increase preparedness for SARS/avian function began in June. These trained placed unprecedented demand on the influenza. The working party developed critical care nurses are available to assist Emergency Department. The number a preparedness plan and a flowchart ward staff to care for patients recently of patients treated in the Emergency to assist in the management of patients transferred from intensive care. Department rose from 41,825 in 2004 – 05 affected by this condition. The plan will The Medical Emergency Team won the to 48,485 in 2005 – 06. This demand had also help with appropriate communication award for Excellence in Safety of Care a flow-on effect to the acute and sub-acute in the event of an outbreak of SARS/avian at the 2005 Victorian Public Healthcare wards. Improved patient flow initiatives influenza. Awards. Record numbers of Medical assisted with managing this growth in Austin Health established a collaborative Emergency Team calls were initiated demand for services. relationship with St Vincent’s Health in 2005 – 06, with a monthly average The Victorian Quality Council chose and the Peter MacCallum Cancer Centre of between 100 and 140 calls. This results Austin Health to lead the statewide Hand to establish an Islet Transplant Program in significant benefit to patients: prior to Hygiene Project. The team from Infectious in Victoria. The program involves the implementing the Medical Emergency Diseases undertook a mentoring role for transplantation of insulin-producing islet Team, four cardiac arrests occurred for new hospitals participating in the project cells as a potential cure for suitable every 1,000 admissions; in 2005 – 06 and were responsible for data collection, patients with type1 diabetes. there was only one cardiac arrest per analysis and staff training in the database. The new Endocrine Centre of Excellence 1,000 admissions. Using medicated wipes for equipment and was launched in August. The centre DeBug hand rub has resulted in a 53 per includes an outpatient treatment area, Cancer, Spinal and Outpatients cent reduction in patients with methicillin- a clinical trials unit, an endocrine laboratory The North Eastern Metropolitan Cancer resistant Staphylococcus aureus bacteremia and a bone mineral density unit. The centre Service (NEMICS) was established to at Austin Health. The Infection Control Team will continue to host research into diabetes, support improvements in the integration won the Minister’s Award for Outstanding obesity and osteoporosis. Located at the and coordination of cancer services for Team Achievement at the 2005 Victorian Heidelberg Repatriation Hospital, the new people living in Melbourne’s north east. Public Healthcare Awards for their work centre provides greatly improved surroundings NEMICS is a consortium of health services on the Hand Hygiene Program. for patients, visitors and staff. including Austin Health, Eastern Health, The appointment of a Director of Emergency Northern Health and the Mercy Hospital Medicine Research has placed Austin Anaesthesia, Perioperative and for Women. NEMICS is one of eight Health at the forefront of research in Intensive Care integrated cancer services established emergency medicine. In 2005 – 06, The Anaesthesia, Perioperative and in Victoria to help implement the Victorian the department published 14 papers (with Intensive Care Clinical Services Unit Government’s Cancer Services Framework. a further five in submission), collaborated purchased seven new operating tables In 2005 – 06, NEMICS developed a strategic in several multicentre trials and formed after receiving funding of more than and service plan, which the Department of strategic links with the Royal Melbourne $400,000 from the Department of Human Human Services has adopted, and formed Hospital and St Vincent’s Hospital Services. The new tables, which are ten tumour streams which reflect the ten departments of Emergency Medicine. electronic, reduce manual handling most common cancer types. There is potential for future collaboration and improve conditions for staff. The Cancer Clinical Services Unit in the areas of toxicology and complementary Two new intensive care unit beds completed the tender for a new radiation medicine, patient flow, pre-hospital care, were funded in 2004 – 05 and became treatment unit in November and chose the pain management and clinical practice operational in September 2005, supplier to install a new state-of-the-art change. The collaboration between the bringing the total number of funded linear accelerator with cone beam facility Austin Health Toxicology Service and the intensive care beds to 16. at the Austin Radiation Oncology Centre. Victorian Poisons Information Service has Installation is underway and patients will led to the establishment of a cooperative begin using the new linac in October 2006. model of care linking pharmacists, poison information specialists and clinical experts.

16/17 The introduction of intensity modulated The Spinal Outreach Risk Reduction Team Access and Demand radiotherapy, which uses a combination continued to assist clients with a chronic The Access and Demand Unit implemented of software and treatment hardware, spinal cord injury in the community. Team a new structure for demand management; resulted in a world-class treatment option members work with the client to resolve this incorporated the appointment of the for patients with prostate cancer. This issues that could potentially lead to Access and Demand Manager responsible radiotherapy was offered to patients in complications and possible hospitalisation. for the coordination of hospital demand regional Victoria at the Ballarat–Austin The Outpatients Department was realigned management initiatives and direct Radiation Oncology Centre – the first time to the Cancer Services Clinical Services management of Bed Resource Managers the treatment had been used in a regional Unit following a restructure of the clinical and the Care Coordination Team. area (previously, patients would have had services units in August. to travel to Melbourne to receive this The department developed and implemented treatment). Now, intensity modulated Following the Auditor-General’s review of an electronic bed management tool to radiotherapy is the standard form of outpatient services released in June 2005, improve bed management and provide treatment for prostate cancer patients. the Outpatients Department worked a whole-of-hospital view of the bed state. closely with the Department of Human Other health services have shown interest In the Federal Budget the Australian Services on planning the Patient Flow in replicating this web-based program. Government announced $10 million in Collaborative II in an effort to find a research funding for the Olivia Newton- Access and Demand also introduced systemic approach to improving the a safety net process for patients waiting John Cancer Centre. Planning continues patient’s journey through outpatients. for the centre, with the project control longer than 24 hours to be admitted from group developing the strategic and service The unit developed a campaign the Emergency Department to a ward. plan. Meetings have taken place with the addressing patients who fail to attend This has resulted in a 94 per cent architects and quantity surveyors to scope outpatient appointments. On average reduction in the number of patients that the project. Cancer Services staff continue more than 100 patients do not attend their wait in the Emergency Department for to work closely with the Fundraising outpatient appointment each day. The a ward bed greater than 24 hours. Department to maximise donations for campaign focused on educating general Since the implementation of a number the cancer centre appeal. practitioners and patients about the high of initiatives, including the above, the number failing to attend appointments The Victorian Spinal Cord Service, as organisation has continued to improve and the steps they should follow to cancel the performance of the emergency and the state service for the management of an appointment. While this campaign had traumatic spinal cord injury, continued to elective access targets. This continued an initial impact on the number of patients improvement was despite a significant experience high and often unpredictable who did not attend appointments, a longer demand. The demand arose from new increase in activity and many challenges term strategy is required. This will form that impacted patient access throughout traumatic spinal cord injured patients being part of the Outpatients Department’s work admitted, unplanned admissions as the year including a severe viral with the Department of Human Services gastroenteritis outbreak. a result of serious complications of a on the Patient Flow Collaborative II in the patient’s chronic spinal cord injury, and next 12 months. patients with a chronic spinal cord injury requiring elective procedures. More than $200,000 was provided under the Department of Human Services’ In 2005 – 06 the spinal service worked targeted equipment funding for 75 new with the perioperative service to introduce patient couches and 13 outpatient trolleys. initiatives to maximise access to available This equipment enhances comfort for beds for those requiring elective procedures. patients and improves safety for staff By improving the coordination of patients, because it doesn’t require manual handling. beds and surgery, the service was able to achieve a significant increase in the Funding was made available through number of patients with chronic spinal the Friends of the Austin to construct cord injury requiring elective procedures children’s play areas in the outpatient being treated. areas of the Austin Hospital and the Heidelberg Repatriation Hospital. Plans are underway to further enhance the physical environment of the outpatient area at the Austin Hospital to improve conditions for patients and staff.

Austin Health 2005/06 Annual Report The Spinal Outreach Risk Reduction Team worked with 149 spinal cord injured patients in the community, preventing hospital admissions in 88 per cent of cases. “Being in a wheelchair and keeping up with two young children keeps me busy, so having a physio and an OT visit me at home makes things a lot easier.” Bridget Day, mother with paraplegia. Clinical Services Chief Medical Officer

A new program to integrate international medical graduates into the Victorian health care system was introduced where graduates ‘shadow’ a junior doctor prior to commencing employment.

Pharmacy Hospital Medical Officer Services Research Ethics Unit Pharmacy settled into the new Austin As part of the Austin Hospital During 2005 – 06 the Drug Trial Sub- Hospital Tower which encompasses redevelopment, hospital medical officers Committee reviewed 111 new protocols, clinical services to the wards and the moved into new quarters in late 2005. the Non-Drug Scientific Review Committee new satellite pharmacies. Facilities include three bedrooms, new reviewed 79 new protocols, and the The Department of Human Services furniture, and a dedicated study area. Human Research Ethics Committee granted ongoing program funding to Hospital Medical Officer Services staff considered 182 new protocols. In addition, the Medication Alert Project. This project moved to new, more centralised offices the Research Ethics Unit considered 90 identifies patients at high risk of medication in June 2006. new studies via the expedited review process misadventure when discharged. Patients Austin Health and the Northern Hospital and reviewed 43 new animal studies. at high risk received a home visit from an were fully matched for intern and hospital The Research Ethics Unit staff restructure outreach pharmacist and patients at low medical officer 2 positions for 2006. came to fruition with a priority to amalgamate risk received a visit from a nurse from Hospital Medical Officer Services staff staff into one office on one site in the the Royal District Nursing Service. produced 523 contracts (PGY1 to registrar), Harold Stokes Building at the Austin Hospital. This resulted in a significant reduction of which 119 required separate applications The amalgamation will reduce time to approve in re-admission. to the Medical Practitioners’ Board of new protocols and protocol amendments. Pharmacy was involved in a number of Victoria and 96 required applications A new robust billing system for submissions other patient safety initiatives, including to the Department of Multicultural and was implemented, permitting updates venous thromboembolism prophylaxis, Indigenous Affairs. to the electronic database. medication reconciliation and perioperative A new Hospital Medical Officer Committee antibiotic prophylaxis. was formed with representatives of senior and junior staff. The committee is a forum to discuss issues such as hospital medical officer health, industrial relations and other areas of concern. Austin Health hopes this committee will strengthen the link between hospital medical officers and Hospital Medical Officer Services.

20/21 The new lounge for Hospital Medical Officers provides a place where junior doctors can relax, have a bite to eat, debrief or study during their breaks.

Medical Education Unit The education and training activities the The Medical Education Unit implemented Medical Education Unit has organised a new program designed to integrate have enabled more junior doctors to enter international medical graduates into the vocational training programs of their hospital system. Medical clinical educators choice. Ten out of 12 Austin Health work closely with international medical doctors were accepted into the basic graduates to provide clinical and surgical training program and all five who educational support. applied were accepted into the advanced surgical training program for 2006. Twenty The Medical Education Unit acquired out of 23 basic physician trainees passed funding to install a web cam link between the written examination, and there was an the Austin and Echuca emergency increase in junior doctors applying for entry departments. This will enable junior into the general practice program. medical staff working in Echuca to seek advice and additional support from senior Austin Health colleagues. The unit coordinated a weekly education program offering a wide range of medical and surgical topics for pre-vocational trainees. Surgical skills workshops took place at the Royal Australian College of Surgeons and a new series of workshops for junior doctors interested in general practice was introduced.

Austin Health 2005/06 Annual Report Clinical Services Ambulatory and Nursing Services

Hospital in the Home managed an average of 52 patients a day at home, requiring 14,500 nursing visits and a further 1,300 visits by other health professionals.

Mental Health A carer consultant position was established The Victorian Psychological Trauma In May 2006 the Mental Health Clinical within the service to enhance carer input Treatment Service builds on the hospital’s Services Unit participated in an in-depth into the treatment of consumers and to long history of post-trauma treatment work mental health review conducted by the enhance support mechanisms for carers with Australian war veterans suffering Australian Council on Health Care associated with the service. post-traumatic disorders. The service also Standards, which assessed Austin Health The Primary Mental Health Team developed offers a specialised group treatment mental health services against national and implemented early psychosis treatment program for traumatised police officers standards. The surveyors were very guidelines. These guidelines were written who have established workcover claims impressed with the service and highlighted for Austin Health clinicians as a best and are seeking more effective treatment strong leadership and a commitment practice guide to assessing and treating of their condition. Results have been to consumer and carer participation. early psychosis. The guidelines advocate extremely positive to date. intensive early intervention and continuity Funding was secured for redeveloping Aged and Residential Care acute psychiatric services into a new of care to reduce duration of untreated 30-bed unit and for replacing Bunjil House psychosis and to promote self-management. After commencing in 2003, the North with a purpose-built secure extended The Victorian Psychological Trauma East Dementia Pilot was completed in care unit with 25 beds. The new buildings Treatment Service was consolidated within 2005 – 06. More than 100 admissions are under construction and will be the Veterans’ Psychiatry Program. The with an average length of stay of 85 days commissioned in late 2006, delivering Victorian Psychological Trauma Treatment occurred during the pilot. Around 65 per state-of-the-art accommodation. During Service is a comprehensive assessment cent of clients remained in the community the year, Mental Health widely consulted and treatment service for those suffering after being discharged from the program. with carers and consumers from both from post-traumatic psychological The Department of Health and Ageing, adult and child and adolescent services conditions, including survivors of the which funded the pilot, indicated it was to discuss issues, listen to feedback Bali bombings, emergency services very impressed with the program and and provide advice on the new site. workers and those who have been the outcomes for clients. Four hundred separate mental health involved in car and workplace accidents. medical records were incorporated into Austin Health medical records to create one integrated medical record for each consumer. This will promote comprehensive continuity of care.

22/23 Aged Care Services coordinated the The centre successfully piloted the new Hospital Primary Care Liaison Improving Care for Older People project, sub-acute ambulatory care services The Hospital Primary Care Liaison Unit funded by the Department of Human funding model. It introduced a new worked closely with Austin’s community Services. Aged Care has participated in minimum data set and reporting of all data partner agencies and the Banyule two audits, one on person-centred care to the Department of Human Services is Nillumbik Primary Care Alliance to for older people and the trial of an older underway. All targets have been met. implement an electronic patient referral person environmental audit tool across The Movement Laboratory at the new system known as S2S eReferral. three areas. A number of projects were Rehabilitation and Sciences Research The system helps to coordinate and undertaken as part of the initiative, Centre was launched to improve manage consumer information across including a new plan to improve care for prospects for patients with a physical services and keeps a history of referrals older people with cognitive impairment. disability by providing a clinical movement and referral outcomes over a period of Austin Health worked with the Department analysis service. Using similar technology time. There are now 14 local agencies of Human Services to commence that athletes use to reach their peak, registered to use the system. Austin Health the State and Commonwealth-funded it is hoped the Movement Laboratory will has 15 services using the system, Transition Care Program to enhance assist people with a disability to become including five new services registered in patients’ transition from hospital to nursing more independent. Current research 2006. Austin clinicians have made almost home. The first patient was admitted to projects involve stroke, spinal cord injury, 500 electronic referrals since the system the program in June 2006. Transition Care multiple sclerosis and amputees. was introduced in 2005. provides short term support and active A Teamwork and Inpatient Review was The unit also implemented electronic management for older people at the end conducted across the Royal Talbot discharge summaries and admission/ of a hospital stay and can be provided in Rehabilitation Centre, which resulted in discharge notifications to general either a residential or community setting. greater consistency of practice and practitioners. The unit’s general practitioner Aged Care Services achieved 153 more documentation across all clinical services. audit highlighted how these forms have separations and a reduction in length of The centre presented the Spinal cord improved communication with Austin Health. stay of five days compared with 2004 – 05 injury: the story continues art exhibition results. A number of factors contributed to in conjunction with Corporate Home and Ambulatory Services the reduced length of stay, such as access Communications to provide hope and Hospital in the Home celebrated its tenth to transition care and meetings across all encouragement to newly injured patients. anniversary and continued to offer wards to bring together community program The poster series profiled 11 patients who targeted patients the option of receiving and inpatient staff for long-stay patients had already returned to the community their hospital care at home. In 2005 – 06 who often have complex care needs. following rehabilitation. the service managed an average of Aged Care Services was successful in Generous donations from Daimler Chrysler, 52 patients a day at home. This required the Australian Government Aged Care the Jack Brockhoff Foundation, Danks 14,500 nursing visits and a further 1,300 Approvals Round, gaining 30 community Family Trust and Team Handcycle resulted visits by other health professionals and aged care packages, ten general extended in a new patient transport bus being support staff. aged care at home packages, and 20 purchased. The $85,000 vehicle allows A patient satisfaction survey conducted in dementia packages. The Extended Aged transportation of up to five people in 2005 indicated 97 per cent of respondents Care at Home and the Dementia Programs wheelchairs and will be used to transport were happy to continue their hospital care are offered through a partnership with patients for leisure activities and between at home and 96 per cent indicated they Melbourne Health. Each of these Austin Health sites. found the service very good or excellent. programs provides long term case management for clients in the community. With funding from the Friends of the The Medi-Hotel offered alternative The Community Aged Care Package Austin, a sensory garden was constructed accommodation to patients who received Program is now operating at 100 per cent outside the Acquired Brain Injury Unit. hospital-type care during the day but did occupancy, the Extended Aged Care at The garden was established as part not require overnight hospital ward care. Home Program at 100 per cent of the Horticultural Therapy Program and Victoria regional patients and their carers occupancy, and the new Dementia provides a place for patients, family and also used the facility when undergoing Program at 80 per cent occupancy. friends to meet outside and enjoy the sight multiple procedures for diagnostic testing and scents of the garden. accompanied by a medical review. Royal Talbot Rehabilitation Centre The centre sought fundraising to extend In 2005 – 06 Medi-Hotel usage increased The Royal Talbot Rehabilitation Centre the creative therapies program. Thanks to by more than 166 per cent and the facility received the highest score in its category donations from private benefactors, trusts accommodated just over 2,000 occupants. in the Victorian Patient Satisfaction and the Friends of the Austin, this program A patient satisfaction survey conducted Monitor, obtaining the highest overall will continue and allow patients to take in December indicated 92 per cent of care index of the 15 Victorian sub-acute part in music therapy, horticulture and art patients surveyed were pleased with their services surveyed. therapy programs. stay in the Medi-Hotel.

Austin Health 2005/06 Annual Report Clinical Services Ambulatory and Nursing Services

Nutrition and Dietetics Research commenced with the Oncology/ The Ngarra Jarra Aboriginal Health Program The Nutrition and Dietetics Clinical Palliative Care Special Interest Group. has continued to steadily develop. Services Unit, in conjunction with the Home assessments in oncology and In November an Aboriginal health peer Neurology Department, conducted palliative care outcome measures were support worker role was established to research into the use of a ketogenic diet developed to determine the effectiveness work closely with Aboriginal and Torres to improve the management of epilepsy. of occupational therapy home assessment. Strait Islander patients. The unit also worked closely with cancer The work included a selection of quality- Austin Health signed collaboration services on an international multicentre of-life tools and a literature review. agreements with six other health and trial to determine the effectiveness of Plans for publication are underway. social welfare organisations pledging to nutritional intervention in patients Occupational Therapy held a career work together to achieve improved health undergoing chemotherapy treatment. evening, ‘Occupational therapy as and social outcomes for Aboriginal people. The Home and Community Care dietetic a career’, for secondary school students Joining Austin Health in the agreement team expanded its role to include work in response to increasing demand are the Commonwealth Care Respite with the Aboriginal community. As a result, from work experience students. Centre, North East Valley Division of it secured funding to work with the It also undertook wide consultation General Practice, Whitehorse Division physiotherapy department to conduct with schools which resulted in a capacity of General Practice, Wesley Mission, targeted health promotion activities for crowd of enthusiastic possible future Moreland Community Health Service, those attending the local social circle. occupational therapists. and Waldreas Village. Planning discharges for patients requiring The unit received funding for a project Physiotherapy to improve the identification and residential care continues to be a key management of patients admitted with Following the move to the new Austin activity. Throughout 2005 – 06 patient malnutrition. This collaborative project Hospital Tower, the Physiotherapy transfers to residential care progressed between Dietetics, Gastroenterology, Department is enjoying the light bright steadily, with a reduction in the number of Clinical Governance and the Clinical space, larger reception area, dedicated patients awaiting placement in appropriate Informatics Unit will take place over diagnostic ultrasound and respiratory community services. Social Work staff two years. rooms, wall oxygen for exercising patients, were also actively involved with Aged Care gait store and teaching spaces. staff in the Transitional Care Pilot and subsequent Transition Care Program. Occupational Therapy The area on level three of the Harold These programs have provided additional Stokes Building has been retained and Occupational Therapy worked with support options for patients who require houses physiotherapy administration, the Hospital Primary Care Liaison Unit residential care or are awaiting a residential including The University of Melbourne and the Banyule Nillumbik Primary Care care vacancy. Partnership to adopt an e-referral system. Physiotherapy Clinical School. Clinical activity in the area continues and includes Ongoing staff training and commitment Speech Pathology have streamlined referrals to services using pulmonary and cardiac rehabilitation e-referral. The Occupational Therapy classes as well as individual assessment A new procedure, fibreoptic endoscopic Department was asked to present to other and treatment. evaluation of swallowing, was safely primary care partnerships to highlight The opening of the Rehabilitation introduced this year. The service is the positive approach it took. Sciences Research Centre at the Royal available for outpatients with swallowing difficulties, and almost 200 procedures Occupational Therapy forged stronger Talbot Rehabilitation Centre enhances research activity. The centre houses a were undertaken with no adverse events links with the Acute Psychiatry Unit during 2005 – 06. The Speech Pathology and community services to develop active state-of-the-art Movement Laboratory, which includes a $400,000 Vicon Department is a national leader in the use relationships and knowledge of services. of this diagnostic and assessment tool to Referrals are now tailored to better match movement analysis system funded by The University of Melbourne. assist people who have difficulty swallowing. the patient need to the service they The department is writing an advanced are being referred to, which improves practice competency training program Social Work the transition for patients returning for delivery to the state as part of the to the community. Social Work appointed additional in-house Department of Human Services’ Better The unit implemented a computer access interpreters to increase Austin Health’s Skills Best Care Workforce project. capacity in Greek, Italian, Cantonese and skills program in spinal rehabilitation, Speech pathologist Michelle Cimoli and Mandarin interpreting and to add resulting in an information technology received the 2006 FJ O’Rourke Award, the languages of Arabic, Macedonian, room being set up at the Royal Talbot providing her with a $5,000 grant to Serbian and Turkish to the service offering. Rehabilitation Centre. Staff have taught visit the United States and a tour of patients how to use the system so they are international centres of excellence that able to access this service independently. treat swallowing disorders.

24/25 The Tracheostomy Review and Nursing Education The centre also completed the Towards Management Service was awarded highly The Clinical Nursing Education Department Safer Student Relationships project. commended status in the 2005 Victorian relocated and the greatly improved This project aimed to explore the issue Public Healthcare Awards’ ‘Innovations teaching and office facilities in the Austin of sexually abusive behaviours that occur in Models of Care’ category. The service Hospital Tower have enhanced the between students in a school context instituted a number of initiatives in 2005 – 06, services this area offers. and to determine the strategies schools including a tracheostomy training program, are using to deal with these behaviours. its own intranet site, and the tracheostomy The Educational Options Program offered The report makes recommendations policy, procedures and e-learning packages. 44 short courses and eight advanced on appropriate support and interventions Other innovations include the publication practice courses. Staff uptake of for those victimised and those exhibiting of the Tracheostomy care resources guide educational options was pleasing, sexually abusive behaviours. It also makes and a CD-ROM of the tracheostomy with many of the courses fully booked. recommendations on schools’ responses e-learning packages. The Tracheostomy One hundred and ten nurses were to abusive behaviour. Review and Management Service continues recruited into the Graduate Nurse Year to be recognised as an innovative leader Program in 2006. Graduate Nurse Year Pastoral Care in the area of tracheostomy care. participants were offered three rotations For the first time, a 24-hour, seven-day- for the year and were asked to nominate a-week on-call pastoral care service Nursing Services their preferred allocations. Ninety-five per was available to the Intensive Care Unit The Enhanced Scope of Practice Project cent of participants were allocated to their and the Liver Transplant Unit as a result focusing on future workforce redesign for first preference. of increased staffing. Division 2 nurses was launched. Nursing Seventy-nine nurses undertook specialist In cooperation with the Mercy Hospital for Services worked closely with the Nurses postgraduate study in the ten postgraduate Women, Pastoral Care held a dedication Board of Victoria and secured funding nursing courses and 14 participants service for the multi-faith chapel, which from the Department of Human Services’ undertook the Refresher/Re-entry Program. 120 representatives from the two hospitals Nurse Policy Branch to conduct a and the local community attended. 12-month project to implement key Northern Centre Against Sexual Assault competencies for Division 2 nurses The department’s chaplains worked closely The Northern Centre Against Sexual to enable them to undertake advanced with the Veteran Liaison Officer to oversee Assault developed new training modules skill development. This work will continue plans and development of the new Anzac and a policy and procedures manual to in 2006 – 07. Memorial Chapel being constructed at the equip staff delivering crisis care. The new Heidelberg Repatriation Hospital. The Department of Human Services training aims to link theory with practice funded Nurse Practitioner Project and ensure service users are provided Child Care Centre progressed with the development of with the best possible service response a framework for implementing the following recent sexual assault. The Austin Child Care Centre received nurse practitioner roles at Austin Health. accreditation from the National Childcare The centre completed a new publication, The first two candidates, both from the Accreditation Council Incorporated under Reconnecting with young people after Emergency Department, have applied the quality improvement and accreditation sexual assault, in response to a lack to the Victorian Nurses Board for system for long care day centres until April of information for parents and carers endorsement as nurse practitioners. 2008. The accreditation process involved of young people who experience sexual Nursing Services has also identified a self-assessment from staff and families assault. The publication provides an key targeted staff and invited them and a validation survey. overview of the impact of sexual assault to attend a mentor education session and ways parents, carers and families to aid them in mentoring future nurse Consumer Advisory Committee can support young people in their practitioner candidates. healing journey. After five years as Chair of the Community Nursing Services met with staff of the Advisory Committee (CAC), Ms Joe Bowen Centre to develop education and Manton stepped down. From July 2006, career path planning to facilitate a smooth the CAC will be chaired by Ms Barbara transition to other clinical areas following Hingston. In 2006 the CAC is focussing the closure of the Bowen Centre in 2007. on the Emergency Department, long-term patients such as liver transplant, spinal and cancer, multicultural services and outpatients.

Austin Health 2005/06 Annual Report Support Services Redevelopment, Infrastructure and Commercial

Patients and staff have enjoyed the first year in the new Austin Hospital Tower and have commented on the light, spacious facilities and improved surroundings.

Redevelopment The State Government allocated funding Engineering and Buildings Staff feedback on the new Austin in the 2006 – 07 State Budget for a The Redevelopment continues to be a Hospital Tower has been extremely new bioresources facility to be situated major focus for the department with the positive. Staff enjoy working in the on the Austin Hospital site. This facility establishment of ongoing maintenance improved surroundings and particularly will incorporate all of Austin Health’s arrangements and enabling works enjoy the light and spacious areas. bioresources facilities, which are currently occupying the attention of staff. in four locations across two sites. Work has continued throughout the year, During the year, contractors were with Baulderstone Hornibrook to rectify Initial scooping work for the project has commenced. appointed to undertake the Boiler and small defects. Infrastructure Replacement Project. Work on the new mental health precinct Planning for the demolition of A Block Installation of the new boilers at Austin continued and is on schedule for completion continued. The demolition will allow for Hospital will commence early in 2006 – 07. in October. The new buildings, which are a loading dock and waste handling area. The project is out to tender and staff purpose-built and were subject to wide Department of Nuclear Medicine and from A Block are moving to level seven consultation, will be a vast improvement Centre for Positron Emission Tomography on the wards at the Heidelberg Repatriation of the Harold Stokes Building. Austin Health will use a $4 million funding Hospital. The Acute, Secure Extended grant from the State Government to Care, Mother and Baby and Eating purchase and install a new cyclotron. Disorders Units will all move to the new Planning for the building works associated site in December 2006. with the replacement cyclotron and new Planning continues for the Olivia Newton- bunker is well underway. The new cyclotron John Cancer Centre, with the project will be situated in the sub-basement block control group working on the strategic and of the Harold Stokes Building. Tendering service plan. Meetings have taken place for equipment and final design and for with the architects and quantity surveyors construction will occur early in 2006 – 07. to scope the project. The redevelopment Strong growth in demand for positron team is working closely with Cancer emission tomography services continued Services to develop the project. in 2005 – 06. Clinical demand has resulted in less access to the position emission tomography camera for research, and the department is seeking to acquire a camera exclusively for research use.

26/27 Food surveys indicate improved patient satisfaction since the new finishing kitchen became operational. The kitchen features a temperature controlled plating and larder area.

Division of Laboratory Medicine Radiology purchased and installed a new Environmental Services Pathology activity significantly increased magnetic resonance imaging machine Environmental Services introduced new after Austin Health signed service contracts and 16-slice CT scanner and both were technology to improve cleaning services for Northern Health, Mercy Hospital for operational by June 2006. The magnetic and maximise efficiency. The department Women, and Mercy Werribee Hospital. resonance imaging machine has greatly purchased ride-on cleaning machines Full pathology services are provided to reduced waiting times for patients for the Austin Hospital Tower and a street all sites, including anatomical pathology, because its increased capabilities allow sweeper to assist in maintaining the car biochemistry, haematology and microbiology. for a greater range of examinations. parks and the larger hospital facilities.

Radiology Food Services Medical Engineering and Physics Radiology implemented a picture archive The new finishing kitchen became Medical Engineering and Physics and communication system across operational in March 2006. This is a state- coordinated the $3.8 million one-off the health service, creating a filmless of-the-art facility and staff are enjoying equipment funding program, which environment by September 2005. working in the improved surroundings. involved completing all purchase contracts Not using film has meant significant In June 2006 Food Services implemented for various clinical service units. savings for the department and an a new patient meal delivery service, which enhanced service for clinicians. Clinicians allows food to be plated earlier and heated Communications Infrastructure provided strong support for the system, within retherm trolleys to keep the meals Communications and Infrastructure and developed a business case for hot while being transferred. Feedback from signed a contract for telephony services installing a web server that would allow patients about this improvement in with a new supplier, resulting in a staff to access the system remotely. customer service has been very positive. significant saving for the organisation. Austin Health received full accreditation Food Services completed training on the for the next five years from the Royal Chefmax Menu Management System for Australian and New Zealand College of all menu monitors and administrative staff. Radiologists for radiology registrar training The Chefmax system allows for electronic (ten positions) and for advanced training menu ordering, putting an end to the in interventional radiology, hepatobiliary paper-based system. This system can imaging, musculoskeletal imaging, store patient menus for up to six months, neuroradiology, oncology imaging and which is advantageous for patients who magnetic resonance imaging. are admitted frequently. The new electronic system is expected to be in full operation by the end of 2006.

Austin Health 2005/06 Annual Report As a result of the expertise of the Tracheostomy Review and Management team, patients are getting tracheostomy tubes out 20 days earlier, talking 10 days earlier, leaving hospital 30 days sooner and staying out of hospital longer. “I wouldn’t be alive today without my tracheostomy tube and the help of the tracheostomy team.”. Valda Burnett, lives at home with a permanent tracheostomy tube. Support Services Corporate Development

7,500 commemorative pavers were purchased during the Austin Hospital Paver Appeal and are being laid on the commemorative circle at the Austin Hospital.

Hospital Admission Risk Program Strategy, Risk and Clinical Governance The Community Link, Chronic Disease Surveyors from the Australian Council on Management, Coaching Patients on Healthcare Standards undertook a periodic Achieving Cardiovascular Health, and review and reported that the work of the Medication Management programs were Clinical Governance Team was recognised all streamlined to form one Hospital as outstanding and a national leader. Admission Risk Program-Chronic Disease The Clinical Governance Team won the Management Program. Austin Health tender to lead the third statewide Pressure formed a Hospital Admission Risk Ulcer Prevalence Survey (PUPPS 3), Program reference working group to which was conducted across 87 Victorian work through issues associated with health services. Survey results provide mainstreaming the program. valid and reliable data for benchmarking, Service agreements were drafted which can assist health services to reduce for all community service providers. pressure ulcers. Key performance indicators are being The department worked with state developed in consultation with Hospital and federal health departments on Admission Risk Program managers. improvement collaboratives, including Work has centred on implementing the safer use of blood and blood products, S2S e-referral system as a central access medication safety, organ donation, point for the Hospital Admission Risk prevention of deep vein thrombosis, and Program-Chronic Disease Management the ‘Safer Systems, Saving Lives’ initiative. Program. All HARP staff were trained in the system.

30/31 The team from Health Information Services rose to the challenge when faced with a 60 per cent increase in the number of medical records transferred between Austin Hospital and Heidelberg Repatriation Hospital.

Corporate Communications The report outlined initiatives to improve Following last year’s successful community the quality of care, and other health open day to mark the opening of the services are now emulating the format Austin Hospital Tower, another six major as a result of positive audience feedback launches were staged in 2005 – 06, and ease of access. including the State Government’s Life Following the opening of the new Austin Sciences statement, the Endocrine Centre Hospital Tower, the switchboard was of Excellence and the Movement Laboratory increasingly busy, with the number of calls at Heidelberg Repatriation Hospital. peaking at 107,000 in March. A poster exhibition telling the stories of To ease demand on operators, Corporate 11 inspiring Austin Health spinal patients Communications introduced a campaign was on display at the Telstra and Transport to reduce the number of internal calls. Accident Commission buildings before Complaints to the Patient Representative being displayed in the foyer of the Austin resulted in Information Technology Hospital Tower. The exhibition reminded developing an electronic solution for the all who viewed it of the remarkable feats switchboard to enable patient telephone that can be achieved despite a traumatic calls to be transferred more efficiently. spinal cord injury. Patient Enquiries staff met overwhelming Austin Hospital was the subject of demand in their first year in the new Austin significant media coverage following Hospital Tower. They provided a positive legionella and gastroenteritis outbreaks. public face to visitors while answering 500 For the third year in a row, Corporate telephone calls each day. Fortunately this Communications distributed 170,000 spike in demand is beginning to subside copies of the Quality of Care Report, at the year’s end. the annual report to the community, to local residents.

Austin Health 2005/06 Annual Report Support Services Corporate Development

Fundraising Olivia Newton-John visited Austin Hospital Information Technology The Austin Hospital Paver Appeal saw in April to oversee plans for a major Information Technology continued 7,500 commemorative pavers purchased. fundraising event for her cancer centre to bed down the extensive data network The first batch of pavers were laid on the appeal, ROCKINC, and to discuss future facilities introduced with the new Austin commemorative circle of Austin Hospital plans for the cancer centre. The Federal Hospital Tower. Tower forecourt and the remaining pavers Government granted Austin Health $10 million to support research facilities The department obtained sponsorship will be laid by the end of 2006. Plans are through HealthSMART to trial mobile underway to conduct similar paver appeals at the Olivia Newton-John Cancer Centre thanks to the efforts of the Olivia Newton- computing in the Intensive Care Unit at the Royal Talbot Rehabilitation Centre and Ward 5. and the Heidelberg Repatriation Hospital. John Cancer Centre Appeal’s executive committee, led by Chief Executive Officer Information Technology extended the The department communicated with and Chair of Goldman Sachs JB Were, use of remote network access to many 30,000 supporters via two new quarterly Terry Campbell, and AFL Chief Executive clinical and managerial staff, increasing donor newsletters: Vitality, focusing Officer, Andrew Demetriou. their capacity to deal with patient and on Austin Health activity and Well Wisher, Two major corporate partners for the administrative responsibilities when which is dedicated to the Olivia Newton- absent from the hospital. John Cancer Centre Appeal. Olivia Newton-John Cancer Centre Appeal were announced during the year. The use of electronic discharge The department received two prestigious The National Australia Bank contributed summaries, which previously were only awards from the Fundraising Institute its first $1 million to the centre appeal and available in the Emergency Department, of Australia for excellence in fundraising. the Australian Pharmaceutical Industries, increased in many inpatient units. This success would not have been representing 1,253 stores throughout The department completed a HealthSMART possible without the incredible support Australia, will conduct a major instore clinical systems ‘benefits realisation of the many donors, bequestors, promotion for the appeal in line with its survey’, which contributes to a baseline corporate supporters and volunteers ‘Inhealth – for total wellbeing’ brand. for measuring outcomes of HealthSMART who contribute to the fundraising effort. These campaigns have the potential to clinical projects. Many more donors made the decision reach more than four million prospective to leave the gift of a lifetime by becoming donors nationwide. Patient Representative bequest ambassadors, bringing the total Media exposure associated with Channel number of bequest ambassadors to 54. 7’s highly rated Dancing with the Stars Demand on the Patient Representative’s office increased following the general Volunteers and auxiliary members from program enhanced the public profile increase in patient activity brought about Friends of the Austin once again dedicated of the Olivia Newton-John Cancer Centre by the opening of the Austin Hospital many hours of their time and raised Appeal. As the charity of choice of former Tower. The office received 985 complaints more than $230,000 for the organisation. Ms Universe and dance contestant, and 499 liaison interventions during Austin Health used this funding to purchase Jennifer Hawkins, the program exposed 2005 – 06. To reflect the ongoing increase new equipment for the Outpatients, the appeal to two million viewers weekly. in numbers of complaints, additional hours Dialysis, Gastroenterology, Cardiology and have been allocated to the Assistant Physiotherapy departments, the Liver Patient Representative. Transplant Unit and the Operating Suite. Recommendations flowing from investigation of complaints led to a number of significant systems improvements and new protocols being developed. During the periodic review by the Australian Council on Healthcare Standards, surveyors noted that the Patient Representative provided national leadership in the role.

32/33 Veteran Liaison Health Information Services Health Sciences Library Veteran Liaison acts as a single point Health Information Services experienced The Austin Library redevelopment was of reference for all veteran-related matters an increased workload in many areas, completed in June 2006. The library now at Austin Health, which is the largest public including an increase of more than 60 provides quality resources and services provider of medical care to Department per cent in the number of medical records in the expanded and refurbished facility, of Veterans’ Affairs patients in Victoria. transferred between facilities. which provides more space for quiet study, Construction of the ANZAC Memorial The department integrated mental health spaces for discussion, and access to Chapel was announced at the records into the Austin Health medical additional computers. Remembrance Day Service in 2005 records and continued to implement the As part of the redevelopment, the library and the new facility will be dedicated electronic patient record by making more collection of the Mercy Hospital for in November 2006 at the traditional clinical information available online. Women was integrated with the Austin Remembrance Day Service. The Casemix Service implemented an collection. This allows staff and students The State Government announced an education program with performance from both hospitals to enjoy access to allocation of $6 million to fund a new competencies and reintroduced meetings a wider collection of resources. hydrotherapy pool and the relocated with specific clinical units in order to Health Services Library purchased Kokoda Gymnasium. The veteran improve medical record documentation authentication software during the year community received this news with and clinical coding. to provide access to the Austin’s great excitement and Austin Health The Clinical Information Unit contributed online resources from the Mercy acknowledges the veteran community’s data as part of the Department of Human Hospital’s network. support for this project, particularly the Services’ Specified Grants Review for Austin Health’s membership of the efforts of Major General David McLachlan Chemotherapy and Radiotherapy and Victorian Health Libraries Consortium AO, Victorian State President of the RSL. contributed to the Dialysis Review. further enhanced access to online The Heidelberg Repatriation Veterans’ The department also participated in the resources. During the year, the library Centre was opened and is a welcome Victorian Cost Weights Study for Inpatients intranet and internet pages were addition to the veterans’ services available and Outpatients. The Patient Services redesigned and there were 57,000 hits at the Heidelberg Repatriation Hospital. Data Group was integrated into Health on the library web pages. The A – Z journal Veteran Liaison continued to provide Information Services and all areas list was accessed 30,000 times. ongoing support to veterans of past, participated in numerous benchmarking recent and ongoing conflicts and strives exercises, such as Health Roundtable to meet the challenges of the future. and studies with other major metropolitan hospitals. The veteran community and many veteran organisations continued to support clinical services, fundraising, working bees and Austin Health activities. They were involved in planning issues and attended, supported and contributed to major projects and annual ceremonies of observance.

Austin Health 2005/06 Annual Report Support Services Human Resources

The ‘In Sickness and In Health’ program was introduced to improve the management of unplanned absences and to ensure employees are taking sufficient annual leave to maintain good health.

Employee Services The Unit also introduced the ‘In Sickness Each participated in 360-degree feedback Employee Services carried out planning for and In Health’ program to improve the and a professional style assessment, the first phase of a new human resources management of unplanned absences which provided feedback on their individual management system, which will introduce and to ensure employees are taking motives, preferences, needs and talents a new and complex payroll system in sufficient annual leave to maintain good in critical work areas. Participants worked July 2006. The payroll component of the health and reduce excess leave with the unit to create their individual Human Resources Management System entitlements which represent a financial development plan and participate in is the first step in implementing a range liability to Austin Health. This program has coaching sessions. Workshops, project of other management functions, and the decreased sick leave usage and reduced work, guest speakers and leadership department completed all the required the financial liability of annual leave accruals. laboratories were a key part of the learning work to allow for the introduction of further methodologies provided. components of the system in the first half Employee Relations More than 100 managers and supervisors of 2006 – 07. These components will Human Resources continued to provide participated in the Frontline Management include training and performance and operational support and advice within Program, which aims to improve workforce management modules that a complex industrial environment. organisational effectiveness by increasing are designed to assist staff and the During 2005 – 06 the focus fell on new the skills of new managers and supervisors organisation in managing career work arrangements in the Austin Hospital in key areas such as occupational health opportunities, training and workforce Tower which met with some employee and safety, recruitment and retention, development requirements. and union concerns. These issues were industrial relations, performance This project was undertaken with financial eventually overcome through sustained management and leading teams. and project management support from dialogue and with the assistance of the The unit participated in a Commonwealth the Department of Human Services’ Australian Industrial Relations Commission. Government funded program, which HealthSMART program as part of a provided more than 60 staff who had statewide initiative. The next stage of this Learning and Organisational no previous formal qualifications with a initiative will be developing a complete and Development Certificate IV in Government. This program electronic rostering solution that is fully The Learning and Organisational covers a variety of topics, including integrated with the new payroll system. Development Unit reintroduced the workplace communication, managing Austin Health expects to participate as Leading People and Change Program in conflict, occupational health and safety, a lead agency in the development and 2005 – 06. Participants came from a range improving workplace systems and implementation of this rostering solution of areas and disciplines and included processes, and industrial relations. during 2006 – 07. a significant number of medical staff.

34/35 Workforce Data – Number of equivalent full-time staff 2004 – 05 2005 – 06 Nursing services 1674.53 1773.75 Administration and clerical 639.27 647.53 Medical support 514.25 584.32 Hotel and allied services 621.14 620.16 Medical officers 122.16 125.29 Hospital medical officers* 322.51 288.80 Sessional medical officers 69.33 73.28 Ancillary support services 324.54 352.00 Total 4305.73 4425.13

*2005 – 06 data for hospital medical officers excludes doctors on rotation.

The unit conducted a program providing The Occupational Health and Safety Unit All security staff undertook training to 109 staff who have training responsibilities undertook considerable work reviewing ensure they satisfied updated industry with a Certificate IV in Workplace Training emergency procedures and emergency licensing standards. This training also and Assessment. Through this program, response systems and improving training prepared staff for using personal protective staff are now qualified to assess training mechanisms and support tools for equipment which is being introduced to needs, design and conduct on-the-job managers and staff. The unit used improve the safety and effectiveness training, and evaluate training outcomes. electronic solutions where appropriate. of security responses. The unit conducted more than 40 The unit also conducted a series of organisational development interventions WorkSafe presentations to acquaint Car Parking aimed at improving workplace performance managers and other staff with changes Austin Health gradually extended the in 2005 – 06. These interventions covered to their legislative obligations under the use of automated car park entry, exit and areas such as process redesign, conflict Occupational Health and Safety Act. payment facilities at the Austin Hospital resolution, model of care development, As part of the new Human Resources and the Heidelberg Repatriation Hospital strategic planning, customer service and Management System, Occupational during 2005 – 06, reducing staffing costs team work. Health and Safety participated in the and increasing car park revenue. introduction of a new incident reporting This department also directed Occupational Health and Safety system (RiskMan). Austin Health expects considerable attention to increasing Human Resources continued to devote this system will improve reporting of visitor and staff use of the new Austin attention to improving the safety of incidents and injuries, allowing the Hospital Tower car park to ensure this staff through targeted training programs organisation to more quickly identify asset is providing an adequate return and development and refinement of action required to prevent further on investment while meeting users’ needs. procedures for dealing with aggression incidents or injury. These efforts were successful, with the in the workplace. The division also car park now fully used at various times continued to focus on improving manual Security of the week. A review of car park signage handling processes. This included During 2005 – 06 security staff became and way finding is presently underway. continuing the operation of the ‘No Lift’ more familiar with new technology in the program introduced some years ago Security Control Room, further improving with considerable positive impact. the standard of security and safety at These and other initiatives to reduce the Austin Hospital. This new technology manual handling injuries were rewarded was particularly useful in prosecuting when a WorkSafe Victoria audit of the thieves and locating lost or confused highest risk non-clinical areas of the patients and visitors. hospital resulted in no recommendations for improvement being issued.

Austin Health 2005/06 Annual Report Research

Austin Health’s 630 researchers shared in $25 million worth of research grants in 2005 – 06.

Research highlights Austin Health has an ongoing commitment The Brain Research Institute was pleased The Victorian Government allocated to research and has strong partnerships to welcome Professor Alan Connolly $24 million in research funding as part with The University of Melbourne and the and his world-class team of physicists of Healthy futures: the life sciences major independent research institutes. and neuroscientists from the prestigious statement. Austin Health will use this Austin Health’s 630 researchers shared University College London, marking a funding to construct two new buildings in just under $25 million worth of research significant expansion to Austin Health’s on the Austin Hospital site. The first will grants in 2005 – 06. magnetic resonance imaging capability. be a new bioresources facility which Researchers in The University of Melbourne The MR Development Group brings a new will be shared between all research groups Department of Medicine at Austin Health understanding of magnetic resonance within Austin Health. The second building were awarded $1.8 million in new National imaging, new skills in development, links will be one campus of the new Australian Health and Medical Research Council with the international community, and a Centre for Neuroscience and Mental grants for 2006. Research supported world-class reputation in development Health Research. This centre will integrate includes studies of models of diabetes, and in teaching. This will be the seed for the Howard Florey Institute, the Brain structural bases of bone strength and an ongoing skill base in bioimaging in Research Institute, the Mental Health investigations of androgen deficiency. Australia which will be seen as increasingly Research Institute, and the National These new grants build on the existing significant in future years. Stroke Research Institute. A second research funding awarded by the National campus will be located at Parkville. Health and Medical Research Council The Commonwealth Government has and other funding bodies supporting contributed $37 million for both nodes research in the fields of androgens and of the Australian Centre for Neuroscience men’s health, bone disease, cardiovascular and Mental Health Research. endocrinology, cardiovascular pharmacology, These facilities represent a major investment diabetes and its complications, growth in research for Austin Health and one factors and cancer, heart disease, that demonstrates the confidence shown neuroprotection and neuroregeneration, in hospital-based research and the neurophysiology, obesity, prostate disease, pre-eminence of the research conducted stroke and thyroid disease. by Austin Health. As part of the Life sciences statement, the government also provided funding to relocate some of the Austin Research Institute groups to The Alfred following its merger with the Burnet Institute.

36/37 Associate Professor David Howells and his team of researchers are working on treatments to limit the damage caused by stroke and spinal cord injury and to promote effective recovery.

The development of advanced imaging The National Health and Medical Research The Ludwig Institute for Cancer technologies at the Brain Research Council Epilepsy Program Grant was Research Melbourne Centre for Clinical Institute will provide local opportunity for renewed in 2006 for more than $11 million Sciences was recently created by the world-leading science developments that for a further five years. This funding separation of the Austin and Parkville have immediate health care benefits. demonstrates that the Brain Research sites. The Melbourne Centre for Clinical The Brain Research Institute and other Institute and the broader neuroscience Sciences will have a primary focus on neuroscience research groups with group at Austin Health are internationally clinical, rather than laboratory, sciences, important questions to address can work recognised as leading the thinking and and will be a site for the Ludwig Institute in conjunction with experienced magnetic applications of imaging technologies and for Cancer Research clinical trials. resonance imaging development scientists genetics to the problems associated with The Director of the new Melbourne Centre to apply the new techniques to clinical epilepsy. Most in the international community for Clinical Sciences is Associate Professor areas of epilepsy, stroke, brain trauma and generally perceive Austin Neurosciences Andrew Scott, former Associate Director mental health. as one of the lead epilepsy research (Clinical) of the Melbourne branch, and The Brain Research Institute now has centres in the world with pre-eminence in Head of the Tumour Targeting Program. its second high-field 3 Tesla magnetic imaging and genetics. Of the investigators The Melbourne Centre for Clinical Sciences resonance imaging system. This second taking part in this study, three of nine has about 80 staff and will primarily 3T magnetic resonance imaging system come from the Brain Research Institute undertake clinical and translational research, realises the vision of an integrated magnetic and are associated with imaging. This grant but will also conduct basic laboratory resonance imaging and neuroscience was obtained with colleagues from the research that supports its clinical activities. facility, where basic problems in biology Epilepsy Research Centre, the Howard The existing joint medical oncology program (from large animal models through to Florey Institute, Monash University and directed by Professor Jonathan Cebon human studies) can be fully investigated the University of Adelaide. with Austin Health and involving molecular with advanced MR methods. imaging will continue within the centre.

Austin Health 2005/06 Annual Report Research

During 2005 – 06 the Ludwig Institute for In April 2005 the Victorian Minister for Professor Chris Christophi and his Cancer Research continued its partnership Innovation announced that the Victorian Hepatic, Pancreatic and Biliary Research with Austin Health for planning and Tissue Bank Initiative was one of Group were awarded $507,750 from the fundraising of the new Olivia Newton-John 17 successful projects in round three of National Health and Medical Research Cancer Centre, which alongside the the Science, Technology and Innovation Council for investigating novel therapies hospital’s cancer services will incorporate Infrastructure Grants Program, receiving that target the blood vessels of liver institute research and clinical programs. $7 million of the $60 million allocated. tumours. This is a collaborative study at Associate Professor Andrew Scott and A consortium of the principal tissue banks national and international levels combining his team were awarded a US$325,000 in Melbourne (Austin, the Ludwig Institute the unique expertise of the various exploratory/developmental research grant of Cancer Research, Royal Melbourne participants, including Professor Hiroshi award (R21) from the National Institute Hospital, Peter MacCallum Cancer Centre, Maeda from Kumomoto, Japan, and of Health to trial a potential colon cancer and Monash Medical Centre), with the Dr Ian Millar from The Alfred hospital. therapy at Austin Health. Cancer Council Victoria, submitted the This has the potential to replace standard application. Austin Health participants hemotherapy as the preferred treatment An antibody drug candidate developed include the Department of Anatomical for patients with bowel cancer spread by a team of researchers at the Melbourne Pathology, the Ludwig Institute for Cancer to the liver. branch of the Ludwig Institute for Cancer Research, and the Ludwig–Austin Joint Gastrin was originally discovered as Research was in-licensed by KaloBios Medical Oncology Unit. Pharmaceuticals, a therapeutic antibody a stomach hormone controlling the company, for the treatment of autoimmune The National Heart Foundation awarded production of stomach acid and aiding diseases. The first generation antibody a $120,000 grant to Professor Louise digestion of food. Recently, the is planned to enter human clinical trials at Burrell, which will enable her team Department of Surgery and others have Austin Health in mid 2006. In September of medical, allied health and scientific shown that gastrins are growth factors 2005, the Ludwig Institute for Cancer colleagues to study an enzyme called produced by cancers of the large intestine Research and KaloBios were awarded ACE2, which is activated after (colorectal cancers) which accelerated the a National Health and Medical Research a heart attack. development of the cancer. Researchers Council development grant ($283,000) Head of the Division of Surgery, Professor from the Department of Surgery have for the development of clinical assays Chris Christophi’s research into the uses discovered that gastrins bind iron to support the phase I study. of laser hyperthermia ablation and new molecules tightly and that, for some forms drug delivery systems targeting the tumour of the hormone, iron binding is essential Professor Jonathan Cebon and his team for biological activity. The overall objective are leading an international phase II clinical vasculature for the treatment of liver cancer won him the Royal Australian College of this project is to understand the trial to further test the effectiveness of the biological significance of the complex therapeutic cancer vaccine NY-ESO-1 of Surgeons’ most prestigious research endowment, the John Mitchell Crouch between ferric ions and gastrins and formulated in the adjuvant ISCOMATRIXTM whether blocking the interaction will for melanoma. Fellowship. The College Council awards the fellowship each year for outstanding block the ability of gastrins to stimulate As part of its Cancer Vaccine Collaborative contributions to the advancement the growth of colorectal cancers. program, the Cancer Research Institute of surgery or to fundamental scientific The health significance of these studies also awarded US$70,000 to Associate research in the field. are novel therapies for treatment of Professor Ian Davis to assist a pilot study colorectal cancers and for subjects with of peripheral blood dendritic cells pulsed iron regulatory disorders. with NY-ESO-1 ISCOMATRIX® in patients with treated cancer and minimal residual disease at high risk of relapse.

38/39 Associate Professor Paul Johnson, The Victorian Spinal Cord Service The Telstra Foundation Community Deputy Director of Infectious Diseases, conducted a joint study with LaTrobe Development Fund gave $55,000 to is the facilitator of a research network with University’s School of Public Health, a one-year project entitled, ‘Premature nodes at Austin Health, Barwon Health, ‘Barriers to post-injury employment faced mothers, fathers and babies – family Department of Primary Industries Attwood, by compensable and non-compensable recovery, relating and infant development’. Monash University and the Victorian patients: a pilot study of traumatic spinal A randomised control trial entitled, Infectious Diseases Reference Laboratory. cord injury patients’. The study aims to ‘Psychological treatment of post natal The group are studying Mycobacterium identify the set of factors (both personal depression (PND) is effective’, was ulcerans, the bacterium that causes and environmental) reported by conducted, comparing cognitive therapy Bairnsdale ulcer, sometimes called interviewees to have impacted on post- with less specialised psychological the ‘flesh-eating bug’ and known injury employment achievements. Results interventions. All were demonstrated internationally as Buruli ulcer. The work from this pilot study will guide the design to be superior to conventional routine care. formed the basis of a BBC Documentary of a subsequent intervention to enhance There are relatively few such studies and to be screened in Europe and the United the post-injury vocational achievements this one had the added strengths of a Kingdom in July 2006. Projects underway of those living with spinal cord injury. broad community sample, formal clinical currently include a case control study on Particularly salient will be services that diagnosis of depression, manualised risk factors for acquisition of Bairnsdale can be commenced while the patient interventions, and well validated rating ulcer on the Bellarine peninsula, trapping is undertaking primary rehabilitation. instruments. and testing of more than 10,000 There is emerging, compelling evidence Dr Sandra Iuliano-Burns and Professor mosquitoes, and work to test whether that tetraplegia, the loss of function in arms artificially infected mosquitoes can transmit Ego Seeman are working closely with the and legs, results in greater secondary Australian Antarctic Division looking at the the organism under experimental disability due to disturbed sleep and conditions. The team also organised and effects of lack of sunlight on vitamin D breathing overnight. The ‘Sleep Health in levels and bone in Australians wintering hosted a consensus conference that was Tetraplegia’ study aims to comprehensively held in February. The resulting consensus in Antarctica. It is believed the lack of evaluate sleep health in tetraplegia by sunlight increases bone loss. During guidelines will be published later in the documenting sleep disturbances and year in the Medical Journal of Australia. winter, vitamin D levels were significantly determining the prevalence and nature lowered and bone resorption (the rate that The Victorian Spinal Cord Service of any sleep disordered breathing in the bone is removed from the skeleton) was participated in an international multicentre Victorian population with tetraplegia. It is highest. Levels returned to normal once clinical drug trial that saw 240 patients known that obstructive sleep apnoea and the subjects had returned to Australia. with chronic spinal cord injury between sleep disturbances are significantly under- Bone density measurements of those the ages of 18 and 65 years take part at diagnosed in people with spinal cord injury returning from Antarctica this summer 30 study centres across Australia, New and this project is likely have an immediate will confirm the amount of bone loss. Zealand, India, America, the United positive impact for the participants as Australian Antarctic Science funded Kingdom and Europe. HP184 is a drug problems are diagnosed and treatments this project. that works to prevent the entry of sodium are offered. Similarly, these data will be and potassium ions through nerves. used to guide future clinical trials of This may improve the functioning of nerves novel therapies. and therefore muscle strength, sensory The Parent–Infant Research Institute was perception, and pain sensation in some awarded a National Health and Medical spinal cord injured patients. The research Research Council grant of $609,875 for a study measured the effect of HP184 four-year project entitled, ‘Intervention to on muscle strength. improve brain, intellectual and behavioural development of premature infants’. This project involves Professor Jeannette Milgrom, Associate Professor Terrie Inder, and Professor Paul Martin.

Austin Health 2005/06 Annual Report Teaching and Training

Austin Health provides the largest postgraduate medical training program in Victoria, covering all medical specialties, including general practice.

Teaching highlights Medical staff at Austin Health provide Teaching activity for the 150 physiotherapy For the many dedicated teaching staff the largest postgraduate medical training undergraduate students from The University working at the Austin the highlight of program in Victoria, covering all medical of Melbourne remained the clinical school’s the year was the success of the education specialties, including general practice. key focus, with the majority of clinical precinct on level four of the new Austin In 2005 – 06 these training programs were supervision being provided by the three Hospital Tower. The new lecture theatre, increasingly integrated with educational facilities of Austin Health. Warringal computer laboratories, seminar rooms activities in the hospitals junior staff rotate Hospital continued to take fourth year and tutorial rooms within the precinct to; Northern, Bendigo, Echuca and cardiothoracic students in 2005 despite have been in almost constant use Horsham. Training programs for interns the change in ownership of the delivering educational programs to several and residents were the main focus of the organisation to Ramsay Healthcare. hundred undergraduate and postgraduate Postgraduate Medical Council of Victoria Wangaratta Base Hospital successfully medical, nursing and allied health trainees annual symposium, which was held took third year musculoskeletal students based at the Austin Hospital. Trainees’ in the education precinct in May 2006. for the first time. The Department of learning was enhanced by regular use The Austin Hospital Medical Education Human Services provided funding for an of new videoconferencing facilities Unit was involved in a pilot program associate professor in allied health for and by improvements to the Austin initiated by the Postgraduate Medical La Trobe University and Northern Health, Hospital library which was expanded Council, which involved employing a which will mean Northern Health’s to accommodate La Trobe University medical clinical educator to educate involvement in the teaching program Nursing Clinical School students and international medical graduates. will be scaled down. to amalgamate the Mercy and Austin The role of the medical clinical educator Third year physiotherapy students were collections. Planning for a multidisciplinary is to orientate international medical among the first students to use the clinical skills laboratory in a ward in the graduates to the Australian hospital facilities in the new education precinct. vacated Harold Stokes Building is well system and to address their post-graduate Use continued to grow throughout the under way. medical education needs. The team rest of the year. Of particular value is the Austin Health/Northern Health Clinical working on the pilot program developed student common room, which gives School graduate, Dr Harriet Gee, an extensive curriculum to address the students a home base and relieves was the top University of Melbourne areas of hospital medical officers’ task pressure on the physiotherapy clinical medical student in 2005. After graduation prioritisation, ordering and interpreting facilities. All students are impressed by she was awarded a Rhodes Scholarship investigations, communication with the quality of the facilities and speak very to commence a PhD at the University staff and patients, and common positively of their student experience with of Oxford in 2007. clinical problems. The curriculum is Austin Health as a result. being delivered during weekly group teaching sessions.

40/41 The new education precinct enables undergraduate nursing students to attend the majority of their classes within the hospital and undertake clinical placement on the wards nearby.

The Austin Health/La Trobe University Awards Anthony Zulli, cardiac surgery researcher, Clinical School of Nursing has also enjoyed Professor Sam Berkovic, Director was awarded the prestigious Peter Doherty its first year in the education precinct. Neurology, was awarded the prestigious Training Fellowship. This is a most During the first semester in the new Zülch Prize from the Max Planck Society prestigious award. premises, 110 year three undergraduate in Germany in recognition of his Nurse Unit Manager, Coronary Care Unit, nursing students attended the majority groundbreaking investigations into the Marcia George received a Medal of the of their classes within the hospital. In genetic foundations of epilepsy. Professor Order of Australia for her service to semester two, ‘clinical rounds’ were trialled Berkovic, who heads the Epilepsy cardiovascular nursing in developing and to enhance the students’ problem-based Research Centre at The University implementing new patient care methods. learning curriculum. The sessions focused of Melbourne and the Comprehensive Dr Philip Hayward, Cardiac Surgery on a number of topics related to complex Epilepsy Program at Austin Health, skills and health assessment. These were Registrar, received the gold medal in received the prize for his major study cardiothoracic specialty examinations very successful and were continued into of people with epilepsy from large families the 2006 program. of the Royal College of Surgeons in the and more than 300 twins with epilepsy. United Kingdom. Dr Hayward previously The clinical program continued in 2006, Professor Berkovic and his research team won the gold medal for the Royal College with 105 students being placed with one were the first to prove that many types of Surgeons Fellowship examinations or two registered nurses for their clinical of epilepsy have a significant genetic in 2000 and this is the first time the same practicum in semester one. Staff of the component. This has directly led to doctor has won both awards. clinical school continue to work closely changes in patient management and with the Clinical Nursing Education new concepts in the understanding Endocrine Centre of Excellence Director Department and contribute to a number of epilepsies. The Zülch Prize is awarded Professor George Jerums received the of hospital nursing courses. annually for outstanding achievements Distinguished Scientist Award to mark in basic neurological research. It is shared Austin Health’s 2005 Research Week. between Professor Berkovic and Professor The award, granted by the Austin Hospital Christian Elger, University of Bonn. Medical Research Foundation, was in Professor Berkovic was also awarded recognition of Professor Jerums’ prominence the 2005 Curtin Medal for outstanding as a scientist and his contribution to the contribution to Australian medical science. research community. His major contribution to research has been in the early detection and treatment of diabetic renal disease.

Austin Health 2005/06 Annual Report By June, the number of patients waiting for elective surgery was the lowest for seven years. “This is the team that got me back on the road.” Brian Jones, bus driver and elective surgery patient. Support Services Finance

The year ended with a small surplus of just under $1 million providing a suitable base for sustainable improvement into the future.

The 2005 – 06 financial year was a Staffing changes have commenced Mail and Transport successful year with a small surplus to improve the skills base and ensure During the second half of 2005 – 06, of just under $1 million (after adjusting resources are focused on improving major reforms and restructures within for capital income and depreciation), workflows and meeting the ever-increasing the Mail Services Department more compared with a $4.7 million deficit the demand to assist Austin Health managers. than halved the handling cost per item previous year. More significantly, the gains of hospital mail processed. Further made during the year provide a suitable Supply Department efficiencies are planned for 2006 – 07. base for sustainable improvement into There was a significant increase in the the future. throughput of goods into the health service The financial turnaround was achieved as a result of the general increase in hospital in difficult circumstances, with the opening activity, support to new hospital statewide of the Austin Hospital Tower drastically contracts (for example, pathology services), increasing patient activity, and related and support to the Mercy Hospital and costs. Success was largely due to the other clients. Despite this, the average successful implementation of an action turnaround time for deliveries to wards plan aimed at using the capacity of the and departments continued at the same new facilities to achieve economies fast rates that were achieved in 2004 – 05. of scale and improve business-related Planning is continuing on new systems revenues. development, including the rollout A restructure of clinical business of the new electronic requisition system. units to improve efficiency and Following a review of the organisation’s accountability across the organisation fleet management function, the Supply achieved further enhancements. Within Department implemented a range Finance Services these changes were of measures designed to reduce fleet accompanied by actions that improved operating costs, such as fuel and financial processes and reporting, and insurance. These initiatives have already the recent implementation of a business- begun to realise savings while maintaining orientated budget system which provides the operational capability of hospital staff. the information required to manage successfully into the future.

44/45 Financial Summary

2001 – 02 2002 – 03 2003 – 04 2004 – 05 2005 – 06 $000 $000 $000 $000 $000

REVENUE & EXPENSES Total Revenue 349,600 374,500 413,800 443,646 474,953 Total Expenses 345,500 374,800 415,000 448,353 474,002

Operating Surplus (Deficit) before capital and specific items 4,100 (300) (1,200) (4,707) 951 Capital and specific items (4,109) 287 1,186 (11,557) (4,991) Operating Surplus (Deficit) (9) (13) (14) (16,264) (4,040) Accumulated Deficit (16,202) (30,967) (45,598) (63,064) (65,732)

BALANCE SHEET STATISTICS Total Assets 300,019 291,838 296,093 673,660 683,512 Total Liabilities 93,809 99,936 117,838 141,934 142,649 Net Assets 206,210 191,902 178,255 531,726 540,863

Total Equity 206,210 191,902 178,255 531,726 540,863

Debtors Indicators

Average Collection Days Inpatient Accommodation Fees Outstanding` 2006 2005 Under 31– 60 61–90 Over Total Total Days Days 30 days days days 90 days 30/6/06 30/6/05 $000 $000 $000 $000 $000 $000

Private 88 99 709 690 500 529 2,428 1,427 Transport Accident Commission (TAC) 77 75 104 132 98 156 490 902 Victorian WorkCover Authority (VWA) 33 37 10 51 4 42 106 229 Other compensables 74 80 35 61 37 103 237 335 Psychiatric 88 89 42 7 4 -7 46 24 Residential Aged Care 0 0 0 0 0 0 0 1 Total 899 940 643 824 3,307 2,918

Austin Health 2005/06 Annual Report Mandatory reporting

Freedom of information applications Consultancies engaged during 2005 – 06 All applications were processed in 1. In excess of $100,000 per consultancy accordance with the provisions of the There were no consultancies in excess Freedom of Information Act 1982, which of $100,000. provides a legally enforceable right of access to information held by government 2. Less than $100,000 per consultancy agencies. Austin Health provides a report There were four consultancies engaged on these requests to the Department at a total cost of $117,819. of Justice.

Freedom of information statistics for 2005 – 2006

Freedom of information statistics for 2005 – 06 Requests received 594 Fully granted 501 Partially granted 17 Denied 2 Other – No documents 12 – De-activated/cancelled requests 24 – Requests transferred to another ‘agency’ (Section 18) 2 In progress 36

Whistleblowers’ Protection Act 2001 Building Act 1993 Competitive neutrality Austin Health has procedures in place During the financial year it has been Austin Health continues to comply with to facilitate the making of disclosures, Austin Health’s practice to obtain Building the Victorian Government’s Competitive to investigate disclosures and to protect Permits for new projects and Certificates Neutrality Policy. In addition, the Victorian persons making disclosures. of Occupancy or Certificates of Final Government’s Competitive Neutrality pricing During 2005 – 06, no disclosures of improper Inspection for all completed projects. principals for all relevant business activities conduct or detrimental action by Austin Registered building practitioners have have been applied by Austin Health from Health or its employees were made. been engaged for all new building projects. 1 July 1998. Procedures are available on the Austin In order to ensure Austin Health buildings Health web site (www.austin.org.au) or can are maintained in a safe and serviceable be obtained from the Protected Disclosure condition, routine inspections and ongoing Officer, Marie Ellis, on 03 9496 5370 or maintenance programs were undertaken. by writing to Austin Health, PO Box 5555, Where required, Austin Health implemented Heidelberg, VIC, 3084. recommendations arising from those inspections through a program of rectification and maintenance works.

46/47 Austin Health activity data – 1 July 2005 – 30 June 2006

Acute Mental Health Aged Other Total

ADMITTED PATIENTS Separations Same day 51,810 23 20 – 51,853 Multi day 27,546 1,058 1,031 – 29,635 Total separations 79,356 1,081 1,051 – 81,488 Emergency 25,513 382 846 – 26,741 Elective 53,839 699 209 – 54,747 Total separations 79,352 1,081 1,055 – 81,488 Public separations 68,592 828 781 – 70,201 Total WIES12 57,552 Average available beds 692 138 62 60 952 Separations per available bed 115 8 17 – 86 Bed days (accrued) 245,243 21,131 20,942 – 287,316

NON-ADMITTED PATIENTS Emergency medicine attendances 48,485 – – – 48,485 Outpatient services – occasions of service 287,919 – 7,804 21,865 317,588 Total occasions of service 336,404 – 7,804 21,865 366,073 Victorian Ambulatory Classification System (VACS) – 100,819 Number of weighted attendances Number of allied health encounters 86,482 – – – –

Performance measures Access

2003 – 04 2004 – 05 2005 – 06

1 ELECTIVE SURGERY PERFORMANCE Category 1 proportion of patients admitted within 30 days (%) 100% 100% 100% Category 2 proportion of patients admitted within 90 days (%) 64% 55% 53% Average waiting times for Category 2 patients on the waiting list as at 30 June 137 156 138 Average waiting times for Category 3 patients on the waiting list as at 30 June 318 264 217

Elective results are provisional pending DHS review of data

2 EMERGENCY DEPARTMENT PERFORMANCE 2a Triage performance Category 1 patients receiving immediate attention 100% 100% 100% Category 2 patients receiving attention within 10 minutes 85% 83% 84% Category 3 patients receiving attention within 30 minutes 74% 75% 75% 2b Patients as a percentage of admissions staying in the Emergency Department 63% 65% 69% for over 8 hours prior to admission to ward 2c Number of ambulance bypass Incidents 72 76 79 3 Average available beds (Acute) 675 673 692 4 Number of intensive care beds 14 14 16 5 Number of coronary care beds 10 10 10

Austin Health 2005/06 Annual Report Senior staff

Chief Executive Officer M Cosgriff A/Prof G Braitberg R DeZilva Director Emergency Medicine Dr Brendan Murphy C Denton Dr D Brown Executive Directors W Driver Director Victorian Spinal Cord Service M George A/Prof R Buchanan John Breguet J Gill Head Rheumatology Unit Redevelopment, Infrastructure and Commercial A Gonzales Prof B Buxton Ian Broadway E Han Director Cardiac Surgery Unit Finance M Heland Mr M Campbell Dr Mark Garwood C Holland Head ENT/Head and Neck Unit Chief Medical Officer KL Hopkins Mr L Castles Ann-Maree Keenan T Hume Head Breast and General Surgery Unit 2 Ambulatory and Nursing Services K Ireland Prof J Cebon Chris O’Gorman G Jepsen Director Austin Ludwig Oncology Unit Corporate Development K Kannan Prof C Christophi Mark Petty E Krstevski Chair Division of Surgery, Professor of Surgery, Acute Operations K Lamb Head of HPB General Surgical Unit 1 John Richardson S Lorman Prof P Clarke Human Resources M Love Head Thoracic Surgery Unit K Luxmore Dr N Coventry Clinical Service Unit Directors I Manley Director Child and Adolescent Mental Health Aged Care A Manley-Grant Service Liz Hamilton R McFarland A/Prof B Crotty A/Prof Michael Woodward J Masci Clinical Dean School of Medicine Anaesthesia, Perioperative and Intensive Care R Monger S Crowe Denis O’Leary A Moulder Deputy Director, Ambulatory and Nursing A/Prof Larry McNicol S Nedelkos Services Cancer, Spinal and Outpatients M Nolen Mr R Cunningham Rhyl Gould CA Northmore Head Orthopaedic Unit 1 Dr Paul Mitchell J Patching Prof G Donnan Medical and Emergency J Payne Director Neurology Jillian Macloy J Phelan Dr L Doolan A/Prof Gwynne Thomas N Poole Director Operating Room Services Mental Health V Reid Mr M Douglas Les Potter B Rickard Head Upper Gastrointestinal and General Prof Graham Burrows K Rim Surgery Unit 3 Royal Talbot Rehabilitation Centre J Scott Dr J Duggan Anne Szysz J Shoesmith Director Clinical Haematology Dr Rob Weller T Tait M Egan Specialty Services K Tan Co-manager Social Work Leanne Turner S Tan Dr B Fabiny Dr Jennifer Johns L Tassell Director Radiology Surgical B Toth A/Prof G Fabinyi Bernadette McDonald B Vandenberg Director Neurosurgery Unit Dr Sue Liew R Vaughan Mr Stephen Flood A Warland Head Plastic, Reconstructive and Oral Nurse Unit Managers N Wendel Maxillofacial Surgery S Afrasiabi A Wilcox J Feltham J Ahmling Co-manager Social Work V Aldridge Senior Clinical Staff H Fithall K Arunasalam Prof P Angus Manager Hospital in the Home K Aspridis Director Gastroenterology and Hepatology, C Fitzgerald M Bassett-Smith Medical Director Liver Transplant Unit Manager Northern Centre Against Sexual I Edney Mr A Auldist Assault N Bridgland Head Paediatric Surgery Unit Prof M Galea J Brown Prof S Berkovic Director Rehabilitation Science Research Centre L Bujas Head Comprehensive Epilepsy Program K Garrett A Caporilli A Bladen Director Pharmacy C Cheshire Manager Occupational Therapy Dr P Gow M Conway A/Prof D Bolton Director Endoscopy MA Cook Head Urology Unit Prof L Grayson Director Infectious Diseases

48/49 Dr K Gullifer Prof A Street B Morton Head Ophthalmology Unit Director La Trobe/Austin Health Clinical Manager Supply Dr G Gutteridge School of Nursing P Oppy Director Intensive Care Unit J Sweeney Chief Information Officer Dr M Hopwood Manager Speech Pathology L Roberton Director Veterans’ Psychiatry Head Brain Dr P Thurlow Patient Representative Disorders Program Director Division Laboratory Medicine C Schleiger Dr S Howard Mr R Westh Manager Occupational Health and Safety Director Post Traumatic Stress Disorder Head Orthopaedic Unit 3 R Sedgwick Program Mr P Wilde Manager Cleaning and Waste Services Prof G Jerums Head Spinal Surgery Service B Sutton Director Endocrinology Dr R Woodruff Director Clinical Training, Manager Medical Prof B Jones Head Palliative Care Education Unit Director Liver Transplant Unit Prof J Zajac M Tymms Prof B Louis Chair Division of Medicine, Professor of Manager Redevelopment Director Clinical Pharmacology, Toxicology and Medicine, Director of General Medicine M Way Hypertension Services Director, Clinical Governance Dr D MacGregor Senior Support Staff A Whitby Director Anatomical Pathology D Bulmer Co-director Pastoral Care AM Mahoney Manager Employment R Winther Manager Clinical Nursing Education G Chatain Veteran Liaison Officer Mr A McLeish Manager Food Services Head Colorectal General Surgery Unit 4 J Clark Dr C Meehan Manager Payroll Services Head Dermatology D Cosentino Prof J Milgrom Manager Child Care Centre Director Clinical and Health Psychology P Dalton C Nall Director Fundraising Director Physiotherapy M Denison Dr D Lim Joon Manager Medical Engineering and Physics Director Radiation Oncology H Earp L Owen Manager Learning and Organisation Manager North East Post Acute Care Development R Paino D Edwards Heidelberg Repatriation Hospital Site Manager/ Manager Clinical Photography Aged and Residential Care Co-ordinator M Ellis A/Prof N Paoletti Board Secretariat and Internet/Intranet Head Consultation/Liaison Psychiatry J Evans L Pearce Manager Strategic and Business Planning/ Manager Nutrition and Dietetics Quality Prof M Permezel C Fuller Head Gynaecology Unit Project Officer Ward Restructure and HR Prof R Pierce Support Director of Respiratory and Sleep Medicine A Germech Prof D Power Financial Controller Director Nephrology G Gibbons Mr A Roberts Co-director Pastoral Care Director Vascular Surgery K Gogel Mr J Robin Manager Employee Relations Head Orthopaedic Unit 2 J Heselev A/Prof C Rowe Manager Corporate Communications Director Nuclear Medicine and Centre for PET C Hirst A/Prof M Saling Corporate Counsel Director Clinical Neuropsychology K Jenkins A/Prof A Scott Manager Health Information Services Head Centre for PET, Program Director Ludwig S Kliene Institute for Cancer Research Manager Hospital Medical Officer Services T Shevchenko M Lawes Manager Hospital Primary Care Liaison Unit Manager Building and Engineering Services Dr F Kerr A McLean Chair Senior Medical Staff Association Manager Health Sciences Library

Austin Health 2005/06 Annual Report Our clinical services

Statewide Services Cancer Services General Medicine Infection Control Australian Centre for Posttraumatic Ballarat Austin Radiation Oncology Centre Infectious Diseases Mental Health Cancer Clinical Trials Medical Assessment and Planning Unit Child and Adolescent Mental Health Services Cancer Immunology Nephrology Ventilation Weaning Unit Cannulation and Aphaeresis Service Paediatric Medicine Victorian Liver Transplant Unit Clinical Haematology Podiatry Victorian Respiratory Support Service Day Oncology/Chemotherapy Renal Dialysis Victorian Spinal Cord Service Familial Cancer Clinic/Clinical Genetics Service Rheumatology Victorian Toxicology Service Medical Oncology Short Stay Observation Unit Palliative Care Toxicology Aged Care Radiation Oncology Lymphoedema Service Aged Care Mental Health Aged Care Assessment Service Cardiothoracic Services Adult Psychiatry Aged Care Co-ordination Teams Brain Disorders Program Aged Care Volunteer Program Angiography Bunjil House (Secure Extended Care) Community Link Rapid Response Service Cardiac Catheterisation Laboratory Clinical and Health Psychology Community Rehabilitation Centre Cardiac Rehabilitation Community Mental Health Services Continence Service Cardiac Surgery Consultation/Liaison Psychiatry Darley House Cardiology Drug Dependence Clinic Medical and Cognitive Research Unit Coronary Care Eating and Mood Disorder Program Memory Service Echocardiography Mental Health North East Dementia Innovations Hypertension Mother and Baby Unit Demonstration Pilot Respiratory and Sleep Medicine Older Veterans’ Psychiatry Program Northern Region Extended Aged Care Respiratory Function Laboratory Veteran Psychiatry at Home Program Sleep Disorders Unit Planned Activity Group Thoracic Surgery Neurosciences and Vascular Surgery Wound Clinic Tracheostomy Review and Management Service Clinical Neuropsychology Allied Health Diagnostic Services Comprehensive Epilepsy Program Epilepsy Unit Nutrition and Dietetics Anatomical Pathology Neurodiagnostics Occupational Therapy Centre for Positron Emission Tomography Neuroimmunology Physiotherapy Chemical Pathology Neurology Social Work Clinical Pathology Neurosurgery Speech Pathology Haematology Ophthalmology Laboratory Medicine Orthoptics Ambulatory Services Magnetic Resonance Imaging Stroke Care Unit Microbiology Acquired Brain Injury Unit Vascular Laboratory Nuclear Medicine Day Treatment Centre Vascular Surgery Hospital in the Home Radiology Medi-Hotel Pharmacy Gastroenterology, Surgical Neurological Rehabilitation Services and Transplantation North Eastern Post Acute Care Specialist Surgical and Spinal Northern Centre Against Sexual Assault Breast Surgery Orthotics and Prosthetics Colorectal Surgery Audiology Outpatients Endoscopy Dental Services Rehabilitation Gastroenterology Ear Nose Throat/Head and Neck Surgery Rehabilitation in the Home General Surgery Oral and Maxillofacial Surgery Staff Medical Services Gynaecological Surgery Orthopaedic Surgery Liver Transplantation Plastic and Reconstructive Surgery Anaesthetic, Perioperative Paediatric Surgery Spinal Surgery and Intensive Care Renal Transplantation Anaesthesia Upper Gastrointestinal Surgery Day Care Unit Urology Day Surgery Medical and Emergency Intensive Care Unit Operating Room Services Clinical Pharmacology, Pain Services Therapeutics and Hypertension Perioperative Services Dermatology Emergency Medicine Endocrinology

50/51 Writer Producer Design Photography Print Lara Mckay John Heselev Mouth Design Patient/Staff Bambra Press Editor For additional Portraits Stock Natalie Smith copies, Josh Robenstone Raleigh Paper please call Austin Health Corporate Communications on 9496 5222 Austin Hospital Heidelberg Royal Talbot 145 Studley Road Repatriation Hospital Rehabilitation Centre PO Box 5555 300 Waterdale Road 1 Yarra Boulevard Heidelberg PO Box 5444 Kew Victoria Heidelberg West Victoria Australia 3084 Victoria Australia 3101 T 03 9496 5000 Australia 3081 T 03 9490 7500 F 03 9496 4779 T 03 9496 5000 F 03 9490 7501 W www.austin.org.au F 03 9496 2541