Review of Operations 2015/2016

Continuing the Mission of the Sisters of the Little Company of Mary

Contents

Report from the Chief Executive Officer 6

Department Reports 8

Activity and Statistical Information 53

Year in Review 54

A Snapshot of our Year 57

Research and Teaching Reports 59

Financial Report 2015/2016 80

Acknowledgement of Land and Traditional Owners Calvary Mater Newcastle acknowledges the Traditional Custodians and Owners of the lands of the Awabakal Nation on which our service operates. We acknowledge that these Custodians have walked upon and cared for these lands for thousands of years. We acknowledge the continued deep spiritual attachment and relationship of Aboriginal and Torres Strait Islander peoples to this country and commit ourselves to the ongoing journey of Reconciliation. Aboriginal and Torres Strait Islander peoples are respectfully advised that this publication may contain the words, names, images and/or descriptions of people who have passed away.

2015/2016 Calvary Mater Newcastle Review of Operations | 1 The Spirit of Calvary

Calvary Mater Newcastle is a service of the Calvary group that operates public and private hospitals, retirement communities, and community care services in four states and two territories in Australia.

Our Mission identifies why we exist We strive to bring the healing ministry of Jesus to those who are sick, dying and in need through ‘being for others’: • In the Spirit of Mary standing by her Son on Calvary. • Through the provision of quality, responsive and compassionate health, community and aged care services based on Gospel values, and • In celebration of the rich heritage and story of the Sisters of the Little Company of Mary. Our Vision identifies what we are striving to become As a Catholic health, community and aged care provider, to excel and be recognised, as a continuing source of healing, hope and nurturing to the people and communities we serve. Our Values are visible in how we act and treat each other We are stewards of the rich heritage of care and compassion of the Little Company of Mary.

We are guided by our values: Hospitality

Demonstrates our response to the desire to be welcomed, to feel wanted and to belong. It is our responsibility to extend hospitality to all who come into contact with our services by promoting connectedness, listening and responding openly.

Healing

Demonstrates our desire to respond to the whole person by caring for their spiritual, psychological, social and physical wellbeing. It is our responsibility to value and consider the whole person, and to promote healing through reconnecting, reconciling and building relationships.

Stewardship

Recognises that as individuals and as a community all we have has been given to us as a gift. It is our responsibility to manage these precious resources effectively for the future. We are responsible for striving for excellence, developing personal talents, material possessions, for our environment and handing on the tradition of the Sisters of the Little Company of Mary.

Respect

Recognises the value and dignity of every person who is associated with our services. It is our responsibility to care for all with whom we come into contact, with justice and compassion no matter what the circumstances, and we are prepared to stand up for what we believe and challenge behaviour that is contrary to our values.

2 | 2015/2016 Calvary Mater Newcastle Review of Operations Being for others

Everyone is welcome. You matter. We care about you. Your family, those who care for you, and the wider community we serve, matter. Your dignity guides and shapes the care we offer you. Your physical, emotional, spiritual, psychological and social needs are important to us. We will listen to you and to those who care for you. We will involve you in your care. We will deliver care tailored to your needs and goals. Your wellbeing inspires us to learn and improve.

2015/2016 Calvary Mater Newcastle Review of Operations | 3 Hospital Executive §§ Director Hunter Drug Information Service: Felicity Prior §§ Director Intensive Care Unit: Dr Katrina Ellem §§ Chief Executive Officer: Greg Flint §§ Director of Cardiology: Dr Kosta Nikoletatos §§ Director of Medical Services: Dr Rosemary Aldrich §§ Director of Medical Oncology: Dr Tony Bonaventura §§ Director of Nursing Services: Roz Everingham §§ Director Melanoma Unit: Dr Fiona Abell §§ Director of Finance and Corporate Services: Wayne Wells §§ Director of Pharmacy: Rosemary James §§ Director of Mission: Mary Ringstad (from March 2016) §§ Director of Radiation Oncology: Dr Jane Ludbrook Service Managers §§ Director of Social Work: Lyn Herd §§ Emergency Department Nurse Manager: Tracy Muscat and §§ Assistant Director of Medical Services: Alison Lee Jo-Anne Berry §§ Assistant Director of Nursing Services: Kim Kolmajer §§ Emergency Department Clinical Nurse Unit Manager: Kim Blayden §§ Financial Accounting Manager: Natasha MacNeill Department Managers §§ Human Resources Manager: Michael Hodgson §§ Alcohol and Drug Unit Nurse Unit Manager: Jason Scott §§ Health Information Services and Information Communications §§ Chief Medical Physicist: John Simpson Technology Manager: Heather Alexander §§ Chief Radiation Therapist: Karen Jovanovic §§ In-Charge Cardiac Technologist: Claudia Henry §§ Clinical Information Manager: Nicole Crockett §§ Intensive Care Nursing Unit Manager: Leanne Bradford §§ Coronary Care Nursing Unit Manager: Anne Thomson §§ JMO Manager: Victoria Wall and Frances O’Connor (from March 2016) §§ Day Treatment Centre Nursing Unit Manager: Kelly Randall §§ Management Accounting Manager: Neville Brown §§ Department of Palliative Care Nurse Unit Manager: Stacey Diana and Kathryn Cooper §§ Medical Centre Nursing Unit Manager / Hospital in the Home: Kelly Crawford and Carolyn Walker §§ Desktop Services Manager: Clinton Starrett §§ Medical Centre Office Manager: Lyn Booth §§ Director Alcohol and Drug Services: Dr Craig Sadler §§ Network and Systems Manager: Beau Dwyer §§ Director of Anaesthetics: Dr Bernard McClement §§ Nurse Manager Clinical Resources: Jason Robards, Carolyn Walker, §§ Director Clinical Pharmacology and Toxicology: Professor Ian Katrina Gunn, Helen Hanbury, Maria Dolahenty, Rebecca Hahn, Whyte and Dr Michael Downes Beth Curry, Anne Waters §§ Acting Director Consultation-Liaison Psychiatry: Professor §§ Nutrition and Dietetics Manager: Andrew Court Gregory Carter §§ Occupational Therapist in Charge: Andrew Wakely §§ Director Department of General Medicine: Dr Michael Hayes §§ Operating Theatre Suite Nurse Manager: Chris Aartsen (from §§ Director Department of Palliative Care: Conjoint Professor February 2016) Katherine Clark §§ Operating Theatre Suite Clinical Nursing Unit Manager: Stanley §§ Director Emergency Department: Dr Cameron Dart Meyers (from April 2016) §§ Director Haematology: Professor Philip Rowlings

4 | 2015/2016 Calvary Mater Newcastle Review of Operations §§ Pastoral Care Manager: Mary Ringstad / April MacNeill (from April Community Advisory 2016) §§ Patient Services Manager: Kerri Doyle Council §§ Payroll Manager: Kerrie Chapman §§ Chairperson: Cathy Tate, Consumer Representative §§ Physiotherapist in Charge: Judy Holland Members: §§ Pre-Procedures Nursing Unit Manager: Emma Brady and Jodie §§ Teresa Brierley, Consumer Representative Casserly §§ Cathy-Lyn Burnard, Consumer Representative §§ Public Affairs and Communications Manager: Helen Ellis §§ Kay Fordham, Consumer Representative §§ Quality Manager: Jeanette Upton §§ Joy Reid, Consumer Representative §§ Radiation Oncology Nursing Unit Manager: Ashley Powell §§ Susan Russell, Consumer Representative §§ Revenue Services Manager: Maylinda Wells §§ Steven Tipper, Consumer Representative §§ Speech Pathologist in Charge: Patricia Potter §§ Brenda Ainsworth, Calvary National Director Public Hospitals §§ Staff Development Coordinator: Judith Thompson §§ Greg Flint, Chief Executive Officer §§ Supply Services Manager: Anne McCormack §§ Mary Ringstad, Director of Mission §§ Supply Services Supervisor: David Millington §§ Wayne Wells, Director of Finance and Corporate Services §§ Ward 4B Surgical Inpatient Nursing Unit Manager: Cheryl Cooley §§ Helen Ellis, Public Affairs and Communications Manager §§ Ward 4C Medical Nursing Unit Manager: Tracey Coates (from September 2015) §§ Ward 5A/MAAZ Nursing Unit Manager: Marissa Ledlin §§ Ward 5B Oncology Nursing Unit Manager: Linda Liversidge §§ Wards 5C/D Haematology Nursing Unit Manager: Wendy Johnson §§ Whole of Hospital Strategy Manager: Roslyn Barker

2015/2016 Calvary Mater Newcastle Review of Operations | 5 Report from the Chief Executive Officer

Calvary Mater Newcastle continues to strengthen its delivery of public health services with a commitment to developing responsive, integrated and patient- centred care. We are firmly focussed on improving equity of access and improved health outcomes for the people and community that we serve. Calvary Mater Newcastle is the major cancer care centre for Hunter New England Local Health District and provides a range of medical and surgical services as an Affiliated Health Organisation under the Health Services Act 1997. Calvary Mater Newcastle is also a major research and clinical trial centre with local, national and international research collaborations and activities taking place. These services are delivered by way of a Service Agreement to provide public hospital services. Under the Service Agreement for 2015/16, Calvary Mater Newcastle has delivered on a range of targets, key performance indicators, and quality and safety measures. Our results demonstrate our commitment and responsibility to provide safe, reliable and timely care. This has been achieved as the demand for health services continues to grow. Enhancements and considerable investment in a wide range of improvements to services will enable our clinicians and staff to manage increasing demand through continuous improvement and innovation. Prioritised health strategies have two major complementary focus areas. Firstly, the strategies enhance services to respond to growth in demand, and secondly, they work in partnership to better integrate care across all providers with patient empowerment at the centre. As Calvary Mater Newcastle continues to deliver excellent patient-centred care, it is facing a number of strategic challenges and opportunities: §§ Responding to demand for health care services from an ageing and growing population as well as continuing to provide care outside the catchment area as a provider of specialist tertiary services. §§ Collaborating with our health care partners to better connect care for our patients as part of a broader health care system. §§ Ensuring communities, consumers and clinicians are central to health service planning, design, delivery and evaluation, particularly in tackling chronic disease. §§ Driving improvements in relation to quality, safety and efficiency through clinical streams in partnership with Local Health District networks. §§ Aligning resources to meet current service needs in areas of future growth. §§ Attracting and developing an increasingly specialised and multidisciplinary workforce. §§ Introducing innovative solutions and new technologies and treatments while managing rising costs. §§ Recognising and promoting our achievements locally, nationally and internationally through collaboration in research activities and innovation. These directions are underpinned by Calvary’s values of Hospitality, Healing, Stewardship and Respect which enables us to achieve our vision of providing world-class health services. During 2015/16 staff innovation and dedication has driven the delivery of quality services across all areas of the hospital and we are extremely fortunate to have the depth of talent and commitment of our staff at Calvary Mater Newcastle. The tireless work carried out by members of our staff and visiting medical officers from each and every department, across all disciplines, is crucial to delivering quality services to the community.

6 | 2015/2016 Calvary Mater Newcastle Review of Operations Calvary Mater Newcastle has continued position of Director of Mission at Calvary our patients with the very best possible the implementation of the New South Mater Newcastle. care. This hard work is appreciated by staff, Wales Ministry of Health Whole of Professor John Forbes was presented patients and the community who encounter Hospital Program. There have been this year with the Premier’s Award for their compassionate care, fundraising many achievements and improvements Outstanding Cancer Research for his efforts and smiling faces. We extend to in patients’ access to care through this contribution to the fight against cancer. them a huge thank you. program. Congratulations to Kathryn Bensley, Calvary Congratulations to our volunteer John In February 2016, an additional four Mater Newcastle’s Palliative Care Senior Gambrill, who was awarded a Medal of the chemotherapy chairs were commissioned Aboriginal Health Education Officer, who is Order of Australia in the General Division which has had a significant impact on now Australia’s first registered Aboriginal in the Queen’s Birthday Honours List. reducing the waiting list. Additional Health Practitioner in Palliative Care. Fane Volunteer Kaye Woods was a finalist in the clinical service enhancements included Falemaka, Clinical Nurse Specialist, was Hunter New England Local Health District establishment of an Infusion Lounge in awarded the hospital’s 2015 Mary Potter 2015 Achievement Awards. the Medical Centre, the opening of the Award. Professor Jim Denham, Senior Winter Strategy Discharge Lounge, the establishment of a Venous Access Team, “This year has given us much to celebrate as staff and increased bed capacity for Haematology Services, increased Pharmacy Services and volunteers have been recognised for their hard work significant enhancements to the Emergency and achievements.” Department to improve patient access through Transfer of Care and Emergency Treatment Performance. Staff Specialist, Department of Radiation The hospital continues to receive valuable There were also significant medical Oncology, was awarded the prestigious support and advice from Little Company of equipment purchases including Intensive honour of the Order of Australia Medal on Mary Health Care Board, Calvary National Care Unit ventilators, upgraded endoscopy Australia Day for his service to medicine and Office and the Local Health District in and fibrescope equipment in Operating medical research. continuing the hospital’s role as a major Theatres, Medical Centre and Radiation Awards and accolades such as these are cancer care and research facility. I would Oncology equipment, Brachytherapy Unit a great form of recognition for the hard also like to thank our generous and loyal equipment, ECG machines and vaccine work of individuals and teams, but there community for its support of the hospital fridges. are many whose work is possibly not and the Community Advisory Council in In December 2015, an additional 273-space formally acknowledged and yet carries huge their advisory role. staff car park was commissioned to provide importance to the hospital. I hope this year’s Review of Operations improved access to the facility for patients, As always our Volunteers and Auxiliary proves to be a valuable and informative relatives, carers and staff. members are a vital component in the day- document and we will continue to strive to This year has provided much to celebrate as to-day running of the hospital. This financial provide a quality service to the community staff and volunteers have been recognised year the Auxiliary presented a cheque to based on our values of Hospitality, Healing, for their hard work and achievements. the hospital for the sum of $321,955 from Stewardship and Respect. In August 2015, Mary Ringstad was the their tireless fundraising work. recipient of a Catholic Health Australia Our Volunteers and Auxiliary members Greg Flint Award for Excellence in Pastoral Care. In bring motivational energy, enthusiasm and Chief Executive Officer February 2016, Mary was appointed to the dedication to assist the hospital in providing

2015/2016 Calvary Mater Newcastle Review of Operations | 7 Department Reports

8 | 2015/2016 Calvary Mater Newcastle Review of Operations Department Reports

General Medicine

The Department of General Medicine continues to care for The Department of General Medicine has again been large numbers of inpatients whilst providing consultations heavily involved in the formal education programs for the across a range of subspecialties to other departments junior medical officers and basic physician trainee registrars. and the Hunter New England Local Health District Mental There is consistently excellent feedback about this program, Health Facility. The department has also seen an increase in which enhances the hospital's reputation as an excellent patients being seen in ambulatory care. centre in which to work and train in internal medicine. The department welcomed Dr Siva Sellathurai as a Dr Susan Miles, General and Respiratory Physician, is Gastroenterologist/General Physician and Dr Sameh Samuel now employed in medical education and oversees the a Respiratory Specialist/General Physician. Both bring Undergraduate Program in Medicine at Calvary Mater youth and enthusiasm to the department and have thrown Newcastle. The department continues to have advanced themselves into busy clinical practice. trainees in general and acute care medicine (four including The Medical Assessment and Admission Zone (MAAZ) a rotation to Maitland Hospital), gastroenterology and continues to fulfill its aim of facilitating early movement geriatric medicine. of patients out of the Emergency Department into an The department remains involved with the work of The environment where they receive intensive assessment, Hunter Alliance, a collaboration between the Hunter New investigation and planning of care. The Emergency England Local Health District, Hunter Medicare Local and Treatment Performance, a key performance indicator, Calvary. Dr Michael Hayes is a Clinical Lead on the Chronic continues to improve despite an increase in admissions. Obstructive Pulmonary Disease Workstream and Dr Annalise The Antimicrobial Stewardship Program continues with the Philcox is a Clinical Lead on the Diabetes Workstream. Both ongoing support of Dr Paul Wilson. of these workstreams are producing innovative work in The department’s commitment to Outreach Clinics integrated models of care, whilst bringing specialist advice continues with regular visits to Moree and Mungindi by Dr and care to the primary care setting. Lex Tierney, and one of the advanced trainee registrars. This vital service provides specialist care to rural and remote populations. The department also supports a Geriatric Clinic in Port Stephens.

Coronary Care and Cardiology

The Coronary Care Unit (CCU) provides inpatient care myocardial infarctions (NSTEMI) and 89 unstable angina for patients with a variety of cardiac related diseases pectoris (UAP). Other cardiac causes made up 215 including coronary artery disease, acute and chronic admissions and non-cardiac causes totalled 138 admissions. cardiac failure, cardiac arrhythmias, cardiac pacing, The CCU also provides remote cardiac rhythm monitoring cardiomyopathy and pericardial effusions. The department for patients on general wards via telemetry. During 2015/16 provides acute cardiac care including pericardiocentesis, a total of 712 patients from Wards 4C, 5A and MAAZ had temporary and permanent pacemaker insertion, automatic their heart rhythm monitored via telemetry. implanted cardiac defibrillator insertion, elective and semi-urgent cardioversion, C-PAP and trans-oesophageal The Coronary Care Unit continues to be part of the Rapid echocardiography. Response Team, Coronary Care attended 829 calls in the 2015/16 period. The Electrocardiogram (ECG) Department provides a diagnostic service for both inpatients and outpatients including ECG recording exercise stress testing and transthoracic and trans-oesophageal echocardiography. The 2015/16 period has been a busy year for both the CCU and ECG Departments. The CCU had a total 658 admissions averaging 55 per month. Of these admissions 18 were ST elevation myocardial infarctions (STEMI), 197 Non ST elevation

2015/2016 Calvary Mater Newcastle Review of Operations | 9 Intensive Care Unit

Activity in the Intensive Care Unit (ICU) decreased during 2015/16 previous year; however, the majority of patients remain on the ward with 411 admissions, of which 50% were ventilated. The use of High after intervention with only 7.3% requiring admission to the ICU. This Flow Nasal Cannula has continued, much to the improved comfort of year the service was expanded into the Mater Mental Health Campus. the 83 patients who received this modality. Average occupancy for The unit continues to be an active member of the ANZICS Clinical the ICU decreased to 68.5%, with the same average length of stay of Trials Group participating in several multicentre, international 3.6 days as last year. The majority of admissions (41%) came directly research projects. The 10th Point Prevalence Study Day is about to be from the Emergency Department, 26% from wards, 14% from the undertaken which provides baseline data on which future trials can be Operating Suite and 19% were admitted via the Retrieval Service. formulated. ADRENAL (hydrocortisone in septic shock) and Transfuse Once again the biggest impact on the ICU workload in 2015/16 was (fresh versus usual-age blood) trials continue recruitment and the having the leading role on the Rapid Response Team which provides unit is in the process of embarking on another four multicentre the response to clinical emergencies throughout the hospital. There randomised controlled trials. were 910 Rapid Response Team calls, an increase of 15% from the

Emergency Department and Emergency Short Stay Unit

Presentations to the Calvary Mater Some of the key improving access projects §§ This year the ED received approximately Newcastle Emergency Department (ED) achieved during this financial year by the ED $40,000 worth of equipment funding. increased to 35,290 for the 2015/16 management team were: A much-needed injection of capital financial period. The admission rate §§ Introduction of Clinical Nursing to support the purchase of ECG also increased to 33.49%, reflecting an Unit Managers to after-hours shifts, machines, ventilators, and a life pack increase in the acuity of the patients. which involved a regrade of position, ECG/defibrillator with the capability to With successive yearly increases in not additional nursing hours. The transmit ECG directly to the cardiologist presentations, the ED was still successful result has provided an experienced working at the John Hunter Hospital in improving its Emergency Treatment emergency nurse to respond to clinical Cardiac Catheterisation Laboratory. Performance (ETP) and Transfer of Care deterioration, provide supervision §§ Funding of Clinical Initiative Nurse. This (TOC). This is a rewarding result and reflects of new and junior staff, facilitate specialised nurse works one shift per the commitment of clinical staff and the interfacility emergency transfers, day and is predominantly responsible management team working towards paediatric resuscitation expertise, clinical for the care of patients in the waiting improving access to emergency care. The leadership and management on the room. Following implementation, ATS ED was one of the top performing facilities afternoon shift. 4 exceeded benchmark by 14%. ATS 5 in the Hunter New England Local Health §§ Fast Track Project - This service delivery exceeded benchmark by 25%. Did not District in the past financial year with non- wait (DNW) performance continues to admitted ED ETP performance at 86.4%. model of care is dedicated to provide patients who are ambulant, and have meet benchmark at 2%. Pressures on emergency services are a single system health complaint, with The 12-bed Emergency Short Stay Unit increasing and the ED faces many timely access to care and aims for a (ESSU) serviced 4,827 admissions, which challenges with the high demand for length of stay in the ED of fewer than two equates to approximately 41% of the inpatient beds. The emergency service hours. The performance target set by the hospital’s total emergency admissions. continually looks to improve operational Ministry of Health according to ETP is set The efficiency of the Emergency Short Stay efficiency by ensuring that the models of at 81% for financial year 2015/16. model is monitored regularly. This ensures care it is using are consistent with current that best practice inclusion and exclusion best practice. §§ Opening of previously non-funded ED beds to function as ambulance criteria are adhered to and contributes to The ED was reinvigorated with some release beds. These beds were funded a significant improvement in the hospital's significant changes to the ‘Front of House on a permanent 24/7 basis. This ETP. During the past financial year a small Service Model of Care’. The results reflect strategy resulted in significant gains in clinical team completed a project to that this newer model is working towards improvement of the ambulance transfer improve referrals from the ED to the ESSU, better access and support for patient care of care time, which aims to reduce the to create more capacity within the ED which with improvements in non-admitted ETP length of time ambulances remain in the in turn increased TOC capability. As a result and benchmark performance in ATS 3 and 4. ED to enable the ambulances to return of this project, ED length of stay for patients The 2015/16 year saw the increased to the community. admitted from ED to ESSU in fewer than four hours improved by 9%. prioritisation of the TOC KPI. The Whole §§ The Director of Emergency Medicine, of Hospital team worked consistently to Dr Cameron Dart, continued his The Emergency Department Quality help the ED achieve 89% of which the involvement as Clinical Lead with the Program continues to implement the department is extremely proud. Hunter New England Local Health Australian College of Emergency Medicine District Emergency Stream. Quality Framework. This is progressing well,

10 | 2015/2016 Calvary Mater Newcastle Review of Operations although the team acknowledges there is towards participation in the Global §§ Capability to provide high flow a significant amount of work ahead as it Airway Registry that is championed by humidified nasal oxygen. continues through this framework. Some of the Emergency Care Institute (ECI). §§ Training – DEMT: Dr Michael Downes the key areas of work so far have been: §§ Medication safety initiatives including and Dr Nicholas Dafters are Co DEMT for §§ The multidisciplinary morbidity and improvements to antibiotic prescribing the Emergency Department. mortality meetings are conducted and dispensing, a paediatric medication §§ RN2: The Emergency Department monthly. The new format has been safety project, storage improvements continues to be a highly desirable embraced by clinical leaders and of patient’s own scheduled drugs and rotation for the RN2 program to gain includes discussion of difficult cases, improvements to after-hours dispensing valuable exposure to subspecialties such results of audits, promotion of clinical of emergency medicines. as oncology, haematology, toxicology, standards and review of issues. These Other achievements this past financial year palliative care and mental health. meetings are well attended by all clinical include: staff. §§ Introduction of the Transition to §§ Partnering with Newcastle Mental Health Emergency Practice Program for new § § Gold Standard Procedural Sedation Hospital to develop and implement nurses to the department. Practices. Procedural Sedation Policy and pathways for patients who require fast Process has been implemented in the As the department enters into 2016/17 it track to the Psychiatric Emergency Care looks forward to the many changes and ED. This is aligned to practice standards Centre. set by the Australian and New Zealand challenges ahead. College of Anaesthetists, and has been §§ Continuing and expanding the Aged Care endorsed by the Australian College of Emergency (ACE) project including the Emergency Medicine. It is consistent Tomaree Peninsular. with the National Safety and Quality §§ Continuing involvement in the Access Health Service Standards (NSQHSS). Block Prevalence Study. §§ Continuation of a Local Airway Registry §§ Participation in the Alcohol and Harm which will form the basis of a move Study.

2015/2016 Calvary Mater Newcastle Review of Operations | 11 Department of Consultation Service New Patients Occasions - Liaison Psychiatry Seen of Service Consultation-Liaison Psychiatry 713 1,513 The Department of Consultation-Liaison Psychiatry was extremely Inpatients active in clinical, research, teaching, professional development and community education activity. Palliative Care Inpatients 92 94 Clinical Activity Youth Cancer Service 32 251 During 2015/16, the Department of Consultation-Liaison Psychiatry (In- and outpatients) consulted on 1,235 individual inpatients, which resulted in more than 3,200 occasions of service. Psycho-Oncology Outpatients 398 1,363 Inpatient referral departments were: Clinical Toxicology (520 referrals), General Medicine (149 referrals), Emergency Department Total 1,235 3,221 (23 referrals), Medical Oncology (20 referrals), Surgery (19 referrals), Radiation Oncology (7 referrals), Haematology (11 referrals), Palliative Care (94 referrals), Youth Cancer Service (32 referrals) and by part-time VMO Psychiatrist, Dr Pek Ang, together with the other (22 referrals). equivalent of two full-time Clinical Psychologists – positions shared The Psycho-Oncology Service accepted referrals of 398 individual by Dr Louisa Gianacas, Sophia Wooldridge, Camille Plant, and Senior outpatients and delivered 1,363 occasions of service through the Clinical Psychologist, Dr Ben Britton. In addition, Dr Kerrie Clover Psycho-Oncology Clinic. The Psycho-Oncology Service provided input works two days a week as Research Manager and is supported by to the following oncology multidisciplinary teams: head and neck part-time, Research Assistant, Shaveena Balakrishnan. cancer, lung cancer, lymphoma and breast cancer. The department has a part-time Clinical Psychologist, Karen Staffing Matthews, for the Youth Cancer Service as part of the Hunter and Northern NSW Youth Cancer Service, which provides clinical services The department provided specialist psychiatric consultation for to oncology outpatients and inpatients aged 15-25 years. all inpatients at Calvary Mater Newcastle. Department staff are The department also includes a Suicide Prevention Program, a led by Senior Staff Specialist Psychiatrist and A/Director, Professor clinical research unit funded from the Burdekin initiative and Greg Carter. The team comprises: Clinical Nurses Consultant, Jenni administered through the HNEMHS, and supported by part-time Bryant, a sessional VMO Psychiatrist to Palliative Care, Dr Pek Ang, Research Manager, Dr Katherine McGill. two rotating Psychiatric Registrars (seconded from HNEMHS on six- month rotations), Advanced Trainees Psychiatry, Dr M Jackson and Student Placements Dr L Gale and part-time Administrative Officer, Christine Cook. Clinical Psychology Program: 2015 - Clinical Masters level, Alyce It also has an outpatient Psycho-Oncology Service providing McKeough, completed placement at Calvary Mater Newcastle. specialist psychology and psychiatric consultations which is staffed

12 | 2015/2016 Calvary Mater Newcastle Review of Operations Alcohol and Drug Clinical Services Unit

It has again been a busy year for the Alcohol and Drug Clincal Quality improvements over the past year include the use of SMS Services Unit. The unit has seen an increase in both inpatient and appointment reminders. This resulted in a reduction of 30% to Did outpatient activity. Not Attend (DNA) appointments. This change contributed to the The small multidisciplinary team (7.5 FTE) provided assessment, unit’s ability to increase its activity as mentioned above. counselling, treatment and support on more than 7,124 outpatient Research continues in the Alcohol and Drug Unit. The department occasions in 2015/16. This represents a 15% increase on the past is currently involved in a treatment outcomes study in conjunction reporting year. In addition, the unit provided 1,064 consultations with the University of Newcastle. to inpatients of which 561 consultations were delivered to the Further activities have included liaison with colleagues at Drug Emergency Department and the Emergency Short Stay Unit of and Alcohol Community Services (DACS), quality committees Calvary Mater Newcastle. with the Ministry of Health, RMS Interlock Program, conference The Alcohol and Drug Unit also offers support for families and presentations and working with Probation and Parole Services. friends of people who have substance use issues. This is a service The Alcohol and Drug Unit is awaiting completion of the Outpatients that is highly sought after as it’s one of only a few clinics that offer Service Review. This review may lead to changes that will help the the service. unit capture activity, identify opportunities to bulk bill, improve the Providing education to health professionals is also a focus of the overall reception of patients to assist their journey throughout the Alcohol and Drug Unit. The department provides teaching to both clinic and monitor activity levels. medical and nursing undergraduates, education to local medical officers and to the staff at Calvary Mater Newcastle and Hunter New England Local Health District.

Clinical Toxicology and Pharmacology

The Department of Clinical Toxicology articles published in refereed journals, were three in-hospital deaths (0.3%). The and Pharmacology provides an inpatient four published letters and 16 papers discharge destination was either home in service for the management of patients presented at international or national 692 (67%), the psychiatric admitting unit with deliberate, recreational, accidental or conferences in 2015/16. Topics included in 239 (23%) or transferred to another other self-poisoning and envenomation. drug-induced QT prolongation, treatment hospital in 79 (7.6%). The median length For the management of patients who have of paracetamol poisoning, the management of stay was 16.4 hours (interquartile range: deliberately self-poisoned, the department of behaviourally disturbed adults and an 9.7 to 26.8 hours). The average number of combines with the Department of Clinical- extensive series of publications on venoms admissions per day was 2.84. This length Liaison Psychiatry as the Hunter Area and antivenoms from Professor Isbister’s of stay is substantially less than the length Toxicology Service. group. The clinicians in the department of stay for poisoning at other hospitals in Clinicians in the department also manage also contribute to the National Poisons NSW and Australia. The most common patients with adverse drug reactions and Information Centre roster and support the drugs taken for deliberate self-poisoning complex medication issues and provide Hunter Drug Information Service. were paracetamol (12.2%), alcohol (9.3%), a consultative service to the Hunter New In 2015/16 there were 1,038 admissions quetiapine (6.9%), diazepam (6.4%), England Local Health District in clinical to the Hunter Area Toxicology Service. The ibuprofen (3.6%), oxycodone (2.9%) and pharmacology. Professor Ian Whyte median age of patients at admission was olanzapine (2.1%). The most common serves on the Quality Use of Medicines 36 years (interquartile range: 24-48 years) complications of overdose were a GCS less Committee of the John Hunter Hospital and and the proportion of female patients was than 9 in 78 (7.5%), delirium in 41 (3.9%), is Chair of both the District Quality Use of 58%. There were 908 individual patients hypotension in 38 (3.7%), seizures in 11 Medicines Committee and the Clinical Trials responsible for these admissions. Eighty- (1.1%), serotonin toxicity in 11 (1.1%), renal Subcommittee of the Hunter New England two patients had more than one admission failure in 19 (1.8%) and hepatotoxicity from Human Research Ethics Committee. during 2015/16. Of the admissions, 807 paracetamol poisoning in 7 (0.7%). Professor Geoff Isbister provides expertise were for deliberate self-harm. In addition, Professor Whyte continues to work 0.75 to the Drug Committee of the Children’s there were 36 envenomations or stings, FTE. Dr Michael Downes has continued Hospital, Westmead, and has recently been 76 recreational drug overdoses, eight as Co-Director with his 0.5 position in the appointed as an Executive Editor for the iatrogenic poisonings and 83 accidental department. Professor Isbister is 0.75 in British Journal of Clinical Pharmacology. overdoses. The majority were admitted to Clinical Toxicology giving 2.0 FTE of senior the Emergency Short Stay Unit 769 (74%), staffing. Dr Ingrid Berling, a recent graduate As well as these activities, there is a 53 (5.1%) were admitted to the Intensive of the department’s training program, substantial commitment to undergraduate Care Unit, 184 (18%) remained in the was appointed VMO in Clinical Toxicology. and postgraduate teaching and an ongoing, Emergency Department and 30 (2.9%) were Subsequently, she has taken a 0.25 position active research program. There were 55 admitted to an inpatient ward bed. There at Calvary Mater Newcastle in Emergency

2015/2016 Calvary Mater Newcastle Review of Operations | 13 Medicine and worked several weeks as a New England Local Health District. A total antibiotics and their use Locum Staff Specialist in Clinical Toxicology of 718 enquiries were received during the (www.aimed.net.au) to cover annual leave. Dr Colin Page 12-month period - a 4% increase: §§ Obtained a HETI Allied Health Workplace continues as VMO in Clinical Toxicology §§ The largest category of enquiries was Learning Grant and provides on call every Monday night ‘adverse drug reactions’ from Brisbane. Dr Kylie McArdle has been §§ Presented at national conferences § appointed a Vocational Trainee in Clinical § The largest proportion of health §§ Participated in teaching activities Toxicology. On completion of her training, professionals making enquiries was §§ Continued regular quality assurance she will be the first intensive care trained hospital pharmacists activities clinical toxicologist in Australia. §§ 65% of enquiries were known to be §§ Conducted a survey of MI training for Members of the department run a website patient related HNE pharmacists at www.wikitox.org. This is an international §§ 74% of respondents used the collaboration of toxicological information information provided in patient §§ Maintained and reviewed local and teaching resources. A subset of the management databases of information on the drugs information on this site, updated by the requiring refrigeration and the effects of §§ 46% of responses were provided via the original authors (Professors Buckley, obesity on drug dosing telephone Dawson and Whyte), is now available as Felicity Prior remains the Director an iOS app named HyperTox. Through this While the provision of therapeutic of the HDIS and a Conjoint Lecturer site, the department also contributes to information in response to enquiries at the University of Newcastle. She a Diploma of Clinical Toxicology Degree continues to be the main priority of the successfully completed the district-wide Course which is internationally subscribed. service, the aminoglycoside monitoring 2015 Foundational Clinical Leadership The department successfully runs a national service is also regarded as a core service. Program. Kate O'Hara left the department toxicology conference each year, Toxicology Since the service was implemented in in May to complete her PhD in Neonatal and Poisons Network Australasia. 2011 there have been 1,343 requests for Pharmacology at the University of recommendations in 187 patients across Newcastle and moved to Canberra Hospital The Hunter Drug Information the Hunter New England Area. A paper and Service as the Lead Pharmacist – Women's, Youth letter to the editor detailing this service and Children's Services. She was replaced The Hunter Drug Information Service were published and opportunities for by Piedad (Pili) Vazquez in July 2016. Bree (HDIS) continues to provide current, up- growth and further research exist. Parks continued her 12-month contract as to-date, clinically relevant and unbiased During the year, the HDIS also: a Pharmacist, supplementing this with work medicines and therapeutic information §§ Continued moderating the HNE/ in a private hospital pharmacy. to health professionals within the Hunter Pathology North discussion site for

14 | 2015/2016 Calvary Mater Newcastle Review of Operations Pharmacy

“The only constant in life is change”, with this in to technician hours was welcomed by the mind, Calvary Mater Newcastle Pharmacy staff pharmacy team. consistently demonstrate their commitment Increased resources facilitated a rise in to quality improvement through the continual the department’s participation in quality assessment and evaluation of work practices to improvement activities. Examples of these ensure that the patients and staff of the hospital include: continue to receive a quality pharmacy service. §§ Clinical pharmacists regularly reviewing The Pharmacy provides a comprehensive Level 6 medication incidents. Pharmacy service to the hospital. §§ Continual review of medication-related Services provided include clinical services, hospital policies. quality use of medicines activities, sterile and non-sterile manufacturing services, antimicrobial §§ Ongoing commitment to the hospital’s AMS stewardship, clinical trial support, drug Program. information, patient counselling, staff education, §§ The development of an enhanced clinical all aspects of medication inventory management monitoring system which enables hospital and a comprehensive dispensing service. oncology/haematology pharmacists to view The Oncology/Haematology Pharmacy provides patient-specific information regarding their chemotherapy and medication support to treatment which includes, but is not limited oncology and haematology inpatients and to, the patient’s clinical notes, disclosing outpatients of the hospital. the frequency of all required blood tests and the source of these blood tests, dose With the Antimicrobial Stewardship (AMS) modifications, compassionate supply programs service now well established, the AMS (where appropriate) and ejection fractions. Pharmacist took on the additional role of Quality Patients are identified using the scheduled Use of Medicines (QUM) Pharmacist. Having patient appointment list generated by ARIA. a dedicated QUM Pharmacist enabled the development of a quality plan which resulted §§ Enhanced Haematology and Oncology in all hospital pharmacists (including the Pharmacy Service including the taking pharmacist intern) undertaking their own quality of a patient’s Best Possible Medication projects in line with either the NSW Therapeutic History (BPMH) and the introduction of the Advisory Group’s (NSW TAG) key performance use of the Medication Management Plan indicators or the Australian Commission on (MMP) form for haematology and oncology Safety and Quality in Health Care’s (NSQHC) inpatients and outpatients. Standard 4 - Medication Safety. It is expected §§ The department maintains its involvement in that each hospital pharmacist (including intern) the National Medication Safety initiatives and will complete a project of their choice at least participates in the periodic audits associated once every second year. The results of these with the National Medication Inpatient Chart. projects are used to provide direction to the The Pharmacy continued its role in student hospital Pharmacy on how to utilise its resources education by: to achieve the best outcome for the patients and staff of Calvary Mater Newcastle. Participation in §§ Supervising both undergraduate and these projects also ensures that the Pharmacy is postgraduate pharmacy students from well positioned to demonstrate its compliance the University of Newcastle and other with the ACHS accreditation requirements for universities. Standard 4 - Medication Safety. §§ Leading tutorials for Year 5 medical students In 2015/2016 the pharmacy staffing levels were from the University of Newcastle. significantly enhanced. 2.6 FTE Pharmacists (1 The Pharmacy remains committed to its support FTE Medical Oncology, 1 FTE Haematology and of medical research and is actively involved in 0.6 FTE Medical Assessment and Admission more than 80 clinical trials. The clinical trials are Zone) and 0.4 FTE Pharmacy Technicians joined associated with the Departments of Radiation the Calvary Mater Newcastle Pharmacy team. Oncology, Medical Oncology, Surgical Oncology, This enhancement has resulted in the provision Haematology, Palliative Care and Consultation- of improved clinical pharmacy services to the Liaison Psychiatry. nominated areas and has enabled an improved Pharmacy staff members actively participate distribution of workload amongst staff. The in hospital, area and national committees, Pharmacy technicians are integral to most specialist clinical teams and advisory groups. pharmacy work practices so the enhancement

2015/2016 Calvary Mater Newcastle Review of Operations | 15 Oncology Medical Oncology

The Department of Medical Oncology is one of the largest and for the extra four chairs in the Day Treatment Centre, together busiest units in NSW. The department saw 1,278 new patients and with enhanced support staff, became a reality and this has reduced provided 25,506 occasions of service. The Day Treatment Centre has the wait times to start chemotherapy to within the two-week increased the number of new patients treated from 416 to 579 and benchmark. The Infusion Lounge in the Medical Centre, for less the National Activity Patient Occasions of Service (NAPOOS) from complex treatments, will also make a significant improvement to 9,124 to 10,103 in the 2015/16 financial year. patient care. The department welcomed many new personnel including: Dr Pinky Scalp cooling has now become an established standard innovation in Baghi as Locum for Dr Steve Ackland who has taken 12 months Long the prevention of alopecia for certain chemotherapy protocols. Service Leave, Dr Tin Quah (Advanced Trainee), Naomi Knoblauch Continuing issues include a model for the appropriate supervision and Kelly Healey (Clinical Trials), Amanda Whitehouse and Sarah of oral chemotherapy, how to best use the outpatient Medical Dale (Personal Assistants) and the return of Leanna Pugliese (Clinical Centre facility, delineation of the role and function of the clinical Trials Pharmacist). care coordinators, ethical aspect of clinical trial information and the Although the workload numbers have not changed significantly over loss of soft funding for senior medical staff. The department believes the past year, there has been an increase in the number of patients that these issues will be resolved before the end of 2016. requiring treatment as a consequence of more complex therapies, Regardless of some hurdles, the department is arguably the best in maintenance therapies and new drugs. Inpatient chemotherapy has the state. become less frequent and the four-bay Ward 5B beds have been transferred to Haematology. In January 2016 the recurrent funding

Surgical Oncology

The Department of Surgical Oncology and studies. This collaboration involves more plus placebo in postmenopausal women the Australia and New Zealand Breast than 700 researchers, 87 institutions and with oestrogen receptor-positive/HER2 Cancer Trials Group (ANZBCTG) continue 75 unique clinical trials in Australia and negative early stage breast cancer. to coordinate national and international New Zealand, and over 1,600 investigators §§ DOMINO - this study aims to find out collaboration in randomised clinical trials globally who contribute to the International if a Decision Aid developed to give for women diagnosed with, or at risk of, Breast Cancer Intervention Studies (IBIS) women information about adjuvant and breast cancer. This national and international with Cancer Research UK in London. The neoadjuvant treatment for breast cancer activity is an important resource for Calvary investigators also collaborate through the helps them make decisions about their Mater Newcastle. The Department of Breast International Group (BIG) Brussels, treatment. Surgical Oncology and the Trials Coordination Belgium; the International Breast Cancer Department of the ANZBCTG are located Study Group (IBCSG) Bern, Switzerland In addition, Surgical Oncology continues in the NBN Telethon Mater Institute on and Amhurst, USA; and the National to follow up with patients on many trials, the Mater Campus. Professor John Forbes, Surgical Breast and Bowel Project (NSABP), including, prevention and long-term Director, Department of Surgical Oncology, Pittsburgh, USA. treatment for breast cancer. Director of Research, ANZBCTG; and Clinical trials open to recruitment in The ANZBCTG researchers have contributed Professor of Surgical Oncology, University Surgical Oncology in 2015/16 are the neo- to 45 publications in the past 12 months. of Newcastle, commenced leave from the adjuvant studies ELIMINATE and LORELEI Members have also contributed to the Early hospital in early 2016 prior to his planned (collaborating with Medical Oncology) and Breast Cancer Trialists’ Collaborative Group retirement in late 2016. the DOMINO study. (EBCTCG), Oxford (overviews of breast cancer trials); the IBCSG, Bern, Switzerland; Surgical Oncology is responsible for holding § § ELIMINATE - this clinical trial investigates and the BIG, Brussels, Belgium. weekly clinics for women at high risk of if giving neoadjuvant (pre-operative) breast cancer or for post-diagnosis and hormone therapy and chemotherapy treatment follow-up. Regular meetings at the same time is more effective include weekly multidiscipline clinical than neoadjuvant chemotherapy alone pathology review of screen detected breast at shrinking the breast cancer before cancers as well as pathology specimens. surgery. Current clinical trials encompass prevention §§ LORELEI - a neoadjuvant study and treatment of all stages of breast cancer, comparing letrozole plus GDC30032 (an as well as many translational research investigation product) versus letozole

16 | 2015/2016 Calvary Mater Newcastle Review of Operations Ward 5B

Ward 5B, Medical Oncology and Haematology, have continued to community organised a Surfest fundraiser in his name and the ward maintain the highest standard of care throughout the year, despite received a $10,000 donation from this incredible occasion, which increased demands for oncology acute care beds at Calvary Mater is set to become an annual event. With this donation, the ward Newcastle. Linda Liversidge, Nursing Unit Manager, continues to be has purchased new single pull-out beds. This enables the family at the helm of Ward 5B, managing staff, doctors, patients and family members and friends of terminally ill patients to remain with them members with the greatest respect and humility. at all times during this difficult period. Over the past year, there have been significant changes to the Ward 5B has also been proactive with the Essentials of Care (EOC) daily running of Ward 5B. Most significantly, the four allotted Program this year, with two major projects being presented at the chemotherapy beds were reassigned and now accommodate Australian Nursing and Midwifery Conference held in Newcastle. haematology patients on a permanent basis, not just as outliers The first is a documentation tool that was developed by staff and to the ward. This has meant the introduction of ongoing is utilised by each staff member to ensure accurate, concise and haematological education for all staff, ensuring optimal, holistic care complete progress notes for each patient. ‘PEAPODSS’ – Pressure for all patients on Ward 5B. Care, Elimination, Access, Pain, Oral Care and Diet, Showering This is being achieved through the appointment of a Clinical and Mobility, and Social, has proven to enhance the ward's Nurse Educator (CNE) for Wards 5B and 5C (Haematology). Casey documentation and enables allied health to access individual Hutchinson is an exceptional educator with many years of nursing aspects of care with ease. The PEAPODSS poster was presented by experience and is a well-respected professional in her field. Her Linda Liversidge, Nurse Unit Manager and Fiona Watkins, Registered appointment as CNE has enhanced the ward’s ability to manage all Nurse, which resulted in overwhelming positive feedback. aspects of care for medical oncology and haematology patients. Calvary Mater Newcastle’s tracheostomy team was represented Throughout the year, the ward has also been privileged to be the by Leeanne Graham, Registered Nurse, and Megan Kepreotis, recipient of some generous donations. Calvary Mater Newcastle Endorsed Enrolled Nurse, who also presented at the conference. Auxiliary ‘Cancer Carers’ continue to tirelessly fundraise, which has Leeanne and Megan are tracheostomy champions on Ward 5B and allowed for the purchase of vital equipment for the hospital’s cancer are an invaluable source of information and knowledge regarding patients’ care and comfort. The Lions Clubs of Raymond Terrace, tracheostomy care and emergencies. Due to the numerous Medowie, Clarence Town, Stroud, Soldiers Point, East Maitland, Tea tracheostomy champions on Ward 5B, the ward is now responsible Gardens, Gloucester, Fingal Bay and Australian Lions Foundation, for all admissions of tracheostomy patients who present to Calvary also made a generous donation with the purchase of an ultrasound Mater Newcastle. machine, specifically for the insertion of intravenous cannulas for During this past year, Ward 5B has faced many challenges, with the compromised patients. This piece of equipment has ensured staff loss of many long-term patients who had touched staff emotionally, are able to insert necessary cannulas in the most efficient and as well as professionally. But this is why staff are here, to ensure competent manner, to minimise pain and discomfort to the patient. each patient is treated with respect and dignity while they progress Also a donation very close to the hearts of Ward 5B staff was through their cancer journey. It is a privilege to be with them at this made by the Forster Tuncurry Boardriders Club on behalf of Toby time. Flew. Toby was a fondly remembered and well-loved patient, who sadly lost his cancer battle at the age of 28 years. Toby’s local

2015/2016 Calvary Mater Newcastle Review of Operations | 17 18 | 2015/2016 Calvary Mater Newcastle Review of Operations Haematology

The Hunter Haematology Department is the hub of a Hunter As part of succession planning, the Venesection Service New England Local Health District area-wide service to was relocated to the Medical Centre Infusion Lounge on manage all malignant and non-malignant haematology 8 February 2016, offering a safer environment with the disorders including autologous stem cell transplant service necessary support services. and all haematology outpatient referrals for the Lower Venesection Clinics run by the Haemophilia Clinical Nurse Hunter District. This is the only service existing at this level in Consultant (Haemophilia CNC) and the Venesection the Hunter New England Area. Registered Nurse managed 1,025 patients in 2015/16. This service consists of haematology staff specialists, nursing, Haemophilia Services allied health and administration staff. The Haemophilia Director and Haemophilia CNC have Department staff continue to perform admirably despite the commenced a Haemophilia/Bleeding Disorders Clinic mismatch of ever increasing demands on fixed resources. on the second Wednesday of each month to streamline The population catchment for the services offered continues the perioperative management and care coordination of to increase and the burden of disease is increasing even patients requiring surgery within and outside Calvary Mater faster due to the aging population. Newcastle. Outpatient referrals As part of Haemophilia Awareness Week in October 2015, The number of newly referred patients continues to increase the Haemophilia Service took part in ‘Red Cake Day’ to every year. In 2015/16, 1,621 new patients were referred raise awareness of bleeding disorders. An amount of $402 to the Haematology Unit. Patient referrals are all reviewed was raised for the Haemophilia Foundation of Australia. A by the 4.4 FTE Clinical Haematology Staff Specialists and foyer display provided information for the public regarding then triaged for urgency to be seen in the Outpatient Clinic. haemophilia and other bleeding disorders. All patient referrals are categorised into urgency codes A total of 328 patients with bleeding disorders were to meet each patient’s clinical need, with 70% of all new also managed with 678 occasions of service including referrals being triaged and allocated an appointment to see a clinical reviews, clotting factor treatments, planning haematologist. The remaining were referred back to their GP and coordination of clotting factor support for surgical with written advice. The average waiting time for outpatient procedures, physiotherapy and radiological interventions and appointments remains at seven weeks. Patients with non-life patient family education. threatening illnesses are required to wait up to 10 months The Haemophilia CNC and Social Worker continue to provide for an appointment. community education regarding haemophilia and bleeding Outpatient Services disorders by presenting teacher education sessions at schools Outpatient services increased from 8,800 in 2014/15 to more and childcare centres as requested. than 9,360 patient visits for 2015/16. Annual meetings and conferences attended during 2015/16 Telehealth include: Australian Bleeding Disorders Registry (ABDR), Data Manager Group (DMG) Melbourne (Dale Rodney, Data Telehealth has now been implemented with great success. Manager) 2016, Australian and New Zealand Haemophilia This service allows patients from rural areas to stay at Conference, Haemophilia Foundation of Australia (HFA) Gold home within their communities. This provides patients Coast (2015), and Australian Haemophilia Nurses Group with timely and equitable access to this service without (AHNG), Melbourne 2016. the inconvenience of travelling. This has also improved the relations between GPs, outreach hospitals and the service. Inpatient admissions Ward 5D The demand on inpatient beds, including those for high dose chemotherapy and stem cell transplant, is similarly The 10-chair Haematology Day Ward treated more than ever increasing from 1,920 inpatients in the 2013/14 period 10,125 patients. to 2,008 in 2015/16. Under Nurse Unit Managers Wendy Activity has increased significantly over the past decade due Johnson and Debbie Carr’s leadership, the staff in Wards 5C to early discharge programs and an increase in haematology (inpatient) and 5D (day ward) maximised the through-put of activity overall. Projections indicate that this increase will patients, by boosting efficiencies by pre-admission work up, continue. and early discharge and outpatient follow up. The occupation of inpatient beds is often in excess of 100%. As a result of the continued increase in activity in the Haematology Day Ward and the resulting overcrowding Many treatments that other hospitals administer as and safety issues, Ward 5D was relocated to the Ward 5E inpatients are administered as outpatient therapy at area under the supervision of Nurse Unit Managers Wendy Calvary Mater Newcastle, to avoid treatment delays, Johnson and Debbie Carr. The new location provides more while also relieving the demand for beds on the inpatient clinical space and improved patient privacy. The move has ward. Unfortunately this does increase the pressure of the enabled the relocation of non-sedated bone marrows and the occasions of service in the day ward. haemophilia treatment space to the Ward 5D procedure room, offering a better support network which is patient focused.

2015/2016 Calvary Mater Newcastle Review of Operations | 19 Planned chemotherapy delays are attend this clinic for ongoing late effects Nursing and allied health undergraduate measured as per triage categories. For management post allo-HSCT. students from University of Newcastle are 2015/16, 64.7% of Triage Category 2 (admit This clinic has been designed for all patients trained in the inpatient ward. within 48 hours) were admitted within the more than two years post-transplant, The staff specialists contribute to medical expected time frame while Triage 3 (admit who have no ongoing post-transplant registrar training and preparation for the within 7 days) were admitted 72.6% of the complications and no longer require Royal Australasian College of Physicians time. medication. Exams. To assist in the reduction of inpatient A review of this service is scheduled for Personnel chemotherapy waiting times, four extra 2016/17. beds were allocated for haematology in Staff Specialists, Dr Seldon and Dr Enno, Ward 5B commencing on 18 January 2016. The aim of Calvary Mater Newcastle’s have recently retired. Dr Bryony Ross is It is expected that this will reduce the Allogeneic HSCT Service is to provide currently providing LOCUM coverage for Dr admission delays in the future. patients with specific post-transplant, long Enno. Dr Ritam Prasad has taken over the term and late effects care that is closer to role of Director Division of Haematology Nursing staff from both Wards 5C and 5D home, thereby reducing the length of stay with NSW Health Pathology. continue to provide excellent nursing care required near the Sydney transplant centre Currently six full-time haematology advance with new recruits well into their training for and reducing travel times for follow-up care. haematology nursing. trainee registrars work equally between Consultative Roles for Hunter clinical and laboratory work. Asma Ashraf is The commencement in May of a New England Local Health in her final year of training and completing Haematology/Oncology Clinical Nurse District and the NSW Ministry of her Masters by Research. Educator has proven to be an instant Health success with an already improved Recognition compliance with essential training and A number of Calvary Mater Newcastle §§ Nomination for Calvary’s Work Health support for all staff in the unit. Haematology staff play an indispensable and Safety Award – Wendy Johnson, role for the Ministry of Health and Hunter Haemopoetic Stem Cell Debbie Carr and the Haematology New England Local Health District (HNELHD) Apheresis, Cryopreservation Department for improved outpatient by providing their expertise: and Transplant Services treatment areas §§ HNELHD Transfusion Committee: §§ Presentation at the Janssen and J&J The Apheresis Service continues to be Dr Sandra Deveridge conference. Presentation by a patient very busy with plasma exchange, stem cell §§ HNELHD Cancer Network Leadership and his family, one daughter's touching collection and coordination of autolous Committee: NUM Wendy Johnson and story “How I got my dad back”. A NFA – transplants. Professor Philip Rowlings Imbruvica patient story The hospital implementation of the Venous §§ HNELHD Haematology Stream: Chaired §§ Implementation of Administration Access Team for Peripherally Inserted by Professor Philip Rowlings and Traineeship Central Catheter (PICC) insertions has coordinated by NUM Wendy Johnson relieved some of the burden from the §§ Volunteers – Margaret Milliken and §§ NSW BMT Network of the Agency role of the Haematology CNC; however Diane Body who do a wonderful job in for Clinical Innovation (ACI): Louisa mandatory reporting and accreditation supporting the department Brown CNC, Transplant Coordinator is requirements have increasingly demanded Donations from the Community Co-Chair the resources available and place the CNC Haematology Department: role under significant strain. §§ NSW BMT Network of the Agency for Clinical Innovation, Chair of the Throughout the financial year, numerous Allogeneic Haemopoetic Stem Autologous BMT Committee: Professor donations were received from individual Cell Transplant Service Philip Rowlings families and the community. The Haematology Service referred 32 §§ NSW Haemophilia Network: Dr Ritam Thanks to the Calvary Mater Newcastle patients for allogeneic HSCT during Prasad Auxiliary ‘Cancer Carers’ hard work and 2015/16. During this period, 20 patients dedication, the Haematology Department ‘Future Directions’ underwent transplant predominantly took receipt of a brand new $130,000 bone at Westmead Hospital. Calvary Mater Work continues on implementing marrow stem cell freezer. Newcastle runs a unique service whereby recommendations from ‘Clinical Haematology Maitland Cancer Appeal volunteers' visiting physicians from the main referral Services Future Directions to 2020’, compiled amazing achievement of raising $100,000 centre (Westmead) conduct monthly follow- by HNELHD Cancer Services and the Planning for leukaemia research. up clinics for transplant patients, with 49 and Performance Department. patients attending these clinics and a total Generous donation from the estate of the Teaching of 177 occasions of service. With the aim of late Georgina Northcott for Haematology providing a truly multidisciplinary service, Medical students from both the University Service development and initiatives. a Respiratory Clinic is run in tandem to of Newcastle and University of New England provide a point of care referral for patients are taught in both the inpatient and with respiratory complications. outpatient setting, as well as by provision of lectures and tutorials at the University of A nurse-led Late Effects Clinic has been Newcastle Callaghan Campus. established. Fifty patients are eligible to

20 | 2015/2016 Calvary Mater Newcastle Review of Operations The Hunter and Northern NSW Youth Cancer Service

This year celebrates the fifth Anniversary number of local participants. Lyndal Australia. All four members of the YCS team of the introduction of the Hunter and Moore, YCS Clinical Nurse Consultant, also attended the AYA Congress. Due to the Northern NSW Youth Cancer Service (YCS) has completed a six-month Nursing popularity and interest in the ‘Link to Ink’ based at Calvary Mater Newcastle. Research Mentorship Program and has photographic exhibition, Julia has submitted The YCS team prides itself on improving recently submitted an ethics application an abstract for the Teenage Cancer Trust support for adolescent and young adults titled "What proportion of AYA cancer Congress in Scotland December 2016. The (AYA) with cancer in the Hunter. In the past patients in the Hunter New England Local photographic exhibition has been displayed 12 months the YCS collaborated with Look Health District are presented at Tumour in the foyer of Calvary Mater Newcastle. Good Feel Better (LGFB) and CanTeen to Specific Multidisciplinary Meetings and The YCS team is always looking for ways to provide two AYA-specific LGFB sessions what are the outcomes." Julia Drake, YCS enhance a young person’s time whilst in with a teen focus. Both sessions were well Social Worker, has been instrumental in hospital either as an inpatient or outpatient. attended and followed with a high tea. a unique project looking at AYA patients They have gained financial support from The YCS has also continued with strong and their tattoos post treatment and the Calvary Mater Newcastle Auxiliary relationships with other non-government their significant meaning in relation to ‘Cancer Carers’ to purchase YCS patient organisations such as CanTeen, Redkite, their cancer treatment. The project titled entertainment trolleys that carry TVs, Starlight, Dreams2Live4 and Mummy’s ‘Link to Ink’ has gained international, playstations and other items to reduce Wish, to ensure AYA patients have access to national and local attention and has been patient boredom. A couple of AYA patients age appropriate services. featured on ABC radio, NBN News, Hunter are very excited to be involved in this Lifestyle Magazine and the UK Daily Mail. process. The YCS team has been active with research In December 2015 Julia exhibited the activities. Karen Matthews’s YCS Clinical project at the Inaugural AYA Youth Summit The YCS is always keen to provide outreach Psychologist is an Associate Investigator at the Hilton Hotel in Sydney and also at to the HNELHD and Julia and Lyndal spent on the CanTeen Distress Thermometer the Inaugural Australasian AYA Oncology time with staff and patients at both Coffs Research Survey looking to validate the Congress. Julia and Lyndal both volunteered Harbour and Port Macquarie, while Karen Distress Screening Tool used by YCS at the Youth Summit and met some amazing made visits to Narrabri, Armidale and nationally and has recruited an impressive and resilient AYA patients from all over Tamworth.

2015/2016 Calvary Mater Newcastle Review of Operations | 21 Radiation Oncology and Medical Physics

It has been an excellent year for service delivery for the Radiation These techniques can improve tumour targeting whilst reducing Oncology Department by providing patients with timely dose to normal structures such as heart, lung and kidneys. consultations and treatment, as well as offering the latest advanced Since 2014, the department has expanded its Stereotactic techniques in radiation treatment. This is thanks to adaptable Radiotherapy Program to treat not only metastatic brain (27%), staff working hard to roll out new techniques which are time bone tumours (16%) and solitary lung nodules (34%), but also consuming and technologically challenging, whilst trying to improve reach other sites such as lymph nodes, prostate and liver (23%). productivity in an ever-changing work environment. New patient Stereotactic radiotherapy is an innovative, highly conformal consultations have averaged within national benchmarks of two technique which delivers precisely-targeted radiation with weeks and routine treatments can start within three weeks. fewer high-dose treatments than conventional radiotherapy. Exceeding national averages - over 60% of patients have received Commissioned in 2015, the department’s new state-of-the-art linear the latest techniques with complex conformal treatment planning accelerator, the Varian TrueBeam, has special features to deliver this with IMRT (Intensity Modulated Radiotherapy) or VMAT (Volumetric stereotactic treatment with speed and precision. Over the past six Modulated Radiotherapy). Motion management is now provided for months, the department has treated its first liver tumours. Whether patients with treatments targeting the chest and upper abdomen unresectable primaries or metastatic, these are a challenge to with both 4D respiratory mapping at treatment planning and deep treat with stereotactic radiotherapy as the precision targeting inspiratory or expiratory breath holding during treatment. required can be undermined by respiratory motion. The department

22 | 2015/2016 Calvary Mater Newcastle Review of Operations been established internationally as a feasible and safe method in the treatment of skin cancers. Dr Mimi Tieu has developed a skin brachytherapy protocol with Medical Physicist Paul Simpson over the past 12 months and they are ready to implement this treatment option for selected patients. Last year, the department continued to build its advanced technology capability with the commencement of the SPARK trial. SPARK stands for Stereotactic Prostate Adaptive Radiotherapy utilising KIM (Kilovoltage Intrafraction Monitoring). SPARK is a TROG cancer research trial co-chaired by the department’s Radiation Oncologist Conjoint A/Prof Jarad Martin. It uses an advanced real time tumour position monitoring system (KIM) developed at the University of Sydney to more accurately target prostate cancer. An important component of the system, to acquire the images needed to determine the prostate position, was developed within the department by Senior Analyst Dr Shashank Bhatia. The department was the first site for this trial which required considerable multidisciplinary effort. Special acknowledgement goes to Senior Radiation Therapist, Lee Wilton, who has become a leader in the SPARK team and has presented around Australia on this technique. This trial allows for a reduction in the number of treatment sessions from 40 to five, clearly of enormous benefit to the patients. Moreover, the department’s Chief Medical Physicist, John Simpson, has secured a research contract with the USA-based Varian for the clinical validation of motion management features on the TrueBeam. This is the first Varian sponsorship agreement at Calvary Mater Newcastle and the second Varian funded agreement in Australia and New Zealand. Congratulations to Professor Jim Denham, one of Radiation Oncology’s Senior Radiation Oncologists and Conjoint Professor of the University of Newcastle, who was awarded a Medal of the Order of Australia in the 2016 Queen’s Birthday honours list. This was in acknowledgment of his lifelong contribution to medicine and medical research, especially in the area of prostate cancer research. An early pioneer of the department, Jim enriches us with his clinical wisdom, statesmanship and passion for research. This year, department nursing staff have excelled in personal achievements and service enhancements. The department’s Nurse Unit Manager, Ashley Powell, has completed ‘Take the Lead 2’, a two-year NSW Health course designed to increase management skills to transform nursing teams into high-performing teams to deliver quality patient-centred care to the community. would like to acknowledge the initiative of Liam Hilleary, Radiation A department Nurse, Charmaine Wilkins, was the recipient of Therapist, in protocol development as well as coaching the first few the Sharon Considine Memorial Grant and has commenced the patients through their treatment. Graduate Certificate of Cancer Nursing, enabling her to continue to develop her skills and knowledge in this field. The radiation In February this year the Radiation Oncology Department replaced oncology nurses have increased their involvement in research within the old High Dose Rate (HDR) brachytherapy unit with a new the department, particularly with input into prostate cancer studies. updated version (Flexitron, Elekta). This new device ensures that In 2016, the nurses have implemented follow-up phone calls to all the department remains a principal centre for the provision of patients after completion of radiation treatment with the aim of gynaecological brachytherapy in New South Wales, treating patients providing reassurance to patients managing any side effects and across a large geographical area from the Central Coast to the Mid giving expert advice as required. The initial feedback from patients North Coast. There has been a steady increase in the number of has been very positive. patients treated since the HDR unit was first commissioned in 2005 when it replaced a Low Dose Rate (LDR) brachytherapy unit. Finally, over the past year, an action plan has been developed to ensure the department is culturally welcoming for Aboriginal The demand for the department’s services is increasing. In 2012 people as part of the ‘Closing the Gap’ strategy. Of special note, new there were 99 HDR brachytherapy occasions of service. In 2014 artwork was commissioned from a talented Aboriginal artist and there were 250 HDR occasions of service, with 40 applicator and was hung this year in the public spaces of the department. The artist seven interstitial insertions requiring general anesthesia and 203 is Sarreta Fielding, who describes herself as born into the Wonaruah vaginal vault occasions of service. The demand for this service Nation of the Hunter Valley. Her contemporary art appeals due to continues to increase into 2016. There is scope for extension of its strong emotive, earthy colours and palpable textures, embedding the HDR brachytherapy service to skin brachytherapy, which has traditional themes of journey, family and home.

2015/2016 Calvary Mater Newcastle Review of Operations | 23 Palliative Care

The Department of Palliative Care remains busy but productive. There have been other changes with Dr Lindy Turner increasing her The team continues to work collaboratively while making quality hours to three days per week. Dr Nina Vogel is splitting her time improvement a priority. between Calvary Mater Newcastle and establishing a new renal Aboriginal Education supportive care service. The department has been lucky to have employed three advanced Kathryn Bensley, Registered Aboriginal Health Practitioner (RAHP) trainees for the past three years and is currently exploring ways this in Palliative Care, has registered with AHPRA this year to become a can continue. fully qualified Registered Aboriginal Health Practitioner expanding her role in Calvary Mater Newcastle. The role has been successful in Nurse Practitioners a number of different ways. First and foremost is the fact that more The two newly-endorsed Nurse Practitioners (NPs) in Palliative Care, Aboriginal people have had contact with Palliative Care Services and Ludmilla Sneesby and Lyn Campbell, have been developing the role working with the cancer coordinators. At present, Kathryn regularly and scope of practice. This role will further enhance palliative care sees a number of Aboriginal people and their families in the nursing by providing timely, equitable and a high standard of care to community, at John Hunter Hospital, Rankin Park Centre and Calvary terminally ill patients and their families in the Hunter area. Mater Newcastle (including the Hospice). The NPs have been involved in many aspects of the delivery of Most recently, the Department of Palliative Care was delighted to Palliative Care throughout Hunter New England Area Health; from join the NAIDOC Week celebrations. Acknowledging this special bedside clinical work to workforce capacity building. occasion, led by Kathryn, the Department of Palliative Care organised the hospital’s third formal Smoking Ceremony. This was The NPs provide consultancy in all clinical settings, that is, in the carried out by Uncle Bill Smith, a Wirrigan Aboriginal Elder and community to all Residential Aged Care Facilities (RACF) and all Steve Lombardi played the didgeridoo. acute care areas located in public hospitals within the area. The department continues to support its colleagues in rural and remote Medical Staff areas through innovations such as teleconference peer review and It was with sadness that the Department of Palliative Care the Hunter Area Palliative Education Nurses Network (HAPENN). farewelled Dr John Cavenagh after 22 years. Although no longer The NPs facilitated and presented education opportunities for all working in the department, Dr Cavenagh's legacy of providing care health care professionals. The department offers an RN Certificate for palliative care patients will continue. in Palliative Care which is a post graduate certificate recognised at selected universities. Another innovation is the Pharmacology in

24 | 2015/2016 Calvary Mater Newcastle Review of Operations Palliative Care for Nurses Workshop. This day has been very purposeful activities. Throughout the past year, patients have popular attracting nurses from all over the state. completed a number of group art works which are on display The department has a close working relationship with the in the Hospice. Many clients attend the group with a desire Palliative Experience in the Palliative Approach (PEPA) NSW. to leave legacy items for family and friends and have been This is a government initiative to promote the palliative assisted in completing life journals and gifts of their choosing. approach to care particularly in RACF. Several workshops Topics that patients have explored this year include: life have been conducted in the past year, catering for a variety stories, the power of friends, the importance of family, art of health care professionals. and relaxation, as well as benefiting from sharing stories, Workshops have also been conducted in collaboration with worries and fears with other patients. the Australian College of Nursing. The departmental diversional therapist provides home Education inservices, or short education sessions, have visits for patients unable to attend the group setting as been conducted for volunteers, community groups, medical well as meditation, massage and teaching alternative pain students, university students, TAFE students as well as RACF, management and relaxation techniques. This role continues hospice and acute care settings. to expand as patients and families request a wide range of activities and interventions during their stay at the Hospice. The NPs are involved at a committee level for the Hunter Aged Palliative Care Network (HAPCN). The HAPCN leads Ongoing professional development continued to be a strong a Link Nurse Program where more than 25 facilities are focus for social work this year. A highlight has been the represented. The aim of this network is to champion opportunity for the social workers to attend workshops with education and training to build skills in palliative aged care. Robert A Neimeyer, a leading clinician and researcher in the field of grief and loss. With a focus on complicated grief, this Nursing workshop has deepened and expanded the team's skills in With an expanded leadership team guiding the nursing this core area of social work practice. cohort, a focus this year has been to instigate and enact In recognition of the emotional and existential challenges cultural change within the nursing and broader departmental facing patients and their families, psychosocial support and team. Nurse managers have undertaken regular professional counselling are high priorities of practice for social work. supervision sessions with an independent psychologist to An enhancement this year has been the allocation and improve their ability to support and lead the nursing team, furnishing of a designated counselling room. This has been with a view to improved patient care outcomes. A significant an important expression of Calvary Mater Newcastle’s value achievement, in this area, has been the establishment and of Hospitality, promoting the comfort and privacy of clients at adoption of a set of agreed departmental values which are this difficult time. proudly on display within the unit. The Values Based Reflective Practice Group is offered to Bi-monthly, nurse-led multidisciplinary Falls Prevention and staff in the department and has now been running for over Medication Safety Committees have seen incident reduction 12 months. This group is facilitated by the palliative care in these two key clinical patient safety areas. Furthermore, social worker and pastoral care worker. It affords staff the acknowledgement that the palliative patient is at higher risk opportunity to reflect on encounters in the workplace that of falls has resulted in a renovation to a triple share room and have challenged them. The group works towards deepening the establishment of a close observation area within the unit. self-awareness as a means to promote client-centred Nurse recruitment has once again been pivotal to meeting practice. the high standard of specialist palliative care the department The Bereavement Service is a specialist service, providing can offer, both to the inpatient population and to those support and counselling to bereaved families and carers of patients living at home, under the close management of the patients who have been under palliative care. The ‘Pathways outreach nursing team. Looking forward, the nursing team through Grief’ Support Group Program is offered three times will be striving to ensure the integration and growth of expert per year and was attended by 61 bereaved people with 194 specialist palliative care continues across the hospital and, occasions of service. In a consumer survey, respondents indeed, area wide. stated they benefited from the opportunity to learn more Allied Health about themselves and their grief and gained confidence from the acceptance and understanding of others in the group. The support of the occupational therapists and The Bereavement Walking Group provides another modality physiotherapists is invaluable for both inpatients and to assist with bereavement. Attendance at this group remains outpatients. The department is pleased to welcome Emily high, with 165 occasions of service over the past 12 months. Baird back from maternity leave who along with Jenny Our trained volunteers provided 908 supportive phone Gleeson and the other Occupational Therapists in the contacts which is a very significant increase on previous department, Natasha Atkinson and Jo Davis, was selected as numbers. a finalist at the Hunter New England Excellence Awards. Just recently the department’s Pharmacist, Pili Vazquez has The Figtree Program continues to offer support to patients accepted a wonderful opportunity to undertake a temporary who reside in their own homes (or who are current Hospice placement with the Hunter Drug Information Service. The inpatients) and who have identified an expressed desire department wishes Pili well with this and is delighted that to ‘engage’ in life. The group maintains a steady flow of Noeline Karlson will be increasing her hours to three days a referrals and supports patients in participating in a range of week.

2015/2016 Calvary Mater Newcastle Review of Operations | 25 Surgical Services Operating Theatre Suite

The Perioperative Services has outperformed previous years, with The team has been going through a transformation of clinical the department's case numbers increased to a total of 3,410 of practice using the resources and framework of Essentials of Care which 724 of these were urgent procedures. The vital access the (EOC) over the past couple of years, including the process of clinical department provides to Mental Health to service the community handover from the scrub nurse to the recovery nurse. This project that requires Electro-Convulsive Therapy (ECT) also increased to 954 has led to the team being successful in its submission to present cases. at the EOC Showcase 2016 in Sydney - a huge privilege. From this, The types of surgery performed includes: thoracic surgery, pace the department is now forging forward with its documented clinical maker insertion, breast surgery including breast reconstruction, handovers between all areas of nursing, the ward to the anaesthetic general surgery including bowel cancer and hepatic surgery and nurse, scrub nurse to the recovery nurse, and from the recovery nurse gynae-oncology surgery. The department also provides access to the ward nurse - completing a full circle. This also precipitated for medical procedures requiring a sterile environment including a change within the Hunter New England Health electronic data endoscopy and bone marrow biopsies which are vital diagnostic information (iPMs) putting in an extra tab for ‘clinical handover’. services. With all these positive changes within the Perioperative Suite, Extra funding was provided for a complete upgrade of all the there has been interest from all areas, enabling the department endoscopic and laparoscopic equipment making the procedures to develop and implement a Transition to Perioperative Nursing performed safer and more efficient, which creates better outcomes Program. This is similar to the New Graduate Nursing Program, for patients. Funding was also made available for an upgrade to however with this program any nurse can apply and be trained anaesthetic machines giving the department the ability to provide to be a perioperative nurse, learning all aspects of scrub/scout, an even safer anaesthetic for the patient. anaesthetic and recovery nursing.

26 | 2015/2016 Calvary Mater Newcastle Review of Operations Pre-Procedures Unit

The Pre-Procedures Unit aims to provide a education and discharge planning are also routine assessments on patients. This quality assessment of patients booked for commenced at the clinic. Phone interviews thorough process ensures that patients are elective surgical admissions to improve their are attended with patients who do not adequately prepared for their surgery and health outcomes, therefore decreasing the require face-to-face consultation and that staff are informed, prior to the day of number of patients cancelled on the day of referral for a GP assessment is made for surgery, of any expected complications in their surgery. those who cannot attend the clinic due to the patient's care. The patient assessment process begins distance or immobility. The clinic functions for five sessions per with the nurse checking all ‘elective Since the introduction of pre-procedure week with three of these sessions delegated surgical patient health questionnaires’ and assessment, the number of patients to patients requiring an anaesthetic review. allocating patients for appropriate cancelled on the day of surgery has The unit is staffed by two 0.5 FTE Nurse Unit pre-operative care. This process facilitates significantly reduced. The Pre-Procedure Managers, and one part-time Administrative the identification of anaesthetic-related Unit works to ensure that patients with Assistant who works 20 hours per week risks and the formation of a treatment plan known pre-existing co-morbidities are during clinic sessions. for the patient. appropriately managed and results Pre-operative investigations are undertaken followed up preoperatively, as well at the clinic wherever possible. Patient as managing incidental findings from

Surgical Unit / Ward 4B

The Surgical Unit/Ward 4B, continues to provide surgical services to general and oncological surgical patients. The following services are managed from the Surgical Unit: § Stomal Therapy/Wound Management § The Acute Pain Service § McGrath Breast Care Nurse The Stomal Therapy Wound Management Service received additional funding for an increase in hours. Jane Fifield commenced as Stomal Therapy Wound Management Nurse in February 2016 sharing the position with Tess Richards. This has allowed for patients across the hospital to receive this service Monday to Friday. Funding was sought from the McGrath Foundation for an additional McGrath Breast Care Nurse and this was successful. This position will commence from 1 January 2017. Funds were gratefully accepted from Dry July which has enabled the ward to purchase Workstations on Wheels. The Workstations on Wheels enable the patients to view imaging and results at the bedside with the medical officers. Ward 4B continues using the Essentials of Care methodology in the implementation of projects with identifiable outcomes and affecting transformational change within the unit. The implementation of hourly rounding has seen a reduction in patient falls by 23.5% and pressure injuries by 72%.

2015/2016 Calvary Mater Newcastle Review of Operations | 27 Melanoma Unit

During 2015/16, the Melanoma Unit has templates. All staff attended regular ARIA The unit's Melanoma Clinical Research seen much operational change with the training sessions and have done an excellent Program continues to grow. A number of implementation of the ARIA Database job of mastering the new system. interesting studies have opened in the unit. Program across both medical oncology and In conjunction with the ARIA The first is a combination of Ipilimumab surgical outpatient clinics. This program implementation project, a review of the and Nivolumab, two immunotherapeutic replaces iPM as an outpatient booking Melanoma Database was undertaken. It drugs. The study is evaluating two different system and functions as an electronic was decided to archive the old system doses of both of these drugs. The unit is clinical record replacing paper based and incorporate the unit data collection also taking part in a study that combines clinical documentation. The benefits of the requirements into ARIA. A working party Intalesional Injections into melanoma on new system have included easier access was established to determine the optimal the skin or in the lymph nodes with the to patient clinical information including clinical data set for both surgical audit administration of immunotherapy. Dr van correspondence and test results, and more purposes as well as future clinical research der Westhuizen also has two investigator- accurate and efficient booking of clinics and projects. initiated trials that will take place in the patient billing. ARIA can also provide reports unit. One is currently underway and open to for monitoring Key Performance Indicators At the invitation of Area Cancer Services, accrual and one is in review. These studies such as outpatient wait times, new patient the Melanoma Unit participated in the look at resistance to immunotherapy numbers and quarterly unit clinical activity. Health Pathways project to develop a when the immunotherapy no longer works web-based melanoma management guide against the melanoma. The studies are The nursing and administrative staff are to for GPs. Representatives from melanoma be commended for their contributions, in focused on the immune system at the nursing, melanoma surgery and medical level of the tumour to examine how the numerous meetings over many months, oncology, provided direction regarding to the ‘customisation’ of ARIA for the immunotherapy can be made effective pathway content and reviewed and edited again to work against the melanoma. Melanoma Unit. This involved reviewing several pathway drafts. The final pathway outpatient clinical processes and designing document is soon to be added to the Health purpose-specific questionnaires and Pathways portal.

Medical Centre

The Medical Centre continues to Patients may spend up to eight hours Access After Hours Service also continues conduct the following outpatient clinics: a day in the Infusion Lounge receiving to operate from the Medical Centre each haematology, medical oncology, radiation treatment. The Infusion Lounge performs evening, on weekends and public holidays. oncology, psycho-oncology, surgical planned blood transfusions and other drug A new initiative is currently commencing oncology, general surgical, medical, infusions predominately for oncology and whereby the department increases the toxicology, alcohol and drug, pre- haematology patients. It will be staffed assistance provided to both patients procedures, physical therapies, stomal by one Clinical Nurse Specialist, plus one and staff by volunteers. The department therapy, speech therapy, nutrition and Endorsed Enrolled Nurse, Monday to currently has one volunteer assisting per dietetics and pacemaker. Friday 8:30-17:00. There are currently four week, but is in the process of orientating The department also conducts treatment chairs donated by Calvary Mater volunteers so that there will be someone multidisciplinary clinics for patients with Newcastle Auxiliary ‘Cancer Carers’, with assisting patients in the waiting room five head and neck, breast and lung cancers. one more to follow. mornings per week. Volunteers will be able Patients continue to visit the department The Venesection Service relocated to the to provide support to patients and their as a new patient on treatment reviews and Medical Centre from Level 3 adjacent to carers in many ways and will be working in a then for follow-up appointments when their Pathology, in February 2016. This provides host capacity. treatment has finished. a safe environment for both patients and Medical Centre staff look forward to staff as consultants are in close proximity The Infusion Lounge is a new treatment continuing to provide excellent care to if needed. There is a large window patients in 2016/17. area in the Medical Centre officially opened overlooking Platt Street and patients on 1 July 2016 as a result of the Whole have said they find it to be a bright and of Hospital Review. Its primary function welcoming environment. is to assist patients to have treatment in an outpatient location and remain The Hospital in the Home Service continues in their own home. This decreases the to operate from, and be managed by, the amount of inpatient hospital admissions. Medical Centre seven days a week. The GP

28 | 2015/2016 Calvary Mater Newcastle Review of Operations Nutrition and Dietetics

Nutrition and Dietetics staff plan and deliver nutrition care for In January 2015, Dietetics welcomed an enhancement to assist with patients admitted to the hospital and those receiving cancer extending care to patients presenting at the Day Treatment Centre. treatment as outpatients. In 2015 the Dietetics Service was involved As a result the team was able to undertake a needs assessment; in the care of more than 2,380 inpatients and 800 oncology consulting with staff and patients to consider how to better manage outpatients, with more than 4,740 and 2,760 occasions of service service delivery. provided respectively. The department contributed to a wide range of consumer-based A key focus was to engage consumers and consider if nutrition care education programs, which included education for breast cancer was adequately targeted. The use of the Patient Experience Tracker support groups, the Drug and Alcohol ‘Lifestyle’ Program and the (PET), consultation with patients attending the Day Treatment Calvary Mater Newcastle Falls Prevention Program. Centre, food satisfaction surveys and talking with patients during The work of the team of Dietetic Assistants, Ranine Siv, Suzie Collins, mealtime audits are examples of methods used to engage with Dianne Kennedy and Cass Christodoulides, is highly valued especially patients. by patients who receive nutrition care support. They communicate The hospital continues to advocate and greatly assist head and neck the needs of patients to food services and advocate continuously for cancer patients. The Executive approved a proposal to continue to the safe and patient-centred delivery of nutrition. subsidise the costs of enteral nutrition costs for head and cancer patients during treatment.

2015/2016 Calvary Mater Newcastle Review of Operations | 29 Speech Pathology

The past year has been a busy one with several staff changes due to is also involved with the stroke team, and has organised training for leave relief. The team was very pleased to continue its partnership nursing staff in screening for swallowing problems in acute stroke with the University of Newcastle through the activity of the Speech patients. The department also compared favourably with other Pathology Student Unit, with more than 20 students undertaking hospitals in aspects of stroke management in the National Stroke clinical placement at Calvary Mater Newcastle. Foundation Audit. The department has trialled a sticker to use in the medical All staff participated in education on management of head and neck notes, in order to streamline and standardise speech pathology oncology, which will be helpful in both inpatient and outpatient documentation. This was found to be useful, and further situations. The department also continues to assist in research modifications and trials are planned for next year. Another project activity in the Radiation Oncology Department. significant project for the year was the continued development of Future plans include encouraging patient-focussed referrals to the department’s ‘whiteboard database’, which is used for caseload the service via the Electronic Patient Journey Board, as well as management as well as a handover tool. The whiteboard has been developing the relationship between the service and speech audited for documentation of clinical plan, execution of the plan and pathology services provided in aged care facilities. staff satisfaction, all with pleasing results. This has been a positive outcome as a result of outstanding effort from all staff in supporting this project. The Department of Speech Pathology has continued to contribute to the ongoing role of the tracheostomy team in the hospital, with input to safe working practices and the self-learning package, as well as presenting at the tracheostomy education day. The service

Physiotherapy

Early lymphoedema education and oncology patient reconditioning Aoife McGarvey has been successful in obtaining a grant from the has been a large focus for the Physiotherapy Department over the Hunter Cancer Research Alliance. This will enable her to build on past 12 months. her recent research in rehabilitation of patients after head and As part of ongoing quality management, survey data was collected neck cancer treatments. This is an important field of work with from patients attending monthly secondary lymphoedema only limited research evidence to date. Aoife was also awarded the education sessions both at Calvary Mater Newcastle and broadcast Research Higher Degree Excellence Award for the Faculty of Health sites including Tamworth, Taree and Muswellbrook. This data was and Medicine at the University of Newcastle for her PhD thesis in analysed and the results presented at the Asia Pacific Lymphology the area of head and neck research. Congress in Darwin. This novel use of resources was shown to The department is continuing to promote cancer services through improve patient’s knowledge of the condition and decrease their presenting lectures and tutorials to physiotherapy students at the anxiety. It has provided rural patients with access to a service they University of Newcastle on the role of ‘Physiotherapy in Cancer would not otherwise have had. Thanks to Julia Britton for her work Care’. The staff continue their involvement in educating students on on this presentation. Over the next 12 months the department will placement at Calvary Mater Newcastle. further develop the use of technology to support patients through Brad Campbell and Amanda Harridge have made important this recovery process. contributions to reducing falls risk by actively participating in the Two staff, Judy Holland and Julia Britton, were supported by the Falls Committee. Clayton Reid continues to be an integral member hospital to attend the Asia Pacific Lymphology Conference May of the tracheostomy care team. Clayton Reid and Brad Campbell 2016 in Darwin. This conference was attended by international have undertaken training in DETECT so that they can teach the Allied researchers and clinicians. Important updates in research evidence Health DETECT sessions for essential inservices. have enhanced clinical practices of the lymphoedema therapists at Rheegan McDonald has undertaken resuscitation training to Calvary Mater Newcastle. Review of current practices and patient enable her to teach the practical component of basic life support resources to reflect this new knowledge has already begun. techniques to allied health staff. She is also the allied health Without the financial support from the education fund, the representative on the Resuscitation Committee. development of evidence-based knowledge and skills in the management of lymphoedema would not have occurred. The Conditioning Program, aimed to assist patients rehabilitate after cancer treatments or other injuries, continues to increase in popularity. The physical and emotional change seen in the patients attending continues to reflect the importance of this group intervention in recovery from the effects of cancer treatment.

30 | 2015/2016 Calvary Mater Newcastle Review of Operations Occupational Therapy

The Occupational Therapy Department throughout 2015/16 has Staff have continued their professional development throughout the continued to provide a range of services across the hospital, as well year with attendance at conferences, inservices and local education as participate in quality activities and student supervision. days, including: The Meditation Group, for oncology patients and their carers, has §§ Australasian Allied Health and Nursing Smart Strokes Conference continued to meet weekly and receives positive feedback from all §§ Hunter Occupational Therapy Education Day those who have participated. This group is facilitated jointly by the §§ Allied Health Research Forum Departments of Occupational Therapy and Social Work, and has been held nearly every Friday morning since 1998. During 2015/16 §§ Rehabilitation in Focus Workshop a weekly yoga group facilitated by Occupational Therapist and §§ Resilience Workshop Master Yoga Instructor, Tamara Coughlan, assisted with staff health, §§ Rural Occupational Therapists Forum and a Mindful Movement Group has been offered to medical ward §§ Haematology Education Day patients. Occupational therapy students from the University of Newcastle The Oncology Loan Pool has provided aids of daily living to scores of embarked on a project to improve the screening of pressure injuries patients to help them and their families manage serious illnesses in throughout the hospital and auditing the effectiveness of existing their own home environment. Expansion of this service continues to products including mattresses. be a goal of the department staff, especially in the area of pressure care management. A recent review of the numbers showed that 335 Occupational Therapy Week held each year in the last week of patients were currently using at least one item out of the loan pool. October was celebrated with a special breakfast at Stockton, and throughout Hunter New England Local Health District staff The Occupational Therapy team has participated as a group in participated in Hunter Occupational Therapy Week celebrations. the Dry July campaign to assist with hospital fundraising. In late 2015 additional funding money was spent on Oncology Loan Pool equipment to enhance the service.

2015/2016 Calvary Mater Newcastle Review of Operations | 31 32 | 2015/2016 Calvary Mater Newcastle Review of Operations Social Work

The members of the Social Work Department Adolescent and Young Adult Oncology Congress continue to provide a comprehensive Social and the inaugural Australasian Youth Cancer Work Service to patients and their families and Summit. carers across all clinical areas. This year has seen Staff have been active in the development and some significant changes in the structure and updating of resources including input in the referral pathways for a range of community- development of patient resources for those based, non-government services with the living with malignant brain tumours, resources establishment of My Aged Care to provide to assist in the care of patients who have services for eligible members of the community suffered strokes, resources for patients who have aged over 65 years. The Hunter was identified as dementia, and bereavement resources in all a trial site for the National Disability Insurance clinical areas of the hospital. Scheme (NDIS) – a new and innovative scheme for the provision of services to members of the Social workers are actively involved in facilitating community aged under 65 with a disability. a range of group programs within the hospital including Head and Neck Cancer Support Group, Social Work staff engage with the medical, Meditation Group, Bereavement Walking Group, nursing, allied health and support staff of Calvary the ‘Pathways through Grief’ Support Group, Mater Newcastle to provide a multidisciplinary Hunter Breast Cancer Information and Support approach to patient care. Social workers in Group, and the Falls Management Program. particular are responsible for attending to Support is also offered to the Newcastle Mater emotional and psychosocial needs of patients, Prostate Cancer Support and Education Group, carers and families. Social Work staff provide Leukaemia Foundation Support Group and the assessment, individual and group programs and Brain Tumour Support Group. services. These may include direct counselling related to dealing with adjustment issues, The department is involved in a number of trauma, grief and loss, domestic violence, the research projects including ‘Distress Screening provision of specialised meditation and support and Psychosocial Support’ for patients group programs, discharge planning, social undergoing stem cell harvesting autologous support services, advocacy with government and transplant. ‘Caring for the Professional Carers’ other agencies to access services. looks at the impact of death and dying on all staff caring for patients and families, and the Staff have continued to provide representation Mood Screening Project works with stroke of the department, allied health and the patients. hospital, on a range of committees both within the hospital and with a variety of community Staff also actively participated in the Calvary groups, including Social Work in Aged Care, Mater Newcastle Cultural Safety Audit which Calvary Mater Newcastle Stroke Team, Newcastle when concluded identified a range of areas Domestic Violence Committee, Haemophilia for improvement with the aim of creating a Social Workers and Counsellors Group, Clinical culturally sensitive hospital environment for Oncology National Oncology Group, COSA Aboriginal and multicultural patients, their Neuro Oncology Group, Cancer Council Regional families and carers. Two working groups have Advisory Committee, NSW Cancer Institute been established in which Social Work staff Neuro Oncology Interest Group, and Youth are actively participating to implement the Cancer Service Network. recommendations from the audit. Staff have also contributed to a range of conferences, workshops and forums by participating in organising committees and presenting papers including the HNE Social Work Conference, the HAA Annual Scientific Meeting, and organised and co-hosted the Mindfulness and Awareness at End of Life three- day workshop in partnership with Rigpa Spiritual Care Programme. The ‘Link to Ink’ photographic exhibition of tattoos and their related stories was launched at the inaugural International

2015/2016 Calvary Mater Newcastle Review of Operations | 33 Pastoral Care

The Pastoral Care Department at Calvary After 17 years as Pastoral Care Department talents, which contribute to the diversity Mater Newcastle has had a particularly busy Manager, Mary leaves the department with of skills within the department and year. a legacy of a united team committed to enrich the experience of pastoral care for In August 2015 Mary Ringstad, Pastoral Care excellence in spiritual care. patients and their families. To facilitate this Manager, now Director of Mission, was the Staffing in the Pastoral Care Department major transition, the pastoral care team recipient of the Catholic Health Australia has had a major reshuffle and has seen the is undertaking team supervision and a (CHA) Excellence in Pastoral Care Award arrival of some new faces. April MacNeill professional development project with the for 2015. The award was presented at the was appointed as Pastoral Care Manager Urban Ministry Movement. CHA National Conference in Canberra. after 11 years of working in the team. Research is emerging as an area with Mary received her award for her dedication She brings to the position a background enormous potential within the Pastoral Care and contribution to pastoral care services in health care, with specialist knowledge Department after Calvary Mater Newcastle at local, state and national levels. Mary’s as a pastoral practitioner, supervisor, participated in a national Calvary research talent and contribution to Calvary Mater and pastoral educator. The department project. The study aimed to establish Newcastle was also recognised in March also welcomed Margot McCrindle, Maria whether pastoral care provided by pastoral 2016 with her appointment as the Director McDonald and Catherine Stace to the team. care practitioners is deemed by patients of Mission for Calvary Mater Newcastle. Each woman brings her own individual and families to be an effective component

34 | 2015/2016 Calvary Mater Newcastle Review of Operations of their overall health experience while occasions this year. The program now look at Radical Theology as a tool to care for inpatients at various Calvary sites in extends to meet the needs of the wider diverse peoples'; 'What matters at the end Australia. Using the Lothian PROM, which community. of life – exploring the work of B.J Miller', measures the impact of specialist spiritual Following the establishment of the Pastoral Palliative Care Physician, Zen Project; care, more than 400 patients and family Placement Program in 2015, the Pastoral and Matt Glover (SCA Executive Officer) members at Calvary Mater Newcastle were Care Department once again worked with presentation on Counselling Skills for invited to participate in the research. The the Maitland-Newcastle Catholic Diocese Spiritual Carers. results of the survey indicated over 94% to offer a six-day education program for The department is grateful for the of people reported that their faith and/or pastoral ministry. Participants received an generosity of those who contribute to the beliefs were valued, and that their situation Introductory Certificate in Clinical Pastoral spiritual care of patients and their families, was acknowledged and understood. This Education. The success of these programs in particular Chaplains Fr Barry Tunks enabled them to focus on decisions about has led to new initiatives established and Fr Thomas Chirackel; Pastor Roger health care. Overall, the research indicated between Calvary Mater Newcastle and Nixon and Mr George Walter; Ministers of the lasting positive contributions of pastoral Maitland-Newcastle Catholic Diocese Communion, Gordon Gardiner, Frank and care towards patients’ and families’ in adult faith development and pastoral Joyce Gardiner; Chris Capper and volunteers wellbeing. ministry in 2017. Sr Therese Wilkinson RSM and Sr Kath Pursuit of academic excellence continues Calvary Mater Newcastle continues to Williams RSM. within the department as Carolyn Nichols be the hub for Spiritual Care Australia in The department also acknowledges the successfully completed postgraduate the Hunter region. In their role as SCA Calvary Mater Newcastle Auxiliary ‘Cancer studies. This achievement, in conjunction Executives, Tony Hassett (President) and Carers’ for its kind donation of a weekly with her role as an accredited facilitator Carolyn Nichols (Secretary) facilitate floral arrangement for the Chapel. of the Seasons for Growth Program, has ongoing professional development enabled Carolyn to provide specialised opportunities for pastoral care practitioners bereavement support for families of those and chaplains in the local area. Activities who have died in the hospital. The Seasons have included a presentation by Tony for Growth Program was offered on three Hassett 'The Strength of Not Knowing – A

Junior Medical Officers' Management Office

Calvary Mater Newcastle currently employs two part-time JMO The day-to-day management of the medical officers includes: (Junior Medical Officer) Managers, Victoria Wall (0.6 FTE) and facilitating hospital and term orientations, producing support Frances O’Connor (0.4 FTE) who joined on a 12-month contract documentation, communicating with key hospital and network in January 2016. Frances’ appointment occurred after Brad stakeholders on the staffing levels and rotations, producing term McDougall, who had been a JMO Manager for the past five years, rosters including after-hours, payroll, support for local and area was farewelled. Denise Parkes, EA to Director of Emergency education and training and term appraisals. Department, also provides administration and rostering support to JMOs are also offered additional clinical and professional support by medical officers in that department. Calvary Mater Newcastle’s Director of Prevocational Education and The JMO Office is responsible for the management and welfare of Training (DPET), a 0.2FTE role funded by the hospital and is currently junior medical officers, medical trainees and surgical trainees who supported by a radiation oncology staff specialist. are allocated to Calvary Mater Newcastle into clinical rotations In November 2015, after months of preparation and hard work, by their designated Hunter New England Local Health Districts Calvary Mater Newcastle successfully hosted a survey team from employment units. Health Education and Training Institute (HETI) to ensure that it was At any one time, throughout the clinical year, the JMO Office adhering to the standards required to be accredited to employ manages up to 47 medical officers, plus additional relieving network JMOs. The highest four-year accreditation was awarded in early staff and is constantly planning for new terms and intakes. There are 2016. five JMO terms and four medical/surgical trainee (registrar) terms per clinical year. Departments supported by these ‘doctors in training’ include: General Medicine, Surgery, Emergency Department, Cardiology, Haematology, Medical Oncology, Radiation Oncology, Palliative Care, Alcohol and Drug.

2015/2016 Calvary Mater Newcastle Review of Operations | 35 Whole of Hospital

The Whole of Hospital (WoH) Program continues to focus on doctor determines which patients are appropriate to be discharged improving access to care and patient flow within Calvary Mater home by senior nursing staff, according to the pre-agreed Newcastle, to help patients get the right care, in the right place, at documented criteria. This allows the patient to go home rather than the right time. WoH has now expanded to include programs such as waiting for the doctor to come and do their rounds. the VIP Program, Escalation Planning and Criteria Led Discharge. Whole of Hospital Escalation Plan - staff across Calvary Mater VIP Program - staff across the hospital identify and meet with Newcastle have developed a ‘Demand Management and Escalation people at risk of frequent unplanned readmissions to the hospital. Plan’ to proactively manage patient flow during periods of high The VIP team then work with these patients to understand the demand and during periods of normal activity. The plan is an social factors which affect their health but are beyond their operational strategy that outlines an agreed hospital-wide approach capacity to control. The team has engaged social and primary care for managing the hospital when there are high or low numbers of organisations to help provide the additional required supports so patients needing assistance. It provides guidance on what actions people can remain at home. are required by departments to increase the hospital's capacity for Since the commencement of the program, the team has worked appropriate safe care provision to patients. with many patients who frequently have unplanned admissions There are four levels of demand and the plan shows what to do and staff have assisted them and have almost halved the number of when it is ‘Business as Usual’ with enough resources and staff times these people need to come to hospital. through to when it is really busy and there is ‘Extreme Compromise’. Criteria Led Discharge - is being rolled out in the medical wards to facilitate patients being returned home from hospital and continue on their recovery journey as safely and quickly as possible. The

36 | 2015/2016 Calvary Mater Newcastle Review of Operations Quality

Building on the astute and constant work of Palliative End of Life Care many clinicians and managers, 2015/16 saw Calvary aims to put the person and family at the comprehensive efforts across all aspects of centre of care in all settings, with particular focus patient safety and programs to prevent harm on palliative and end of life care. in health care. In preparation for Accreditation in August 2016, a significant focus of this effort Calvary Mater Newcastle continues to be a leader was to ensure that strong evidence was available in palliative end of life care working collaboratively to demonstrate that Calvary Mater Newcastle with patients and their families throughout all routinely complies with the 10 National Safety phases of end of life care. Such care is dependent and Quality Health Service Standards (NSQHSS). on open and early communication in an The NSQHSS cover all aspects of governance, environment of trust. documentation and communication, medication Calvary Mater Newcastle has implemented the safety, infection prevention, falls prevention and Calvary Palliative End of Life Care (PEoLC) Strategic management, pressure injury prevention and Plan. Most recently the work of the strategic management, and quality use and management plan has been consolidated into a Quality End of blood and blood products. The standards of Life Care Framework which will be available ensure patients are cared for appropriately when in each clinical area for reference and guidance. becoming critically unwell and that patients are It is accompanied by all the critical documents/ always partners in their own care. guidelines/tools necessary for the provision of In terms of patient safety and harm minimisation, quality end of life care. in 2015/16 serious incidents were less common Patient feedback than in previous years, with many fewer in the Calvary Mater Newcastle participates in the NSW first six months of 2016 compared with the first Health Bureau of Information ongoing patient six months of the year before. Serious incidents surveys. Of the 321 Emergency Department are formally reviewed. Open disclosure occurs patients surveyed, 93% reported their overall with patients, families, carers and staff who experience was either very good or good are affected by a serious adverse event while compared to the NSW average of 89%. Calvary receiving health care. One key outcome during Mater Newcastle continues to use Patient the year was that years of consolidated efforts Experience Trackers to provide real time feedback to prevent blood stream infections in our very of patient experiences of their care. Patient Care vulnerable patients began to bear fruit so that Boards in inpatient areas together with hourly the number of potentially preventable blood rounding, have proven to be an effective way of stream infections were more than halved. With on supporting patient/carer communication with average one event monthly until October 2015, clinicians. and then between October 2015 and June 2016 there was one potentially preventable infection This initiative recognises that carers provide detected. an important role in supporting the daily care for many patients and that alternative As part of responding to events, staff members communication strategies are required to achieve are encouraged to identify and take steps to effective and meaningful engagement. During prevent harm to patients by being alert to the 2015/16 Calvary Mater Newcastle has expanded risks that pervade the modern health care the 24 hour post discharge phone follow-up environment. Risks of harm for patients might service to include all admitted patients. be illuminated through the investigation of an incident, by vigilant members of staff, or indeed by patients and their carers. A number of significant quality improvement activities continued or were initiated during 2015/16 to minimise harm and improve patient and carer engagement in their care, including: § Sepsis Kills § VTE prophylaxis § Essentials of Care Program, including hourly rounding and patient care boards § Whole of Hospital

2015/2016 Calvary Mater Newcastle Review of Operations | 37 The Clinical Ethics Committee

All clinical practice at Calvary Mater Newcastle is underpinned by that ethics education entails raising awareness of ethical issues the Code of Ethical Standards for Catholic Health and Aged Care and developing the skills of ethical decision-making, but rarely Facilities in Australia, and Calvary Mater Newcastle’s Clinical Ethics confronts the challenge of implementing the decisions we make Committee has a role in supporting clinicians and researchers to about right action in complex workplace or social contexts. Also, deliver care consistent at all times with these ethical standards. a panel of senior Calvary Mater Newcastle clinicians, who every While Calvary Mater Newcastle Clinical Ethics Committee is not a day lead others in ethical practice, offered their insights into this Human Research Ethics Committee constituted according to the challenge. requirements of the National Health and Medical Research Council, Members of the Clinical Ethics Committee it does have a number of functions. Committee members review 2015/16 research which has already been approved by a Human Research §§ Dr Rosemary Aldrich, Director of Medical Services, CMN – Ethics Committee (HREC) to ensure that it is able to be conducted Chairperson in this hospital in a way consistent with the Catholic Code of Ethical Standards. In addition, members of the Clinical Ethics Committee §§ Mary Ringstad, Director of Mission CMN (commenced March seek to support education of hospital staff on ethical issues and 2016) can assist with sourcing advice for hospital staff on decisions that §§ Mary Ringstad, in her capacity as Pastoral Care Manager, CMN have ethical considerations. Auspice Clinical Ethics Forums are also until March 2016; replaced by April MacNeil, Pastoral Care held throughout the year on issues of relevance to staff across the Manager from mid-2016 hospital. §§ Dr Tim Stanley, Staff Specialist, Intensive Care Medicine, CMN In the year July 2015 to June 2016, the Clinical Ethics Committee §§ Dr John Cavenagh, Staff Specialist, Palliative Care, CMN examined 80 Human Research Ethics Committee-approved research §§ Elizabeth Milligan, Deputy Director of Social Work, CMN proposals. §§ Ludmilla Sneesby, Nursing Representative, CNC Palliative Care, Ethics Forums for 2015/16 CMN Two well-attended clinical ethics forums were held during 2015/16: §§ Fr Barry Tunks, Parish Priest of Holy Trinity, Chaplain, CMN 1. Handing over, passing on: the ethics of end of life discussions 30 §§ Wayne Dever, Lawyer, MRM Lawyers, Mayfield November 2015 §§ Dennis Carroll, Theologian and Ethicist: Member, Catholic Moral Presenters: Theologians Association, Australia and New Zealand § Professor Katherine Clark, Director of Palliative Care §§ Paula Watts, Community Representative § Dr Tony Bonaventura, Director of Medical Oncology There were a number of resignations from the committee during § Dr Peter Saul, Senior Staff Specialist, Intensive Care the 2015/16 year. Dr John Cavenagh retired and left the Clinical Ethics Committee after many years of dedicated advice and input. Using a Grand Rounds format, three senior Calvary Mater Similarly the retirement of Elizabeth Milligan meant she too Newcastle clinicians presented patient stories to illustrate the concluded her years of considered expertise and compassionate complexities and ethical challenges when supporting patients, comments. Dr Tim Stanley resigned after a number of years of and their loved ones, at the end of a patient’s life. Speaking to a expert clinical thinking combined with critique and reflection, full auditorium, many attendees rated this the most instructive including suggesting our guest speaker Professor Sandra Lynch. Grand Rounds Clinical Ethics Forum to date. Two community members also bade a farewell: Paula Watts decided 2. Integrity and Self-Defence in Ethical Education and Practice. 22 to step down after decades of volunteer service to Calvary Mater February 2016 Newcastle - a tremendously generous contribution to the well-being Presenter: of the hospital community. Wayne Dever also indicated his desire to § Professor Sandra Lynch, Director, Institute for Ethics and conclude his membership, again, after many years of consistent and Society and Professor of Philosophy, University of Notre highly-valued input. Dame Australia Work has been underway since the first half of 2016 to replace Panellists: the members who have said goodbye. Calvary Mater Newcastle Community Advisory Committee member Steven Tipper joined the § Mary Ringstad, Pastoral Care Manager Clinical Ethics Committee from early 2016. § Roz Everingham, Director of Nursing Services The Clinical Ethics Committee meets on the fourth Wednesday of § Dr Michael Hayes, Director of General Medicine each month with the exception of December. § Dr Charles Douglas, Visiting Medical Officer, Melanoma Professor Sandra Lynch is a moral philosopher, with expertise in applied and professional ethics, ethics and values education. Professor Lynch presented her work reflecting on the assumption

38 | 2015/2016 Calvary Mater Newcastle Review of Operations Human Resources

The Departments of Human Resources (HR) and Payroll Services and guidance to hospital workers and managers required to have implemented a number of changes during 2015/16: work within these systems. § The HR Department has overseen the implementation of the § Face-to-face delivery of WHS training, specifically targeted at internet-based ‘Calvary Careers’ e-recruit system and the training managers, has included Aggression Minimisation for Managers, of all managers required to use the system in order to recruit Chemical Management for Managers and Delegates, Hazardous new staff. ‘Calvary Careers’ has resulted in significant changes to Manual Task Training for Managers, Incident Investigation the way recruitment requests are lodged and approved, the way Training for Managers, and Risk Assessment and WHS Action applications are received and processed, and the way contracts of Plan Overview Training. employment are issued. Paper applications are no longer received § In conjunction with Best Practice Australia, the HR Department and there is no reliance on external and internal mail systems, has once again coordinated a staff pulse survey to monitor ensuring the timely delivery of applications. Applications, change since the last hospital-wide ‘Being For Others’ staff resumés and other documents are also no longer printed, thus survey held in March 2015. The pulse survey was conducted in avoiding bulky recruitment files holding the applications of up to Ward 5A/Medical Assessment and Admission Zone in early April 150 candidates at a time. Selection panel members are able to 2016. securely access and assess applications and schedule interviews § The HR Department has also overseen the implementation of online. Selection reports and all other documentation are all the ‘Speak Out’ Program and promotion of the program to all stored securely online and acknowledgement and advice emails staff. The program provides a process for all employees to let and letters of offer are all generated from within the system, management know when ‘something doesn’t seem right’. It is a saving time and improving accuracy and consistency. means of allowing employees to confidentially report what they § The HR team has commenced the introduction of new Working believe to be corrupt, illegal, unethical or undesirable conduct With Children Checks as required by NSW legislation. All via a 1800 hotline which is available 24/7 and run by a provider relevant staff members have been advised of the changes and that is external to Calvary. The service also includes the offer of the new requirements, and the verification of existing staff counselling for all callers. members is now underway. § There has been a gradual shift to staff completing all their § All hospital policies relating to human resources issues were mandatory training on the NSW Ministry of Health’s Internet- reviewed, updated and transferred to Calvary Connect, an based learning platform, HETI Online. Once this change online intranet that provides a new medium by which staff, is finalised, the completion of training modules and the and groups of staff across Australia with like responsibilities monitoring and reporting of compliance with mandatory and interests, can communicate and work collaboratively training requirements should be simplified. This will be assisted online. Calvary Connect also provides a source of information by the proposed development of an interface between HETI for employees and ensures consistency and currency of all the Online and Chris21 (the hospital’s Payroll and Human Resources information it holds. Information System). § MyKiosk, a self-service application accessible by all staff, is being § In general, the HR Department continues to meet the skill needs expanded to allow staff members to lodge leave forms and of the hospital by recruiting skilled clinical and non-clinical staff access more details in relation to their pay, leave and training from across Australia and overseas, addressing industrial issues history. The new functionality will improve confidential access and the personal concerns of staff as they arise, and ensuring to, and processing of, personal information for all employees. that professional training and development opportunities are § Payslips, which were printed and distributed as paper copies accessible to all staff. until a year ago, have been distributed by email over the past 12 months. However, in an effort to encourage all staff members to become more familiar with MyKiosk, it is proposed that pay slips will soon only be available to staff via download from MyKiosk. Exceptions will be made for some employees such as agency nurses and those on long-term leave. § The completion of the Calvary Work Health and Safety (WHS) Systems Verification Audit in 2015. In preparation for the next Calvary WHS Systems Verification Audit, the WHS Coordinators have been conducting various self-assessment audits across the site. § The WHS Coordinators have successfully implemented new Calvary work health and safety systems and documentation, and resolved inconsistencies between Calvary National, Calvary Mater Newcastle, Local Health District and NSW Ministry of Health systems. The WHS Coordinators provide ongoing support

2015/2016 Calvary Mater Newcastle Review of Operations | 39 40 | 2015/2016 Calvary Mater Newcastle Review of Operations Health Information Services and Information Technology

In all areas of patient administration, health records Guest Internet Services have been extended and are now and technology services staff have continued to meet functioning well in key areas. All patient care treatment new challenges positively, and to adapt to change as units now have access to the hospital’s WiFi service, necessary. They have engaged with clinical initiatives which supports approved portable technology use, and willingly and sought to bring their experience and skills some administrative areas have also benefited from this to the various discussions. service. Mobile phone coverage has been improved in The most significant overhead and challenge in terms of the past 12 months in the Medical Centre and Operating management of our services in the past year has been Theatre as a result of 'smart antenna' installations, and in the area of health records management. The hybrid work continues in this area. environment for health records and associated functions Privacy Management and Release of Information are complex and difficult to manage, as eHealth requests have increased in complexity and number. As initiatives continue to be implemented externally, and more staff have access to more information in electronic local operational impacts are sometimes overlooked. systems and consumer expectations continue to grow in eHealth systems provide enhanced access to electronic terms of service delivery, more questions are being asked records but often require staff to access multiple systems about “who has accessed my information”, and “was the to obtain information for clinical care, medico-legal and care I received appropriate”. Locating all of the records coding purposes for the one patient. and responding to these requests has become more time consuming but necessary. Patient activity levels have also continued to increase during this period with staffing remaining fairly An external review of Outpatient Services delivery consistent. Increasing complexities of systems and was undertaken in late 2015 and this has resulted in records mean constant review of existing business a local project now being established to determine processes is required to identify areas where efficiency recommended areas for change to be implemented. can be improved and processes streamlined. Medical Centre Front Office staff are integrally involved in this project. Data from multiple systems is relied upon more and more to assist clinical communication and coordination The successful design, implementation and use of of care. The Electronic Patient Journey Boards now information and communications technology are a implemented in all inpatient areas mean that real time, greater challenge than ever, with so many systems or as close to real time as possible, data entry into the and outside influences. Patient activity will continue to iPM (patient administration system) is now essential. increase, as will consumer expectations, and accurate These systems and data facilitate development and health records and data are key to safe patient care, and spread of new health care delivery models and safer assisting future planning and services strategies. patient care. Thanks goes out to a most dedicated and professional External reporting has become more complex with new team working across all areas of Health Information Non-Admitted Patient (NAP) system extracts needing Services and Information and Communications to be developed and tested during the period for the Technology Services. ARIA systems. Increased monitoring of data integrity and submissions locally is now required, and these systems and error reports continue to evolve. Calvary Connect intranet is now embedded in daily operations, with staff able to access all hospital and Calvary policies and valuable resources via this platform. Contingencies have been developed for down time, and the link upgraded between the hospital and Calvary. Some staff are yet to use the system to its full potential, and staff education and development continue in this area. Performance Data via Key Performance Indicators (KPIs) and activity data are reported in various formats and to multiple entities, including the Hunter New England Local Health District, The Health Round Table, the ACHS and Calvary. Coding and Diagnosis Related Groups (DRG) report requests are being relied upon more to assist local operations and this has resulted in increased workload.

2015/2016 Calvary Mater Newcastle Review of Operations | 41 Public Affairs and Communications

The Public Affairs and Communications Unit continues to flourish steer the hospital’s National Safety and Quality Health Service and immerse its work in the running of the hospital. Throughout Standards (NSQHSS) Standard 2: Partnering with Consumers 2015/16, the unit has been involved in a number of new projects, Committee. This role sees the unit and committee liaising with all with community engagement at the forefront. departments regarding effective communication with consumers. A The team significant proportion of time was spent ensuring robust evidence was available to demonstrate how Calvary Mater Newcastle The three-person team: Helen Ellis, Debra Astawa and long- routinely partners with consumers because the team was aware standing volunteer, Margaret ‘Maggie’ Sulman OAM, have been that accreditation surveyors would be visiting in August 2016. kept extremely busy. In April 2016, Helen Ellis was appointed Our supporters permanently to the position of Public Affairs and Communications Manager, after Ingrid Airlie resigned following a year’s leave. Calvary Mater Newcastle is fortunate enough to receive generous Subsequently, Debra Astawa was appointed permanently to the support from fundraisers and donors, including individuals, position of Public Relations Officer in June 2016. community groups and local organisations. The team’s much treasured volunteer, Maggie, continues to be a These donations enable the hospital to purchase special equipment great support in the day-to-day running of the unit. Maggie assists and furniture, pursue vital research, and enhance the care provided across a number of hospital areas and projects and the team to patients. These purchases are only made possible through the continues to remain thankful for her kindness and dedication. generosity of a community of wonderful supporters who have Engaging with the community contributed to many departments throughout the hospital. The hospital is fortunate to continue to be a Dry July beneficiary. Calvary Mater Newcastle is committed to engaging with consumers Dry July is a fundraiser that challenges individuals/teams to give up to develop services and resources responsive to the community’s alcohol throughout July to support adults living with cancer. Through needs. the generosity of Dry Julyers and their supporters the hospital is The team continues to strengthen partnerships with consumers able to purchase equipment and fund projects that make a real across the hospital to allow the perspectives of patients, their difference to patients undergoing cancer treatment in our hospital. families and carers to contribute directly to high quality health care The generosity of the community towards Calvary Mater Newcastle at Calvary Mater Newcastle. is phenomenal. This is testament to the great care given by staff In March 2016, the Public Affairs and Communications Manager time and again. The continued support of the community is much joined together with the newly appointed Director of Mission to appreciated.

42 | 2015/2016 Calvary Mater Newcastle Review of Operations Management hospital, speeches and a dinner. One guest commented, “It really was a lovely night. The night brought back lots of memories and The Public Affairs and Communications Manager continued the role stories of our days at the Mater which to most of us were times of Acting Volunteer Manager and Chair of the Heritage Committee we will remember with fun, laughter, amazing friendships and a up until the hospital’s new Director of Mission, Mary Ringstad, was lot of hard work.” The hospital’s close relationship with the Mater appointed in March 2016. Mary has now been able to dedicate her Graduate Nurses’ Association will continue to be nurtured by the time to recruiting new volunteers and progressing ongoing Heritage hospital. Committee projects. A major project for the unit was the creation and launch of the The unit continues to manage and have an important working hospital’s new and improved website, www.calvarymater.org.au. The relationship with the Calvary Mater Newcastle Auxiliary website forms part of the Calvary website that showcases Calvary’s ‘Cancer Carers’, who are the hospital’s ever dedicated cancer public and private hospitals, retirement and aged care facilities and care fundraisers. From posters and leaflets, to assistance with community care centres. The new modern website offers visitors community grant applications and events, the unit enjoys its up-to-date, informative content on services and clinics, patient and work with this dedicated, talented, kind, group, while the hospital visitor information, ease of navigation, accompanied by new photos continues to thrive with the significant amount of equipment and featuring patients and staff. projects they help fund each and every year. The total funds raised by the Auxiliary for the 2015/16 financial year was $321,954.97, The unit was pleased to coordinate and manage a vast array of a staggering achievement. Thanks goes to each member of the projects, events, meetings and activities throughout 2015/16, Auxiliary for their support and for continuing to be fantastic including the following: ambassadors for the hospital. §§ Coordinating NSQHSS Standard 2: Partnering with Consumers Our Wig Service team, Kim Rossi and Margaret Bottrill, continue to §§ Organisation and management of three Senior Staff Forums provide a pivotal free service to patients who lose their hair through §§ Ongoing development and updating of the hospital’s website, cancer treatment. These friendly volunteers help patients choose the research website and Radiation Oncology’s Hunter Cancer a flattering wig, fit it correctly and then provide advice on wig Treatment website, as well as sharing news on the internal maintenance and care, all while taking into account the individual intranet site, Calvary Connect needs of each patient. Without their commitment, the service would not be able to help the many women, men and adolescents §§ Writing and submitting external award and grant applications who leave with hope and empowerment after having their new wig §§ Management of all hospital media and press releases fitted. The team’s tireless commitment was recently acknowledged §§ Management of hospital marketing collateral including brand when they were announced as finalists in the Volunteer of the advocacy and monitoring Year Group category at the 2016 Hunter New England Health §§ Coordination of various hospital and community fundraising Achievement Awards. Congratulations on this achievement and and education events, together with community initiatives such recognition. as school choirs singing for patients and the ‘Acts of Kindness’ Media initiative The media continues to assist in sharing the hospital's news, patient §§ Coordination of heritage tours of the hospital stories, community fundraisers, ongoing campaigns and events. §§ Support and assistance to Calvary Mater Newcastle Auxiliary Some highlights of the coverage from the past year include the ‘Cancer Carers’ Youth Cancer Service ‘Link to Ink’ photo exhibition featuring young §§ Coordination of the Pride of the Mater Team of the Month Award cancer survivors' thoughts on surviving cancer by way of tattoos, and the commissioning of four new chemotherapy chairs for the §§ Member of the Research Committee and Research Website Day Treatment Centre as part of an initiative to improve services Working Group and reduce waiting times for the Hunter region’s cancer patients. §§ Member of the Community Advisory Council The unit continues to forge relationships with key media and §§ Assistance and coordination of hospital events – Celebration stakeholders, and its ongoing relationship with Hunter Lifestyle of Service, World Hand Hygiene Day, April Falls Day, Medical Magazine continues to blossom, as the unit writes varied and heart- Research Week, Breast Cancer Awareness Month, Heritage warming article submissions for each edition of the magazine. events and launches, Dry July 2015, Multicultural Health Week, Key activities NAIDOC Week, Auxiliary AGM, Christmas Carols, Mary Potter Day, Christmas Giving Tree, and health awareness days/weeks Every year, the unit provides direction to a number of departments §§ Attended multiple guest speaking engagements and cheque in the compilation of educational tools for patients, such as handovers brochures, fact sheets, posters, thereby assisting the promotion of the hospital’s services to patients and staff. The Public Affairs and Communications team remains committed to further enhancing the delivery of professional communication The unit offers renewed ideas and fresh approaches to existing services across the hospital and looks forward to progressing new practices, including the rejuvenation of marketing collateral and and integral projects throughout the coming year. the advancement and development of events run at the hospital. In March 2016, members of the Mater Graduate Nurses’ Association were invited to attend a night at the hospital in their honour. More than 70 nurses filled the hospital’s Lecture Theatre (once the Old Chapel) with chatter of hard work and frivolities of yesteryear. The PR team organised the event which consisted of a tour of the

2015/2016 Calvary Mater Newcastle Review of Operations | 43 Calvary Mater Newcastle Auxiliary ‘Cancer Carers’

Another year has passed and once again members of Calvary Mater Over the past year the Auxiliary purchased hospital equipment and Newcastle Auxiliary ‘Cancer Carers’ have astounded the hospital made donations to the value of $372,057.47. with their significant donation. The following equipment was purchased by the Auxiliary in The Auxiliary is a group of 30 dedicated volunteers, both men 2015/16: and women, ranging in age from 56 to 98 years, who fundraise to Four treatment chairs for the new Infusion Lounge located in purchase oncology equipment and items of need for the care and the Medical Centre, together with a laptop cart and notebook = comfort of patients at Calvary Mater Newcastle. The members’ hard $26,691.28 work is very much appreciated by staff, patients and the community who encounter their compassionate care, fundraising efforts and Wigs for the Wig Service = $1,000 smiling faces. Operating on a fortnightly basis, the Wig Service is a much-needed Sadly, many Auxiliary members have endured their own cancer resource for patients who lose their hair through cancer treatment. journey, while others have lost loved ones to this formidable The wig for many of our patients is a lifeline, a way of gaining back disease. Together the group offer each other friendship and some control on what can be a distressing journey. support, while cheerfully fundraising for a cause they hold close to Fifty children’s books on cancer = $750 their hearts. The book ‘My mummy has cancer’ was written by a Calvary Mater Through members' tireless fundraising, the Auxiliary raised a Newcastle patient with her daughter. The book explains terminal massive $321,954.97 for the 2015/16 financial year. Over this cancer to a child. It provides comfort, hope and love, and makes period, the Auxiliary worked 38,617 hours in total, the equivalent of that difficult conversation just that little bit easier. 1,485 hours per member. This equates to $14,310 being raised per member - an enormous result.

44 | 2015/2016 Calvary Mater Newcastle Review of Operations Two microcap capnographs for the Emergency Department = Five diversional therapy trolleys complete with iPads for the $9,000 hospital’s inpatient wards = $30,000 This technology allows staff to obtain an accurate, reliable and easy- For many patients, the experience of staying in hospital can be to-use assessment of a patient’s respiratory status. distressing and can cause unnecessary frustrations that can manifest One blood pressure machine for Ward 5C (Haematology) as behavioural and psychological symptoms. To help alleviate = $4,851.20 these problems, the hospital purchased five diversional therapy trolleys, complete with an array of activities, that will be based in This observation machine automatically measures blood pressure, the hospital’s wards. These activities are particularly beneficial for pulse, oxygen saturation and temperature, with easy to use blood patients with dementia. pressure cuffs. Six vital sign monitors for Ward 4B (Surgical) = $18,162 A new stem cell freezer for the Haematology Department = $128,990 This equipment provides a quick assessment of vital signs for patients who have undergone surgery. Patients with Haematology Cancers, Multiple Myeloma, Non Hodgkins Lymphoma and Hodgkin Lymphoma, often require a bone marrow stem cell “Individually we are one drop but transplant for cure or control of their cancer. together we are an ocean” This requires having the patients' stem cells kept Ryunosuke Satoro frozen for months to years. Toiletry bags and supplies for Hospice patients = $1,500 Fundraising These toiletry bags make a big difference to the lives of patients The Auxiliary continues to be competently led by Auxiliary President, who through varying circumstances have no personal care items Elaine Wellard, Treasurer, Kay Fordham, and Secretary, Margaret when they are admitted to the Hospice. This funding has allowed Dougherty, all of whom do an outstanding job. the hospital to establish ongoing support of such patients. The group is well known for bowling days, coach trips, fashion Fresh flowers for the Mary Potter Chapel every week (Pastoral parades, celebration luncheons, craft goods, baking and their highly Care) = $1,040 popular lolly tables at the hospital. They are also widely supported by the community which continues to donate to the Auxiliary for the The beauty of fresh flowers in this calm and serene environment benefit of the hospital and its patients. adds to the experience for patients, visitors and staff. Throughout the year, the Auxiliary raised $80,816.74 through the Two electric pressure chairs for stroke patients on Ward 5A/MAAZ lolly tables at the hospital and a further $38,066.25 was raised = $13,136 through craft sales, and craft and cooking days. Patients admitted to the Stroke Unit often have severe deficits The Auxiliary was also fortunate enough to receive a $20,000 grant which impact on the way they are able to move about, their safety from ClubGRANTS NSW (via the Wests Group) that went towards and comfort. These special chairs allow patients to be supported to the purchase of the five diversional therapy trolleys. prevent injury, as well as allow for adequate pressure relief to assist with reducing complications like pressure areas. The Auxiliary would like to give special thanks to the following people for their ongoing assistance: A Cinema Vision Audio Video System and MRI goggles for use when patients receive a MRI scan = $55,221.49 §§ Public Affairs and Communications Department - Helen Ellis and Deb Astawa Thanks to the hard work of the ‘oncology dollies’, Linda, Narelle and § Kylie from Ward 5B, a massive $31,000 was raised for this appeal. § Finance Department - Katrina Thornton, Lynda Evans and Craig The Auxiliary then agreed to make up the difference so the goggles Cutler and entertainment system could be purchased. §§ Support Services Team - David Millington, Peter Martyn, Peter Hobson and Peter Bird Unfortunately some of our patients cannot undergo MRI tests and require sedation due to claustrophobia and anxiety. The §§ Auxiliary Assistant Treasurer, Jo Pritchard entertainment system allows DVDs to be displayed helping to make §§ Volunteer, Kaye Woods an MRI a more comfortable experience for patients. §§ The lolly packers who enjoy the mornings catching up with Equipment for the Occupational Therapy Oncology Loan Pool friends, lolly tasting and talking = $11,715.50 §§ Beresfield Bowling Club for its support in conducting House on This equipment benefits oncology and haematology patients by Saturdays and Sundays for the benefit of the Auxiliary addressing their unique care, comfort and pressure care needs §§ Other district bowling clubs whilst at home. §§ Muree Golf Club CANcierege App = $70,000 §§ The families, friends and members of the community and A new CANcierge App is being developed for the hospital’s patients, hospital staff families and carers. The App will endeavour to provide easily accessible, relevant and reliable cancer information to patients and their carers to supplement the existing support services provided. The App's launch will take place in 2017.

2015/2016 Calvary Mater Newcastle Review of Operations | 45 Volunteers

“The value of volunteering is immense and appointed Director of Mission. One of their ongoing commitment to their work irreplaceable.” Volunteering Australia the first jobs to occur was processing the at the hospital. Additionally the annual Every day the team at Calvary Mater enquiries regarding volunteering that had Volunteer Christmas Party is always an Newcastle recognises the truth of this accumulated while the Director of Mission event that is eagerly anticipated and the statement. During 2015/16, the hospital's position was vacant. The long list was a 2015 festive celebrations were enjoyed remarkable volunteers continued to reminder of the esteem within which the with an afternoon of entertainment at enhance the experience of both patients hospital is held by the local community. Wests Bowling Club New Lambton, which of and their families by generously giving their Every person was contacted to acknowledge course included delicious food, singing and time, talents and compassion. A diverse, their enquiry and to determine ongoing dancing. vibrant community of volunteers come interest in joining the volunteer workforce More formally, the contribution and from a variety of backgrounds but all work at Calvary Mater Newcastle. dedication of volunteers have been with a unified sense of purpose - to make In June this year the team began a newly recognised through a series of award a difference to the lives of patients, visitors designed selection and orientation program nominations and ceremonies. and staff. for 37 new recruits. When the 2016 Hunter New England Health Last year volunteers donated 8,570 hours Before undertaking their duties at Calvary Achievement Awards were announced we of their valuable time. From assisting with Mater Newcastle, each volunteer completes were delighted to see three of the hospital's patient care in clinical areas, to clerical a thorough induction process as well a volunteers featured proudly on the list. June work behind the scenes, to providing number of mandatory Calvary training Hill, Medical Ward 4C volunteer, is a finalist hospitality and companionship in outpatient modules: Calvary National Induction in the Volunteer of the Year Individual departments, and following up those who Program, Work Health and Safety, Palliative Award. Kim Rossi and Margaret Bottrill of have been bereaved in palliative care. The and End of Life Care One and Two, and the Wig Service are finalists in the Volunteer dedication of volunteers, their reliability Hand Hygiene. For the first time all of the Year Group category. Calvary and their unique contribution continues to volunteers are able to complete these Mater Newcastle wishes them well and honour the legacy of Venerable Mary Potter. modules online from home. Nevertheless, congratulates them on their achievements The volunteers continued to be managed we are thankful for the commitment and and this recognition. by Helen Ellis, as part of her already time it takes each of them to complete their Calvary Mater Newcastle volunteers are full-time position as Public Affairs and training. a vital part of the hospital community Communications Manager. Needless to One of the best ways to demonstrate and staff are eternally grateful to every say Debra Astawa, PR Officer, and Maggie the importance of volunteers to the volunteer who dedicates their time to assist Sulman, volunteer, ably assisted Helen in hospital community is to ensure their in providing excellent care to patients, ensuring the volunteers were organised, contributions are recognised, valued and families and friends. Every volunteer is so supported and celebrated throughout the celebrated. When possible, staff like to important to the ongoing running of such a year. join together with volunteers to celebrate caring and supportive hospital. In March 2016, this responsibility was this remarkable group’s achievements. To returned to the management of the newly mark National Volunteer Week, a morning tea was held to thank volunteers for

46 | 2015/2016 Calvary Mater Newcastle Review of Operations Heritage Committee

The Heritage Committee is a small and hospital’s corridor walls; the photos to be Cross, destabilised and dismantled after the dedicated group of staff and community displayed are currently being finalised to earthquake. This local landmark has been members who are committed to ensuring celebrate the hospital’s heritage, including missed by the Newcastle community and the rich history of the hospital is preserved its places, people and events. Images the hope is it will soon be lighting up the and has a place in continuing the wonderful of the 1989 Newcastle earthquake, the night sky of Waratah and beyond. legacy of all those who have contributed to nursing school, the opening of New Med Calvary Mater Newcastle has also been the life of Calvary Mater Newcastle. II and commencement of radiotherapy keen to restore the Stations of the Cross It is thanks to the dedication and and oncology services for the Hunter, past located in the Convent Chapel, now Mater commitment of committee members Dr buildings, staff members and events, are Lecture Theatre. Finding a craftsman to Pam Harrison, Kay Fordham, Ron O’Neill, to name but a few of the photos that have complete this fine work has been difficult. Elizabeth Grist, Milli Sneesby, Rosemary been painstakingly found and preserved The committee will continue to work on this James, Helen Ellis and Pat Barrett, that this for future generations to enjoy. While the project with much determination. important preservation work continues. method of display and its location are still a work in progress, it is hoped that 2017 will The committee looks forward to continuing The committee has been working hard on a see its unveiling in the hospital. its important heritage projects in the number of new projects with commitment coming year. and diligence from all team members. Other works currently being negotiated One such project is a photo display for the are the restoration of the original Copper

Community Benefit

“Community Benefit initiatives are the best care and support for patients Growth Program is held three times a vital to the mission life of the services and their families. year for those grieving. Recently it has and in many ways express our vision of §§ Hosting of NSW Cancer Council been extended to include people from providing healing, hope and nurturing Information Centre for cancer patients the local community. to the communities we serve. They and carers. This includes the provision §§ Hospice Arts for Health Project funded also demonstrate in a practical way the of infrastructure and IT equipment at by Dry July funds. Provided and managed ‘Spirit of Calvary’ and the impact this no charge to NSW Cancer Council. The an artworks program in the Hospice has in the communities we serve, and in service has been developed with the that created opportunities for contact making a difference in the lives of these help of experienced health professionals with artists in the community. It helped communities.” from the Cancer Council Helpline, people enhance the relationship between Mark Doran, National CEO, Calvary with cancer and some of NSW's top hospital staff, local community groups, Some of the hospital's community benefit cancer experts. volunteers and patients. activities this year included: §§ The Palliative Care Bereavement Program §§ General Medicine Clinic at Indigenous §§ The Oncology Equipment Loan Pool. The has continued to provide support Health Centre. The project is coordinated Occupational Therapy Department run to families, friends and carers for 12 by the Medical Specialists Outreach a popular and well utilised Oncology months after a patient death through a Assistance Program and is an initiative Equipment Loan Pool free of charge. range of supportive initiatives including: of the hospital’s Department of General This equipment benefits oncology and telephone follow-up, anniversary cards, Medicine. The hospital provides the haematology patients, addressing their support groups, walking group and infrastructure to support this program. unique care, comfort and pressure care information sessions. Volunteers, under §§ Support to women with breast cancer. needs while at home. the guidance of staff, spend many hours To help relieve the cost and psychosocial ensuring all these activities occur and §§ Meditation Group for oncology and stressors experienced by women with records are maintained. haematology patients and their carers. breast cancer. Support and funding of The hospital runs a free, weekly §§ Members of the Pastoral Care team a Breast Care Nurse is provided by the meditation group. Sessions are designed provide a significant number of McGrath Foundation who works with the to be simple, enjoyable and practical, community talks and education sessions hospital's service in provision of care for whilst providing support to those who throughout the year without charge. women. have had a diagnosis of cancer and to Topics include: spirituality, grief and loss, §§ Multicultural Week. By raising their carers. and communication at the end of life. awareness about different cultures, Four times a year, at the beginning of §§ The hospital’s volunteer program staff are educated on the contribution each season, a Remembrance Service provides training for volunteers who that all people in the community can is held in the Mary Potter Chapel work throughout the hospital in a variety achieve. The hospital promotes and for relatives of deceased patients. of departments and wards. Volunteers in manages a number of activities to foster Volunteers provide valuable support, partnership with the caring team, work multicultural harmony in the hospital whether through music, hospitality, or towards the mutual aims of providing and the community. providing morning tea. The Seasons for

2015/2016 Calvary Mater Newcastle Review of Operations | 47 §§ Fig Tree Program. The project aims to afford an opportunity help ensure the development of more effective treatments for for palliative care inpatients and outpatients to participate cancer. in activities that are communal. Occupational Therapy staff §§ The hospital hosts the ANZ Breast Cancer Trials Group (ANZBCTG) established that many palliative care patients have an enhanced onsite. This group occupies these facilities rent free as part quality of life when provided with a range of activities in of the hospital's commitment to improving care of patients in conjunction with other patients. the region. The ANZBCTG is the largest independent, oncology §§ Palliative Care PEPA. Program of Experience in the Palliative clinical trials, research group in Australia and New Zealand. Approach (PEPA). For example, this year workshops aimed to §§ The provision of wigs to patients who have lost their hair as a explore the meaning, and review strategies and management of, result of their cancer treatment. This is a free service that assists the behavioural and psychological symptoms of dementia (BPSD) with the wellbeing of patients. at the end of life. Sharing information with the community §§ Assisting with subsidised accommodation in The Villas and as well as networking, community engagement and building McAuley Lodge for patients and carers from remote, rural and relationships. regional areas, who are required to come to the hospital for §§ Facilitating and hosting Hunter Primary Care GP Access After cancer treatment. The accommodation offers discounted rates Hours Service. Calvary Mater Newcastle's partnership with from commercial comparisons and helps alleviate some of the Hunter Primary Care in hosting an after-hours GP service for pressure and stress on families while receiving care. patients in the community. Includes provision of facilities, §§ Provided a number of funerals for those patients who died in the infrastructure, security, parking and IT equipment to host the hospital without access to financial resources. service at no charge to Hunter Primary Care. §§ Organised a Christmas Giving Tree on behalf of St Vincent de Paul §§ Treatment of patients who do not qualify for Medicare Benefits and encouraged staff to make donations of new toys, games and Schedule. The hospital treats people living or travelling in the other gifts for the disadvantaged in the community. local area who are not covered by Medicare (ineligible patients) and require necessary medical care to stabilise their condition §§ Organised a ‘Bra Drive’ on behalf of the Uplift Project. More and have no financial means to pay for health care. than 2,000 bras were collected to be distributed to women in communities including Fiji, Papua New Guinea, Philippines, Bali, §§ Provision of supplies at cost to Mercy Community Health Care to Cambodia and Sri Lanka. enable community work. No margin or overhead is applied for provision of this service. §§ Information stands in the hospital’s main foyer for stakeholder profile raising and/or fundraising purposes. Stakeholders §§ The hospital hosts the Trans Tasman Radiation Oncology Group include: HNE Carer Education and Support Program, Leukaemia (TROG) onsite. TROG occupies these facilities rent free as part of Foundation, Cancer Council, CanTeen, Legacy and McGrath the hospital’s commitment to improving care of patients in the Foundation, to name but a few. region. TROG Cancer Research is Australia and New Zealand's specialist clinical research group for cancers that can be treated §§ As part of the hospital’s Foyer Series, staff hosted a number with radiotherapy. TROG is a cooperative organisation dedicated of information stands throughout the year to educate and to the control of a wide range of cancers through quality multi- inform patients and visitors to the hospital. Examples include: centre research. Heart Week, National Stroke Week, World Hand Hygiene Day, World Cancer Day, Medical Research Week and Breast Cancer §§ Hunter Cancer Research Alliance (HCRA). Infrastructure provided Awareness Day. rent free. HCRA is a cooperative multidisciplinary organisation dedicated to the control of a wide range of cancers through §§ Ongoing coordination of education and heritage tours of the quality multi-centre research. HCRA provides the infrastructure hospital for interested community members, including fundraiser and governance for national and international collaborations to groups, local organisations, scout groups, schools and the Mater Graduate Nurses' Association.

48 | 2015/2016 Calvary Mater Newcastle Review of Operations Mission

Calvary Mater Newcastle's mission is to bring the healing ministry of Jesus to all those who are sick, dying and in need through ‘being for others’. This is the reason Calvary Mater Newcastle exists and it is central to all of its activity at the hospital. Mission provides Calvary Mater Newcastle with focus and direction in order to provide the range of services that meet the needs of the community. All staff witness this mission through their engagement with patients, family members and visitors, as well as through their relationships with their colleagues. This mission is exemplified by the commitment and action of each staff member to living out the values of Hospitality, Healing, Stewardship and Respect. Venerable Mary Potter was the Foundress of Little Company of Mary in 1877 and it is her legacy that is foundational to the continuing work of Little Company of Mary Health Care. To celebrate the birthday of Mary Potter (22 November 1847), an ecumenical service was held on 19 November 2015 in the Mary Potter Chapel. Staff were delighted to welcome Sr Kathleen Cotterill LCM as a guest for the day. Of special significance was her opportunity to sit with the students from the Pastoral Placement Program (Maitland-Newcastle Diocese) who were present for the last day of a six-day placement with the Pastoral Care Department. Sr Kathleen explored with the students the links between the vision of Venerable Mary Potter, the work of Calvary Mater Newcastle and the health needs of the local community. Later Sr Kathleen joined the staff at the celebratory BBQ lunch. An important achievement this year was the appointment of a Director of Mission in March 2016. Mary Ringstad was the successful candidate and moved into her new role from her position as Pastoral Care Manager. Mary continues to work closely with her colleagues across Calvary under the guidance and direction of the National Director of Mission, Mark Green. Mission Education Mission education continues to be an important focus of life at Calvary Mater Newcastle. The orientation of new staff includes a mission and values session that introduces the staff to Calvary and its values. Other examples of opportunities for education include the leading of reflections at the Senior Staff Forums, presentations at three onsite ethics forums each year, teaching on spiritual care of the dying which is integrated into the on-site program for medical students, and the annual Registered Nurse Certificate Course in Palliative Care. An important focus for Mission has been the completion in June 2016 of a Cultural Safety Audit. The aim of the project was to investigate the experience of patients from both Aboriginal and Culturally and Linguistically Diverse (CALD) backgrounds at Calvary Mater Newcastle by engaging directly with them and their representatives in the community served by the hospital. Suze Smith, Social Worker, led the project with great skill and knowledge resulting in the establishment of some significant relationships with local community groups and health services. Calvary Mater Newcastle is now in a position to implement the 20 recommendations of the audit through two working parties established with representation from the Aboriginal and multicultural community and health services, as well as staff who are excited and committed to ensuring Calvary Mater Newcastle is a culturally safe place for all members of the community. Mission Accountability Framework Calvary now has a Mission Accountability Framework developed by the National Director of Mission in consultation with the Directors of Mission. This framework details the 12 focus areas for Mission, and the plan by which specific outcomes for each of these focus areas will be achieved.

2015/2016 Calvary Mater Newcastle Review of Operations | 49 The Public Private Partnership

Calvary Mater Newcastle’s Public Private Partnership (PPP) includes the financing, design, construction and commissioning of new buildings and refurbishment of existing buildings, facilities management and delivery of ancillary non-clinical services on the site until November 2033. These services are provided through the PPP by Novacare. Management of the PPP, including asset management services, is provided by the Plenary Group under the guidance of Novacare General Manager, Stuart Robson. The PPP continues to demonstrate strong relationships between the Novacare Consortium, Hunter New England Local Health District and Calvary Mater Newcastle. In addition, there is a clear demonstration of the ongoing delivery of high quality services to the hospital as detailed in the sections below. Novacare is looking forward to another exciting and challenging year in partnership with the management and team at Calvary Mater Newcastle.

Soft Services

Medirest proudly provides specialist food, §§ The hospital campus generated 63.1 providing an average of 5,502 customers retail, hospitality and support services to tonnes of clinical waste per week with high quality meals and patients across the entire Calvary Mater §§ 20,918 events were logged through the beverages in a number of environments. Newcastle campus. Help Desk These outlets include the Deli Marche café, Amigo-to-Go express/convenience store, Highlights for the Medirest team in 2015/16 §§ 88,736 phone calls and emails were as well as conveniently located coffee carts included: received by the Help Desk and vending outlets. §§ Introduction of a tablet-based §§ 33,858 deliveries were received via the environmental cleaning auditing loading dock Staff have responded to customer surveys by delivering a greater range of cooked café system that provides more powerful §§ 9,761,614 units of clinical items were items, together with a number of meal deal performance reporting distributed by Materials Management options. These have been very popular with §§ Continued outstanding performance of Catering Services visitors and staff. cleaning services within state-wide Bone Marrow Transplant audits - topping the The Catering Department provided a Help Desk state with 100% in the final audit monthly average of 32,320 high quality, hot The Help Desk provides a primary point of and cold meals, prepared on-site for Calvary §§ A new two-week cycle menu that communication for all requests regarding Mater Newcastle patients during 2015/16. incorporates improved recipe nutrition the delivery of all Novacare services onsite Working closely with Nutrition and Dietetics §§ “A” rating from NSW Food Authority 24 hours a day, seven days a week, 365 days staff, Medirest ensures extra care is taken License for patient catering operations a year. Sophisticated facilities management to provide special meals to patients who software provides a system for reporting §§ A 5 Star food safety rating from require specific diets and supplements. Newcastle City Council for all retail and responding to requests, incidents and To respond to patient feedback and outlets suggestions for improvements. On average nutritional needs, the team worked closely over the 2015/16 period, the Help Desk Service Statistics with the hospital dietitians to introduce received 7,395 calls and email requests §§ 387,841 meals were served to Calvary a new two-week cycle menu. The menu each month and logged 1,743 events. introduces a number of contemporary Mater Newcastle patients Customer satisfaction surveys are regularly dishes together with greater nutrition §§ The Security team attended 503 'Code carried out, inviting all hospital users to through recipe redevelopment. Blacks' within Calvary Mater Newcastle participate and offer their feedback on areas Retail the service. These surveys have allowed staff to respond to customer suggestions §§ The Reactive Cleaning team made Medirest-operated retail outlets continued for improvement, and they continue to 10,790 Calvary Mater Newcastle beds to prove popular across the hospital, strive for greater efficiency and open

50 | 2015/2016 Calvary Mater Newcastle Review of Operations communication with customers. The and a monthly average of 5.3 tonnes of During 2015/16 the team responded to an department's overall satisfaction rating clinical waste was removed from the site. average of 42 'Code Black' incidents per increased to over 80%. Medirest continues to introduce month within Calvary Mater Newcastle Cleaning and Environmental innovations to raise the cleaning standard areas. Services in the hospital. The new tablet-based Materials Management environmental cleaning auditing system Medirest’s Cleaning and Environmental The Materials Management Department provides powerful reporting that pinpoints Service solution comprises scheduled provides an efficient, high-quality service areas of improvement. The team has again cleaning, reactive cleaning, periodic and for the receipt and distribution of materials been acknowledged and recognised as best project cleaning, in addition to a complete throughout the hospital, including clinical in class for its cleaning services within state- waste management program. The success supplies, general consumables and hospital wide Bone Marrow Transplant audits when of the Cleaning and Environmental Service mail. compared with similar facilities. is based on a deep understanding of the On behalf of Calvary Mater Newcastle, the Security critical importance of delivering cleaning, department maintains supply of a wide domestic and waste management The Medirest Security team provides range of items required in clinical areas. (environmental) services to Calvary Mater efficient and quality security escort and During 2015/16, the department issued Newcastle in a collaborative approach by response services around the clock across 9,761,614 units of clinical items to hospital working closely with Clinical and Infection the Calvary Mater Newcastle site. The team wards and achieved a unit accuracy rating Control Units. is responsible for the safe response to of 91.1% in the annual stocktake. Reactive cleaners made an average of 899 internal incidents and the security of people beds per month over the 2015/16 period, and property.

Hard Services

The Honeywell Facility Management upgrade to aluminium construction and they share a commitment to health, safety team has had a busy year with a number the installation of roof cladding makes and environment. of projects being completed throughout the space cooler and more comfortable, Honeywell has maintained focus on 2015/16 including: and has enabled the area to be opened working at heights safety during 2015/16. § Painting and refurbishment projects: up and created more space, in particular Additional safety systems have continued to for those with less mobility. - New Med II Stairs be installed and enhanced. In partnership § The Mental Health Centre has seen with contractors, Honeywell has guided - Internal common areas of Mental upgrades to the staff station's flooring. contractors so that they have adopted Health Administration, This has consisted of replacing the Honeywell’s high standards regarding Wards 4C, 5C and 5E carpet with vinyl to all departments working at heights training. This is also - Internal and external Hospice within the Mental Health Centre. consistent with Honeywell’s ongoing § New Med air compressor upgrade to a During 2015/16, Honeywell received 7,694 commitment to training onsite. high efficiency, low maintenance and events (compared to 6,323 in 2014/15). Building and Maintenance low noise unit. The rectification times indicates that Services § Gardens upgrade and refurbishment 95% (compared to 88% in 2014/15) of all throughout the facility including Platt In addition to the 7,694 reactive events events raised through the Help Desk were Street, Hospice, Edith/Lorna Street, received during 2015/16, Honeywell has completed within 24 hours. Mental Health Administration and generated 1,410 programmed maintenance Villas. Removal of existing vegetation Safety events so that the building services are maintained to ensure reliability, safety and which consisted predominantly of During 2015/16, Honeywell implemented a longevity of the facility assets. native grasses. Increased irrigation and prequalification system in which contractors low maintenance plantings have been and suppliers meet and maintain minimum During 2015/16, Honeywell undertook a installed. An added feature is the colour insurance, regulatory and safety terms site-wide review of the tree plantings. that welcomes visitors to the facility. and conditions to work for Honeywell. This Selected Banksia trees were earmarked for § The nurse call system located in HAPS process includes the gathering, verification, removal, not requiring council approval, Department on New Med Level 3 and management of contractor and and this was implemented swiftly. Other was upgraded. The over door lights, supplier information such as certificates trees identified to be removed, required pendants, buzzers and installation of of insurance, safety programs, training prior council approval. Once received, these emergency call points were enhanced as and other documents that are required as trees were also removed. The tree removal part of this upgrade. part of the contract process. This ensures was the first step towards the Gardens § Upgrade to the barbeque and seating Honeywell employs the best contractors Enhancement Program. outdoor shelter at the Hospice. The and suppliers available and ensures that

2015/2016 Calvary Mater Newcastle Review of Operations | 51 52 | 2015/2016 Calvary Mater Newcastle Review of Operations Activity and Statistical Information

ADMITTED PATIENTS 2015/2016 2014/2015

Total Admissions (includes Same Day) 16,937 16,391 Same Day Admissions 5,322 4,978 Average Length of Stay of Admitted Patients 3.7 3.7 Bed Occupancy Rate 93% 92%

Number of Operations 3,162 3,069

EMERGENCY DEPARTMENT

Number of Attendances (includes Admitted Patients) 35,290 34,365 Number of Admissions via Emergency Department (ED) 11,818 11,297

OUTPATIENT SERVICES (EXCLUDES ED) 342,029 309,206

Total FTE Staff Employed 30 June 980 967

2015/2016 Calvary Mater Newcastle Review of Operations | 53 Year in Review

54 | 2015/2016 Calvary Mater Newcastle Review of Operations Year in Review

2015/2016 Calvary Mater Newcastle Review of Operations | 55 Year in Review

56 | 2015/2016 Calvary Mater Newcastle Review of Operations Year in Review A Snapshot of our Year

The Dietetics Service was involved in the care of more than 2,380 inpatients and 800 oncology outpatients, with more than 4,740 and 2,760 occasions of service provided respectively 16,937 The Coronary Care patients were Unit treated a admitted to hospital total of 658 The 12-bed Emergency Short patients, Stay Unit cared for averaging 4,827 55 patients patients per month 342,029 occasions of outpatient services were provided to our community The Haematology Day Ward 5D treated more than The Alcohol and Drug Clincal Services Unit 10,125 provided assessment, patients counselling, treatment and support to more than ...occured through

9,360 the Haematology 7,124 patient visits outpatients 35,290 Outpatient Clinics patients were cared for by our Emergency Department

The Intensive Care Unit provided The Department of specialist care to Consultation-Liaison Psychiatry consulted on 411 Our wonderful 1,235 volunteers donated patients individual inpatients, delivering over 3,200 8,570 occasions of service hours of their of which 50% were valuable time ventilated

The Operating Theatre Suite 387,841 The Department of performed meals were served to Medical Oncology delivered 3,410 our patients 25,506 procedures, of occasions of service which 724 were urgent

Our dedicated Auxiliary members raised 1,038 patients were treated $321,954.97 by the Hunter Area this equates to $14,310 being raised Toxicology Service per member

2015/2016 Calvary Mater Newcastle Review of Operations | 57 58 | 2015/2016 Calvary Mater Newcastle Review of Operations Research and Teaching Reports

A Message from the Research Committee

The Calvary Mater Newcastle Research appreciated contributions came to an end capable hands of Dr Jennette Sakoff. Her Committee (CMNRC) acts as a during 2015/16: passion for research and natural leadership representative of all Calvary Mater §§ Lisa Lincz, Chairperson qualities will make her an excellent Newcastle researchers, providing a means Chairperson. I look forward to working with §§ Kylie Murchie, Administration Assistant of disseminating information and offering her and the rest of the committee, as a support for research activities. One of the §§ Jane Maguire, Nursing Representative member, for many more years to come. - Academic goals of the committee is to showcase Conjoint A/Prof Lisa Lincz, PhD and promote the vast array of outstanding The committee would also like to welcome research being conducted the following new Chairperson and member Message from the Incoming by Calvary Mater Newcastle staff. The to the committee: Chairperson main medium for this is now the research §§ Jennette Sakoff, Chairperson On behalf of the CMNRC I would like to website, www.calvarymater.org.au/research. §§ Crystal Tindall, Administration Assistant take this opportunity to acknowledge the Since its inception in June 2013, the website dedication and tireless effort of Lisa in has regularly received more than 100 new Message from the Outgoing Chairing the Research Committee for the visitors each week. It contains biographies Chairperson last 10 years. We are eternally indebted of more than 40 researchers, and is After much deliberation, I decided to step to Lisa for her professionalism and drive regularly updated with research stories, down from the position of Chairperson to foster and maintain quality research at grant outcomes, and highlights from the for the CMNRC. I have thoroughly enjoyed Calvary Mater Newcastle. Thus, it is with quarterly Research Committee meetings. working with the committee members heartfelt thanks that we acknowledge It has also generated some generous over the past 10 years and feel we have Lisa’s contribution. As we move forward donations in memory of past patients, often achieved great things together. Their into a new phase of the CMNRC, it is an accompanied by touching recollections and enduring dedication and enthusiasm is a honour for me to step into the position expressions of immense gratitude for the valuable asset to this organisation and I of Chairperson. I aspire to bring the same care and compassion provided by staff at would like to personally thank them for all level of professionalism to Calvary Mater Calvary Mater Newcastle. of their support. My term has been both Newcastle and to build upon the legacy of The committee would like to take this challenging and rewarding, but the time has the CMNRC. opportunity to thank the following come for some new ideas and energy. I am Dr Jennette Sakoff, PhD members whose valuable and much confident leaving the position in the very

Research Grants

The CMN Research Committee received 15 The remaining three high-quality (Funding Allocation Panel). None of the applications for funding in 2016, requesting applications were ranked and placed members of the Funding Allocation Panel $385,506 from a total of $152,500 available on a waiting list in the event that the were listed as investigators on any of funding. Only one of these was solely for recommended grant recipients secured the grant applications. The six external equipment funding, while two others had alternative funding. Overall there were reviewers, along with the two head and equipment components included within five applications considered unsuitable for neck specialists, submitted their scores the project proposals, totalling $23,684 funding in their current form. and comments to the Chairperson of the requested from a pool of $33,500 from As per the terms of reference for grants Research Committee, who then met with the Coalfields Cancer Support Group Fund. review, when grant applications in any the Funding Allocation Panel on Tuesday Three applications were eligible for the one round exceed 10, all grants were 6 October 2015 to prioritise applications James Lawrie Grant (requesting $71,045 independently reviewed by two expert based on collated review scores and from $60,000 available). Overall, $118,448 specialist reviewers who were external to comments provided. All agreed on the final in project and $14,884 in equipment the CMN Research Committee for each of rankings and determined the allocation of funding was awarded (total = $133,332). the specialist areas of radiation oncology, funds against the individual bequest criteria. Although there were eight applications of medical oncology and qualitative research. The committee would like to acknowledge very high quality, only five could be funded, In addition, the three applications for and thank the assessors for their time and and the panel recommended they be fully James Lawrie funding were also assessed commitment to providing expert scientific funded, leaving a surplus of only $18,616 in by two independent head and neck cancer reviews and invaluable advice for funding the Coalfields fund and nominal amounts specialists. The Chairperson and two distribution. in other funds. These unused funds will be members of the CMN Research Committee held over for allocation in a future year for a were nominated to read and be able to suitable grant. provide comment on all 15 applications

2015/2016 Calvary Mater Newcastle Review of Operations | 59 SUCCESSFUL PROJECT AND 6. Buckley N.A., Dawson A.H., Juurlink D.N., 20. Isbister G.K. Risk assessment of drug- EQUIPMENT GRANTS AWARDED Isbister G.K. Who gets antidotes? Choosing induced QT prolongation. Aust. Prescr. FOR FUNDING BY THE RESEARCH the chosen few. Br. J. Clin. Pharmacol. 2015;38(1):20-24. COMMITTEE IN 2016 2016;81(3):402-407. 21. Isbister G.K., Buckley N.A. Therapeutics Coalfields Cancer Support Group 7. Calver L., Page C.B., Downes M.A., et al. The in clinical toxicology: In the absence Equipment Grant Safety and Effectiveness of Droperidol for of strong evidence how do we choose Sedation of Acute Behavioral Disturbance between antidotes, supportive care and Madhu Garg, Jennette Sakoff – Medical in the Emergency Department. Ann. Emerg. masterful inactivity. Br. J. Clin. Pharmacol. Oncology Med. 2015;66(3):230-238. 2016;81(3):408-411. "Essential Equipment for Smooth and Consistent 8. Chaisakul J, Isbister GK, O'Leary MA, et al. 22. Isbister G.K., Calver L., Downes M.A., Operation of Medical Oncology Laboratory Prothrombin activator-like toxin appears to Page C.B. In reply. Ann. Emerg. Med. Research" mediate cardiovascular collapse following 2016;67(1):146-147. Kerrie Clover, Chris Wratten, Ben Britton, Greg envenoming by Pseudonaja textilis. Toxicon. Carter - Psycho-Oncology/Radiation Oncology 23. Isbister G.K., Calver L.A., Downes M.A., 2015;102:48-54. Page C.B. Ketamine as Rescue Treatment for "Early identification of patients likely to 9. Chan B.S., Isbister G.K., O'Leary M., Chiew Difficult-to-Sedate Severe Acute Behavioral experience procedural anxiety during radiation A., Buckley N.A. Efficacy and effectiveness Disturbance in the Emergency Department. therapy for head and neck cancer: Clinical of anti-digoxin antibodies in chronic digoxin Ann. Emerg. Med. 2016;67(5):581-587e1. validation of a screening questionnaire for head poisonings from the DORA study (ATOM-1). and neck cancer" 24. Isbister G.K., Maduwage K., Saiao A., et al. Clin. Toxicol. 2016;54(6):488-494. James Lawrie Grant Population pharmacokinetics of an Indian 10. Chiew A., Raos M.P., Isbister G.K. Sub- F (ab')2 snake antivenom in patients with Kerrie Clover, Chris Wratten, Ben Britton, Greg mammary injection of ropivacaine resulting Russell's viper (Daboia russelii) bites. PLoS. Carter - Psycho-Oncology/Radiation Oncology in severe toxicity with seizures. EMA Emerg. Negl. Trop. Dis. 2015;9(7):no pagination. "Early identification of patients likely to Med. Australas. 2016;28(2):246-247. experience procedural anxiety during radiation 25. Isbister G.K., Maduwage K., Scorgie F.E., et therapy for head and neck cancer: Clinical 11. Chiew A.L., Isbister G.K., Duffull S.B., al. Venom concentrations and clotting factor validation of a screening questionnaire for head Buckley N.A. Evidence for the changing levels in a prospective cohort of russell's and neck cancer" regimens of acetylcysteine. Br. J. Clin. viper bites with coagulopathy. PLoS. Negl. Pharmacol. 2016;81(3):471-481. Trop. Dis. 2015;9(8):no pagination. Peter Greer, John Simpson, Richard Middleton - Radiation Oncology 12. Chiew AL, Fountain JS, Graudins A, 26. Isbister G.K., Sellors K.V., Beckmann "Using real-time patient treatment verification Isbister GK, Reith D, Buckley NA. Summary U., Chiew A.L., Downes M.A., Berling I. system to evaluate clinically significant dose statement: new guidelines for the Catecholamine-induced cardiomyopathy delivery discrepancies" management of paracetamol poisoning in resulting from life-threatening funnel- Jane Reid Harle Memorial Grant Australia and New Zealand. Med J Aust. web spider envenoming. Med. J. Aust. 2015;203(5):215-8. 2015;203(7):302-304. Jennette Sakoff, Jayne Gilbert - Medical Oncology 13. Cohen A., Pattanaik S., Kumar P., et al. 27. Isbister GK, Downes MA, Mcnamara K, Organised crime against the academic Berling I, Whyte IM, Page CB. A prospective "Selectively targeting breast cancers" peer review system. Br. J. Clin. Pharmacol. observational study of a novel 2-phase Margaret Mitchell Grant 2016;81(6):1012-1017. infusion protocol for the administration of Mike Fay, Jennette Sakoff – Radiation Oncology/ 14. Cowan T, Gibson R, Berling I. Endoscopic acetylcysteine in paracetamol poisoning. Medical Oncology Treatment of Upper Gastrointestinal Clin Toxicol (Phila). 2016;54(2):120-6. "Enhancing the effect of radiation treatment in Obstruction After Ingestion of Illicit Drug 28. Isbister GK, Gault A, Tasoulis T, O'Leary brain cancer patients" Packets. Clin Gastroenterol Hepatol. MA. A definite bite by the Ornamental 2015;13(7):e65-6. Snake (Denisonia maculata) causing Department Research 15. De Boer A., Cohen A.F., Ferro A., et al. mild envenoming. Clin Toxicol (Phila). 2016;54(3):241-4. CLINICAL TOXICOLOGY AND Editors' report for 2015, December 2015. PHARMACOLOGY Br. J. Clin. Pharmacol. 2016;81(1):6-7. 29. Isbister GK, Maduwage K, Saiao A, et al. Population Pharmacokinetics of an Indian REFEREED JOURNAL ARTICLES 16. Downes M.A., Berling I.L., Mostafa A., F(ab')2 Snake Antivenom in Patients with 1. Berling I, Isbister GK. Prolonged QT Risk Grice J., Roberts M.S., Isbister G.K. Acute Russell's Viper (Daboia russelii) Bites. PLoS Assessment in Antipsychotic Overdose behavioural disturbance associated with Negl Trop Dis. 2015;9(7):e0003873. Using the QT Nomogram. Ann Emerg Med. phenibut purchased via an internet supplier. 2015;66(2):154-64 Clin. Toxicol. 2015;53(7):636-638. 30. Isbister GK, Maduwage K, Scorgie FE, et al. Venom Concentrations and Clotting Factor 2. Berling I, Isbister GK. The Half RR 17. Downes M.A., Taliana K.E., Muscat T.M., Levels in a Prospective Cohort of Russell's Rule: A Poor Rule of Thumb and Not Whyte I.M. Sodium azide ingestion and Viper Bites with Coagulopathy. PLoS Negl a Risk Assessment Tool for QT Interval secondary contamination risk in healthcare Trop Dis. 2015;9(8):e0003968. Prolongation. Acad Emerg Med. workers. Eur. J. Emerg. Med. 2016;23(1):68- 2015;22(10):1139-44 70. 31. Isbister GK, Poklis A, Poklis JL, Grice J. Beware of blotting paper hallucinogens: 3. Berling I., Buckley N.A., Isbister G.K. The 18. Ediriweera D.S., Kasturiratne A., severe toxicity with NBOMes. Med J Aust. antipsychotic story: changes in prescriptions Pathmeswaran A., et al. Mapping the Risk 2015;203(6):266-7e.1 and overdose without better safety. Br. J. of Snakebite in Sri Lanka - A National Survey Clin. Pharmacol. 2016;:249-254. with Geospatial Analysis. PLoS. Negl. Trop. 32. Johnston C., Ryan N.M., Isbister G.K. Sea Dis. 2016;10(7):no pagination. snake envenoming in Australia causes 4. Buckley N.A., Dawson A.H., Isbister myotoxicity, local effects and non-specific G.K. Serotonin syndrome. Praxis. 19. Gulati A, Faed JM, Isbister GK, Duffull SB. systemic symptoms (ASP-24). Clin. Toxicol. 2014;103(17):1031-1041. Application of Adaptive DP-optimality to Design a Pilot Study for a Clotting 2016;54(4):511. 5. Buckley N.A., Dawson A.H., Isbister G.K. Time Test for Enoxaparin. Pharm Res. 33. Johnston C., Silva A., Siribaddana S., Ryan Treatments for paracetamol poisoning. BMJ 2015;32(10):3391-402. N.M., Maduwage K., Isbister G.K. Sri Lankan (Online). 2016;353:no pagination.

60 | 2015/2016 Calvary Mater Newcastle Review of Operations Russell's viper envenoming causes mild Toxicol (Phila). 2016;54(2):152-4. myotoxicity. Clin. Toxicol. 2016;54(4):480- 47. Prior FH, O'Hara K, Whyte IM. Best practice 481. aminoglycoside monitoring. Intern Med J. 34. Klein-Schwartz W., Stassinos G.L., Isbister 2015;45(7):791-2. G.K. Treatment of sulfonylurea and 48. Ryan N.M., Downes M.A., Isbister G.K. insulin overdose. Br. J. Clin. Pharmacol. Clinical features of serum sickness after 2016;81(3):496-504. Australian snake antivenom. Toxicon. 35. Lim A.Y.L., Singh P.N., Isbister G.K. 2015;108:181-183. Severe rhabdomyolysis from red-bellied 49. Ryan NM, Isbister GK. Tramadol overdose black snake (Pseudechis porphyriacus) causes seizures and respiratory depression envenoming despite antivenom. Toxicon. but serotonin toxicity appears unlikely. Clin 2016;117:46-48. Toxicol (Phila). 2015;53(6):545-50. 36. Maduwage K, Buckley NA, de Silva HJ, 50. Ryan NM, Kearney RT, Brown SG, Isbister Lalloo DG, Isbister GK. Snake antivenom GK. Incidence of serum sickness after for snake venom induced consumption the administration of Australian snake coagulopathy. Cochrane Database Syst Rev. antivenom (ASP-22). Clin Toxicol (Phila). 2015;6:CD011428. 2016;54(1):27-33. 37. Maduwage K, O'Leary MA, Scorgie FE, et al. 51. Silva A, Maduwage K, Sedgwick M, et Detection of venom after antivenom is not al. Neuromuscular Effects of Common associated with persistent coagulopathy Krait (Bungarus caeruleus) Envenoming in a prospective cohort of Russell's viper in Sri Lanka. PLoS Negl Trop Dis. (Daboia russelii) envenomings. PLoS Negl 2016;10(2):e0004368. Trop Dis. 2014;8(12):e3304. 52. Silva A., Siribaddana S., Sedgwick M., et al. 38. Maduwage K.P., O'Leary M.A., Silva Neurotoxicity due to Sri Lankan Russell's A., Isbister G.K. Detection of snake viper envenomation is caused by a weak venom in post-antivenom samples by presynaptic neurotoxin. Clin. Toxicol. dissociation treatment followed by Enzyme 2015;53(7):640. Immunoassay. Toxins. 2016;8(5):no 53. Skinner K., Saiao A., Mostafa A., et al. pagination. Isoniazid poisoning: Pharmacokinetics 39. Maduwage K.P., Scorgie F.E., Lincz L.F., and effect of hemodialysis in a O'Leary M.A., Isbister G.K. Procoagulant massive ingestion. Hemodial. Int. snake venoms have differential effects in 2015;19(4):E37-E40. animal plasmas: Implications for antivenom 54. Whyte I., Buckley N., Dawson A. testing in animal models. Thromb. Res. Calcium channel blockers. Medicine. 2016;137:174-177. 2016;44(3):148-150. 40. Miller M, O'Leary MA, Isbister GK. Towards 55. Wijesinghe CA, Williams SS, Kasturiratne rationalisation of antivenom use in A, et al. A Randomized Controlled Trial of a funnel-web spider envenoming: enzyme Brief Intervention for Delayed Psychological immunoassays for venom concentrations. Effects in Snakebite Victims. PLoS Negl Trop Clin Toxicol (Phila). 2016;54(3):245-51. Dis. 2015;9(8):e0003989. 41. O'Hara K., Prior F.H., Whyte I.M. LETTERS Implementation of a centralised 1. Berling I, Isbister GK. In reply. Ann Emerg aminoglycoside monitoring service. J. Med. 2015;66(2):216-7. Pharm. Pract. Res. 2015;45(2):198-202. 2. Buckley N.A., Dawson A.H., Isbister G.K. 42. O'Hara K., Wright I.M.R., Schneider J.J., Authors' reply to Thomas and colleagues. Jones A.L., Martin J.H. Pharmacokinetics BMJ (Online). 2016;353:no pagination. in neonatal prescribing: Evidence base, paradigms and the future. Br. J. Clin. 3. Isbister GK, Calver L, Downes MA, Page CB. Pharmacol. 2015;80(6):1281-1288. In reply. Ann Emerg Med. 2016;67(1):146-7. 43. O'Leary M.A., Maduwage K., Isbister G.K. 4. Isbister GK, Page CB. Brown snake Detection of venom after antivenom envenoming: Why are we left in the dark?. administration is largely due to bound Clin Toxicol (Phila). 2015;53(9):925. venom. Toxicon. 2015;93:112-118. CONFERENCE PRESENTATIONS 44. Oxley SO, Dassanayake TL, Carter GL, et al. 1. Chiew A.L., Isbister G.K., Page C.B., Buckley Neurocognitive Recovery After Hospital- N.A. Massive paracetamol overdose: Treated Deliberate Self-Poisoning With An observational study. Clin. Toxicol. Central Nervous System Depressant 2016;54(4):429. Drugs: A Longitudinal Cohort Study. J Clin 2. Chiew A.L., James L.P., Letzig L.G., Isbister Psychopharmacol. 2015;35(6):672-80. G.K., Buckley N.A. Paracetamol-protein 45. Page C, Murtaugh RJ. Hypoglycemia adducts following acute paracetamol associated with oleander toxicity in a dog. J overdose. Clin. Toxicol. 2016;54(4):472. Med Toxicol. 2015;11(1):141-3. 3. Cooper J.M., Isbister G.K. Desvenlafaxine 46. Page CB, Mostafa A, Saiao A, Grice JE, overdose and the incidence of serotonin Roberts MS, Isbister GK. Cardiovascular toxicity, seizures and cardiovascular effects. toxicity with levetiracetam overdose. Clin Clin. Toxicol. 2015;53(7):708.

2015/2016 Calvary Mater Newcastle Review of Operations | 61 4. Cowan T., Foster R., Isbister G.K. Acute and to providing quality training to haematology this area of research. There are presently three chronic oesophageal injury following caustic registrars. Many of the staff hold conjoint PhD students associated with the laboratory. ingestions in a 25-year cohort. Clin. Toxicol. appointments with the University of Newcastle Researchers in the laboratory are also responsible 2016;54(4):376-377. and engage in teaching undergraduate medical for the processing of blood samples from CMN 5. Downes M., Bastick M., Cowie C., students and supervising biomedical student patients who participate in clinical trials and Roberts M.S., Isbister G.K. Methyl ethyl projects. The unit is fortunate to have strong donate tissue to the Australasian Leukemia ketone peroxide toxicity treated with community support and is grateful for all the and Lymphoma Group Tissue Bank. The group acetylcysteine. Clin. Toxicol. 2016;54(4):420. generous donations received in 2015/16. maintains strong collaborations with researchers HAEMATOLOGY CLINICAL TRIALS 6. Isbister G.K., Heppell S.P., Page C.B., Ryan internationally through the International Society N.M. Adult clonidine overdose: Prolonged Clinical Trial Coordinators: Michele Gambrill, on Thrombosis and Haemostasis, nationally bradycardia and central nervous system Tara Novak, Marguerite Hughes, William (School of Human Life Sciences, University of depression, but not severe toxicity. Clin. Whitbread-Brown and Nick Stankovich Tasmania) and locally with the departments of Toxicol. 2016;54(4):450. Administrative Officers: Patricia Rozanski and Neurology (JHH), Endocrinology (JHH), Molecular and Cytogenetics (HNEH), Clinical Toxicology 7. Isbister G.K., Poklis A., Poklis J.L., Grice J. Emily Morris Pharmacology (CMN), Medical Oncology (CMN), Beware of blue pills and blotting paper Over the past year the Haematology Clinical Trials and the School of Biomedical Sciences and hallucinogens severe toxicity with NBOMe. Office has enrolled 128 participants to either Pharmacy (University of Newcastle). Clin. Toxicol. 2015;53(7):685-686. clinical trials, disease database registries and/ or The Australasian Leukaemia and Lymphoma COLLABORATION WITH PRIORITY RESEARCH 8. Jayaweera D.S., Islam S.A.K.M., Gunja N., Group (ALLG) Tissue Bank. The year 2015/16 has CENTRE FOR HEALTH BEHAVIOUR et al. Severe poisoning after ingestion of seen 10 new clinical trials activated to total 21 Anoop Enjeti, Philip Rowlings, Michele Gambrill, chloroform. Clin. Toxicol. 2016;54(4):420. currently recruiting trials and a further 16 trials Alix Hall, Christine Paul 9. Johnston C., Ryan N.M., Isbister G.K. Sea with participants in the follow-up phase. The The Hunter Haematology Research Group has snake envenoming in Australia causes open trials cover a wide range of haematological a number of initiatives undertaken with the myotoxicity, local effects and non-specific conditions both in acute and chronic diseases. Priority Research Centre for Health Behaviour, systemic symptoms (ASP-24). Clin. Toxicol. Of the 37 open trials/registries (including Faculty of Health, The University of Newcastle & 2016;54(4):511. those open to recruitment and those closed Hunter Medical Research Institute. The first of 10. Michael A.P., Mostafa A., Cooper J.M., Grice to recruitment but with participants either on these to be completed was a systematic review J., Roberts M.S., Isbister G.K. Erratum: The treatment or in follow up) being managed in among haematological cancer patients looking pharmacokinetics and pharmacodynamics 2015/16, 17 are administered by the ALLG, 20 at rates of adherence to self-administered of severe aldicarb toxicity after overdose sponsored by pharmaceutical companies and/or cancer treatments and factors impacting on (Clinical Toxicology (2015) (1-3)). Clin. investigator initiated. their adherence. Other research studies and an Toxicol. 2015;53(7):788. The increasing complexity of pharmaceutical NHMRC grant proposal are currently underway. 11. Michael AP, Mostafa A, Cooper JM, sponsored trials and the administration required RESEARCH FUNDING Grice J, Roberts MS, Isbister GK. The to successfully manage them has warranted 1. 2016 Mark Hughes Foundation project pharmacokinetics and pharmacodynamics additional staff to the Haematology Trials Office grant. Defining and predicting clinical of severe aldicarb toxicity after overdose. this year. We welcomed Emily Morris to the toxicity in GBM patients undergoing Clin Toxicol (Phila). 2015;53(7):633-5. Haematology Clinical Trial Office team. temozolomide-radiation treatment: A 12. Miller M., O'Leary M.A., Isbister G.K. BONE MARROW STEM CELL TRANSPLANT multivariate study. J Lynam, J Sakoff, J Rationalisation of antivenom use in RESEARCH Martin, L Lincz, M Fay, G C Marchett, P funnel-web spider envenomation: Philip Rowlings, Louisa Brown, Hong Zhang, Galettis. $25,000 Enzyme immunoassays for venom and Linda Bisset, Geordie Zaunders 2. 2015 Maitland Cancer Appeal Group. antivenom concentrations. Clin. Toxicol. Patient transplant data are reported to the Grant of $100,000 to support research 2015;53(7):644-645. Australian Bone Marrow Transplant Recipients into leukaemia, Myeloma, Lymphoma and 13. Page C.B., Rosek T., Roberts M.S., Isbister Registry (ABMTRR) as part of Australian BMT related disorders being conducted by the G.K. Severe toxicity with triclopyr overdose: research and development. These data are also Hunter Haematology Research Group. A case report. Clin. Toxicol. 2016;54(4):421. part of the Asia Pacific Bone Marrow Transplant CONFERENCE PROCEEDINGS 14. Page C.B., Ryan N.M., Isbister G.K. The use (APBMT) group research group. The CMN Unit HAA-ASTH 2015, 18- 21 Adelaide, SA and safety of high-dose insulin euglycaemia is the lead site on the ethics application for data 1. Dyer G, Larsen S, Gilroy N, Brice L, Brown L, therapy in toxin-induced cardiac toxicity. collection of the NSW BMT Network, a subgroup Hogg M, Kabir M, Greenwood M, Moore J, Clin. Toxicol. 2016;54(4):481. of the Agency for Clinical Innovation (ACI) of Hertzberg M, Kwan J, Huang G, Tan J, Ward the Ministry of Health. Professor Rowlings is a 15. Twaddell S., Whyte I.M., Isbister G.K. Use of C and Kerridge I (2015) Secondary Cancers, member of the Scientific Advisory Committee octreotide as a novel treatment for insulin Cancer Screening Adherence and Health of Asia Pacific BMT Group (APBMT), and was overdose in a non-diabetic patient. Clin. Behaviours in Survivors of Allogeneic Blood appointed in March 2016 as a member of Toxicol. 2016;54(4):446-447. and Marrow Transplantation (BMT) in NSW. the board of Worldwide Blood and Marrow poster. 16. Wong L.Y., Wong A.Y., Rozek T., Roberts Transplant network (WBMT). 2. Dyer G, Gilroy N, Brown L, Hogg M, Brice L, M.S., Isbister G.K. Severe hypertension LABORATORY RESEARCH - THE HUNTER Kabir M, Greenwood M, Larsen S, Moore j, and bradycardia secondary to midodrine HAEMATOLOGY RESEARCH GROUP overdose. Clin. Toxicol. 2016;54(4):438 Hertzberg M, Kwan J, Huang G, Tan J, Ward Lisa Lincz, Fiona Scorgie, Anita Ariyarajah, C and Kerridge I (2015) Blood and Marrow HAEMATOLOGY Elisabeth Pearsall, Nadine Berry, Anoop Enjeti, Transplantation (BMT) Survivor Preference OVERVIEW Ritam Prasad, Philip Rowlings for Long Term Care in NSW. poster. The Haematology Unit engages in both clinical The Haematology Research Laboratory conducts 3. Lindsay J, Gilroy N, Kabir M, Dyer G, Brice L, and laboratory based research. Clinicians and studies into haematological cancers and disorders Greenwood M, Larsen S, Moore J, Hertzberg nurses are actively involved in research directed of coagulation, with a primary interest in M, Kwan J, Brown L, Klinkenberg M, Huang at improving patient care, while the department circulating microparticles. The laboratory is linked G, Tan J, Stevenson W and Kerridge I also supports dedicated laboratory and clinical to the University of Newcastle and offers tuition (2015) Complementary and Alternative trials teams. The staff specialists are committed and scholarships to encourage students to enter

62 | 2015/2016 Calvary Mater Newcastle Review of Operations Medicine Therapy (CAM) use by Allogeneic THE AUSTRALIAN SOCIETY FOR MEDICAL §§ Laboratory Science and MDS/AML Haematopoietic Stem Cell Transplant (HSCT) RESEARCH SATELLITE SCIENTIFIC MEETING, Subcommittee Australian Lymphoma and Survivorship Patients: Preliminary Results NEWCASTLE, AUSTRALIA, APRIL 2016 Leukemia Group (ALLG) from the Sydney Post-BMT Study. poster. 1. Kahl RGS, Smith AM, Murray HC, Flanagan Michael Seldon 4. Scholes T, Enjeti A, Ashraf A, Carr D HM, Panicker N, Lee EM, Lock RB, Enjeti AK, §§ VTE Guidelines Subcommittee HNEAH and Ahmad N (2015) Transfusional Iron Dun MD, Verrills NM. (2016) Inhibition of §§ Haemophilia Directors Committee Australia Overload in MDS: To Look or Overlook. Oncogenic Kinases Together with Activation poster. of Tumour Suppressing Phosphatases- a Cathie Milton 5. Alwan M and Enjeti A(2015) Synergistic Approach for Treatment of Acute §§ Cancer Council, reviewer for patient Thromboprophylaxis Decisions in Patients Myeloid Leukaemia (AML). information booklet with Multiple Myeloma- Review of Practice 2. Flanagan HM, Rigby CJ, Almazi JG, Kahl RGS, §§ BMT network, review for scholarship in a Single Centre. poster. Li X, Enjeti AK,Verrills NM and Dun MD program 6. Carville A, Enjeti A and Dunn E (2015) (2016) New Insights into the Mechanism PUBLICATIONS [1-20] Underpinning the Tumour Suppressor, Is VTE Prophylaxis Safe in Severe 1. Alkhatatbeh, M.J., N.M. Ayoub, N.M. Protein Phosphatase 2A (PP2A) Inhibition in Thrombocytopenia? poster. Mhaidat, N.A. Saadeh, and L.F. Lincz, Acute Myeloid Leukaemia. poster. 7. Fagan F, Rana M and Enjeti A (2015) VTE Soluble cluster of differentiation 36 3. Murray HC, Almazi JG, Kahl RGS, Flanagan Risk Assessment Haematology Admissions. concentrations are not associated with HM, Smith ND, Enjeti AK, Larsen MR, poster. cardiovascular risk factors in middle-aged Verrills NM and Dun MD (2016) Synergistic subjects. Biomed Rep, 2016. 4(5): p. 642-8. Berry N, Carville A Rowlings P 8. and (2015) Targeting of FLT3-Activated Signalling 2. Alkhatatbeh, M.J., L.F. Lincz, and R.F. Acute Lymphoblastic Leukaemia- the “Trap” Pathways in Acute Myeloid Leukaemia of Poor Metaphase Morphology. poster. Thorne, Low simvastatin concentrations (AML). poster. reduce oleic acid-induced steatosis in 9. Milton C, Walker M and Rowlings P 4. Sillar J, Murray HC, Flanagan HM, Kahl HepG2 cells: An in vitro model of non- (2015) Developing a Pathway to Improve RGS, Huang H, Larsen M, Enjeti AK, Verrills alcoholic fatty liver disease. Exp Ther Med, Psychosocial Support for Patients NM and Dun MD (2016) Reactive Oxygen 2016. 11(4): p. 1487-92. Undergoing Peripheral Blood Stem Cell Species Promote Leukaemogenesis; Altered 3. Dyer, G., N. Gilroy, J. Bradford, L. Brice, M. Harvest (PBSCH) and Autologous Stem Cell Signalling Pathways as New Drug Targets for Kabir, M. Greenwood, S.R. Larsen, J. Moore, Transplant (ASCT). poster. the Improved Treatment of Acute Myeloid M. Hertzberg, J. Kwan, L. Brown, M. Hogg, HUNTER CANCER RESEARCH SYMPOSIUM OF Leukaemia. poster. G. Huang, J. Tan, C. Ward, and I. Kerridge, HCRA HMRI NOVEMBER 2015 ASIA PACIFIC ASSOCIATION OF MEDICAL A survey of fertility and sexual health 1. Dun MD, Murray HC, Al-mazi J, Kahl RGS, TOXICOLOGY (APAMT) 14TH INTERNATIONAL following allogeneic haematopoietic stem Flanagan HM, Smith ND, Enjeti AK, Larsen SCIENTIFIC CONFERENCE, PERTH, AUSTRALIA, cell transplantation in New South Wales, MR and Verrills NM (2015) Identification DECEMBER 2015 Australia. Br J Haematol, 2016. 172(4): p. and Synergistic Targeting of FLT3-activated 1. Maduwage KP, Scorgie FE, Lincz LF, O’Leary 592-601. Pathways in Acute Myeloid Leukaemia. MA and Isbister GK (2015) Effect of 4. Dyer, G., N. Gilroy, L. Brown, M. Hogg, L. Ashraf A, Enjeti AK, 2. Hasnat M and Procoagulant Snake Venoms on Different Brice, M. Kabir, M. Greenwood, S.R. Larsen, Rowlings PA (2015) Assessment of Blood Animal Plasma. Oral presentation J. Moore, M. Hertzberg, J. Kwan, G. Huang, Transfusion Practices in Patients with ADVISORY/BOARD MEMBERSHIP J. Tan, C. Ward, and I. Kerridge, Erratum Myelodysplastic Syndromes in the Era of Philip Rowlings to: "What They Want: Inclusion of Blood Hypomethylating Agents. and Marrow Transplantation Survivor §§ Board of Directors, Australia Leukaemia and 3. Ashraf A, Enjeti AK, Hasnat M and Preference in the Development of Models Lymphoma Group Rowlings PA (2015) Assessment of of Care for Long-Term Health in Sydney, § Epidemiologic Profile o fPatients with § Board member, Worldwide Blood Marrow Australia" [Biol Blood Marrow Transplant Myelodysplastic Syndromes in Hunter Transplant Group 2016;22:731-743]. Biol Blood Marrow Region. poster. §§ Executive Committee, NSW BMT Network Transplant, 2016. of the Agency for Clinical Innovation, NSW 4. Carville A, Enjeti AK, Dunn E, Stephens 5. Dyer, G., N. Gilroy, L. Brown, M. Hogg, L. Health E, and Milton C (2015) Is VTE Prophylaxis Brice, M. Kabir, M. Greenwood, S.R. Larsen, Safe in Haematological Cancers Undergoing §§ Scientific Advisory Board of the Asia Pacific J. Moore, M. Hertzberg, J. Kwan, G. Huang, Autologous Transplantation. poster. Bone Marrow Transplant Group (APBMT) J. Tan, C. Ward, and I. Kerridge, What They 5. Rigby C, Kahl AK, Flanagan H, Li X, Lisa Lincz Want: Inclusion of Blood and Marrow Transplanation Survivor Preference in the Enjeti AK, Verrills N and Dun M (2015) §§ Outgoing Chairperson, CMN Research Characterisation of a Novel PP2A Inhibitory Committee Development of Models of Care for Long- Oncoportein in Acute Myeloid Leukaemia Term Health in Sydney, Australia. Biol Blood §§ Member, NSW Hunter New England Central (AML). poster. Marrow Transplant, 2016. 22(4): p. 731-43. Coast Research Hub Council 6. Garg M, Ackland S, McCluskey A, Scorgie FE, 6. Dyer, G., S.R. Larsen, N. Gilroy, L. Brice, Anoop Enjeti Lincz LF, McCluskey S, Gilbert J and Sakoff M. Greenwood, M. Hertzberg, M. Kabir, J (2015) The Protein Phosphatase Inhibitor §§ VTE Guidelines Subcommittee HNEAH L. Brown, M. Hogg, G. Huang, J. Moore, Cantharidin, Potentiates the Effect of All- §§ Treasurer and Executive Council member D. Gottlieb, J. Kwan, J. Tan, C. Ward, Trans Retinoic Acid in Acute Promyelocytic Australasian Society of Thrombosis and and I. Kerridge, Adherence to cancer Leukaemia Cells. poster. Haemostatis (ASTH) screening guidelines in Australian 7. Faulkner S, Lincz LF, McElduff P, Scott R, §§ Vascular Biology Subcommittee, survivors of allogeneic blood and marrow Thorne R, Walker M, Hondermarck H and International Society of Thrombosis and transplantation (BMT). Cancer Med, 2016. Hunter Cancer Biobank (2015) Comparing Haemostasis (ISTH) 5(7): p. 1702-16. Digital Versus Visual Scoring Methods for §§ Evidence Based Guidelines (EviQ) 7. Enjeti, A.K., K. Chapman, P.J. Taylor, and C. Immunohistochemical Staining: A Case Committee NSW Cancer Institute (NSW CI) Meldrum, Congenital late onset thrombotic Study in the Hunter Cancer Biobank. poster thrombocytopenic purpura: a diagnostic

2015/2016 Calvary Mater Newcastle Review of Operations | 63 challenge. Pathology, 2015. 47(6): p. 585-6. animal models. Thromb Res, 2016. 137: p. beyondblue. The service provides outreach- 8. Enjeti, A.K., A. D'Crus, K. Melville, N.M. 174-7. based, non-clinical follow-up to people who have Verrills, and P. Rowlings, A systematic 16. Phang, M., R.F. Thorne, M.J. Alkhatatbeh, been admitted to hospital after an episode of evaluation of the safety and toxicity of M.L. Garg, and L.F. Lincz, Circulating deliberate self-poisoning, in order to bridge the fingolimod for its potential use in the CD36+ microparticles are not altered by gap between hospital and community-based treatment of acute myeloid leukaemia. docosahexaenoic or eicosapentaenoic acid services. Service delivery is by staff employed Anticancer Drugs, 2016. 27(6): p. 560-8. supplementation. Nutr Metab Cardiovasc by Hunter Primary Care and seconded to Calvary Mater Newcastle. Consortium partners 9. Gifford, G., N. Gilroy, G. Dyer, L. Brice, M. Dis, 2016. 26(3): p. 254-60. include Hunter New England Mental Health Kabir, M. Greenwood, S. Larsen, J. Moore, 17. Smith, A.M., M.D. Dun, E.M. Lee, C. Services, Hunter Institute of Mental Health D. Gottlieb, M. Hertzberg, J. Kwan, G. Harrison, R. Kahl, H. Flanagan, N. Panicker, and Relationships Australia. Service delivery Huang, J. Tan, L. Brown, M. Hogg, C. Ward, B. Mashkani, A.S. Don, J. Morris, H. Toop, commenced in April 2016 and will conclude in and I. Kerridge, The experience of survival R.B. Lock, J.A. Powell, D. Thomas, M.A. October 2017. following allogeneic haematopoietic stem Guthridge, A. Moore, L.K. Ashman, K.A. cell transplantation in New South Wales, Skelding, A. Enjeti, and N.M. Verrills, The evaluation framework comprises three Australia. Bone Marrow Transplant, 2016. Activation of protein phosphatase 2A components: process measures (including service in FLT3+ acute myeloid leukemia cells uptake, reach and client quality measures), 10. Hall, A.E., C. Paul, J. Bryant, M.C. Lynagh, qualitative evaluation (including interviews and P. Rowlings, A. Enjeti, To enhances the cytotoxicity of FLT3 tyrosine and H. Small, discussions with patients and service providers adhere or not to adhere: Rates and reasons kinase inhibitors. Oncotarget, 2016. about their experiences of the service) and an of medication adherence in hematological B.K. Ross, 18. Toop, H.D., M.D. Dun, H.M. effectiveness evaluation (comparing rates of re- cancer patients. Crit Rev Oncol Hematol, Flanagan, N.M. Verrills, and J.C. Morris, presentation and admissions for deliberate self- Development of novel PP2A activators 2016. 97: p. 247-62. poisoning for the period during which the service for use in the treatment of acute myeloid 11. Iland, H.J., M. Collins, K. Bradstock, S.G. was available compared with historical controls). leukaemia. Org Biomol Chem, 2016. 14(20): Supple, A. Catalano, M. Hertzberg, P. Accredited Person Project: Mental Health Act p. 4605-16. Browett, A. Grigg, F. Firkin, L.J. Campbell, of NSW A. Hugman, J. Reynolds, J. Di Iulio, C. Tiley, 19. Dimopoulos, M.A., P. Moreau, A. Palumbo, Prior to 2003, only medical officers could write a K. Taylor, R. Filshie, M. Seldon, J. Taper, J. D. Joshua, L. Pour, R. Hajek, T. Facon, Mental Health certificate requiring a person to be Szer, J. Moore, J. Bashford, and J.F. Seymour, H. Ludwig, A. Oriol, H. Goldschmidt, L. involuntarily assessed at a defined mental health Use of arsenic trioxide in remission Rosinol, J. Straub, A. Suvorov, C. Araujo, facility with possible involuntary hospitalisation induction and consolidation therapy for E. Rimashevskaya, T. Pika, G. Gaidano, to follow. The Accredited Persons Program was acute promyelocytic leukaemia in the K. Weisel, V. Goranova-Marinova, introduced in New South Wales in 2003 and Australasian Leukaemia and Lymphoma A. Schwarer, L. Minuk, T. Masszi, I. provided provision for experienced non-medical Group (ALLG) APML4 study: a non- Karamanesht, M. Offidani, V. Hungria, A. mental health clinicians to be trained and randomised phase 2 trial. Lancet Haematol, Spencer, R.Z. Orlowski, H.H. Gillenwater, become Accredited Persons, with similar powers 2015. 2(9): p. e357-66. N. Mohamed, S. Feng, and W.J. Chng, and responsibilities in completion of Mental (P Rowlings collaborator) Carfilzomib 12. Kumar, R., F. Kimura, K.W. Ahn, Z.H. Hu, Health certificates under the Mental Health Act and dexamethasone versus bortezomib Y. Kuwatsuka, J.P. Klein, M. Pasquini, K. of NSW. A Clinical Nurse Consultant within the and dexamethasone for patients with Miyamura, K. Kato, A. Yoshimi, Y. Inamoto, Calvary Mater Newcastle’s Consultation-Liaison relapsed or refractory multiple myeloma T. Ichinohe, W.A. Wood, Jr., B. Wirk, M. Psychiatry Department was among the first group (ENDEAVOR): a randomised, phase 3, Seftel, P. Rowlings, D.I. Marks, K.R. Schultz, of Accredited Persons appointed by the program. open-label, multicentre study. Lancet Oncol, V. Gupta, L. Dedeken, B. George, J.Y. Cahn, This is a collaborative project with members from 2016. 17(1): p. 27-38. J. Szer, J.W. Lee, A.Y. Ho, A. Fasth, T. Hahn, Calvary Mater Newcastle, Hunter New England F.E. Scorgie, N. Khera, J. Dalal, C. Bonfim, M. Aljurf, Y. 20. Isbister, G.K., K. Maduwage, Mental Health Services and the University Comparing Outcomes Atsuta, and W. Saber, S. Shahmy, F. Mohamed, C. Abeysinghe, of Melbourne. A longitudinal cohort study with Bone Marrow or Peripheral Blood H. Karunathilake, M.A. O'Leary, C.A. comparing the clinical characteristics of people Stem Cells as Graft Source for Matched L.F. Lincz, enom Gnanathasan, and V referred for involuntary assessment, and the Sibling Transplants in Severe Aplastic Concentrations and Clotting Factor Levels in subsequent mental health facility admission Anemia across Different Economic Regions. a Prospective Cohort of Russell's Viper Bites rates, for people assessed by medical officers with Coagulopathy. Biol Blood Marrow Transplant, 2016. 22(5): PLoS Negl Trop Dis, or the Accredited Person after an episode of p. 932-40. 2015. 9(8): p. e0003968. deliberate self-poisoning and presentation to 13. Lim, M.S. and A.K. Enjeti, Safety of CONSULTATION-LIAISON Calvary Mater Newcastle between 2003 and anticoagulation in the treatment of PSYCHIATRY (INCLUDING 2013. venous thromboembolism in patients PSYCHO-ONCOLOGY SERVICE) Deliberate Self-Poisoning in Older Ages with haematological malignancies and CURRENT PROJECTS This is a 'Scholarly Project' for an Advanced thrombocytopenia: Report of 5 cases and Trainee in Old Age Psychiatry under the training literature review. Crit Rev Oncol Hematol, KADS (Ketamine for Adult Depression Study) requirements of the RANZCP. A longitudinal 2016. A NHMRC funded multi-centre RCT of cohort study comparing the clinical and service subcutaneous low-dose ketamine with 14. Lim, M.S., K. Lemmert, and A. Enjeti, use characteristics of middle aged (45-64 years) intermittent dosing over four weeks, given for Blastic plasmacytoid dendritic cell neoplasm and older (65+ years) adults who presented to treatment resistant depression. Recruitment will (BPDCN): a rare entity. BMJ Case Rep, 2016. Calvary Mater Newcastle after an episode of be for 200 participants and key endpoints are 2016. deliberate self-poisoning between 2003 and depression remission and suicidal ideation. The 15. Maduwage, K.P., F.E. Scorgie, L.F. 2013. trial duration will be two years. Lincz, M.A. O'Leary, and G.K. Isbister, Drug Induced Delirium The Way Back Project Procoagulant snake venoms have This is a 'Scholarly Project' for an Advanced The Way Back Support Service is an innovative differential effects in animal plasmas: Trainee in Consultation-Liaison Psychiatry under approach to suicidal behaviour, which is being Implications for antivenom testing in the training requirements of the RANZCP. A piloted in the Hunter region with funding from

64 | 2015/2016 Calvary Mater Newcastle Review of Operations longitudinal cohort study investigating which Memorial Research Grant). This is a longitudinal s13063-015-0978-5 drugs ingested in an episode of hospital-treated cohort study of men with localised prostate 4. Fernando I, Carter G. self-poisoning are independently associated cancer, which will examine their psychological A case report using the Mental State with delirium; and if delirium is associated with adjustment and quality of life over a 12 month Examination Scale (MSES): A tool for adverse secondary outcomes including ICU follow-up period after diagnosis and treatment measuring change in mental state. admission, length of stay in the general hospital selection. The study will close after final follow-up (Australasian Psychiatry 2016 vol. 24 no. 1 or discharge destination. in December 2016. 76-80). Effective psychological and psychosocial Early identification of patients likely to 5. Kristen McCarter, Ben Britton, Amanda approaches to reduce repetition of self-harm: a experience procedural anxiety during radiation Baker, Sean Halpin, Alison Beck, Gregory systematic review, meta-analysis and meta- therapy for head and neck cancer: Clinical Carter, Chris Wratten, Judy Bauer, Debbie regression. validation of a screening questionnaire Booth, Erin Forbes, Luke Wolfenden This is a collaborative project with members from This is a Calvary Mater Newcastle project funded Interventions to Improve Screening Calvary Mater Newcastle and the University of by a 2015/2016 Coalfields Cancer Support Group and Appropriate Referral of Cancer Melbourne. A systematic review, meta-analysis Equipment Grant and the James Lawrie Head and Patients for Distress: In Health Settings: and meta-regression to examine the efficacy of Neck Grant. To ensure accurate dose-delivery Systematic Review Protocol (BMJ psychological and psychosocial interventions during radiotherapy for head and neck cancer Open 2015;5:e008277. doi:10.1136/ to reduce repeat self-harm in adults. This study a tight-fitting mask is placed over the head and bmjopen-2015-008277) demonstrated that effective treatments are face to immobilise the patient. An important 6. Oxley SOC, Dassanayake TL, Carter G, Whyte now available to reduce repetition of self-harm sub-set of patients find this so anxiety-provoking I, Jones AL., Cooper G, Michie PT. and outlined some of the challenges for clinical that intervention is required and their treatment Neurocognitive recovery after hospital- implementation. can be disrupted. Successful interventions are treated deliberate self-poisoning with available, including anxiolytic medication and Accuracy of Suicide Risk Assessment Tools central nervous system depressant drugs: psychological treatment. However, the patient’s This is a collaborative project with members A longitudinal cohort study. (Journal of distress is often not evident until the day of the from Calvary Mater Newcastle, University of Clinical Psychopharmacology 35(6):672-680, procedure. This can cause delays in treatment for Newcastle, University of Melbourne and Monash December 2015.) University. It involves a systematic review and the patient, causes them distress and disrupts the 7. Milner A, Page A, Morrell S, Hobbs G, Carter meta-analysis identifying the accuracy of suicide efficient running of the linear accelerator used to GL, Dudley M, Duflou J, Taylor.R. risk assessment tools in predicting future suicidal provide radiation therapy. Social connections and suicidal behaviour behaviours. This study will provide important In a previous pilot study we identified five in young Australian adults: Evidence from information to clinicians in general hospital and questions which showed promise as a brief a case-control study of persons aged 18 to psychiatric settings, about the (in)accuracy of screening questionnaire to identify patients who 34 years in NSW, Australia. (Social Science these instruments and their unsuitability as the were more likely to experience session disruption & Medicine - Population Health. December basis for the allocation of after-care services. due to anxiety. In this proposed study we plan 2015:1, 1-7). Reported increases in young female hospital to test how well the screening questionnaire 8. Britton B, Baker A, Clover K, McElduff P, treated self-harm: real or artefact works in clinical practice to predict later anxious reactions and session disruption. If successful, Wratten C, Carter G. This is a collaborative project with members from this brief screening questionnaire could be Heads Up: A pilot trial of a psychological Calvary Mater Newcastle, Hunter New England used to flag patients who might need additional intervention to improve nutrition in head Mental Health Services and the University intervention for anxiety prior to sessions in the and neck cancer patients undergoing of Western Sydney. An observational study linear accelerator. Through early identification radiotherapy"( European Journal of Cancer comparing rates of hospital-treated self-harm at and management we hope to reduce disruptions Care 2016 DOI: 10.1111/ecc.12502) Calvary Mater Newcastle, a sentinel unit for the to treatment and improve patients’ quality of life. 9. Xu Y, Hackett M, Carter G, Loo C, Gálvez Newcastle, Lake Macquarie and Port Stephens This would also aid in the efficient management V, Glozier N, Glue P, Lapidus K, McGirr A, local government areas with national rates of access to the linear accelerator. Somogyi A,. Mitchell P, Rodgers A. reported by the Australian Institute for Health Effects of low-dose and very low-dose and Welfare. PEER REVIEWED PUBLICATIONS dose ketamine among patients with EAT (Eating as Treatment) 1. Lambert S.D, Clover K, Pallant J.F, Britton B, King M.T, Mitchell A, Carter G. major depression : a systematic review The research team is led by a team with members Making Sense of Variations in Prevalence and meta-analysis (International Journal from Calvary Mater Newcastle, University of Estimates of Depression in Cancer: A Co- of Neuropsychopharmacology April 2016 Newcastle and Queensland University. An Calibration of Commonly Used Depression 19(4): 1–15) NHMRC funded multi-centre stepped wedge Scales Using Rasch Analysis (Journal of the 10. Allison Milner, Matthew J Spittal, Nav Kapur, design trial that aimed to improve nutrition National Comprehensive Cancer Network Katrina Witt, Jane Pirkis, Greg Carter. in head and neck cancer patients undergoing 2015;13:1203-1211 July 2015) Mechanisms of brief contact interventions radiotherapy using psychological interventions. in clinical populations: a systematic review. Data collection is now complete. The preliminary 2. Clover KA, Britton B, Mitchell AJ, Carter G. (BMC Psychiatry. June 2016, 16:194. DOI: results demonstrate a significant improvement Why do oncology outpatients who report 10.1186/s12888-016-0896-4) in nutrition, a significant reduction in unplanned emotional distress decline help? (Psycho- admissions and radiotherapy treatment Oncology Jul 2015 24:7 812-818.) 11. Beck AK, Britton B, Baker A, Odelli C, interruptions. doi:10.1002/pon.3729 Wratten C, Bauer J, Wolfenden L, Carter G. Choosing Active Surveillance for localised 3. Beck, A.K., Baker, A., Britton, B., Wratten, C., Preliminary report: Training Head and prostate cancer: Psychological adjustment and Bauer, J., Wolfenden, L, Carter, G. Neck Cancer Dietitians in Behaviour Quality Adjusted Life Years Fidelity considerations in translational Change Counselling (Psycho-oncology 2016 (wileyonlinelibrary.com). DOI: 10.1002/ This is a collaborative project with members from research: Eating As Treatment — a stepped pon.4129) Calvary Mater Newcastle, Hunter Institute of wedge, randomised controlled trial of Medical Research and University of Newcastle. a dietitian delivered behaviour change 12. McKetin R, Dean O, Baker AL, Carter G, The study was funded by two 2012 Calvary counselling intervention for head and neck Turner A, Kelly PJ, Berk M. Mater Research Grants (Coalfields Cancer cancer patients undergoing radiotherapy, A potential role for N-acetylcysteine in Support Group Equipment Grant and Jane Reid Trials, October 2015 16:465 doi:10.1186/ the management of methamphetamine

2015/2016 Calvary Mater Newcastle Review of Operations | 65 dependence. Drug and Alcohol Review D., Forbes, D., Madden, S., Newton, R., Greg Carter. (Drug and Alcohol Review. 2016 Surgenor, L., Touyz, S., Ward, W., Zepf, F., Institute of Brain, Behaviour and Mental (wileyonlinelibrary.com). DOI: 10.1111/ Gray, C. and Fagermo, N. Health| Faculty of Medical & Human dar.12414 ) The 2014 RANZCP Clinical Practice Guideline Sciences, University of Manchester UK. 13. White J, Attia J, Sturm J, McElduff P, Carter Project and CPG for Eating Disorders December 2015 G, Parker Magin. Australian and New Zealand Journal of 8. Examining restrictive practice and the Predictors of quality of life in community Psychiatry. vol. 49 (S1), pp 29-30. 2015. culture of control: Evaluating the Accredited dwelling stroke-survivors: a cohort study 5. Britton, B., Baker, A., Bauer, J., Wolfenden, Person’s Program at the Calvary Mater (Family Practice, February 2016 online L., Wratten, C., McElduff, P. and Carter, Newcastle version doi:10.1093/fampra/cmw011) G. (2015). Eating As Treatment: A Jenni Bryant 14. Hossein Hassanian-Moghaddam, Saeedeh stepped wedge multi-centre trial of a Australian College of Mental Health Nurses’ Sarjami, Ali-Asghar Kolahi, Terry Lewin, psycho-nutrition intervention to improve Consultation Liaison Special Interest Group Gregory Carter. outcomes in head and neck cancer patients Annual Conference, Royal Prince Alfred Postcards in Persia: 12-24 month follow-up undergoing radiotherapy. Psycho-Oncology Hospital. June 2016 of a randomised controlled trial for hospital 24: 8. 9. Eating As Treatment (EAT): A stepped wedge treated deliberate self-poisoning. Archives CONFERENCE PRESENTATIONS randomised controlled trial to improve of Suicide Research 2016 http://dx.doi.org/ 1. Patient, Clinician and Systems Change: nutrition in head and neck cancer patients 10.1080/13811118.2015.1004473 Using Cognitive and Behavioural Strategies undergoing radiotherapy. 15. Clover KA, Oldmeadow C, Nelson L, Rogers to Improve Treatment Outcomes for Head Britton, B., Beck, A., McCarter, K., Baker, K, Mitchell AJ, Carter G. and Neck Cancer Patients Undergoing A., Wolfenden, L., Wratten, C., Bauer, J., Which items on the Distress Thermometer Radiotherapy. McElduff, P., Carter, G. Problem List are most distressing? Britton, B., Beck, A., McCarter, K. World Congress on Larynx Cancer, Cairns. (accepted Supportive Care in Cancer June World Congress of Behavioural and July 2015. 2016) Cognitive Therapies, (Symposium) 10. Head and Neck Cancer: A psychologist’s Melbourne. June 2016. 16. Gregory Carter, Andrew Page, Matthew perspective. Large, Sarah Hetrick, Allison Joy Milner, Nick 2. A clinical practice change intervention Britton, B., Gianacas, L., Wooldridge, S., Bendit, Carla Walton, Brian Draper, Philip to increase dietitian provision of routine Plant, C., Clover, K. Hazell, Sarah Fortune, Jane Burns, George depression screening and appropriate World Congress on Larynx Cancer, Cairns. Patton, Mark Lawrence, Lawrence Dadd, Jo referral for psychosocial support in head July 2015. Robinson, Helen Christensen. and neck cancer patients. RESEARCH GRANTS Royal Australian and New Zealand College McCarter, K., Wolfenden, L., Baker, A., 1. 2015 NHMRC Application ID 1105089 of Psychiatrists Clinical Practice Guideline Britton, B., Beck, A., Carter, G., Bauer, J., Ketamine therapy among patients for the management of Deliberate Self- Wratten, C., McElduff, P., Halpin, S. with treatment-resistant depression: harm (accepted Journal of Australian and Cancer Institute NSW Innovations in Cancer a randomised, double-blind, placebo- New Zealand College of Psychiatrists June Treatment and Care Conference, (TCRC controlled trial. 2016) Early Career Researcher session) Sydney. CIs: Loo, Mitchell, Glue, Fitzgerald, Somogyi, BOOK CHAPTERS October 2015. Galvez, Leyden, Hadzi-Pavlovic, Glozier, 1. Joseph Rasimas, Gregory L. Carter, (in 3. Characterising the impact of the social Hackett press). Psychiatric Issues in the Critically determinants of health (SDOH) on re- AIs Carter, Mihalopoulos, Rodgers, Malhi, Poisoned Patient. In Jeffrey Brent, Keith presentation and re-admission to hospital Berk, Hood, Barton, Baune, Scott Burkhart, Paul Dargan, Benjamin Hatten, for patients with COPD. $2,069,381.68 over three years Bruno Megarbane and Robert Palmer. MaryAnn Ferreux, Rosemary Aldrich, Greg 2. 2015 Calvary Mater Research Grants (Eds.). Carter, Michael Hayes. Early identification of patients likely to Critical Care Toxicology 2nd Edition. Annual Scientific conference Royal experience procedural anxiety during Australasian College of Medical PUBLISHED CONFERENCE ABSTRACTS radiation therapy for head and neck Administrators, Auckland, 9-11 September 1. A Bennett, K Kerr, R McKay, N O'Connor, G cancer: Clinical validation of a screening 2015. Carter questionnaire for head and neck cancer. Measuring The Quality Use Of Antipsychotic 4. Ketamine, brief contacts, and talking: Clover K, Wratten C, Britton B, Carter G. Medicines In Acute Mental Healthcare helping people who feel suicidal. $ 1,100 Coalfields Cancer Support Group Australian And New Zealand Journal Of Greg Carter. Equipment Grant and $ 34,948 James Psychiatry 49 (S1), 95-96. 2015 Suicidal Behaviour Research Laboratory, Lawrie Head and Neck Grant. Institute of Health & Wellbeing, University 2. A Bennett, K Kerr, R McKay, B O'Connor, G 3. 2016 Victorian Department of Health and of Glasgow UK. November 2015 Carter Human Services Development Of Indicators For The 5. Low prevalence disorders and the Review of ‘Working with the Suicidal Quality Use Of Medicines In Acute Mental limitations for prediction (a debate). Person: Clinical Practice Guidelines for Healthcare Greg Carter. Emergency Departments and Mental Health Australian And New Zealand Journal Of Lancet Suicide Symposium, Oxford Services’ Psychiatry 49 (S1), 104-104. 2015 University UK. November 2015 Pirkis J, Milner A, Witt K, Hetrick S, Robinson J, Spittal M,Carter G. $48,940. 3. Hay, P., C. Galletly, G. Carter, G. Andrews, D. 6. Special K: can a cat anaesthetic produce Chinn, D. Forbes, S. Madden et al. beneficial effects on depression and suicidal 4. 2016 HCRA Implementation Science RANZCP Clinical Practice Guidelines For ideation in depressed humans? Flagship Program Pilot Project and Eating Disorders. Greg Carter. Literature Review Funding Australian And New Zealand Journal Of British Isles Research Workshop, Oxford ‘Interventions to improve screening and Psychiatry, vol. 49 (S1), pp. 30-31. 2015 University UK. December 2015 appropriate referral of patients with cancer for distress: systematic review’ 4. Malhi, G., Oakley-Browne, M., Hay, P., 7. Ketamine, brief contacts, and talking: Kristen McCarter, Luke Wolfenden, Galletly, C., Carter, G., Andrews, G., Chinn, helping people who feel suicidal.

66 | 2015/2016 Calvary Mater Newcastle Review of Operations Benjamin Britton, Amanda Baker, Sean RESEARCH FUNDING/GRANTS breast cancer in postmenopausal women Halpin, Alison Beck, Gregory Carter, Chris 1. Dr Aoife McGarvey was awarded a with locally excised ductal carcinoma in situ Wratten, Laura Twyman, Erin Forbes. Hunter Cancer Research Association (IBIS-II DCIS): a double-blind, randomised $9,910.51 over one year. Implementation Project grant for $28 000 controlled trial. Lancet 2016; 387: 866-873. 5. 2016 HCRA Implementation Science in May 2016. Aoife is Chief Investigator 6. Lombard JM, Zdenkowski N, Wells Flagship Program Pilot Project and for the translational multicentre project K, Beckmore C, Reaby L, Forbes JF, Literature Review Funding titled “Improving physical assessment and Chirgwin. Aromatase inhibitor induced ‘Assessment of alcohol use in people who physiotherapy for head and neck cancer musculoskeletal syndrome: a significant are undergoing outpatient treatment for survivors following neck dissection surgery” problem with limited treatment options. cancer’ AWARDS Support Care Ca 2016; 24(5): 2139-2146. Vanessa Clark, Ashleigh Guillaumier, 1. Dr Aoife McGarvey was awarded the 7. Phillips K, Regan MM, Ribi K, Francis PA, Amanda Baker, Billie Bonevski, Benjamin University of Newcastle 2015 “Research Puglisi F, Bellet M, Spassapan S, Karlsson P, Britton, Chris Wratten, Kypros Kypri, Higher Degree Excellence Award for the Budman DR, Zaman K, Abdi EA, Domchek Gregory Carter. $17,637.00 over one year. Faculty of Health and Medicine” for her SM, Feng Y, Price KN, Coates AS, Gelber 6. 2016 HCRA Implementation Science PhD thesis titled “Physiotherapy for Patients RD, Maruff P, Boyle F, Forbes JF, Ahles T, Flagship Program Pilot Project and with Head and Neck Cancer”. Fleming GF, Bernhard J, for the Co-SOFT Literature Review Funding DEPARTMENT OF SURGICAL Investigators. Ajuvant ovarian function ‘Quantifying and addressing the evidence- ONCOLOGY suppression and cognitive function in practice gap in distress screening: a national women with breast cancer. BJ Cancer 2016; JOURNAL ARTICLES/PUBLICATIONS 2016 environmental scan and short pilot-test 114(9): 956-964. 1. Bartlett JMS, Ahmed I, Regan MM, Sestak to determine improvement areas and 8. Smith J, Banks H, Campbell H, Douglas A, I, Mallon EA, Dell’Orto P, Thurlimann BJK, acceptability of implementation strategies Fletcher E, McCallum A, Moger TA, Peltola Seynaeve C, Putter H, Brookes CL, Forbes for Australian cancer services’ M, Svereus S, Wild S, Williams LJ, Forbes JF, Colleoni MA, Bayani J, van de Velde CJH, Elizabeth Fradgley, Christine Paul, Gregory JF. Parameter heterogeneity in breast Viale G, Cuzick J, Dowsett M, Rea DW. HER2 Carter, Paul Jacobsen, Benjamin Britton, cancer cost regressions – evidence from status as predictive marker for AI vs Tam Kerrie Clover, Douglas Bellamy, Kristen five European countries. Health Economics benefit: A TRANS-AIOG meta-analysis of McCarter, Martine Cox. $29,750 over two 2016; 24: 23-37 (Supplement 2) years. 12129 patients from ATAC, BIG 1-98 and TEAM with centrally determined HER2. 9. Spagnolo F, Sestak I, Howell A, Forbes JF, 7. 2016 NSW Health Translational Research Ca Research 2016; 76(Suppl 4) Meeting Cuzick J. Anastrozole-induced carpal tunnel Grants Scheme Abstract S4-06 (SABCS Dec 2015) syndrome: Results from the international SMS SOS: Effectiveness of SMS text breast cancer intervention study II 2. Chirgwin JH, Giobbie-Hurder A, Coates AS, messages in improving survival and prevention trial. Jnl Clin Oncol 2016; 34(2): Price KN, Ejlertsen B, Debled M, Gelber RD, rehabilitation rates of deliberate self harm 139-143. patients and reducing re-presentation of Goldhirsch A, Smith I, Rabaglio M, Forbes 10. Thorat MA, Jones LJ, Levey PM, Elia DSH patients to hospital. JF, Neven P, Láng I, Colleoni M, Thürlimann G, Evagora CA, Bundred NJ, Fentiman Alison Jones, Gregory Carter, Ian Whyte, B. Treatment adherence and its impact IS, Forbes JF, Cuzick J. Prognostic role Andrew Page, Naren Gunja, Christopher on disease-free survival in the Breast and impact of multi-clonal ER and PgR Ryan, Graham Gould, Garry Stevens. $ International Group 1-98 trial of tamoxifen expression in ductal carcinoma in situ: 331,514 over two years. and letrozole, alone and in sequence. Jnl Clin Oncol 2016; 34(21):2452-2459. Results from the UK/ANZ DCIS trial. Ca PHYSIOTHERAPY Research 2016; 76(4): Meeting Abstract P3- 3. Colleoni M, Sun Z, Price KN, Karlsson JOURNAL ARTICLES/PUBLICATIONS 07-01 (SABCS Dec 2015) P, Forbes JF, Thürlimann B, Gianni L, 1. McGarvey, A., Hoffman, G., Osmotherly, Castiglione M, Gelber RD, Coates AS, 11. Thorat MA, Wagner S, Jones LJ, Levey P., Chiarelli. “Maximizing-shoulder- Goldhirsch A. Annual hazard rates of PM, Bulka K, Hoff R, Sangale Z, Flake function-after-accessory-nerve-injury-and- recurrence for breast cancer during 24 DD, Bendred NJ, Fentiman IS, Forbes JF, neck-dissection-surgery-A-multicenter years of follow-up: Results from the Lanchbury JS, Cuzick J. Prognostic and randomized controlled trial”. 2015. Head International Breast Cancer Study Group predictive relevance of HER2 status in ductal and Neck. 37(7). 1022- 1031. Trials I to V. Jnl Clin Oncol 2016; 34(9): carcinoma in situ: Results from the UK/ANZ CONFERENCE PRESENTATIONS 927-935. DCIS trial. Ca Research 2016; 76(4) Meeting Abstract P3-07-02 (SABCS Dec 2015). 1. Judy Holland and Julia Britton attended the 4. Cuzick J, Forbes JF, Sestak I, Howell 2016 Asia Pacific Lymphology Conference A, Bonanni B, Bundred N, Levy C, von 12. Zdenkowski N, Butow P, Fewster S, and presented at a concurrent session. Minckwitz G, Eiermann W, Neven P, Beckmore C, Wells K, Forbes JF, Boyle F. §§ Doing more with what we have: tele- Stierer M, Holcombe C, Coleman RE, Exploring decision-making about neo- health and secondary lymphoedema in Jones LJ, Ellis I. Anastrozole versus adjuvant chemotherapy for breast cancer. Hunter New England LHD tamoxifen for the prevention of loco- Br Journal 2016; 22;1: 133-134. §§ The presentation was looking at a review regional and contralateral breast cancer 13. Zdenkowski N, Forbes JF, Boyle FM, of our telehealth model of presenting in postmenopausal women with locally Kannourakis G, Gill PG, Bayliss E, Saunders early lymphoedema education to excised ductal carcinoma in-site (IBIS-II C, Della-Fiorentina S, Kling N, Campbell rural patients at risk of secondary DCIS). Ca Research 2016; 76(4): Meeting I, Mann GM, Coates AS, Gebski V, Davies Abstract S6-03 (SABCS Dec 2015). lymphoedema. L, Thornton R, Reaby L, Cuzick J, Green M, on behalf of the ANZ Breast Cancer 2. Dr Aoife McGarvey was an invited keynote 5. Forbes JF, Sestak I, Howell A, Bonanni Trials Group. Observation versus late evening presenter for the Australian B, Bundred N, Levy C, von Minckwitz G, reintroduction of letrozole as adjuvant Physiotherapy Association with the Eiermann W, Neven P, Stierer M, Holcombe endocrine therapy for hormone receptor presentation titled “Head and Neck Cancer: C, Coleman RE, Jones L, Ellis I, Cuzick positive breast cancer (ANZ0501 LATER): An Implications for Physiotherapists”. May J, on behalf of the IBIS-II investigators. open-lable randomised controlled trial. Ann 2016. Sydney. Anastrozole versus tamoxifen for the prevention of locoregional and contralateral Oncol 2016; 27(5): 806-812.

2015/2016 Calvary Mater Newcastle Review of Operations | 67 2015 N, Reaby L, Forbes JF, Chirgwin J. Aromatase 75(9) Suppl.S, Meeting Abstract PD4-1 1. Coates AS, Winer EP, Goldhirsch A, inhibitor induced musculoskeletal (SABCS Dec 2014) Gelber RD, Gnant M, Piccart-Gebhart MJ, syndrome (AIMSS) in Australian women CONFERENCE/MEETING PRESENTATIONS Thürlimann B, Senn HJ, Andrè F, Baselga J, with early breast cancer: An Australia and 1. Australian Clinical Trial Alliance (ACTA) 2015 Bergh J, Bonnefoi H, Burstein H, Cardoso F, New Zealand Breast Cancer Trials Group Symposium Castiglione-Gertsch M, Colleoni M, Curigliano (ANZBCTG) survey of members of the Presentation: “Breast Cancer G, Davidson NE, Leo AD, Ejlertsen B, Forbes Breast Cancer Network Australia (BCNA). Prevention”8-10 October 2015 - Sydney Ca Research 2015; 75(9) Suppl S, Meeting JF, Galimberti V, Goodwin P, Harbeck N, 2. Cancer Clinical Network Leadership Meeting Abstract P1-12-05 (SABCS Dec 2014) Hayes DF, Huober J, Hudis CA, Ingle JN, Presentation: “Breast Cancer and Jassem J, Jiang Z, Karlsson P, Morrow M, 6. Mathe A, Wong-Brown M, Morten B, Screening” Forbes JF Orecchia R, Kent Osborne C, Partridge AH, de , Braye SG, Avery-Kiejda KA, Scott 16 October 2015 – Newcastle la Peńa L, Pritchard KI, Rutgers EJT, Sedlmayer RJ. Novel genes associated with lymph 3. NSW Translational Breast Cancer Research F, Semiglazov V, Shao ZM, Smith I, Toi M, Tutt node metastases in triple negative breast Symposium 2016 A, Viale G, von Minckwitz G, Watanabe T, cancer. Scientific Reports 2015; 5 (Article Presentation: “25 years of the ANZ Breast Whelan t, Xu B. Tailoring therapies-improving No: 15832). Cancer Trials Group, lessons and highlights” the management of early breast cancer: St 7. Nielsen S, Sulaiman B, Goode S, Young 31 March 2016 – Sydney Gallen International Expert Consensus on the B, Koegelenberg A, Thorne R, Forbes JF, RESEARCH FUNDING/GRANTS Primary Therapy of Early Breast Cancer 2015. Scott R, Walker M. The essential role of Annals of Onc 2015; 26(8): 1533-1546. anatomical pathologists in tissue biobanking 1. Cancer Australia Infrastructure Grant 2. Cuzick J, Sestak I, Cawthorn S, Hamed H, – a win-win situation. Asia-Pac Jnl of Clin CI: Forbes JF Holli K, Howell A, Forbes JF. 16 year long- Oncol 2015; 11: 14, Suppl 5, Special Issue, Amount: $1,379,944 term follow-up of the IBIS-I breast cancer Meeting Abstract PP28 Period: Jul 2013-Jun 2016 prevention trial. Ca Research 2015; 75(9) 8. Phillips KA, Feng Y, Ribi K, Bernhard J, 2. National Breast Cancer Foundation Suppl S, Meeting Abstract S3-07 (SABCS Dec Puglisis F, Bellet M, Spazzapan S, Karlsson (Infrastructure Grant) 2014) P, Budman DR, Zaman K, Abdi EA, Domchek Title: Maximising support for breast cancer research by the Australian Breast Cancer 3. Dowsett M, Forbes JF, Bradley R, Ingle SM, Regan MM, Coates AS, Gelber RD, Tissue Bank. J, Aihara T, Bliss J, Boccardo F, Coates A, Maruff P, Boyle F, Forbes JF, Fleming GF, Forbes JF Coombes RC, Cuzick J, Dubsky P, Gnant Francis PA. Co-SOFT: The cognitive function CIs: Clarke C, Marsh D, , Scott R, M, Kaufmann M, Kilburn L, Perrone F, substudy of the suppression of ovarian Dahlstrom JE, Zeps N, Sandiran Y, Blasdall S. Rea D, Thürlimann B, van de Velde C, Pan function trial (SOFT). Ca Research 2015; Amount: $1,250,000 H, Peto R, Davies C, Gray R. Aromatase 75(9) Suppl S, Meeting Abstract P1-12-06 Period: 2013-2017 inhibitors versus tamoxifen in early breast (SABCS Dec 2014). 3. National Breast Cancer Foundation cancer: patient-level meta-analysis of the 9. Pundavela J, Roselli S, Faulkner S, Attia J, (National Collaborative Breast Cancer randomised trials. Lancet 2015; 386(10001): Scott RJ, Thorne RF, Forbes JF, Bradshaw Research Grant) 1341-1352. RA, Walker MM. Nerve fibers infiltrate Title: Enabling clinical epigenetic 4. Giobbie-Hurder A, Thurlimann B, Ejlertsen the tumor microenvironment and are diagnostics: the next generation of B, Neven P, coleman RE, Smith I, Wardley associated with nerve growth factor personalized breast cancer care. Forbes JF AM, Lang I, Colleoni M, Debled M, Forbes production and lymph node invasion in CIs: Trau M, Francis G, Clark S, , Brown M, Dobrovic A, Scott R. JF, Price KN, Regan MM, Rabaglio M, breast cancer. Molecular Onc 18 March Amount: $5,990,978 (University of Goldhirsch A, Coates AS, Gelber RD. IBCSG 2015; 9(8): 1626-1635. Newcastle component net $305,301) BIG 1-98 study: The long-term follow-up 10. Sestak I, Howell A, Forbes JF, Neven P, Period: 2013-2018 experience. Ca Research 2015; 75(9) Suppl Cuzick J. Timing, severity and risk factors for S, Meeting Abstract P4-18-03 (SABCS 2014) arthralgia in the IBIS-II trial: A retrospective 4. HCF Grant (DOMINO) Title: Development and evaluation of 5. Lombard JM, Zdenkowski N, Wells K, Grant and exploratory analysis. Ca Research 2015;

68 | 2015/2016 Calvary Mater Newcastle Review of Operations a decision aid for women considering MOR TRIALS: Hospital Scientists: Dr Jayne Gilbert and Madhu neoadjuvant systemic therapy for operable Clinical Trials CNC/Supervisor: Kim Adler Garg breast cancer Clinical Trial Coordinators: Sue Brew, Catherine Technical Officer: Ms Alesia Ogrodnik CIs: Zdenkowski N, Forbes JF. Johnson, Kirrilee Askew, Louise Plowman, Melissa The MOR Laboratory encompasses the Amount: $220,654 Lloyd, Mary Hunter, Kelly Barker and Sandy Experimental Therapeutics Group which Period: 2014-2018 Mackellar focuses on improving outcomes for cancer 5. NHMRC Project Grant (APP1066479) Administrative/Finance Officer: Alison Leonard– patients undergoing chemotherapy. The main Title: Randomised phase II trial of England areas of research include (i) the development neoadjuvant chemotherapy +/- concurrent of new small molecules for the treatment of Data Manager: Naomi Knoblauch and Kelly aromatase inhibitor endocrine therapy cancer, (ii) identifying ways to reducing clinical Healey to down-stage large oestrogen receptor toxicity to chemotherapy and (iii) implementing positive breast cancer. (ELIMINATE Trial) During the past year the MOR Trials were able to therapeutic drug monitoring in order to optimise CIs: Francis P, Wilcken N, Murray N, Forbes offer 149 patients the opportunity to participate chemotherapy dosing. Our drug development JF, Redfern A, Boyle F, Spillane A. in a clinical trial. Of these, 66 patients have program primarily targets brain and breast Amount: $2,182,283 chosen to participate and have been enrolled in cancers, while our studies of clinical toxicity and Period: 2014-2018 a clinical trial. We currently have 32 trials actively drug monitoring span all tumour types. 6. Cancer Institute NSW (Translational Cancer recruiting participants and four trails waiting for PUBLICATIONS approval to commence. Of the trials currently Research Centre Grant) 1. Jefford M, Gough K, Drsodowsky A, Russell recruiting there is a mixture of phase II and III Centre Name: Hunter Cancer Research L, Aranda S, Butow P, Phipps-Nelson J, cooperative group and pharmaceutical sponsored Alliance; HCRA Young J, Krishnasamy M, Ugalde A, King D, studies and investigator initiated studies. CIs: Ackland S, Scott R, Forbes JF, Sanson- Strickland A, Franco M, Blum R, Johnson Fisher R, Zhang XD, Proietto A, Greer P. The last 12 months has been a year of innovation C, Ganju V, Shapiro J, Chong G, Charlton Amount: $6,498,216 and change. With the aim of remaining a J, Schofield P. A Randomized Controlled Period: Jul 2014-Jun 2019 sustainable 'preferred site' for clinical research Trial (RCT) of a Nurse-Led Supportive Care 7. Breast Cancer Research Foundation that ensures patients of the Hunter have access Package (Survivorcare) for Survivors of (NewYork) to new cancer treatment options, we have Colorectal Cancer. Cancer Nursing. 38(4S) Title: ANZBCTG High Risk Bio-Bank introduced a more streamlined approach. This (Supplement 1):S1-S106, July/August 2015. CIs: Forbes JF, Co-PI: Cuzick J includes introducing a new team structure DOI: 10.1097/NCC.0000000000000287 of tumour specific teams - lung, breast and Amount: US$250,000 2. Jefford M, Gough K, Drsodowsky A, Russell gynaecological studies and brain, gastrointestinal Period: 1 Oct 2015-30 Sep 2016 L, Aranda S, Butow P, Phipps-Nelson J, and genitourinary studies and the introduction of 8. NHMRC Project Grant (APP1083172) Young J, Krishnasamy M, Ugalde A, King D, a data manager to each team. Expanding on this Title: POSNOC (POsitive Sentinel NOde – a Strickland A, Franco M, Blum R, Johnson we are in the process of introducing a laboratory randomised trial of adjuvant therapy alone C, technician role, this person will be responsible for Ganju V, Shapiro J, Chong G, Charlton versus adjuvant therapy plus Clearance or all study sample processing. J, Schofield P. A Randomized Controlled axillary radiotherapy). Trial (Rct) of a Nurse-Led Supportive Care Staff members of MOR Trials were recognised for CIs: Mann G, Spillane A, Forbes JF, Chua Package (Survivorcare) For Survivors of their great commitment and resilience with the B, Wilcken Ni, Kollia J, Pyke C, Campbell I, Colorectal Cancer. J Clin Oncol 33:5s, 2015 constant challenges around performing clinical Goyal A, Saunders C. (suppl; abstr 9566) trials by being voted the hospital's Team of the Amount: $1,210,724 Johnson C Month in May 2016. 3. . International Cancer Nursing Period: 2015-2020 News (ICNN):Blog Post. Nursing and the MOR Trials is also participating in Phase 1b 9. NHMRC Project Grant (APP1099899) impact of non-communicable diseases: Are studies with our first two studies to commence in Title: Randomised phase III trial of adjuvant you ready to make a difference? http:// late 2016. This will provide patients of the Hunter radiotherapy versus observation following news.isncc.org/nursing-and-the-impact-of- with increased treatment options. breast conserving surgery and endocrine non-communicable-diseases-are-you-ready- therapy in patients with molecularly CLINTRIAL REFER ONCOLOGY NSW APP to-make-a-difference/ characterized low-risk luminal A early breast As part of an initiative to improve clinical trial 4. Johnson C and Adler K. Manual for Clinical cancer. accrual across NSW and with funding from the Trials Nursing (Third edition), Chapter 45. Forbes CIs: Chua B, Loi S, Francis P, Mann G, Hunter Cancer Research Alliance (HCRA), we have Oncology Nursing Press Inc, USA, 443 – 454, JF, Krishnasamy M, Wilcken N, Spillane A. collaborated with the Haematology ClinTrial Refer 2015 ISBN: 9781935864370 Amount: $4,087,187 App to produce an oncology specific version. 5. Johnson C, Blanchard G and Cox Y. A survey Period: 2016-2020 Since becoming publicly available for Apple and of Australian cancer nurses: The prevention Android devices in November 2015, Clinical MEDICAL ONCOLOGY RESEARCH and control of non-communicable diseases Trial Units in 22 locations across Metropolitan (MOR) (CanPaC study). Asia-Pacific Journal of and Regional NSW have been included, with Oncology Nursing. 2 (3) July-September The Medical Oncology Department has a very information currently available for 181 different 2015. active research unit (MOR) in which they conduct medical oncology and radiation oncology clinical both laboratory and clinical research. MOR is trials. Tracking data shows that in nine months 6. Lombard J, Zdenkowski N, Wells made up of clinicians, scientists, nurses, clinical the App has been accessed almost 4,000 times K, Beckmore C, Reaby L, Forbes J, trial coordinators and data managers dedicated (up to 50 users per day) and feedback from sites Chirgwin J. Aromatase inhibitor induced to the improved management of patients has been very positive, with several reporting musculoskeletal syndrome: a significant with cancer and the advancement of cancer an increased number of external referrals for problem with limited treatment options. treatment. participants to clinical trials. Supportive Care in Cancer 2015:25(5);2139- With the aim to promote cancer research and MOR EXPERIMENTS: 46. understanding of clinical trials MOR has been Zdenkowski N Director of MOR Laboratory and Chief Hospital 7. , Butow P, Mann GB, Fewster involved in publicity drives on Clinical Trials Day Scientist: Dr Jennette Sakoff S, Douglas C, Boyle FM. Decisions about and Medical Research Week. neoadjuvant systemic therapy for breast cancer: a survey of Australian and New

2015/2016 Calvary Mater Newcastle Review of Operations | 69 Zealand specialists. Australia and New Young J, Krishnasamy M, Ugalde A, King D, L, Swart AM, Cook A, Kaplan RS, Parmar MK; Zealand Journal of Surgery 2015;85:797- Strickland A, Franco M, Blum R, Johnson ICON6 collaborators. Cediranib in patients 799. C, Ganju V, Shapiro J, Chong G, Charlton J, with relapsed platinum-sensitive ovarian 8. Pages BJ, Zhang Y, Li F, Sakoff J, Gilbert Schofield P. A Randomized Controlled Trial cancer (ICON6): a randomised, double- J, and Aldrich-Wright JR. Cytotoxic and of a Nurse-Led Supportive Care Package blind, placebo-controlled phase 3 trial. structural analyses of 2,2ʹ-bipyridine, (SurvivorCare) for Survivors of Colorectal Lancet. 2016 Mar 12;387(10023):1066-74. 4,4ʹ-dimethyl-2,2ʹ-bipyridine & 2-(2ʹ-pyridyl) Cancer. Oncologist. 2016 Aug;21(8):1014-23. 26. Pharoah PD, Song H, Dicks E, Intermaggio quinoxaline platinum(II) complexes. Eur. J. 17. Bajwa P, Nagendra PB, Nielsen S, Sahoo MP, Harrington P, Baynes C, Alsop K; Inorganic Chemistry. 2015, 4167-4175. SS, Bielanowicz A, Lombard JM, Wilkinson Australian Ovarian Cancer Study Group, 9. Macias FJ, Deo KM, Pages BJ, Wormell JE, Miller RA, Tanwar PS. Age related Bogdanova N, Cicek MS, Cunningham JM, P, Clegg JK, Zhang Y, Li F, Zheng G, Sakoff increase in mTOR activity contributes Fridley BL, Gentry-Maharaj A, Hillemanns J, Gilbert J, Aldrich-Wright JR. Synthesis, to the pathological changes in ovarian P, Lele S, Lester J, McGuire V, Moysich KB, analysis of the structure, diffusion and surface epithelium. Oncotarget. 2016 Apr Poblete S, Sieh W, Sucheston-Campbell cytotoxicity of heterocyclic platinum(IV) 12;7(15):19214-27. L, Widschwendter M; Ovarian Cancer complexes. Chemistry. 2015 Nov 18. Zdenkowski N, Butow P, Hutchings E, Association Consortium, Whittemore AS, 16;21(47):16990-7001. Douglas C, Coll JR, Boyle FM. A Decision Dörk T, Menon U, Odunsi K, Goode EL, Karlan BY, Bowtell DD, Gayther SA, Ramus 10. Kondrashova O, Love CJ, Lunke S, Hsu AL; Aid for Women Considering Neoadjuvant SJ. PPM1D Mosaic Truncating Variants in Australian Ovarian Cancer Study (AOCS) Systemic Therapy for Operable Invasive Ovarian Cancer Cases May Be Treatment- Group, Waring PM, Taylor GR. High- Breast Cancer: Development and Protocol Related Somatic Mutations. J Natl Cancer Throughput Amplicon-Based Copy Number of a Phase II Evaluation Study (ANZ1301 Inst. 2016 Jan 27;108(3). pii: djv347. Detection of 11 Genes in Formalin-Fixed DOMINO). JMIR Research Protocols Paraffin-Embedded Ovarian Tumour 2016;5(2):e88. 27. Zaleta-Pinet D, McCluskey A, Hall S, Sakoff J, Samples by MLPA-Seq. PLoS One. 2015 Nov 19. Herrmann A, Mansfield E, Hall AE, Brophy J, Ashhurst-Smith C, and 16;10(11):e0143006. doi: 10.1371/journal. Sanson-Fisher R, Zdenkowski N. Willfully van Altena I. The Use of the Toxic Plant pone.0143006. eCollection 2015. out of sight? A literature review on the Myoporum montanum in a Traditional Australian Aboriginal Medicine. Aust. J. 11. Oza AM, Cook AD, Pfisterer J, Embleton effectiveness of cancer-related decision Chem. 2016, 69, 161–168. A, Ledermann JA, Pujade-Lauraine E, aids and implementation strategies. BMC Kristensen G, Carey MS, Beale P, Cervantes Medical Informatics and Decision Making. 28. Trinh TN, McLaughlin EA, Abdel-Hamid A, Park-Simon TW, Rustin G, Joly F, Mirza 2016;16(1):1-9. MK, Gordon CP, Bernstein IR, Pye V, Cossar Sakoff JA MR, Plante M, Quinn M, Poveda A, Jayson 20. Zdenkowski N, Butow P, Mann GB, Fewster P, , McCluskey A. Quinolone-1- GC, Stark D, Swart AM, Farrelly L, Kaplan S, Beckmore C, Isaacs R, Douglas C, Boyle (2H)-ones as hedgehog signalling pathway R, Parmar MK, Perren TJ; ICON7 trial FM. A survey of Australian and New Zealand inhibitors. 2016 Organic and Biomolecular investigators. Standard chemotherapy clinical practice with neoadjuvant systemic Chemistry. Org Biomol Chem. 2016 Jul with or without bevacizumab for women therapy for breast cancer. Internal Medicine 14;14(26):6304-15. with newly diagnosed ovarian cancer Journal 2016 [Mar 1 epub ahead of print]. 29. Lin AJS, Russell C, Baker JR, Frailey SL, (ICON7): overall survival results of a phase Sakoff JA 21. Zdenkowski N, Forbes JF, Boyle FM, and McCluskey A. A Facile hybrid 3 randomised trial. Lancet Oncol. 2015 Kannourakis G, Gill PG, Bayliss E, Saunders ‘flow and batch’ access to substituted Aug;16(8):928-36. doi: 10.1016/S1470- C, Della-Fiorentina S, Kling N, Campbell I, 3,4-dihydro-2H-benzo[b][1,4]oxazinones. 2045(15)00086-8. Epub 2015 Jun 23. Mann GB, Coates AS, Gebski V, Davies L, 2016 Organic & Biomolecular Chemistry. 12. Burmeister EA, OʼConnell DL, Beesley VL, Thornton R, Reaby L, Cuzick J, Green M. Accepted for publication. Goldstein D, Gooden HM, Janda M, Jordan Observation versus late reintroduction of 30. Guo ST, Chi MN, Yang RH, et al. Ackland SP.. SJ, Merrett ND, Payne ME, Wyld D, Neale letrozole as adjuvant endocrine therapy INPP4B is an oncogenic regulator in human RE; Describing Patterns of Care in Pancreatic for hormone receptor positive breast colon cancer. ONCOGENE Volume: 35 Cancer: A Population-Based Study. cancer (ANZ0501 LATER): An open-label Issue: 23 Pages: 3049-3061 Published: Pancreatic Cancer Patterns of Care Study randomised controlled trial. Annals of JUN 9 2016 Group. Pancreas. 2015 Nov;44(8):1259-65. Oncology 2016;27(5):806-12. 31. Khasraw M, Lee A, McCowatt S, et al. 13. Vuong QV; Hirun S; Chuen TL; Goldsmith 22. Zdenkowski N, Butow P, Tesson S, Boyle Ackland SP…Cilengitide with metronomic CD; Munro B; Bowyer MC; Chalmers F. A systematic review of decision aids for temozolomide, procarbazine, and standard AC; Sakoff JA; Phillips PA, Scarlett C; patients making a decision about treatment radiotherapy in patients with glioblastoma Physicochemical, antioxidant and anti- for early breast cancer. The Breast and unmethylated MGMT gene promoter cancer activity of a Eucalyptus robusta (Sm.) 2016:26;31-45. in ExCentric, an open-label phase II trial. leaf aqueous extract. Industrial Crops and 23. Zdenkowski N, Butow P, Fewster S, Journal of Neuro-Oncology, Volume: 128 Products. 64:167-174, 1 Feb 2015. Beckmore C, Wells K, Forbes JF, Boyle Issue: 1 Pages: 163-171 Published: MAY 14. Rixson JE, Abraham JR, Egoshi Y, Skelton BW, FM. Exploring decision making about 2016 Young K, Gilbert J, Sakoff JA, Gericke KM, neoadjuvant chemotherapy for breast 32. McLachlan S, Fisher RJ; Zalcberg J, et al. McCluskey A, Stewart SG. The synthesis and cancer. The Breast Journal 2016;22(1):133- Ackland SP…The impact on health-related biological activity of novel anthracenone- 134. quality of life in the first 12 months: A pyranones and anthracenone-furans. Bioorg 24. Davey RJ, van der Westhuizen A and randomised comparison of preoperative Med Chem. 2015, 23:3552-3565. Bowden NA. Melanoma treatment: Can short-course radiation versus long-course 15. Bryant J; Sanson-Fisher R; Fradgley E; we learn from the past to improve the chemoradiation for T3 rectal cancer et al. Ackland SP. Oncology patients future? Critical Reviews in Oncology & (Trans-Tasman Radiation Oncology Group overwhelmingly support tissue banking. Haematology. 2016, 98:242-253 Trial 01.04). European Journal of Cancer, BMC CANCER Volume: 15 Article Number: Volume: 55 Pages: 15-26 Published: MAR 25. Ledermann JA, Embleton AC, Raja F, Perren 413 Published: MAY 17 2015 2016 TJ, Jayson GC, Rustin GJ, Kaye SB, Hirte H, Gedye CA 16. Jefford M, Gough K, Drsodowsky A, Russell Eisenhauer E, Vaughan M, Friedlander M, 33. and Fleming J, Forsaking cures for L, Aranda S, Butow P, Phipps-Nelson J, González-Martín A, Stark D, Clark E, Farrelly cancer: why are we discarding the tumour

70 | 2015/2016 Calvary Mater Newcastle Review of Operations biospecimens of most patients? Med J 5. Milioli HH, Tishchenko I, Riveros C, Sakoff biomarker inmetastatic colorectal cancer Aust 2016; 204 (8): 297-298. doi:10.5694/ J, Berretta R, Moscato P. Consensus on (mCRC). Asia-Pacific Journal of Clinical mja15.00961 breast cancer cell lines classification for Oncology Volume: 11 Special Issue: SI 34. Gedye C, Sirskyj D, Lobo N, Meens J, Hyatt an effective and efficient clinical decision- Supplement: 3 Pages: 69-69 Published: E, Robinette M, Fleshner N, Hamilton RJ, making. Conference: IMPAKT Breast Cancer AUG 2015 Kulkarni G, Zlotta A, Evans A, Finelli A, Conference Location: Brussels, BELGIUM 13. Holz, L & Ruhl, J ‘Using Distress Screening Jewett MAS and Ailles LE. Cancer stem Date: MAY 07-09, 2015. Sponsor(s): Assessments To Improve Quality Care”. cells are underestimated by standard European Soc Med Oncol. Annals of CNSA Annual Congress in Cairns: “Bridging experimental methods in clear cell renal Oncology.Volume: 26 Supplement: 3; the Gap”. 2016 Meeting Abstract: 99P Published: MAY cell carcinoma. Scientific Reports, accepted 14. Courneya KS, Vardy JL, O'Callaghan CJ, 2015 manuscript, 13 April 2016. Friedenreich C, Campbell KL, Prapavessis H, 35. Lobo N, Gedye C, Apostoli A, Brown KR, 6. Ackland SP, Sakoff JA, Johnson C, Garg MB. Crawford JJ, O'Brien P, Dhillon HM, Jonker Paterson J, Stickle N, Robinette M, Fleshner Optimal TDM and pharmacodynamics of DJ, Sun Chua N, Lupichuk SM, Susmoy N, Hamilton RJ, Kulkarni G, Zlotta A, Evans mitotane in adrenocortical cancer (ACC) in Sanatani M, Gill S, Meyer RM, Begbie S, A, Finelli A, Moffat J, Jewett MAS, Ailles L. children and adults. Asia–Pacific Journal of Bonaventura A, Burge ME, Tu D, Booth CM; Efficient Generation of Patient-Matched Clinical Oncology, Volume: 11, Pages: 50-50; Effects of a structured exercise program Malignant and Normal Primary Cell Cultures Supplement: 3; Special Issue: SI; Published: on physical activity and health-related from Clear Cell Renal Cell Carcinoma AUG 2015. fitness in colon cancer survivors: One year Patients: Clinically Relevant Models for 7. Bond D, Turner A, Richmond R, Sadeqzadeh feasibility results from the NCIC CTG CO.21 Research and Personalized Medicine, E, Vuong QV, Bhuyan DJ, Rifai Y, Chalmers (CHALLENGE) trial. J Clin Oncol 34, 2016 accepted manuscript, BMC Cancer, 21 AC, van Altena IA, Gaston TF, Bowyer MC, (suppl; abstr 3621); ASCO 2016 Meeting. March 2016 Brzozowski J, Jankowski H, Weidenhofer J, 15. Mileshkin LR, Edmondson RJ, O'Connell R, 36. Khoja L, Atenafu EG, Ye Q, Gedye C, Sakoff ,J Thuong PT, Ha DT, Khoi NM and Sjoquist KM, Cannan D, Jyothirmayi R, Beale Chappell M, Hogg D, Butler MO and Joshua Scarlett CJ. The search for novel treatment PJ, Bonaventura T, Goh JC, Hall M, Clamp AM. Real world efficacy, toxicity and clinical agents for Pancreatic Cancer: Tales from AR, Green JA, Lord R, Scurry J, Friedlander management of ipilimumab treatment in the land and sea. HCRA 2015. Asia-Pacific M, Paragon Study Group; Phase II study metastatic melanoma, Oncology Letters, Journal of Clinical Oncology Volume: 11 of anastrozole in recurrent estrogen (ER) 11(2):1581-1585 Feb 2016. Special Issue: SI Supplement: 5 Pages: / progesterone (PR) positive endometrial 19-19 Meeting Abstract: PP44 Published: 37. Chia PL, Gedye C, Boutros P, Wheatley-Price cancer: The PARAGON trial—ANZGOG 0903. DEC 2015 P, John T, Current and Evolving Methods to J Clin Oncol 34, 2016 (suppl; abstr 5520); Visualise Biological Data in Cancer Research, 8. Garg M, Ackland SP, McCluskey A, Scorgie ASCO 2016 Meeting. Journal of the National Cancer Institute, F, Lincz L, McCluskey S, Gilbert J, Sakoff CONFERENCE ORAL PRESENTATIONS accepted manuscript, 2016. JA. The protein phosphatase inhibitor 1. Budden T, van der Westhuizen A and cantharidin, potentiates the effect of all- 38. Gedye CA, Cardwell T, Dimopoulos N, Bee Bowden N A. Global Demethylation Can trans retinoic acid in acute promylocytic Shin Tan, Jackson H, Svobodová S, Anaka Restore XPC Expression and Overcome leukemia cells. HCRA 2015. Asia-Pacific M, Behren A, Maher C, Hofmann O, Hide H, Platinum Therapy Resistance in Melanoma Journal of Clinical Oncology Volume: 11 Caballero O, Davis ID, Cebon J, Mycoplasma in vitro. Hunter Cancer Research Alliance Special Issue: SI Supplement: 5 Pages: infection alters cancer stem cell properties Symposium, 2014 15-16 Meeting Abstract: PP33 Published: in vitro, Stem Cell Research and Reviews, in 2. Budden T, van der Westhuizen A and DEC 2015 press, 2016. Bowden NA. Global Demethylation Can 9. Garg M, Sakoff JA, Johnson ,C Martin J, CONFERENCE ABSTRACTS Restore XPC Expression and Overcome Ackland S. Therapeutic Drug Monitoring for 1. Budden T, van der Westhuizen A and Platinum Therapy Resistance in Melanoma. cancer patients receiving chemotherapy. Bowden NA. Global Demethylation Australian Society for Medical Research HCRA 2015. Asia-Pacific Journal of Clinical Increases XPC Expression and Overcomes Newcastle Satellite Day, 2015 Oncology Volume: 11 Special Issue: Carboplatin Resistance in Melanoma in 3. Gedye CA: ANZUP 2016 Annual Scientific SI Supplement: 5 Pages: 8-8 Meeting vitro. Pigment Cell and Melanoma Research. Meeting, July 2016 (Chair, Kidney Cancer Abstract: PP9 Published: DEC 2015 Vol. 28. No 6. (2015) pp. 760 Masterclass; Trials in Action; Concept 10. Sakoff JA, Gilbert J,De Iuliis G 2. Budden T, van der Westhuizen A and Development Workshop; Biomarkers in and McCluskey A. A novel class of Bowden NA. Repair of UVB-induced DNA Renal Cell Carinoma). phenylacrylonitrile-based small molecules damage is reduced in melanoma due to 4. Gedye CA: Australian Biospecimen Network selectively induce double strand DNA attenuated XPC and global genome repair. Association Annual Scientific Meeting, Oct damage in breast cancer cells. American Pigment Cell and Melanoma Research. Vol. 2015. Association for Cancer Research, New 28. No 6. (2015) pp. 759 Orleans, USA, April 2016. 5. Gedye CA: 2nd Thomas Ashworth 3. Budden T, Davey RJ, Vilain RE, Ashton KA, Symposium on Circulating Tumour Cells, 11. Fradgley E, Paul C, Bryant J, et al. Ackland Braye S, van der Westhuizen A and Bowden October 2015. SP…Advancing collaborative quality NA. Global Demethylation Increases XPC improvement in tertiary settings: Do 6. Gaynor J: “Cooling heads in the DTC” expression and Sensitises Melanoma to chronic disease outpatients and health presented at Hunter Breast Cancer Carboplatin in vitro. American Association professionals identify similar types and education evening 20 April 2016. for Cancer Research (AACR) Annual Meeting numbers of quality initiatives? Asia-Pacific GRANT FUNDING 2016, New Orleans, USA, April 2016 Journal of Clinical Oncology Volume: 11 1. Holz, L & Ruhl, J received CNSA travel grant 4. Brew, S: Chair of ANZGOG Study Special Issue: SI Supplement: 5 Pages: to attend CNSA Annual Congress in Cairns: Coordinators’ Committee – Chair of 2 7-8 Meeting Abstract: PP7 Published: “Bridging the Gap”. 2016 x SCC workshops (including workshop DEC 2015 Lombard J organisation) and co-chair of QOL session at 2. , Associate investigator:2015: 12. Zdenkowski N, Plowman L, Hall S, et al. ANZGOG 2016 ASM. HMRI cervix cancer grant (HMRI 15-70) $15 Ackland SP… MIDKINE (MK) as a predictive 000 : Nerves and neurotrophins as new

2015/2016 Calvary Mater Newcastle Review of Operations | 71 therapeutic targets in cervical cancer. Equipment grant. Calvary Mater Newcastle spectrum from within the department through 3. Zdenkowski N, Sproule V, Brown S, Lynam Hospital. $13,000 to major international collaborations. We have J. 2016. Linking cancer patients with clinical 20. Sakoff JA, McCluskey A and Martin J. a wide base of research activity extending from trials: Examining patients’ willingness to (2016). Exploiting a drug metabolic pathway basic sciences, technical projects and quality travel. Hunter Cancer Research Alliance for the development of new therapies assurance activities, through to multicentre pilot grant: $20,000. against breast cancer. Hunter Cancer clinical trials with the potential to shape future clinical practice. Several of our medical, physics 4. Zdenkowski N, Ackland S, Forbes J. 2016- Research Alliance. $20,000. and radiation therapy staff are acknowledged 18. Hunter New England Local Health 21. Sakoff JA, Gilbert JA, McCluskey A (2016). leaders in their fields, with many site visits District Clinical Research Fellowship: Targeting breast cancer. HMRI $20,000. from large cancer centres to Newcastle, and $335,400. 22. Lynam J, Sakoff JA, Martin J, Lincz L, Fay invitations to speak at national and international 5. Bowden NA, van der Westhuizen A, M, CelliMarchett G, Galettis P (2016). forums. There has also been significant media Ramaciotti Foundation Health Investment Defining and predicting clinical toxicity in interest in our research activities, with both the Grant. 2016-2017 $110,000 GBM patients undergoing temozolomide- PROMETHEUS and SPARK trials featuring in print, 6. Bowden NA, Vilain RE, van der Westhuizen radiation treatment: A multivariate study. on radio and television. Two of our staff were A, Warren C. HCRA Biomarkers and Targeted Mark Hughes Foundation. $25,000. co-authors for likely practice changing abstracts Therapies Pilot Grant. 2016 $10,000 23. Garg M, Sakoff J, Lynam ,J Martin J, Dias C. recognised with oral presentations at the ASCO ASM. It is clear that our research program 7. Adler K: HCRA Infrastructure grant 2016 for Novel biomarkers of systemic inflammation continues to move from strength to strength. Centrifuge ($9224.00) as predictors of clinical toxicity with temozolomideradiation treatment in We have observed a steady increase in outputs 8. Gedye CA: 2015 Mark Hughes Foundation glioblastoma. HCRA Biomarkers and including 53 peer-reviewed publications (four Project Grants: Bringing CLARITY to brain Targeted Therapies Flagship Pilot Project awaiting citation data, one letter), 58 conference cancer and BAALC – a novel target for the grants (2016). $15,000. presentations (including six invited oral development of new treatments for brain presentations and 24 published abstracts), one cancer, total of $29,000. RADIATION ONCOLOGY AND chapter in a book, 13 conference posters, and MEDICAL PHYSICS 9. Gedye CA: 2015 CINSW Infrastructure $8,286,711.91 in competitive research funding. Grant: Single Cell Analysis Facility Operator, OUR AIM Twenty-one staff had conjoint appointments with Associate Investigator. To be a national and international leader in the University of Newcastle, and there were 18 10. Gedye CA: 2015 HCRA Pilot Grant Funding; radiation research. Higher Degree Research (HDR) students who three projects, total of $33,000. HIGHLIGHTS were either members of our group, supervised by our staff, or who conducted their research 11. Sanson-Fisher R, Carey M, Proietto A, § Involvement in >$8 million of competitive within our department. This led to one HDR Martin J, Lynam J. Consultancy Tender: research grant funding submission (Dr Todasporn Fuangrod, who, at time To assess needs and outcomes in relation § >50 Peer reviewed publications of printing, had his PhD passed) and three HDR to cancer control for people who are § 124 participants enrolled into clinical trials conferrals (Drs Jidi Sun, Danny Lee and Yolanda socioeconomically disadvantaged and have Surjan). Our staff served on the CMN Governance experienced cancer. Cancer Institute NSW § Coinvestigators for 2 oral presentation at committee, national and international conference (2015). $84,870 ASCO 2016 ASM, the world’s largest cancer conference organising committees, editorial boards, funding 12. Ackland SP and Garg MB (2015). Research peer-review panels, collaborative research groups § 18 Higher Degree Research (HDR) student Assistant Salary in Medical Oncology (such as the Trans-Tasman Radiation Oncology supervisions (3 PhDs conferred) Research Laboratory at the Calvary Mater Group), the CMN Research Committee and Newcastle Hospital. HCRA $25,000. OUR STRATEGIES Hunter Cancer Research Alliance (including two 13. Scarlett C and Sakoff JA. (2015). New § Continued research infrastructure, including Executive Committee members). drug leads for the treatment of pancreatic research-dedicated staff and funding Our work is having a significant presence at cancer. Calvary Mater Newcastle Hospital. § Define and support priority areas national annual scientific meetings. Four of $25,000. our registrars’ abstracts were accepted for oral § Provide structure and strategy to 14. Sakoff JA. (2015). Technical Officer Salary presentations at the prestigious Varian Prize progressing projects in the Experimental Therapeutics Group in session at the RANZCR College meeting in 2015. § the Department of Medical Oncology at the Broad engagement of staff No other centre had more than two abstracts Calvary Mater Newcastle Hospital. HCRA § Research as part of core service delivery selected for this highly competitive session. $25,000. § External engagement The quality of the research and preparation for the event received the ultimate 15. Robinson P, Chircop M, Reddel R, McCluskey OUR RESEARCH PRIORITY AREAS acknowledgement when Dr Yuvnik Trada won A, Sakoff .J 2015 An integrated in-cell Support promising areas; championed by staff the Varian prize. The Medical Physics team also cancer drug screening system. Cancer with specific expertise in: Institute NSW. $499,762. had a record-breaking 13 abstracts accepted § Imaging using technologies such as for presentation at the 2015 Engineering and 16. Lynam J. Salary support for Clinical Trial Magnetic Resonance Imaging (MRI), and Physical Sciences in Medicine Conference. Coordinator for Investigator Initiated Trials. Positron Emission Tomography (PET), Seven abstracts were deemed outstanding for HMRI Medical Research Support Program oral presentation, plus Conjoint Professor Peter (2016). $56,365 § Radiation Therapy with particular focus on Image-Guided Radiation Therapy (IGRT) and Greer was an invited speaker. In all, for this one 17. Sakoff JA, Gilbert JA(2016). Selectively treatment verification, conference alone, there were 10 different first targeting breast cancer. Calvary Mater authors and 17 different contributors from a § Radiobiology, and Newcastle Hospital. $34,000 range of staff within the hospital's Medical Physics 18. Fay M and Sakoff JA (2016). Enhancing § Clinical trials. and greater Radiation Oncology Department. effects of radiation in GBM. Calvary Mater EXECUTIVE SUMMARY We continue to have a strategically-focussed Newcastle Hospital. $24,500 The growth in research activity in the Department Research team comprising Director of 19. Garg M, Ackland S, Sakoff JA (2016). of Radiation Oncology continues. Our staff are Research, Associate Professor Jarad Martin broadly engaged in projects extending the full (2012-); Research Coordinator, Dr Mary-Claire

72 | 2015/2016 Calvary Mater Newcastle Review of Operations Hanlon (2013-); and Research Administrative control and gantry speed tests. Journal of 32(3), 316-323. Assistants, Ms Nicole Matthews (2013-2015) Applied Clinical Medical Physics, 17(3). 12. Delahunt, B., Egevad, L., Srigley, J. R., and Ms Stephanie Phillipp (2016-). We provide 3. Beck, A. K., Baker, A., Britton, B.,Wratten , Steigler, A., Murray, J. D., Atkinson, C., on-the-job, clinically-driven research training, C., Bauer, J., Wolfenden, L., & Carter, Matthews, J., Duchesne, G., Spry, N. A., monthly research newsletters and workshops, G. (2015). Fidelity considerations in Christie, D., Joseph, D., Attia, J.,Denham & , and regular Tumour Stream meetings. Our translational research: Eating As Treatment J. W. (2015). Validation of International eight Tumour Streams focus specifically on - a stepped wedge, randomised controlled Society of Urological Pathology (ISUP) locations or radiation delivery methods. At these trial of a dietitian delivered behaviour grading for prostatic adenocarcinoma meetings, we discuss current and proposed change counselling intervention for head in thin core biopsies using TROG 03.04 research, as well as monitoring trial progress. and neck cancer patients undergoing 'RADAR' trial clinical data. Pathology, 47(6), For example, staff who have skills or interest in radiotherapy. Trials, 16, 465. 520-525. lung cancer or body stereotactic research (and 4. Bell, C., Dowson, N., Fay, M., Thomas, 13. Denham, J. W., Steigler, A., Joseph, D., its implementation) attend those meetings. We P., Puttick, S., Gal, Y., & Rose, S. (2015). Lamb, D. S., Spry, N. A., Duchesne, G., also manage a research trust fund, thanks to the Hypoxia Imaging in Gliomas With Atkinson, C., Matthews, J., Turner, S., generosity of our patients and their loved ones, 18F-Fluoromisonidazole PET: Toward Clinical Kenny, L., Tai, K. H., Gogna, N. K., Gill, S., as well as the income we receive from the clinical Translation. Seminars in Nuclear Medicine, Tan, H., Kearvell, R., Murray, J., Ebert, M., trials for which we recruit. This funding enables 45(2), 136-150. Haworth, A., Kennedy, A., Delahunt, B., us to buy equipment, support statistical analysis, Oldmeadow, C., Holliday, E. G., & Attia, J. publish in well regarded open access literature, 5. Bell, C., Dowson, N., Puttick, S., Gal, Y., (2015). Radiation dose escalation or longer and test our own ideas with pilot funding. Thomas, P., Fay, M., Smith, J. G., & Rose, androgen suppression for locally advanced We host a weekly Tuesday Forum to facilitate S. (2015). Increasing feasibility and utility prostate cancer? Data from the TROG dissemination and peer-review of research from of 18F-FDOPA PET for the management 03.04 RADAR trial. Radiother Oncol, 115(3), within the department as well as the opportunity of glioma. Nuclear Medicine and Biology, 301-307. to hear visitors from other departments, 42(10), 788-795. institutions, and countries, speak about their 6. Bell, C., Pannek, K., Fay, M., Thomas, P., 14. Dowling, J. A., Sun, J., Pichler, P., Rivest- research and research methods. Bourgeat, P., Salvado, O., Gal, Y., Coulthard, Henault, D., Ghose, S., Richardson, H., Our Clinical Trials Coordination team, ably-led A., Crozier, S., & Rose, S. (2014). Distance Wratten, C., Martin, J., Arm, J., Best, L., by Sarah Gallagher, included Dr Faizan Jameel, informed Track-Weighted Imaging Chandra, S. S., Fripp, J., Menk, F. W., & Jo Smart, Skye Bullen and welcomed Angela (diTWI): A framework for sensitising Greer, P. B. (2015). Automatic Substitute Johns. The coordinators have a combined total streamline information to neuropathology. Computed Tomography Generation and of over 40 years of research experience with NeuroImage, 86, 60-66. Contouring for Magnetic Resonance Imaging (MRI)-Alone External Beam backgrounds in general science, diagnostic 7. Bell, C., Rose, S., Puttick, S., Pagnozzi, A., Radiation Therapy From Standard MRI radiography, pharmacy and clinical trial Poole, C. M., Gal, Y., Thomas, P., Fay, M., Sequences. Int J Radiat Oncol Biol Phys, monitoring. Jeffree, R. L., & Dowson, N. (2014). Dual 93(5), 1144-1153. During July 2015 to June 2016, we had 41 acquisition of 18 F-FMISO and 18 F-FDOPA. currently active studies, including 37 clinical trials Physics in Medicine and Biology, 59(14), 15. Dunn, L., Lehmann, J., Lye, J., Kenny, J., which were in recruitment or follow-up, and 3925. Kron, T., Alves, A., Cole, A., Zifodya, J., & Williams, I. (2015). National dosimetric other staff-led studies which tested feasibility, 8. Britton, B., McCarter, K., Baker, A., safety and efficacy, as well as retrospective audit network finds discrepancies in AAA Wolfenden, L., Wratten, C., Bauer, J., Beck, audits. Five new studies were activated, 124 lung inhomogeneity corrections. Phys Med, A., McElduff, P., Halpin, S., & Carter, G. participants were enrolled and 470 participants 31(5), 435-441. (2015). Eating As Treatment (EAT) study were in follow-up. Integral to the smooth and protocol: a stepped-wedge, randomised 16. Fay, M., Head, R., & Martin, J. (2015). efficient operation of research activities is the controlled trial of a health behaviour Where is the radiobiology and assistance that the clinical trials coordinators change intervention provided by dietitians pharmacology research to improve provide in registering trials and ethics to improve nutrition in patients with head outcomes in glioblastoma? J Neurooncol, applications, and the many progress reports and neck cancer undergoing radiotherapy. 124(1), 1-3. associated with these research projects. Two BMJ Open, 5(7), e008921. 17. Garvey, G., Cunningham, J., He, V. Y., Janda, major projects were undertaken, the first was the M., Baade, P., Sabesan, S., Martin, J. H.,Fay , implementation of electronic data capture for 9. Butler, D. J., Stevenson, A. W., Wright, T. E., Lehmann M., Adams, J., Kondalsamy-Chennakesavan, trial participants within Varian ARIA. The second Harty, P. D., , J., Livingstone, J., & S., & Valery, P. C. (2016). Health-related was the development of electronic case report Crosbie, J. C. (2015). High spatial resolution quality of life among Indigenous Australians forms through REDCap (Research Electronic dosimetric response maps for radiotherapy diagnosed with cancer. Quality of Life Data Capture), which is a secure, web-based ionization chambers measured using Research, 1-10. doi: 10.1007/s11136-016- application providing an intuitive interface for kilovoltage synchrotron radiation. Phys Med 1233-6 validated data entry, audit trails, automated Biol, 60(22), 8625-8641. export procedures to common statistical 10. Carter, G., Clover, K., Britton, B., Mitchell, 18. Ghose, S., Mitra, J., Rivest-Hénault, D., packages, and procedures for importing data A. J., White, M., McLeod, N., Denham, J., Fazlollahi, A., Stanwell, P., Pichler, P., from external sources. & Lambert, S. D. (2015). Wellbeing during Sun, J., Fripp, J., Greer, P. B., & Dowling, PEER-REVIEWED PUBLICATIONS Active Surveillance for localised prostate J. A. (2016). MRI-alone radiation therapy planning for prostate cancer: Automatic 1. Barnes, M. P., & Greer, P. B. (2016). Time- cancer: a systematic review of psychological fiducial marker detection. Med Phys, 43(5), resolved beam symmetry measurement for morbidity and quality of life. Cancer Treat 2218-2228. VMAT commissioning and quality assurance. Rev, 41(1), 46-60. Journal of Applied Clinical Medical Physics, 11. Cheng, M., Fay, M., & Steinke, K. (2016). 19. Hosein, A. N., Lim, Y. C., Day, B., Stringer, B., 17(2). Percutaneous CT-guided thermal ablation Rose, S., Head, R., Cosgrove, L., Sminia, P., Fay, M., & Martin, J. H. (2015). The effect of valproic 2. Barnes, M. P., Rowshanfarzad, P., & Greer, as salvage therapy for recurrent non- acid in combination with irradiation and P. B. (2016). VMAT linear accelerator small cell lung cancer after external beam temozolomide on primary human glioblastoma commissioning and quality assurance: dose radiotherapy: A retrospective study. International Journal of Hyperthermia, cells. J Neurooncol, 122(2), 263-271.

2015/2016 Calvary Mater Newcastle Review of Operations | 73 20. Jameel, F., Phang, M., Wood, L. G., & Garg, Celecoxib or diclofenac hepatic status in the P. M., Chytyk-Praznik, K., Greer, P. B., & M. L. (2014). Acute effects of feeding presence or absence of rebamipide. Eur Rev McCurdy, B. M. (2015). Validation of a fructose, glucose and sucrose on blood lipid Med Pharmacol Sci, 19(17), 3318-3325. method for in vivo 3D dose reconstruction levels and systemic inflammation. Lipids in 31. Nelligan, R., Baldwin, Z., Ostwald, T., Tran, for IMRT and VMAT treatments using on- Health and Disease, 13(1), 195. T., & Bailey, M. (2015). ACPSEM ROSG TBE treatment EPID images and a model-based 21. Jameel, F., Thota, R. N., Wood, L. G., working group recommendations for quality forward-calculation algorithm. Med Phys, Plunkett, B., & Garg, M. L. (2015). Sex- assurance in total body electron irradiation. 42(12), 6945-6954. dependent association between circulating Australasian Physical & Engineering 41. Whelan, B., Kumar, S., Dowling, J., Begg, irisin levels and insulin resistance in healthy Sciences in Medicine, 38(3), 479-492. J., Lambert, J., Lim, K., Vinod, S. K., Greer, adults. Journal of Nutrition & Intermediary 32. Neville, K. E., Bisquera, A., & Capp, A. L. P. B., & Holloway, L. (2015). Utilising Metabolism, 2(3-4), 86-92. (2015). Involved-field radiotherapy for pseudo-CT data for dose calculation and 22. Jones, M., Hruby, G., Solomon, M., patients with mantle cell lymphoma. J Med plan optimization in adaptive radiotherapy. Rutherford, N., & Martin, J. (2015). The Imaging Radiat Oncol, 59(5), 631-639. Australas Phys Eng Sci Med, 38(4), 561-568. Role of FDG-PET in the Initial Staging and 33. Paganelli, C., Lee, D., Greer, P. B., Baroni, G., 42. Williams, I., Lehmann, J., Lye, J., Kenny, J., Response Assessment of Anal Cancer: A Riboldi, M., & Keall, P. (2015). Quantification Alves, A., Dunn, L., & Kron, T. (2015). The Systematic Review and Meta-analysis. Ann of lung tumor rotation with automated Australian Clinical Dosimetry Service, a Surg Oncol, 22(11), 3574-3581. landmark extraction using orthogonal cine Bespoke National Solution. Med Phys, 42(6 23. Kron, T., Lehmann, J., & Greer, P. B. (2016). MRI images. Phys Med Biol, 60(18), 7165- SU-E-P-03), 3227-3227. Dosimetry of ionising radiation in modern 7178. 43. Woodruff, H. C.,Fuangrod , T., Van Uytven, radiation oncology. Phys Med Biol, 61(14), 34. Pollock, S., O'Brien, R., Makhija, K., Hegi- E., McCurdy, B. M., van Beek, T., Bhatia, S., R167-205. Johnson, F., Ludbrook, J., Rezo, A., Tse, R., & Greer, P. B. (2015). First Experience With 24. Lee, D., Greer, P. B., Ludbrook, J., Arm, J., Eade, T., Yeghiaian-Alvandi, R., Gebski, V., & Real-Time EPID-Based Delivery Verification Hunter, P., Pollock, S., Makhija, K., O'Brien, Keall, P. J. (2015). Audiovisual biofeedback During IMRT and VMAT Sessions. Int J R. T., Kim, T., & Keall, P. (2016). Audiovisual breathing guidance for lung cancer patients Radiat Oncol Biol Phys, 93(3), 516-522. Biofeedback Improves Cine–Magnetic receiving radiotherapy: a multi-institutional 44. Wratten, C., Anne, S., Tieu, M. T., Kumar, Resonance Imaging Measured Lung Tumor phase II randomised clinical trial. BMC B., & Eisenberg, R. (2015). The dangers of Motion Consistency. International Journal of Cancer, 15, 526. diagnosing cystic neck masses as benign in Radiation Oncology*Biology*Physics, 94(3), 35. Puttick, S., Stringer, B. W., Day, B. W., Bruce, the era of HPV-associated oropharyngeal 628-636. Z. C., Ensbey, K. S., Mardon, K., Cowin, G. cancer. Med J Aust, 203(9), 371-372. 25. Lee, D., Greer, P. B., Pollock, S., Kim, T., & J., Thurecht, K. J., Whittaker, A. K., Fay, M., 45. Wu, R., Woodford, H., Capp, A., Hunter, P., Keall, P. (2016). Quantifying the accuracy of Boyd, A. W., & Rose, S. (2015). EphA2 as a Cowin, G., Tai, K. H., Nguyen, P. L., Chong, the tumor motion and area as a function Diagnostic Imaging Target in Glioblastoma: P., & Martin, J. (2015). A prospective study of acceleration factor for the simulation of A Positron Emission Tomography/Magnetic of nomogram-based adaptation of prostate the dynamic keyhole magnetic resonance Resonance Imaging Study. Mol Imaging, 14, radiotherapy target volumes. Radiat Oncol, imaging method. Med Phys, 43(5), 2639- 385-399. 10, 243. 2648. 36. Rundle-Thiele, D., Day, B., Stringer, B., Fay, 46. Yahya, N., Ebert, M. A., Bulsara, M., 26. Lindsay, J., Dooley, M., Martin, J., Fay, M., Martin, J., Jeffree, R. L., Thomas, P., Haworth, A., Kennedy, A., Joseph, D. M., Kearney, A., Khatun, M., & Barras, M. Bell, C., Salvado, O., Gal, Y., Coulthard, A., J., & Denham, J. W. (2015). Dosimetry, (2015). The development and evaluation of Crozier, S., & Rose, S. (2015). Using the clinical factors and medication intake an oncological palliative care deprescribing apparent diffusion coefficient to identifying influencing urinary symptoms after prostate guideline: the ‘OncPal deprescribing MGMT promoter methylation status early radiotherapy: An analysis of data from guideline’. Supportive Care in Cancer, 23(1), in glioblastoma: importance of analytical the RADAR prostate radiotherapy trial. 71-78. method. Journal of Medical Radiation Radiother Oncol, 116(1), 112-118. 27. McCarter, K., Britton, B., Baker, A., Halpin, Sciences, 62(2), 92-98. 47. Yahya, N., Ebert, M. A., Bulsara, M., House, S., Beck, A., Carter, G., Wratten, C., Bauer, 37. Seregni, M., Paganelli, C., Lee, D., Greer, M. J., Kennedy, A., Joseph, D. J., & Denham, J., Booth, D., Forbes, E., & Wolfenden, L. P. B., Baroni, G., Keall, P. J., & Riboldi, J. W. (2015). Urinary symptoms following (2015). Interventions to improve screening M. (2016). Motion prediction in MRI- external beam radiotherapy of the prostate: and appropriate referral of patients with guided radiotherapy based on interleaved Dose-symptom correlates with multiple- cancer for distress: systematic review orthogonal cine-MRI. Phys Med Biol, 61(2), event and event-count models. Radiother protocol. BMJ Open, 5(9), e008277. 872-887. Oncol, 117(2), 277-282. 28. Moulton, C. R., House, M. J., Lye, V., Tang, 38. Sridharan, S., Macias, V., Tangella, K., 48. Yahya, N., Ebert, M. A., Bulsara, M., House, C. I., Krawiec, M., Joseph, D. J., Denham, Kajdacsy-Balla, A., & Popescu, G. (2015). M. J., Kennedy, A., Joseph, D. J., & Denham, J. W., & Ebert, M. A. (2015). Registering Prediction of prostate cancer recurrence J. W. (2016). Statistical-learning strategies prostate external beam radiotherapy with a using quantitative phase imaging. Sci Rep, generate only modestly performing boost from high-dose-rate brachytherapy: 5, 9976. predictive models for urinary symptoms a comparative evaluation of deformable 39. Trada, Y., Kneebone, A., Paneghel, A., following external beam radiotherapy of registration algorithms. Radiation Oncology, Pearse, M., Sidhom, M., Tang, C., Wiltshire, the prostate: A comparison of conventional 10(1), 1-10. K. L., Haworth, A., Fraser-Browne, C. L., and machine-learning methods. Med Phys, 29. Murrell, D. E., Denham, J. W., & & Martin, J. (2015). Optimising Radiation 43(5), 2040-2052. Harirforoosh, S. (2015). Histopathology and therapy Quality Assurance in Clinical PRE-PRINTS AWAITING CITATION AND LETTERS oxidative stress analysis of concomitant Trials: A TROG 08.03 RAVES substudy. TO THE EDITOR misoprostol and celecoxib administration. J International Journal of Radiation 1. Fay, M. F., Head, R., Sminia, P., Dowson, Toxicol Pathol, 28(3), 165-170. Oncology*Biology*Physics, 93(5), N., Cosgrove, L., Rose, S. E., & Martin, J. H. 30. Murrell, D. E., Rahmasari, Y., Denham, J. 1045–1051. (2016). Valproate in Adjuvant Glioblastoma W., Panus, P. C., & Harirforoosh, S. (2015). 40. Van Uytven, E., Van Beek, T., McCowan, Treatment. Journal of Clinical Oncology, Letter to the Editor.

74 | 2015/2016 Calvary Mater Newcastle Review of Operations 2. Bitsika, V., Sharpley, C. F., Christie, D. R. H., imaging and targeted radiotherapy using Cancer, Red Journal or JACMP; Hanlon, M. Bradford, R., Steigler, A., & Denham, J. W. audiovisual biofeedback (NHMRC (National C., & Martin, J. M.; (2015) Open Access (2016 online preprint). Measuring personal Health & Medical Research Council)) 2 Pre-Approval (Centre for Clinical Radiation and functional changes in prostate cancer years, Aust Competitive - Commonwealth - Research) Ongoing, survivors: development and validation of Development Grant 16. $3,000 per item, unlimited; Hanlon, M. the FADE: data from the TROG 03.04 RADAR 6. $535,547; Ebert, M., Dowling, J., Denham, C., & Martin, J. M.; (2016) CReDITSS Pre- trial. Psycho-Oncology, n/a-n/a. J. W., Joseph, D., Gulliford, S., Dearnaley, Approval (Centre for Clinical Radiation 3. Forshaw, K., Hall, A., Boyes, A. C., M., & D., Haworth, A., Holloway, L., Kron, T., & Research) Ongoing, Competititve Martin , J. M. (Accepted 30 May 2016). Greer, P. B.; (2015) Radiotherapy treatment 17. $2,546.67; Fay, M.; (2015) American Patients’ experiences of preparation for for prostate cancer – direct evidence for Society for Therapeutic Radiation Oncology radiotherapy: a qualitative study. Oncology targeting and toxicity effects using real Meeting, San Antonio, Texas, 18-21 Nurses Forum. outcomes data – moving towards voxel-level October 2015 (Mark Hughes Foundation) 4. Martin, J., Arm, J., Smart, J., Palazzi, radiotherapy treatment planning (NHMRC Conference Travel, Competitive Project Grant) 2015-2017, Competititve: K., Capp, A., Ainsworth, P., & Cowin, 18. $504.50; Bandera, V., & Hanlon, M. C.; NHMRC Project Grant G. (2016; Epub ahead of print). Spinal (2016) CREDITSS balance (Centre for Clinical multiparametric MRI and DEXA changes 7. $435,000; Foroudi, F., Khoo, V., Pryor, D., Radiation Research) Competititve over time in men with prostate cancer Foote, M., Ball, D., Graham, P., Martin, 19. US$500; Zwan, B., Barnes, M. P., Fuangord, treated with androgen deprivation therapy: J. M., Greer, P. B., Millward, M., & Trans T., Stanton, C. J., O'Connor, D. J., Keall, P. J., a potential imaging biomarker of treatment Tasman Radiation Oncology Group; (2016) & Greer, P. B.; (2016) An EPID-based system toxicity. Eur Radiol. A multistage multi centre international for gantry-resolved MLC quality assurance randomised trial of Conventional 5. Yahya, N., Ebert, M. A., Bulsara, M., for VMAT (Centre for Clinical Radiation Denham care Or Radioablation (stereotactic Kennedy, A., Joseph, D. J., & , J. W. Research) (In press - corrected proof). Independent body radiotherapy) for Extra-cranial BOOK CHAPTERS external validation of predictive models oligometastatic disease in lung, breast for urinary dysfunction following external and prostate cancer (CORE) (Cancer 1. Fay, M., Bell, C., Dowson, N., Puttick, S., & beam radiotherapy of the prostate: Issues Australia) 3 years, Aust Competitive Rose, S. (2015). Imaging of Brain Tumours. in model development and reporting. - Non Commonwealth - Priority-driven In T. Lichtor (Ed.), Molecular Considerations Radiotherapy and Oncology. Collaborative Cancer Research Scheme and Evolving Surgical Management Issues in the Treatment of Patients with a Brain FUNDING AWARDED 8. $376,612; Denham, J., Joseph, D., Duchesne, G., & Attia, J.; (2016) The role of Tumor (pp. 235-276). Rijeka, Croatia: 1. $2,234,524.90; Sanson-Fisher, R., Butow, InTech. P., Tattersall, M., D'Este, C., Doran, C., adjuvant zoledronic acid in locally advanced CONFERENCE PRESENTATIONS AND PUBLISHED & Martin, J.; (2015) Improving and prostate cancer (NHMRC (National Health CONFERENCE ABSTRACTS maintaining holistic cancer survivor & Medical Research Council)) 2 years, Aust outcomes. A system-based program. Competitive - Commonwealth - Project Grant 1. Alves, A., Lehmann, J., Lye, J., Dunn, L., (Cancer Council NSW) 5 years, Competititve 9. $223,664; Hutmacher, D. W., Russell, P., Kenny, J., Kron, T., & Williams, I. (2015). Denham Comparing the ACDS Level II and III audit 2. $1,272,142 Hofman, M., Francis, F., Williams, E., & , J. D.; (2015) A outcomes. Paper presented orally at the Frydenberg, M., Lawrentschuk, N., Martin, Humanised in vivo Model to Test Novel EPSM, Wellington, NZ. J. M., Roach, P., Thomas, P., Williams, Therapeutic Strategies Against Prostate S., Francis, R., Scott, A., Foroudi, F., Cancer Bone Metastasis (Worldwide 2. Artschan, R., Jones, R., Ostwald, P., Pichler, Weickhardt, A., Hicks, R., Murphy, D., Cancer Research (formerly AICR)) 2 years, P., Simpson, J., & Lehmann, J. (2015). Sandhu, S., Parameswaran, B., Holt, T., Vela, International - Competitive - Project Grant Extension of QA for cranial stereotactic I., Heathcote, P., Hayne, D., Tang, C., Gupta, 10. $105,000 Simpson, J., Greer, P. B., & radiosurgery from cone based to HD-MLC S., Wood, L. G., Kovacev, O., Ramdave, S., & Lehmann, J.; (2016) The accuracy and based treatments. Paper presented orally at Emmett, L.; (2016) Multi-centre randomised utility of Intra-fraction Motion Review (IMR) the EPSM, Wellington, NZ. clinical trial of PSMA PET/CT for staging in clinical practice using the Truebeam 3. Barakat, M., S., Field, M., Stirling, D., of prostate cancer (PCFA - Movember STx (Varian Medical Systems, Inc.) 1 year, Holloway, L., Ghose, A., Bailey, M., Carolan, Clinical Trial Award) 5 years, 2016 - 2021, International - Competitive M., Dekker, A., Delaney, G., Goozee, G., Competitive 11. $50,441.04; Jovanovic, K., & Hanlon, M. C.; Lehmann, J., Lustberg, T., van Soest, J., 3. $1,000,000; Ackland, S., Zhang, X., Forbes, (2016) RT Research Position Backfill (Centre Sykes, J., Walsh, S., Vinod, S., & Thwaites, D. J., Greer, P. B., Martin, J., Bowden, N., for Clinical Radiation Research) Ongoing, (2016). An Australian radiotherapy decision Martin, J. M., Dun, M., Verrills, N., Jiang, Competitive support system with contextual justification. Paper presented orally at the ESTRO 35, C., & Scarlett, C.; (2016) Priority Research 12. $25,000; Simpson, J., Lau, P., Denham, Turin, Italy. Centre: Cancer Research, Innovation and J. D., Greer, P. B., & Ramadan, S.; (2015) Translation (The University of Newcastle ) 5 Improved prostate tumour identification 4. Barnes, M., Artschan, R., Lehmann, J., years, 2016-2020, Priority Research Centre and delineation using multi-parametric & Greer, P. (2015). Evaluation of the 4. $594,197; Holloway, L., Haworth, A., magnetic resonance imaging (Centre for TrueBeam Machine Performance Check Dowling, J., Ebert, M. A., Jameson, M., Clinical Radiation Research) 1 year, (MPC) Beam Constancy Checks. Paper presented orally at the EPSM, Wellington, Kron, T., Vinod, S., Leong, T., Greer, P. 13. $19,020; Simpson, J.; (2015) OZcat Secure NZ. B., & Creutzberg, C.; (2016) Reducing Data Storage (Centre for Clinical Radiation the greatest uncertainty in radiotherapy Research) 10 years, 5. Bhatia, S., Wilton, L., & Simpson, J. (2016). (NHMRC (National Health & Medical PlanAssist – A planning tool for the rapid 14. $6,400; Greer, P., Martin, J., Wilton, L., Research Council)) 1 year, Aust Competitive assessment of dose constraints. Paper Gallagher, S., Fay, M., & Legge, K.; (2015) - Commonwealth presented orally at the Varian Australasian Salary support - Research Assistant (Centre Summit, Auckland, NZ. 5. $588,000; Keall, P., Kay, J., O'Brien, R., for Clinical Radiation Research) 1 year, Kron, T., Greer, P. B., Hebblewhite, M., & Competitive 6. Butler, D., Wright, T., Stevenson, A., Oliver, Sawant, A.; (2015-2016) Improving cancer C., Harty, P., Lehmann, J., Livingstone, J., 15. $3,000 for open access publishing in BMC

2015/2016 Calvary Mater Newcastle Review of Operations | 75 & Crosbie, J. (2015). Calculated spatial EPID Dosimetry: pre-treatment verification, 27. Lee, D., Greer, P., Lapuz, C., Ludbrook, response of ionization chambers in air and clinical trial credentialling and real-time J., Pollock, S., Kim, T., & Keall, P. (2015). water. Paper presented orally at the EPSM, patient dose monitoring. Paper presented SU-E-J-236: Audiovisual Biofeedback Wellington, NZ. orally at the EPSM, Wellington, NZ. Improves Breath-Hold Lung Tumor Position 7. Catton, C. N., Lukka, H., Julian, J. A., Gu, C. 16. Greer, P. (2016). Invited Oral Presentation: Reproducibility Measured with 4D MRI. S., Martin, J. M., Supiot, S., Chung, P. W. VESPA Update. Paper presented orally at the Med Phys, 42(6 (AAPM)), 3320-3320. M., Bauman, G., Bahary, J. P., Ahmed, S., TROG Annual Scientific Meeting, Brisbane, 28. Lee, D., Greer, P., Lapuz, C., Ludbrook, Cheung, P., Tai, K. H., Wu, J., Parliament, QLD, Australia. J., Pollock, S., Kim, T., & Keall, P. (2016). M., & Levine, M. N. (2016). Invited Oral 17. Greer, P. (2016). TU-D-BRC-02: Free MO-FG-CAMPUS-JeP2-02: Audiovisual Presentation: A randomized trial of a Information - EPID-Based In Vivo Dosimetry Biofeedback Guided Respiratory-Gated MRI: shorter radiation fractionation schedule for (Invited Presentation). Med Phys, 43(6 An Investigation of Tumor Definition and the treatment of localized prostate cancer. (AAPM)), 3745-3745. Scan Time for Lung Cancer. Med Phys, 43(6 Paper presented orally at the 2016 ASCO (AAPM)), 3721-3721. 18. Greer, P. B. (2016). Invited Oral Annual Meeting Chicago, USA. Presentation: EPID and in-vivo dosimetry. 29. Lee, D., Greer, P., Ludbrook, J., Paganelli, 8. David, R., Zwan, B., Hindmarsh, J., Seymour, Paper presented orally at the EPI2K16, St C., Pollock, S., Kim, T., & Keall, P. (2015). E., Kandasamy, K., Arthur, G., Lee, C., Louis, USA. SU-E-J-235: Audiovisual Biofeedback & Greer, P. (2016). MO-FG-CAMPUS- Improves the Correlation Between Internal 19. Greer, P. B., Dowling, J., Rivest-Henault, D., TeP1-01: An Efficient Method of 3D Patient and External Respiratory Motion. Med Phys, Ghose, S., Pichler, P., Sun, J., Richardson, Dose Reconstruction Based On EPID 42(6 (AAPM)), 3320-3320. H., Menk, F., Martin, J., & Wratten, C. Measurements for Pre-Treatment Patient (2015). SP-0021: Generation of density 30. Lee, F., Liney, G., Begg, J., Dong, B., Greer, Specific QA. Med Phys, 43(6 (AAPM)), maps for dose calculations from MRI using P., & Vial, P. (2016). The feasibility of 3718-3718. atlas methods. Radiotherapy and Oncology, incorporating an EPID with the Australian 9. DeMarco, J., Moran, J., Barnes, M., 115(ESTRO), S11-S12. MRI-LINAC. Paper presented orally at the Greer, P., Kim, G., Fraass, B., Yang, W., & EPI2K16, St Louis, USA 20. Greer, P. B., Miri, N., Legge, K., Vial, P., McKenzie Boehnke, E. (2016). SU-F-T-476: Legge Wilfert Martin Moore, A., & Lehmann, J. (2016). Remote 31. , K., Cutajar, D., , A., , Performance of the AS1200 EPID for dosimetric auditing for clinical trials using J., Rozenfeld, A., O’Connor, D. J., & Greer, Periodic Photon Quality Assurance. Med EPID. Paper presented orally at the EPI2K16, P. (2016). SU-F-T-328: Real-Time in Phys, 43(6 (AAPM)), 3572-3572. St Louis, USA. Vivo Dosimetry of Prostate SBRT Boost 10. Field, M., Barakat, M. S., Bailey, M., Carolan, Treatments Using MOSkin Detectors. Med 21. Greer, P. B., Woodruff, H., &Simpson , J. M., Dekker, A., Delaney, G., Goozee, G., Phys, 43(6 (AAPM)), 3538-3538. PD-0138: Real-time EPID based delivery Holloway, L., Lehmann, J., Lustberg, T., van Legge Lehmann Miri verification during lung stereotactic 32. , K., , J., Vial, P., , N., Soest, J., Sykes, J., Walsh, S., & Thwaites, D. body radiotherapy: initial experience. & Greer, P. (2016). SU-D-201-06: Remote (2015). A distributed data mining network Radiotherapy and Oncology, 115(ESTRO), Dosmetric Auditing of VMAT Deliveries for infrastructure for Australian radiotherapy S65-S66. Clinical Trials Using EPID. Med Phys, 43(6 decision support. Paper presented orally at (AAPM)), 3335-3335. the EPSM, Turin, Italy. 22. Jeans, C., Ward, L., Cartmill, B., Vertigan, Legge Wilton A., Wratten, C., & Hanlon, M. C. (2016). 33. , K., Nguyen, D., Ng, J., , L., 11. Field, M., Barakat, M. S., Holloway, L., Internal lymphoedema: swallow and voice. Booth, J., Keall, P., Martin, J., O’Connor, Bailey, M., Carolan, M., Delaney, G., Ebert, Paper presented orally at the Advanced D. J., & Greer, P. (2016). SU-G-JeP4-10: M., Ghose, A., Goozee, G., Greer, P. B., Head and Neck Cancer Symposium, Measurement of Prostate Motion Lehmann, J., Lustberg, T., Miller, A., van Brisbane, Australia. Trajectories During Prostate SBRT Boost Soest, J., Stirling, D., Vinod, S., Walsh, S., Treatments with a Rectafix. Med Phys, 43(6 23. Jones, R., Artschan, R., Doebrich, M., Sykes, J., Dekker, A., & Thwaites, D. (2016). (AAPM)), 3683-3683. Distributed rapid learning for decision Stanton, C., Aldrich, B., Barnes, M., Greer, 34. Lehmann, J., Miri, N., Legge, K., & Greer, P. support down under and around the world. P., & Lehmann, J. (2015). Medium term B. (2016). Virtual EPID Standard Phantom Paper presented orally at the ICCR, London, experience with automated linac based Audit (VESPA) for remote IMRT and VMAT UK. Winston-Lutz style testing of gantry and couch rotations. Paper presented orally at credentialing. Paper presented orally at the 12. Fuangrod, T., Simpson, J., Middleton, R., & the EPSM, Wellington, NZ. ICCR, London, UK. Greer, P. (2016). TH-CD-207A-11: Sensitivity 35. Lehmann, J., Miri, N., Vial, P., Hatton, J., Analysis of Action Limits for Real-Time EPID- 24. Jones, R., Artschan, R., Ostwald, P., & Zwan, B., Craig, A., Beenstock, V., Molloy, Based Delivery Verification System Using Lehmann, J. (2015). Verification of complex T., Sloan, K., & Greer, P. (2015). MO-D-213- Artificial Clinical Relevant Error Simulations. treatment plans with rectilinear End- 08: Remote Dosimetric Credentialing for Med Phys, 43(6 (AAPM)), 3882-3882. To-End Audit Phantom for Stereotactic Radiotherapy. Paper presented orally at the Clinical Trials with the Virtual EPID Standard 13. Fuangrod, T., Simpson, J., Middleton, R., EPSM, Wellington, NZ. Phantom Audit (VESPA). Med Phys, 42(6 & Greer, P. (2016, 29 April-3 May 2016). (AAPM)), 3555-3555. Simulation of clinical relevance errors 25. Jones, R., Artschan, R., Thwaites, D., & 36. Lehmann, J., Sun, J., Doebrich, M., Zwan, detected by real-time EPID-based patient Lehmann, J. (2015). SU-E-T-282: Dose B., Fuangrod, T., Bhatia, S., & Greer, P. verification system. Paper presented orally Measurements with An End-To-End Audit (2016). TH-CD-207A-02: Implementation at the ESTRO 35, Turin, Italy. Phantom for Stereotactic Radiotherapy. Med Phys, 42(6 (AAPM)), 3398-3398. of Live EPID-Based Inspiration Level 14. Fuangrod, T., Simpson, S., Middleton, R., & Assessment (LEILA) for Deep Inspiration 26. Kupfer, T., Lehmann, J., Franich, R., Butler, Greer, P. B. (2016). Simulation of clinically Breath-Hold (DIBH) Monitoring Using MV D., Ramanathan, G., & Rykers, K. (2015). significant errors detected by a real-time Fluoroscopy. Med Phys, 43(6 (AAPM)), Applications of dose-area product in small EPID-based patient verification system. 3879-3880. Paper presented orally at the EPI2K16, St field dosimetry using a large-area parallel- 37. Martin, J. M. (2016). A Randomized Trial of Louis, USA. plate ionization chamber. Paper presented orally at the EPSM. a Shorter Radiation Fractionation Schedule 15. Greer, P. (2015). Invited Oral Presentation: for the Treatment of Localized Prostate

76 | 2015/2016 Calvary Mater Newcastle Review of Operations Cancer (PC): Profit - An OCOG/TROG short-course radiotherapy with or without 54. Williams, I., Lye, J., Alves, A., Lehmann, Intergroup Study. Paper presented orally at concomitant and adjuvant temozolomide J., Dunn, L., Kenny, J., & Kron, T. (2015). the RANZCR ASM, Gold Coast, Qld. in elderly patients with glioblastoma (CCTG The Australian clinical dosimetry service: 38. Miri, N., Baltes, C., Keller, P., & Greer, CE.6, EORTC 26062-22061, TROG 08.02, Existing findings and the future. Paper P. (2015). SU-E-T-265: Development of NCT00482677). Paper presented orally at the presented orally at the EPSM, Wellington, Dose-To-Water Conversion Models for 2016 ASCO Annual Meeting, Chicago, USA. NZ. Pre-Treatment Verification with the New 47. Ritter, T., Schultz, B., Kim, G.,Barnes , M., 55. Wilton, L. (2016). Decreasing Rectal Dose AS1200 Imager. Med Phys, 42(6 (AAPM)), Perez, M., Farrey, K., Popple, R., Greer, P., & in Prostate SBRT: An Evaluation of Two 3393-3394. Moran, J. (2016). SU-G-TeP4-07: Automatic Rectal Displacement Devices (RDD). Paper 39. Miri, N., Legge, K., Vial, P., Moore, A., EPID-Based 2D Measurement of MLC Leaf presented orally at the RANZCR ASM, Gold Lehmann, J., & Greer, P. B. (2016). Remote Offset as a Quality Control Tool. Med Phys, Coast, Qld. dosimetric auditing for clinical trials using 43(6 (AAPM)), 3686-3686. 56. Wilton, L. (2016). Invited Oral Presentation: EPID Paper presented orally at the EPI2k16, 48. Simpson, J., Lehmann, J., & Greer, P. Prostate hypofractionation and SBRT - How St Louis, USA. (2015). PO-0922: Management of intra- low can you go? Paper presented orally 40. Miri, N., Lehmann, J., Vial, P., & Greer, P. fraction motion in prostate radiotherapy: at the TROG Annual Scientific Meeting, (2016). SU-F-T-240: EPID-Based Quality a study of 100 patients imaged for all Brisbane, QLD, Australia. Assurance for Dosimetric Credentialing. fractions. Radiotherapy and Oncology, 57. Zwan, B. J., Barnes, M., Hindmarsh, J., Med Phys, 43(6 (AAPM)), 3517-3517. 115(ESTRO), S480. doi: 10.1016/S0167- Seymour, E., O’Connor, D. J., Keall, P. J., 8140(15)40914-4 41. Miri, N., Lehmann, J., Vial, P., Hatton, J., & Greer, P. B. (2016). MO-FG-202-04: Zwan, B., Craig, A., Beenstock, V., Cousins, 49. Stanton, C., Artschan, R., Dempsey, C., Gantry-Resolved Linac QA for VMAT: A A., Molloy, T., Sloan, K., Gustafsson, H., & & Lehmann, J. (2015). Characterisation Comprehensive and Efficient System Using Greer, P. B. (2015). Credentialing clinical and prevention of data loss due to An Electronic Portal Imaging Device. Med trials based on EPID dosimetry. Paper undersampling in retrospective low-pitch Phys, 43(6 (AAPM)), 3712-3712. presented orally at the EPSM, Wellington, helical CT (4DCT). Paper presented orally at 58. Zwan, B., Colvill, E., Booth, J., O’Connor, J., NZ. the EPSM, Wellington, NZ. Keall, P., & Greer, P. (2016). TH-AB-202-02: 42. Miri, N., Lehmann, J., Vial, P., Legge, K., & 50. Sun, J., Doebrich, M., & Lehmann, J. Real-Time Verification and Error Detection Greer, P. (2016). TU-FG-201-06: Remote (2016). Live EPID-based Inspiration Level for MLC Tracking Deliveries Using An Dosimetric Auditing for Clinical Trials Using Assessment (LEILA) for deep inspiration Electronic Portal Imaging Device. Med Phys, EPID Dosimetry: A Pilot Study. Med Phys, breath-hold (DIBH) monitoring using MV 43(6 (AAPM)), 3856-3857. 43(6 (AAPM)), 3754-3754. fluoroscopy. Paper presented orally at the CONFERENCE POSTERS ICCR, London, UK. 43. Moorrees, J., Stanton, C., Simpson, J., & 1. Bhatia, S., Walsh, P. C., Field, M., Bakarat, 51. Thwaites, D., Carolan, M., Fielding, A., Lehmann, J. (2015). Impact of Interplay M. S., Greer, P., Ludbrook, J., Dekker, A., Lehmann Effect on the Dosimetry of SBRT Treatments Franich, R., House, M., , J., Holloway, L., Vinod, S. K., Thwaites, D., using 6MV FFF beams. Paper presented Metcalfe, P., Penfold, S., & Rosenfeld, A. & Lehmann, J. (2015). Sifting data from orally at the EPSM, Wellington, NZ. (2015). The Australian national collaborative the clinical coalface: Implementation of a academic Medical Physics Network: Radiation Oncology data mining system in 44. Nguyen, D., Kim, J., O’Brien, R., Huang, C., structure, activity and outcomes. Paper Greer Legge Newcastle, Australia to aid clinical decisions. Booth, J., , P., , K., Poulsen, P., presented orally at the EPSM, Wellington, Martin EPSM, Wellington. NZ. , J., & Keall, P. (2016). TH-AB-202-12: NZ. The First Clinical Implementation of a 2. Brobowski, K., Sun, J., Dowling, J., O’Connor, 52. Warren, L. E., Chen, M. H., Denham, J. W., Real-Time Six Degree of Freedom Tracking L., Best, L., & Greer, P. (2016). Assessment Steigler, A., Renshaw, A. A., & Loffredo, System During Radiation Therapy. Med of distortion in MRI images for head and M. J. (2016). Gleason grade 5 and the risk Phys, 43(6 (AAPM)), 3859-3859. neck radiation therapy planning. MR in RT of death from prostate cancer following Symposium, Ann-Arbor, USA. Lee Greer 45. Paganelli, C., , D., Kipritidis, J., , radiation with or without 6 months of 3. Cho, G., Lehmann, J., & Thwaites, D. P., Riboldi, M., & Keall, P. (2015). TU- conventional androgen deprivation therapy. (2015). An analysis of small field dosimetry CD-BRA-06: 3D Reconstruction From 2D Journal of Clinical Oncology, 33(15 ASCO), uncertainty due to field aperture position CineMRI Orthogonal Slices: A Feasibility suppl e16099. Study. Med Phys, 42(6 (AAPM)), 3606-3607. variations. EPSM, Wellington, NZ. 53. Williams, I., Lye, J., Alves, A., Lehmann, 4. De Leon, J., Rivest-Henault, D., Keats, S., 46. Perry, J. R., Laperriere, N., O'Callaghan, C. J., Dunn, L., Kenny, J., & Kron, T. (2015). Jameson, M., Rai, R., Arumugam, S., Wilton, J., Brandes, A. A., Menten, J., Phillips, C., The Australian Clinical Dosimetry Service, Fay L., Ngo, D., Martin, J., & Sidhom, M. (2016). , M. F., Nishikawa, R., Cairncross, J. G., Outcomes to Date and the Future. Paper Rectal immobilisation device in stereotactic Roa, W., Osoba, D., Sahgal, A., Hirte, H. W., presented orally at the RANZCR The Royal prostate treatment: intrafraction motion Wick, W., Laigle-Donadey, F., Franceschi, E., Australian and New Zealand College and dosimetry. ESTRO 35, 29 April-3 May Chinot, O. L., Winch, C., Ding, K., & Mason, of Radiologists’ 2015 Annual Scientific 2016, Turin, Italy. W. P. (2016). Invited Oral Presentation: A Meeting. phase III randomized controlled trial of 5. DeMarco, J., Eckhause, T., Ritter, T., Al-Hallaq,

2015/2016 Calvary Mater Newcastle Review of Operations | 77 H., Booth, J., Farrey, K., Kim, G. Y., Popple, R., Transit Beam Image Processing. (PhD 17. Sun, J. (Conferred 2015). Development Perez, M., Park, S., Barnes, M., Pawlicki, T., (Electrical Engineering)), The University of of Magnetic Resonance Imaging Based Schultz, B., Alkhatib, A., Roberts, D., Raxter, Newcastle. Prostate Treatment Planning. (Doctor of D., Greer, P., & Moran, J. M. (2016). An 5. Gholizadeh, N. (Currently enrolled - Full- Philosophy (Physics)), The University of Automated EPID-based Dose QA Suite to Time). PhD Candidate - Improved Prostate Newcastle, Newcastle, NSW, Australia. Standardize Testing in a Multi-Institutional Tumour Identification and Delineation 18. Surjan, Y. (Conferred 2016). Brachytherapy QA Consortium. ICCR, London, UK. Using Multiparametric Magnetic Resonance treatment for equine ocular and/or 6. Doebrich, M., Downie, J., Stanton, C., Imaging. (PhD (Magnetic Resonance in periocular squamous cell carcinoma. Dempsey, C., & Lehmann, J. (2015). Med) - in progress), The University of (Doctor of Philosophy (Medical Radiation Feasibility of MV cine imaging for Newcastle. Science)), The University of Newcastle, monitoring of DIBH treatments. EPSM, 6. Jeans, C. (Currently enrolled - Part-Time). Newcastle, NSW, Australia. Wellington, NZ. PhD Candidate - Lymphoedema in head 19. Zwan, B. (Currently enrolled - Full-Time). 7. Johnstone, E., Dowling, J., Henry, A., Short, and neck cancer patients: prevalence, PhD Candidate - Investigations of EPID Based S., Wyatt, J., McCallum, H., Kelly, C., Greer, risk factors, and functional impact on Dosimetry Methods for Use in MRI-Linac P., & Speight, R. (2016). Investigating the swallowing, voice and quality of life (PhD Radiotherapy. (PhD - in progress), The feasibility of using diagnostic MR images for (Speech Pathology) - in progress), University University of Newcastle. MR only brain radiotherapy planning using a of Queensland. PALLIATIVE CARE multi-atlas technique. MR in RT Symposium, 7. Jones, M. (Currently enrolled - Part-Time). The Palliative Care Research Unit remains active Ann-Arbor, USA. PhD Candidate. (PhD - in progress), The with a number of clinical trials and research 8. Legge, K., Greer, P., Cutajar, D., Wilfert, A., University of Newcastle. projects underway. The unit is staffed by two Martin, J., Rosenfeld, A., & O'Connor, J. J. 8. Kupfer, T. (Currently enrolled - Part- full-time research nurses and medical cover (2015). Real time in vivo MOSFET dosimetry Time). MSc candidate - Use of a Bragg is provided by the staff specialists from the for prostate SBRT boost treatments. EPSM, Peak ionization chamber in stereotactic department. The unit continues to increase in Wellington, NZ. radiotherapy fields. (MSc transferring both the numbers of potential participants who 9. Legge, K., Greer, P., Martin, J., & O'Connor, J. to PhD), Royal Melbourne Institute of receive study information and in numbers of J. (2015). Investigation of cine image header Technology (RMIT) University. patients who consent and go on to participate in gantry angles and their effect on a 3D EPID 9. Lee, D. K. (Conferred 2016). Magnetic one of the studies we have available. dosimetry method. EPSM, Wellington, NZ. resonance imaging of lung cancer in the During the last financial year, we had four 10. Legge, K., Greer, P., Ng, J., Booth, J. T., presence of respiratory motion: Dynamic clinical trials and four research projects open to Keall, P., Martin, J., & O'Connor, J. J. (2015). keyhole and audio visual biofeedback. recruitment, the number of referrals received Kilovoltage intrafraction monitoring of (PhD), University of Sydney, Sydney, NSW, was 128, with an additional 1,693 patients who prostate SBRT boost treatments. EPSM, Australia. were either admitted to the Hospice or attended Wellington, NZ. 10. Legge, K. (Currently enrolled - Full-Time). oncology clinics. These patients were reviewed for potential study suitability. A total of 76 study 11. Stanton, C., & Artschan, R. (2015). The use PhD Candidate - In Vivo Dosimetry and information sheets were provided to patients of average output correction factors as a Intrafraction Motion During Prostate and 19 people provided consent to be involved. pragmatic approach for small field relative Radiotherapy. (PhD (Physics) - in progress), Of those, 14 people went on to participate (six dosimetry. EPSM, Wellington, NZ. The University of Newcastle. Sertraline dyspnoea study; one Pyridostigmine Martin 12. Sun, J., Greer, P., Pichler, P., Martin, J., 11. , J. M. (Currently enrolled - Part- constipation study; seven Ultrasound study). Wratten, C., Best, L., & Dowling, J. (2016). Time). PhD Candidate. (PhD - in progress), Eight patients also returned the Health Related Investigation of adaptive MRI-only prostate University of Queensland. Quality of Life survey. In addition to this 29 planning. MR in RT Symposium, Ann-Arbor, 12. McNeilly, A. (Currently enrolled - Full- community patients indicated their interest in USA. Time). PhD Candidate - EPID Based Dose being notified about our research activities and 13. Wyatt, J., Dowling, J., Kelly, C., McKenna, Reconstruction for use in MRI-Linac elected to join our research register. J., Johnstone, E., Speight, R., Henry, A., Radiotherapy. (PhD (Physics) - in progress), The research nurses and two of the doctors in Greer, P., & MacCallum, H. (2016). Can an The University of Newcastle. the department attended an ultrasound training atlas-based pseudo-CT algorithm for the 13. Miri, N. (Currently enrolled - Full-Time). PhD course in Melbourne in September 2015. This prostate facilitate the generalisation of Candidate - Remote EPID-Based Dosimetry course trained the staff in 2D gastric ultrasound MR-only radiotherapy to other centres and for Credentialing Radiation Therapies. (PhD - techniques to enable assessment of gastric MR scanners? . MR in RT Symposium, Ann- in progress), The University of Newcastle. volume and emptying, and enabled a pilot study Arbor, USA. 14. Mucheru, D. (2015). Social Isolation, to assess the use of bedside 2D ultrasound for HIGHER DEGREE RESEARCH STUDENTS AND Diet Quality and Food Security in people measurement of gastric volumes and gastric SUPERVISIONS diagnosed with psychosis. (Bachelor of emptying in palliative care patients to commence. 1. Barnes, M. P. (Currently enrolled - Part- Nutrition & Dietetics (Honours)), The This study is now almost completed with only a Time). PhD Candidate - Linear Accelerator University of Newcastle. few more patients to reach sample size. Quality Assurance for Modern Radiotherapy 15. Mucheru, D. (Currently enrolled - Full-Time). The sertraline dyspnoea study is also on target to Clinical Practice. (PhD (Physics) - in A Healthy Living Program for Australians be completed in the coming months and a new progress), The University of Newcastle. Living with Psychosis. (MPhil - to be dyspnoea study is due to open in the second half 2. Cho, G. (Currently enrolled - Part-Time). PhD upgraded in 2017 to PhD), The University of of 2016. Candidate – Biological treatment planning. Newcastle. News last year from the NSW Government (PhD), The University of Sydney. 16. Oultram, S. (Currently enrolled - Part-Time). announcing the provision of funding to undertake 3. Fay, M. (Currently enrolled - Part-Time). PhD MPhil, transferring to PhD - The Use of a Medicinal Cannabis Study and recruitment to Candidate. (PhD - in progress), University of 3D Ultrasound in the Radiation Therapy occur at Calvary Mater Newcastle has created a Queensland. Simulation of Breast Cancer. (M Philosophy flurry of activity by the investigating team based in Sydney to develop the study protocol and 4. Fuangrod, T. (Passed August 2016). Real- (Med RadiationSc)), The University of submit to ethics. As always this process takes Time Radiotherapy Error Detection Using Newcastle.

78 | 2015/2016 Calvary Mater Newcastle Review of Operations longer than anticipated, but it is expected that palliative care: What are the comparative the Australian Acute Care Setting, EAPC, recruitment will open in the latter part of 2016. performances of the medications in a Copenhagen, May 2015 (poster) GRANTS palliative care population? Supportive Care TEXTBOOKS in Cancer 2015 23(9):2517-20 1. Chief investigators: Collier A, Clark K, Kelly 1. Clark K. Dysphagia, dyspepsia, hiccups in B, Ward P, McCaffery N, Phillips JL, Currow 8. Clark K, Curry T, Byfieldt .N A Pre-And- Oxford Text Book of Palliative Care. Editors: DC. Use of Benzodiazepines in Specialist Post Study of the Effect of a Care Bundle on Cherny N, Fallon M, Kassa S, Portenoy R, Palliative Care. Flinders University seeding Nursing Staff Attitudes and Self-Assessed Currow DC, 2015 Competencies when Caring for the grant for $15,000 to commence in 2016 2. Agar M, Clark K. “Palliative care” in Imminently Dying on Acute Medical Wards. 2. Chief investigators: Mileshkin L, Livingstone Essentials of Internal Medicine, Elsevier International Journal of Palliative Nursing A, Stockler M, Le B, Agar M, Yoong J, Clark Australia, Chatswood, NSW, Australia. Talley 2015;21(8):392-80 K, Philip J, Currow D, Philips J, Nowak A, N, Currow DC, Frankum B, 2015 Veillard AS, Ball D, Hughes B, Uglade A, 9. Currow DC, Clark K, Kamal A, Collier A, Agar Pavlakis N, Duffy M. Early Palliative Care in MR, Lovell MR, Phillips JL, Ritchie C. The Advanced Lung Cancer. Cancer Australia Population Burden of Chronic Symptoms grant for $ 600,000 to commence in 2016 that Substantially Predate the Diagnosis of PUBLICATIONS a Life-Limiting Illness. Journal of Palliative Medicine 2015;18(6): 480-485 1. Hatano Y, Moroni M, Wilcock A, Quinn S, Clark K Csikós Á, Allan SG, Agar M, Clark K, Clayton 10. . Invited commentary re Plain JM, Currow DC. Pharmacovigilance in radiographs to assess constipation in hospice/palliative care: the net immediate palliative care. ANZPM newsletter, July 2016 and short-term effects of dexamethasone 11. Currow DC, Phillips J, Clark K. Using for anorexia. BMJ Support Palliat Care. 2016 opioids in general practice for chronic Jun 10. pii: bmjspcare-2015-001037. doi: non-cancer pain: an overview of current 10.1136/bmjspcare-2015-001037. [Epub evidence. Medical Journal of Australia ahead of print] 2016;204(8):305-309 2. Clark K, Lam L, Talley N, Byfieldt N, Quinn 12. Clark K, Eagar K, Currow DC. Letter to the J, Blight A, Currow DC. Assessing the Editor: Embedding Objective Measurements presence and severity of constipation with of Quality into Routine Practice in Hospice. plain radiographs in constipated palliative Journal of Pain and Symptom Management. care patients. Journal of Palliative Medicine Accepted July 2016 2016; 19(6):617-21 13. Clark K. Letter to the Editor: Another 3. Currow DC, Sanderson C, Quinn S, bundle to improve care of the dying? BMJ Doogue M, Clark K, Lee J, Chye R, Agar M, Supportive and Palliative Care, Published Lovell M, Rowett D. Pharmacovigilance Online First: 28 October 2015 doi:10.1136/ in hospice/palliative care: net effect of bmjspcare-2014-000836 pregabalin for neuropathic pain. BMJ SUBMITTED PUBLICATIONS Supportive and Palliative Care 2016 pii: 1. Watts G, Clark K, Lam L, McDonald C, bmjspcare-2014-000825. doi: 10.1136/ Doogue M, Currow DC. Study Protocol: bmjspcare-2014-000825. [Epub ahead of A phase III randomised, double-blind, print] parallel arm, stratified, block randomised, 4. Clark K, Willis A, Byfieldt .N An placebo controlled trial investigating the Observational Study to Explore the clinical and cost effectiveness of sertraline Feasibility of Assessing Bereaved Relatives’ for the palliative relief of breathlessness Experiences Before and After a Quality in people with chronic breathlessness Improvement Project to Improve Care of (bmjopen-2016-013177) Submitted to BMJ Dying Medical Inpatients. American Journal Open of Hospice and Palliative Medicine. (Epub 2. Clark K, Connolly A, Clapham S, Quinsey K, ahead of print]. Published Online First Eagar K, Currow DC. Physical symptoms at January 2016 the time dying was diagnosed: a prospective 5. Waller A, Turon H, Mansfield E,Clark K, cohort study to describe the prevalence Hobden B, Rob Sanson-Fisher R. Assisting and intensity of problems experienced by the bereaved: A systematic review of the imminently dying palliative care patients evidence for grief counselling. Palliative by diagnosis and place of care. Submitted Medicine 2016;30(2):132-48 Journal of Palliative Medicine 6. Agar M, Koh E-S, Gibbs E, Barnes EH, Hovey CONFERENCE PRESENTATIONS E, Livingstone A, Sawkins K, Chye R, Lovell 1. Clark K, Lam L, Talley NJ, Byfieldt ,N Quinn MR, Clark K, Vardy J, King M. Validating J, Blight A, Currow DC. Assessing the self-report and proxy reports of the presence and severity of constipation with Dexamethasone Symptom Questionnaire plain radiographs in constipated palliative -Chronic for the evaluation of longer-term care patients, EAPC, Dublin, 2016 corticosteroid toxicity. Supportive Care in 2. Clark K. Byfieldt ,N Lam L, Currow DC. A Cancer 2016;24(3):1209-18 Comparison of Faecal Loading and Colon 7. Clark K, Quinn SJ, Doogue M, Sanderson C, Transit Times in Palliative Patients, EAPC, Lovell M, Currow DC. Routine prescribing of Copenhagen, May 2015 (poster) gabapentin or pregabalin in supportive and 3. Clark K. Optimising Care of the Dying in

2015/2016 Calvary Mater Newcastle Review of Operations | 79 Financial Report

Financial Report for the Year Ended 30 June 2016 Calvary Health Care (Newcastle) Limited | ABN 75 081 149 126

80 | 2015/2016 Calvary Mater Newcastle Review of Operations Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

DIRECTORS' REPORT DIRECTORS' REPORT

The Board of Directors of Calvary Health Care (Newcastle) Ltd submit their report for the year ended 30 Directors (cont'd) June 2016. The Directors attended the following Board meetings and applicable Committees each Director was eligible to attend: Directors Director Board ARC MEC PRC SDC CGC The names of the Company's Directors in office during the financial year and until the date of this report Meetings are as follows. Held Att Held Att Held Att Held Att Held Att Held Att Directors were in office for the entire period unless otherwise stated. Hon John Watkins AM 87 Michael Roche AM 8 8 55 11 NAME QUALIFICATIONS AREAS OF SPECIFIC Hon Gregory Crafter AO 33 22 RESPONSIBILITY Rebecca Davies 8 8 554432 Hon. John Watkins AM MA, LLB, DipEd, Hon DLitt Chair Macq All Committees, Ex Officio John Mackay AM 87 4433 Michael Roche AM BA (Accounting), FCPA, Deputy Chair Assoc Prof Richard Matthews AM 8 7 22 1144 MACS Member, ARC Prof Katherine McGrath 87 331144 Chair, SDC Patrick O'Sullivan 8 8 55 11 Rebecca Davies BEc, LLB (Hons), FAICD Director David Catchpole 8 8 55 3311 Chair, MEC Member, ARC Jennifer Stratton 54 22 22 Member, PRC Jim Birch AM 4 4 22 1122 John Mackay AM BA (Admin/Economics), Director FAIM Chair, PRC Key: Member, MEC ARC Audit & Risk Committee Associate Professor Richard Matthews AM MBBS Director MEC Mission & Ethics Committee Member, CGC PRC Performance & Remuneration Committee SDC Strategy & Development Committee

2015/2016 Calvary Mater Newcastle Review ofOperations Member, SDC Member, MEC CGC Clinical Governance Committee Professor Katherine McGrath MBBS, FRCPA, FAICD Director Chair, CGC Short and long term objectives Member, PRC Calvary's strategic aims are to: Member, SDC 1) Put the person and family at the centre of care in all settings, continuing to focus on palliative and end Patrick O’Sullivan CA, MAICD Director of life care; Chair, ARC 2) Sustain the ability of our hospital, to provide quality and compassionate care in the community we Member, SDC serve; David Catchpole BEc University of Tasmania Director 3) Improve our current delivery system in order to promote effective, equitable, quality care and ensure Dip FP Deakin Member, ARC FAICD safety for all; and Member, PRC FCPA (Retired) 4) Grow, integrate and innovate within our 'circle of competence' within the environment we operate. Member, SDC Jennifer Stratton (appointed 27 November BA (Economics, English Director 2015) and History), FAICD Member, MEC It's Calvary's aim to provide a highly valued service that's greater than the sum of its parts. Member, CGC Jim Birch AM (appointed 1 February 2016) BA (Health Administration), Director FCHSM, MNATSIHEC Member, ARC Principal activities Member, CGC The principal activities of the Company are the ownership and operation of the Calvary Mater Newcastle Member, SDC Hospital. Hon Gregory Crafter AO (retired 26 LLB Director November 2015) Chair, MEC Significant changes in the state of affairs Philip Maloney BCom, LLB, Grad Dip CSP, Company Secretary There were no significant changes in the state of affairs of the Company during the financial year. ACIS, MAICD David Bergman BCom, MEc, ACA, FFin Alternate Company Secretary |81 1 2 82 | 2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd

DIRECTORS' REPORT

Results A deficit of $2.9M was incurred for the financial year ended 30 June 2016 (2015: deficit $2.9M).

Review of operations The Company continued to provide quality services in accordance with the mission, vision and values of the organisation.

(a) Revenues The Company's revenue from operating activities totalled $164.9M (2015: $158.4M). Grants and subsidies from Government for hospital operations totalled $132.6M (2015: $127.2M). Grants and subsidies represent 80% (2015: 80%) of revenue from operating activities.

Revenue from operations for the year ended 30 June 2016 included $0.9M (2015: $1.0M) resources received free of charge - revenue relating to the recognition of the NSW government funding of superannuation contributions for employees who are members of the defined benefit contribution schemes SASS and SSS.

(b) Expenses The Company's expenses from operating activities totalled $174.3M (2015: $166.5M). Expenses on personnel costs represent 65% (2015: 65%) of total operating expense.

Staffing levels for clinical services have increased during the reporting period with total staff of 967 full time equivalents as at 30 June 2016 (2015: 955). The actual number of staff as at 30 June 2016 was 1,306 (2015: 1,295).

(c) Hospital activities The overall inpatient activity for the year was 16,752 separations, an increase of 2% on the year ended 30 June 2015. Non-inpatient activity for the hospital during the year was 300,899 occasions of service, a decrease of 9% on the year ended 30 June 2015.

Future developments The Company plans to continue the integration and expansion of its current range of services in accordance with the mission, vision and values of the organisation.

Significant events after year end There has not arisen in the interval between the end of the financial year and the date of this report any item, transaction or event of a material and unusual nature likely, in the opinion of the Directors of the Company, to affect significantly the operations of the Company, the results of those operations, or the state of affairs of the Company, in future financial years.

Deed of access and indemnity - Directors Little Company of Mary Health Care Ltd has executed a Deed of Access & Indemnity which provides Directors with the right of access to records for seven years after they cease office and also indemnifies Directors (to the extent permitted by law) against liability incurred in the course of their duties as a Director of companies within the Calvary group ("the Group").

3 2015/2016 Calvary Mater Newcastle Review of Operations | 83 84 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

TABLE OF CONTENTS STATEMENT OF PROFIT OR LOSS AND OTHER COMPREHENSIVE INCOME Page FOR THE YEAR ENDED 30 JUNE 2016 Statement of profit or loss and other comprehensive income 8 Statement of financial position 9 Statement of cash flows 10 2016 2015 Statement of changes in equity 11 Note $ '000 $ '000 Notes to the financial statements 1 Summary of significant accounting policies 12 Revenue from operations 164,911 158,431 2 Revenue and other income 19 Other income 6,471 5,163 3 Expenses 19 4 Cash and cash equivalents 19 Total revenues 2 171,382 163,594 5 Trade and other receivables 19 6 Other financial assets 20 Employee benefits expense 112,682 108,327 7 Property, plant and equipment 20 Depreciation expense 3 7,104 6,671 8 Restricted assets 22 Finance costs 3 11 9 9 Trade and other payables 22 Supplies 21,938 20,768 10 Bank overdraft and financing arrangements 23 Computer expenses 165 136 11 Provisions 23 Consulting and legal costs 89 37 12 Retirement Benefit Plans 25 Contracted services 23,752 22,037 13 Commitments for expenditure 25 LCMHC shared service contributions 2,495 2,621 14 Related parties 26 Power, light and heat 4 3 15 Financial risk management 27 Repairs and maintenance 328 267 16 Contingent liabilities 27 Travel 925 972 17 Economic dependency and going concern 28 Other expenses 4,774 4,679 18 Events subsequent to balance date 28 19 Registered office and principal place of business 28 Total expenses 174,267 166,527 Independent Auditor's Report 29 Net deficit for the year attributable to Calvary Health Care (Newcastle) Ltd (2,885) (2,933)

Total other comprehensive income for the year - -

Total comprehensive loss for the year attributable to Calvary Health Care (Newcastle) Ltd (2,885) (2,933)

The Statement of Profit or Loss and Other Comprehensive Income is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28.

7 8 Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

STATEMENT OF FINANCIAL POSITION AS AT 30 JUNE 2016 STATEMENT OF CASH FLOWS FOR THE YEAR ENDED 30 JUNE 2016

2016 2015 2016 2015 Note $ '000 $ '000 Note $ '000 $ '000

Current assets Cash flows from operating activities Cash and cash equivalents 4 18,870 14,663 Receipts from customers 36,830 35,927 Trade and other receivables 5 2,598 2,357 Payments to suppliers and employees (153,930) (146,872) Inventories 1,234 1,157 Government grants received 127,453 116,515 Other financial assets 6 45,000 44,000 Capital grants received 2,185 2,508 Other current assets 739 469 GST recovered from the ATO 4,914 4,923 Total current assets 68,441 62,646 GST payments to ATO (14,733) (14,152) Interest received 1,508 1,825 Non-current assets Interest paid (11) (9) Property, plant and equipment 7 114,401 119,815 Other income received 2,795 2,208 Total non-current assets 114,401 119,815 Net cash provided by operating activities 7,011 2,873 Total assets 182,842 182,461 Cash flows from investing activities Current liabilities Proceeds on disposal of property, plant and equipment 379 529 Trade and other payables 9 7,463 6,403 Payment for property, plant and equipment (2,183) (6,180) Provisions 11 33,154 31,119 Payment for investment in term deposits (1,000) (5,000) Total current liabilities 40,617 37,522 Net cash used in investing activities (2,804) (10,651) 2015/2016 Calvary Mater Newcastle Review ofOperations Non-current liabilities Provisions 11 984 813 Net increase / (decrease) in cash held 4,207 (7,778) Total non-current liabilities 984 813 Cash at the beginning of the financial year 14,663 22,441 Total liabilities 41,601 38,335 Cash at end of the financial year 18,870 14,663 NET ASSETS 141,241 144,126 Separate disclosure of operating and other cash at the end of Equity the financial year: Retained earnings 141,241 144,126 Operating cash 10,966 8,475 Special purpose, trust and other restricted cash 8 7,904 6,188 TOTAL EQUITY 141,241 144,126 18,870 14,663 The Statement of Financial Position is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28. The Statement of Cash Flows is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28. |85 9 10 86 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

STATEMENT OF CHANGES IN EQUITY FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

1 Summary of significant accounting policies Retained earnings Total Statement of Compliance $ '000 $ '000 These financial statements are general purpose financial statements which have been prepared in accordance with the Australian Charities and Not-for-profits Commission Act 2012 and Australian Accounting Standards - Reduced Disclosure Requirements, and comply with other requirements of Balance 1 July 2014 147,059 147,059 the law. Deficit for the year (2,933) (2,933) Calvary Health Care (Newcastle) Ltd is a not for profit Public Company limited by guarantee, incorporated and domiciled in Australia. Total comprehensive loss for the year (2,933) (2,933)

Balance 30 June 2015 144,126 144,126 The financial statements were authorised by the Board on 24 August 2016.

Basis of Preparation The financial statements have been prepared on the basis of historical cost. All amounts are Balance 1 July 2015 144,126 144,126 presented in Australian dollars.

Deficit for the year (2,885) (2,885) The Company is a company of the kind referred to in ASIC Corporations (Rounding in Financial/Directors' Reports) Instrument 2016/191, and in accordance with the Class Instrument, Total comprehensive loss for the year (2,885) (2,885) amounts in the financial report are rounded off to the nearest thousand dollars, unless otherwise indicated. Balance 30 June 2016 141,241 141,241 Application of new and revised accounting standards effective for these financial statements The Statement of Changes in Equity is to be read in conjunction with the notes to the financial statements set out on pages 12 to 28. There were no amendments to accounting standards effective in the current financial year which had a significant impact on the results or position of the Company.

The following significant accounting policies have been adopted in the preparation and presentation of the financial report:

(a) Comparative figures Comparative figures have been adjusted to conform with changes in presentation for the current financial year.

(b) Taxation The Company is exempt from income tax under the current provisions of the Australian Income Tax Assessment Act (1997). Accordingly, there is no income tax expense or income tax payable.

11 12 Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

(c) Goods and services tax (f) Cash and cash equivalents Revenues, expenses and assets are recognised net of the amount of goods and services tax Cash and cash equivalents in the Statement of Financial Position comprise cash at bank and in (GST), except where the amount of GST incurred is not recoverable from the Australian Taxation hand and term deposits with a term of less than three months. For the purposes of the statement Office (ATO). In these circumstances, the GST is recognised as part of the cost of acquisition of of cash flows, cash and cash equivalents consist of cash and cash equivalents as defined above, the asset or as part of the expense. Receivables and payables in the Statement of Financial net of any outstanding bank overdrafts. Position are shown inclusive of GST. (g) Financial instruments The GST components of cash flows arising from operating, investing and financing activities Financial assets and liabilities are recognised when an entity becomes a party to the contractual which are recoverable from, or payable to, the ATO are classified as operating cash flows. provisions of the instrument. The net amount of GST recoverable from, or payable to, the ATO is included as a current asset Financial assets and liabilities are initially measured at fair value. Transaction costs that are or liability in the Statement of Financial Position. directly attributable to the acquisition or issue of financial assets and liabilities are added to or deducted from the fair value of the financial assets or financial liabilities, as appropriate, on initial (d) Revenue recognition recognition. Revenue is measured at the fair value of the consideration received or receivable. Financial assets Rendering of services The classification of financial assets depends on the nature and purpose of the financial assets Patient fee revenue is recognised when the fee in respect of services provided is receivable. and is determined at the time of initial recognition. Accrued patient income represents an estimate of fees due from patients not billed at balance date. This estimate is calculated with reference to individual episode information and per diem Loans and receivables rates. Trade receivables, loans and other receivables that have fixed or determinable payments that are not quoted in an active market are classified as 'loans and receivables'. Loans and receivables Grants received are measured at amortised cost using the effective interest rate, except for short-term receivables when the recognition of interest would be immaterial. 2015/2016 Calvary Mater Newcastle Review ofOperations Reciprocal grants Grants received on the condition that specified services be delivered, or conditions fulfilled, are Held to maturity investments considered reciprocal. Such grants are initially recognised as a liability and revenue is Term deposits with fixed maturity dates in excess of three months that the Company has the recognised as services are performed or conditions fulfilled. positive intent and ability to hold to maturity are classified as held-to-maturity investments. Held- to-maturity investments are measured at amortised cost using the effective interest method less any impairment. Non-reciprocal grants Revenue is recognised when the grant is received or receivable. Impairment of financial assets Financial assets are assessed for indicators of impairment at the end of each reporting period. Resources received free of charge Financial assets are considered to be impaired where there is objective evidence that, as a result Revenue is recognised when fair value can be reliably measured. Usage of resources is of one or more events that occurred after the initial recognition of the financial asset, the recognised as a corresponding expense. estimated future cash flows of the investment have been affected.

Interest For certain categories of financial asset, such as trade receivables, assets that are assessed not Interest is recognised as it accrues, taking into account the effective yield on the financial asset. to be impaired individually are, in addition, assessed for impairment on a collective basis. Objective evidence of impairment for a portfolio of receivables could include the Company's past Donations experience of collecting payments, an increase in the number of delayed payments in the Donations are recognised at fair value in other income when received and any obligations in portfolio past the average credit period of 30 days, as well as observable changes in national or relation to the donation are extinguished. local economic conditions that correlate with default on receivables.

For financial assets carried at amortised cost, the amount of the impairment loss recognised is (e) Borrowing costs the difference between the asset's carrying amount and the present value of the estimated future Borrowing costs include interest and finance lease/hire purchase finance charges and are cash flows, discounted at the financial asset's original effective interest rate. expensed as incurred. |87 13 14 88 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

The carrying amount of the financial asset is reduced by the impairment loss directly for all (i) Property, plant and equipment financial assets with the exception of trade receivables, where the carrying amount is reduced Property, plant and equipment is stated at historical cost less any accumulated depreciation and through the use of an allowance account. When a trade receivable is considered uncollectible, it any accumulated impairment losses. is written off against the allowance account. Subsequent recoveries of amounts previously written off are credited against the allowance account. Changes in the carrying amount of the Subsequent costs are included in the asset's carrying amount or recognised as a separate asset, allowance account are recognised in profit or loss. as appropriate, only when it is probable that future economic benefits associated with the item will flow to the Company and the cost of the item can be measured reliably. All other repairs and For financial assets measured at amortised cost, if, in a subsequent period, the amount of the maintenance are charged to profit and loss during the financial period in which they are incurred. impairment loss decreases and the decrease can be related objectively to an event occurring after the impairment was recognised, the previously recognised impairment loss is reversed through profit or loss to the extent that the carrying amount of the investment at the date the Depreciation is recognised so as to write off the cost of assets less their residual values over their impairment is reversed does not exceed what the amortised cost would have been had the useful lives, using the straight line method. Leasehold improvements are depreciated over the impairment not been recognised. shorter of either the unexpired period of the lease or the estimated useful lives of the improvements. Assets held under finance leases are depreciated over their expected useful lives on the same basis as owned assets. However, when there is no reasonable certainty that Derecognition ownership will be obtained by the end of the lease term, assets are depreciated over the shorter The Company derecognised a financial asset only when the contractual rights to the cash flows of the lease term and their useful lives. from the asset expire, or when it transfers the financial asset and substantially all the risks and rewards of ownership to the asset to another entity. On derecognition of a financial asset in its The estimated useful lives, residual values and depreciation method are reviewed at the end of entirety, the difference between the asset's carrying amount and the sum of consideration each reporting period, with the effect of any changes in estimate accounted for on a prospective received and receivable and the cumulative gain or loss that has been recognised in other basis. comprehensive income and accumulated in equity is recognised in profit or loss. The depreciation/amortisation rates used for each class of asset are as follows: Financial liabilities Financial liabilities, including borrowings and trade and other payables, are initially measured at 2016 2015 fair value, net of transaction costs. Financial liabilities are subsequently measured at amortised Buildings and building improvements 2.5 - 10% 2.5 - 10% cost using the effective interest rate method, with interest expense recognised on an effective Plant and equipment, comprised of: yield basis. Plant, equipment, fixtures and fittings 10.0% 10.0% Medical, surgical and office equipment 15.0% 15.0% Derecognition Computer equipment 33.3% 33.3% The Company derecognises financial liabilities when, and only when, the Company's obligations are either discharged, cancelled or they expire. The difference between the carrying amount of the financial liability derecognised and the consideration paid and payable is recognised in the Motor vehicles are not depreciated as the Company's policy is to hold motor vehicles for less profit or loss. than one year.

An item of property, plant and equipment is derecognised upon disposal or when no future Effective interest method economic benefits are expected to arise from the continued use of the asset. Any gain or loss The effective interest method is a method of calculating the amortised cost of a debt instrument arising on the disposal or retirement of an item of property, plant and equipment is determined as and of allocating interest income over the relevant period. The effective interest rate is the rate the difference between the sales proceeds and the carrying amount of the asset and is that exactly discounts estimated future cash receipts (including all fees on points paid or received recognised in profit or loss. that form an integral part of the effective interest rate, transaction costs and other premiums or discounts) through the expected life of the debt instrument, or (where appropriate) a shorter period, to the net carrying amount on initial recognition.

(h) Inventories Inventories are measured at the lower of cost and net realisable value. Costs are assigned on the basis of weighted average costs.

15 16 Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

(j) Impairment of non-financial assets (l) Employee benefits At each reporting date, the Company assesses whether there is an indication that an asset may A liability is recognised for benefits accruing to employees in respect of salaries and wages, be impaired. If any indication exists, or when annual impairment testing for an asset is required, annual leave, long service leave, and sick leave when it is probable that settlement will be the Company estimates the asset's recoverable amount. An asset's recoverable amount is the required and they are capable of being measured reliably. higher of an asset's or cash-generating unit's (CGU) fair value less costs of disposal and its value in use. Recoverable amount is determined for an individual asset, unless the asset does not Liabilities recognised in respect of short-term employee benefits are measured at their nominal generate cash inflows that are largely independent of those from other assets or groups of values using the remuneration rate expected to apply at the time of settlement. assets. Where the carrying amount of an assets or CGU exceeds its recoverable amount, the asset is considered impaired and is written down to its recoverable amount. Liabilities recognised in respect of long-term employee benefits are measured as the present value of the estimated future cash outflows to be made by the Company in respect of services provided by employees up to the reporting date. Value in Use is calculated as the higher of the present value of future cash flows or the asset's depreciated replacement cost. In assessing the present value of future cash flows, future cash Payments to defined contribution retirement benefit plans are recognised as an expense when flows are discounted to their present value using a pre-tax discount rate that reflects current employees have rendered service entitling them to the contributions. market assessments of the time value of money and the risks specific to the asset. In determining fair value less costs of disposal, recent market transactions are taken into account. If no such transactions can be identified, an appropriate valuation model is used. These (m) Critical accounting judgements and key sources of estimation uncertainty calculations are corroborated by valuation multiples or other available fair value indicators. In the application of the Company's accounting policies, the Directors are required to make estimates and judgements about the carrying amount of assets and liabilities. The estimates and The Company bases its impairment calculation on detailed budgets and forecast calculations, associated assumptions are based on historical knowledge and best available current which prepared separately for each of the Company's CGUs to which individual assets are information. Estimates assume a reasonable expectation of future events and are based on allocated. These budgets and forecast calculation generally cover a period of five years. For current trends and economic data obtained both externally and within the group. Actual results longer periods, a long-term growth rate is calculated and applied to future cash flows after the may differ from these estimates. fifth year. The estimates and underlying assumptions are reviewed on an ongoing basis. Revisions to

2015/2016 Calvary Mater Newcastle Review ofOperations accounting estimates are recognised in the period in which the estimate is revised and in future Impairment losses are recognised in profit or loss. For non-current assets excluding goodwill, a periods where applicable. previously recognised impairment loss is reversed only if there has been a change in assumptions used to determine the asset's recoverable amount since the last impairment loss was recognised. The reversal is limited so that the carrying amount of the asset does not exceed its recoverable amount, nor exceed the carrying amount that would have been determined, net of depreciation, had no impairment loss been recognised for the asset in prior years. Such reversal is recognised in profit or loss.

(k) Provisions Provisions are recognised when the Company has a present obligation (legal or constructive) as a result of a past event, it is probable that the Company will be required to settle the obligation, and a reliable estimate can be made of the amount of the obligation.

The amount recognised as a provision is the best estimate of the consideration required to settle the present obligation at the end of the reporting period, taking into account the risks and uncertainties surrounding the obligation. When a provision is measured using the cash flows estimated to settle the present obligation, its carrying amount is the present value of those cash flows (where the effect of the time value of money is material).

Where some or all of the economic benefits required to settle a provision are expected to be recovered from a third party, a receivable is recognised as an asset if it is virtually certain that reimbursement will be received and the amount of the receivable can be measured reliably. |89 17 18 90 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

2016 2015 2016 2015 Note $ '000 $ '000 Note $ '000 $ '000

2 Revenue and other income Other receivables Revenue from operating activities Other receivables 1,562 1,283 Revenue from rendering of services 32,265 31,207 Other receivables due from related parties 14 5 - Recurrent grants received/receivable 129,720 123,938 1,567 1,283 Public Health Service capital grants 1,986 2,280 2,598 2,357 Public Health Service resources received free of charge 940 1,006 Total revenue from operations 164,911 158,431 Movement in the impairment of receivables Balance at the beginning of the year (56) (43) Other income Impairment losses recognised/reversed during the year (40) (100) Interest 1,508 1,825 Amounts written off/recovered 48 87 Donations 1,945 1,098 Balance at the end of the year (48) (56) Canteen takings and meals and accommodation 168 159 Other income 2,850 2,081 Trade and other receivables 6,471 5,163 Patient fees receivable are generally settled by Health Funds within 30 days. No interest is charged on trade receivables during this credit period. Total revenue and other income 171,382 163,594 Other receivables are generally settled within 30 days. 3 Expenses Depreciation of property, plant and equipment 7,104 6,671 6 Other financial assets

Total interest expense for financial liabilities not classified as at Loans and receivables at amortised cost fair value through profit or loss 11 9 Current Term deposits 45,000 44,000 Superannuation - defined contribution 7,494 7,337 Superannuation - defined benefit 940 1,006 7 Property, plant and equipment Freehold land - at cost (a) 7,946 7,946 Loss on disposal of property, plant and equipment 114 125 Buildings - at cost (a) 131,378 131,276 4 Cash and cash equivalents Less: Accumulated depreciation (36,877) (33,595) Current 94,501 97,681 Cash at bank and on hand 10,966 8,475 Cash at bank - special purpose funds 8 7,904 6,188 Plant and equipment - at cost 31,155 30,496 18,870 14,663 Less: Accumulated depreciation (19,606) (16,743) 11,549 13,753 5 Trade and other receivables Current Motor vehicles - at cost 405 435 Trade receivables Receivables for patient fees 1,079 1,130 114,401 119,815 Less: Allowance for impairment loss (48) (56) 1,031 1,074

19 20 Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

2016 2015 2016 2015 Note $ '000 $ '000 Note $ '000 $ '000

Reconciliation of property, plant and equipment (a) Land and buildings In 2005/06 the NSW Health Administration Corporation entered into a contract with a private sector Cost provider, Novacare Project Partnership, for financing, design, construction and commissioning of a new hospital facility, a mental health facility and refurbishment of existing buildings, and facilities Freehold land management and delivery of ancillary non-clinical services on the Calvary Mater Newcastle site until Balance at 1 July 2015 7,946 November 2033 (the Public-Private-Partnership ('PPP')). Balance at 30 June 2016 7,946 The official opening of the new facilities took place in August 2009. The legal documentation for the ongoing operation of the PPP arrangement, following finalisation of the construction phase of the Buildings PPP, was executed on 20 May 2011. Balance at 1 July 2015 131,276 Additions 102 Hunter New England Local Health District (HNELHD) transferred control of the newly constructed Balance at 30 June 2016 131,378 general hospital facility through a sub-lease agreement to the Company. The terms and conditions of the use of the redeveloped facility are contained in a Head Lease between the parties to the PPP Plant and equipment arrangement. The recognition of the assets is based on the fact that the Company, being an Balance at 1 July 2015 30,496 Affiliated Health Organisation which is outside the accounting control of either HNELHD or the NSW Additions 1,665 Ministry of Health, recognises its funding (recurrent or capital) as grant income in the year of receipt. Disposals (1,006) Balance at 30 June 2016 31,155 8 Restricted assets The Company holds assets which are restricted by externally imposed conditions, for example, in Motor Vehicles line with the 'Accounts and Audit Determination' of NSW Ministry of Health in exercising its powers 2015/2016 Calvary Mater Newcastle Review ofOperations Balance at 1 July 2015 435 conferred by the Health Services Act 1997 (NSW) and grant and donor requirements. Additions 416 Disposals (446) The assets are only available for application in accordance with the terms of these restrictions. Balance at 30 June 2016 405 Brief details of externally imposed conditions Accumulated depreciation and impairment Category / Conditions Special Purpose / Conditions imposed by granting body 14,105 12,030 Buildings No.2 Account / Conditions imposed by NSW Ministry of Health 26,771 26,468 Balance at 1 July 2015 (33,595) Research grants / Conditions imposed by granting body 7,028 6,690 Depreciation expense (3,282) 47,904 45,188 Balance at 30 June 2016 (36,877) Disclosed in the Statement of Financial Position as: Cash and cash equivalents 4 7,904 6,188 Plant and equipment Other financial assets 6 40,000 39,000 Balance at 1 July 2015 (16,743) 47,904 45,188 Eliminated on disposal of assets 959 Depreciation expense (3,822) 9 Trade and other payables Balance at 30 June 2016 (19,606) Current Trade payables 1,791 983 Grants / income received in advance 83 431 Accrued salaries and wages 1,778 1,306 Accrued expenses 2,943 2,891 Other payables 868 792 7,463 6,403 |91 21 22 92 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

2016 2015 2016 2015 Note $ '000 $ '000 Note $ '000 $ '000

Trade payable terms vary from 7 to 30 days generally. No interest is charged on trade payables. The Company has indemnification from the NSW Ministry of Health for any accrued public hospital employee leave entitlements or any other employee entitlements such as redundancies payable by Grants and other income received in advance relate to the component of grants received from The Calvary Health Care (Newcastle) Ltd which the Company is liable to pay at the time of, or becomes University of Newcastle for work agreed to be performed under the terms of the grant next financial liable to pay as a consequence of, ceasing to conduct a public hospital in whole or part, as a public year 2016/17 and Government funded paid parental leave received from Centrelink for payment in hospital listed in the Third Schedule of the Health Services Act or any successor Act subject to: next financial year 2016/17. - the Company being specified in the Third Schedule of the Health Services Act 1997 or any successor Act as the operator of the public hospital; - a transparent system being established to provide annual verification to the Local Health District of Other payables and accruals comprise salaries and wages accruals and goods and services the accrued recreation and long service leave entitlement in respect of each named public hospital expenses incurred. employee as at 30 June each year; - real property and other substantial assets used to conduct the public hospital not being disposed of 10 Bank overdraft and financing arrangements at any time without the full knowledge and agreement of the NSW Ministry of Health; The Company has access to the following lines of credit: - the completion of a due diligence process should it be required in the event of wind up or cessation Group pooling facility - bank 2,000 2,000 of operations whereby assets, or parts thereof, used to conduct the hospital are to be applied to offset liabilities properly incurred in operating the public hospital; and Facilities not utilised at balance date: - the Company using its best endeavours to transfer all relevant employees together with the liability Group pooling facility - bank 2,000 2,000 for the accrued entitlements for those employees as part of such transfer of operations, if at some future time the Company enters into an agreement to transfer part or all of the operations of the public hospital to a public health organisation (as defined in the Health Services Act) or to the State. 11 Provisions Current Other provisions Employee benefits: Other provisions comprise roster days accrued. Annual leave 12,214 11,263 Long service leave 20,778 19,720 12 Retirement Benefit Plans Other employee provisions 162 136 33,154 31,119 Defined contribution plans Non Current The Company contributes to employee superannuation funds for all eligible employees based on Employee benefits: various percentages of their gross salary, with a minimum contribution of 9.5% of gross salary. All Long service leave 984 813 employees are entitled to benefits on retirement, disability or death.

Employee benefits A small number of employees who commenced employment with the Company prior to 18 Employee benefit provisions are reported as current liabilities where the Company does not have an December 1992 are members of the defined benefit State Authority Superannuation Scheme unconditional right to defer settlement for at least 12 months. Consequently, the current portion of (SASS). This scheme is managed by the State Super Authority and the Company has neither the employee benefit provision includes both short-term benefits measured at nominal values and control nor responsibility for the scheme. The Company's only obligations are the payment of any long-term benefits, measured at present value. Employee benefit provisions that are reported as employee salary sacrificed employer contributions and employee post-tax employee contributions. non-current liabilities refer to long-term benefits of non vested long service leave that do not qualify The NSW Treasury remits all other required employer contributions directly to the scheme. The for recognition as a current liability, and are measured at present value. Company accounts for the liability paid by NSW Treasury as having been extinguished resulting in the amount assumed being shown as part of the non-monetary revenue item described as Resources received free of charge. Funding of employee entitlements The NSW Ministry of Health, via the Local Health District, has committed to providing annual The superannuation expense for the financial year is determined by using the formulae specified by funding to meet employee entitlements that become payable in that year in the course of providing the NSW Ministry of Health. The expense for certain superannuation schemes (ie Basic Benefit and services. These funds are part of the normal operating subsidies paid to the Company by Hunter First State Super) is calculated as a percentage of the employees' salary. For other superannuation New England Local Health District. schemes (ie State Superannuation Scheme and State Authorities Superannuation Scheme), the expense is calculated as a multiple of the employees' superannuation contributions.

23 24 Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

2016 2015 2016 2015 Note $ '000 $ '000 $ $

13 Commitments for expenditure 14 Related parties Public private partnership (PPP) (a) Transactions with key management personnel In 2005/06, the NSW Health Administration Corporation entered into a contract with a private sector provider, Novacare Project Partnership for financing, design, construction and commissioning of a From time to time Directors and other key management personnel of the Company may be treated new hospital facility, a mental health facility and refurbishment of existing buildings, and facilities as patients. This service is provided on the same terms and conditions as those entered into by management and delivery of ancillary non-clinical services on the site until November 2033. other employees or customers and are trivial or domestic in nature.

Other expenditure commitments, totalling $7.7M (2015: $7.7M), for the provision of facilities A payment, the details of which are confidential and not disclosed, was made by the Parent Entity, management and delivery of other non-clinical services on the Calvary Mater Newcastle site, were Little Company of Mary Health Care Ltd, in respect of a contract of insurance indemnifying all expended for the year ended 30 June 2016. As the Company is not contractually committed to the Officers against liability for any claims brought against a Director or Officer. agreement, the expenditure commitment over the life of the service provision is contingent upon recurrent funding continuing to be received from the NSW Ministry of Health, via Hunter New Compensation of key management personnel England Local Health District. Non-Executive Directors' fees and National executive salaries are paid and are reported separately by the Parent Entity, Little Company of Mary Health Care Ltd. Remuneration for the Company's Executives is detailed below.

Compensation to key management personnel of the Company 555,488 543,244

(b) Transactions with other related parties Amounts included in income received during the year from LCMHC group companies: Supplier rebate income 22,031 26,168 2015/2016 Calvary Mater Newcastle Review ofOperations Recovery of salaries and wages (incl on-costs) 16,526 37,140 Recovery for goods and services 295 - Recovery of training costs - 273

Amounts included in expenditure during the year to LCMHC group companies: National Office shared service contribution 1,553,028 1,486,152 National IT shared service contribution - recurrent 708,708 615,030 National IT shared service contribution - non-recurrent 233,472 520,000 Payments for goods and services 16,904 40,812 Insurance premiums 79,600 78,000

(c) Receivables Amounts receivable from LCMHC group companies: Other receivables 4,736 - |93 25 26 94 |2015/2016 Calvary Mater Newcastle Review ofOperations

Calvary Health Care (Newcastle) Ltd Calvary Health Care (Newcastle) Ltd

NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016 NOTES TO THE FINANCIAL STATEMENTS FOR THE YEAR ENDED 30 JUNE 2016

15 Financial risk management 17 Economic dependency and going concern The Company's financial instruments consist mainly of deposits with banks, accounts receivable The Company derives most of its income from the NSW Ministry of Health, via Hunter New England and accounts payable. Local Health District. A going concern basis for the preparation of the financial statements has been adopted as it is expected that sufficient funding from the NSW Ministry of Health will continue. Categories of financial instruments 2016 2015 An indemnification has also been obtained from the NSW Ministry of Health in relation to employee $ '000 $ '000 benefits refer to Note 11. Financial assets Loans and receivables 2,598 2,357 Of total revenue, 77.4% is derived from NSW Government funding, and 6 .9% is derived from Term deposits 45,000 44,000 private patient revenue. Benefits are paid in accordance with agreements between the NSW Cash and cash equivalents 18,870 14,663 Ministry of Health and the Health Funds. 66,468 61,020 The constitution of the Company has the provision required under s187 of the Corporations Act Financial liabilities which expressly authorises the Company to act in the best interests of the Parent Entity, so that it is Amortised cost 7,463 6,403 capable of providing economic assistance to the Parent Entity, provided the Company will not become insolvent as a result of giving such economic assistance. 16 Contingent liabilities Claims on managed fund The Parent Entity may, in turn, provide economic assistance to any of its subsidiaries including the On 1 July 1989 the NSW Government implemented a self insurance scheme known as the Company, by withdrawing funds from any other of its subsidiaries, except for those moneys located Treasury Managed Fund (TMF). Since that time, the Company has been a member of the TMF. in certain Special Purpose or Trust Fund Accounts, to provide such support as is necessary to The TMF will pay to or on behalf of the Company all sums which it shall become legally liable to enable the Parent Entity or subsidiary to pay its debts as and when they fall due, provided neither pay by way of compensation or legal liability except for employment related, discrimination and the Parent Entity or the Company will become insolvent as a result of the withdrawal. harassment claims that do not have state-wide implications. Therefore, since 1 July 1989, apart from the exceptions noted above no contingent liabilities exist in respect of liability claims against The Directors currently believe that, collectively, the Parent Entity and its subsidiaries have sufficient the Company. A Solvency Fund (now called Pre-Managed Fund) Reserve was established by cash resources to ensure the Company, the Parent Entity, and other subsidiaries of the Parent the NSW Government to deal with the insurance matters incurred before 1 July 1989 that were Entity will continue to trade as going concerns and they are unaware of any material uncertainties, above the limit of insurance held or for matters that were incurred prior to 1 July 1989 that would events or conditions, which may cast significant doubt on this belief. have become verdicts against the State. The Pre-Managed Fund will respond to all claims against the Company. 18 Events subsequent to balance date There has not arisen in the interval between the end of the financial year and the date of this report Workers compensation hindsight adjustment any item, transaction or event of a material and unusual nature likely, in the opinion of the Directors The NSW Treasury Managed Fund normally calculates hindsight premiums each year. However, of the Company, to affect significantly the operations of the Company, the results of those in relation to workers compensation, adjustments are delayed. The final hindsight adjustment for operations, or the state of affairs of the Company in future financial years. the 2010/11 fund year and an interim adjustment for the 2012/13 fund year were not calculated until 2015/16. As a result, the 2011/12 final and 2013/14 interim hindsight calculations will be 19 Registered office and principal place of business paid in 2016/17. The Company's registered office is Level 12 135 King Street Sydney NSW 2000 and its principal place of business is Calvary Mater Newcastle Hospital Edith St Waratah NSW 2298. It is not possible for the Company to reliably quantify the benefit to be received or amount payable.

There are no other events identified and not brought to account which could be expected to have a material effect on the financial statements in the future.

27 28 2015/2016 Calvary Mater Newcastle Review of Operations | 95 96 | 2015/2016 Calvary Mater Newcastle Review of Operations

Locked Mail Bag 7 Hunter Region Mail Centre, NSW 2310, Australia P: 02 4921 1211 www.calvarymater.org.au