11th Annual Report 2007/08 Our Highlights Our Vision for the Year To provide a comprehensive and • Results from 2007-2008 Victorian integrated quality health care service Patient Satisfaction Monitor - catering for the needs of all within our 100% of patients very satisfied with community the care they received.

• Promoting Healthy Lifestyles for our community. Our Mission Facilitated the award winning Providing the highest standard of care ‘Sustainable Farm Families’ program for the health and well being of our with 21 local families participating. rural community • Increased the number of participants in exercise/healthy lifestyle programs.

Our Values • Successful submission for HACC Delivering services in a friendly and • Living at Home program. enthusiastic manner • Being responsive to patient and client • New quarterly bulletin for HACC needs clients ‘HACC Happenings’. • Ensuring that services are of a high quality through fostering continuous • 99% rating achieved in external quality improvement and striving for cleaning audit. best practice • Encouraging professional • Community support – Donations development of staff $68,321. • Being accountable to the community

Timboon & District Healthcare Service Annual Report 2007/08 1 Our Rural Health Service Our Performance

Timboon and District Healthcare these beds are allocated for high care from , 1% from Colac/ Acute Care Service is an integrated health service permanent residents and the remaining Otway Shire and 4% from other Admitted Patients 2007/08 2006/07 2005/06 under a multi purpose service model of 2 beds for respite care. localities across the state, reflecting Same Day Separations 283 317 297 health care, administered by both the the needs of a number of visitors and Multi Day Separations 422 526 608 Australian Department of Health and The former Timboon Hospital, which tourists to the area. Total Separations 705 843 905 Ageing and the Victorian Department was founded in 1955, was designated Emergency 345 485 484 of Human Services. a multi purpose service in 1998, and Elective 271 216 325 Other including Maternity 89 142 96 at that time a major redevelopment Patients by locality of Total Separations 705 843 905 • We deliver acute care, accident of the facilities was undertaken. The residence 2007-2008 Total WIES 425.54 484.75 531.67 and emergency, maternity services, redevelopment provided additional Total Bed Days 2254 2297 2639 residential aged care, community facilities for the expansion of allied Length of Stay (days) 3.2 2.66 2.84 aged care, allied health, district health and primary care services. Scotts Creek 7% Length of Stay excluding Same Day Patients (days) 4.83 3.78 3.86 Surgical and Diagnostic Procedures 210 225 225 nursing, health promotion, active life Responsibility for the provision of a full Timboon 45% Cobden 6% style programs and youth services range of Home and Community Care Births 40 66 74 6% Child Birth Classes - Group Sessions 12 15 22 throughout the Timboon and Services within the catchment was Domiciliary Midwifery Visits 68 59 73 Cobden districts. added to the role of the organisation. Princetown 4% Simpson 4% This growth in primary and community 2007/08 2006/07 2005/06 Peterborough 3% Non Admitted Patients • We work closely with regional and services has enabled the organisation Cooriemungle 3% Emergency Department Presentations 1,816 1,633 1,652 Radiography Occasions of Service 300 471 667 specialised health services to extend to fulfil its mission of meeting the needs 2% the scope of services available. of all within the community. Other 20 % Allied Health Services 2007/08 2006/07 2005/06 Occasions of Service Audiology* 18 28 32 • We are committed to continuously Timboon 45% Continence Clinic (Timboon, Cobden) 60 35 141 improving our Healthcare Service in Our Catchment Diabetic Education (Timboon, Cobden) 164 187 180 terms of quality of care and scope Scotts Creek 7% Counselling (Psychologist) 66 72 72 We provide services mainly for the Nutrition 80 85 113 of services to meet the needs of our southern section of Corangamite Shire Cobden 6% Occupational Therapy 74 77 32 local community. and adjoining areas of Moyne Shire, Port Campbell 6% Physiotherapy 517 543 673 a rural area including the tourist icon Podiatry* (Timboon, Cobden) 667 619 466 Princetown 4% Speech Pathology 249 293 318 of the Twelve Apostles and the Great Total Occasions of Service 1,895 1,939 2,027 Our Hospital Ocean Road. This catchment area Simpson 4% * Private sessions are also held at the Healthcare Service The facilities of Timboon and District has a population base of 8,000. The Peterborough 3% Healthcare Service provide for 14 beds area provides employment through Home Care Services for acute care and residential aged care, the dairying and other primary Cooriemungle 3% Timboon and Cobden districts Hours of Service 2007/08 2006/07 2005/06 4 day-stay chairs, operating theatre industries, tourism and commercial and Terang 2% suite, radiology, emergency department community services. District Nursing 2,297 2,261 2,562 Personal Care 887 683 861 and clinic rooms for allied health and Other Moyne Shire 9% Domestic Assistance 5,579 5,137 5,059 primary care services. The graph details the townships and Corangamite North 5% Respite (in home) 1,083 1,016 878 areas from which patients are drawn. Warrnambool 1% Property Maintenance 2,017 1,861 1,820 In accordance with our Service Plan 80% of patients are drawn from Colac Otway Shire 1% Adult Day Activity Centres 10 beds have been allocated for acute localities in the southern section of Other 4% Timboon 3,695 4,360 4,216 Cobden 4,870 5,600 5,923 care with 2 of these beds specifically Corangamite Shire, 5% from the Source: Victorian Admitted Episodes Dataset Client Transport (number) 1,848 1,880 N/A designed for maternity services, and 4 northern section of Corangamite Shire, Delivered Meals (number) 11,455 8,567 8,791 beds for residential aged care. Two of 9% from adjoining Moyne Shire, 1%

2 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 3 to be a goal and success in this area is to the rebuilding of the ambulance have acknowledged this in this year’s essential for the ongoing maintenance station has affected the planning Victorian Patient Satisfaction Monitor of the organisation. but now that issue is resolved, it is with 100% of patients responding that expected that the project will proceed they were very satisfied with the care As we move into the 2008-2009 year, in the coming year. they received. the Board of Management has engaged consultants to seek out the views of The achievements of the Healthcare the community and our associated Ambulance Service are also a testament to the health agencies to assist them to The Board of Management has strong support received from the develop a new strategic plan and welcomed the announcement that the community through ongoing generous service plan for the next three years Timboon ambulance station will be financial support and the willingness of President’s Report – a requirement to meet our funding re-built and expanded to incorporate a volunteers to assist with community obligations with the Department of permanent ambulance officer. programs. Human Services and the Department of Health and Ageing. The Board in its strategic planning As Chairman of the Board I wish to thank the many people and In accordance with the Financial The Board of Management places on had decided to re-build rather than Strategic Planning The Board of Management has also organisation that have contributed to Management Act 1994, I am pleased to record our considerable appreciation renovate the former community health The strategic goals of the organisation engaged consultants experienced in the the provision of services throughout present the Report of Operations for for the twelve years of service building and this decision has created set for 2005-2008 were: field of retirement villages/independent this year - the Timboon and District Healthcare provided to the hospital and to the the necessary space and suitable site living units to fully ascertain whether Service for the year ending 30 June community by Dr. Jeannie Brown and for the new ambulance station. • to promote a rural model for health the Timboon community has the • Board of Management members 2008. Dr. Michael Brownstein. We were services based upon an integrated capacity to support into the future • Management and Staff indeed very fortunate to have such The Healthcare Service looks forward multi service approach such an endeavour. The size and • Visiting Medical Officers highly skilled, dedicated and caring to working in close cooperation with • to continue to promote student age profile of the community, socio/ • Volunteers and Auxiliaries general practitioners. training placements Ambulance and a permanent economic factors, specific needs and Timboon paramedic to enhance • Timboon Lions – Red Cross • to foster medical and nursing staff community interest in such a venture Transport Richard McVilly In the interim locums and part-time ambulance and emergency services. recruitment and retention are among the issues that will be taken • South West Healthcare President, Board of Management general practitioners have been • to provide additional facilities for into account. • Lyndoch, Warrnambool Timboon recruited to maintain the operation of community activities • Brophy Youth and Family Services 17 September 2008 the Timboon Clinic. We appreciate • to promote effective governance One goal established in the strategic Acknowledgments • Terang & Mortlake Health Service the services provided by these part- • to continue to develop a culture of plan and not yet achieved is the Many people and organisations • Western District Health Service time and locum general practitioners continuous quality improvement expansion of our facilities to provide contribute to the success of Timboon • Corangamite Shire The Healthcare Service has during - Dr. Naomi Harris, Dr. Campbell • to promote safe practices and a safe for additional community and aged and District Healthcare Service. Our • Barwon-South West Region, 2007-2008 continued to provide a McKellar, Dr. Jojy Thomas, Dr. Bruce environment. activities including the relocation of the staff has built up the fine reputation Department of Human Services range of services and, particularly, in the Rossiter and Dr. Kevin Shannon. adult day centre on-site. Issues relating this Healthcare Service has as a • Our Community. health promotion area has achieved Staff are multi skilled and deliver a caring and quality service. Patients considerable success. Against the In this difficult climate of - wide range of services, providing an backdrop of the advanced notice of wide shortage of general practitioners, integrated service model encompassing intended departure by Drs. Jeannie and particularly, the difficulty of acute care, residential aged care, Brown and Michael Brownstein, there recruitment to rural areas, the emergency services, allied health, has been some degree of uncertainty Board of Management sought the primary care and health promotion. in the recruitment of general assistance of Health Financial Pty. Ltd. This Report together with the practitioners. and has entered into a private/public Quality of Care Report which is arrangement for the management of included within the Annual Report the Timboon Clinic and associated outline in detail our services and Medical Staff recruitment of general practitioners. activities undertaken to meet our goals. Dr. Jeannie Brown and Dr. Michael Brownstein continued to practice at The Board of Management remains Timboon and District Healthcare Timboon until the end of December optimistic that general practitioners will Service was successful this year in 2007. During 2007 Dr. Ellie Ananiev be found. attracting the innovative and award had been recruited and following winning “Sustainable Farm Families” the departure of Drs. Brown and The Healthcare Service has well health promotion program to Timboon Brownstein Dr. Galia Millington established partnerships with visiting to meet the need of local farm families. joined the practice. However, the medical specialists to enhance the Health promotion staff undertook recruitment of these two doctors has medical services available at Timboon. specific training in order to deliver this not led to a permanent arrangement program. and at the end of this financial year both resigned. As outlined above recruitment and retention of medical staff continues

4 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 5 Patient Services Emergency Services Food Services During this financial year there were Emergency attendances for 2007-2008 Staff takes pride in ensuring meals are 705 inpatients treated, a decrease of reached a high of 1,816 – an increase appetising, nutritious and meet patients’ 138 patients compared to the previous of 183 attendances over the previous dietary requirements year. This decrease in patients can be year, and one of the highest on record. attributed to the loss of permanent The summer months from December The 2008 Victorian Patient Satisfaction general practitioners in Timboon, to March show a marked increase in Monitor recorded: reducing from four to two over 2007- the number of attendances reflecting the number of visitors to the coastal 2008. Of the 705 inpatients admitted, % Patients’ area during this period. approximately half were admitted Satisfied through the emergency department. Temperature of Clinical Services 100 hot meals The number of bed days remained Electronic Medical Records similar to the previous year, totalling Timboon and District Healthcare Quality of food 100 2254 bed days compared to 2297 Service is one of the leaders within the Quantity of food 100 Patient Satisfaction the surveys in 2007 and 2008. It is in the previous year. Although less South West Alliance of Rural Health patients were treated length of stay The Victorian Patient Satisfaction to be noted that in each category (information technology alliance) in All meal preparation, cooking and increased due largely to an increased Monitor is a regular six monthly except Access and Admission in 2008 the introduction of electronic medical cleaning follows our Food Safety Plan number of palliative care patients. survey conducted by an independent Timboon and District Healthcare records. Clinical information now prepared in accordance with the Food company on behalf of the Department Service achieved the upper score. being recorded electronically includes Act safety and handling standards. A wide range of medical conditions of Human Services, which is sent to emergency admissions, clinical notes This requires the documentation of continues to be treated. The graph all food service activities including patients after their discharge from TDHS Category M TDHS Category M and observations, pathology results Index Measure below demonstrates that all ages the temperature of food served and hospital to reflect upon a wide range 2008 2008 2007 2007 and medical discharge summaries. (20-100 Scale) within the community are catered for, stored and cleaning routines. These of aspects of their hospital stay. The Score Score Range Score Score Range Advantages of the electronic record with the age group of patients treated results are fed back to each hospital, are that it improves the clarity of audits include the kitchen and adult Overall Care 88 77 – 88 89 81 - 89 ranging from neonatal to over 75+. providing an important opportunity for the record, reduces paperwork and day activity centres. All audits received Access and Admission 87 76 – 94 86 77 - 86 quality improvement. 100% compliance. General Patient Information 89 80 – 89 92 83 - 92 All staff has completed Food Safety The Service appreciates the time Treatment and Related 85 75 – 85 88 77 - 88 Level 2 in Health and further taken by patients in participating in the Information undertook Certificate III in Hospitality surveys and thus providing valuable Complaints Management 88 77 – 88 92 80 - 92 feedback on our acute services (Operations) during the year. The Physical Environment 89 77 – 89 89 80 - 89 covering all aspects of care. Supervisor completed Certificate IV in Discharge and Food Safety Practices in the Workplace. The questionnaire has three questions 87 72 – 87 88 72 - 88 that are considered to measure the Follow-up patient’s “overall hospital experience”. Category M – Peer Group of seven multi purpose services. Food services include both inpatients These are: and community clients receiving ‘meals • Thinking about all aspects of your on wheels’. hospital stay, how satisfied were you? • How much do you think you were actually helped by your stay in Maternity hospital? – a continuum of care • Was the length of time you spent in During 2007-2008 a total of 40 babies hospital appropriate? were delivered at Timboon and District Diagnostic and Surgical Procedures Healthcare Service. This is a decrease Overall Hospital Experience enhances access to patient information Included in the 705 patients treated from previous years and reflects 100% Very Satisfied during 2007-2008 by health professionals. The long were 210 diagnostic and surgical term aim is that medical practitioners staffing changes in the latter half of the procedure cases, the majority of these year, moving from an obstetric/general The survey includes over 100 questions throughout the south west will be cases being day-stay. This number practitioner model to a midwifery led covering issues relating to Access and able to access records when clients of cases is similar to the 225 cases model of care. Admission, General Patient Information, are transferred between referring in the previous year. These services Treatment and Related Information, hospitals, assisting patient care. This are provided on a regular basis by For the past two years Timboon Complaints Management, Physical is particularly important for patients visiting surgeons and physicians from and District Healthcare Service Environment and Discharge and of Timboon and District Healthcare Warrnambool and Colac. midwives have been involved with Follow-up. Service where patients may from time to time be referred to the regional the Corangamite Managed Clinical hospitals of South West Healthcare and Network, which has as one of its The following table sets out the aims – to ensure the continued detailed results for each section of Barwon Health.

6 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 7 availability of midwifery services against Early Childhood Program Residential and Respite a background of a diminishing rural general practitioner workforce. – ‘Bookworms’ Services ‘Bookworms’ is a program focusing Four beds are utilised for residential The Corangamite Managed Clinical on socialisation, attachment and early and respite services. Permanent Network, which involved the literacy for parents and young children residents admitted are nursing home Department of Human Services, in Timboon and district. Parents gain or high level care clients. Respite the regional hospital of South West skills and confidence which enables clients are admitted for varying Healthcare and neighbouring hospitals them to create positive family patterns periods of respite according to their together with Timboon and District during their children’s crucial early needs. Prior to admission all respite Healthcare Service, developed a years, and give their children healthy clients have been assessed by the Aged range of activities to up-skill general early experiences with language and Care Assessment Service. Bookings practitioners and midwives. Midwives communication. for respite are coordinated through were up-skilled to expand their role to the regional Carer Respite Centre at provide full care to “low risk” women. The ‘Bookworms’ program runs Warrnambool. This service is also able monthly at Timboon and District to offer some financial assistance in With the departure of obstetric/ Healthcare Service and at the Port meeting respite accommodation fees, general practitioners in Timboon a Campbell Playgroup. Each month depending upon a family and client’s primary maternity care service has approximately 16 adults and 30 financial circumstances. children attend either of the programs. been developed. This care is provided High Level Care 2008 2007 2006 by midwives working in association The 40 new mothers who birthed with obstetricians who visit Timboon at Timboon and District Healthcare Places 2 2 2 Service received a ‘Bookworm’ package regularly. Separations 1 0 1 service in 2001 the number of women which provides every child with age Well Women’s Service Total Bed Days 730 730 683 screened has been slowly increasing. appropriate books at birth that will The aim of the service is to offer Midwives are now providing ante Through regular advertising in the local encourage parent-child attachment and Respite Care within our catchment a service that natal care clinics in association with paper and the Healthcare Service’s foster literacy skills. (High & Low offers women options as to where obstetricians. These clinics involve Level Care) they can obtain pap tests, advice and newsletter ‘HEY’ women are more diagnosing pregnancy, monitoring well aware and informed regarding their Places 2 2 1 education regarding breast health, being of women and baby and follow contraception, menopausal issues or own health. A re-call service is in place Separations 15 21 17 up with pathology tests and scan Parenting other related health issues and provide to ensure that all women eligible for reports. Parenting programs have continued Total Bed Days 366 489 246 referrals to other health professionals screening are reminded – a service that during 2007-2008. Parents have as appropriate. Clinics are run is well received by the women. Since the establishment of the Timboon participated in ‘Little Tackers’ general regularly at Timboon and Cobden Maternity Team in February 17 births information sessions and a ‘Positive and contracted to Terang & Mortlake The graph below illustrates by areas have taken place at the hospital. Parenting Program’. Health Service. Results of pap tests within the service area the increase in Areas covered in are sent to local general practitioners, screening from 1999 to 2007. Domiciliary Care ‘Little Tackers’ include if required by the client. Women with Midwives provide domiciliary visits for speech and language abnormalities are referred on to a all new mothers throughout the district development, first gynecologist for further investigation. – whether the birth has taken place aid, and sleep. The Comparison of Women Screened in each To wnship at Timboon and District Healthcare Triple P parenting In this financial year 885 Service or at another health care program focuses upon women accessed the Well agency. behaviour management Women’s Service with 700 that will prevent parent equal numbers of women Childbirth Classes and family life stressors. being under and over 50 600 Prior to birth, parents attend evening years of age. child birth classes. These are open to 500

all expectant parents within the district omen Increase in Screenings 400 regardless of where they choose to W One of the outcomes 1999 have their child. for the introduction 300 2007 of this service was to New Parents Groups increase screenings, as Number of 200 Under the auspice of the Maternal and data in 1999 obtained Child Nurse new parents throughout from Cytology Victoria 100 the district are offered a series of 8 showed a low incidence 0 classes on a range of topics relevant of screenings for this to new parents. Staff of Timboon and Timboon Cobden/ Port Campbell/ Mortlake Terang catchment area. Since Simpson Peterborough District Healthcare Service provide the the introduction of the educational sessions.

8 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 9 Promoting Health Corporate Governance

Sustainable Farm Families diabetes and cholesterol are checks Community Health at Cobden Organisational Chart The ‘Sustainable Farm Families’ Program that many farmers just don’t “get Priority health issues being addressed is an award winning initiative of around to”. are cancer, chronic illness, cardiovascular Western District Health Service based disease, diabetes and mental health. Board of Board Sub-Committees in Hamilton and this year Timboon staff A participant commented “we book Cancer support and education have Management Board Executive undertook the training to deliver the our tractors and balers in for regular been identified by the community as Finance and Audit program to 21 local farm families. maintenance but never see our own a priority. To meet this need a Cancer Credentials & Medical health as a priority so put off getting Support Group under the direction Visiting Medical Officers Appointments Advisory The ‘Sustainable Farm Families’ program ourselves checked over, until something of the community health nurse has is delivered over a two year period drastic gets us to the doctor”. commenced in Cobden. and aims to develop the knowledge of farmers regarding their own health and Evaluation at the end of the program During 2007-2008 the community Director of Nursing Staff Committees indicated that 85% of the farmers’ well-being and farm safety issues, with health nurse has undertaken: Clinical and Residential Aged Care Community Services a focus on what practical steps can felt more empowered by their own Clinical Services be taken to improve the lives of farm health. Some also found that they • 285 cancer support visits Chief Operating Theatre Nursing Services families and the improvement this can were able to make better decisions • 116 sunspot screenings at Executive Pharmacy Occupational Health & Safety Officer deliver to their farm business. because they had a new perspective Cobden, Simpson and Timboon Infection Control of how important their health and Quality Improvement with referrals as appropriate to Residential and Respite Services The program covers a range of health families were in their lives. All of the general practitioners for biopsy - 3 Hotel Services topics including cardiovascular disease, participants will return to complete melanomas and 27 carcinomas were Occupational Health & Safety cancer, diabetes, women’s and men’s another two day workshop in 2009, confirmed. health, stress depression, farm safety, allowing them to track their health • two ‘Secret Girls Business’ programs nutrition and exercise. indicators over time. with 10 families attending each Community Services Manager • health screenings at local industries Participants found the course • ‘Positive Parenting Programs’ at Primary and Community Services provides significant and relevant Food for Thought Program Cobden and Timboon Allied Health Professionals information, with all participants “Left us with a good healthy mental • new mothers group education in Community Clinical Nurse Educators leaving with increased motivation to approach to eating and lifestyle”. association with the maternal and Community Health Nurse – Cobden tackle health, well-being and safety child health nurse Community Health Nurse – Timboon issues for their farm business. One The ‘Food for Thought’ program • school and community health Health Promotion and Education session involved a tour at the local follows a health coaching model and education programs Youth Worker supermarket examining a range of focuses on nutrition, healthy lifestyles • facilitation of Diabetes Support District Nursing products, with health professionals on and reducing tobacco and alcohol Group and Grief, Loss and Suicide Home & Community Care Coordinator hand to explain the contents of each consumption. The program provides Support Group. Adult Day Centres product in context to their nutritional seven group sessions followed by a requirements. Understanding what quarterly newsletter over the next Additional health promotion programs Corporate Services to look for and how to make better twelve months. During the past are outlined in the Quality of Care decisions for yourself and the family twelve months 20 women have Report section of this Annual Report. Finance had been a highlight for many participated in two ‘Food for Thought’ Human Resources participants. programs and they are currently in Administration Health Information phase 2 of the follow-up program. Maintenance Having blood tests done on day one of the workshop for issues such as

10 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 11 Responsible Ministers Board of Management matters arising between meetings, but of Nursing, Community Services Australian Government Timboon and District Healthcare all decisions relating to policy must be Manager and staff in accordance with The Honourable Nicola Roxon, MP, Minister for Health and Ageing Service is governed by a nine member referred to the next full meeting of the the Instrument of Delegation and the The Honourable Justine Elliot, MP, Minister for Ageing Board of Management, appointed by Board of Management. Health Services Act 1988. Victorian Government the Governor-in-Council upon the The Honourable Daniel Andrews, MLA, Minister for Health recommendation of the Minister for Finance and Audit Committee Health. Board members are appointed The Finance and Audit Committee Board of Management for periods up to three years and serve assists the Board of Management in in a voluntary capacity. fulfilling its financial and compliance oversight responsibilities. The activities of the Healthcare Service are directed by a tripartite Agreement The Committee monitors and oversees incorporating a Service Plan, which is the financial performance and financial negotiated between the Australian and reporting process, the scope of work, State governments and the Healthcare performance and independence of Service on a three yearly basis. The both internal and external auditors, Chief Executive Officer Timboon and District Healthcare the operation and implementation of Elaine Collins BA, MHA, GradDipAcctg, the financial and organisational risk CHE Richard McVilly PhC, MPS Tom Walsh BVetSc, MACVSc, DipAgEc, Michael Broomhall BEd, GradDipEd, DPT Service is accountable through the President GradCertAcc Treasurer Board of Management to both the management framework. The Officer is directly responsible to Pharmacist (Retired) Vice-President Primary teacher State Minister for Health and the the Board of Management for the First appointed: 12.03.1998 Partner in Timboon Veterinary Group First appointed: 12.03.1998 Australian Government Minister for Medical Appointments Advisory/ overall management and financial Current term of appointment: 01.03.2007 First appointed: 01.11.2005 Current term of appointment: 01.03.2007 - Health and Ageing and the Minister for Credentials Committee accountability. - 30.06.2009 Current term of appointment: 01.11.2005 - 30.06.2009 Ageing. The Committee advises the Board of Member of Finance and Audit Committee 31.10.2008 Chairperson of Finance and Audit Management on matters of a medical and Medical Appointments Advisory Re-appointed: 01.11.2008 - 30.06.2011 Committee and member Medical The Board of Management is nature relating to the appointment Committee Appointments Advisory Committee responsible for the governance and of medical staff. Its role is to assess strategic direction of the service the suitability of applicants requesting and is committed to ensuring that appointment to the Healthcare the services meet local needs in Service as visiting medical practitioners accordance with the vision, mission and and make recommendations to the objectives of the organisation. Board of Management. It delineates the privileges associated with such In addressing its governance role the appointments ensuring they are Board of Management strives to: suitable to the role and function of Director of Nursing the Timboon and District Healthcare Anne McMeel BN, RN, RM Margaret Bull RN Josh McKenzie BE(Chem), BSc Margaret McKenzie TSTC Registered Nurse South West Healthcare Chemical Engineer Member of local tourist and economic • Meet community expectations by Service. The Committee is also The Officer is responsible for the First appointed 01.11.2006 First appointed: 01.11.2004 development groups achieving quality health service empowered to take disciplinary action management and quality of care of Current term of appointment: 01.11.2006 - Current term of appointment: 01.11.2007 First appointed: 12.03.1998 delivery if necessary. All medical appointments clinical and residential services provided 30.06.2009 - 30.06.2008 Current term of appointment: 01.11.2005 - • Ensure there are corporate and are reviewed on a three yearly basis. by the nursing and hotel services Re-appointed: 01.07.08 - 30.06.2011 31.10.2008 clinical standards for accountability workforce. Member of Finance and Audit Committee Re-appointed: 01.11.2008 - 30.06.2010 and leadership within the Healthcare Quality and Safety Member of Medical Appointments Service The Board of Management directly Advisory Committee • Address the management and takes responsibility for quality and identification of risks and hazards safety throughout the organisation. by implementing a comprehensive It receives regular reports from clinical and non-clinical risk the Occupational Health and management system Safety Committee and from • Ensure staff and facilities are assessed, senior management on the quality reviewed and credentialled. improvement plan and other internal staff committees monitoring clinical care issues. Director of Community Services Catherine Marr DPT Monica Ryan BVetSc Ray Smith Committees Self employed, former Corangamite Shire Veterinarian Former dairy farmer and self employed Amanda Nash RN, RM Board Executive Committee The Officer is responsible for the councillor First appointed: 01.11.2003 First appointed: 01.11.2005 The Board Executive Committee Executive Staff First appointed: 01.11.2001 Current term of appointment: 01.07.2007 Current term of appointment 01.11.2005 - management, development and quality includes the Office Bearers of the The Board of Management delegates Current term of appointment: 01.11.2007 - - 30.06.2009 31.10.2008 of care of primary care services and Board of Management. The Committee the operational activities of Timboon 31.10.2008 Re-appointed: 01.11.2008 - 30.06.2010 and District Healthcare Service to health promotion and education. Re-appointed: 01.07.2008 - 30.06.2011 Member of Finance and Audit committee is empowered with the authority the Chief Executive Officer, Director Member of Finance and Audit Committee of the Board to act on its behalf on

12 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 13 Human Resources

Workforce JUNE JUNE Merit and Equity Principles JUNE Labour Category Current Current Month Timboon and District Healthcare is YTD FTE Month FTE Head Count committed to providing a workplace Nursing 21.38 20.95 34 environment that fosters fair and equal work opportunities in accordance Administration and Clerical 2.97 3.27 5 with Equal Opportunity legislation and Medical Support 1.88 1.82 2 the values, employment principles and Occupational Health and or procedures or may lead to an as care when dealing with ‘sharps’, Hotel and Allied Services 7.58 7.93 11 code of conduct as laid down by the adverse outcome relating to patient hand hygiene practices, care with State Services Authority. Processes Safety or staff safety. manual handling and what to do if Nursing comprises all Division 1 and Long Service and systems are in place to apply the The Occupational Health & Safety • Regular safety audits are carried out injured at work. public sector values and employment Committee forms a key part of the 2 nurses including community health At the Annual Meeting of the to help highlight actual or potential • Maintenance of ‘No Lift’ compliance principles set out below. These values management system framework for nurses, district nurses, planned activity Healthcare Service held on 13th safety issues and departmental staff procedures for nursing staff in acute and principles govern the manner in managing the organisation’s health and group coordinator and home and November 2007, the Board of participates in these audits with the and community settings and manual which the organisation operates. safety obligations to provide a safe community care assessment officer. Management expressed its appreciation Occupational Health and Safety handling compliance for non-clinical Medical Support comprises health environment. This staff committee Committee representative. staff. for the service of the following staff reports to the Board of Management. professionals providing health who reached the following milestones Public Sector Values promotion, community services and of service: • Responsiveness - providing best Maintenance of safety through education There were no lost workdays due to exercise therapy. The Committee’s role extends workplace injury in the 2007/08 year. standards of service and advice beyond employee safety to include Hotel/Allied comprises food and 40 Years • Integrity - earning and sustaining Staff education and training in correct domestic services and maintenance responsibility for ensuring a safe procedures is one of the keys to Barbara Fraser public trust environment for patients, visitors and staff. • Impartiality - acting objectively maintaining a safe environment. This Environment Administrative and Clerical staff and has incorporated infection 25 Years • Accountability - accepting responsi- year education has focussed upon: Timboon and District Healthcare comprises chief executive officer and control into its charter. Jan Burkhalter bility for decisions and actions Service understands its obligations administrative and clerical staff. • Orientation of new staff to the • Respect - treating others fairly and The role of the committee is under government legislation to reduce 20 Years objectively work area and relevant policies and energy use wherever practicable and its The above table does not include supported by safe practice guidelines Sandra Mugavin • Leadership - actively implement- procedures to enable safe work obligations to reduce waste, use water allied health professionals who are and compliance requirements of the Maureen Turner ing, promoting and supporting the practices. wisely and to consider the impact of contracted from other health agencies, Occupational Health and Safety Act • Compulsory training sessions values. 2004. our actions on the environment. visiting medical officers who are 15 Years reviewing emergency procedures engaged on a fee for service basis Public Sector Employment Principles Sheryl O’Connor including fire, and evacuation, • Energy usage is monitored and and home and community care • Merit - employment decisions are The Occupational Health and Safety manual handling, infection control reported on a quarterly basis to the workers who are contracted from the based on merit Committee meets regularly to discuss 10 Years and occupational health and safety Department of Human Services. Corangamite Shire. These contracted • Fair and Reasonable - public sector a wide range of topics concerning staff, Heather Power policies. • Heating to the hospital is by way of a staff contributes significantly to the employees are treated fairly and patients, volunteers, allied health and Tricia Klemm • The introduction of an OH&S reticulated water heating system. range of services provided by Timboon reasonably community clients, contractors and Alan Rhode Information Board in the staff room, • All waste is appropriately segregated and District Healthcare Service. • Equal Employment Opportunity - visitors. highlighting on a monthly basis and where appropriate re-cycled. Timboon and District Healthcare equal employment opportunity is response codes and actions to each provided Safety issues are reviewed through: Service is very fortunate to have emergency situation. In future facilities development of • Avenue of Redress - there is a rea- the dedicated service of staff, the • A regular OH&S/Infection Bulletin energy and water saving measures will sonable avenue of redress against • Analysis of incident reports and issued to each staff member with majority of whom have been with the recommendations as required. Staff be addressed. organisation for many years. unfair or unreasonable treatment their pay slip raising awareness of safe is required to report any incident work practices covering topics such which is a deviation from protocol

14 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 15 Our Staff

Positions held at Timboon & District Community Services Corporate Services Healthcare Service as at 30 June 2008 Community Services Manager Chief Executive Officer Amanda Nash RN, RM Elaine Collins BA, MHA, GradDipAcctg, Clinical Care And Residential CHE Services Community Health Nurses Cobden Administration and Finance Director of Nursing Lyn Russell GradDipNursg Kristie Coverdale BComm Anne McMeel BN, RN, RM Pharmacists Relieving General Practitioners Relieving (Community Health), RN, RM Barbara Fraser Ms. Danielle D’Onofrio BSc(Hons), Dr. A.L. Brown MBBS, DRANZCOG, Dr. C. Sutherland MBBS, FRACS Timboon Sheryl O’Connor Night Supervisors B.Pharm, MPS FRACGP, Amanda Nash RN RM Kristen Williams Karen Kennedy RN Mr. George D’Onofrio Bsc, B.Pharm, Dr. T. Fitzpatrick MBBS, FRACGP, Tricia Klemm RN, RM (OH&S M.Pharm, MPS DRANZCOG, GradDip Family Health Promotion Officer Hotel Services Supervisor Visiting Private Services Coordinator) Medicine Audiologists Melanie Green BHSci (Speech Monica Easterbrook Margaret Tesselaar RN, RM Staff contracted from South West Dr. S. J. Menzies MBBS, MMed, FRACGP, Ms. C. Scott BSc, MClinAud, MAudSA Pathology) Healthcare DRANZCOG (Advanced) (CCP) Chef After Hours Supervisors Biomedical Engineer Dr. R. Stewart MBBS, DRANZCOG, Ms. S. Tai BASc, MClinAud, MaudSA Allied Health/Community Health Lorraine Wilson Mary Guy RN, RM Continence Nurse FACRRM Officer Heather Power RN, RM (Infection Dietician Chiropractor Tracey Heeps BEd (PhysEd) Food & Domestic Assistants Control Coordinator) Occupational Therapist Anaesthetists Mr.R. McIlveen BAppSc(Chiropractic) Jan Burkhalter Pam Robb RN, RM (Baby Friendly Physiotherapist Dr. K. Cronin,MBBS, FANZCA District Nurses Vera Convey Coordinator) Speech Pathologist Dr. M. Duane MBBS, FANZCA Podiatrist Lynda Avery, RN BAppSci Katrina Currell Maureen Turner RN, RM Dr. G. Kilminster MBBS, FANZCA Ms.R. Simpson BAppSc(Pod) Julia Gale BN, RN (on leave) Paula Gay Staff contracted from Terang & Dr. K. Prest MBBS, FANZCA Marie Jones Lesley Henriksen Division 1 Registered Nurses Mortlake Health Service Radiographer Corry Kerr Gaye McVilly Kristie Couch, RN Ms. Michelle Symons, RN, Diabetes Obstetricians & Gynaecologists Mr.G. Osborne AssocDipAppSci, MIR Sherryl Mueller, RN Linda Pender Lynda McKenzie, RN Educator Dr. C. J. Beaton MBBS, FRANZCOG, Bernadette O’Brien BN, RN Doreen Poustie Nikaiya McVilly, RN FRCOG, MRCGP Enid O’Connor Wendy Wagstaff Lynn Marr RN Staff contracted from Western District Dr. E. M. Uren MBBS, FRANZCOG Leanne Unwin Joanne Poustie RN Health Service Dr. J. D. Friebe MBBS, FRANZCOG Maintenance Officer Ingrid Rial, RN Health Information Manager Adult Day Activities Coordinator Alan Rhode Michelle Selten RN Physicians Sandra Mugavin Visiting service from Lyndoch, Dr. C. Charnley, MBBS, FRACP Adult Day Activities Assistant Division 2 Registered Nurses Warrnambool Relieving Physicians Joanna Harris Kathy Brown Visiting Clinical And Allied Podiatrist Dr. B. Morphett, MBBS, FRACP Mary Duynhoven Dr. S. Nagarajah, MBBS, FRACP Assessment Officer/Care Manager Health Staff Julie Giblett Audiologists Fiona Hanel Surgeons Julie Harkin Ms. C. Scott BSc, MClinAud, MAudSA Visiting Medical Officers Jodie Skilbeck General Practitioners Mr. B. Mooney MB ChB, BAO (Hons), Youth Services (CCP) Vickie Stevens Dr. N. Harris MBBS BSc (Anat.) (Hons), MCh, FRCSI, (in association with Brophy Youth and Ms. S. Tai BASc, MClinAud, MaudSA Michele Webber Dr. C. McKellar MBBS FACRRM, FRACS Family Services) Dr. D. Robert Doctor of Medicine Helen Wiggins Mental Health Social Worker Dr. B. Rossiter MBBS FACRRM (Univ Paris), FRCS (Edin) Fiona Younis Mr.Lee Town BSW, MAASW Dr. K. Shannon MBBS, FACRRM Dr. J. Thomas MBBS

16 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 17 Our Community

The Timboon and District Healthcare Ritchies Supermarket - helpers. Their activities throughout Service is very appreciative of the the year included catering for various support of our local community, who Community Benefit Card functions, the Christmas and Easter regularly contribute in many ways to $24,265 was received this year, arising special raffles and jointly organising our Service. from community members nominating the local Monster Plant sale with the the Timboon and District Healthcare Cancer Council of Victoria – Timboon Support for our Service is provided Service to be the beneficiary of the Unit. These funds will purchase a BIS partners Health nights. These events through regular donations by 1% of purchases donated by Ritchies awareness monitor for the operating Donations in lieu of flowers Facilities Upgrade provided a wide audience to promote individuals, the Annual Appeal, Supermarket to charity. theatre. Several families throughout the year Theatre health issues affecting men and women fundraising by the Timboon Cruisers, encouraged families and friends to - Air flow, air conditioning $65,000 of all age groups and were very well the Timboon and District Healthcare Members of the Auxiliary were donate to the hospital in lieu of flowers. received. Service Auxiliary, community groups Timboon Cruisers - Murray to deeply saddened during the year by Their support is appreciated. All other donations will go towards the and voluntary service, particularly to the death of former member, Mrs. further development of community Moyne Cycle Relay Scotts Creek Indoor Bias facilities for adult day activity programs, assist the activities and services which A small group of keen Timboon cyclists Doris Felmingham. Mrs. Felmingham operate for the frail aged and disabled had been a strong contributor to the Bowling Club Equipment and Facilities maternal and child health, child care and their support crew enjoy this well and exercise programs. members of the community. known annual fund raising cycle relay Auxiliary and continued to provide A regional tournament organised by Upgrade event, in which many supporters of ongoing support behind the scenes. the Scotts Creek Indoor Bias Bowling The maintenance of facilities and This support plays a large part in the hospitals across the state compete, Club each year raises funds for the equipment requires continual upgrade success of the organisation. Regular riding over a weekend from the Murray Timboon and District Healthcare and replacement. Listed below is donations help to maintain the high river to . Much hard work Cancer Council of Victoria - Service. Much work goes into the major equipment purchased with standard of our medical equipment and goes into seeking sponsorships and organisation of the tournament and donations and capital grants from the facilities. Timboon Unit the Healthcare Service very much general fund raising for the event The local Monster Plant sale has Department of Human Services. A appreciates this year’s donation of including wood raffles and a fund become an annual event in Timboon major upgrade of the operating theatre $1600, which will asssist with the raising trip to . Our local assisted by local gardeners potting facilities took place to meet current purchase of a patient lifting machine. Major Support 2007/08 team – the Timboon Cruisers – are up plants throughout the year, and standards. Annual Appeal $23,165 a dedicated group. Sponsorship then being well supported by the Ritchies Benefit Card $24,265 from Popes Bus Lines, Timboon community. Timboon Unit run a Timboon P-12 School Timboon Cruisers $ 8,500 Motors, Timboon Post Office, Waves number of events throughout the A group of five students from Year 12 Medical Equipment Restaurant and the community Timboon & District year contributing to the valuable work took the initiative to participate in the Scope video processor $17,500 continues each year. This year $8,500 Healthcare Service Auxiliary $ 7,000 of the Cancer Council of Victoria. Cancer Council of Victoria’s Shave for a Gastroscope $6,450 has been raised and will purchase a BHP Billiton $ 8,050 However, funds raised from the Cure and with the financial support of Lo-lo bed $4,915 new ECG monitor for the hospital. Monster Plant sale are donated to the school friends and family raised $602. Reclining adjustable wheelchair $3,500 Healthcare Service to assist palliative The district nurses, whose role includes Drug fridge $3,085 Annual Appeal care. Together with the Auxiliary this providing palliative care in the home, Pulse oximeter $1,250 Support for the annual appeal was Timboon and District event raised $3,635. have used these funds to purchase once again very generous – with a total specific items to assist their palliative Healthcare Auxiliary care role. of $23,165 being raised. This small group of dedicated ladies Non-Medical Equipment has once again had a very busy and BHP Billiton Freeezer $3,700 successful year fund raising for the The Healthcare Service acknowledges Hobart Mixer - Kitchen $2,800 Healthcare Service, resulting in a the financial support of a total of Lawn mower $1,236 donation of $7,000. Auxiliary members $8,050 for sponsorship of both the would like to thank a number of loyal very successful Women’s and Men’s and

18 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 19 Volunteers

Timboon and District Healthcare Life Governors Mr. Stewart A. Lindsay, JP, FHA Service gratefully acknowledges the An award of Life Governorship is Manager/Secretary Timboon Hospital support of a large group of men and made by the Board of Management to 1955-1972 women who regularly give their time to recognise valuable voluntary service to assist our community care programs: the organisation over a considerable Mr. Stewart Lindsay, who died this period of time. year at the age of 101, is not only • Meals on Wheels commemorated in the history of • Community Transport Mrs. H. Bullen Ms. J. Burkhalter Warrnambool Base Hospital, now • Red Cross Transport Mrs. M. Coe Mrs. P. Couch South West Healthcare, as an • Adult Day Activities Mrs. J. Duro Mrs. D. Fairweather outstanding manager for over 20 • Visually Impaired Group Mr. A. Felmingham Mrs. E. Finch years but he holds a significant place Mrs. E. Finnigan Mr. N. Finnigan in the history of Timboon Hospital, These programs rely upon volunteers Miss B. Fraser Mrs. L. Giblett serving jointly with his role as manager to give freely of their time to support Mrs. H. Herrin Mrs. J. Hortin at Warrnambool Base Hospital, as members of our community and play a Dr. D. Jackson Mr. L. Joiner the Manager/Secretary of Timboon valuable role in assisting the elderly to Mrs. N. Joiner Mr. K. Jepson Hospital from its inception in 1955 to remain in their homes. For the elderly Mr. H. Kruse Snr Mrs. G. Kruse 1972. During this period he oversaw in this rural community, social isolation Mrs. P. Lawson Mrs. Y. Lawson the building of the initial 10 bed is an issue, due to the lack of transport. Miss R. McMeel Mrs. L. Meek hospital and its extension to a 20 bed Mrs. D. Merrett Mrs. H. Morris hospital. The hospital and its services Mrs. B. Newey Mrs. B. O’Brien developed rapidly in this period as the Red Cross Transport Mrs. E. Padbury Mrs. S. Phillips Heytesbury settlement and Timboon The Timboon Lions together with Mrs. K. Robbins Mrs. E. Rundle district farm communities expanded. local Red Cross volunteers greatly Mrs. V. Sharp Mrs. G. E. Symons assist with transport of clients for Mrs. D. Taylor Mrs. J. Toller-Bond medical appointments in Warrnambool, Mrs. F. Thompson Mr. D. Trigg and at times transport to Mr. J.A. Vogels MP Melbourne.

Vale Timboon Ambulance Service Mrs .Eva Hardwick Although not a part of the hospital Mrs. Eva Hardwick was an office organisation, we acknowledge the bearer, holding at various times important role played by the local the posts of President, Assistant community ambulance officers in Secretary and Treasurer, of the former supporting the hospital. This small Cooriemungle Hospital Auxiliary. Her group give freely of their recreational Life Governorship, awarded in 1975, time to provide an essential service to was in recognition of over ten years of the community. fundraising for the Timboon Hospital.

20 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 21 Quality of Care Report

Quality revolves around a central The format of the report has been • the way staff involved you in commitment by staff to continually based upon the Quality of Care decisions about your care improve quality outcomes for our reporting guidelines, input from clinical • the willingness of hospital staff to community. staff and feedback from community listen to your health concerns. members, following a survey seeking This report outlines various initiatives comments and input. Staff and Trend data for 2005 to 2008 show undertaken by staff during the current community members considered that that at each six monthly interval of year in service delivery and the the report conveyed key aspects of reporting over this period Timboon nursing and planned activity groups. Caring for Carers • Respite care in the client’s home. structures and systems that are in place quality and safety and no changes were and District Healthcare Service Regular evaluation of health promotion Our role is not confined to patients/ • Residential respite care linked to to assist us meet our quality and safety requested. Given the small size of our exceeded the average for our peer activities seeks the views of participants clients but extends to ensuring that the central booking agency in the goals. Healthcare Service it was considered group of seven multi purpose services on the value of each program and how families including carers are cared for south west – Carer Respite Centre, appropriate that the Quality of Care across the state and far exceeded the improvements can be made. during a patient’s hospital stay and that Warrnambool. We welcome feedback from patients Report be incorporated within state average for all hospitals as shown suitable arrangements are made upon • HACC Assessment Officer who and community members on how we the Annual Report, providing a in the table and graph below. discharge for the patient and carer. is available for advice and able to may further improve our services in consolidated report to promote the Complaints Management District nurses and our home and coordinate access to additional services to assist carers and clients. order to assist and contribute to the activities of the Service. Consumer Participation Indicator Patients’ perceptions of their ability community care assessment officer play community’s health and well being. to make a complaint are monitored an important role in extending care • Services for parents of young 100 Timboon & District Healthcare Service through the Victorian Patient into the community setting. disabled children. Hospital Category M Mean Satisfaction Monitor. The table below Consumer, Carer 95 State-wide Mean Informing the community and Community highlights the 2007-2008 Victorian Services for carers have been The Quality of Care Report will again 90 Patient Satisfaction Monitor complaints highlighted through network meetings Meeting Cultural Needs be distributed with the Healthcare Participation management index for Timboon for carers and the publication of a Cultural Diversity Plan Service’s Annual Report and launched The Consumer 85 and District Healthcare Service for quarterly ‘HACC Happenings’ bulletin The cultural diversity plan has been at its annual meeting. It will be made Participation Indicator the surveys in 2007 and 2008 and mailed to all HACC service recipients. designed to take account of the needs available to the community through (CPI) is designed 80 comparison with peer multi purpose of patients and clients from culturally to help answer the services. Our Healthcare Service provides: and linguistically diverse and indigenous our mail distribution to supporters and 75 key stakeholders of the Healthcare question, “How can a • Adult Day Activity Centres (Planned backgrounds. public health service Activity Groups) at Timboon and Service. Copies will also be on display 70 Few complaints are received by assess and report on its Cobden, with one day specifically and available at reception throughout Wave 9 Wave 10 Wave 11 Wave 12 Wave 13 Wave 14 Timboon and District Healthcare The 2006 census for country of birth the year. performance in involving Service and no written complaints focusing on Respite for Carers. for our catchment area comprising patients, carers, and the Timboon & District • Transport for the frail aged to attend Healthcare Service 91 89 90 86 91 85 relating to patient care were received Corangamite South Statistical Local In association with the Healthcare community in the areas during this financial year. various Centre activities. Area, with a population base of 7414, Hospital Category of health care delivery, 84 84 84 84 85 81 Service’s Annual Appeal a bulletin M Mean shows: planning, development outlining key activities and features Category M Category M Australia 93%, New Zealand 2%, and improving quality State-wide Mean 81 80 80 80 79 80 Index Measure TDHS TDHS from the Quality of Care report 2008 2007 United Kingdom 2% and the remaining and safety?” (20-100 Scale) 2008 Score 2007 Score is distributed to each household Score Range Score Range 3% of overseas born being drawn To complement the work of the mainly from Western Europe. Census throughout the catchment. Complaints The CPI is calculated using three Victorian Patient Satisfaction Monitor data also reveals Management 88 77-88 92 80-92 questions from the Victorian Patient Timboon and District Healthcare to be less than 1% of the population. An electronic copy will be placed on Index the Service’s website Satisfaction Monitor. These items are: Service conducts a number of specific Category M – Peer group of seven Multi www.timboonhealthcare.com.au surveys seeking the views of clients Achievements in meeting the goals Purpose Services • the opportunity to ask questions on service delivery relating to meals of the Cultural Diversity Plan include about your condition or treatment on wheels, home care services, district the training of staff in how to access

22 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 23 Quality and Safety in Practice

Clinical Governance The risk management program is linked Purchasing, validation, monitoring Timboon and District Healthcare to the quality improvement program. and maintenance of sterilizers and Service demonstrates its commitment associated equipment to continuously improving standards Key preventable clinical risks to patients Overall average score for 94% of care through its system of when they enter any health service 44 participating hospitals have been identified as infection clinical governance. The Board of Timboon and District control, falls, pressure ulcers and 95% Management, executive nursing staff, Healthcare Service the telephone interpreting service, staff committees, together with all staff medication errors and our activities in particular, paying attention to the and outcomes to prevent these risks members directly involved with client Quality Management needs of tourists/visitors attending the care, contribute towards good clinical follow. emergency department, provision of Overall average score for governance. 97% standard international signs and multi procedures are continuing to ensure 44 participating hospitals continuous quality improvement. All language pamphlets. Food services Some of the key components of clinical Infection Control Timboon and District staff are able to plan menus to meet mandatory criteria were met. 98% governance at Timboon and District Theatre Sterilisation Audits Healthcare Service individual client needs and cultural Healthcare Service include: Prevention of infection for diagnostic preferences. During the year the home The organisation is now preparing and surgical procedures is of the Data collected during audits is used to and community care assessment officer for the next organisation wide survey • clinical audits highest importance in maintaining a improve procedures and adopt best attended a training workshop on scheduled for February 2009, with an • review of policies and procedures safe environment for patients, staff and practice. assessment processes and awareness emphasis upon reviewing policies and • on-going education related to clinical visitors. procedures against evidence based for clients of culturally diverse standards Staff responsible for cleaning, backgrounds. Staff in our planned practice and that rigorous evaluation is • employment of staff with relevant AS/NZS 4187:2003 is the Australian disinfecting and sterilizing surgical or activity groups highlight national events applied to quality activities. qualifications/experience and New Zealand standard for cleaning, medical equipment receive ongoing and provide reminiscence days specific • incident reporting disinfecting and sterilizing reusable training in these processes and this to individual clients. The aim of the ACHS accreditation • complaints handling medical and surgical instruments year procedures have been reviewed in Our aim is to listen to and respond to program is to increase the quality • risk management strategies. and equipment, and maintenance of association with a neighbouring hospital the needs of each individual. and safety of care through providing associated environments in health care to provide a uniform approach to the an organisation- wide framework for facilities. Ensuring that health services handling of shared equipment. minimising risk, evaluating performance Risk management are adhering to the requirements of and implementing improvements. Hand Hygiene – Preventing the spread Accreditation Risk management is an important this standard independent audits are of disease Timboon and District Healthcare component of any quality system. undertaken by Department of Human Research has demonstrated the Service participates in the EQuIP It is the process that looks at the Services’ appointed infection control importance of hand hygiene – the program operated by The Australian major risks facing an organisation nurses utilising a standard audit tool practice of regularly cleaning hands Council on Healthcare Standards and as part of clinical governance enabling benchmarking and comparison between patients to reduce the risk of (ACHS) and received the full term the Board of Management and staff between health facilities in meeting the transmitting bacteria and disease. In four year accreditation at our last implement policies and procedures to requirements of the standard. fact hand washing is considered the organisation wide survey in 2004, and minimise these risks and the possible single most effective measure to stop this was re-endorsed at the periodic consequences which may occur. At This year 44 facilities including the spread of infections in health care review survey in December 2006 Timboon and District Healthcare Timboon & District Healthcare Service settings. as part of the EQuIP program four Service the Board of Management participated in the audit. year accreditation cycle. The periodic oversees the risk management process To increase the culture of more review re-assessed compliance with and receives reports on quality actions frequent hand washing by health the 19 mandatory standards and taken to minimise risk. re-confirmed that activities and professionals across the hospital

24 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 25 system, the Victorian Quality Council Required Standard is 55% coughing or sneezing, particularly in commenced a hand hygiene monitoring 100% closed and confined areas such as program in 2006 to encourage 80% hospitals. 60% greater compliance. Timboon and 40% District Healthcare Service has 20% Protecting community members 0% adopted the Victorian Quality Council 2008 Community health staff undertakes recommended use of antiseptic hand a high profile campaign each year gel as an alternative to soap and water Hotel Services Maintain High Cleaning advocating members over 65 to take washing and dispensing units have been Standards advantage of the free flu shots, and installed in each patient room and Hotel services staff play an important visit senior citizen and adult day activity other areas of the Healthcare Service. role in infection control through high groups providing immunisation. A Also a program of encouraging compliance with cleaning standards and similar program is provided for local patient’s visitors to also use the hand take pride in presenting a clean and school teachers. gel as advocated by the Victorian attractive environment for patients and Quality Council has been promoted as visitors. Regular internal audits coupled Protecting against other diseases a further measure to reduce the risk of with an annual external audit are Several other vaccinations are patient infection. undertaken. This year staff achieved an recommended for health care workers, overall score of 99.14%, with the four including whooping cough, measles, and To further encourage hand hygiene the very high risk areas (operating theatre hepatitis B. This hospital has a program Department of Human Services has rooms) scoring 100% and the seven in place to ensure staff are vaccinated introduced a new program in 2008 high and moderate risk areas scoring against these diseases. – known as the ‘5 Moments of Hand 99%. Hygiene’ – to serve as a reminder to Monitoring infection rates • Application of risk management Falls Monitoring and • Use of walking aids such as frames staff of the most opportune times As indicated in the graph below over Timboon and District Healthcare principles to medication Prevention and sticks. during patient care to cleanse hands. the past five years, the overall score Service participates in the VICNISS administration aligned to evidence • Ensure that there is adequate lighting Preventing patient falls is a key focus This is to protect both the patient has ranged between 97% – 99%, which hospital acquired infection surveillance based practice. available before a patient accesses in maintaining a safe environment for and staff member from cross infection. well exceeds the benchmark standard program, but there has been minimal ensuite facilities at night. patients and preventing injury during Patients in hospital are often at their of 85%. data to report. Timboon and District Healthcare • Reporting, documentation and their stay. Nursing staff undergo most vulnerable as at times of illness Service uses the recommended analysis of all falls through the 100% Required Standard is 85% regular training in falls prevention and the immunity or ability of our bodies to All the above activities have National Standard Medication Chart incident reporting system. 95% the use of aids to assist patients. fight infections can be reduced. 90% contributed to Timboon and District to provide a uniform approach to the 85% Healthcare Service having an extremely recording of medications. Previous analysis of falls has highlighted 80% Key to the prevention of patient falls Hand Hygiene Compliance low infection rate. that the majority of falls have arisen 75% is staff awareness of issues that may A Victorian Hand Hygiene Centre 70% Although staff are highly trained due to patients not seeking assistance 2004 2005 2006 2007 2008 lead to falls and actions that may assist compliance auditing system has been and are regularly assessed for when accessing the ensuite facilities. prevention. introduced measuring hand compliance Preventing Infection – Flu Vaccination Medication Management their competency in medication The audit also revealed that the management errors or deviation from majority of falls were in the 70+ age washing, by moment, glove compliance Compliance Correct administration of medications protocols can occur on occasion. All There are many contributory factors group. and produce usage. Timboon and District Healthcare is a vital part of each patient’s incidents relating to non-compliance which increase risk of falls in hospital Service continues to be a leader in treatment and care, and monitoring with medication administration including medical treatment, weakened Of the 11 falls this year, 3 falls resulted Timboon and District Healthcare influenza vaccination rates of health of administration of medication is protocols including documentation or physical condition due to illness, effect in slight skin tears and no injuries Service has embraced this new care staff by achieving one of the undertaken to ensure compliance error in dosage administration must be of medications and unfamiliarity with resulted from the other falls. For concept of ‘5 Moments of Hand highest participation rates in the with medical instructions and standard reported utilising the incident reporting surrounds. 2007-2008 there were 3,350 bed days. Hygiene’. state. In 2006 Timboon and District best practice protocols for the welfare system. This gives a ratio of 1 fall to 304 bed Healthcare Service topped the of patients. All Division 1 nurses are Strategies that have been implemented days or a ratio of 0.49% per patient The Victorian Hand Hygiene Centre state with a compliance rate of 84% qualified to administer medications and There was one medication error in include: bed day. This ratio is much less than has set an acceptable quality standard compared with the stage average the majority of the Healthcare Service’s of 55% compliance. In the most of 34%, and in 2007 we achieved a this financial year. This related to an that experienced by other publicly Division 2 nurses have undertaken • Use of a risk screening tool on recent survey undertaken in June compliance rate of 91%. This year our incorrect dosage being given, which funded organisations. the medication administration course, admission, which takes into account 2008 by the regional infection control compliance rate fell slightly to 85%. resulted from a breakdown in the which enables them also to administer a patient or resident’s physical consultants, Timboon and District checking protocol. medications. disabilities, the possible impact Healthcare Service achieved 79% The National Health and Welfare of medications and the hospital compliance, considerably higher than Council and the Department of Staff education covers: Year No. of Medication Errors environment. the Victorian Hand Hygiene Centre Human Services encourage all hospital • Understanding of pharmacology 2008 1 • Ongoing education of staff and acceptable quality standard and above staff to be immunised, not only to and medication procedures patients on falls prevention strategies. comparable facilities in our region. protect staff but also to protect the 2007 2 including legislative and regulatory • Advice and encouragement to health of vulnerable patients and 2006 1 requirements patients to seek assistance before aged care residents, as the flu spreads • Operational practices to ensure getting out of bed especially if there easily from person to person through quality and safe use of medications is an increased risk of falling.

26 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 27 residents, who were quite immobile, Credentialing and Certification of other visiting specialists were re- developed Stage 1 pressure ulcers. It is credentialed and re-appointed for a important to note that not all pressure of Staff further three year period. problems can be avoided especially Visiting Medical Officers if patients are critically ill, poorly Credentialing refers to the formal Nursing Staff and Allied Health nourished and perhaps at the end of process undertaken by an appointed Professionals their life. sub-committee of the Board of All nursing and allied health Management comprising Board professional staff are required to Wound Management members, executive staff , together provide evidence of their qualifications If a pressure ulcer develops staff with appropriate independent and maintain registration with their examine the cause and reflect on how medical practitioners to review a relevant professional bodies. Proof of to prevent further problems occurring. medical practitioner’s application for continued registration with appropriate Care of and dressings for the ulcer appointment to the Healthcare Service authorities is required annually. In would be detailed in the patient/client’s to undertake various procedures as addition, mandatory competency history and progress charted. specified in the initial application or checks and professional development subsequent application for renewal activities are a requirement for Palliative Care in the Home of appointment. Initial appointments continued employment. Palliative care patients cared for in their may be for one year and subsequent homes have available, on loan, a recliner appointments are usually made on Nursing staff undertaking specialised chair, soft overlay mattresses and aids a three yearly basis. National and services/tasks are required to undergo to help support them in their beds Department of Human Services’ re-accreditation with the Nurses Board or in a supportive soft chair. District guidelines have been established to of Victoria. Nurse immunisers are During this year there has been • Advice from the occupational assessment tool nursing staff has been well-trained in guide Boards of Management in these re-accredited on a three yearly basis as increased emphasis upon reminding therapist on the use of aids in the • Regular routine skin check wound management and prevention. procedures. also is our Women’s Health Nurse Pap patients to seek assistance, and home to prevent falls/slips. monitoring Test Provider, who this year completed reminder notices have been placed in • Referrals to a podiatrist to assist • Use of pressure relieving mattresses The process involves ensuring that re-accreditation. medical staff are registered with the each patient’s room. optimal foot health. • Use of specialised seating/cushions/ Incident Reporting Falls over the past three years have • Referral to and promotion of 10 adjustable beds to relieve pressure Medical Board of Victoria and that Incident reporting is the key tool used On-going staff education is an essential shown a decrease, with a significant week body balance program. • Ongoing training of staff utilising the their qualifications are appropriate for by the Healthcare Service to monitor element of maintaining quality and 38% reduction in falls this financial year. • Referral to and promotion of Victorian Quality Council on-line the needs of Timboon and District adverse events or near misses. An safety. rehabilitation exercise program, pressure ulcer prevention training Healthcare Service. Other factors adverse event is defined as “an incident strength training and tai chi programs. modules to be taken into account in the No. of Ratio of Patient in which unintended harm resulted Continuing Professional Development • Attendance at regional wound credentialing process is for the Board Year Patient Falls/ Falls/Slips to to a person receiving health care” Participation in continuing professional management study days and of Management to ensure, particularly Slips Bed Days and a near miss as “an incident that education is an indicator of staff workshops in the case of surgical procedures, that commitment to continuous quality 2008 11 0.49% Pressure Wound Monitoring did not cause harm”. No adverse • Maintaining skin integrity during such procedures are appropriate to event or near miss occurred during improvement. All staff throughout 2007 18 0.78% and Prevention theatre procedures through the the role of the Healthcare Service and the year. Staff is encouraged and the organisation are encouraged to 2006 21 0.79% A pressure wound is defined as ‘any introduction of pressure reducing that the Healthcare Service has the required to report any incident that attend professional development lesion caused by unrelieved pressure, devices such as gel pads. necessary resources both in terms of may cause injury or non-compliance and skills upgrade programs through resulting in damage to the skin and • Availability of a specialist continence physical facilities, financial viability and Residential Aged Care with protocols. There were a total attendance at seminars, workshops and underlying tissue’. nurse to assist with specific nursing and other allied health staff No patient falls have related to our of 12 incidents relating to patients as conferences, as well as attendance at continence issues. trained to complement and support 2 high care clients or respite clients. reported in the sections above. compulsory in-house training courses There was, however, 1 fall/slip relating Pressure wounds or ulcers are the procedures being undertaken. It covering essential regular training in acknowledged as a significant health No acute inpatient has acquired a is also expected that medical staff to a client at a day centre activity. The Healthcare Service has a ‘no blame’ cardiac pulmonary resuscitation and problem in health care settings and can pressure ulcer during their hospital provide evidence and demonstrate approach to clinical incidents in order infection control. With a small group adversely affect the quality of life and stay over the past three years. Several a commitment to on-going medical Falls Prevention in the Community to identify what contributed to the of staff providing a wide range of morbidity of patients and unnecessarily patients have presented on admission education. Actions taken to promote falls incident and to investigate how the services, staff requires multiple skills. increase length of stay. Patients over 60 with a pressure ulcer, and have received prevention, with particular emphasis health care systems and processes can amongst clients in the 70+ category, years of age are most at risk. appropriate wound management care. At Timboon and District Healthcare Timboon and District Healthcare be improved to reduce the likelihood Service the above procedures include: of such an incident happening again. Service is a member of the South Every endeavour through ongoing Residential Aged Care are undertaken by the Medical West Healthcare Continuing Education • Individual ‘no falls’ assessments for staff education and establishment of For the past two years Timboon Appointments Advisory Committee. Consortium. This consortium provides members of the senior citizens best practice policies and procedures and District Healthcare Service has As many visiting medical staff also a range of courses recommended by groups and adult day centre clients. are in place for the prevention and participated in the Public Sector hold appointments with South West the Directors of Nursing from the five • Home ‘no falls’ assessments management of pressure ulcers Residential Aged Care Services Healthcare, or other regional hospitals, participating hospitals. In addition to undertaken by district nurses and including: (PSRACS) quality indicators, which advice is also sought from these attendance at these courses staff access the home and community care includes prevalence of pressure ulcers. hospitals’ credentialing committees. workshops and seminars appropriate assessment officer. • Assessment of ‘at risk’ patients During the year the two high care During the year visiting anaesthetists to their needs through Barwon Health utilising the Norton scale risk sought appointments and a number

28 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 29 Continuum Of Care

A Case Study Journey from The district nurses cared for Mrs. Firth’s Mrs. Firth was explained the wound and helped with personal importance of accessing (and Acute Care to Community care until her ankle healed and then accepting) the services available for her Services the HACC assessment and care to use. Mrs. Firth also acknowledges Mrs. Firth is an 84 year old woman coordinator arranged for a personal the importance to her health of getting living on her own in Timboon. She care worker. out in the community and mixing with experienced a bad fall and was taken old and new friends. Mrs. Firth is Education Centre, South West TAFE, practitioners issued with the results by ambulance to Timboon and District At this point Mrs. Firth was able to now settled into her new lifestyle, no Australian College of Nursing and of the review of the records and Healthcare Service and admitted. Mrs. access many varied services offered longer so lonely, and feeling healthier similar training bodes in order to obtain recommended actions to improve Firth suffered a deep skin tear on her by Timboon and District Healthcare and more energetic. On her visits a broad range of training to meet quality. ankle and was generally stiff and sore. HACC assessment and care to the Healthcare Service Mrs. Firth individual and organisational needs. She was very shaken by the event coordinator. This process addressed smiles and says she is thankful that a fall The Otway Division of General and was a little frightened of returning social and emotional needs as well could open her eyes to all the services Practice records that adverse events home alone. While still an inpatient the as the obvious physical and home available to her and others in Timboon! Limited Adverse Occurrence across the ten participating hospitals acute nursing staff referred Mrs. Firth maintenance needs, following a home are infrequent and usually not severe. to Timboon and District Healthcare visit by the assessment officer. Screening (LAOS) Service district nursing service, What is LAOS? home and community care (HACC) Limited Adverse Occurrence Screening coordinator and various allied health is a system to identify critical incidents professionals. that may occur in hospital. Health Information Managers review each medical record according to a set of criteria and forward a record for review by a panel of general practitioners. Timboon and District Healthcare Service is one of ten small hospitals participating in the Otway Division of General Practice program. Medical records are reviewed by general practitioners to investigate whether treatment could have been handled differently to improve the medical outcome. The medical records are managed in a secure way to ensure the privacy and confidentiality of all patients’ records.

The Purpose of the Program The purpose of the program is to provide a mechanism for peer review of general practice and to provide a forum for education for local general practitioners, with all general

30 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 31 Primary Care and Home and Community Care Services available from Timboon and District Healthcare Service

Mrs Firth’s fall at home

Ambulance transport

Acute Care at Timboon and Health Promotion District Healthcare

As an integrated health service, health sessions each week at our facility. They The guest speaker drew upon her Physiotherapy District Nursing promotion plays an integral part in choose from the following activities: 25 years experience in nutrition and our quality of care activities. Health human health and provided information promotion is achieved in partnership • Tai Chi on how to get rid of unwanted weight Correct walking stick HACC Services with the community, through individuals • Gentle Exercise and attain vibrant health and well and groups participating in various • Strength Training being without dieting, drugs, surgery or educational and active programs with • Better Balance spending your life at the gym. Emphasis • Active Expectations (antenatal) Gentle Exercise Class Domestic Assistance Meals on Wheels a emphasis upon each individual taking was placed upon knowing what control through an understanding of • Bounce Back with Babes (post natal) ingredients and additives go into the the key factors affecting their health food we are eating. Health Outcomes and well being. Podiatry Personal Care Home Maintenance The exercise program was evaluated Results from the evaluation of the using the Health Education Impact evening of which 109 out of the 124 Promoting Exercise Questionnaire (HEIQ) - an Australian women present completed revealed developed impact evaluation which Referral to Optometrist Safety Link The health benefits of physical 90% satisfaction: activity are well established. Physical is able to profile the intended activity helps to prevent and manage outcomes of health education and “Congratulations on choosing Sherry self management programs. A change Strong – both entertaining and Occupational Therapy Planned Activity Group many chronic diseases, injury from of greater than 33% is considered informative” (Adult Day Centre) falls, mental health conditions and substantial. musculoskeletal health generally. Men’s Health Night Diabetes Educator Community Transport For good health, the evidence based • Bounce Back with Babes showed a Men were encouraged to bring their National Physical Activity Guidelines 40% change in health, positive and partners as results from the previous for Australians recommend a minimum active engagement in life and social men’s health night had indicated that and integration support. men would like their partners present Dietician Multi Purpose Taxi Card of 30 minutes of moderate intensity physical activity undertaken “on most, • Group Strength Training indicated as women often influence their preferably all days”. The evidence a 50% change in positive and active partner’s and family’s health. engagement in life, constructive shows that the relationship between The guest speaker, Dr. Geoff Broomhall, levels of physical activity and health are attitude shift and skill technique Home Maintenance Transport was recommended by Andrology Services available specifically curvilinear, that is, the more you do, the and acquisition as well as social Fitting of aids around the house – rails, Community driver to transport clients Australia. Dr. Broomhall highlighted greater the impact on your health, until integration and support. for older adults lawn mowing, handyperson services. to medical appointments, local services diabetes and cardiovascular disease and you reach extreme levels of physical • Tai Chi had a 36% change in skill Allied Health Services – planned activity groups, exercise made reference to prostate and mental activity. The greatest health benefit is technique and acquisition. Physiotherapist, Dietician, Podiatrist, Personal Care classes health issues. derived from moving from no or little Exercise Instructor, Audiologist, Showering and dressing, incontinence activity to undertaking some form of Occupational Therapist – advice on support, grooming and hair care. Personal Alarm Victoria (PAV) Focusing on the Health Needs 86% of participants stated that the aids in the home. activity. evening met their expectations and Alarm pendant activated to summon of Men and Women Activity Groups assistance – eg neighbour, relative rated the evening as excellent Nursing Services The Timboon and District Healthcare Women’s Health Night Planned activity groups (adult day Timboon and District Healthcare Service exercise program aims to One hundred and twenty four women Ongoing issues for men at the evening Continence Nurse, Diabetes Educator, centre) at Timboon and Cobden. Service staff assists with application. District Nurses – home visits. provide a comprehensive program attended the annual women’s health – stress, heart disease and coping with offering options to a wide audience night. The evening featured Sherry change. Meals on Wheels Exercise Classes Domestic Assistance of older adults with different levels of Strong, a nutritional strategist and Hot meals cooked at hospital and Gentle exercise, strength training, tai Message from the evening: “Be more General home cleaning, assistance with mobility and health. organisational health and well being delivered to clients’ homes by volunteer chi, better balance concerned about my own health” shopping. Up to 49 men and women make consultant. drivers. a commitment to attend exercise

32 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 33 Cruising Corangamite friendships, social interaction and P-12 school with two challenges having ‘HEY’ • Mental Health Government through the Department improve overall health with an been conducted. The target group • Water Safety of Health and Ageing. It is a national Challenge emphasis upon regular exercise. was Grade 5 & 6 students. Over 350 Health Education for You • Sustainable Farm Families program that has established practices Focusing on both physical and mental students have been involved in the Health education and information aims • Youth Services and processes to enhance school’s health the Cruising Corangamite Participants of varying fitness levels program since it was launched in 2006. to improve people’s understanding • Men’s Health understanding of asthma issues and program aims to promote were encouraged to join in and each Students also participated in a follow- about the causes of health and illness, • Heart Health to provide a framework for the was issued with a journal and map up evaluation testing their knowledge the services and support available management of asthma. of Corangamite – and on healthy foods and healthy eating. to maintain or improve health, and encourage personal responsibility for physical Students showed an increased Asthma Friendly Schools Fifty one teachers from both schools activity awareness of appropriate healthy actions affecting their health. were instructed on the recognition of foods, recommended water Program asthma symptoms and the use of the equated intake, recommended sleep and The Healthcare Service has been During the year an asthma friendly Asthma Emergency Kit. to varying recommended physical activity. The producing a monthly health promotion schools training program was run at distances, students’ breakfasts have become newsletter since 2002. The Timboon P-12 school and Simpson with the healthier and less students skipped information provided by the newsletter Primary School for all teaching aim to walk breakfast in the post evaluation. aims to improve health and wellbeing staff. The Asthma Friendly Schools the Shire of of our local community. program is funded by the Australian Corangamite. Overall the program has become a Nutrition very useful tool in promoting physical The newsletter provides information information activity and nutrition within the school that is quality assured, reliable, up to was provided environment. date, easy to understand and locally within the relevant. The information in HEY journal including includes healthy living tips, information healthy eating on health conditions, healthy and tips for each nutritious recipes and services and food group. programs currently available in the local area. Many of the health articles are The challenge was obtained from the recognised website conducted over – the Better Health Channel. a 10 week period with 13 teams The range of topics covered in the last participating. 12 months included: A similar • Exercises program has been • Osteoporosis incorporated into • Breastfeeding the local Timboon • Breast Awareness • Sunsmart

34 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 35 Legislative Compliance in our Activities

The activities of the Timboon and Building Act 1993 Consultancies District Healthcare Service are Timboon and District Healthcare The Healthcare Service did not utilise performed under the direction Service complies with the building and the services of consultants during this of a range of Parliamentary Acts, maintenance provisions of the Building financial year. Regulations and Standards set by Act 1993 in accordance with the government and other regulatory Minister for Finance Guideline Building bodies to ensure that our activities Act 1993/Standards for Publicly Owned Freedom of Information Act guarantee a high standard of care and Buildings/November, 1994. safety for patients, staff and visitors and - Application and Operation Whistleblowers Protection Act Disclosures in writing will be received Operations. The Victorian Freedom of Information that business activities are conducted - Application and Operation by Ms E.M. Collins, Chief Executive (g) Details of overseas visits with integrity. National Competition Policy Act 1982 provides the right for Officer or the Ombudsman, Level 22, undertaken including a summary members of the public to obtain The purpose of the Whisleblowers 459 Collins Street, Melbourne Victoria of the objectives and outcomes of The Healthcare Service has Protection Act 2001 is to provide an The following statements provide information held by the Timboon 3000 Telephone 1800 806 314. each visit. implemented competitive neutral environment in which to encourage annual information and disclosures and District Healthcare Service, and (h) Details of major promotional, pricing principles for all contracts reporting of any improper conduct by required under specific legislation and consumers are entitled to access public relations and marketing for services provided to the private the Service or its employees. Timboon regulations. their medical record through the activities undertaken by the entity sector, to ensure a level playing field in Freedom of Information process. Nine and District Healthcare Service has Additional Information The following information, where to develop community awareness accordance with National Competition Freedom of Information requests were policies and procedures in place to it relates to Timboon and District of the entity and its services. Policy including the requirements of processed this financial year. All related enable compliance with the Act, and Healthcare Service and is relevant to (i) Details of assessments and the Government policy statement, to medical record information. provide a safe environment in which the financial year 2007-08 is available measures undertaken to improve Competitive Neutrality Policy Victoria, Applications are to be directed to the disclosures can be made, people upon request by relevant Ministers, the occupational health and safety and subsequent reforms. nominated Freedom of Information are protected from reprisal and the members of Parliament and the public: of employees. Officer, Ms. E. M. Collins. A fee and investigation process is clear and (j) General statement on industrial charges for associated costs may apply provides a fair outcome. The privacy of (a) A statement of pecuniary interest relations within the entity and in accordance with the Act. all individuals involved in a disclosure is details of time lost through assured of protection at all times. has been completed. (b) Details of shares held by senior industrial accidents and disputes, The Service is committed to the which is not otherwise detailed in Publications principles of the Act and at no time will officers as nominee or held beneficially. the Report of Operations. • Annual Report and Quality of Care improper conduct by the Service or (c) Details of publications produced by (k) A list of major committees Report any of its employees be condoned. the department about the activities sponsored by the entity, the • Newsletter of the entity and where they can purposes of each committee and • HEY ‘Health Education for You’ A copy of the policy is available upon be obtained. the extent to which the purposes monthly newsletter request. Web sites of interest for (d) Details of changes in prices, fees, have been achieved. • Brochures and booklets on services complaint procedures regarding this charges, rates and levies charged These publications are available upon Act are: http://www.ombudsman.vic. by the entity. request at reception. gov.au and http://www.health.vic.gov. au/hsc (e) Details of any major external reviews carried out on the entity. Victorian Industry Disclosures (f) Details of major research Since the introduction of the Act in and development activities Participation Policy 2002 there have been no disclosures undertaken by the entity that are There are no disclosures in relation to received and no notification of not otherwise covered either in contracts commenced or completed disclosures to the Ombudsman or any the Report of Operations or in under the Victorian Industry other external agency. a document that contains the Participation Act 2003 for 2007/08. financial report and Report of

36 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 37 Financial Overview

The financial results are outlined in the Financial Comparison Operating Statement, Balance Sheet A comparison of the Healthcare and Notes to the Financial Statements Service’s operating performance over a for the year ended 30th June 2008. five-year period is as follows: These comprehensive statements are outlined in a separate document 2008 2007 2006 2005 2004 forming part of the Annual Report. $’000 $’000 $’000 $’000 $’000 Revenue Indicators The statements have been prepared in Total Revenue 5,353 4,884 4,680 4,753 4,219 Average Collection Days Revenue by Source Expenses by Source accordance with the Standing Direction Total Expenses 4,215 3,878 3,789 3,945 3,776 2008 2007 4.2 of the Financial Management Act 3% Operating Surplus 1,138 1,005 882 808 443 Private 35 41 8% 7% 1994, applicable Financial Reporting Retained Surplus 1,138 1,005 882 808 443 5% 13% Directions, Australian Accounting TAC 43 0 Total Assets 14,001 12,761 11,286 10,515 9,639 9% Standards and other mandatory VWA 47 105 8% professional reporting requirements. Total Liabilities 1,171 1,146 1,091 1,202 1,135 Residential 34 41 75% Net Assets 12,830 11,614 10,195 9,313 8,504 Aged Care 72% The Healthcare Service completed Total Equity 12,830 11,614 10,195 9,313 8,504 the year with a total entity surplus of $1,138,216. Fees Policy Compliance with Australian/ The Service charges inpatient, primary Other 8% Depreciation 7% health and Home and Community The result includes the government Risk Management New Zealand Risk Donations 3% Other Expenses 13% funded sector, hospital and community In addition to the accounts being Management Standard Care (HACC) fees in accordance with the Victorian Government Department Fees 5% Supplies & Consumables 8% initiatives and capital funds. Through audited by the Victorian Auditor- I, Elaine Collins, certify that the of Human Services fee directives and support from hospital and community General’s Office, internal audits are Timboon and District Healthcare Dept of Health & Ageing 9% Employee & Contracted Staff 72% Aged Care fees in accordance with initiatives including interest on reserves conducted by an external consultant Service has risk management processes fee directives of the Australian Gov- Dept of Human Services 75% $416,016 was received and interest to ensure correct procedures and in place consistent with the Australian/ ernment Department of Health and earned on the operating account practices are in place, not only in the New Zealand Risk Management Ageing. amounted to an additional $72,824. financial area but throughout the Standard and an internal control organisation. system in place that enables the Also the decline in the number of executives to understand, manage and Debtors Outstanding as at patients treated this year resulted in This internal audit process forms satisfactorily control risk exposures. 30 June 2008 less than expected medical expenses, a part of the organisation’s risk The Finance/Audit Committee verifies Under 31-60 61-90 Over Total Total thus contributing to the operating management strategy. This year internal this assurance and that the risk profile 30 days days days 90 days 30/06/08 30/06/07 surplus. audit reviewed compliance with the of the Timboon and District Healthcare Financial Management Act 1994 and Service has been critically reviewed Private 3,436 2,047 268 0 5751 33,643 Ministerial Directions. A number of within the last 12 months. TAC 0 0 0 0 0 0 recommendations were made to VWA 0 0 0 0 0 4,428 improve the Instrument of Delegation. Residential The audit found that the financial risk 3,159 382 0 0 3,542 4,406 Aged Care management control environment is Elaine Collins TAC Transport Accident Commission sound. Chief Executive Officer VWA Victorian WorkCover Authority Timboon 17 September 2008

38 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 39 Disclosure Index

The Annual Report of Timboon and District Healthcare Service is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the organisation’s compliance with statutory disclosure requirements in accordance with Ministerial Directions.

Legislation Requirement Page Reference

Ministerial Directions Financial Statements – FRD Guidance

Report of Operations – FRD Guidance Legislation Requirement Financial Page Reference

Charter and purpose Financial statements required under Part 7 of the FMA FRD 22B Maintenance of establishment and the relevant Ministers 2,12 SD 4.2 (b) Operating Statement 5 FRD 22B Objectives, functions, powers and duties 13 SD 4.2 (b) Balance Sheet 6 FRD 22B Nature and range of services provided 44 SD 4.2 (b) Statement of Changes in Equity 7 SD 4.2 (b) Cash Flow Statement 8 Management and structure SD 4.2 (c) Accountable officer’s declaration 2 FRD 22B Organisational structure 11 SD 4.2 (c) Compliance with Australian accounting standards and other authoritative pronouncements 9 SD 4.2 (c) Compliance with Ministerial Directions 9 Financial and other information SD 4.2 (d) Rounding of amounts 9 SD 4.2(j) Accountable officer, signed off report of operations 4 SD 4.5.5 Risk Management Compliance 38 Legislation FRD 22B Operational and budgetary objectives and performance against objectives 3 Freedom of Information Act 1982 FRD 22B Statement of merit and equity 14 Whistleblowers Protection Act 2001 FRD 22B Workforce Data Disclosures 14 Victorian Industry Protection Act 2003 FRD 22B Occupational health and safety 15 Building Act 1993 FRD 22B Summary of the financial results for the year 38 Financial Management Act 1994 FRD 22B Significant changes in financial position during the year 38 Audit Act 1994 FRD 22B Major changes or factors affecting performance 4 FRD 22B Subsequent events N/A FRD – Financial Reporting Directions issued by the Department of Treasury and Finance FRD 22B Application and operation of Freedom of Information Act 1982 36 SD – Standing Directions of the Financial Management Act 1994 FRD 22B Compliance with building and maintenance provisions of Building Act 1993 36 FRD 25 Victorian Industry Participation Policy disclosures 36 FRD 22B Statement on National Competition Policy 36 FRD 22B Application and operation of the Whistleblowers Protection Act 2001 37 FRD 22B Details of consultancies over $100,000 36 FRD 22B Details of consultancies under $100,000 36 FRD 22B Statement of availability of other information 37 FRD 10 Disclosure index 40 FRD 11 Disclosure of ex-gratia payments N/A FRD 21A Responsible person and executive officer disclosures FS 34

40 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 41 Our Donors

Ackerley Mr & Mrs K N Cashmore Mr & Mrs D B Felmingham Mr A A & Hibburt Mr C Maskell Mr S & Mrs W Adams Mr P Cashmore Mr P & Mrs E the late Mrs D M Hibburt Mr D W Mathieson Mrs B Allan Ms F Chisholm Mr S Ferguson Mr & Mrs G D Hill Mrs J McCallum Mrs U D Anderson Mr & Mrs B D Clarke Mr F & Mrs M Ferrari Mr G & Mrs S Hintum Mr T F & Mrs D McConnell Mr T J Anderson Mr J Clarke Mr & Mrs J J Finch Mr P & Mrs K Horan Mr M McDonald Mr & Mrs M A Anderson Mr M J Clements Mr L S & Mrs M A Finlayson Mr & Mrs W A Hortin Mr M D& Mrs J McDowell Mrs A Andrew Mr N J Clough Mr B Fitzpatrick Mrs S L Hose Ms B McKenzie Mrs C H Arundell Ms J Clover Mr G & Mrs J Flanagan Mrs C Hose Mr M McKenzie Ms D Arundell Mr M Clover Mr M & Mrs M Fleming Mr M Hose Mr T McKenzie Mr D& Mrs L Askew Mr L Coles Mr & Mrs R G Footman Mr R A Hose Mr W R McKenzie Mr J D & Mrs J Pike Mrs O J Sharp Mr & Mrs M R Tregea Mrs N Williams Mr O & Mrs N Austin Mrs A Coles Mr W Ford Mr R J Hovenden Mr & Mrs J K McKenzie Mr L & Mrs B A Pike Mr R B & Mrs J Simpson CWA Trigg Mrs B Williams Mr & Mrs O M Collins Ms E Foster Mr D & Mrs E Howitt Mr W G McKenzie Mrs N F Pitman Mr G J & Mrs L Simpson Mr E R & Mrs Y Trigg Mr & Mrs D J Wills Mrs G V Collins Mrs H Francome Mrs Y E Huffading Mr C & Mrs B McKenzie Mrs T Plozza Mr M J Sinclair Mr & Mrs B Trotter Mrs K & the late Mr C Wills Mrs N J Bacon Mr KF & Mrs M A Cook Mr G & Mrs L Fraser Miss B A Hughes Mr F McKinnon Mr K P Plozza Mr S F & Mrs S J Slater Mr & Mrs R W Trotter Mr S G & Mrs G J Wilson Mr J C & Mrs S Baker Mr G & Mrs N Coombe Mr J Fratantaro Mr & Mrs A Hunt Mr M J & Mrs J M McKinnon Mr N F Pouw Mr & Mrs C E Smethurst Mr B R & Mrs L Wines Mr W Baker Mr & Mrs P J Copeland Ms G Fulton Mr & Mrs A R McLennan Mrs W Powell Mr & Mrs R W Smith Mr R & Mrs J Winkler Mr R W & Mrs B Baldwin Mrs B Couch Mr P L & Mrs R M McMeel Ms A M Price Mrs M A Spokes Mr M G & Mrs J Uebergang Mr G O & Mrs P Wisbey Mr & Mrs J Bamford Mr S J Couch Mr T & Mrs J Irvine Mr J R McMeel Mr E M & Mrs J M Price Mr R & Mrs L Stafford Ms L Uebergang Mr M Wood Mr W A & Mrs H J Barr Mrs G Couch Mr & Mrs T Gale Mr D & Mrs J Irvine Mrs K D McMeel Miss R Pride Mr A & Mrs N Stanbury Mr E T & Mrs P P Umbers Mr L E Worrall Mrs E C Bassett Ms M Couch Mr & Mrs L H Gale Mr M & Mrs R Irwin Mr R Merrett Mr D & Mrs S Princetown Friendship Group Stansfield Mr G Worrall Mrs N Bateman Mr & Mrs A Cowley Mrs M Gardner Mr & Mrs C Jeffs Mr & Mrs B D Merrett Mr R D & Mrs D M Stapley Mr P R & Mrs M Wouters Mr F C & Mrs B A Baxter the late Mr H F Cunnington Mr R W & Mrs J J Garner Mr & Mrs V Jepson Mr K & Mrs M Mitchell Mr R M & Mrs N Steen Mrs P Vallance Ms A Wright Mr M Beamon Mr & Mrs D Cunnington Mr & Mrs S Gaut Mrs S Johnstone Mr D Monk Mr H & Mrs G Quota International of Cobden Stephens Ms A Van Donk Mrs P Wurlod Mr & Mrs W J Begely Mr & Mrs J M Currell Mr D & Mrs H Gay Mr C & Mrs M Joiner Mr & Mrs L H Moore Mr & Mrs A J Stephens Ms L Van Duynhoven Mr J A & Mrs Bekker Mr G & Mrs A Currell Mrs N I Gay Mr E A & Mrs W Joiner Mr M A & Mrs C M Moore Mr C O Stephenson Mr S I A M Bell Mrs C J Giblett Mr & Mrs B Jones Mrs B Moore Mrs W Rantall Mr & Mrs N G Stevens Mr R W Van Leerdam Dr J & Mr K Yeaman Mrs B A Bell Ms K Giblett Mrs L Jones Ms D Moorfield Mr & Mrs C D Reinen Mrs R & the late Mr A Stevens Mrs S F Van Nieuwkerk Mr & Mrs J Younis Mr P J & Mrs S Bellis Mr & Mrs I Daff Mrs L E Giblin MrJ & Mrs M Kee Mr & Mrs C G & W Morey Mr R G & Mrs T A Renyard Mr J C & Mrs H J Stinchcombe Ms L Van Nieuwkerk Mrs M Benson Ms B Dalton Mr J A Gillespie Mr H M & Mrs T Keegan Mr J R Morgan Mr B Retallack Mr J & Mrs M Stinchcombe Mr R E & Mrs B Veenstra Mr H & Mrs K Bentley Mr M & Mrs K Delaney Mr E J & Mrs D Gillin Mr & Mrs P Kerekes Mr J Morgan Mr & Mrs P G Rhode Mr & Mrs M Sturzaker Mrs M Vickers Mr D & Kelly Ms E Bentley Mrs V D Delaney Mr J F & Mrs G M Gillingham Mr R Kermond Mr C & Mrs C Murrell Mrs D Rhode Mr R Sullivan Mr G E & Mrs D H Vickers Mr R W & Mrs H E Berry Mr & Mrs K Delaney Mrs T Gilson Mr & Mrs N K Kerr Mr & Mrs A G Rippon Mr A & Mrs L Symons Mr & Mrs G E Vogels Mr A J Bettens Mr & Mrs H D Delforce Mr C Gledhill Mr & Mrs K Klemm Ms T Ritchies Stores Pty Ltd Vogels Mr & Mrs F M BHP Billiton Dendle Mr D & Mrs C Glerum Mrs D Konings Mr M Neal Miss A Robb Mr T S & Mrs T M Vogels Mr J A Blain Mr A J Dendle Mr & Mrs L W Gordon Ms M Kordupel Mr W P & Mrs E Neal Mr G A & Mrs H Roberts Mr & Mrs A H Tarasiuk Mr S Vogels Mr J G Blain Mrs H F Dickinson Mrs N Graham, Mr J Kors Mr G & Mrs J Neal Mrs T Roberts Mr & Mrs J Taylor Mr & Mrs C R Vogels Mr N Blain Mrs S M Dickmann Mrs T Greig Mr K G & Mrs J Kruse Mr H & Mrs G Nelson Mr T Roberts Mrs J E Thomas Mr C Blunt Ms J Drake Mr R F Gristede Mr PR & Mrs MA Krybolder Mr & Mrs T Nesseler Mr & Mrs K Robertson Mrs J Thompson Mr A & Mrs F Boehm Mrs B Duffield Mr D & Mrs I Groves Mrs J Newey Mr P C Rogers Mr & Mrs C W Thompson Mr G & Mrs A Walker Mr & Mrs M J Bond Mr C & Mrs V Duncombe Ms D I Gunn Mr L Newton Mr B J & Mrs L Rudolph Miss A P Thompson Mr W & Mrs E Wallace Mr B R & Ms L Boxshall Mr N & Mrs L Dunkley Mrs S F Guy Mr W & Mrs N Lawson Mrs Y M Norton Ms C Rudolph Mr G W Thomson Mr I Wallace Mr D L & Mrs S Brittain Mr J Duro Mr & Mrs C A Leske Mrs M Norton Mr & Mrs W M Rundle Mr L M & Mrs E Thornton Mrs P Wallace Mr & Mrs R J Brittain Mr K R & Mrs M C Duro Mrs M Lindquist Mrs F J Nowell Mr S J Rundle Mr G J Thow Mr S & Mrs J Walsh Mr & Mrs T A Bryant Mr J Duynhoven Mrs J A Hallyburton Mrs I J & Lindsay Mr R M & Mrs J Rundle Mrs R Timboon & District Healthcare Ward Mr & Mrs B E Bryant Mrs N R Duynhoven Mrs M the late Mr I Lions Club of Timboon Rundle Mr T & Ross Ms A Service Auxiliary Warrnambool Home Buckland Mr M Dwyer Mr & Mrs J Hallyburton Mr & Mrs N Lloyd Mr K A & Mrs M R O’Keeffe Mr M A Russell Mr A D & Mrs B L Timboon Cruisers Improvements Bufton Mr R B & Mrs R M Dwyett Mr W Hampson Mr G Loch Ard Motor Inn O’Keeffe Mr P W Ryan Mr J F & Mrs M J Timboon Motor Cycles & Plumbing Pty Ltd Bullen Mr J & Mrs H Hanel Mrs S Loveday Mr J & Mrs J Oldfield Mr J M & Mrs C Timboon Motors Warrnambool Motorcycle Burkhalter Ms J Hanson Mrs D E Lowe Mrs O Owen Mr P Timboon P12 School Owners Club Burkhalter Mrs R Easterbrook Mr & Mrs R Hardingham Mr N & Mrs B Said Mr P Timboon Pharmacy Webster Mr J L Buxton Mr P Easterbrook Mrs I Harkin Mr M Saunders Mr M & Mrs L Timboon Plumbing & Pumps Welton Mr & Mrs D N Eden-Jones Mr S Harkin Mr & Mrs P F Macka’s Farm Page Mr N Scholte Mr J H Timboon Uniting Church Westacott Mr T Edge Mr & Mrs R Harkness Mr C B & Mrs D Magilton Mr W J & Parfett Mr R & Mrs B Schulz Mr H Fellowship Wetmore Mr D & Mrs M Campbell Mrs L Harris Mr I & Mrs A-M the late Mrs P Parfett Ms S Scott Mrs A Toller-Bond Ms M White Mr I Campbell Mr P R Haugh M N W & Mrs P Malden Mrs E Park Mrs I A Scott Mrs M Total Dairy Service White Mr & Mrs R P Cancer Council Victoria Fagan Mr & Mrs G Hay Mr P Marr Mr & Mrs A W Patterson Mr L Scotts Creek Indoor Bias Townsend Mr G N & Mrs M White Mr R J & Mrs V – Timboon Unit Fagan Ms M Heatly Mr C L Marr Mr & Mrs D A Patullock Mr & Mrs C Bowling Club Treble Mrs K E Whitehead Mr J R & Mrs L Capizzi Mr & Mrs F Farrar Mr L W Heatly Mr I K Marr Mr R W & Mrs C A Patullock Mr & Mrs L G Searle Mr G & Mrs F Tregea Mr A & Whiting Mr A R & Mrs L J Casey Mr J Hellessey Mr D & Mrs S Martin Mr D Philip Mrs S Serong Mr & Mrs K Copeland Ms G Wiggins Mr & Mrs G T

42 Timboon & District Healthcare Service Annual Report 2007/08 Timboon & District Healthcare Service Annual Report 2007/08 43 Our Services - What We Deliver

Acute Care Health Promotion and Education Emergency Services Childbirth Classes General Medicine Body Balance Classes General Surgery Bounce Back with Babes Obstetrics and Gynaecology Community & School Health Education and Promotion Palliative Care Health Screenings Strength Training Diagnostic Services Tai Chi Pathology Women’s Health Radiology Home and Community Care (Aged and Home Nursing Disability Support) District Nursing Assessment and Care Management Maternity Outreach Community Transport Palliative Care Delivered Meals Post Acute Care Home Care Home Maintenance Residential Aged Care Personal Care High Care Respite Care Respite Care Support Groups Allied Health Adult Day Activity Groups Audiology Arthritis Self Help Group Chiropractic Grief, Loss and Suicide Support Continence Visually Impaired Group Diabetes Education Dietetics Youth Service Mental Health Social Work/Counselling Counselling Occupational Therapy Youth Activities Physiotherapy Podiatry Speech Pathology Cobden South Ecklin Naringal

Scotts Creek Simpson Timboon Curdie Vale VICT ORIA

Peterborough Port Campbell

Princetown

44 Timboon & District Healthcare Service Annual Report 2007/08