Health matters: vol.2 (3), Autumn 2006

Item Type Report

Authors Health Service Executive (HSE)

Rights HSE

Download date 01/10/2021 10:15:55

Link to Item http://hdl.handle.net/10147/44523

Find this and similar works at - http://www.lenus.ie/hse Elder Abuse Immunisation CEO Interview

Working as an elder abuse Immunisation reaches Professor Brendan Drumm officer in Kerry 95% in midlands discusses his first year as CEO

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Volume2 Issue3 Autumn2006

National Staff Newsletter of the Health Service Executive Healthma5136_HSE_100PLUS_AD_V2tt 29/08/2006e 10:02 Pager 1 s Hospitals With

High Performing 100 PLUS

A&Es to be Rewarded A National Scheme to reward hospitals with high performing he HSE has introduced ‘100 Plus’, a national scheme to As funding under this scheme is limited, the number of reward hospitals that are maintaining high performing consultant appointments available to each hospital will be Emergency Departments T Emergency Departments. determined by their individual performances, relative to other Under the scheme, the HSE will fund the appointment of up hospitals, and their size. As an illustration it is envisaged that The HSE is funding the appointment of up to 100 to 100 new Category I Consultant posts to hospitals that are a medium sized hospital (circa 400 beds) that is consistently new Category 1 Consultant posts for hospitals that meeting the HSE’s Emergency Department targets. meeting the targets could receive funding to appoint five to are meeting the HSE’s Emergency Department targets. Improving the performance of Emergency Departments, seven additional consultants. particularly in relation to patient waiting times, is a priority for It is important to note that these additional appointments To download full details, visit contact your HSE Hospital Network manager. the HSE. are not designed to address current difficulties being www.hse.ie The vast majority of hospitals have responded positively to experienced in Emergency Departments – they are designed or the challenge and many are performing very well. to reward hospitals which have already overcome these All hospitals with Emergency Departments are eligible to difficulties and assist them enhance and maintain their apply to the scheme and funding will be allocated based on overall performance levels. performance during the winter months against these targets. A hospital that is not performing in accordance with the Funding will be announced early next year. targets set out will not qualify for funding under this scheme.

HSE Highlights Young Competitiors who Participated in Quality and Safety the HSE Community

he first National Quality and get involved. Games Finals this Safety Week for healthcare In addition to Quality and Safety Summer Tand social service locations Week, an awards competition will be held on October 23 to 27, has also been announced which 2006 to coincide with European seeks to reward centres that have Week for Health and Safety at Work. made an exceptional effort to Centres around the country are promote quality and safety in their in the process of planning events, workplace during the past year. talks, displays and information The awards will be announced on sessions on quality and safety to December 7th next. run during the week to promote Full details regarding criteria, good practice and raise awareness format and submission instructions on key quality and safety issues. are available on the HSE Announcing the initiative website. Alternatively, you can (L to R): Margaret Bolton, National PRO, HSE Community Games and Tanya Kelly, HSE Community Games volunteer with Kevin Shanahan, Professor Brendan Drumm, email [email protected] or U-13 rounders finalist from Co. Kerry and Gillian O’Keeffe, gymnast from Co. Tipperary CEO of the HSE, urged staff to telephone 057-9357874. HSE infoline 1850 24 1850 Healthmatters

Message Children from Cork Di ary dates from the University and Kerry 14th October General Hospitals A day for parents and professionals on Editor issues affecting teenagers. Days Hotel, Main Street, Heli Cruise to Fun Centre Tullamore 10am – 4pm Tickets, which include light lunch, A big thank you to all of you who made the effort during cost e15. the summer months to organise material for this edition of Telephone: 057 8664513 Health Matters. With each edition the amount of material Email: [email protected] contributed directly by HSE staff members continues to grow and this will be obvious to all those who read this Autumn edition. 17th-23rd October Thank you also to all of you who filled in our special HSE Quality and Safety Week Reader Survey in the Summer edition. We received lots of comments and ideas from you and we will be keeping these in mind as we plan future editions. 20th & 21st October Most of you who responded feel it is a good idea to have Irish Gynaecological Oncology Society a staff newsletter and enjoy reading Health Matters. In Annual Scientific Meeting addition most readers who responded are happy with the Trinity Centre for Health Sciences, current size and format. St. James’s Hospital, Dublin 8. There was also a big demand for stories about new service developments, people news and diary dates. In this edition we highlight the success of the Obstetrics 21st October and Gynaecology Department of University College IARNA National Conference Hospital following the hospital’s accreditation as a Baby 5th National Conference of the Irish Friendly Hospital. Also featured is the achievement in the Anaesthetic & Recovery midlands on reaching the World Health Organisation’s Nurses Association, recommended target of 95% for immunisation uptake at Rochestown Park Hotel, 24 months for all of the childhood vaccines. Douglas, Cork. Marie Mellon writes about combining her administrative Email: [email protected] work in Mayo General Hospital with her needs as a dialysis Web: www.iarna.ie patient there. She is Secretary of the Mayo Branch of the Irish Kidney Association. Marie Kehoe of the Irish Society for Quality and Safety 24th November in Healthcare writes about Integrated Care and says that Third All Ireland Nursing Conference Superman eat your heart out! Jonathan Price (9) from Greenfort, Co. Sligo properly developed Integrated Care Pathways can help us pictured on the annual Bubble Gum Club (children's charity) big day out at Avonrí ‘Fundamental issues in Breast Cancer. reduce complexity, work in effective teams, and improve Adventure Centre, Blessington Lakes yesterday. Are they being addressed?’ the patient experience. Education Centre, The launch of the HSE’s Health Information Line atients in the Childrens’ Wards at Cork University and Kerry AMNCH is featured. This service now provides confidential General hospitals were helicoptered to Avonrí Leisure Centre, Email: [email protected]. information on over 110 topics, including all health service P Blessington, Co Wicklow for fun and games in July. entitlements, eligibility, application forms and contact The children, aged between nine and 15, and from Cork, Kerry, Limerick details for services across the country. and Tipperary, flew from Cork and Farranfore airports in five helicopters. 24th November – 9th December There is an article about the new Revenue On Line “Going to Avonrí Leisure Centre is ‘just what the doctor ordered’ Domestic Violence – International Service for the public and an interview in the centre pages especially for those who have had a particularly difficult year,” said Marie Poster Exhibition with our CEO, Professor Brendan Drumm, marking his first Watson, CNM, CUH. “The day is so much fun and the children get to take Cork City Library. year in the job. part in everything from Karaoke to magic shows. A trip like this is a real Organised jointly by HSE South and As always your comments, suggestions and ideas are boost for them and we are exceptionally grateful to everyone who has voluntary agencies. Open to the public welcome. The email address to send your contributions worked so hard and given so much to make it possible. ” Telephone: Eibhlin Fleming/Joan Murphy to is [email protected] The deadline for the next Kerry youngsters were accompanied by nursing staff Eily O’ Connor 021 4921728 edition is October 31 next. and Noreen Keane. The trip is all thanks to the Bubble Gum Club and E-Mail: [email protected] or fundraising efforts of Cork University Hospital Children’s Club. [email protected]

29th November MIDOC Refocusing Acute Psychiatry A Master Class will be held at Rochestown Stephen McGrath – Editor Out-of- Park Hotel, Cork. Head of Internal Communications Theme: High Performance Acute Units Email: [email protected] Hours Facilitator: Mr. Nick Bowles, Senior (L to R): Dr Jerry O'Flynn, Medical Director, Out of While every effort is made to ensure the accuracy of information published Hours Service, PJ Smyth, Manager, Primary Care Unit, Lecturer, University of Bradford. in Health Matters, the Health Service Executive accepts no responsibility for Service, Theresa Kennedy, Manager Out of Hours Service, Email: [email protected] errors or omissions contained herein. Also note that inclusion of an article and Dr Kevin Flanagan, Chairperson, Longford GP in Health Matters does not necessarily imply endorsement of the article’s Out Of Hours Co-Op. content, unless otherwise stated. Longford he HSE, in partnership with General Practitioners launched the 30th November ©2006 Health Service Executive. MIDOC GP Out-of-Hours Service in County Longford this summer. Refocusing Acute Psychiatry All rights reserved. No part of this publication may be reproduced, stored The aim of the service is to deliver the highest standards of care 2nd Annual Conference in a retrieval system or transmitted in any form or by any means electronic, T to members of the public wishing to avail of a Family Doctor Service during Rochestown Park Hotel, Cork. mechanical photocopying, recording or otherwise without prior permission of the publishers. out of hours periods (i.e. outside doctor’s normal surgery hours) for urgent Email: [email protected] medical conditions. Health Matters is published by Harmonia Ltd., The MIDOC Service currently operates in Laois, West Offaly and Clanwilliam House, Clanwilliam Place, Dublin 2. Westmeath and results from satisfaction surveys show a high level of 7th December Tel: 01 240 5300 Fax: 01 661 9757 patient satisfaction with this model of service delivery arrangement. HSE Quality and Safety Awards, Ormond ISSN: 1649-7996 The Service operates from 6pm to 8am Monday to Friday, and with 24 Hotel, Kilkenny. hour cover on weekends and public holidays. p2 Healthmatters Autumn2006 Autumn2006 Healthmatters p3 Healthmatters UCH Galway Wins Baby Friendly Hospital Award

reast is Best is the motto at University College Hospital Galway following The Ten Steps to Successful B its accreditation as a Baby Friendly Breastfeeding are: Hospital. The hospital won the award from the 1 Develop a written breastfeeding policy Baby Friendly Hospital Initiative in Ireland and and regularly communicate it to health the Irish National Health Promoting Hospitals care staff. Network for its Ten Steps to Successful 2 Train health care staff in the skills needed Breastfeeding programme. to implement the policy. UCH promotes breastfeeding as the healthiest 3 Inform pregnant women about the benefits way for a mother to feed her baby with posters and management of breastfeeding. and information leaflets displayed throughout 4 Help mothers to start breastfeeding within the Obstetrics and Gynaecology Department. a half hour of birth. Staff provide ongoing support for breastfeeding 5 Show mothers how to breastfeed and mothers. The hospital also helps its own how to maintain lactation even if they are employees who are new mothers to continue separated from their babies. breastfeeding when they return to work by 6 Give newborn babies no food or drink providing lactation breaks and comfortable other than breast milk, unless medically rooms to express milk or breastfeed. indicated. Breastfeeding helps mothers to bond 7 Allow mothers and babies to stay together with their babies, regain their figures and 24 hours a day. lower their risk of breast and ovarian cancer 8 Encourage breastfeeding on demand. and osteoporosis. Advantages to the baby 9 Give no artificial teats or pacifiers to include bonding, immunity against childhood breastfeeding babies. infections, reduced childhood illness and better 10 Promote breastfeeding support groups The Obstetrics and Gynaecology Department of University College Hospital, Galway has been successful in mental development. Since implementing the and refer mothers to them on discharge achieving Full Baby Friendly Accreditation Status to the Global Criteria for Baby Friendly Hospitals. At the Celebrations were from (L to R): Carmel Connolly, Gemma Manning, Ann Martin, Clinical Midwife Manager, programme, breastfeeding rates have increased from the hospital or clinic. Margaret McLoughlin, Marie Hession, Una Carr, Mary Lane, Theresa Hughes and Anna O'Reilly - Marshall. at the hospital.

(L to R): Una Carr, Professor John Morrison and Clinical Director Gemma Manning. (L to R): Carol O'Shea, Maeve Kirrane, Marian Warden and Carmel Monahan. Green Fingers at St. Mary’s

sensory garden polytunnel was recently therapeutic medium. erected for residents use at St. Mary’s Discussions with the residents and their A Hospital in Dublin’s Phoenix Park. families revealed that they perceived the garden The initiative is part of the hospital’s to be a “working area” for use of residents with horticultural programme known as the Green the interest and ability to take part in group Bubble Garden Project. interventions and individual projects. The polytunnel contains a sensory planting The Garden has also become a place where scheme, herb garden and is complete with a residents, families and staff can relax in, meet water feature. friends and family and enjoy the peace and quiet. Deirdre Drew, Chairperson of the Green Bubble This project has been led by a committee of Garden Committee, formally opened the new residents known as the Green Bubble Garden tunnel in June and residents relaxed with light Committee who worked in conjunction with refreshments and musical entertainment. occupational therapy staff to plan and design The project allows residents to learn more the project. Fund raising initiatives and funding about gardening and to carry on participating in from the hospital paid for the project. Hospital former interests. A new outdoor sensory garden maintenance staff and hospital management were is now being planned. instrumental in seeing this project come The sensory garden polytunnel compliments to fruition. the hospital’s first polytunnel known as the In 2005 due to the success of the first Green Pictured in the new garden tunnel at St. Mary's Hospital were Deirdre Drew, Chairperson of Horticultural Green Bubble Garden which opened in 2001 Bubble Garden a further need was identified for Committee and Hilary Delaney, Horticultural Instructor when horticulture was introduced as a a sensory garden area. p2 Healthmatters Autumn2006 Autumn2006 Healthmatters p3 Healthmatters Healthmatters Working as an Elder Abuse Officer

aureen Chalmers, a Senior Social happening as they should for older people. cases of elder abuse. I receive approximately nine Worker working as an Elder Abuse Not all the referrals are specifically abuse cases referrals per month, mostly be telephone. I receive M Officer in Kerry, outlines her role to but may consist of the person having some more referrals about women than men; the Health Matters. difficulty or impediment in gaining access to average age of clients is in mid 70s and alcohol is As well as taking referrals and holding the services available to them. On receiving a factor in a significant number of cases. consultations on elder abuse in Kerry, I also a referral I formulate a plan and work jointly Referrals come from the Garda Siochana, hold workshops throughout the county to raise with other services such as housing, public community welfare officers, public health nurses, awareness about elder abuse. After four years health nurses, along with families and the social workers or anyone who has contact with in the post, I believe I have trained nearly 3,000 individuals themselves. elder members of the community. Almost always people through workshops held in Kerry. The social workers on the Atlantic Seaboard the older people referred to me are known to other Until the designated elder abuse posts are of Ireland have met and together we established community service departments already. filled, elder abuse is dealt with by social workers, WISE: West of Ireland Social Workers for Elders. The reasons for the referrals are categorised as hospitals and nurses. However, when these posts We stretch from Donegal to Kerry and meet four physical, emotional, financial and sexual abuse are filled there will be a designated service (as times a year in Galway. It is a great help as the or neglect. However, all abuse will include an there is at the moment in Kerry) to which referrals issues which affect elderly people in rural and element of emotional abuse. Financial abuse is a can be made. often isolated areas are vastly different to those particular problem and the most prevalent. I work jointly with various services within and which affect the elderly in cities. WISE and SIGA, a The majority of referrals relate to either single outside the HSE from housing, public health social workers specialist interest group on ageing or widowed people, often living alone. The abused could be you or me. nurses and discharge co-ordinators to GPs and from Dublin, meet and liaise on issues pertaining alleged perpetrators are frequently family or Elder abuse happens because it can. Any the Garda Siochana. I deal with alleged abuse to older people. carers. They are not extraordinary. The abuser obstacle we can put in the way to prevent elder cases but also with cases where things are not At any one time I deal with on average, 25 could be you or me, just as the person being abuse from happening really helps. HSE Appointing 30 New Elder Abuse Officers

he HSE is appointing 30 new programme within the HSE aimed at ensuring meeting the need for appropriate resources to achievable, we are working hard to ensure that Elder Abuse Officers to provide that systems and processes are in place assess and manage cases of suspected elder high quality residentialcare is available. This T support to vulnerable older people to respond to concerns expressed both by abuse. Many other elements of the report such option however, must be available on a in the community. older people and their relatives and friends. as awareness campaigns require the presence standardised and quality assured basis.” The officers will be working closely with The HSE is committed to ensuring that all of such personnel to be effective.” In the first half of 2006, an additional fellow health care professionals, agencies and the recommendations in the “Protecting the Professor Drumm stressed that the HSE €30m was invested in home care packages the gardai to provide guidance for older people Future” report are implemented. was focused on developing services that for older people and another €25m is who are experiencing harm or abuse. More than 7,800 staff members are now would allow older people to live in their own earmarked for similar developments in 2007. The development was recommended in the formally trained in elder abuse awareness in communities in dignity and independence for More than 2,600 older people benefited report, “Protecting Our Future”, of the Working residential facilities, private nursing homes, as long as possible. from the packages between January and Group on Elder Abuse chaired by Professor hospitals and community services. “We recognise that independence and the April this year. Desmond O Neill. Commenting on the appointment of the ability to remain in their home setting is crucial Acknowledging the first annual World Elder Addressing the Annual General Meeting new elder abuse officers, Professor O’Neill for older people and restoring them to that Abuse Day, Professor Drumm stressed that the of Age Action Ireland in June, Professor (Chair of the Government’s Implementation setting after illness is an extremely important HSE was committed to ensuring that responses Brendan Drumm, CEO of the HSE, said: “The Group For Policy In Elder Abuse) said: “It aim for those of us who are designing services. developed were appropriate to the needs and filling of these posts is part of an ongoing represents one of the most important means of “Where such independence is no longer wishes of older people. Dublin GAA Team Members Greet Children at Crumlin Hospital

embers of the Dublin GAA football team took time out and made a surprise visit to children attending Our Lady’s Children’s Hospital, Crumlin in July. M A number of players and manager, Paul Caffrey, told the children and their families all about their fitness regime and what it was like to win a Leinster Football title for a second year running. After signing autographs the players toured the wards with the Delaney Cup. “I would like to congratulate the Dublin GAA Football Team for their success on winning another Leinster Football Final Title. On behalf of the children, families and staff I wish to thank the Dublin team for their kindness shown to us today and always. The children were overwhelmed with the surprise which has left a smile on their faces for the week, even from children from other sporting counties,” said Evelyn Hempenstall, Deputy Chief Executive of Our Lady’s Children’s Hospital, Crumlin. Parent Jason McCourtney and his twin girls aged six months Lucy and Isabelle McCourtney from Dublin with Dublin Manager Paul Caffrey and members of the Dublin Senior Football Team with the Delaney Cup during a Players who visited included Alan Brogan, Brian Cullen, Tomas Quinn, Declan Lally, Barry Cahill recent visit to Our Lady’s Children’s Hospital, Crumlin. and Shane Ryan. The players are keen supporters of the hospital.

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Help for non-English World No Tobacco Speakers in Mayo Day 2006

ayo General Hospital has developed leaflets Min six languages for pregnant non-English speakers. Titled Having your Baby at Mayo General Hospital, the leaflets provide vital health information about childbirth, including: > Reasons to come into hospital > Items needed after delivery > Contact details for relevant professionals > Translations services. Pictured during World No Tobacco Day at Our Lady's Hospital, Navan, Co Meath were (L to R): Linda Matthews, Staff Nurse, Carolina Aquilar, Staff Nurse; Sean Murray, Porter; Jackie Meredith - Lynch, Smoking Cessation The leaflets, which are available Nurse, Jane Christie, Staff Nurse and Jim Reilly, Porter. in French, Russian, Spanish, Portuguese, Polish and Chinese ur Lady’s Hospital, Navan, used World No Tobacco Day on May 31st to highlight the Mandarin, will be handed out at damage that tobacco can do and to encourage smokers to quit. The hospital organised an the women’s first antenatal visit. Oexhibition in the reception area showing some of the 4,000 chemicals found in cigarettes and had Smoking Cessation Nurses on hand to provide information. Some 44 people visited the display and most were surprised to discover the range of chemicals in cigarettes. Just under half were smokers while 9% were ex-smokers. The smokers had a brief information session with the nurses and were offered written information on stopping Pictured at the launch of a new smoking. In all, 85% were either thinking about or preparing to quit. Only three people had no leaflet entitled "HAVING YOUR BABY AT MAYO GENERAL intention of quitting. HOSPITAL" -were Sandra Hart Meanwhile, in Galway, environmental health officers interviewed primary school children and her daughter Katie, aged on attitudes to smoking and found that one in three mistakenly believed that ‘light and ‘mild’ 3 Months from Castlebar, Co. Mayo. cigarettes were safer to smoke than other tobacco products, thus highlighting the important role of both parents and tobacco retailers in keeping cigarettes out of the reach of children. Worldwide, tobacco-related illnesses kill an estimated five million people each year.

Merlin Park Hotel Walkers Galway Team Treats and Friends Raise 2120,000 Dozens of Children in Albania team of plastic surgeons, doctors and treating a badly burnt Albanian child and for his nurses from Galway treated dozens of long support of voluntary initiatives. He is the A children with burns in Albania in founder of the charity Irish Friends of Albania. early April. The patients were in the main children The Galway based team of 26 worked with from very poor families, with burns sustained Albanian colleagues in the Burns and Plastics from home cooking fires, mine and dynamite Unit of Mother Teresa Hospital, Tirana. explosions. The Galway team was led by Mr. Jack Patients with a variety of needs such as McCann, consultant plastic surgeon in cleft palates, club hand and tumours were University College Hospital Galway and Bon also treated. Secours Hospital, Galway. This was the second such working visit by Mr McCann was awarded the title Galway Galway surgeons. The first visit was in April 2005 Person of the Year in 2003 for his work in when more than 70 operations were performed. New IHCA President r. Mary McCaffrey, consultant obstetrician and gynaecologist at Kerry General Hospital, was Local charities recieve n120,000 from the Merlin Park Hospital Walkers and Friends group at Merlin Park named President of the Irish Hospital Consultants Hospital, Galway. Included in the picture (front L to R): are charity representatives David O Donnell, Cancer Care D West, Alan Kerins, Emer Mulkerrins, Galway Hospice, Seona Joyce, CROI, and Marie Brennan, Cystic Fibrosis. Association in June. She previously served as Vice President of the Association. She also serves on the Focus Group which runs the business of the Association between he Merlin Park Hospital Walkers and Cardiology Foundation, Special Olympic meetings. She is a former Assistant Master at the Friends Galway Bay Seafront Mini Network, Galway Branch, Alan Kerins, Rotunda Hospital. T Marathon Charity Fun Walk took place Zambia Fund, Irish Red Cross, Galway Branch She takes over the leadership of a body that represents in Galway in April from Claddagh Hall to and Cystic Fibrosis, Galway Branch. over 1,800 members including both medical and dental Gentin Hill, Salthill (5 miles). The Merlin Park Hospital Walkers and hospital consultants and has placed bed capacity and More than 1,000 people participated and Friends was established by Gerry O’Neill, contract reform at the top of her agenda during her term. more than €120,000 was raised for local Martin Geary, John Gammon and Michael University College Hospital Galway (UCHG), radiologist charities like the Galway Hospice Foundation, Cronin six years ago. Over the years the Dr David O’Keeffe and Beaumont Hospital pathologist Cancer Care West, Croi West of Ireland amount raised has exceeded €500,000. Professor Mary Leader were elected Vice Presidents. p4 Healthmatters Autumn2006 Autumn2006 Healthmatters p5 Healthmatters Healthmatters 300 Additional Professionals Being Recruited to Primary Care Teams One of the HSE’s priorities is the further enhancement of services available within local communities. Central to this is the development of hundreds of Primary Care Teams (PCTs) across the country.

rimary Care Teams serve defined realignment and reconfiguration of existing population groups (circa 10,000) and resources in line with implementing the Pprovide them with a comprehensive Strategy in collaboration with senior range of quality professional services. These managers and heads of discipline by services are fully integrated and delivered by organising the meetings and work of the local community based GPs, Nurses, Occupational Primary Care Implementation Teams and also Therapists, Dieticians, Social Workers, Family participating as members of these teams. and Home Care Workers and others. Their work will involve fostering strong The HSE is now recruiting 300 additional working relationships with providers and professionals posts to support the Primary users of the service and the promotion of Care Teams. One hundred Primary Care a co-ordinated approach to the delivery of Teams are being established this year and a the Strategy. further 150 are planned for next year. It will also involve communicating with These Teams will support Primary public and community representatives Community and Continuing Care (PCCC) regarding service and service developments reform during what is a unique and and working with GPs, staff colleagues favourable time for change. and other primary care providers on the The additional professionals will play a training (needs, delivery and design) of leading role in the Primary Care Strategy multidisciplinary team working and Implementation and report to the PCCC change management. General Managers. The work will also involve the co-ordination In addition to managing resources the of training and education for the PCTs and post holders will manage geographic Social Care Networks and the implementation mapping of services, people and locations in of an appropriate audit system to ensure Best Hopscotch line with the Strategy. Practice in team performance. They will also be involved in the co- The post holders will provide leadership ordination and undertaking of Needs and vision for the team for which they Assessment for individual PCTs and will be working and contribute to Returns to School Social Care Networks. They will drive the policy development. Playgrounds in the HSE launches Winter Initiative North East he HSE recently launched a Winter 4.Improve public awareness regarding ore than 50 schools in the north east have been presented with a Playground Markings Initiative programme designed to health maintenance and well being Stencil Pack by the local Health Promotion team to encourage children to increase physical T ensure that the extra demands placed during the winter months. M activity by engaging in traditional style games like Hopscotch. on the health system during the winter season In recent weeks, national schools in Louth, Meath, Cavan and Monaghan have been provided with the do not result in a diminution in the quality of A Winter Initiative Project Team is now in Pack by the Department of Health Promotion, Health Service Executive, Dublin North East. the services we provide year round, place, led by John O’Brien, National Director, Emer Smyth, HSE Cardiovascular Strategy Facilitator said: “We piloted the programme in 50 schools particularly in relation to A&E Departments. Winter Initiative. The National Director is across Louth, Meath, Cavan and Monaghan and the response was very positive. Children loved the old The Winter Initiative will be similar to supported by a small team including fashioned games like Hopscotch and those who weren’t involved in organised sport like football were those in place in other health systems Maureen Lynott, Special Adviser to the given an opportunity to take part in a fun physical activity. We decided to implement the programme internationally. Successful programmes HSE, Ruth Langan, CEO’s Office and across the four counties and offered the games to each primary school.” have been developed in the UK, Australia Audrey Lambourn, National Communications With over 300 schools in the region, the HSE undertook to design and produce re-usable stencils for and Canada. Unit. Over the coming weeks John O’Brien each school that could be applied according to the individual schools needs like available space etc. The primary objectives of the will be working with managers and staff The HSE plans were given a huge boost when Louth County Council sought to be involved in the roll Winter Initiative are to: across the country to ensure that we make out of the programme in Louth and provide each school in Louth with the funding to purchase the special 1.Improve system wide integration to adjustments that will lead to significant paint required to apply the markings. County Councils in Cavan, Monaghan and Meath also came on ensure patients will have ease of access benefits for our patients. Board to support schools in their respective counties with grants towards the cost of purchasing paint. to appropriate care in a timely and This project will have short, medium and In June, Louth County Council Chairman, Cllr. Peter Savage, joined representatives from the responsive manner. long-term strategies to develop in Department of Health Promotion, HSE Dublin North East, in a visit to St. Oliver Plunkett National School, 2.Support the A&E Task Force in the consultation with key HSE personnel. The Blackrock to view the recently installed Playground markings there. St. Oliver’s is one of the first schools implementation of its recommendations. short-term priorities are being drafted and in Louth to avail of the HSEs stencil pack and Louth County Council Markings Installation Grant and put 3.Support patient care in the home they will be actioned in the coming months the markings in place. and community based settings so that improvements will be in place for the The initiative is an example of the ongoing partnership and conjoint working between HSE and County where possible. coming winter. Councils to enhance health and wellbeing of the population of the area. p6 Healthmatters Autumn2006 Autumn2006 Healthmatters p7 Healthmatters Healthmatters HSE infoline 1850 24 1850

(L to R): Geraldine McCarville,Laura Hendrick, Tina Englishby, Sarah Kelly and Jacqueline Mulholland. HSE launches National Information Service

he Health Service Executive recently is proving a major success story for the officially launched its national information  HSE. Even in its pilot stage, it played a major service, the HSE infoline 1850 24 1850, Back to School Clothing and part in a number of national information T Footwear Scheme which gives the public easy access to information initiatives, like the Hib Booster Campaign, on over 110 health and social service topics for Home Help Services the launch of the GP Visit Card, the Madden less than the cost of a local call. Nursing Home Subvention Report into Post Mortem Practice and the Health Promotion literature Lourdes Hospital Enquiry.” The service was piloted in The HSE Infoline operates from 8.00 am – 8.00 December 2005, and initially pm Monday to Saturday and up to July of this covered queries on the following The HSE infoline now provides confidential year more than 13,000 calls had been answered topics: information on over 110 topics, including – primarily from members of the public, but all health service entitlements, eligibility, also from voluntary organisations and health application forms and contact details for professionals such as GPs. The HSE sees this Medical Cards services across the country. service as one of fundamental importance and GP Visit Cards Information is also made available via e-mail looks forward to exploring the potential of the European Health Insurance Card or fax, and the infoline offers a sigma text-pad service in the coming months and years. Drugs Payment Scheme facility for people with a hearing impairment. You can contact the HSE Infoline on Long Term Illness Scheme Visiting the HSE infoline, Professor Brendan Callsave 1850 24 1850, Fax 041-6850330 Professor Brendan Drumm with Geraldine Charman Drumm, CEO of the HSE, said: “The HSE infoline or Email [email protected] at the launch of the HSE infoline. Blind Cyclists Complete Mizen to Malin Cycle wo blind cyclists were among a group of 50 to Linda Hogan, acting health promotion manager, who cycled 680km across Ireland over six days. HSE South: “We know from extensive research how T The tour was co-sponsored by the HSE. important regular exercise is for our health and well The sponsored cycle aimed to raise €250,000 for being. From a health and fitness point of view, cycling Irish Guide Dogs for the Blind to help meet the cost of is a great activity for improving the body’s engine, the training more guide dogs and each participant raised heart and lungs, especially if, like a lot of people, the 21,250 to partake. gym is not for them. The group travelled with tandem bikes, single bikes, “We want to encourage people to try cycling as a garda outriders and bike mechanics in tow, making form of exercise - not necessarily riding 680Km across quite a colourful splash while passing through the Ireland - but taking small steps like cycling to school or towns and villages en route. work; cycling during leisure time or while on holidays. The HSE sponsorship was designed to help The longer summer days are an ideal time to give A large group of cyclists participated in the Mizen to Malin Head tour to raise money for Irish Guide Dogs for the Blind. highlight the health benefits of cycling. According cycling a try,” she said. p6 Healthmatters Autumn2006 Autumn2006 Healthmatters p7 Healthmatters Healthmatters

School Visits Initiative by Benefits of Waterford Physiotherapists Breastfeeding Highlighted

chool children in Waterford “There was a great sense of achievement who successfully completed six among the children. Five months on they Sweek exercise diaries were were able to remember the information presented with certificates from the Irish given in January regarding posture and Heart Foundation in June. carrying schoolbags.” Earlier in the year on “move for “I believe the school visit initiative health day” in January the children was a success and that the message had received information about of good posture, ergonomics and the standing and sitting postures, computer importance of physical activity has ergonomics and how best to carry brought a change in the childrens’ school bags when physiotherapists from behaviours. It is hoped that this will Waterford Regional Hospital visited a contribute to a healthier lifestyle long number of local primary schools. into the future.” The importance of physical activity was “Move for Health Day” is a nationwide discussed and the children were given event run by the chartered society exercise diaries. of physiotherapists promoting the Speaking after the June presentation importance of exercise and movement in physiotherapist Catherine Cullinane said: our everyday lives.

Staff from Ballygall Health Centre in Finglas and Botanic Health Centre in Glasnevin, who attended the Level One staff awareness session on the protection, promotion and support of breastfeeding policy. (L to R): John Delaney CWO, Angela Kennedy ADPHN, Mary McGarry, Home Help Carer, Rachael Kavanagh, Dental Nurse and Sheena McHugh, PHN.

ore than 100 staff in Dublin north Service, Dental Nurses, Community RGNs, west have recently attended Level Occupational Therapy, Clerical Administration, MOne staff awareness sessions on Customer Care Staff, GP Practice Nurse, and the protection, promotion and support of Community Welfare Officers. breastfeeding policy. There were suggestions from different The latest staff in this area to attend a disciplines to Public Health Nurses on how session were multidisciplinary staff from they could help promote breastfeeding to Ballygall Health Centre, Finglas and Botanic their clients and provide a welcoming Health Centre, Glasnevin. atmosphere for breastfeeding families coming The session was attended by the Home Help into their health centres. Summer School for Health Bantry Hospital et Connected, the first HSE Summer in this innovative approach to education School on Young People’s Health, and learning on the issue of young Gwas held in St Angela’s College, people’s health. Lifestyle Challenge Sligo in July. > The Summer School was organised by the HSE Population Health Children and ighty staff participated in a Health rate for staff participating in the challenge The aims of the event were: Young People’s Team in conjunction with Promotion organised Hospital Lifestyle was negotiated with local fitness clubs. The > To provide learning and development St. Angela’s College, Sligo and the Office E Challenge which ran for an eight week most noticeable activity at the hospital was the opportunities for those involved in young of the Minister for Children and Young period this summer at Bantry Hospital in Co. Cork. lunchtime walk. people’s health. People’s Forum. The eight week Lifestyle Challenge is a At the end of eight weeks those who > To promote evidence based practice in At the summer school health professionals physical activity programme an individual successfully reached their targets received an young people’s services. and managers joined with young people in undertakes based on their own fitness levels achievement certificate (gold, silver or bronze). > To develop joint learning opportunities for exploring issues related to mental health, and on personal goals they set out to achieve. Many participants were sorry to see the adults and young people. nutrition and health service provision. This Throughout the programme there were a variety Challenge end and even asked for their cards > Thirty young people, and adults with an was done through workshops, drama and of events running that could be accessed by back so that they could continue meeting interest in young people’s health, took part outdoor activities. staff while at work. A reduced membership their targets! p8 Healthmatters Autumn2006 Healthmatters p9 Healthmatters Healthmatters

Continuing Care Unit Staff Participate in Practice Development Programme

two-year practice development with the opportunity to explore their vision for > Professor Brendan McCormack, University programme involving staff at the practice and commit to practical ways in which of Ulster//Royal Hospitals Belfast Community Nursing Unit in Birr, Co. that vision can be turned into reality in order to (Programme Leader). Mary Manning, Regional Practice A > Offaly and St. Mary’s Care Centre, Mullingar, improve experiences of care for older people Co. Westmeath has been praised by both staff and increase satisfaction with work for staff,” Development Facilitator for the Older and patients. Ms Manning said. Person Nursing & Midwifery Planning & The programme was developed by the Nursing The development framework of the Development Unit, HSE Dublin Mid-Leinster. and Midwifery Planning and Development programme is centred around three > Rita Devlin, Development Co-ordinator, Ulster Unit of the HSE (Dublin Mid-Leinster) and the development cycles, namely developing a Community and Hospital Trust, Dundonald University of Ulster. shared vision with patients; developing a > Janet Dewing, Senior Practice Development It was designed to develop person-centred culture and a context of practice, and leadership Fellow, Royal College of Nursing Institute, London. practices in continuing care units for older development. (L to R): Mary Molloy Corcoran, Domestic Superviser, people. > Miriam Mc Guinness, Assistant Director and Kay Hayes Hickey, CNM2. According to Mary Manning, Regional Some achievements of the of Nursing, Birr Community Nursing Unit Practice Development Facilitator for Care of the project included: (Lead Internal Facilitator) the Birr Community Nursing Unit. Older Person, staff said they felt more positive > Gerry McCormack, Assistant Director of > A vision for practice was developed at both “The Patient Information Booklet was about their work following their involvement in Units. Nursing, St Mary’s Care Centre Mullingar developed to improve the sharing of information the programme. (Lead Internal Facilitator) > There was increased openness to change with potential new residents and it is hoped the “A number commented that communication and new possibilities for person-centred care booklet highlights our commitment to continued has improved with patients because patients were accepted. One of the most recent initiatives to emerge choice and independence for residents. The feel they are partners in their care and able to > Numerous clear and concise projects from the programme was the development of development of the booklet in itself has been make informed choices. Residents feel valued connected to several areas of the a patient information booklet for prospective a work of partnership with staff, residents, and respected. One said it was great to be on a fundamentals of care for older people were clients of the Birr Community Nursing Unit. carers and families involved in each step of committee at 94 years of age, “ she said. completed or are in progress The booklet answers many of the commonly the process. We are confident that future “Person-centredness is a complex concept > Changes to nursing and care attendant asked questions from new clients and their residents and their families will benefit from and its working in practice requires sustained working patterns were introduced to support families. Topics covered include what to expect the Information Booklet and look forward to cultural change over many years,” explained greater person-centred care and continuity on your arrival, activities and services at the continuing to work together as a team on further Mary, a HSE Project Manager in Tullamore. of care. Unit, as well as useful telephone numbers and patient centred projects,” she added. “Person-centred care is not just about the > Resident and patient action groups were set facilities. For further information about the person care that patients receive, it also focuses on up and are now influencing practice and the “Under the person centred care project, centred care project, contact Mary Manning, the support and development infrastructure care environment. we identified how admission of patients to a Regional Practice Development Facilitator available to nurses and care workers to work in Increased levels of facilitation and long term care unit can be quite traumatic so for Care of the Older Person at Unit 4, Central > a patient centred way, allowing staff to achieve leaderships skills in Registered Nurses. the project team began work on strategies to Business Park, Clonminch, Portlaoise Road, the highest possible satisfaction from their work. improve the transition from home to long term Tullamore, Co. Offaly. Telephone 057 9357866 “Through this programme, staff are provided The project team members were: care”, said Kay Kennedy, Director of Nursing at or email [email protected] On Your Mark, get set, go – HSE Community Games National Finals!

he HSE Community Games Finals took place over two weekends at the end of August in the Mosney Centre, Co. Meath. T Over 6,000 young people represented their county and became local heroes in a diverse range of activities such as football, rounders, volleyball, art, chess and dancing. Over 500,000 young people compete annually in the HSE Community Games which emphasises participation rather than a competition based approach and provides great opportunities for young people to have fun, make new friends and experience new and exciting activities. In his speech at the opening ceremony, Gerry Davenport, Chairman of the HSE Community Games, congratulated all who took part and hoped “all the participants had fun, formed lasting friendships and happy memories, which are at the core of the Games”. He also thanked the invaluable input of all the volunteers for their help at every level. Research conducted by The National Health & Lifestyles Surveys (SLAN) showed that 59% of 10-11 year olds exercise on a regular basis. However there is a sharp decline in this figure among the 15-17 year old age group, to 35% with only 25% of girls aged 15-17 exercising regularly. The HSE Community Games provides opportunities for young people to participate in physical activity, sport and cultural activities from an early age. “Almost 1 in 5 young people exercise less than weekly, this trend of physical inactivity has significant implications for the health of our young people in the future”, said Maria Lordan Dunphy, A/Assistant. National Director Population Health - Health Promotion, HSE. “The HSE Community Games is committed to supporting the improvement of health and encouraging healthy lifestyle choices for young people through awareness raising, participation, and fun”. The HSE through Community Games provides information to young people and their families taking part in the games on health promotion issues such as nutrition and physical activity. It recommends making healthy lifestyle choices by eating at least five portions of fruit and vegetables daily, choosing wholegrain foods to protect the body from ill health and being physically active for 30-60 minutes most days of the week. The HSE Community Games is a voluntary organisation operating through local communities at Area, County, Provincial and National level with over 500,000 participants, 20,000 volunteers and 1.3 million supporters. p8 Healthmatters Autumn2006 Healthmatters p9 Healthmatters Healthmatters Options Highlighted for Those With Hepatitis C

ublin rocker Damien Dempsey and Irish the virus, which attacks the liver and can cause writer Antonia Leslie came together serious health problems in later life. in June to launch a new Hepatitis C The education campaign – titled ‘Hepatitis D Dublin rock singer Damien Dempsey and writer Antonia Leslie raise awareness of Hepatitis C. awareness campaign. C – You have Options’ – supported by Roche Hepatitis C is particularly common amongst Products (Ireland) Limited and the Blood Borne those who have shared any injecting equipment Virus Forum, hopes to encourage anyone treated. Unfortunately, I’ve pretty much done in the 1980’s and many people who survived that to take drugs at any time in their lives and it is who took drugs by sharing either injecting or everything to contract hepatitis C. I took hard experience are now drug free for years, entering among this group and their families that the duo snorting equipment to get tested, and if positive drugs when I was a teenager, shared razors and middle age and settled with families. hope to raise awareness. for Hepatitis C , discuss treatment options toothbrushes, and I even have tattoos. “It’s tragic to think that this disease may in the Experts believe that, of those in Ireland who with their doctor. It is also hoped that a newly “Yes, the treatment is difficult, which was future, cause potentially serious health problems inject drugs for a year on average, between launched website, www.hepinfo.ie, and phone why I delayed, but now I know that it’s possible for those who are unaware of their infection two thirds and three quarters will develop the number 01-4549772 will provide access to vital to stick with it and get free of this virus. The today. I’d advise anyone who ever used a needle disease. The implications of this are stark. Of the information in a confidential manner. benefits are so obvious – if I had to do it again, to be courageous. Contact a doctor. Get a test, estimated 14,000 or so people who access drug Writer Antonia Leslie is no stranger to I’d opt for treatment in an instant.” check your treatment options and then get on treatment in the Dublin area alone, the majority Hepatitis C. The Monaghan-born socialite Damian Dempsey, a singer-songwriter who is with life.” are suspected to have been exposed to hepatitis was diagnosed with hepatitis C five years ago, proud of his working class roots in the Northside Because hepatitis C is a ‘silent disease’, often C. However, it is also possible to become infected following the birth of her daughter, but waited of Dublin, said he became involved in the with no obvious symptoms, most of those who after sharing injecting equipment only once. three years before she undertook her treatment campaign because he believes those who have are infected are not aware that the virus is in their Many people will have kicked their drugs for the disease. Fortunately, her treatment was used drugs deserved health information just as system. habit and are living normal lives with their successful and she is now hepatitis C free. much as anyone else in society. Although the chances are smaller, the families, tragically unaware that the virus may be “I’m delighted to be involved in this “It’s tempting but simply wrong to say that condition can also be contracted through causing serious liver damage, and that they do awareness campaign, and to be given this these people broke the law or took a risk and contaminated tattooing, piercing equipment and have options. opportunity to dispel the fears of the many now have to live with the consequences. It’s well also sharing contaminated razors, toothbrushes Thankfully, treatments are available to tackle people with hepatitis C, who are afraid of getting known that Dublin was hit by a heroin scourge or snorting equipment. Tackling Health Difficulties and Palliative Business Jargon Through Plain English By Clodagh McCarthy, National Adult Literacy Agency (NALA) Care Booklet

very year, many patients with literacy a thorough review of a document to verify that it make a significant Launched difficulties come in contact with the meets international plain language standards. difference. One Ehealth service in Ireland. For most HSE materials worked on by NALA include mother who took part of them, their anxiety about their health booklets for the Irish Cervical Screening in NALA research condition is compounded by their inability to Programme and a series of three guidebooks on on health literacy in fully understand health information and their caring for children from birth to five 2003 described an awkwardness about their literacy difficulties, years for the Child Health Information ideal experience of a nurse showing her how which in turn affect their self-confidence and Services Project. to manage her child’s asthma condition. She ability to communicate effectively. NALA has also worked on leaflets on was shown pictures of lungs to explain what In a health context, literacy means using the continence for Our Lady’s Hospital, Navan, happens during an asthma attack and was skills of reading, writing, listening, spelling and leaflets about the community occupational asked to breathe out and then try to speak numeracy to understand health information and therapy service in the east coast area, so that she could experience the sensation confidently ask questions in case of uncertainty. dental health and a booklet on MRSA of an attack. But according to the International Adult Literacy for the southern area. Patients and health professionals have a joint Survey from the Organisation for Economic Co- The most co-ordinated and streamlined responsibility to discuss health conditions and (L to R): Dr. Dympna Waldron, Consultant in Palliative operation and Development, one in four Irish assistance is through an agreement with the manage and improve health. It may be expected Medicine, Eileen Dunne, RTE and Therese Soden, Community Palliative Care, Mayo at the launch of adults has a significant literacy difficulty. This HSE to assist the National Health Promotion that patients will know what questions to ask, Palliative Care: An Information Booklet for Patients means they may not be able to understand and Information Project. This is a year-long pilot take action and follow instructions to the letter, and Families in Galway, Mayo and Roscommon. fill in consent forms or follow written or verbal initiative that involves editing and reviewing but some patients, such as those with literacy advice and instructions. the clarity of a range of health promotion difficulties, need assistance with this. he Health Service Executive West has But the prognosis isn’t all bad. One way materials to make sure they follow plain For more information on plain English and launched a Palliative Care Information to avoid sometimes unsatisfactory health English standards and can receive the health literacy, phone the National Adult TBooklet for patients and their families in consultations is to use plain English in written NALA Plain English Mark. Already we Literacy Agency on (01) 855 4332 or email Galway, Mayo and Roscommon. The booklet, and verbal information. As its focus is on have approved the clarity of booklets on [email protected]. which includes the experiences of family everyday language, plain English helps to back care, teenage alcohol use, healthy members, explains the medical and psychosocial reduce the mystery and anxiety that surround eating during pregnancy and giving up smoking, What is plain English? aspects of palliative care and gives details on certain health conditions. This naturally among others. Plain English is a style of presenting benefits, entitlements, contacts and how to benefits all patients, not just those with The importance of plain English in written information that the intended reader can access support and counselling.According to literacy difficulties. information is just one part of the puzzle. understand and act on after a single reading. family member Mary Towey: “This booklet gently Various hospitals and projects within the HSE Although time constraints can prevent lengthy Shorter sentences, everyday words, a direct and practically starts us on a journey. It gives have already taken this on board. Many have consultations, even a few minutes spent talking and personal tone and well-known images some direction. The route we choose will always contacted NALA for advice, editing and our patients (or their guardians) through leaflets, and symbols can contribute to clearer be a personal one on which we should never be Plain English Mark, a logo that is only given after consent forms and dosage instructions can communication to everyone. alone or lost. It is a valuable tool.” p10 Healthmatters Autumn2006 Healthmatters p11 Healthmatters Healthmatters Immunisation Reaches 95% in the Midlands By Dr Patrick O’Sullivan, Public Health Department, HSE Dublin Mid-Leinster

fter clean water, immunisation is known to be the most effective public health A intervention we can make to save lives and to promote good health among the populations we serve. Statistics from the Health Protection Surveillance Centre (HPSC) for the fourth quarter of 2005 show that the Local Health Office areas of Laois/Offaly and Longford/ Westmeath were recently successful in reaching the World Health Organisation’s recommended target of 95% for immunisation uptake at 24 months for all of the childhood vaccines including the MMR (Measles, Mumps and Rubella). The midlands part of the HSE Dublin Mid Leinster Area met this target with an uptake of 95% for the MMR and 96% for the other childhood vaccines at 24 months, that is for Haemophilus Influenza B, Meningococcus C, Diphtheria, Tetanus, Whooping Cough and Polio. This is the first time the target of 95% for MMR1 has been reached by such an area since the collation of these statistics commenced in 1999. Nationally, the uptake of these vaccines is not yet at the recommended level, with figures of around 90% for the uptake of the majority of the vaccines and 88% for the MMR. Vaccination coverage in the midlands has not always been as good as it is now and, in fact, the documented uptake in 2002 was one of the Dr. Phil Jennings, Director of Public Health (sitting), Eileen Kinsella, Regional Immunisation Co-Ordinator, Karen Nugent, Regional Immunisation Co-ordination Assistant lowest in the country. and Olivia Finnerty, Assistant Staff Officer - Immunisation Office, Primary Care. Dr. Phil Jennings, Director of Public Health, said the improvement in the vaccination uptake since then has been a result of the hard work Co-ordinator, who made a very significant put in by all of the healthcare staff involved in contribution to the improvement in the The main steps taken to improve vaccination uptake the promotion and the delivery of vaccination vaccination coverage in the area overall. in the midland area: programmes in the region. Of course, the parents must also be > The uptake rates for each GP were analysed and action plans were implemented. commended for ensuring that their children >  The GPs with the lowest uptake rates were targeted by the Regional Immunisation Co-ordinator Immunisation Uptake in the are protected against these potentially serious on an ongoing basis, to assist them in increasing and maintaining their uptake rates. Midlands 2002 and 2006 but vaccine-preventable diseases. Achieving > Protocols were drawn up for each practice in relation to immunisation in consultation with the In response to the poor uptake, a detailed the WHO target of 95% coverage with all of Practice Nurses (PNs) and the GPs. analysis was undertaken of the steps involved the recommended childhood vaccines in the > One-to-one training sessions were held with each Practice Nurse outlining the administrative in the vaccination process to see where the midland area is really a win-win situation. procedures for immunisations. difficulties were occurring. This study sought The children benefit from the protection they > A customised record of the vaccination schedule was distributed to each GP so that they could the views of parents and of health professionals, receive against these diseases, the parents track each child’s immunisation status at a glance. and it examined the reasons why parents benefit from the knowledge that they are doing > Continuous feedback was given to each GP, informing them of their own practice’s uptake and were not having their children immunised. the best they can to protect their children and the uptake of each LHO area. A number of steps were taken to improve health care staff can feel that, by achieving > Clear communication channels were put in place for PNs – direct contact with Regional the process, including the appointment of a the 95% target for vaccine coverage set by Co-ordinator and designated Primary Care Unit clerical staff for administrative queries and Regional Immunisation Co-ordinator and the WHO, they are doing the best they can do direct contact with Senior Public Health Nurses for medical queries re immunisation.

the centralisation of immunisation data to protect the population from the spread of > Direct and timely contacts were made with defaulters by Regional Co-ordinator’s office to collection in the area to one site in the these diseases. In addition, as a result of their remind parents to bring their children for immunisation. There was good feedback from Primary Care Unit. involvement in this process, the majority of GPs parents as a result of this contact. Parents were also given the contact details of the Senior Correcting all these potential stumbling are now achieving 95% uptake in their practices Public Health Nurse for Immunisations for their area, if they had a medical query.

blocks meant that all health care staff involved and are, therefore, receiving the appropriate > There was continuous and timely follow up by PHNs of defaulters. in the vaccination programme had to make bonus payments. efforts to identify and correct any weaknesses in their part of the chain. This was successfully achieved thanks Immunisation Uptake in the Midlands 2002 and 2006 to everyone’s commitment to improving the situation in the midlands regarding coverage Primary Childhood Vaccinations MMR with the childhood vaccines including GPs, Practice Nurses, Public Health Nurses, Birth Laois/ Offaly Longford/ Westmeath Laois/ Offaly Longford/ Westmeath Registration Staff in the Health Centres, Senior Public Health Nurses for Immunisation, Q1 - 2002 73% 76% 71% 71% staff in the Primary Care Unit and staff in the Department of Public Health, particularly Ms. Q1 - 2006 97% 97% 95% 95% Eileen Kinsella, the Regional Immunisation p10 Healthmatters Autumn2006 Healthmatters p11 Healthmatters Healthmatters What is the Value of Integrated Care? By Marie T. Kehoe, President of the Irish Society for Quality and Safety in Healthcare (ISQSH)

he concept of “integrated care”, the notion that all disciplines involved in healthcare Multidisciplinary Clinical Tcould work together as a “team” around collaboration Primary Care Clinical Audit Quality &Fairness Governance our patients’ care rather than in the traditional professional silos is one that is gathering momentum in today’s healthcare environment. Identifies good Clinical As with all change, this concept has its practice Effectiveness champions and its detractors. Let’s explore this concept and determine whether it is idealistic as some would argue or whether it is indeed an idea Commissioning Variance Tracking whose time has come. To begin, it should be stated that there are pockets of practice in our country and elsewhere ICPs (Integrated Care Pathways) where this concept is not new; it is something Benchmarking Research & that has evolved quite naturally over the years. Development In these areas, multidisciplinary teams work together in an environment of mutual respect, shared agendas, and high standards of quality. Clinical Risk Patient & Public Management Involvement Operating theatres have been an example of this where consultants, nurses, anaesthetists, porters etc. have developed a team approach to their Social care work quite possibly due to the close proximity Accountability Identifies education Change HIQA in which they work. Other areas however, needs management interfaces have demonstrated work practices where professionals dared not question each other,

and the environment was such that standards of (2001) was the need to improve integration improvements in practice > There must be a programme of education for practice deteriorated and there was little or no of services so as to create a seamless, people > Work in partnership with patients all members of the multidisciplinary teams on transparency in the system. centred service. To attain this goal, we must have > Reduce risk by eliminating duplication quality improvement tools, team-building etc. In the current climate of health care reform, the tools, skills and a structure/framework to > Providing clear expectations for > Evaluation and research focus we have an opportunity to take a considered make change happen. We also need commitment patients/families

approach to the steps necessary to redesign our from senior management as well as clinicians. > Standardise path of care throughout In the main, people present themselves to the health care service to one where audit, research, At a recent conference co-hosted by the HSE the system health service with a common range of problems risk management and quality/accreditation are and the Irish Society for Quality and Safety So how do we move forward? The Irish healthcare that are entirely predictable – chronic lung not separate departments; and more importantly in Healthcare; the CEO of the HSE, Professor system is in need of fundamental change. disease, asthma, heart disease, diabetes etc. As are not seen as a threat to clinical autonomy, Brendan Drumm, stated that the implementation Many patients, doctors, nurses and health care a first step, we must understand how these are but rather as tools that support multidisciplinary of ICPs could unleash an “explosion of human leaders are concerned that the care delivered diagnosed and treated and ensure that they are clinical practice throughout the patient journey. potential”. This event highlighted examples of is not essentially the care that patients should managed consistently in line with best practice. A model of Integrated Care Pathways (ICPs) integrated care in action in the Irish health system. receive. The frustration levels of both patients We must also work with patients, learn from developed by multidisciplinary healthcare teams, It showed how a properly structured department and clinicians have probably never been higher. them, and educate them to manage their health with the active involvement of patients, could offer of elderly medicine had contributed to improved Healthcare has safety and quality problems in a more proactive way. Where an admission is a practical means to embedding best practice, efficiency in the hospital and continuing care because it relies on outmoded systems of work. necessary, we must work on the patient journey role clarity and efficiency into the complex utilisation by 20%. It showed how dignity and Poor designs set the workforce up to fail. Higher through the system and design our systems to processes of care. ICPs are not new; they are respect could be afforded to people in their levels of quality cannot be achieved by further make the patient experience an effective and celebrating their 21st year of use in healthcare. last days and hours of life through a planned, stressing current systems of care. Trying harder efficient one, doing the right thing at the right Their aim and purpose has remained steady thoughtful, and considered approach to their care. will not work; changing systems of care will. time in the right place. Properly developed ICPs throughout those two decades: support quality It also highlighted how acute and community can help us reduce complexity, work in effective care and patient satisfaction while managing services could work together to improve the In order to support the teams, and improve the patient experience. resource utilisation. experience and outcomes of patients with chronic development of ICPs in Ireland A lot of energy has been focused on capacity One significant early benefit to the service long term conditions – each of these are examples critical success factors will need issues in our health system. ICPs are not the during the development of a local ICP is that of clinically led and team based approaches to to be put in place: solution to all these problems but may however it optimises communication and collaboration care. These experiences should be the norm and > Commitment must be demonstrated (by be a very valuable tool in focussing attention among interdisciplinary team members as well not the exception. providing resources) at senior management on variable practice and waste, on improving as with the patient/family. The Primary Care level and clinical levels effectiveness and efficiency in a systemised way,

Strategy (2001) recognises care infrastructure as Integrated Care Pathways support > Involvement of multi-disciplinary team and and in involving patients as partners in their care. “poorly developed and services fragmented with the delivery of a quality services patients in planning and development Once implemented we may then be better able little teamwork and limited availability of many by helping us complete: > ICPs must be included as part of an to articulate where the real gaps in capacity lie so professional groups”. One of the main challenges > The audit cycle organisational quality programme that we can invest in and build the health service facing healthcare professionals, managers, and Manage change ICPs must be “owned” by the clinical staff that we all deserve. > > administrators today is trying to make the best > Increase the body of knowledge where little and patients ISQSH has extensive experience with Integrated use of resources, whilst providing high quality, evidence exists > There must be local and national champions Care Pathways and is developing a Community of timely, evidence-based care that is centred on the > Manage clinical risk > ICPs must be based on available evidence Practice for any individuals who have experience needs of the patient and their families/carers. In > Increase transparency in the system and best practice including milestones and in the area or who are interested in developing this context, there is a new emphasis towards the > Incorporate guidelines into everyday expected outcomes Care Pathways in Ireland. For further information provision of a model of Integrated Care. practice > Variations must be collated, analysed and contact Marie Kehoe via [email protected] Specifically identified in the Primary Care Strategy > Continuous and transformational fed back to staff or 01-8092585. p12 Healthmatters Autumn2006 Autumn2006 Healthmatters p13 Healthmatters Healthmatters Innovative DVD Resources for Children Promotes Physical Activity and Young People’s Services number of resources that can be used PCHI may disrupt the process of to enhance quality in Children and communication and normal language Leadership Among Staff A Young People’s Services have recently acquisition, leading to poor language, been made available by the Programme of communication and literacy skills. This has Action for Children. long term consequences for a child in terms of These include two Adolescent Friendly educational achievement, mental health and Quality Assessment Tools [AFQuATs] designed quality of life. to provide a method for health service In addition more than 2,000 doctors and providers and planners to assess the quality nurses have received training in their roles in of services for young people in relation to child health surveillance. adolescent friendly quality standards. Young The objective of the training was to ensure people and health professionals have been that:

involved in designing these tools. > Each child has the opportunity to realise Another resource is a report that his/her full potential in terms of good health, recommends neonatal screening which well-being and development.

can identify Permanent Childhood Hearing > Remediable disorders are identified at the Impairment (PCHI) early, leading to early earliest possible date and treated in a timely intervention. fashion.

(Back L to R): Teresa Hurley, Head of Department of Health, Sport and Exercise Science, WIT, Niamh Murphy, Director of Centre for Health Behaviour Research, WIT, Joe Mooney, Hospital Manager, St Patrick's Hospital, Thunder and Lightning Waterford, Ann Coin-Nevin, Director of Nursing, St Patrick's Hospital, Waterford, Damien Jackson, Videographer, Mairead Loughnan, ACT Tutor, WIT, Patricia Dawson, ACT Tutor, Age and Opportunity. (Front L to R): Meabh McGuinness, Health Promotion Officer, HSE, Mary Cowman, Project Manager, ACT Programme, WIT. at Dublin Hockey Final

DVD which demonstrates safe and participants are trained to design and lead chair effective ways to deliver “chair based based activity sessions aimed at increasing and A activity sessions” for residents in long maintaining functional capacity, independence stay facilities for older adults was launched in and quality of life for dependent, older adults Waterford in June. residing in these facilities. The innovative DVD was produced by the Mary Cowman (Project Manager for the ACT HSE in co-operation with the Activity in Care Programme) said the DVD would prove to be a Training (ACT) team in the Department of valuable training tool which can be used within Health, Sport and Exercise Science at Waterford the training schedule to reinforce principles of Institute of Technology (WIT). best practice discussed throughout the training Filmed at St. Patrick’s Hospital in Waterford, programme. the DVD features some of the hospital Alternatively, she added, it can act as a residents. It provides a practical demonstration useful training aid for home-based learning of a chair based physical activity session for by allowing the trainees review and reinforce participants of varying needs and abilities. course learning at a time and location that suits The session enables ACT Trainees to learn their own needs. appropriate activities, leadership skills and The programme was developed by the Health safety precautions in an interactive and Behaviour Research Group in the Department Competitors in the Dublin Inter Hospitals Hockey Competition creative manner. of Health, Sport and Exercise Science at WIT Staff at St. Patrick’s Hospital have been in collaboration with the Health Promotion eaumont Hospital triumphed in Hospital overcame CRC to clinch the title. delivering physical activity sessions to the Department of the HSE South and “Age in this year’s Dublin Inter Hospitals This is the 38th year of the Inter Hospitals residents there since the beginning of the ACT Opportunity”. B hockey competition beating Tallaght competition. Each team can have a panel of project. Both staff and residents have been key Successful candidates receive a certificate Hospital 2-1 in the Division One final played 16 players and, of the eleven on the pitch at to developing the training resource. from the Adult Education Department in during a thunderstorm. any one time, six must be female. Otherwise Speaking at the launch Meabh McGuinness the School of Education and Professional On their path to the final Beaumont all rules are the normal rules of the game (Health Promotion Officer) said the ACT Development at WIT. overcame Tallaght Hospital seconds in the of hockey. programme provides staff in long stay care To date, 170 leaders from 70 facilities and 19 semi-final and beat Our Lady’s Hospital, It is hoped that next year local Health Office facilities for older adults with a qualification counties in Ireland have successfully completed Crumlin in the quarter-final following a penalty teams will play in the competition. Once bitten in physical activity leadership. Successful the programme. shoot-out. In the Division Two final St. Patrick’s by the bug most teams will play year after year. Carlow/Kilkenny Co-Ordinator appointed for Family Support Strategy South East Regional Drugs Task aria Fox has been appointed initiate, develop and implement responses to n inter agency group of organisations the group), the Carlow Institute of Further Co-ordinator of the South East the growing issues of drug misuse. working on supports for families in the Education, Comhairle, Enable Ireland in Kilkenny, MRegional Drugs Task Force. The South East Regional Drug Task ACarlow and Kilkenny areas - including the Forward Steps Resource Centre in Tullow, Maria takes over the role from the Force membership is comprised of statutory, representatives of the Health Service Executive the Kilkenny Early Years Project, Newpark Close Health Service Executive’s Tony Barden, voluntary and community members who all South - have developed and launched a Strategy Family Development Ltd. in Kilkenny and the who has acted as interim Co-Ordinator play a vital role in the provision of coherent document to inform further service development Co. Carlow Vocational Education Committee. for the past three years - a period which strategies to address the complex issues of in both counties. The group, which received funding from the saw him spearhead the development and drug misuse. The agencies represented on the Strategy Department of Social & Family Affairs, Comhairle, implementation of the South East Regional Initiated in 2003, the South East Regional Development Group were the Health Service Carlow County Council and the Health Service Drugs Task Force (SERDTF) Strategic Plan Drugs Task Force is one of 10 which are Executive, the Barnardos Family Support Project Executive also recently launched a Directory of 2003 - 2008. spread geographically across the former in Carlow (Marian Dowd of Barnardos chaired Family Support Services for both counties. The Task Forces’ primary objective is to Health Board regions/HSE areas. p12 Healthmatters Autumn2006 Autumn2006 Healthmatters p13 CEOInterview

This time last year Professor Brendan Drumm took up the post of Chief Executive Officer for change and guardian of the interests of patients and clients. of the Health Service Executive (HSE). Health Matters met with him recently to discuss At corporate level, the unified approach what has been achieved during the past year and the challenges ahead. has proved to be particularly effective in our comprehensive Capital Planning Process and Q. Are you satisfied with the professionals, the changes will be gradual as Health care teams of the future must look after following on from this, during the year, we progress made during the past the reform gathers momentum. Many others specific population groups regardless of their announced a €555.5 million capital investment 12 months? will continue to do the same job they did before needs and engage specialist assistance as plan which is part of our €3.48 billion five year the HSE was established. required, while maintaining overall responsibility Capital Plan. Yes. While large process change takes time, we From an organisational point of view, we for the patient’s welfare. Indeed keeping these We now also have a very structured process are making inroads into challenging the way we have made progress in integrating the old population groups healthy will be as important to our annual submission to the Department view things and do things. structures with the new. as providing diagnosis and treatment. of Health and Children for new developments Last year there was a belief that the answer It is worth remembering that we started with The current approach encourages disconnect which reflects the needs of the organisation as to the difficulties in our hospital system was a landscape where the Health Boards and between service providers. For example I a whole and not individual units. to simply add more acute beds. There is now various bodies were quickly brought together have come across a situation where up to 20 As a unified organisation we spend more an acceptance that maintaining a system to under the umbrella of the HSE and the plan to different HSE agencies were interacting with than €3 billion a year on goods and services do things in the same way as they have been migrate more than 100,000 employees into the the same family. This is obviously in nobody’s and we established a specific National done for the past 20-30 years will not lead to four predetermined Administrative Areas was Procurement function to use this buying power improved services - they will in fact deteriorate. light on detail. to make significant savings, which will be used We have no choice but to challenge all our As part of the ongoing process we now hold to improve services. practices and modernise them. regular meetings in the four Administrative We have also established a new National For example at the moment many have to Areas to capture feedback and identify how I am Estates function to enable us to better manage travel, sometimes long distances and at great we need to respond to local issues from a our €4 billion estates portfolio. Again, savings inconvenience, to their local hospitals to have corporate point of view. The challenge is to determined that that will accrue from this function will be simple x-rays. With modern technologies this get clinical providers involved in this process “we will link money channelled back into improving health services. does not have to be the case; simple x-rays and more of them directly involved in the Indeed up to 2010 we hope to make savings should be available locally and provided management process. to output and of more than €500 million through Value for within communities. Money Initiatives. This is just one example of the type of practice Q. People care most about how performance Our single body status enabled us to make a we need to address to make it easier for patients quickly they can access the major breakthrough in relation to the costs of and make better use of hospital facilities. health system, get treated and pharmaceuticals from manufacturers and this I believe that our energy and resources are get out of the system. Are you will save us around €300 million during the now completely directed toward delivering best interests. We have started to” tackle this next three years. We will now pursue further satisfied that enough progress quality, safe services that everyone can easily and are undertaking a root and branch review cost savings with wholesalers and subsequently access, regardless of their financial status or has been made in this area? of all the various steps patients and clients with community phamacists. location. I also believe that the vast majority It is important that we recognise up front that have to take to access and receive our various In a related development we launched a of staff, including clinicians, health care the vast majority of our services are top quality, services. We have to put an end to situations national online service available to all GPs who professionals, management and administratives delivered by committed professionals who are where patients are passed from person to can now check patient lists in real time, make staff, share this goal and are enthusiastic working hard to deliver care, but the system is person, receive repetitive and sometimes claims online, track claims and payments and about making the changes needed to see often overly complex. unnecessary clinical appointments, x-rays, keep their patient lists and client data up to this come about. It is often said that the difficulty is not with blood tests and so on. date. This initiative is part of the Primary Care the quality of care we provide, it is the difficulty Reimbursement Service, which is managed Q. Some staff have not yet patients and clients have accessing it in the first Q. One of the criticisms you by our National Shared Service which will be fully integrated into their place. I agree with this. Easier access is vital. made of the health system in a significant force in extracting economies of new roles. Is this something However, achieving this will involve major the past was that it rewarded scale from our national back office activities. that concerns you? work practice changes. For example individual inefficiency. Have you started These are examples of how the HSE has health professionals such as doctors, therapists to address this anomaly? enabled us to focus in on where we can make Yes, unfortunately for some there is no quick fix etc., will need to work more closely together in substantial savings and at the same time and we are working actively on addressing the teams and take responsibility for the health of Yes. I am determined that we will link money to improve quality, on a national basis. outstanding issues. a defined group of people, (avg. 7,000-10,000). output and performance. We have introduced Overall I am pleased that the HSE is maturing However, for the vast majority of staff We need to steer away from defining target some initial mechanisms to reflect this as an independent organisation and is proving who are working at the front line, doctors, groups by illness, disease, disability, age or approach and the Finance Directorate has a its credentials to make decisions that will have nurses and many thousands of other health location (hospital or community). specific brief to follow through on this. a direct impact on improving care. For example, when allocating development funds for new projects we are now giving Q. Are there initiatives priority to hospitals and local health offices that are breaking even on their budgets. Those undertaken during the year that are more than 5% over budget will not be that you are pleased with? eligible for development funds. That is a difficult question because when you In relation to A&E waiting times we are mention specific projects you leave out many introducing an incentive scheme that will enable others. It has been a particularly intense year and hospitals that are performing in accordance with I am pleased with the progress we are making in set targets to employ more consultants. increasing the number of services we provide in community settings. I am also pleased with progress in tackling Q What do you see as the main issues within hospitals on a national basis such advantage of the HSE ? as increasing hygiene standards and reducing As a single national organisation focused Emergency Department waiting times. on efficiently delivering quality care, we are Our long term aim is to keep people out of beginning to engage constructively with staff hospitals by providing as much care as possible and the public. From this I think that there is within communities and as close as possible to a growing acceptance that our only agenda their home. For example we need to support and is to deliver quality safe services and there is encourage better management of chronic illness therefore more support for our proposals and and disease similar to the achievements being Pictured at the launch of the Ballymun Primary Care Team Strategy and Progress Report were Breedge Conlon, Dr. Brid Hollywood, Dr. Wai Sun Chan, Aileen Doyle, Dr. David Gibney, Dr. Mary Jennings, Dr. Deirdre Horneck; recommendations for change. made by multidisciplinary teams such as the Angela O'Malley; Orla Donnelly, Maria Kelly, Catherine O'Reilly, Seoighe Ni Rua, Kartherine McIntyre, Lavina I believe that the Government recognises Ballymun Primary Care Team in North Dublin. Walsh, Agnieszta Biedrycha, Dr. Neasa McDonagh, Edel McNamara, Peter Lennon, Mary Kenny, Phil Dunne, Anne Fahy, Michelle McKevitt, Prof. Brendan Drumm, Vanda Cummins. this and this is contributing significantly to The new GP contract, currently the subject of the development of the HSE as a real force union negotiations, should also have a significant p14 Healthmatters Autumn2006 Autumn2006 Healthmatters p15 CEOInterview

impact on how quickly we can enhance these driven by clinicians. It has proved very helpful in How quickly we can increase the numbers types of community based services. setting out hospital by hospital specific issues will depend on how soon a new contract can We are in the process of establishing Primary that have to be handled. be finalised. Care Teams and will have 100 up and running However, I want to emphasise that while There are many consultants engaged in thanks to the enthusiastic response from GPs we acknowledge that there are difficulties in health reform initiatives such as the A&E Task and the work of HSE staff around the country. particular hospitals, the vast majority of people Force and the reconfiguring of hospital services During 2007 we should have a further 100-150 who attend Emergency Departments get top in the North East. I believe that there are many teams up and running. class service. more who want to become more actively Added to this are the Community Intervention We see, on average, 3,000 people a day in involved in the reform programme and play Teams one of which has been established in Emergency Departments around the country, leadership roles. Cork and others are scheduled to be rolled out in 2,500 of these are treated and discharged there I accept that the representative bodies have a Dublin and Limerick during the coming months. and then. About 500 of these require admission responsibility to their members but I really hope They will enable people to live independently and of these, a relatively small percentage that we can find an acceptable solution that will when ill, avoiding a stay in an acute hospital. sometimes have to wait unduly for an in-patient see consultants at the forefront of the current I am also particularly pleased that next month bed to become available. change programme. It really is a case of how the first comprehensive out of hours GP service The challenge for us is to make sure that this much they want to be leaders or participants. is scheduled to begin in North Dublin serving waiting occurs in a suitable environment with 500,000 people from five treatment centres. I access to appropriate facilities. believe it will be very successful for patients During the coming months we will be Q. What do you see as the key Young children on the playbus at Ballybane challenges for the HSE for the and GPs alike. opening a series of admission lounges to make Community Resource Centre in Galway. The issue of a single national Tertiary it significantly more comfortable for people next 12 months? Children’s Hospital for seriously ill children has waiting for inpatient beds and we will be From the point of view of our patients and been the subject of debate for many years. Again expanding our own community facilities (circa This new tracking system is also throwing up clients, we have to dismantle the barriers that the strength of the HSE’s focused and unified 600 community beds) to accommodate people some interesting patterns; for example the data separate services provided in the community approach enabled us to bring direction and who no longer need acute care but are not well shows that Tuesdays and Wednesdays tend to and services provided in hospitals. clarity to the situation. This has culminated in enough to return home. have the highest numbers waiting which is a Because hospitals and community services the site being selected for Ireland’s new National Without overstating it we are making consequence of most elective patients being have traditionally been viewed separately, we Children’s Hospital. This was achieved against substantial progress in reducing the year on admitted on Mondays. On the other hand have hospital-based therapists, doctors and a backdrop of little progress being made during year waiting times and the majority of this has Saturdays and Sundays are the days when we social workers looking after people in hospital the past 20 years as the facilities at Temple Street come about from the focused attention being have the lowest numbers waiting. with another set of the same professionals and Crumlin Hospitals deteriorated. given to the issue by individual hospitals and We have also established a Winter Initiative looking after these people when their care The provision of appropriate hospital services providers of community services. Project Team that will be examining issues right transfers to the community. in the North East of the country is another We are also displaying on our website the daily across the health system to ensure that the extra For example we have in-patients who are issue which has caused difficulty for the local admission waiting times which is a far more winter demands do not compromise services. regularly assessed by hospital-based therapists communities for many years. Again bringing its important measure than the numbers waiting. yet cannot be discharged with a home care total focus on quality of care and safety, the HSE The community needs to accept that there Q. In the past you expressed package until there is another assessment by has presented a model of care that will provide will always be a requirement for people to the need to involve the public, the community-based therapist. the community in the North East with a much wait in Emergency Departments in a manner doctors, nurses, paramedics This kind of approach cannot be justified and improved service. Indeed a model that will act consistent with their clinical needs, be it for and other interested groups in is unsustainable. We must work towards having very much as a blueprint for the development of diagnosis, observation or treatment. the planning and delivery of single health teams (hospital and community) hospital services in other parts of the country. serving specific communities regardless of The Steering Group and Project Team responsible services. What progress has where people receive treatment. This will for implementing the changes are now in place. been made in this? overcome unnecessary delays, enable patients Following the launch of the Government’s Highlights This was in relation to Expert Advisory Groups reduce the length of their hospital stays and in Cancer Strategy we now have an unprecedented > HSE balanced its first Budget; and I am pleased to say that we will shortly be some cases avoid hospital altogether. opportunity to build a truly world class > New incentives for hospitals/local announcing the details of our first four Groups cancer control service. Our National Cancer health offices covering Children, Mental Health, Older People Accountability Control Programme will host the single national > Significant improvement in and Chronic Disease. I would like us all at the HSE to become more budget for all cancer control activities and hospital hygiene We have had a huge response to the public accountable for our work. It is not fair that provide the necessary leadership governance > Primary Care Teams & Community invitation to people to become involved in some services perform wonderfully and others, and integration. Intervention Teams set up these Groups and this obviously reflects the with similar resources, do not. We have to The very positive response to these initiatives, > Enhanced Out of Hours GP service willingness of people to devote their own time continually ask ourselves, as individuals, what and they are just a sample of the many others in North Dublin to transforming our health service. impact our daily work is having on the quality taking place around the country, show that when > Blueprint for North East These groups will create an opportunity for of services that patients and clients receive. As the prospect of delivering world class health Hospital services people to become directly involved in planning measurement of performance becomes stitched services is communicated to people in an open > Site selected for New and developing our services and also measure into every part of the health services, individual and transparent manner they are very willing to Children’s Hospital our existing service against international accountability will become part of the fabric of become part of the change, rather than criticise > A&E Task Force recommended standards to determine where improvements the way the HSE operates. from the sideline. We will have to build further hospital specific actions need to be made. on this approach and, where we can, be more > Winter Initiative Project Clinicians involved in management inclusive in our communications processes Group Launched Q. In one of your first interviews Getting more clinicians such as doctors, nurses > Partnership Agreement you said that concluding a and therapists, directly involved in management Q. Are you satisfied with the included commitment to new Consultant Contract was is essential if we are to achieve these goals rate of progress that has extended working day and indeed our health care goals in general. I > €300 million savings in important for reform. Do you still been made in relation to the hold this view? am determined that we develop systems that pharmaceutical costs over 4 years will facilitate participation by clinicians in the difficulties facing some of our > Stand alone Procurement and Emergency Departments? I am disappointed with the lack of progress we management of our services. Estates functions established have made in negotiating the new consultant While these difficulties have national implications > New Estimates Planning contract. We will just have to keep working away Recognise Achievement for the way people view our services, the Process established until we get a solution that is agreeable to all. Finally, I would like us to more actively recognise solutions are local; there is no one solution. > National Information Phone Consultants are highly skilled and effective and applaud the everyday achievements and There are some particular hospitals that are Line expanded people and have a great deal to offer in clinical contributions that I know are being made day in experiencing recurring difficulties. The National > Progress made with National management and developing patient-focused day out by our colleagues around the country. Hospitals Office is working very closely with Shared Services processes and systems. The vast majority of people joined the health them, it has set clear national targets and is > National Cancer It is obvious we really do need a lot more of service to help others and believe that the aiming to radically improve the facilities for Control Programme them working on rosters over an extended day, onus is on us to continually strive to create an people who are waiting for admission. so that patients can have greater access to environment that enables this commitment to We also have an A&E Task Force which is senior decision makers. flourish. p14 Healthmatters Autumn2006 Autumn2006 Healthmatters p15 Healthmatters Healthmatters

Limerick North Tipperary Welcomes Celebrates New Cardiologist and International New Cardiac Services Day of the Midwife

Maria, John and baby Jack, born on the May 5, 2006. Sophrina Merrigan, Midwifery Student (left) Ann Kirby, Midwife (right).

nternational Day of the Midwife was celebrated at the Regional Maternity Hospital, Limerick on May 5, 2006 when Ieach woman who gave birth that day received a special medal welcoming their baby into the world. Dr. Abbas S.F. Abbas, Consultant Cardiologist, pictured with Acuson Sequoia and KinetDx Workstation at St. Joseph's Hospital, Nenagh, Co. Tipperary The International Day of the Midwife was established by the International Confederation of Midwives (ICM) to celebrate midwifery and to bring awareness of the importance of atients from North Tipperary and East Limerick no Limerick Regional Hospital has been reduced, waiting lists have midwives’ work to as many people as possible. longer need to make the journey to Limerick city since been cut considerably and the use of auxiliary services such as During the day at the hospital a number of education P the appointment of Dr Abbas Syed F. Abbas, Consultant ambulance support and nursing staff has been lessened. sessions on international midwifery were conducted. Midwives Cardiologist at St. Josephs Hospital, Nenagh, Co Tipperary. Echocardiograms, exercise stress testing, event monitoring pledged a donation to the White Ribbon Alliance for Safe Dr Abbas took up his new post in October 2005. This is a joint as well as blood pressure and holter monitoring services are Motherhood, a special Mass was celebrated and a coffee appointment between the Mid Western Regional Hospitals, on offer to all patients. Ultimately this new service means less morning held. Nenagh and Limerick. inconvenience for patients and a more rapid and efficient service. Margaret Quigley, Assistant Director of Midwifery, said: He is primarily based at Nenagh Hospital and provides a full Dr Abbas carries out cardiac catheterization in the Cardiac “It’s important that the profile of the midwife is raised not only range of non invasive cardiac investigations. angiography suite at Mid Western Regional Hospital, Limerick locally but also nationally and internationally. This event is A newly purchased Acuson Sequoia and KinetDx workstation regularly and flexibly, primarily for North Tipperary area. important as it acknowledges the contribution midwives make and the appointment of two new cardiac technicians ensure He hopes to expand further care of cardiac patients with a full to safe and satisfying maternity care. All the women who patients are now receiving a first class Echo service. With the cardiac rehabilitation; heart failure programme and pacemaker/ received a medal were delighted to get one. It was a really nice introduction of this vital service the travelling of patients to AICD follow up clinics. way to mark their very special day.” New ICU, Theatre and PACS at UHG niversity College Hospital Galway opened a new Intensive Care Unit (ICU) and Theatre Complex in July, as part of its €110 million phase II capital development Uprogramme. The hospital also unveiled an integrated Picture Archive Communications System (PACS), creating Ireland’s first hospital-based paperless and filmless radiology department at a cost of €9 million. The new ICU is a mixed medical-surgical tertiary referral centre and is the only Level 1 ICU in the West. The unit caters for all medical and surgical specialities with the exception of neurosurgery, specialist paediatric surgery and cardiothoracic services. Cardiothoracic surgery is scheduled to be added by the end of 2006. The main Theatre Complex has 12 theatres which cater for all surgical specialties as well as day surgery and endoscopy. PACS is an integrated service involving the radiology departments in University College Hospital Galway, Merlin Park Hospital, Clifden Hospital and Merlin Park Imaging Centre. All radiology examinations, from request to report, are handled online with images and reports instantly available on a web-based intranet. Among the benefits of the system are:

> reduced turnaround time > better risk management around missing film > time savings for junior doctors following up on film > a paperless, filmless and transparent service for end-users Kevin Clarkson, Consultant Anaesthetist, Mary Fitzmaurice, CNM 3 and Mary Harney, Minister for Health and Children support for digital mammography when BreastCheck is commissioned and at the opening of a new Intensive Care Unit (ICU) and Theatre Complex at UCHG. > > the potential for the extension of web order entry to GPs and community care p16 Healthmatters Autumn2006 Autumn2006 Healthmatters p17 Healthmatters Healthmatters Combining a Working Life With a Chronic Illness

arie Mellon works in the Accreditation in the 1980’s. I eventually went on dialysis at age life line to other patients Office, Mayo General Hospital, 29 in the Royal London in Whitechapel, London. in the same position. M Castlebar and is also Secretary of the I secured work with the National Health Service There are many facilities Mayo Branch of the Irish Kidney Association. She in London and continued to work part time while available to patients was living in Dublin and working with the Eastern raising my daughter. ” within this organisation Health Board when first diagnosed with Chronic i.e. counselling, Renal Failure when she was 24 years of age. Marie was called for her first dietary advice, social transplant in 1990. welfare information, We asked Marie to outline “Unfortunately this was not successful and after holiday co-ordinator the events leading up to that a week I was back on dialysis. I returned to etc. The Irish Kidney first diagnosis. Ireland in 1993 and was called for my second Association’s main “I was living and working in Dublin for the Eastern transplant in October 1994. This was carried out function is to highlight Health Board. I had felt unwell since I was 18 and in Beaumont Hospital. This kidney lasted for 9 the increasing demand suffered from anaemia, high blood pressure and years but unfortunately I returned to dialysis on for organ donation severe back ache. I was initially investigated for a August 6, 2003.” for transplantation by number of complaints and was finally diagnosed making an informed during the course of a Medical Examination for Marie describes how decision to carry an a job in Baghdad in Iraq (this was pre Saddam dialysis currently plays organ donor card. days). I was advised at this Medical to seek a big part in her life. The headquarters further Medical advice from a Nephrologist. “I am presently on dialysis in Mayo General are in Dublin and is I approached one of the doctors in the Richmond Hospital. The unit is made up of 10 beds which appropriately named Hospital whom I worked for. He referred accommodates 40 patients on 2 shifts a day. I Donor House. ” me to a Consultant Nephrologist in Jervis St. attend on Monday, Wednesday and Friday for 4 Marie Mellon, Mayo General Hospital, Castlebar, Co. Mayo. Hospital, Dublin. hours. The staff and doctors in the Renal Unit What is it like in Castlebar are terrific and I can honestly say I to be a patient who gave me the OK and I then was on the “Subsequent tests were carried out which would not survive without their care. Dialysis is on dialysis? ‘treadmill’ which is the life of a dialysis patient. I confirmed that I was suffering from Chronic Renal a process which cleans the blood. The patient’s “Being a patient on dialysis can be emotionallly am now on the transplant list awaiting my third Failure. I was told that my kidneys would fail and blood is filtered through the dialysis machine and and physically draining. Fortunately for me I am transplant. A successful transplant would give that I would need dialysis. Needless to say my the toxins are removed during dialysis. A strict keeping as well as can be expected being on my life a freedom that is lacking now.” family or I had never heard of dialysis, a term diet has to be adhered too as the machine can dialysis and am very fortunate in that I am able we were to get very familiar with over the only do so much. Chocolate, chips, ice cream etc to work. I work for the HSE in Mayo General What are your blessings in life? coming years. ” would not be on my menu!” Hospital, Castlebar and can combine my I count my blessings in life because I have a working day with my dialysis. My Consultants terrific and supportive husband (Terry) who Marie first went on dialysis We asked Marie about her and Nurses who look after me in the Dialysis has been with me through ‘thick and thin’ five years later when she was involvement with the Irish Unit support and encourage me to continue ‘highs and lows’ and there were plenty of those, living in London. Kidney Association. working. The management in Mayo General I have a beautiful daughter (Lisa), great siblings “I had continued to feel very unwell for the next five “I am actively involved in the Irish Kidney were very supportive in helping me when I and extended family, I am able to work and years; I married, had my daughter Lisa and went Association; I am the Secretary of the Mayo had to return to dialysis. I discussed with the maintain a fairly OK quality of life. I have had to Sydney Australia for a year. I returned and went Branch. This organisation is very important to Sister in the Unit suitable hours to fit around my to accept the cards that I was dealt and deal to work in London, as work in Dublin was scarce patients with Chronic Renal Failure as it is a working day, I then liaised with Management with them accordingly. Careers Information for Secondary School Pupils

n information seminar for secondary director of nursing and a clinical placement school pupils in Co. Laois, was co-ordinator from psychiatric nursing A organised by the Partnership services. Committee at the Midland Regional The allied health professionals were divided Hospital, Portlaoise. into two sessions – therapies and diagnostics, The seminar was attended by 60 students with the following areas being covered: and two Career Guidance teachers. physiotherapy, occupational therapy, nutrition and dietetics, speech and language therapy, The aims of the seminar were social work, cardiac diagnostics, radiography > To provide some insight into the day to day and medical laboratory science. work of healthcare professionals in the The final session consisted of pharmacy and hospital environment. emergency medical technician. > To clarify subjects necessary or useful for the When the information sessions finished, the academic component of the profession. students and their teachers mingled with the > To outline the routes possible to attain the speakers and other staff who were able to join various qualifications. the group for the last hour or so, mainly student Hospital Manager Declan McCormack gave an nurses on their rostered clinical placement, who overview of hospital life and how the different shared their experience so far. disciplines interact for the smooth running of GP Robert Lawlor and community social the hospital. worker Cyril Marron contributed. Mary Gorman, Medical career options were explained by a Physiotherapy Services Manager and joint chair consultant obstetrician and a GP and nursing of the Partnership Committee also participated Some of the pupils attending the information seminar on careers in healthcare held in Portlaoise. career options were outlined by an assistant in the seminar. p16 Healthmatters Autumn2006 Autumn2006 Healthmatters p17 Healthmatters Healthmatters

Health Advice for Hidden Pregnancy Men in Fat Tony’s Barber Shop

at Tony’s barber shop in Galway city recently became the focus of heart health screening for men that involved F blood pressure and cholesterol checks and advice on nutrition and physical activity. Health Promotion and Nutrition and Dietetics in the HSE and Croi (West Of Ireland Cardiology Foundation) intend to continue to provide the service at a number of locations and conduct follow-up monitoring so as to encourage long term behaviour changes. Meanwhile, more than 80 men attended a seminar in Renmore in Galway city. The seminar was organised by the Renmore Active Retirement Association in association with the local HSE Health Promotion Services. Speakers included a cardiologist, urologist, psychiatrist and a health promotion officer and they addressed coronary heart disease, prostate cancer, depression and men’s general health and well-being. Also in the Galway area the Health Promotion Service recently trained nine facilitators to deliver a course called Raising Boys for Fathers. The focus of this course is to remind fathers of their importance in their sons’ lives, to help them in their role as a parent, to build a better relationship with their sons and to offer (L to R): Sarah McMickan, Director of Nursing & Midwifery, Portiuncula, Mary Burke, Maternity Portiuncula, Mary Hoey, Ante Natal Educator, ways which they can help their boys develop well. The course is Portiuncula and Margaret Cooke, CPC Portiuncula Hospital at the Crisis Pregnancy Agency and the HSE West launch of their joint research report held over two nights. “Concealed Pregnancy: A Case Study in an Irish Setting” in the Hodson Bay Hotel in Athlone. Since November 2005 some 79 men have participated in the Raising Boys for Fathers course which was initially developed by ew research has found that denial and concealment of the former North Western Health Board. pregnancy continues to exist among women of all age Ngroups, social classes and marital status and is not a For further details about any of these initiatives contact thing of the past, as many might expect. Paul Gillen, Health Promotion Services, West City Centre, The research, Concealed Pregnancy: A Case Study in an Irish Seamus Quirke Road, Galway. Setting, was carried out by the Women’s Education, Research and Telephone: 091-548323 Resource Centre at UCD. It found that the social stigma attached Email: [email protected] to becoming pregnant in unconventional circumstances and fear of families’ reactions were the main reasons why some women hid their pregnancies. The research, which is the first of its kind in Ireland, recommends the development of a national policy and framework CUH Doctor of services covering medical, social, counselling and support service settings. At the launch of the report on May 23rd, the Crisis Pregnancy Agency said it would consult with the media Appointed President and Gardaí on reporting guidelines for this sensitive area. (L to R): Cathy Fox, Manager Crisis Pregnancy Support Service, To see the full text of the report, visit www.crisispregnancy.ie or Catherine Duffy, Development Officer, Primary Care Services, Olive of the College of www.hse.ie. Braiden, Chair, Crisis Pregnancy Agency and Researcher Catherine Conlon of the Women’s Education, Research and Resource Centre (WERCC) UCD. Anaesthetists

r J. McAdoo has been a member of the Council of the College of Anaesthetists for seven years and has been D the chairman of a number of its committees including the examinations committee and credentials committee. The college promotes best practise in anaesthesia, provides training, education and examinations and advises the Department of Health and Children and the Medical Council on matters relating to anaesthesia in Ireland. It also runs the specialist registrar training programme in Ireland and provides support to other countries where training and education is less well developed. The college has plans to expand its teaching education and training facilities and resources in the near future and this will involve both structural expansion and the extension of IT based education. Speaking on his appointment Dr McAdoo said: “This is a great personal honour but is also an honour for Cork University Hospital and our Department of Anaesthesia”. Dr McAdoo has been a consultant anaesthetist at CUH since 1988 and he has a special interest in Ophthalmic Anaesthesia and has published in this field. He has been chair of the Department of Anaesthesia at CUH and is also a former member of the hospital’s Executive Management Board. He is looking forward to the challenges and appreciates the support of his (L to R): Researcher Catherine Conlon of the Women’s Education, Research and Resource Centre (WERCC) UCD Olive Braiden, Chair, Crisis consultant and management colleagues at CUH as he embarks Pregnancy Agency and Catherine Duffy, Development Officer, Primary Care Services, HSE West on his Presidency. p18 Healthmatters Autumn2006 Autumn2006 Healthmatters p19 Healthmatters Healthmatters A&E Audit at Portlaoise n evalutation of referrals to the ways, such as by ambulance, prison doctor the same A&E. Emergency Department over a two-week period. Accident and Emergency (A&E) or Gardai. The A&E Department comprises a Main During the period of the evaluation, 775 A Department at the Midland Regional The evaluation was carried out by the Emergency Department, a Maternity Emergency patients attended the Main Emergency Hospital at Portlaoise has confirmed that most Clinical Audit and Research Service, Dublin Department and a Paediatric Emergency Department, 244 respondents were triaged as of the people attending are self-referrals and Mid Leinster. It was commissioned by the Department. Patients are triaged on whether categories 4 and 5. Ninety-eight per cent were have not consulted with a GP prior to attending Partnership Committee at the Hospital due to they have immediate, imminent or potential resident in Ireland, and 34% were GMS holders. at the Department. the trend of increasing use of A&E services year life-threatening conditions, that is categories The evaluation confirms that there needs to A total of 63% attending in the period of the on year. 1, 2 and 3. Patients triaged as category 4 be greater public awareness of the need to use evaluation had not consulted a GP or out of In 2004, a total of 30,120 patients attended have a potentially serious condition, while A&E as an accident and emergency service only, hours GP service, while 17% were referred by a A&E (an increase of 4,500 or 17.5% on 2003 triage category 5 includes people with a less and to continue to promote and highlight the GP, 9% by the GP out of hours service MIDOC figures). From 1st January to 31st August urgent condition. This evaluation evaluated availability and purpose of the MIDOC out-of- and the remaining 11% were referred in other 2005 a total of 21,200 patients had attended triage category 4 and 5 referrals to the Main hours service. Primary Teachers Householders Course Emergency Guide lmost forty Primary school teachers in Cork and Kerry learnt all about health promoting schools when they attended two courses run by the HSE South’s Health Promotion and Published A Public Health Nursing departments this summer. Health Promoting Schools identify healthy choices, positive relationships and environments within new guide for the general public services, perform basic first aid, store important their school, as well as looking at how healthy eating and physical exercise can be promoted. ‘Preparing for the unexpected documents safely, make contact with family Each course was sanctioned by the Department of Education and Science and was facilitated by A – householders guide to major members outside the home and prepare an a health promotion officer and a school’s public health nurse with input and expertise from other emergencies’ has been published by the Cork emergency kit with items like batteries, torch, Health Promotion staff and external agencies. and Kerry Joint Emergency Planning groups; radio, first aid kit, medications, etc. The collaborative groups, comprising the Health booklet also offers advice on how to react to Topics on the agenda included: Service Executive (HSE) South, An Garda the different types of major emergencies that > Providing participants with an understanding of major health issues for children in primary Síochána, Cork County Council, Cork City might occur, the emotional implications of these schools and highlighting the support available from the Health Promotion Department. Council and Kerry County Council, that work events and basic first aid tips that could be

> Enhancing the awareness of the Health Promoting School initiative, which is being developed in together to prepare for major emergencies. performed. partnership with the Public Health Nursing Department in the HSE South. The guide, which was sent by post to every Alice O’Sullivan, emergency management

> Introducing or providing further training in Action for Life, a physical activity programme for household in Cork and Kerry, outlines practical officer said: “If and when a major emergency primary schools. and simple arrangements that can be made occurs, the emergency services have a joint

> Learning skipping games and playground games using yard markings. in the home and local community in order to major emergency plan in place outlining how > Raising awareness of promoting positive mental health and an anti-bullying ethos in schools. be better prepared should a major emergency the HSE South, An Garda Síochána and the > Looking at relationships and sexuality education and exploring the area of adolescent occur. local authorities work together to respond development. A major emergency is a phrase used to effectively and efficiently. However, there are

> Highlighting the support available from the community dieticians and providing an opportunity describe a range of incidents from a major a number of simple steps that can be taken by to look at nutrition resources which support the nutrition component of Social, Personal & road traffic accident, rail crash or fire to a flood, households and communities which can help in Health Education (SPHE). severe storm or explosion. the unlikely event of a major emergency taking

> Exploring basic first aid techniques for use with children and adults. Practical advice for householders includes place; knowing what to do makes it easier to > Providing an introduction to creative dance as a method for encouraging an alternative type of knowing how to: disconnect power/water remain calm and deal with the situation as best physical activity and self esteem. supplies in the home, contact the emergency you can.”

Ageing with Confidence Programme – Ready to Roll-Out in the Midlands hirteen people from counties Laois, myths and stereotypes about ageing. They also Longford, Offaly and Westmeath have learn about ageism and about attitudes that can T recently completed the Ageing with limit their expectations as they age, and they are Confidence Facilitators’ Training Programme. encouraged to develop a positive outlook and a The programme was jointly organised by the proactive approach to the maintenance of their Health Service Executive, Dublin Mid-Leinster own health – in fact to age with confidence!. and Age & Opportunity and also involved Both Margaret Feeney, Director of Services the Leader companies in each of the four for Older People, HSE and Jim Reilly, Local counties. The Training Programme is designed Health Officer, HSE, attended the final day of to train facilitators to deliver the Ageing with the Programme in July 2006 and were delighted Confidence programme to older people living in that the HSE was able to bring the training the community, something that is expected to programme to the Midlands. start in Autumn 2006. The Ageing with Confidence programme was The aim of the Ageing with Confidence developed by the former Northern Area Health Pictured at the conclusion of the Ageing with Confidence programme in the midlands were (Back L to R): programme is to provide participating groups Board in collaboration with Age & Opportunity. Rose Keegan (ACT), Finola Colgan (MHI), Marian Delaney-Hynes (HSE), Teresa Doyle (participant), Carmel Walsh (ASI), Margaret Feeney (HSE), Helen Power (Age & Opportunity). (Front L to R): Trish O'Rourke with information on physical, psychological and It has already been delivered in Longford, but (participant), Eilish Redmond (Age & Opportunity), Jim Reilly (HSE), Liz Shiel (ACT) and Anne Galvin social aspects of growing older. Participants this is the first time that facilitators have been (Westmeath Community Development Ltd). explore their own ageing and learn to challenge trained outside of Dublin to deliver the course. p18 Healthmatters Autumn2006 Autumn2006 Healthmatters p19 Healthmatters Healthmatters ‘Say No to Ageism’ Campaign 2006

Naas, Co Kildare, Louth County Hospital, anti–ageism and workshops were held where staff Dundalk, Co. Louth, Sunhill Nursing Home, from the 14 exemplar sites presented their plans. Terfmonfeckon, Co. Louth, Silver Stream A report is to be prepared so that the learning Healthcare, Head Office, Ratoath Manor, from the 14 sites can be disseminated. Ratoath, Co. Meath, West Kerry Primary Care To support the programme the HSE has Centre, Dingle, Co. Kerry, Cashel Primary distributed and disseminated relevant campaign Care Team- HSE – Co. Tipperary, Community material within the health services and to many Rehabilitation Teams, Athlone and Longford groups and organisations we work with. Mater Hospital, Dublin. This year for the first time the transport A national HSE ‘Say No to Ageism’ conference industry has become involved and Bus was held in May in Tullamore. Brenda Hannon Eireann and Irish Rail have initiated ‘Say No outlined the HSE role in raising awareness of to Ageism’ projects.

Pictured above is the 'Say No to Ageism' Conference Steering Committee from (L to R): Niall Crowley, CEO Equality Authority, Margaret Feeney, HSE, Bob Carroll, Director, National Council on Ageing and Older People and Ann Coyle, Jim Murphy, Brenda Hannon, Hilary Scanlan and Paschal Moynihan, all HSE.

he ‘Say No to Ageism’ campaign is an sites around the country where initiatives initiative of the HSE, the Equality Authority to further enhance age friendly service Tand the National Council on Aging and provision would be promoted. HSE participants Older People are joined by staff in the private sector and The National Campaign was launched in May acute hospitals. by Niall Crowley, CEO of the Equality Authority, Brenda Hannon, Director of Services for Older Sites involved include: Persons, HSE Dublin Mid Leinster and Eibhlin St Patrick’s Community Hospital, Carrick-on- Byrne, Chairperson, National Council on Ageing Shannon, Co. Leitrim, Dean Maxwell Community and Older People. Nursing Unit, Roscrea, Co. Tipperary, Cherry This is the third year the HSE has been Orchard Hospital, Ballyfermot, Dublin, St. actively involved in promoting the campaign Francis’ CNU, Newcastle, Co. Galway, Sacred and providing leadership by developing and Heart Hospital and Bethany House Welfare implementing a HSE action plan for 2006. Home, Co. Carlow, St Vincent’s Hospital, This year the plan was to develop ‘exemplar’ Mountmellick, Co Laois, Naas General Hospital, Miniature Camera Used Information Leaflet in Endoscopy Service for Childminders n investigation using a miniature and adjacent organs, such as pancreas and camera is being used at the Centre for bile duct. In 2006, the hospital established its A Gastroenterology at Mercy University linear endoscopic ultrasound service. Linear Hospital (MUH) in Cork. endoscopic ultrasound allows us to perform The hospital’s capsule endoscopy service invasive techniques such as pancreatic biopsy, is the only one in the country providing this lymph node biopsy and cyst drainage, outside investigation and provides this service on a of the gastrointestinal tract. This will facilitate nationwide basis. more accurate staging of gastrointestinal During this test, a small computerised cancers and the initiation of more appropriate camera, roughly the same size of a medication treatment. We are the only centre outside of capsule, is swallowed and this transmits images Dublin providing this service. to a receiver carried on the patient’s waistline. Another development is the establishment Having swallowed the capsule in the of a diagnostic and therapeutic ERCP service. morning, the patient returns to the hospital in At ERCP the bile ducts and pancreatic ducts the evening where the information from the are visualised and therapeutic procedures receiver is downloaded. This then provides such as stone removal or stent insertion are The Health Service Executive West in Mayo launched the ‘Children First for Childminders’ information leaflet in April. Pictured at the launch were (L to R): Barbara Quinn, Training Manager, Northern Ireland Childminders a video showing the entire small bowel performed. We provide a regional tertiary Association; Mary O'Hara Gavin, Childminding Advisory Officer, HSE West; Sandra Claxton, HSE West; Jim lining. This technique has revolutionised our referral ERCP service. Power, Co-ordinator, Mayo County Childcare Committee, Paul Murphy, HSE West Childcare Manager and understanding of small bowel diseases. MUH has an active research unit at the Geraldine O'Grady, Childminder. While it was initially mainly used to detect Centre for Gastroenterology, where a full-time bleeding in the small bowel, recent research Research Registrar and other team members A new information leaflet to support the professional development of childminders has been launched in 2005 has demonstrated that it has a variety are currently looking at the role of bacterial by the Health Service Executive West. The leaflet, Children First for Childminders, is the first of its kind of uses and it is envisaged that this modality of overgrowth in irritable bowel syndrome and in the country. It outlines the positive and safe practices needed when working with children. investigation will become more widely used in the aetiology of diverticular disease. The the future. unit is also involved in multi-national studies These include: MUH also now provides a supra regional looking at non-ulcer dyspepsia, clostridium > Getting to know children and their families; endoscopic ultrasound service. During difficile and inflammatory bowel disease. Staff > Settling-in procedures; this technique, an endoscope with an work closely in conjunction with our surgical > Supporting an open door policy; ultrasound probe is passed along the upper colleagues, Departments of Histopathology and > Information for parents and others; gastrointestinal tract. This allows excellent Microbiology, and the Department of Medicine > Who children will come into contact with during the day. imaging of the wall of the oesophagus, stomach at University College Cork (UCC). > Policies and procedures. p20 Healthmatters Autumn2006 Autumn2006 Healthmatters p21 Healthmatters Healthmatters Midlands Welcomes Overseas Nurses n Integration Day to welcome more than 100 international nurses to health Afacilities throughout the midlands was recently held in Mullingar as part of the HSE’s Nurse Recruitment & Retention National Project. The purpose of the event, which was held at Belvedere House, was to give the new nurses the opportunity to meet together as a group and to integrate with their colleagues on a social basis. Every support was given to the nurses from the time they arrived in the midlands from providing assistance in sourcing accommodation to providing additional English language support in association with the local VEC. The integration day in Mullingar was part of that support process. A full day of activities and events was organised for the new staff including walks, a Tram Tour of Belvedere, a Falconry Display, and an Audio Visual and House Tour that included historical information on Irish culture. Representatives from the Indian and Filipino nurses spoke of their positive experience of coming to work with the Irish health service. The day ended with a stunning display of traditional dance performed by a group of the Indian nurses. “Credit is due to the staff working in the clinical areas, management, nurse education and all staff in the Midlands and elsewhere in the country who have been involved with, and supported this initiative and for making the overseas nurses feel welcome and valued in the service,” said Larry Bane, Assistant National Director HR HSE. A nursing needs analysis for the remainder of 2006 has taken into consideration the number of new Irish graduates who intend to apply for nursing positions in the midlands following their registration in June 2006. This will be the first group of nurses completing the four year undergraduate nursing degree programme (BSc) in General and Mental Health Nursing in Athlone Institute of Technology. A challenge for the future is to explore all issues relating to an adequate supply of midwives and mental health nurses. This is currently being Nurses from the Midland Regional Hospital at Mullingar who performed a native Indian dance at the nurses integration day. (L to R): Manju Kuchery Ammini, Suma Rejinon, Simy Cherian, Sharmila Bala, Mariet Sheen Thomas, Laticia Kalangi Phillips, Mariamma Varghese, Shynymole Sebastian, Lakshuie Oman Kuttan (front) Julie Barnabos and addressed by two dedicated sub-groups set up as Shirley Robson . part of the recruitment and retention project. Are you Paying too Much Tax?

an’t be bothered filling in tax returns or contacting the Full Internet Service of a change of address, and track the progress of written tax office to sort out your tax and get that tax back that The best option, the full internet service, will allow you to: correspondence with Revenue. you know you are entitled to? Did you know you can sort > View your personal tax record C Texting your problems out quickly and easily over the internet from the > Claim a wide range of tax credits on-line comfort of your own home? > Apply for refunds of tax including health expenses If you don’t have access to the internet you can also contact The Revenue Commissioners have recently launched a range of > Request a review of your tax (balancing statement/P21) for Revenue by using your mobile phone as follows: new self service options over the internet for employees, the PAYE 2005 onwards

On-Line Services, where you can claim the credits you are entitled > Re-allocate credits between yourself and your spouse Simply Text : to, claim a review for last year, e.g. for Health Expenses, check on > Change your address and update other personal information. > info credit bin to 51829 to claim Refuse Charges Credit progress of correspondence you have sent Revenue, or just look To avail of this service you will need to register with reachservices, > info credit carer to 51829 to claim Home Carer Credit up your current tax credits. the Government service set up to provide secure and confidential > Info credit union to 51829 to claim Trade Union The new service for employees is based around the Revenue access to public services over the internet. Although it takes Subscriptions Credit

On-Line Service (ROS) which businesses have been using a little time to get fully registered with reachservices to use > Info credit age to 51829 to claim Age Credit successfully for the past few years to file tax returns and to make this service initially, it is a once off registration and will be > Info credit relative to 51829 to Dependant Relative Credit payments. worth it in the long run particularly if you want to be able to > Info address to 51829 to change your address on The service is being rolled out through the issue of information claim reviews and tax credits or keep a good eye on your tax Revenue record

leaflets to over two million employees over the coming months affairs in future. > Info form to 51829 to order certain PAYE Forms containing a personal Revenue PIN which you will need to keep > Info leaflet to 51829 to order certain PAYE Leaflets Limited Internet Service safely as you will need it to use the service. Keep an eye out for > Info post to 51829 to check progress on written your leaflet in the post and follow the instructions to get yourself The Limited Internet services, requiring your Personal Public correspondence with Revenue set up. Service Number (PPSN) and your Revenue PIN only, is a simple There are two options open to you in the new service, a full but quite limited version of the PAYE On-Line service which will You will need your Revenue PIN and your Personal Public Service internet service and a limited internet service. allow you to claim a small number of tax credits, notify Revenue Number (PPSN) to use this service. p20 Healthmatters Autumn2006 Autumn2006 Healthmatters p21 Healthmatters Healthmatters Post Polio Support Group he Post Polio Group focuses on maintaining the independence and Tdignity of Polio Survivors supporting them at work, in the home and in other aspects of their daily lives. There are more than 7,000 Polio Survivors in Ireland. Around 60% of survivors may be experiencing the late effects of Polio or Post Polio Syndrome which can occur many years after the original infection. The Post Polio Support Group creates awareness and provides information regarding the late effects of Polio among Polio Survivors and the wider medical profession, and works to ensure that no Polio Survivors Pictured with dietitian Susan Higgins at the Presentation Primary School in Kilkenny were Lauren Gleeson, Katie Cahill, Brian O' Reilly, Brian O'Hanrahan, Sean Devane, Dirmuid Coffey, Hannah Dowling, Grainne O Halloran, David Buckley, Declan Coffey, Katie Brennan, Oscar Bennett, Ronan McMorrow and Abigail Bennett. have needs relating to their condition, which are not being met. Polio Survivors help each other to cope with the challenges presented by the condition. The Post Polio Support Group can put you in touch with other survivors through various Healthy Lunch Project Award meetings and other events. A person concerned about the Late Effects Community Dietitian Manager with the promotion officers, dentists, public health nurses, project was evaluated, results showed that the of Polio should contact a General Practitioner Health Service Executive, Susan Higgins, principals, teachers, parents and pupils. children in these schools have increased who will offer advice on the management A was recently announced as the winner Upon receiving the Award, Susan said: awareness of healthy eating and the nutritional of the condition. Physiotherapists and of a Community Nutrition Award sponsored by “We know from National Children’s Survey quality of the lunches had also increased in occupational therapists can provide advice to the food firm Bird’s Eye Ltd. that the eating habits of many children are three quarters of the schools. I’m delighted assist daily living. Susan, who is based in Kilkenny, and her not good. In fact, 20% of boys and 25% of that the project has since been extended to The Post Polio Support Group has a variety colleagues in the south east counties have been primary school aged girls are overweight or include schools in counties Carlow and of programmes to assist Polio Survivors in developing the “Munch & Crunch” project in obese. The school lunch is an ideal opportunity South Tipperary”. coping with their conditions. recent years. The project aims to encourage to encourage a healthier diet for young children. “Community nutrition in Ireland is developing You can learn more and get lots of useful schools to develop and implement their own It was essential to have involvement from rapidly and many innovative and highly effective information on our website www.ppsg.ie healthy lunch policy that is unique all parties to ensure the success of this health promotion projects are being If a Polio Survivor wishes to talk she or he to their school. important project.” implemented all over the country. We contact Karen Holmes at: The ‘Munch & Crunch Healthy Lunch Project’ is “216 schools in counties Wexford, Waterford are delighted to receive recognition of the Telephone: ( 01) 873 0338 the result of the work of a collaborative team lead and Kilkenny have now developed and hard work of dietitians working on the Fax: ( 01) 8726839 by Susan Higgins which includes health implemented a healthy eating policy. When the ground in communities.” Email : [email protected] Mater Wins Customer Plans for Ireland’s First Services Team of the Year 2006 Children’s Hospice he Mater Misericordiae University Translink and Ulster bank. lans for Ireland’s first Children’s accommodation, will be built at Leopardstown Hospital Patient Services Department In winning the Customer Service Hospice were viewed by An Taoiseach to provide more Respite Care and Residential T was declared the Customer Service Team of the Year Category the Mater P Bertie Ahern TD in July when he visited Care. The Capital Development Budget is Team Of The Year 2006 in June. Misericordiae University Hospital Patient the Children’s Sunshine Home. €9m and both the Children’s Sunshine Prior to announcing the winner, Claire Services demonstrated commitment to In Ireland, there are an estimated 1,369 Home and Laura Lynn have been actively Byrne, Master of Ceremonies (TV3 News) high standards of customer service both children with life-limiting conditions, with an fundraising for some time. said: “The winner is a team that represented a through personal dealings with customers average of 354 children’s deaths per annum. Speaking about the plans, Philomena Dunne, tradition of serving the public throughout many and by contributing to the overall customer The Children’s Sunshine Home was started CEO of Children’s Sunshine Home said: generations. Despite their long and proud care policy by their involvement in to help these children and their families. “We are responding to the needs of the times, history they run an operation that is both caring communications, problem solving Ireland’s first Children’s Hospice called Laura currently we have 53 children attending, with and yet modern and forward looking in their and innovation. Lynn House will be able to support over 300 demands for up to 2/3 children requiring attitude to service.” Congratulations and well done to families across Ireland a year. The Laura Lynn palliative support per month. This has a knock- The judging panel, chaired by Don Hales of Phil O’ Neill, Clinical Support Manager, House Paediatric Palliative Care Unit will provide on effect and reduces the amount of respite Quest Media, included representatives from Nuala King, Deputy Patient Services Manager/ eight bedrooms along with living facilities care available. Unfortunately we only have Hibernian Insurance, Institute of Customer Complaints Manager, Rebecca Byrne, Cora as well as four family apartments, to enable capacity for 5 respite places at any one time Service, Kerry Group, DRM, Bank of Ireland, Herbert, Johanne Hanevy, Patient Liaison relatives to be close to their children. These and currently can only serve the east coast Irish Greyhound Board, Ladbroke Ireland, EIQA, Officers, Patient Service Department, units will be an essential component of the of Ireland. So we will be delighted to provide American Chamber of Commerce Ireland, Suzanne Lawless, Routine Access Officer Palliative Care Programme. A further three support and comfort to over 300 families Merchants, Irish Life, Dublin City Council, and Barbara Drew, Personal Assistant. units, each with eight bedrooms and living when building is complete in early 2008”. p22 Healthmatters Autumn2006 Autumn2006 Healthmatters p23 Healthmatters Healthmatters

Athlone Student Wins HSE Sponsored Competition to Create New Cinema Advertisement for Samaritans

design student at Athlone Institute cinemas in the HSE Dublin Mid-Leinster of Technology (AIT) has won a region from this autumn. The adjudicating A competition to create a new cinema panel included representatives of Carlton advertisement for the Samaritans. Linda Screens, the Samaritans, the National Office Galvin, from Ballina, Co. Mayo, is a third year for Suicide Prevention and the HSE’s Suicide student on the BA (Hons) in Design in Visual Resource Office. Communications. As well as the prestige of The HSE Dublin Mid-Leinster region has the Samaritans are targeting. The Samaritans have recently launched being the competition winner, Linda also picks supported the Samaritans Helpline for a number Cinema advertising has proven particularly a texting service to add to their existing up a cheque for €1,000, sponsored by the of years by means of a cinema advertising effective in creating an awareness of the helpline and email listening service to try to Suicide Resource Office of the local Health campaign. When the decision was made earlier Samaritans’ service. Over half of those meet the needs of the population who avail of Service Executive. this year to renew the advertisment, third questioned in an evaluation were able to recall this service. In the Midlands the Samaritans The advertisement is based on the creative level institutes were invited to get involved. By details of the previous advertisment. The age have a drop-in centre at 3 Court Devenish, concept of a poem that Linda wrote and bringing this project into the colleges it was profile of the cinema-going population shows Athlone. The Samaritans can be contacted on showcases the actual writing process. The hoped to create an awareness of this service that 40% are under the age of 35, which is 1850 60 90 90 or by text 087 260 9090. voiceover is provided by another AIT student, amongst that specific population, while also similar to the age profile of those at greatest risk The Suicide Resource Office can be contacted Finn Conlon. The advertisement will air in getting a design concept from the age profile of suicide in this country. at 057 866 4513. Galway/Donegal Network Mountmellick in Race for Breast Care Services Against Waste he HSE has concluded a review of options symptomatic breast disease service. t Vincent’s Hospital in Mountmellick, Co. Laois for the future provision of breast services The network will allow for the service in is participating in the Race against Waste T for Donegal. This review was based on the Letterkenny to be maintained and developed in a S environmental project.. commitment to develop a sustainable model for manner that is consistent with the objective of the Information about the project has been made available the provision of a high quality accessible service National Cancer Control Strategy. through a series of waste management workshops for Donegal patients. It will be quality assured by appropriate encouraging everyone to reduce, reuse and recycle. It has been decided to proceed with the review and audit systems. This decision marks a Everything that can be recycled is recycled including provision of breast care services within a significant development for breast services and paint tins, glass, paper and scrap metal. All hospital food framework that merges the Regional Breast Care will establish the first review and audit driven waste goes for composting. Grass cuttings are mulched Unit at Galway Regional Hospitals with that at service nationally. and old clothes, furniture and equipment is given to Helping the Race Against Waste Project Letterkenny General Hospital. This will allow for It is intended to appoint a permanent surgeon charities and overseas agencies for re-use. at St Vincent’s Hospital, Mountmellick are from (L to R): Ann Norton, Lucy Campbell a managed clinical network to be established, with a special interest in breast surgery who will be The hospital was recently featured in an RTE Nationwide and Derek Alcorn. operating to defined standards and protocols for primarily based at Letterkenny General Hospital. report on its progress in the Race against Waste. HSE Pilots The Health Parenting Services Innovation Programme Awards 2006 for Travellers record number of entries have been and communications. received for the 2006 National Health Expressions of interest were invited from all Pictured at the First Parenting pilot programme at programme titled Encouraging Your the Birr training centre were from (L to R): Margaret A Innovation Awards. More than 250 public organisations that make a positive Child’s Development was recently Sheridan, Director, Jacinta Nolan, Senior Clinical entries were examined and the applications contribution to health. piloted at the Senior Traveller Training Psychologist, HSE, Tracey McDonagh, Learner, have now been short-listed to 16 finalists. There are awards for each category winner, A Patricia Martiensson, Public Health Nurse and Centre in Birr, Co. Offaly. Winnie Doyle, Learner. special merit award and certificates. There will The programme was delivered by the There are four entry categories be one overall winner. HSE Laois/Offaly Psychology Department 1.General Innovations in the community to A perpetual trophy will also be awarded to the and directors of public health nurses in the and bereavement issues were also covered in promote principles of the health strategy most popular entrant, voted by other entrants Birr Training Centre, in partnership with the the programme. 2.General Innovations in health facilities to – The Derek Dockery Popular Choice Award. The Travellers and Offaly VEC. The course content was adapted to take promote principles of the health strategy award ceremony will take place in Dublin Castle Held over a six week period, the course account of and acknowledge the lifestyle, 3.Innovations involving new collaborations on the 11th October 2006. covered such topics as attachment, relationship attitudes and value systems of both Travellers between/across health services/agencies/ If you require further information please contact building, communication and behaviour and settled family lifestyles and how they blend sectors/borders/organisations email: [email protected] management. Bullying, body image, depression and harmonise with one another. 4.Innovations in management, technology Phone: 6201820 p22 Healthmatters Autumn2006 Autumn2006 Healthmatters p23 Healthmatters Healthmatters

Martina Marron, Clinical Nurse Specialist, Reduce Your Risk Cavan General Hospital. of Bowel Cancer

ost of us at some time in our lives condition know as polyps or adenomatous Treatment experience problems with our polyposis your risk is increased. For the majority of people with bowel cancer bowels. There are many common > Ulcerative Colitis or Crohn’s Disease - People surgery is performed. The section of the bowel M  conditions that affect the health of our bowels. with ulcerative colitis or crohns disease are containing the cancer is removed. Most people Most people with symptoms do not have bowel at increased risk. who have surgery for bowel cancer do not cancer but if you have bowel symptoms that require a colostomy (an opening from the bowel persist, you should see your doctor and have it Reduce your chances of onto the abdomen, an appliance (bag) is worn to checked out. developing bowel cancer! collect bowel motion). However, in some cases If diagnosed and treated early bowel cancer If there is a history of bowel cancer in your a colostomy is necessary. is one of the most curable of all cancers. Early family, if you have polyps in the bowel or if you Chemotherapy (drug therapy) and or warning signs of bowel cancer are easily have ulcerative colitis or crohn’s disease you radiotherapy (x-ray treatment) may be used overlooked and even when recognised can be may be at greater risk of developing bowel in addition to surgery or occasionally as an difficult to talk about. cancer and should consult with your doctor who alternative to surgery. can advise you on screening. Don’t let embarrassment stop you from What to watch out for Eat healthy, limit intake of high fat foods, eat seeking medical advice.

> A change in bowel habit such as more fibre, fresh fruit and vegetables. Be active Surely a little embarrassment isn’t potentially constipation or diarrhoea that lasts more – take regular physical exercise. worth dying for.

than a month. > Don’t smoke. > A feeling that you need to pass a bowel > Drink (alcohol) in moderation. Bowel cancer claims the lives of   950 people in Ireland each year. motion that is not relieved by doing so. > If overweight – lose weight until you reach a > Bleeding from your back passage or blood in healthy level – maintain it. Further information on bowel cancer is your bowel motion. available from: How is Bowel Cancer Diagnosed > Pain / discomfort in your abdomen or back passage. If you are referred to hospital for investigations The Irish Cancer Society Free phone 1800 200 700 > Weight loss with no obvious cause. you are likely to have one or more of the following tests. Website www.cancer.ie What causes bowel cancer Sigmoidoscopy / Colonoscopy – a thin > In many cases the cause of bowel cancer is flexible tube with a camera on the end is used Beating Bowel Cancer (UK) unclear, however the following factors are to look inside the bowel. You will be given Phone 0044 20 8892 5256 believed to increase your risk of developing laxatives beforehand to ensure your bowel is Website www.beatingbowelcancer.org the disease, clear. Usually sedation will be given prior to

> Family History – If you have a close family the procedure. If any abnormalities are seen a American Cancer Society member with the disease you are more at biopsy (piece of tissue from the bowel wall) is Website www.cancer.org risk. taken and analysed in the laboratory.

> Diet – Evidence suggests that if your diet is Barium enema is a special x-ray of the Acknowledgements high in fat, protein and calories and low in bowel. Laxatives are taken to clear the bowel I wish to thank the following organisations for fibre, fresh fruit and vegetables you increase beforehand. A special liquid is passed into information provided, The Irish Cancer Society your risk. the bowel via a thin tube inserted in the back and ‘Beating Bowel Cancer’ (UK organisation).

> Lifestyle – Obesity, smoking, high alcohol passed, x-rays are then taken. intake and lack of physical exercise are Remember the vast majority of people Martina Marron, believed to increase your risk. who have bowel investigations do not have Clinical Nurse Specialist,

> Polyps – If you or family members have a bowel cancer. Cavan General Hospital. North Dublin Athletes Triumph in Belfast thletes from the Estuary Centre in north The athletes trained hard all year and Dublin recently returned from a Special participated in four events - swimming, five-a- A Olympics event in Belfast with almost side football, athletics and bocce. 30 medals. Members of the Estuary Centre staff The athletes, who were part of the Eastern congratulated all the athletes on their excellent Region Special Olympics team for 2006, performances and wished them the best of luck achieved 13 Gold, two Silver, 14 Bronze and one for the future. Ribbon at the games. The Estuary Centre is part of Eve Ltd, a The Estuary Centre squad was: subsidiary company of the HSE that provides Swimming Carol Norton and Mary Mc Guirk. training for people with intellectual disabilities. Football Darren Barnes, Anthony Murray, The training is designed to equip the Gary Fitzsimons, Matthew participants with personal, social and work Colgan, Roy Quinn, Chris O'Neill, related skills which will benefit them to integrate Sean Conroy and Derek Mahon. into the wider community, becoming more Bocce Dessie Brady, Linda Mooney, independent and improving their quality of life. Carol O’Rourke and Nineteen Estuary Centre athletes ranging in Joe Cosgrove. ages from 30- 63 years participated, providing Athletics Janet Hogan, Pat Conroy, a clear indication of the inclusive nature of the Fiona Cobbe, Pauline Rush Athletes from the Estuary Centre show off their medals Special Olympics. and Mary Finnegan. p24 Healthmatters Autumn2006 Autumn2006 Healthmatters p25 Healthmatters Healthmatters

60m facility Cork Opens at Podiatrist Provides Dublin’s Training St. Vincent’s in Albania

The Chairman of St. Vincent's Hospital, University Prof. Noel Whelan with Minister for Health and Children Mary Harney TD. Hospital he new Clinical Services Building, the Department, Day Care Unit, Operating centrepiece of the €250m redevelopment Theatres, Day Surgery Theatres Tproject at St. Vincent’s University Specialised clinics and care facilities to Michael Kenning, Senior Podiatrist, North Cork Community Podiatry Service, performs nail surgery in Albania Hospital, Dublin was officially opened in July. include many new specialist clinics for closely filmed by Dr. IIir Shani. The €60m, 14,000sqm, 5 storey over- breast, Hepatitis C, liver transplant and basement building is designed to accommodate liver related activity and special clinic ork colleagues were among those and with the consent of the hospital director the renewal of all the major treatment and facilities for Cystic Fibrosis patients and who supported north Cork podiatrist and town doctor, Dr Lek Leshi, he undertook diagnostic areas of the hospital and create an related respiratory disorders W Michael Kenning when he made both total and partial nail procedures, and Ambulatory Day Care Centre for outpatient one- > Emergency Department a recent trip to Albania where he provided also assessed and advised locals on a range day procedures. > Operating theatres training in nail surgery techniques to hospital of foot problems. The new building will cater each year for in medical staff. Nail surgery records and advice sheets had excess of 40,000 A & E attendances, including Previously completed buildings Michael was based for two weeks in the been translated into Albanian, and Michael 10,000 admissions, 100,000 outpatients and as part of overall project on the isolated town of Fushë – Arrez in the north worked closely with translators during 15,000 day care patients, four million pathology campus are: of the country and in the City of Durres, assessment and treatment. Dr. Lleshi was tests and in excess of 120,000 x-rays. > BreastCheck building for National Breast Albania’s seaport. very enthusiastic and was presented with a Screening Programme Conditions in Fushe-Arrez are basic with range of instruments and dressings at the

The facility will greatly > 54 Bed Psychiatry Unit poor infrastructure, marked poverty and end of the visit. improve patient-focussed > Pharmacy building unemployment. Medical services in the town Michael was joined on the trip by David delivery of care, providing > Mortuary/post-mortem facility are minimal, and the hospital is dilapidated Barnatt, a private podiatrist from England. accommodation for the > New Road and Surface Car Parking and lacks facilities. Michael had identified They would like to thank everyone who following departments: > Waste marshalling facilities nail surgery as a useful way they could provide supported the trip including Hans Bakker > ICU & HDU Departments: 16 beds > Extensive landscaping and infrastructural a free service to the locals and also liase with and Canonbury Healthcare, David Watterson works > Radiology & Diagnostic Imaging Services local Albanian medical staff and working and Imelda Cunning from North & South Lee The redevelopment is funded principally by > Pathology Department through a local church and charitable Community Podiatry Service, and the staff of Ambulatory Day Care Centre: - Outpatient the National Development Plan. foundation – Christian Centre Fushë – Arrez, North Cork Community Services. > Waltzing, Salsa, Jive, Foxtrot and Line Dancing in the North East programme. Dancing for fun and enjoyment is a great way to keep active and meet new people. As well as being a great workout for your heart and lungs, dancing is fantastic for improving mobility, posture and co- ordination, and is one of the best natural remedies to beat stress and depression. Instruction in Waltzing, Salsa, Jive, Foxtrot and Line dancing was provided by Everna Corcoran-Mills of Dublin Dance School. Kay O’Sullivan John Doyle, Chairperson of Corduff Rafarigh Active Retirement Group, said: “The day was Retires as socially significant for participants as it is very important for older adults to meet with each other. Some members of our older community Director of never get a chance to meet up but these dance events leave a very impressionable friendly and Nursing at Cork relaxing environment for people to engage with each other. Days like this help build self-esteem University Hospital and confidence creating a greater sense of dependency and fulfillment in life”. ay O’Sullivan, Director of Nursing, Cork The ‘Vintage Dance Day’ is a part of the University Hospital retired after 41 years overall ‘Go for Life’ physical activity and with the health services recently. Kitty and Paddy Bowden, Dunleer step it out at the Vintage Dance Day for the older adults in the Dunleer sport programme that has been running K Recreation Centre, Co. Louth A function held to mark Kay’s retirement was successfully in the north east since 2002. The attended by many staff, past and present, from programme includes physical activity leader Cork, Kerry and Waterford. ore than 300 people in the north successful ‘Vintage Dance Days’ for older adults training (PALs), physical activity presentations Many tributes were paid to Kay who was east recently joined health held by the HSE Health Promotion Department and sports fests. thanked for the great contribution she has M promotion professionals in days in the north east. The HSE in the north east in partnership made to nursing and patient care over the years. of fun and laughter by means of dancing the The main aim of each event was to with Monaghan County Council has recently Her management colleagues, staff and a good old days! highlight various types of dance to participating secured cross-border funding to run a series of wide circle of friends wish her well for many Members of active retirement and older groups thereby encouraging dance as a form Sports Fests for older adults during 2006/2007 years ahead. adult groups attended a series of highly of physical activity into their active retirement and details are to be announced later in the year. p24 Healthmatters Autumn2006 Autumn2006 Healthmatters p25 Healthmatters Healthmatters Rise in Falls and Injury Awareness Following Team Project in North Dublin

wareness about risks of falls and injuries that make the programme successful. showed the commitment of St. Monica’s to the for residents increased among staff after The main areas the programme addressed programme. A a multidisciplinary team project was were risk factors for falling in relation to Staff also received training on nutrition for carried out at St Monica’s Age Related Health residents themselves, the environment in St. older people. Nutrition guidelines for the unit Care Facility in Dublin’s north inner city. Monica’s, and staff training and education. were drafted and circulated to residents and Staff from St Monica’s, the HSE Dublin/ All resident’s received regular medical reviews their families. Feedback was provided and the North East Health Promotion Service and the and emphasis was placed on re-assessing nutrition guidelines are now displayed in the Physiotherapy and Occupational Therapy service medications and the need for Calcium and unit. A weekly menu cycle was developed in Dublin North Central joined together to Vitamin D supplements. An Optician came to the and displayed. explore how the risk of falls and injuries among unit to examine all the residents and the quality The programme was evaluated in a number residents could be reduced. of life has improved for some residents with the of ways. A major outcome has been the Kathleen O'Sullivan, resident, and Leonora Kiernan, Care Attendant, St. Monica's Home provision of new glasses which has enabled increased awareness of staff around the issue Accidental falls and injuries them to read better. of falls in St. Monica’s. As a result changes Falls are the leading cause of accidental injury Residents who are at high risk of falling in work practices have occurred in the unit. among older people, and people living in received individual physiotherapy and For example the speedy reporting of faulty Study of cost of falls in residential settings are more at risk of falling occupational therapy assessments and follow up. equipment and the immediate replacement older people at CUH than people living in the community. With this in Physical activity sessions are also run in the unit. of light bulbs when required. Doctors who recently published a survey mind a multidisciplinary team led by Bernadette An audit is now being conducted to ensure in relation to falls, in those aged over 65 Rooney, from the Health Promotion Service was A general environmental all elements of the programme have been years, found that it costs Cork University established to examine the issues around falls assessment was conducted. implemented in so far as possible. Hospital €10.8 million annually to treat and to oversee the falls and injury minimisation Changes made included: This is an excellent model for use in residential these patients. Calling for a nationwide programme at St Monica’s. The team started The use of higher wattage bulbs in the lift settings and has been initiated in two more falls prevention strategy, Drs Paul Cotter

their work by reviewing the number and types > Refurbishment of the garden area for residential units in the north Dublin area. and Denis O’Mahony found that some of falls at St Monica’s, and looking at the disabled access with specialised seating For information contact: 810 admissions to CUH during the year long survey were as a result of falling. The research on falls programmes for people living > The application of contrasting colours on Bernadette Rooney in residential care facilities. the walls and floors of the unit when it was Tel: 01-8823410 average length of stay for each patient repainted E-mail: [email protected] was 11 days and 10% of older people had The falls and injuries to be readmitted to hospital in the year minimisation programme Staff training and education Websites of Interest following the fall. Some 80% of those From the research a falls and injury minimisation All staff in the unit were involved in the Additional information on the prevention admitted had suffered a fracture; one half programme was established. The programme programme and one of the aims of the staff of falls can be obtained from: of fractures occurred at the hip joint. It was based on model used in Australia and training was to highlight that all staff have American Geriatrics Society cost €14,339 to treat a single hip fracture contained a fall risk assessment tool that was a role in minimising falls and injuries. Four (www.americangeriatrics.org/education/forum) following a fall and these patients were validated for use in a nursing home setting. The staff training sessions were run. Feedback NSW Health Department less likely to be discharged, the study programme has a number of elements to it and from participants was very positive. The high (www.health.nsw.gov.au) Report on found. it is the combination of all the elements together number of staff who attended training sessions Preventing Injuries from Falls in Older People New Therapeutic Day Centre in Waterford Improves Care for the Elderly

new €400,000 Therapeutic Day Gee, General Manager, Waterford Community Centre was officially opened in June Services, said strides were being made all A at St. Patrick’s Hospital, Waterford. the time as regards having the best possible Funds from the HSE, the Friends of St. equipment in place in the most comfortable of Patrick’s Hospital Committee and the proceeds surroundings to aid the patients in the care of of the annual Waterford City Mayor's Ball trained staff. combined to provide the new facility for She said the HSE very much appreciated elderly patients. the support of the Mayor and the Friends Speaking at the official opening, Mayor Ald. Committee in ensuring that St. Patrick’s Hilary Quinlan, said the vital role played by continued to serve the people of the city of physiotherapy and occupational therapy in the Waterford and surrounds in providing a 122 care of the elderly at St. Patrick’s Hospital would bed hospital (including four respite, 20 be enhanced by the benefits the new facility rehabilitation and 98 long stay beds) and would bring. physiotherapy, occupational therapy and € Mayor Quinlan - a former Chairman of the reminiscence therapy. Pictured at the presentation of a cheque for 200,000 from the Friends of St. Patrick’s Hospital towards the funding of the new Therapeutic Day Centre were (L to R): Michael Rowe (Treasurer, Friends of St. Patrick’s Hospital South Eastern Health Board - praised all of Dermot Halpin, Local Health Manager, Committee), Eamon Griffin (Chair, Friends of St. Patrick’s Hospital Committee), Mayor of Waterford Ald. Hilary those who had worked so tirelessly to develop Waterford Community Services Area, Joe Quinlan, Bridget Roche (CNM 2, Our Lady’s Ward at St. Patrick’s Hospital), Joe Mooney (Manager, St. Patrick’s Hospital), Frances Hickey (Secretary, Friends of St. Patrick’s Hospital Committee), Una Denton (Rehab Aide, St. Patrick’s Hospital in recent years - especially Mooney, Manager, St. Patrick’s Hospital & St. Patrick’s Hospital), John O’Brien (Friends of St. Patrick’s Hospital Committee), Anne Coyne - Nevin (Acting members of staff and the Friends of St. Patrick’s Waterford Elderly Services and Anne Coyne Director of Nursing, St. Patrick’s Hospital), Anne Kennedy (Director of Nursing, St. Patrick’s Hospital), Jim Hospital Committee. Nevin, Acting Director of Nursing, St. Patrick’s Hennessy (Friends of St. Patrick’s Hospital Committee), Anne Skeete (Acting Assistant Director of Nursing, St. Patrick’s Hospital) and Dr. Josie Clare (Consultant Geriatrician, St. Patrick’s Hospital). Speaking on behalf of the HSE, Annette Hospital also attended. p26 Healthmatters Autumn2006 Healthmatters Healthmatters

Big Step forward in Mental Health Services Development

ignificant changes in the way mental health services provisions of the Act targeting service users, family and carers, adherence to high standards and best practice in mental health are delivered are to come into effect before the end of wider health service staff and other stakeholders from the care in Ireland,” Mr Rogan added. S the year. community. This will be delivered by HSE staff on a nationwide He said the development would enhance the protection of the The trigger for these changes will be the implementation basis. rights of those who use mental health services and contribute to of the remaining sections of the Mental Health Act 2001 by A group is currently working on developing clear and the achievement and maintenance of high standards and best commencement order on November 1st next. consistent advice to assist local services in reviewing and practice in mental health care. From this date there will be a regulatory framework for developing policies and procedures. Commenting on the full implementation of the legislation “approved centres” within which mental health services Commenting on preparations for the full implementation of Mary Harney TD, Tanaiste and Minister for Health and Children can be delivered. Such centres and the delivery of care and the legislation Martin Rogan, National Care Group Manager said: “This represents a major step forward in the development treatment in them will be governed by regulations issued by for Mental Health, said: “HSE mental health service staff have of our mental health services. The introduction of mental health the Department of Health and Children and by rules issued by worked exceedingly hard particularly over the past year to tribunals to review all involuntary admissions represents an the Mental Health Commission. prepare for this new era and are to be commended for the important step in the protection of the interests of people who In addition the Act provides that where a person is admitted way they have embraced this change. I would like to pay suffer from mental disorders.” to an approved centre for care and treatment against their will tribute in particular to all those who have had a key role in The Tánaiste thanked the HSE and the Mental Health for their own protection and the admission will be examined and this project, the project team and national liaison group, Commission for their work to date in this important area. adjudicated on by a Mental Health Tribunal established for the our cohort of trainers, those who were involved in working “I look forward to the full implementation of the Act, which will protection of the rights of the detained person. groups, service users and carers and their organisations and have a major positive impact on the lives of a vulnerable group in Preparations for the full implementation of the legislation staff and professional associations, the Mental Health our society,” she said. include: Commission and the Mental Health Division of the Department HeBE established an Implementation Project in 2004 to assist

> Provision for the development of 18 new consultant led of Health and Children.” mental health services and associated health services to prepare multi-disciplinary teams in mental health and the further Different working groups within the HSE have been addressing for the changes required by the legislation. A project team was enhancement of 14 other mental health teams to improve the various aspects of implementation including training and appointed to act as a technical advisory group to the project and capacity of services to deliver high quality interventions. information, additional staffing requirements, the needs of membership reflected the range of disciplines and management

> A two-day training programme designed by the Mental particular service user sub groups, policies and procedures, involved in mental health care as well as G.P. and service user Health Commission has been delivered by HSE trainers I.T requirements and other technical aspects of the new interests. A national liaison team was also established consisting to 5,300 mental health and allied staff. A one day training requirements. of senior managers from each of the former Health Boards to programme will target a further 4,000 staff. “The implementation of the remaining sections of the Mental ensure that the change process would be led and facilitated at

> Facilities have been developed in each relevant inpatient site Health Act 2001 constitutes a significant moment of change local area level. Under the chairmanship of Martin Rogan both for the holding of tribunals. in the way in which mental health services are delivered and these groups have delivered an extensive programme of action to Preparations are underway for an information campaign on the marks the beginning of an era of enhanced accountability and ensure HSE readiness for the new situation.

Health Professionals Society and PCCCD also Working Group Established to Identify attended. Professor Hay outlined how Reader Survey Requirements of People With Arthritis the rheumatology service had developed in Stoke. Some of the key points she outlined were: Draw Result > Condition-specific clinics for follow up can Thank you to all those readers who be very effective and, with the right supports, completed our Reader Survey in can be delivered on outreach basis the last issue. The lucky winner of a

> Good communication and agreement Weekend Break in a Brennan Hotel is between primary and secondary is central. In Grainne Murphy, Disability Services, Stoke, this has enabled agreement with local HSE South, Blackpool, Cork. GPs to use a standard pro-forma for referral and an agreed urgency scale

> One of the cultural differences between primary and secondary care that has Contributions Wanted! emerged in Professor Hay’s experience is Why not write or suggest an article or that hospital consultants tended to feature for the next edition of Health Members of the HSE Working Group on Services for People with Arthritis and Related Conditions, pictured with emphasise diagnosis while primary care Matters and help keep us updated on Prof. Elaine Hay, Keele University and John Church, CEO, Arthritis Ireland (L to R): Dr. Regina Kiernan (Public practitioners’ emphasis was on managing Health Specialist), Louise McMahon (Network Manager and Chair of Working Group), Deirdre Crowley (NHO), what’s happening in health around Prof. Oliver FitzGerald (Consultant Rheumatologist), Noralee Kennedy (Irish Rheumatology Health Professionals pain and disability. This underpins the the country? If you are interested in Society), Prof. Hay, Claire Kinneavy (Arthritis Ireland), John Church, Dr. Sinead Harney (Consultant importance of working at building mutual a service, development or initiative Rheumatologist) and James Conway (National Care Group Manager) understanding being highlighted contact any member > It is important that clinical service of the HSE’s Communications team Working Group has been established by along with the different disciplines involved in developments are underpinned by academic for assistance. You can also write the HSE to identify clearly the current providing services to people with arthritis and / research posts (including medical, nursing to us at Health Matters, Internal Aprovision and future requirements of the related conditions. These disciplines include and allied health disciplines) Communications, Health Service health and social care system for people with Consultant Rheumatologists, nursing and allied > Consultant rheumatologists in the Stoke Executive, Dr Steevens’ Hospital, arthritis and related conditions. health professionals, PCCCD and population service have played an important role in Dublin 8. Alternatively you can email The Working Group on Services for People health specialists. supporting the expansion of the role / us at: [email protected] Please with Arthritis and Related Conditions, chaired Elaine Hay, Professor of Community scope of specialist nurses and allied health make sure to provide your name, work by Louise McMahon, Hospital Group Manager, Rheumatology at Keele University recently made professionals. address and telephone number in National Hospitals Office, was formed as part of the journey to Dublin to meet with the HSE > Demand management has been crucial. correspondence. Articles may be edited its commitment to develop integrated services Working Group and to address a meeting of the The triage system in the Stoke service or cut. The deadline for the next issue is for patients with chronic illness. Irish Society for Rheumatology. Representatives was first introduced around back pain. October 31, 2006. It brings together patient representation from Arthritis Ireland, the Irish Rheumatology Multidisciplinary clinics work well there.

Autumn2006 Healthmatters p27 Healthmatters

Five Fold Increase in Parents Urged to Educate Renal Disease Predicted Themselves on Drug Misuse

across the country. “Drug misuse can be a confusing and daunting subject for many parents. We hope this DVD can provide clarity on the topic and give families clear information and advice. In many cases, parents have no idea of what drugs are available or how to recognise the signs of drug misuse in their own children. Launching the campaign South Dublin TD Liz O’Donnell said drug misuse was an issue every family should discuss. Dr. Ide Delargy, Director of the Drug Misuse Programme at the Irish College of General Practitioners, supported the project saying: “I am delighted to welcome this DVD, Empower, as a particularly useful educational tool. The consequences of substance abuse are dealt with in a realistic and measured way and Tom Needham, HSE Addiction Councillor speaking at the launch of the Empower DVD. I am sure that the issues addressed in this DVD will generate discussion for parents and young new drug awareness campaign, people alike. launched in June, is urging parents to “It would be particularly useful to see Aeducate themselves about drug misuse this DVD in school libraries and used as a and discuss the issue with their teenage children. resource to increase awareness of the growing Empower: The family guide to understanding problem of substance abuse.” drugs in Ireland is a 30-minute DVD aimed at Irish Library Council Director Norma parents and teens which is available on loan McDermott said her organisation was pleased Speakers at the CAWT cross border seminar on renal disease (L to R): Dr. Kieran Hannan, Consultant from local libraries throughout the country. to support the project. Nephrologist, HSE Dublin North East; Deirdre Keown, CAWT Project Manager and Dr. Peter Garret, It is the story of one Irish teenager’s “Public libraries have always had a Consultant Nephrologist, Sperrin Lakeland Trust. experience with drug misuse and offers advice mission to provide trusted, reliable and relevant on the signs of drug addiction and a guide to information for people, information that can recent EU funded cross border seminar Dr Austin Stack, Consultant Nephrologist drug terms and language. contribute to health and wellbeing in the widest on renal disease highlighted that with the Regional Kidney Centre in HSE West, HSE substance misuse counsellor Tom sense. The library is the ideal environment to A serious kidney disease in Ireland is highlighted significant statistics on the growth Needham said Empower DVDs would be access information on this important issue.” predicted to increase five-fold over the next of renal disease in Ireland. He said “of a available for loan at each of Ireland’s 382 local The campaign was developed by the HSE ten years. combined population on the island of Ireland of libraries, and campaign posters had been and the Tipperary Regional Youth Service Currently there are approximately 1,740 almost six million, we have an estimated distributed to more than 1,000 health centres, (TRYS) and is supported by Schering-Plough people in Ireland, North and South, suffering 300,000 who have kidney disease” youth clubs and community organisations Pharmaceuticals (Ireland). from end stage kidney disease. By 2015 this Professor Peter Maxwell, Consultant number will have increased to 7,050. Organised Nephrologist from Belfast City Hospital, by Co-operation and Working Together (CAWT), provided an overview of current services to the cross border health and social care patients with kidney disease and outlined the End of an Era at partnership, this event brought health best way forward in the future for optimising professionals together from both sides of the services. border, to discuss and agree joint approaches in He said “accurate renal epidemiology is vital to St. Canice’s Hospital the treatment of kidney disease. predict future service needs”. Describing the Dr Peter Garrett, Consultant Nephrologist CAWT eMed Renal System as a sound he last remaining mental health patients By the 1980s, the emphasis on Mental Health from Tyrone County Hospital said: “The investment, he also called for “a high level review from St. Canice’s Hospital building in Care changed from an institutional to a management and treatment of renal disease is of Renal Services in order to match funding for T Kilkenny were recently relocated to more Community Care model. This resulted in a one of the fastest growing areas of medicine in workforce and facilities with patient needs”. modern surroundings in St. Gabriel’s Unit where dramatic decrease in the numbers of inpatients. this country, which requires all health Professor Maxwell said that the 22 patients are accomodated. St. Canice’s Hospital was caring for 90 patients professionals to have a co-ordinated response unprecedented growth of dialysis capacity is The original St. Canice’s Hospital building by the time a new 45 bed Acute Psychiatric Unit regarding its future treatment delivery. We aim fuelled by historic under provision, an ageing is now being utilised for a variety of Mental opened at St. Luke’s to develop collaborative strategies to address population and the epidemic of diabetes. Health services including a Day Hospital, General Hospital in identified deficiencies, leading to continuous “Efforts should be increased to target accommodation for Support Staff, exercise hall, 1993, which caters for quality improvement and enhanced health primary and secondary prevention of chronic catering, laundry and associated services and people from counties within the community”. kidney disease which would be cost effective” accommodation of offices of the HSE South. A Carlow and Kilkenny. One such innovative cross border project, he said. new Children’s Physiotherapy and Occupational Mary O’ Hanlon, profiled at the seminar by Project Manager Renal patient Karl Cronin, described his Therapy area was opened last year and is HSE South’s Manager Deirdre Keown, will enhance patient care when experiences, and asked for an increased expected to be expanded later this year. for Elderly Care and completed. The project involves six hospitals awareness of the need for organ donation. He The predecessor of St. Canice’s Mental Mental Health Services located close to the border, actively encouraged all to promote the carrying of organ Hospital opened its doors in Kilkenny on in the Carlow/Kilkenny collaborating in sharing clinical information as donor cards. 1st September 1852, when 54 patients were Community Services part of a professional network. The six hospitals, Dr Kieran Hannan, Consultant Nephrologist transferred from the Carlow Asylum. The hospital Area, said she was Cavan General Hospital; Sligo General Hospital; at Cavan General Hospital, told the audience initially had accommodation for 150 people. With delighted that plans Letterkenny General Hospital; The Altnagelvin that the number of renal patients being dialysed increased demand for accommodation in the for purpose built Group of Hospitals in Derry; Tyrone County is now double the figure from 2000, however the years which followed, several extensions were accommodation in modern surroundings for the Hospital and Daisy Hill Hospital in Newry all number of available organs for transplant has carried out. The early part of the 20th century patients concerned had come to fruition. She now have systems in place to enable sharing remained static. saw large numbers of patients facilitated in St. said great credit was due to the hard-working and comparison of information, that will assist The seminar concluded with a lively question Canice’s, peaking at 550 in 1939. For many years excellent staff in St. Canice’s Hospital, whose in the planning and management of kidney and answer session chaired by Dr Seamus the hospital was almost self sufficient, supplied endeavours would now be greatly assisted by disease treatment. Healy, Consultant Physician in HSE West. from its own farm. the opening of the new St. Gabriel’s Unit. p28 Healthmatters Autumn2006