WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW 2013/14 HEALTHCARE A SHARED SENSE OF PURPOSE CONTENTS
The Value of Communication ...... 1 COVER STORY Vision, Mission, Values ...... 1 A large number of individuals bring a President's Report – From the President's View ...... 2 multitude of skills to form an effective, professional health service. At WWHS many Chief Executive Officer’s Report have joined our ranks from overseas. Linda – The Cutting Edge of Rural Healthcare ...... 3 Knight (walking next to CEO John Smith in A Noteworthy Year ...... 8 the cover photograph), is a typical example. Our Services ...... 16 Linda came to work at Nhill from Zimbabwe following robust support for her migration Community, Volunteers, Donations and Fundraising ...... 18 application from the CEO and executives. Statement of Priorities ...... 21 Having successfully completed the move to Strategic Directions Targeting Health Issues ...... 22 Nhill, Linda soon discovered she was part of a multicultural team that shared a cohesive Statistics Overview ...... 26 sense of purpose that characterises West Financial Performance ...... 29 Wimmera Health Service and the people who Clinical Services ...... 32 work under its aegis. Residential Aged Care ...... 32 Aged Care in Our Community ...... 35 Acute Patient Care ...... 38 HEALTHCARE - A SHARED Allied Health ...... 41 SENSE OF PURPOSE Radiology ...... 43 This Annual Review/Quality of Care Report is Pharmacy ...... 43 an all encompassing report by West Wimmera Dental ...... 44 Health Service to our communities, colleagues and partners. The Report is a comprehensive Disability Services ...... 46 overview of the achievements, successes and Medical Report ...... 49 disappointments for the reporting period 1 Medical and Clinical Visiting Consultants ...... 50 July 2013 – 30 June 2014 and is a companion documents to the Annual Report 2013-2014. Quality of Care ...... 52 Items contained in this report specifically Stories of Quality of Care in Allied Health ...... 52 pertaining to quality satisfy the Victorian Consumer Care and Community Participation ...... 54 Department of Health’s guidelines for reporting the safety and quality of our care. Dimensions of Quality in Residential Aged Care ...... 58 The Report will be released at the 2014 Annual Quality and Safety for Our Patients ...... 62 General Meeting of the Service to be held in the Preventing and Controlling Healthcare Associated Infections . . . . . 64 Nhill Community Centre at 8.00 PM on Friday 21st November 2014. Corporate and Quality Services ...... 66 The Guest Speaker at the meeting will be Dr Peter Environmental Sustainability ...... 68 G. Habersberger AM, a renowned Cardiologist, Occupational Health and Safety ...... 70 long serving member of the Royal Australian Human Resources ...... 72 Naval Reserve. This Report will be available at all sites of West Staff 2013-2014 ...... 73 Wimmera Health Service, by contacting 03 5391 Human Resource Management ...... 74 4222 and can be found on the Internet at www. Staff Service Awards ...... 75 wwhs.net.au/publications Governance ...... 76 Your comments on this publication would be most welcome. Lines of Communication ...... 77 The Board of Governance ...... 78 The Executive Group ...... 80 Clinical Governance at West Wimmera Health Service ...... 82 Accreditation Status ...... 84 Glossary ...... 86 Index ...... 87 Sponsors / Acknowledgements ...... 88 Notes ...... 89 Help Support Your Service ...... 91 Reader Survey ...... 92 Location ...... IBC OUR VISION To establish a health service without peer through the pursuit of excellence and by opening the doors to innovation and technology.
OUR MISSION West Wimmera Health Service is committed to the delivery of health, welfare and disability services which are compassionate, responsive, accessible and accountable to individual and community needs, which result in quality outcomes for the people of the West and South Wimmera, and Southern Mallee.
THE VALUE OF COMMUNICATION OUR VALUES STRONG LEADERSHIP AND This Annual Review overviews the events, activities, management MANAGEMENT and people that represent the performance and progress of West We value our organisation and will encourage exceptional professional Wimmera Health Service during the financial year 2013-2014. skills and promote collaborative teamwork to drive better outcomes for our consumers. The accessibility of the information this publication contains and A SAFE ENVIRONMENT the manner of its presentation are important to us. Safety will always be our prime focus. As a health service it is vital that we tell our story well – to A CULTURE OF CONTINUING IMPROVEMENT our communities, to our staff and to health professionals in The delivery of superior care to our Australia and around the world who may consider joining us. In consumers motivates a culture of quality improvement in all we do. addition we are required to keep the government of Victoria up EFFECTIVE MANAGEMENT OF to date with every aspect of our Service, to make a valid call for THE ENVIRONMENT Our Service is managed in ways benefactors and fundraisers to support the work we do and to which recognise environmental imperatives. an array of suppliers and business relations to demonstrate the RESPONSIVE PARTNERSHIPS professionalism of our organisation. WITH OUR CONSUMERS We maintain a productive The consistent quality of our communications across diverse relationship with our communities and stakeholders through open media channels has been recognised at the highest level for communication, honest reporting and a willingness to embrace its excellence. constructive suggestions.
More importantly it has proved to be an integral component in establishing understanding and support in our communities and helping to grow our Service in scope, scale and quality.
ANNUAL REVIEW 2013/14 1 PRESIDENT’S REPORT
THE PRESIDENT’S VIEW
The central purpose of West Wimmera Health Service is to improve the health and wellbeing of the people in our diverse communities. This Report clearly sets out the progress made towards meeting that imperative.
In my first term as Chair it is with confidence I report to our stakeholders the solid performance of West Wimmera Health Service for 2013-2014, details of which are contained in this Report.
Astute financial management in a STRATEGIES AND PROGRESS Of course the Board could not carry testing economic climate resulted in a out its duties without the unparalleled small Operating Surplus which will make In this, the second year of addressing support and advice of the Chief sure West Wimmera Health Service the Statement of Priorities, an Executive Officer, the Executive retains its role as a key provider of agreement to meet objectives set by the Directors, Managers and the 500 plus healthcare for the communities of rural Department of Health, Victoria, we met people who form the team that makes remote North West Victoria. all and exceeded many of the targets this organisation ‘tick’. set. Each year the Board sets targets I express my gratitude and appreciation to meet its essential imperative by Performance against our Strategic to you one and all and look forward to providing a broad spectrum of services. Directions 2012-2015 policy was strong even greater achievements in the next and has provided a sound base for the reporting year. I am pleased to report our performance progress expected in the coming year. and degree of success against these Performance details against these MOVING FORWARD targets. This included compliance with strategies can be found on page 22. regulatory obligations and, in particular, Given the health reforms set to take the access of our communities to an BOARD COMPOSITION place in the coming year this Service will essential selection of health services. continue to lead rural health care and There were no changes to the The result was excellent and a true retain the diverse nature of services composition of the Board this year, currently available. reflection of the Board's comprehensive however, Darren Walter, who was forethought and planning. appointed to the board on 1st July In accordance with our Vision of being 'a This Report also brings to the forefront 2011, bringing a host of community health service without peer' the board the benefits of instigating our Capital knowledge to the board-table did not is adamant to maintain the Service's Infrastructure Plan to “support the seek re-appointment. Thank you for leadership in providing broad-based, delivery of clinically appropriate your valuable contribution Darren. high quality healthcare for our rural and and cost-effective care in the most remote communities. appropriate setting” . THANK YOU I am privileged to be elected as Chair of this impressive Health Service, and I take the opportunity to thank all Board Members for their commitment of time, Leonie G. Clarke JP energy and undoubted desire to retain President West Wimmera Health Service as a pre- eminent service being able to maintain its social, environmental and financial sustainability.
2 WEST WIMMERA HEALTH SERVICE CHIEF EXECUTIVE OFFICER’S REPORT
THE CUTTING EDGE OF RURAL HEALTH
The diversity of staff, services and facilities at West Wimmera Health Service unite to create an environment of exemplary hospitality and comfort. Our industry-leading systems, assets and work practices ensure our communities receive first-rate healthcare, in a timely and accessible manner close to home.
SUMMARY OF OUR YEAR This union is in the public interest and CAPITAL INVESTMENT we envisage it will offer sustainable This report discloses the activities, health services to the region and ensure In a busy year for capital investment achievements and challenges of West a more effective and efficient use of we have focused on four significant Wimmera Health Service for the public funds. It will also offer increased infrastructure projects: reporting period 1 July 2013 to 30 stable health-related employment in • Completion of the ‘New’ Goroke June 2014. It measures performance the Dunmunkle area. Community Health Centre; against targets, describes the methods Construction of the Natimuk employed in delivering our services, and We now await the Government’s • Medical and Allied Health Clinic; ensures conscientious compliance with approval of this request. regulatory and reporting standards. • Construction of the Allied Health, MEDICAL PRACTITIONER Day Centre and Community Financially, WWHS continues to be Rehabilitation Centre, Nhill; very well placed. This year’s operating EXPANSION Construction of residential surplus of $14,000 was an important We are exploring, in conjunction with • accommodation for students and achievement ensuring patients, Tristar Medical Group, a very innovative staff is underway. residents and clients continue to concept of employing a General experience exemplary services. Practitioner to be based at Nhill Workplaces designed specifically Hospital. General Practitioners in our for the programs and activities they BUSINESS EXPANSIONS Hospitals and Residential Aged Care are to be used for promote efficient Units have Visiting Rights but are not and cost effective work practices. PROPOSED MERGER OF directly employed by the Service. They also provide an environment SERVICES conducive to the delivery of safe, high If the concept comes to fruition it will quality care and it is our premise that Our proposed amalgamation with add a very different dimension to our our planned capital development will Dunmunkle Health Service will see medical services in the support for continue to add value to every aspect increased service delivery as we unite nursing and existing Tristar General of our Service. with them in the provision of top Practitioners, expediting medical class healthcare to the communities reviews diagnostic matters, medical surrounding Rupanyup, Minyip and administration and importantly may Murtoa in the North Western Region be a model for other small rural health of Victoria. services to take up.
ANNUAL REVIEW 2013/2014 3
CHIEF EXECUTIVE OFFICER’S REPORT
NHILL COMMUNITY GARDEN If successful the Appeal will set the All such recommendations have now course of our ability to deliver ever been implemented and we move We have continued working with the improving services in the future. forward confident in the knowledge Hindmarsh Shire Council and Regional that surgical services at Nhill Hospital Development Victoria to expand SURGICAL SERVICES REVIEW will continue to be provided in a safe, the Community Garden. The garden effective and efficient manner. has doubled in size since it opened, In June 2013 the Department of with continued interest from a broad Health initiated a review of procedural MEDICAL SERVICES REVIEW spectrum of community members. services at the Nhill Hospital. The result of the Surgical Services The garden, a very positive community The Review was conducted by an Review has encouraged us, in project, brings many sections of the expert panel of prominent Medical conjunction with the Department of community together in a healthy, Practitioners who visited Nhill Health, Ballarat Health Service and learning and enjoyable activity. It gives to investigate first hand surgical Wimmera Healthcare Group to conduct rise to the integration of many sections processes, including interviewing a similar review for medical services. and many age groups including the Surgeons, General Practitioners and We are presently seeking advice from Karen community and the clients of our nursing staff. the Department about how we should Disability Service. The Surgical Review provided a plan such a review and which eminent We are presently investigating funding resounding endorsement of elective practitioners would be best suited to opportunities to increase rain water surgery at Nhill Hospital, noting that assist with this process. storage at the site to allow the garden “the range of procedural services We are making unflagging efforts to to be expanded. undertaken at Nhill Hospital is ensure what we do is the best course considerable and impressive for a rural of action to guarantee our services are hospital. We do not recommend ceasing FUNDRAISING FOR THE impeccable! FUTURE or changing the range of surgical services at Nhill.” While the Commonwealth and State Governments provide a component A number of recommendations were of our funding, they do not provide a made aimed at enhancing the safety and total financial solution. It is becoming quality of service provided including evident that we will be required to make the purchase of new equipment, increased financial contributions to greater collaboration with the Regional the provision of our services in future Hospital and ensuring that some years. Given this prospect the Board surgeons stay overnight following of Governance decided to embark theatre sessions in order to supervise patients through the important first 24 on a major fundraising initiative, The new Goroke Community Health Centre - an pursuing a $5 million target for use on hours post surgery. example of how fundraising can ensure quality Capital Projects. infrastructure for West Wimmera Health Service This is astute governance.
4 WEST WIMMERA HEALTH SERVICE DENTAL CARE LOOKING TOWARD THE The Review recommended replacing Medicare Locals with a smaller number The Graduate Dentist Program FUTURE of Primary Health Care Networks. funded by Dental Health Service The next twelve months will involve Victoria Voluntary Dental Graduate adapting to significant issues relating As a result the Grampians Medicare Year Program provided two graduate to healthcare reforms in all sections of Local is to be disbanded and the dentists this year. Why was that our Service, and the restructuring of our communities serviced by West Wimmera important? The funding provided the funding sources. Health Service will be incorporated into salary for the graduates and also a the Grampians and Barwon South East mentoring allowance. NATIONAL HEALTHCARE Primary Health Care Network, which will cover an area from Geelong and Ballarat The program assists us to provide REFORM through to the South Australian border ongoing clinical support for new The National Health Reforms put in and present a significant change to dentists, enhancing their practice place this year will test our capability to how primary health care funding and experience and professional sustain the model of care we efficiently services are delivered. development. It also significantly and effectively provide within current benefits the community, providing an policy. Given the important role that primary increased dental workforce and service health care plays within our Service, delivery capacity. Significant changes are on the horizon from district nursing through to for Aged Care services. We have allied health such as physiotherapy RURAL FLYING DOCTOR commenced making structural changes and occupational therapy and health within our administrative staffing SERVICE promotion activities including to ensure the requirements of the community nursing and Planned Activity Visits from the Royal Flying Doctor reform agenda are met. We have also Groups the Board of Governance will Service to our smaller sites have been endeavoured to alert our consumers monitor closely changes to programs a welcome contribution to oral hygiene to impending changes and possible and endeavour to work closely with the programs and more importantly for implications for residential aged care new Primary Health Care Network to parents to have the recommendations and lifestyle support. ensure we retain current services and of an experienced Dentist addressing Through the Rural Primary Health indeed gain new services appropriate to the future dental care requirements of Services program, health and ageing the needs of our individual communities. children. services will be streamlined by In this region where it is sometimes consolidating 159 Commonwealth NEW SERVICES difficult to access dental services funded programs in this sector into 18 We are currently investigating the these visits proved to be an incredible larger and more flexible funds. We look feasibility of establishing a Laundry bonus. For children to undergo a forward to seeing how this model will service. This initiative will create more comprehensive review of the status affect our operations. local employment opportunities, of their teeth at no cost, in their generate a material revenue stream community and for parents then to have GRAMPIANS MEDICARE and ensure we have increased control the opportunity to act on the result is a LOCALS over the cost and quality of the end tangible improvement within our dental The advent of Medicare Locals may product. Further research will take place services program. well cause significant changes to in the next year to ensure such a project our organisation in the near future, is viable. POLITICAL LOBBYING depending on the influence it will We remain a leader in rural health We have passionately lobbied the have on Primary Healthcare funding services where our patients are always Federal Government about the and service delivery. There is some number one! In line with our Purpose, the proposed repeal of the Australian uncertainty surrounding the future common thread running through every Charities and Not-for-profits Act 2012 of this program, and it is important to element of this Service is to provide a (Cth) and Charities Act 2013 (Cth). note that we must maintain a Board of platform to assist the members of the We voiced our concern that abolishing Governance in its own right, which will communities which form West Wimmera these Acts would limit the ability of preserve its authority and autonomy at Health Service to manage their health public hospitals to attract donations all times. and improve their lifestyle. from charitable funds. We have also advocated against federal cuts to PRIMARY HEALTH CARE health funding and discussed our NETWORKS apprehension about the reallocating In 2014 the Commonwealth Government of funding under the Medicare Locals undertook a Review of Medicare Locals scheme, and the effect these initiatives throughout Australia. The report found will have on our services. that many patients were experiencing We are committed to lobbying the fragmented and disjointed primary Federal and State governments for health care that was impacting better healthcare and facilities in the negatively on their health and wellbeing. West Wimmera and the Southern Mallee.
ANNUAL REVIEW 2013/14 5 CHIEF EXECUTIVE OFFICER’S REPORT
VISION AND CHALLENGES Looking into the next twelve months, the Service will seize every opportunity to achieve its vision, delivering health, welfare and disability services which are compassionate, responsible, accessible, and accountable to individual and community needs, and which result in quality outcomes for all. In achieving our vision, we will face many challenges, given our ageing population, which will increase the demand for broad ranging healthcare provision. We must ensure healthcare remains accessible for the significant portion of our community with a low socio- economic status, particularly in the face of rising operating and capital costs and restricted and fragmented funding sources. We must continue to deal with distance as we deal with the seven highest health risks affecting rural areas which include arthritis, depression and anxiety, cancer, heart disease, diabetes, osteoporosis and stroke. Finally, we are tasked with ensuring our processes remain flexible, effective and progressive and that funding will be available where it is needed most! CULTURE OF SUCCESS West Wimmera Health Service has demonstrated its ability to handle change effectively servicing our patients, residents and client’s needs despite our ageing population and increasing financial constraints. Our astute management, commitment to service delivery, use of innovative practices and sheer persistence provides us with a ‘culture of success’ ensuring we will always rise to the occasion as future challenges present!
John N. Smith PSM Chief Executive Officer
6 WEST WIMMERA HEALTH SERVICE Darren Gebert, Luke Oldaker, John Smith, Linda Knight, Tenille Gould, Charlotte King. John Smith, CEO, leads his dynamic staff with proficiency, reinforcing a positive culture for progress throughout this remarkable Health Service.
ANNUAL REVIEW 2013/14 7 A NOTEWORTHY YEAR
OPENING OF GOROKE NEW CLINICAL PLACEMENTS CONTINUING EDUCATION – COMMUNITY HEALTH CENTRE FOR UNIVERSITY CONTINUED IMPROVEMENT The new Goroke Community Health UNDERGRADUATE STUDENTS IN CARE Centre was opened on Friday 4th Clinical placements for undergraduate Our workplace environment October 2013 by Mrs Gwen Bourchier, Speech Pathology students have been nurtures and supports continuous a long standing member of the Goroke created in 2013-14 resulting in: education and access to courses to community and, with her late husband, • A wider clinical placement upgrade qualifications. Harry were major donors to the Centre. experience opportunity for RIPERN NURSES The Centre was constructed at a cost of Speech Pathology students in a $1.63 million and contains: rural setting Three Registered Nurses have • Four Consulting rooms – for use by • Professional development in terms completed RIPERN training and Visiting Medical Practitioners and of student supervision for the another has started training and will other Health Professionals. incumbent Speech Pathologist complete the course next year. • A combined Dental / Podiatry Clinic • Recruitment potential through rural The RIPERN nursing model enables bringing Dental Services to Goroke experience opportunity practice at a more advanced, for the first time in many years. • Embedding clinical placement and autonomous level in collaboration • Physiotherapy unit. student supervision into Speech with other clinicians for the benefit Pathology Department profile of the patient. • Renovated Activities area, including a new covered outdoor area. Endorsed RIPERN Nurses are able to ACCREDITATION – FULL make autonomous clinical decisions • Multi-disciplinary meeting room COMPLIANCE IN ALL AREAS with video‑conference facilities. for many of the patients who present at Primary Care Casualty Spacious Management and We undertake a series of external • Urgent Care and are able to obtain, Administrative Centre. accreditation processes which measure our performance across Acute Inpatient supply and administer an approved The ‘new’ Goroke Community Health Care, Residential Aged Care, Disability limited range of medications which Centre will ensure that the community Services, Radiology and Diagnostic are indicated within the Primary of Goroke has access to excellent Imaging, Home and Community Care, Care Manual for particular clinical quality healthcare for many years Food Safety and general cleanliness of diagnoses thus reducing the need to come. the healthcare environment. for a medical practitioner to review patients in Primary Care. It is very gratifying to note that in FINALIST VICTORIAN PUBLIC Among the many skills gained are HEALTH CARE AWARDS 2013/14 full compliance was achieved across all programs confirming external simple suturing and the appropriate The Board, Executive and Staff were endorsement that West Wimmera application of a temporary support delighted to be chosen as a finalist in Health Service is providing safe and for a fractured limb before a longer the Victorian Public Health Care Awards quality care to the communities it lasting plaster. Each RIPERN nurse in the Premier's Awards for Rural Health serves. will be credentialed to undertake the Service of the Year. advanced skills they have developed. It was indeed an honour to be held above APPRENTICESHIPS our peers and in such esteem by the review panel. To be a finalist and Highly A number of staff have commenced Commended is testament to the high apprenticeships and traineeships quality of care our Service provides. to gain qualifications which will assist the Service to continue to provide quality healthcare and facilities; Commercial Cookery, Business, Aged Care, Disability, Front Line Management, Occupational Health and Safety, Home & Community Care, Carpenter, and Electrical Tagging.
Registered Nurses Judith Thomson and Trish Heinrich were awarded prestigious Sir Albert Coates’ Memorial Trust Rural Nursing Scholarships, offered specifically for the post-graduate training of rural emergency care nurses.
8 WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW 2013/14 9 A NOTEWORTHY YEAR
DENTAL SERVICES INTRODUCING NEW TECHNOLOGY Progress continues in the Dental Clinic with the new intra-oral camera enabling patients to observe exactly what the Dentist sees during the course of an examination. The Orthodontic service and its use in school student screenings have also benefitted from this new equipment as has the specialist advice and care provided by our visiting Oral Surgeon. The new Orthopantogram (OPG) machine has also brought a new perspective to our Dental Services t providing a panoramic view of the mouth, teeth and bones of the upper and lower jaws allowing the Dental Surgeon to make a more informed decision on treatment.
10 WEST WIMMERA HEALTH SERVICE Demi Holcombe, Federation University Student Nurse taking advantage of the diagnostic imaging available from the new OPG machine while on work placement at Nhill Hospital .
ANNUAL REVIEW 2013/2014 11 A NOTEWORTHY YEAR
12 WEST WIMMERA HEALTH SERVICE PREPARING STUDENT AND NEW STAFF ACCOMMODATION UNITS IN NHILL
Construction commenced on three residential houses in Nhill which will provide quality accommodation for: • Undergraduate and Post-graduate student placements; • New staff relocating to work at West Wimmera Health Service; • Medical Practitioners taking up practice with Tristar Medical Group Embarking on this innovative project is indicative of the broader thinking necessary to make sure we are aware of emerging challenges such as attracting staff and students to our Service.
When it comes to construction and maintenance at WWHS we are one step ahead. The skilled, qualified Engineering & Maintenance team are able to tackle most tasks. Here Aaron Beer with Craig Henley are installing the kitchen in the new accommodation units.
ANNUAL REVIEW 2013/14 13 A NOTEWORTHY YEAR
NHILL COLLEGE AND WEST The driving force for its existence is a ROYAL FLYING DOCTOR SERVICE WIMMERA HEALTH SERVICE commitment to ensure the provision of – MEETING A COMMUNITY IN PARTNERSHIP a continuously improving, appropriate, REQUEST and geographically accessible mix of In consultation with the Nhill College high quality hospital and community A survey of the Goroke Community and Nhill Police it was discovered that based health services for residents seeking them to prioritise the services domestic violence and self-harm are of the Wimmera Mallee sub-regional they thought were important to bring to areas for concern within our catchment. planning area. Goroke revealed Dental services as the A comprehensive assessment of all highest priority. Year 7 school students took place to The primary outcome in any decisions The request was realised by partnering understand self-esteem, motivation that the Alliance make will enhance with the Royal Flying Doctor Service for self-harm and bullying. 75% of services for stakeholders. Alliance Mobile Dental Care Team. Dental students were assessed to be at risk members have an ongoing commitment appointments for the week of the 3rd with 2% having had suicidal ideation to work as equal partners based on February 2014 thirty six patients were and thoughts of self-harm. As a result mutual respect thereby acknowledging examined and during the week of 26th intensive programs have been put the different and complementary roles May 2014, twenty eight patients were into place at the school and across the and responsibilities each Health Service seen. This initiative has meant that community for more than 100 students. plays within the Region. patients from Goroke have had access to The Governance Committee meets Dental services in their local community EXTERNAL CLEANING AUDITS quarterly and members include the where none existed previously. – OUTSTANDING RESULTS Board Chairs and CEO’s and other representatives of each health service. VICTORIAN HEALTH Extraordinary results in external The Primary Care Partnership team also EXPERIENCE SURVEY cleaning audits are the ‘norm’ for attends as the Project Managers. West Wimmera Health Service. We are New in 2014, the Victorian Health required by the Department of Health The Wimmera Southern Mallee Health Experience Survey (VHES) provides to regularly monitor the cleanliness of Alliance is gratified with what it has opinions from patients who have each area of our facilities and measure achieved in its three short years. been admitted to an acute hospital whether we are providing a safe (WSMHA Newsletter) bed in Victoria and is conducted by and clean environment for patients an independent Research Institute on and residents. CANCER RESOURCE NURSES behalf of the Victorian Department of Health. WHY IS MAINTAINING A Better access to cancer services for CLEAN ENVIRONMENT SO our residents will be the result of a It is completely anonymous providing patients with the opportunity to IMPORTANT? new program introduced through a joint project between the Grampians contribute frank and honest responses Excellent results minimise risk of cross Integrated Cancer Service and the to questions providing hospitals infection, increase the level of patient WSMHA to introduce this welcome with a unique insight into the patient satisfaction and reflect a positive image resource at West Wimmera Health hospital experience. of the health service: Service and other Services of Importantly, the Survey enables us the Alliance. OUR RESULTS to compare our patient experience Nurses have undertaken training with like size services as well as all 100% audit outcome achieved for • and visited the cancer services in Victorian Hospitals. cleaning standard audits conducted Ballarat and Horsham to learn from in the very high risk area of the 72 randomly selected patients from our their experiences and expectations. Operating Theatre. Service participated in the first survey The community is appreciative of the April – June 2014, 94% rated their 98% achieved for audit in the high • addition of this new role. Staff are Overall Hospital Experience as either risk area of Acute, far exceeding the embracing this opportunity to make a 'very good' or 'good’, our Overall Care target of 85%. difference for someone on the difficult was rated at 94% compared with a peer • 97% achieved for audit in the journey of living with cancer. result of 97.8% and a state-wide result medium risk area of Radiology, far While the nurses are not specialists of 92.1%. exceeding the target of 85%. in the area of Cancer Nursing, their We rated particularly well on a number training and experience add another THE WIMMERA SOUTHERN of measures including; care and dimension to the care and support treatment received from nurses; short MALLEE HEALTH ALLIANCE available immediately and near to home. (WSMHA) length of time on the waiting list prior The Cancer Resource Nurses also to admission to hospital; care and The Alliance was formed in 2010 and all maintain a Cancer Resource Hub treatment from allied health staff. member services have just re-signed which is a display of current brochures The results have been analysed, the new memorandum of understanding. and pertinent information for including areas requiring improvement, the community. and actions are now in place to ensure we provide an unparalleled experience for our patients at all times.
14 WEST WIMMERA HEALTH SERVICE Executive Director of Finance and Administration, Ritchie Dodds expressed his congratulations and that of all staff to Chief Executive Officer John Smith on being presented with the prestigious Sidney Sax Medal by the Australian Hospital and Healthcare Association.
SIDNEY SAX MEDAL – A PRESTIGIOUS AWARD “A lifelong commitment to delivering There is no doubt that John Smith has high quality health services in Australia, the interests of rural communities particularly in rural communities, at heart and works with the utmost was acknowledged by the Australian commitment to ensure their future is Healthcare and Hospitals Association assured. It is with this sentiment and (AHHA), John Smith, West Wimmera with recognition of his contributions Health Service Chief Executive Officer across the health sector that the AHHA was awarded the prestigious Sidney is pleased to award John with the 2013 Sax Medal for 2013. Sidney Sax Medal.” (AHHA) The award recognises outstanding achievement in, and contribution to the development and improvement of the Australian healthcare system – and while there are many very dedicated professionals who are worthy of such recognition, John Smith stands out in the crowd.
ANNUAL REVIEW 2013/14 15 OUR SERVICES
AGED CARE ALLIED AND COMMUNITY SUPPORT Aged Care Assessment Ante/Post Natal Classes Immunisations - District Nursing Asthma Education staff WWHS and Home Care Package Program Cancer Council Victoria major local employers National Respite for Carers Program - Cancer Awareness Kindergarten Screenings Residential Hostels & Nursing Homes Cancer Support Group Speech Pathology, Cardiac Rehabilitation Program Occupational Therapy, CLINICAL Community Health Nursing Physiotherapy, Massage Therapy Acute Hospital Care Continence Education Maternal and Child Health Admission and Discharge Clinic Diabetes Education Meals on Wheels Audiology Dietetics Men’s Sheds Dental Diagnostic District Nursing Mother/Daughter Puberty Nights Dental Prosthetic Drug and Alcohol Program National Diabetes Service Dialysis Emergency Relief Program Nutrition Education Domiciliary Midwifery Exercise Groups – Occupational Therapy ENT Surgery Aerobics, Falls & Balance Optometry Gastroenterology Group, Gentle Exercises Orthodontic Referral General and Specialist Medical Care & Tai Chi Pap Smear & Health Check General and Specialist Surgery Farm Safety Education Clinics Laparoscopic Surgery Fitness Assessments Physiotherapy Maternity Shared Care Clinic Football Practice for Farmers Planned Activity Groups Nursing Traineeships Fun Fit & Fabulous - (Adult Day Centres) Obstetrics and Gynaecology Gateway to GirlPower – Podiatry Ophthalmic Surgery Nhill, Kaniva, Rainbow Puberty Biz for Grade 6 Oral Surgery Guys & Gals School Program Children and Parents Orthopaedic Surgery Gym/Weights Program Puberty Nights for Boys Palliative Care Hairdressing QUIT Trainer Pathology Health Education and Promotion Radiology – Pharmacy Wimmera Machinery Field Days CT scanning, ultrasound, X-ray Post Acute Care Healthy Habits Happy Life, Rural Primary Health Service Primary Care Casualty Stroke Awareness Presentations Secret Men’s Business Psychiatry Men’s Health Week Social Work Reconstructive Surgery Hearing Services - Welfare and Counselling Service Regional Discharge Planning Strategy Home and Community Care Hospital in the Home Speech Pathology Hospital to Home Strutting Strollers WorkHealth Checks
DISABILITY Adult Day Service Individual Support Advocacy Living Skills Community Access Respite Care Community Inclusion Program Retail Assistant Training Exercise Program Supported Employment Food Preparation and Sales Therapy Programs Futures for Young Adults Vocational Training Garden Maintenance Program
16 WEST WIMMERA HEALTH SERVICE REGIONAL SERVICE SUPPORT NURSING HOMES – HOSTELS Allambi Elderly Peoples Home, Education NHILL Dimboola Engineering and Maintenance Iona Digby Harris Home Avonlea Hostel, Nhill Environmental Dunmunkle Health Service Health Information Management KANIVA Edenhope Hospital Hospitality Archie Gray Nursing Home Goroke P-12 College Library and Resource Centre Kaniva Cottages Hostel Hindmarsh Shire Council Volunteers JEPARIT Jeparit Primary School Jeparit & District Nursing Home Kaniva College TRAINING AND ALLIANCES Jeparit Hostel Kindergartens - Nhill, Jeparit, Kaniva, Traineeships RAINBOW Rainbow, Goroke, Lutheran Primary Universities Rainbow Bush Nursing Home Annexe School (Nhill) – Australian Catholic, Charles Darwin, Rainbow Bush Nursing Hospital Hostel Natimuk Primary School Charles Sturt, Deakin, Latrobe, Nhill College Federation, Melbourne, South Australia NATIMUK Rainbow College Wimmera Football League Natimuk Bush Nursing Home Annexe Rainbow Primary School – Physiotherapy ‘Allan W Lockwood’ Special Care Hostel Rural Northwest Health Wimmera Hub Inc Trescowthick House Hostel St Patrick’s Primary School, Nhill Work Experience West Wimmera Shire Council Work Placements Woomelang Bush Nursing Centre Yarriambiack Shire Council
COMMUNITY PROGRAMS NATIONAL RESPITE FOR CARERS POST ACUTE CARE (PAC) PROGRAM (NRCP) HOSPITAL TO HOME (H2H) Provides community based services This program aims to enhance such as community nursing and The program supports patients in the quality of life for carers and personal care.= the transition from hospital to home. care recipients, who are frail older HOME AND COMMUNITY CARE Patients must live in municipalities people, people with dementia, young PROGRAM (HACC) associated with West Wimmera Health people with a disability and people Service. with a terminal illness in need of This program provides care in home HOSPITAL IN THE HOME (HITH) palliative care. and community settings to frail older adults, younger people with The program contributes to the HITH is the provision of hospital care disabilities and their carers, promoting support and maintenance of caring in the comfort of the person’s own independence and avoiding premature relationships between carers and their home. Patients are regarded as hospital or inappropriate admission to long term dependent family members or friends inpatients and remain under the care of Residential Aged Care. their treating medical practitioner. by facilitating access to information, respite care and other support appropriate to the individual needs of carers and those people for whom they care. Home Care Packages are planned and coordinated packages of care to help older people remain living in their own homes. They are funded by the Australian Government to provide for the complex needs of older people.
ANNUAL REVIEW 2013/2014 17 COMMUNITY, VOLUNTEERS, DONATIONS & FUNDRAISING
FUNDRAISING APPEAL OFF The majority of the gifts to date have GOROKE, JEPARIT AND RAINBOW been “one off” with the commitment TO A GREAT START $350,000 to address important to consider further support for this renovations to upgrade facilities at The “Health of our Communities Appeal” project. Had gifts so far committed Jeparit and Rainbow Hospital and Aged began in May 2014 and to date has been five-year pledges the amount Care facilities is now being sought. raised $1 million which as a result of the raised would be nearing half our goal. process adopted is a wonderful start. The importance of planned pledges over Having become the proud recipients After a careful preparation including the entire campaign period cannot be of brand new facilities, the Goroke several months of individual discussions over emphasised. To ensure this project community is being canvassed throughout our service region during proceeds funding intentions must be for pledges to assist with funding which we received many helpful clear. services at Goroke and Nhill given the suggestions which emphasised we importance of the care amenities being The Kaniva campaign is full of promise! should not conduct a “big bang” appeal developed will assist the communities’ seen to be “Nhill centric”. NATIMUK general needs. SEVEN SEPARATE APPEALS In May a concerted effort was applied to attract “gap funding” of $200,000 for MURRAY TO MOYNE Given such sentiment six separate the New Medical & Allied Health Centre CYCLE RELAY fundraising campaigns addressing which is poised to open soon. The result Natimuk, Kaniva, Nhill, Jeparit, Rainbow Twenty one cyclists entered the annual has been outstanding with pledges and Goroke communities were instigated Murray to Moyne Cycle Relay in our 20th amounting to $260,000 over the next clearly stating that funds raised in year of participation in the event. five years received. each location will be distributed in that The team raised $9,251.00 through community. NHILL fundraising events such as the hugely With our Patron, Philip Cramer, a seventh The hub of West Wimmera Health successful “Loop the Lodge” Fun Run appeal comprising high-level contacts in Service, “Nhill Hospital” with many of the held on Sunday 13th October 2013 Melbourne to more generally fundraise central services to fund, has set a target with 120 participants from Horsham, for the expensive projects which are of $1.8 million for an urgent renovation Bordertown, Nhill, Goroke, Kaniva, centred on and particularly pertinent to of the Kitchen and Medical Record Jeparit and Rainbow. We are looking Nhill Hospital. It is important to note the Department. 160,000 fresh meals are forward to this the event growing even appeal focuses on gathering five-year provided yearly from this antiquated bigger and better in November 2014. pledges so that planning of progressive facility. The Murray to Moyne team also took expenditure of funds can be instituted. Substantial submissions and part in the ‘Friday Fiesta Program’ at the The management of seven campaigns approaches have been made to the State Nhill Lake for the month of February. It is proving complex. Our process at this Government for these funds, which was great to be a part of this community stage is centred on consultation with regrettably have been unsuccessful. event whilst promoting our team’s people we believe may lead the program Given this is the case we must now turn fundraising efforts. and contribute in many ways themselves. to the generosity of our communities to VOLUNTEERS ensure this vital project will proceed. It is our intention to conduct a “public We acknowledge the many individual appeal” embracing all communities To complete the MIRA (Allied Health volunteers and groups whose invaluable simultaneously mid 2015. Services) Centre we are fundraising contributions are so appreciated for $1.2 million. For the Day Procedure, KANIVA by West Wimmera Health Service: Surgical Unit where increasing numbers Auxiliaries, Church Groups, Community At Kaniva the target is $1 million to of procedures demand renovations Groups and Schools assist through provide the funding for a new Aged and modernisation to accommodate fundraising, entertainment, assisting Care facility which will adjoin the Kaniva facilities for this popular mode of care with activities, reading and outings for hospital. Local, personal leadership we seek to raise $450,000. our residents – much appreciated. provided has been invaluable and Nhill campaigning is in its infancy and the gathering of groups who with Volunteers are an essential element in conjunction with our Patron Mr Philip compassion have delivered the great of West Wimmera Health Service and Cramer, we are working diligently in importance of this new facility to that bring joy and comfort to patients Nhill, Melbourne and beyond to solicit community.. and residents. A long term volunteer support and funding, which to date is of over 30 years said “It is a pleasure An amount of $245,000 has been very encouraging given an amount of volunteering and being supportive of the pledged in Kaniva at this early stage $535,000 has already been committed. residents whenever possible. still leaving a substantial amount to be raised.
18 WEST WIMMERA HEALTH SERVICE The pleasure I receive is also AND NEXT YEAR... Darren Taylor, Maintenance Handyman at reciprocated by the residents and it is Natimuk Residential Aged Care Centre always lovely to see their happy faces”. Fundraising will continue throughout measuring in preparation for installing the year with a special emphasis on the signage on the waiting area wall in the new A much appreciated volunteer at Oliver's Capital Campaign and we look forward to Medical & Allied Health Centre. Café for over 15 years said “I enjoy the outcome. mixing with the Cooinda clients and find them warm loving people. After Our Health Service is such an important retirement I had the time and wanted component of the six communities to be involved and contribute to the which make up West Wimmera Health community in some way. I have found Service. It is the major employer in most volunteering very rewarding.” communities, it offers healthcare locally, vulnerable members of the community A volunteer new to the town decided are quickly integrated into our programs, that volunteering would be a great way assisted to access services, offers to meet people and to help others. She such a wide variety of services – how has now been volunteering at Iona for fortunate we are. about 6 months along with her little daughter who brings such enjoyment In 2014-2015 please place your strength to the residents. “As I was new to town behind the Capital Campaign which I didn’t really know anybody and I enjoy will contribute enormously to each visiting our special friends to make them community. It will also make sure all feel special.” retain the remarkable facilities and services which we are privileged to have in place now.
ANNUAL REVIEW 2013/14 19 DONATIONS 2013/14
$ Amt VV Marshman Trust 150,000 Dyer Families 50,000 Collier Charitable Fund 45,000 JM & TF Sudholz 10,000 William Angliss Trust 5,000 Millington Family Trust 5,000 Under $200 3,496 Loop the Lodge Fun Run 2,633 Senior Citizens 2,352 Sarah Stott Trust 2,313 Murray to Moyne 2,113 Director of Nursing, Kaniva, Lesley Hawker with Alwyn Dyer, leader of the Nhill Hospital Ladies Auxiliary 2,000 Kaniva Capital Campaign Team making suggestions for the Plans for the long awaited Hostel Units planned to be built at Kaniva if the Campaign is successful. Nhill Duck & Jazz Committee 2,000 Cooinda Ladies Auxiliary 1,950 BEQUESTS AS A WHAT NOW? Avonlea 1,921 FORM OF GIVING The fact that the first million dollars Chocolate Sales 1,273 In an ageing community such as ours has come from a small number of gifts Jessie Guest 812 many people are restricted as to how is testament to the process of working Wood Raffles 532 they can help and are unable to make silently with prospects who have the pledges of support. However, there ability to support this Campaign. Peter & Denise Ralph 500 are others who may well consider that There are many of our most successful IR & LJ Hately 500 after properly caring for family and citizens and significant businesses, Westvic Spares 500 loved ones it may be possible to make Philanthropic Trusts and Foundations a Bequest to this appeal. Bequests Estate of Elma Graetz 500 to access yet. We anticipate they will are part of this campaign and those SMI Services Pty Ltd 500 seriously consider our submission who adopt this approach are to be and with their support numbers the Margery Wallis 500 recognised and thanked as valuable goal in each community will be more Estate of Mytrle Lennon 435 donors now, during their lifetime. achievable. Caltex 400 Bequests are the fastest growing source of fundraising income in the Hugh Delahunty MLA 300 western world today. Horsham Sports & Community 265 Centre Elders Ltd 250 WWHS CAPITAL GRANTS 2013 2014 Jetfire Protection Pty Ltd 250 PFD Food Services Pty Ltd 250 Source Purpose Total Ahrens Group Pty Ltd 250 Department of Health Home and Community 20,726 Care Minor Equipment TC Fire 250 Department of Health Residential Aged Minor 50,000 Rural Energy 250 Capital Cec Hopper & Sons 250 Department of Health Infrastructure 59,300 Barry Johnson 250 Replacement Nhill Pharmacy 250 Department of Health Medical Equipment 74,700 Bow Bakery 250 Replacement Lake Charlegrark Country Music 250 Department of Human Services Minor Equipment 3,409 Nhill College 226 Foundation for Rural and Regional Snappy Seconds 3,500 Dr Mark Chehade 200 Renewal Refurbishment DN & HM Wilson 200 Australian Government / Australian Equipment 8,000 St Peters Lutheran Church Guild 200 Catholic University for Education Dulkeith Computer Solutions 200 Accommodation Hindmarsh Shire Council 200 Australian Government Natimuk Medical Centre 350,000 Nhill Fire Brigade 200 569,635 GRAND TOTAL (AUD) 296,970
20 WEST WIMMERA HEALTH SERVICE STATEMENT OF PRIORITIES – A SUMMARY
What is the Statement of Priorities? The Statement of Priorities (SoP) is a formal funding and monitoring agreement between the Health Service and the Secretary for Health. The agreement which is signed annually facilitates delivery of or substantial progress towards key shared objectives of financial viability, improved access and quality of service provision.
HOW IS THE STATEMENT OF Effectively the Strategic Plan LOOKING AHEAD TO PRIORITIES DIFFERENT FROM encapsulates the vision adopted by the 2014-2015 THE STRATEGIC PLAN? Board of the Health Service locally, and the Statement of Priorities ensures The priorities for the Statement of The Statement of Priorities agreement the Health Service is working towards Priorities remain focusing on new areas has priorities based on the Victorian the larger picture of Victorian Health such as Heart Health, concentrating Governments health policy. outcomes. on the Karen population and Board assessments. West Wimmera Health Service then proposes deliverables which align HOW DID THE SERVICE West Wimmera Health Service will with state policy and relevant to MEASURE UP TO THE always strive to meet the priorities the community in which we operate. DEPARTMENTS STATEMENT established with the Department Agreement by both parties finalises the OF PRIORITIES TARGETS? through achieving the deliverables Statement of Priorities Charter. which are relevant to our communities. The Service was fully compliant with all The deliverables set out in the targets and achieved deliverables for all Statement of Priorities closely align priority areas. with the organisational Strategic Plan therefore there is similarity in the documents. Shanae Bastin, rushed from school with a suspected fracture, was grateful to have the quick response of Dr Shepherd Chifura and Dr Wei Cheng Chen to attend to her at Jeparit Hospital. The Doctors cover the Jeparit and Rainbow communities, a far cry from the days when only one doctor was available.
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STRATEGIC DIRECTIONS TARGETING HEALTH ISSUES
STRATEGIC DIRECTIONS PERFORMANCE 2012-14 The Strategic Directions for West Wimmera Health Service adopted by the Board to cover the three year period 2012-2015 set an unwavering commitment to move towards more responsive, clinically appropriate and cost effective healthcare planned specifically to stay ahead of the dynamic environment of the health industry and importantly to target the health issues of the people who rely on us for healthcare.
1. MATCH SERVICES WITH • Review of Surgical Services at • A Cancer Care Nurse has been OUR COMMUNITIES’ Nhill Hospital with an outcome that employed 0.2EFT as a resource for CHANGING NEEDS “surgical services are being delivered clients living with cancer. in a safe and effective manner Full accreditation status achieved • The Nhill Community Garden • and that surgical services at the across all programmes of care situated on WWHS land adjacent current level of complexity should delivery including: Australian to Cooinda is flourishing with continue to be performed at Nhill”. Council on Healthcare Standards people from the Karen Community, A resounding endorsement! EQuIP Accreditation, Aged Care students from Nhill College and Standards Agency Accreditation, • Memory Lane Cafés in conjunction Nhill Lutheran School, participants Home and Community Care with Alzheimer's Australia and from Cooinda and others from the (HACC) Community Care Common Department of Health have taken Nhill Community making use of Standards, Diagnostic Imaging place. Sessions are held monthly the garden. Accreditation and Disability Service in Nhill and also occur at Rainbow, • Funding of $28,500 was successful Standards. Goroke and Natimuk. through a Regional Growth Fund • Recruitment and retention of • The WHY (West Wimmera, “Putting Locals First” grant with Visiting Medical Practitioners Hindmarsh, Yarriambiack) project Stage 1 of the project which is across all communities. has commenced in the areas to establish garden beds, water of Occupational Therapy and supply, and pathways being Physiotherapy and delivering achieved. services in all regions.
22 WEST WIMMERA HEALTH SERVICE Dr Alvin Ng, with relaxed Karen patient Eh Kyan Kyaw Tha Ei, happy to have Registered Nurse and qualified interpreter May Hei Eh Kyaw Kyaw assisting him during his dental examination.
2. IMPROVED ACCESS 3. ENHANCED • Participation of Allied Health staff TO SERVICES COMMUNICATION WITH in local Agricultural shows and health expos. • Introduction of CT (Computed OUR COMMUNITIES Tomography) Scanner at Nhill • Recognition of the importance of • Launch of modern Website and Hospital and increase in Diagnostic increasing consumer engagement Facebook site to target the “tech Radiology Services. with introduction of Consumer savvy” generation of stakeholders. • Increase in Dental Services through Position on the Clinical Quality • Fundraising Appeal meetings held commencement of new Dental Governance Committee. in each community to support and Clinics in Rainbow, Goroke & Kaniva. • Details of our Aged Care Residential inform of capital infrastructure and associated financial imposts. • Large increase in number of facilities published on My Aged patients receiving Macular Care website to inform prospective Degeneration Injections since residents of accommodation and 4. MAINTAIN AND ENHANCE commencement in June 2012. financial options. OUR FINANCIAL Restoration of vision provides a • Ladies Auxiliaries and Friends SUSTAINABILITY quality of life where the patient and Relatives Groups active in • Contracted a specialist health can safely navigate daily activities all communities with Nursing economist to review our of life. Patients able to receive Management participating in performance using bench marking treatment locally, no longer having meetings. parameters and industry data to travel to Melbourne/Adelaide • Large presence in local and regional specifically relevant to our key every six weeks, saving overnight media platforms showcasing service areas. accommodation and 800km services, achievements and health • Meetings held with Federal round trip. promotion informing communities. Members of Parliament to argue the • Agreement signed with Wimmera • Community meetings held in case for increased funding for rural Health Care Group to share a all six townships to inform and remote public health. physician on site in Nhill monthly community members and listen • 9th consecutive surplus recorded which will commence early to opportunities for enhancing in 2013/14. 2014‑2015. services provision. • Net surplus before capital of • Annual General Meeting held with $14,000. outstanding attendances in 2012 • Capital investments - $ 4.37 million. and 2013.
ANNUAL REVIEW 2013/14 23 STRATEGIC DIRECTIONS
• Current Ratio – 0.72 in line with the 6. CONTINUE TO IMPROVE OUR Region Executive Nurse Network, Department of Health’s benchmark FACILITIES AND EQUIPMENT Grampians Regional Health Alliance minimum of 0.7. Finance Committee, Nhill Town A highlight was the opening of • Committee, Hindmarsh Economic • Turnover $33.8 million. the Goroke Community Health Development Strategy Advisory Capital purpose income $722,000. Centre on 4th October 2013. This • Committee. • Donations totalling $493k received community has a state of the art facility capable of providing in 2012/2013 and 2013/14, 8. USE THE LATEST including $250,000 from VV support services for health maintenance into the next decade TECHNOLOGIES MORE Marshman Trust as part of $400K EFFECTIVELY total donation over three years for and includes: Mira Stage 2, received $100k in • Expanded clinical areas including • Introduction of a number of 12/13 from Marshman Trust plus new consulting rooms for Medical specialist and tertiary services another $150k in 13/14. Practitioners and Allied Health offered locally via telehealth: Professionals. • Physiotherapy – Royal Melbourne 5. ADOPT A FLEXIBLE, • Public Dental facility created Hospital Orthopaedics. COLLABORATIVE • Expanded Day Activities Program • Wound – Tertiary Wound Specialist APPROACH TO RESOURCE area for elderly people of the – Department of Health Wound ALLOCATION IN THE community. Care Nurse. REGION • Community access areas created • Residential Aged Care/Acute • WWHS is now a member of the for community meetings, patients – Geriatrician/Physician Wimmera Southern Mallee Health workshops, and self-help groups Ballarat. Alliance Building Capacity initiative • Improved Disability access. • Dietetics – Ballarat Health Services in addition to the founding Alliance Dietitian Mentoring. Natimuk Medical Clinical group. • redevelopment project in final • Completion of a ‘Wireless Network” • Due diligence to amalgamate stages at June 2014. at Nhill and Kaniva hospitals has with Dunmunkle Health Services enabled staff to access and update Building commencement of 3 in responding to their invitation • aged care resident information new Accommodation Houses in to consider to amalgamation including resident care plans, Macpherson Street Nhill due to be with them. Submission to do so charts and assessments, at the completed late 2014. submitted to Minister of Health. bedside. Finance Department office Health Promotion Plans developed • Installation of a fully integrated • relocated to a more central and • in partnership with Wimmera security system throughout the accessible are within the Nhill Primary Care Partnership and Local Nhill campus. Hospital. Government Councils undertaken. Mira Redevelopment Stage 2 Relationship built with Ballarat • 9. BUILD OUR PEOPLE’S • incorporating planned activity Health Services and Edenhope CAPABILITIES group and rehabilitation, design District Memorial Hospital for the and planning has been finalised • 13 Middle Managers have provision of laundry services. with construction works to begin in successfully completed the • WWHS outsources significant Allied July 2014. Advanced Diploma of Business. Health services to neighbouring • 5 staff have successfully completed hospitals that would otherwise not 7. STRENGTHEN AND EXPAND Certificate IV in Disability Studies. receive such services, including OUR PROFESSIONAL 4 nurses are undertaking Rural Woomelang Bush Nursing Centre, • and Isolated Practice Endorsed Dunmunkle Health, Edenhope RELATIONSHIPS Registered Nurse (RIPERN) course District Memorial Hospital, Rural • CEO membership on a number of with another 3 enrolled in 2014- Northwest Health and Dimboola key stakeholder bodies including 2015. Aged Care Facility. Australian Council on Healthcare Standards Board – Vice Chairman, Expansion of the Injury Initial planning undertaken for the • • Australian Council on Healthcare Management Team who support real time intelligence project with Standards International Board and educate Middle and Senior Ballarat Health Services to promote – Treasurer, Victorian Health Management on effective return to sharing of patient information to Industrial Association Board – Vice work process. more effectively manage step down Chairman, Australian Hospital & process. • 25 Occupational Health & Safety Healthcare Association Council, Representatives and Managers Clinical Executive Meetings • National Health Alliance, Friends of have completed the one day between WWHS and Wimmera Alliance Council. refresher OH&S course between Health Care Group enhancing Executive Team represented on 2012-2013 and 2013-2014. clinical communication and • various Boards and Committees resource sharing. including: Women’s Health Grampians, Small Rural Executive Nurses Network, Grampians
24 WEST WIMMERA HEALTH SERVICE Tim Seymour and Nathan Ruge (foreground) checking construction levels.
10. STRENGTHEN OUR • Implementation of a new Accuracy and proficiency by skilled GOVERNANCE, Committee Structure to ensure craftsmen is setting a sound PERFORMANCE, robust review and enhanced structure for the construction of the TRANSPARENCY AND performance. Community Rehabilitation Centre. ACCOUNTABILITY. • New Clinical Quality Governance Committee has increased clinical Introduction of an electronic • expertise to strengthen review Quality Register that links of credentialing and policy directly to the Risk Register development and review. providing timely and accurate information relating to Continuous • Proud to be a Finalist in the Improvement throughout the Premier’s Rural Health Service of organisation. the Year Award 2014. • Strengthening the Clinical Quality Governance Committee STRATEGY-INSPIRED membership with a specific As we commence the final year of this emphasis on credentialing. phase of Strategic Planning our minds • The improved performance of our are turning to the direction the future credentialing process has been progression of this Service will take, noted by the Department of Health and how we our planning must ensure in relation to Credentialing and this Service will cement its place as Scope of Practice and Partnering the central focus for healthcare for the for Performance, and identified as communities of West Wimmera Health a good example for the application Service. of a local performance discussion Improving the health and wellbeing of record template with guidelines the people in our diverse communities for use and applicability criteria will always be the objective we pursue. with 0.2 EFT or less Visiting Medical Officer (VMO) or General Practitioner (GP).
ANNUAL REVIEW 2013/14 25 STATISTICS OVERVIEW
Measurement of the services we deliver provides a clear insight into the inspiring outcomes achieved for our patients, clients and residents.
ACUTE INPATIENT – PERCENTAGE OCCUPANCY BY SITE 2013/14
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0 Jul Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun
Rainbow Jeparit Kaniva Nhill Budget 2013/14
Percentage occupancy varied considerably across our four acute inpatient sites. Several facilities have a very small number of beds which increases occupancy volatility. Occupancy levels at Kaniva, Jeparit & Rainbow were affected by a period of time when there was no Medical Practitioner available in these communities. WWHS has worked diligently to recruit Medical Practitioners to work at these locations. Weighted Inlier Equivalent RESIDENTIAL AGED CARE WEIGHTEDSeparation INLIER (WIES) EQUIVALENT Comparison SEPARATION – PERCENTAGE OCCUPANCY 2013/14 (WIES) COMPARISON
100 2000
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20 0 2013/14 2012/13 2011/12 2010/11 2009/10 2008/09 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Weighted Inlier Equivalent Separations (WIES) is the mechanism used to measure the mix or type of acute patient treated, and is also used by Nursing Homes Target Nursing Homes Government to provide funding to hospitals. Episodes of care are funded based on the condition treated, length of stay and whether a procedure was Hostels Target Hostels undertaken. This type of funding is known as 'casemix funding' and provides a fairer method of funding with hospitals receiving funding based on the type Nursing Homes and Hostels maintained excellent occupancy levels throughout of patients treated.2013/14 had the highest WIES result in the past five years the year. WWHS is proud to be able to offer quality residential aged care to the and 6.4% more than treated in 2012/13. rural and remote communities of Nhill, Kaniva, Jeparit, Rainbow and Natimuk, communities providing elderly and vulnerable members of these communities with the opportunity to remain close to family and friends
26 WEST WIMMERA HEALTH SERVICE ALLIED & COMMUNITY HEALTH ACUTE CARE – PERFORMANCE BY CATEGORY – NON-ADMITTED OCCASIONS OF SERVICE Note 2013/14 2012/13 Variance Department Note 2013/14 2012/13 Variance Patients Treated - Total 1 2211 2210 0.0% Diabetes Education 731 1058 -30.9% Occupied Bed Days 2 8930 8728 2.3% Dietetics 1632 3003 -45.7% - Total Massage Therapy 771 712 8.3% Occupied Bed Days 3 8572 8071 6.2% Occupational Therapy 2381 3084 -22.8% - Acute Podiatry 3120 4175 -25.3% Occupied Bed Days - 3 358 588 -39.1% Physiotherapy 3928 5916 -33.6% Nursing Home Type Percentage Occupancy 63.00% 58.50% 7.7% Speech Pathology 1006 1570 -35.9% Social Work 960 627 53.1% Average Length of Stay 3.9 3.67 6.3% (Days) Maternal and Child 1701 1670 1.9% Health Procedures Total 745 870 -14.4% Centrelink 362 316 14.6% DVA NHT Occupied 4 85 28 203.6% Dental - Public 2 2526 1351 87.0% Bed Days Dental - Private 2 957 1035 -7.5% Average DRG Weight 0.7847 0.7107 10.4% Primary Care Casualty 676 4039 -83.3% WIES 5 1630.44 1500.7 8.6% (Emergency+Other) DVA WIES 4 94.92 130.46 -27.2% Visiting Surgeons 1977 1891 4.5% TAC WIES 1.09 8.89 -87.7% Radiology 3 4825 3222 49.8% Renal WIES (Dialysis) 39.6 58.45 -32.2% Total Allied and Primary 1 27553 33669 -18.2% Health 1. The number of patients treated was similar to the previous year. Tota Meals Provided 183047 180908 1.2% 2. There was a 2.3% increase in occupied bed days due to patients at 1. There was a decrease in allied and community health throughput with many smaller sites having longer lengths of stay as a result of complex departments experiencing periods where staff vacancies were difficult to medical conditions. fill. By the end of the year all departments were again fully staffed.2. Dental 3. Acute occupied bed days were above that of the previous year, throughput was substantially above the previous year with an increase in nursing home type bed days continued to decline staffing levels, including the employment of a graduate dentist. Dental 4. Throughput in DVA programs was unpredictable with one over clinics also commenced in Kaniva, Rainbow and Goroke. 3. Radiography throughput was 50% above the previous year with strong demand for this budget and the other below budget service including CT Scan 5. There was an 8.6% increase in Weighted Inlier Equivalent Separations (WIES) due to an increase in the complexity of HACC Funded Note 2013/14 2012/13 Variance conditions treated. Great care is taken to ensure that patients Activity Hours are treated safely in the most appropriate setting, however every attempt is made to ensure patients are treated close to home, if District Nursing 4503 4571 -1.5% that is possible. Day Centre 36107 28027 28.8% Physiotherapy 1039 651 59.6% Podiatry 1132 1162 -2.6% RESIDENTIAL AGED CARE Speech Pathology 68 42 61.9% – PERFORMANCE BY CATEGORY Occupational Therapy 426 349 22.1% Note 2013/14 2012/13 Variance Dietetics 87 76 14.5% Nursing Home Days 1 26194 27275 -4.0% There was an increase in HACC Hours, particularly in the areas of Day Centre, Hostel Bed Days 16110 16250 -0.9% Physiotherapy and Speech Pathology Nursing Home 80 55 45.5% Rural Primary Health Note 2013/14 2012/13 Variance Discharges Service (RPHS) Program Hostel Discharges 41 32 28.1% Physiotherapy 752 771 -2.5% Percentage Occupancy 1 93.20% 97.0% -3.9% Community 1362 1634 -16.6% Nursing Homes Nursing Nhill Percentage Occupancy 2 95.90% 96.80% -0.9% Community Nursing 750 682 10% Hostels Edenhope 1. There was a decrease in nursing home occupancy compared to the Health & Fitness Centre 1 699 1849 -62.2% previous year. Social Work 506 656 -22.9% 2. Hostel occupancy levels were similar to that experienced the previous year. The Rural Primary Health Program is a Commonwealth Government funded program aimed at providing additional primary health services to rural and remote locations. This program operates at all WWHS sites and also at Edenhope. 1. The Health and Fitness Centre closed midway through the year with funds from this program reallocated
ANNUAL REVIEW 2013/14 27 STATISTICS OVERVIEW
ADMISSIONS BY POSTCODE 2013/1 MOST COMMON REASONS FOR ADMISSION TO ADMISSIONS BY POSTCODE 2013/14 WWHS HOSPITALS 2013/14 WIES No. of Cases Nhill Goroke Haemodialysis 388 Kaniva Dimboola Rainbow Warracknabeal Lens Procedures 143 Jeparit Murtoa Dental Extractions and Restorations 63 Horsham Edenhope Bordertown Other Oesophagitis and Gastroenteritis 51 & District Colonscopy, Sameday 45 Knee Procedures 45 85.4% of acute inpatient admissions were from our immediate Respiratory Infections/Inflammations 38 catchment area, an increase from 84% the previous year. Endoscopy Check/Follow-up, Sameday 36 A major purpose of local hospitals is to provide services that Other Digestive System Diagnoses 35 meet the needs of local communities, we are achieving this goal evidenced by the high percentage of local people being treated Respiratory Infections/Inflammations 34 in their local hospitals 9.5% of admissions were from within the Back Pain and Sciatica 34 Wimmera sub-region and another 2.3% from towns just over the South Australian border. Tonsillectomy and/or Adenoidectomy 30 Being able to provide elective surgical services to patients from the Dysequilibrium 29 wider sub-region decreases the elective surgery burden on regional and metropolitan hospitals and assists in ensuring that patients Chronic Obstructive Airways Disease 29 from the Wimmera area are able to have their operation performed Cellulitis 29 in a timely and safe manner without having to travel long distances. Other Factors Influencing Health Status 28 Chest Pain 27 ELECTIVEElective SURGERY Surgery By BY Type TYPE 2013/14 2013/14 Otitis Media and Upper Respiratory Infections 25 Rehabilitation 24 Orthopaedics Kidney and Urinary Tract Infections 23 Ophthalmology Red Blood Cell Disorders 23 ENT Gynaecology Heart Arrhythmia, Cardiac Arrest and 22 General Surgery Conduction Disorders Dental Bronchitis and Asthma 21 Syncope and Collapse 20
Dialysis was the most common reason for admission to hospital and comprised WWHS provides a range of low risk elective surgery. This is an 17.5% of all admissions. 143 lens procedures were performed restoring the important service as it allows patients to be treated locally, at gift of sight to 143 people. the same time decreasing the burden on larger regional and metropolitan hospitals. A total of 605 elective procedures were undertaken in 2013/14. General Surgery and Ophthalmology were the busiest specialties.
28 WEST WIMMERA HEALTH SERVICE FINANCIAL PERFORMANCE
For the ninth consecutive year the Service has reported an operating surplus (Net Result before Capital and Specific Items). This outcome is testament to our financial agility and in particular our ability to continue to find new revenue streams while at the same time keeping a close eye on our costs.
While the $14k net result before FINANCIAL RATIOS CONSULTANCIES capital items is comparatively low it remains a commendable effort for the CURRENT RATIO: .72 Consultancies during the year costing Service to have effectively balanced less than $10,000 (exclusive of GST) The Current Ratio (Current Assets its budget given the difficult financial per consultancy, the number and total divided by Current Liabilities) is used environment faced throughout the year. cost (exclusive of GST) of engagements to indicate how well the Service is was not applicable to West Wimmera able to meet its short term financial OPERATING INCOME Health Service. However consultancies commitments. At 30 June 2014 the which exceeded $10,000 are required ($33.75M) Service’s Current Ratio was 0.72 (1.18 to be declared. Victorian State Government at 30 June 2013) which is slightly above (predominantly the Department the Departmental benchmark level of ADVERTISING EXPENDITURE of Health) sourced grant income 0.70. Declaration of this item was not comprised 54% of total operating applicable to WWHS this year. income (2012/13: 52%) followed QUICK ASSET RATIO: 1.21 by Commonwealth Government The Quick Asset Ratio is similar to the EX-GRATIA EXPENSES Residential Aged Care Subsidies on Current Ratio but provides a better 22% (23%). indication of the Service’s short term There were no ex-gratia expenses made solvency by only including those current by the Service during the financial year. OPERATING EXPENDITURE assets and current liabilities of an ($33.74M) easily liquefiable nature. This result means that the Service has $1.21 Total employee related costs made ($1.43) in liquid assets for every dollar up 78% (76%) of total operating of short term liabilities. expenditure emphasising the critical role that our staff play in the level and DEBT TO EQUITY (GEARING) quality of care we provide. RATIO: 0.22 CASH AND INVESTMENTS This ratio is used to indicate the degree to which the Service is reliant At 30 June 2014 the Service held total on externally sourced funding and the cash and investments of $7.858m result at 30 June 2014 of 0.22 (0.29) comprising $4.339m for the Service’s shows that only a very small amount of own funds and $3.519m in residential such funding is required. aged care accommodation bonds. The lower result in 2014 is due DEBTORS DAYS: 32 primarily to capital works expenditure On average it took the Service 32 days associated with the new Natimuk (29) to recoup money owed to it for Medical Clinic and the Macpherson patient, client and resident fees over Street, Nhill student housing projects the year. as well as less residential aged care bonds being held compared with the CREDITORS DAYS: 29 previous year. This measure shows that it took the This outcome keeps the Service Service on average 29 days (28) to pay relatively well placed in terms of being its creditors over the year. able to meet its short to medium term operating and capital cash requirements.
ANNUAL REVIEW 2013/14 29 FINANCIAL PERFORMANCE
FINANCIAL POSITION – PERFORMANCE CHANGE AND OBJECTIVES SIGNIFICANT CHANGES IN OUR FINANCIAL THE OPERATIONAL AND BUDGETARY POSITION INCLUDING SIGNIFICANT FACTORS OBJECTIVES OF THE HEALTH SERVICE THIS THAT AFFECTED OUR PERFORMANCE FINANCIAL YEAR AND PERFORMANCE The Service experienced a significant reduction (10%) AGAINST THOSE OBJECTIVES INCLUDING in Commonwealth Government Residential Aged Care SIGNIFICANT ACTIVITIES AND Subsidy Income. This was primarily due to lower than ACHIEVEMENTS DURING THE YEAR normal occupancy rates but which had substantially A key financial performance indicator for West Wimmera recovered toward year end. Health Service is the Net Result before Capital and Specific The consequential negative impact on the Service’s Items for which the Service budgeted to achieve a $15,227 net operating result was sufficiently offset by positive surplus for the year. The result actually achieved was outcomes for items such as Private Inpatient Fees, Aged $14,204. Care Resident Fees, Dental Grants, Radiography Income We also aim to retain sufficient levels of untied cash and and Medical & Surgical Supplies so that a surplus Net investments at all times so that short to medium term Result before Capital and Specific Items result was operational and capital objectives remain achievable from achieved. a financial aspect. Re-evaluations carried out with effect on 30 June 2014 We held some $4.4m of such monies at 30 June 2014 resulted in the fair value of the Service’s property (land and against its originally budgeted amount of $5.5m. The buildings) and transport fleet increasing significantly over lower than expected outcome was principally due to the the year. substantial completion of the capital works associated The amount of these upward revaluation was $17.5m for with the new Natimuk Medical Centre occurring earlier than property and $152k for transport. These revaluations had was originally anticipated. no effect on the Service’s Net Result before Capital and Specific Items as these amounts were taken directly to EVENTS SUBSEQUENT TO BALANCE DATE the Asset Revaluation Surplus in the Balance Sheet which There were not any events subsequent to balance date increased from $14,341m at 30 June 2013 to $31.993m at which had a significant effect on the operations of the 30 June 2014. Health Service in subsequent years.
CASHFINANCIAL AND INVESTMENTS YEAR ENDING 30 JUNE NETNET RESULTS RESULTS BEFOREBEFORE CAPITAL GAINS GAINS
12 700000
10.87 612500 10.28 10 10.3
9.09 525000
8 7.86 437500 7.3 7.13 6.7
6 6.15 350000 262500 4 4.34 175000 2 87500 0 0 2009/10 2010/11 2011/12 2012/13 2013/14 2010 2011 2012 2013 2014
Including Accommodation Bonds
Excluding Accommodation Bonds
30 WEST WIMMERA HEALTH SERVICE OPERATING EXPENDITURE INCOME STATEMENT – 5 YEAR COMPARISON OPERATING EXPENDITURE Financial Year Ending 30 June Employee Related Costs 78% 2010 2011 2012 2013 2014 General Supplies & Services 5% $'000s $'000s $'000s $'000s $'000s Administrative Expenses 4% Revenue 28,396 29,453 32,496 33,582 33,751 Medical & Pharmaceutical Supplies 3% Employee Related Expenditure (20,162) (21,212) (22,210) (23,937) (24,662) Information & Communication Technology 3% Non-Salary Labour Costs (1,042) (1,104) (1,458) (1,553) (1,498) Food Supplies 3% Supplies & Consumables (2,208) (2,218) (2,263) (2,269) (2,099) Electricity, Gas & Water 2% Other Expenses (4,352) (4,722)OPERATING (6,353) (5,719)EXPENDITURE (5,478) Repairs and Maintenance 2% Net Result before Capital Items 632 197 212 104 14
Employee Related Costs 78% Net Capital Items & (2,398) (2,847) (2,211) (2,120) (3,839) General Supplies & Services 5% Specific Items Administrative Expenses 4% Medical & Pharmaceutical Supplies 3% Net Result for the Year (1,766) (2,650) (1,999) (2,016) (3,825) Information & Communication Technology 3% Food Supplies 3% BALANCE SHEET Electricity, Gas & Water 2% Financial Year Ending 30 June Repairs and Maintenance 2% 2010 2011 2012 2013 2014 $'000s $'000s $'000s $'000s $'000s Current Assets 9,941 11,108 11,636 11,408 8,761 Total Non-Current Assets 49,944 46,885 45,842 50,013 65,783 OPERATINGTotal INCOME Current Liabilities (9,287) (10,002) (11,391) (12,975) (12,170) Non-Current Liabilities (639) (802) (897) (981) (1,082) Net Assets (Equity) 49,959 47,189 45,190 47,465 61,292
CONSULTANCIES (NOT CONTRACTORS) WHOSE CONSULTANCY AMOUNTED TO $10,000+ Consultant Project Total Project Total Fees Future Fee Approved Incurred Commitment $’000s $’000s $’000s
DVA Navion Capital 163 100 63 Fundraising Victorian State Government Grants 54% Victorian State Government Grants 54% Commonwealth Government ResidenmalCommonwealth Aged Care Government Subsidies 22% Residenmal Aged Care Subsidies 22% Pament Fees 15%
OtherPament Revenue Fees 3% 15%
CommonwealthOther Revenue Government Grants 3% 3%
RetailCommonwealth Sales Government Grants2% 3%
InterestRetail Sales 1% 2% Donations 1% Interest 1%
Donations 1%
ANNUAL REVIEW 2013/14 31 CLINICAL SERVICES
RESIDENTIAL AGED CARE
Our residential aged care units provide an environment in which residents feel assisted and encouraged to live their lives meaningfully. They are ‘home’ for our residents and it is the positive attitude of our staff that makes them feel at home.
HIGHLIGHTS FROM THE YEAR Montessori training was introduced in all residential units. Staff, applaud Accreditation at all units this year the philosophy which is an asset in was very special. Accreditation is developing individual care plans for assessed every three years on two residents, and assists in a meaningful pre-determined days by highly qualified way to encourage different behaviours. assessors. At least one unannounced Broadening the scope of Montessori visit at each of our nine sites occurs will continue to improve activities each year. Assessors look at records, and lifestyle for residents living policies and procedures, interview with dementia. staff, residents and families to determine our quality of care across 44 Our residents are able to access every outcome standards. type of allied health professional which is a hallmark of our Service, with high We received our accreditation with a calibre staff ensuring the physical, score of 100%! Assessors did not find social and emotional needs of residents any instances of non-compliance at the can be met immediately. unannounced visits. We are very proud of this effort. Over the coming 12 months, we anticipate some changes to our This year, we received significant residential aged care delivery due to funding from the Department of Health the Aged Care Reforms, which will for equipment to aid lifting, mobility affect access, cost, and resident and early assessment for clinical decision-making. management of residents’ needs. Facilities in Nhill and Natimuk received LOOKING TOWARD THE $20,000, while Rainbow, Jeparit and FUTURE Kaniva received $12,000 each. With state-wide aged-care reforms This equipment has increased comfort coming into play in July 2014, WWHS is in and safety for residents and staff good stead, as senior staff and financial across our organisation. officers have attended metropolitan and regional information sessions in Other significant achievements include preparation for a smooth introduction our continued access to an experienced to the changes. and respected Geriatrician, installation of a breakfast bar and sensory room The reforms will see consumer choice at ‘Iona’. The breakfast bar increases and industry marketing promoting resident experiences by providing a competition with each other to comfortable place reminding them to attract residents. sit and eat, while the sensory room is a restful environment designed to inspire We will also advance Montessori the senses. training with additional furnishings and equipment being planned to support Staff training throughout the year the program, as well as further staff covered elements from medication training scheduled, being ever mindful management to legislative and that Aged Care is our ‘core business’. regulative requirements, how to recognise and report situations such as elder abuse, and manual handling, ensuring our standards are industry leading.
32 WEST WIMMERA HEALTH SERVICE Dulcie Hogan, Resident of Bowhaven Hostel, Rainbow, welcomes husband Les for his daily visit.
ANNUAL REVIEW 2013/2014 33 CLINICAL SERVICES
Kayleen Kingwill, Aged Care Administration Officer, West Wimmera Health Service, discussing care options for their mother with Trudy and Peter Gebert.
AGED CARE – THE CHANGES BECOMING A RESIDENT YOUR FIRST INTERVIEW West Wimmera Health Service Services To become a resident in any aged care ABOUT PROPOSED provides residential aged care on a facility requires an assessment by an RESIDENTIAL AGED CARE permanent or respite basis at five Aged Care Assessment (ACAS) Officer. At initial interview which will usually sites throughout the Wimmera Mallee The ACAS service can be accessed be with the Director of Nursing you will Region. through any West Wimmera Health have the opportunity to tour the facility Service site. Our residents receive the individual and explain any matters that may need attention they require from Referral to the ACAS service can be clarification you have. professional and committed staff. Our made by your General Practitioner, Discussion will embrace: staff pride themselves on their genuine service provider, family member or Best choice of facility for the care dedication to deliver the highest carer or by self-referral. • required standard of care 24 hours a day, every “Aged Care Assessment Services day of the year. • General Practitioner - choice (ACAS) are independent teams who of General Practitioner. If the West Wimmera Health Service Services assist frail older people and their GP is unable to visit provision provide care that is planned to suit the carers identify what kind of care will is made for a choice of caring individual. We encourage our residents best meet their needs. Assessment General Practitioners and medical to live their lives to the fullest and make teams are multi-disciplinary and can specialists who offer services to the most of what we have to offer. include health professionals such West Wimmera Health Service as medical officers, social workers, As from 1st July 2014 the residential units. nurses, occupational therapists and Commonwealth Government will physiotherapists. A meeting with the Aged Care Finance introduce sweeping changes to the way Officer will transpire and the following residential aged care will be managed They conduct comprehensive medically items will be addressed with the including to resident classification and based assessments for those needing intending resident, family and/or carer. funding processes. community services or aged care Accommodation options and residential services. They assess for all • appropriate facilities restorative and potential care options” (Aged Care in Victoria) • Daily care fees • Accommodation payments • Out of pocket expenses
34 WEST WIMMERA HEALTH SERVICE Rainbow Dance Club members, Alan and Laurie Bretag enjoy their weekly dances with Rainbow aged care residents, community members and staff but not as much as our residents. Dulcie & Les Hogan, Lauris & Alan Bretag, Adele Vincent, Dorothy Gould, Joan Jones, Val Roll.
AGED CARE IN OUR COMMUNITY Caring for the aged in our communities takes many forms. High Care, Low Care, Care in the WWHS facilitates a number of community home care community and sometimes the packages for clients, designed to assist ageing community integration of many elements. Volunteers from the community who members to live in their homes for as long as possible. visit our aged care units add so much Currently, our packaged services include domestic assistance, extra to the day for our residents and transport, social outings, maintenance, personal care and visitors who appreciate their interest respite care. enormously
HIGHLIGHTS OF THE YEAR LOOKING TOWARD THE Demand is increasing substantially FUTURE for the 20 home care packages WWHS Home care packages are set to change delivers. These packages are managed with aged care reform, meaning clients by a case manager who sets up services will have a much bigger say in the way and monitors the client to ensure their money allocated to their package is needs are met, and are available in all of spent so that their goals meet both our communities. physical and social needs. We are also providing support to carers This is a very innovative and of our clients, enabling them to enjoy challenging approach to the delivery breaks through the National Respite of this specialist program. 29 for Carers Program. This type of care specialist program. is managed and tailored individually, ensuring the best outcome for both client and carer.
ANNUAL REVIEW 2013/14 35 Adelaide McKenzie enjoying the company of Registered Nurse May Hei Eh Kyaw Kyaw in the calm surroundings of Nhill Acute Hospital.
36 WEST WIMMERA HEALTH SERVICE MAY'S STORY
A LONG JOURNEY FROM THAI-BURMA BORDER TO NHILL
Hi! My name is May JH Hei and I am a On the 14th of February 2008, our Karen from Thai-Burma border. I was family which consist of my pregnant born in a refugee camp called Klert mum, dad, me and my two little brothers, Koht in Thailand. This refugee camp we had landed safely to our now called was shut down and our family moved homeland, Australia. My little sister into a new camp nearby called Mae La was born after our 4 months arrival Refugee Camp. I was one year old at in Australia. that time. I lived there until I turned 16 I was lucky enough to be in an age range years of age. Through these long years where I can attend the high school when of growing up in a refugee camp, I had I first arrived. I spent 1 term in Western no idea of how the actual normal world English Language School to improve my would be outside the camp. English speaking and writing. After that, Our camp was very crowded and barbed I started my 2nd semester year 10 in wires fences all around us. There are Hoppers Crossing Secondary College. still approximately 50, 000 refugees in I took Victorian Certificate of Education Mae La Camp. We were not allowed to go (VCE) subjects for year 11 and year 12 outside of the barbed wire. Every entry for the next following 2 years. After site of the camp was patrolled by two and a half years in high school, soldiers. The United Nations (UN) gave I had made enough score to get into us food monthly with a ration. They gave university. I chose to study Bachelor of us rice, fish paste, oil, yellow peas and Nursing because of the experience that I chilli which we made food out of these had in the Mae La Camp. I had witnessed supplies. I attended school in the camp many deaths of the refugees due to lack which taught by the local teachers and a of healthcare supplies and qualified few foreigners who were volunteering. healthcare workers. In year 2005, the UN government open After 3 years I graduated as a registered the door for our refugees to settle nurse in 2013. I was hoping that, one day down in the developed countries I can go back and work in Thai-Burma such as Australia, America, England, border to help out the poor people and Sweden, etc. My family chose to apply the refugees with the knowledge and our new lives in Australia. To be able the skills that I had learnt in this country to be successful, we had to go through as a registered nurse. interviews and medical check which And now here I am in West Wimmera took a very long process depends on Health Service (WWHS) to put the each family situation. It took 1 to 4 years theories I learnt into practice. I am doing to be able to know whether you are graduate nurse program at Nhill and successful or not. For our family, it took very grateful that WWHS let me fulfil nearly 3 years to come to Australia. my dream. A few months after the successful I am also helping the Karen people from medical check, we had to attend an Nhill with interpreting English related to orientation week of the new life. We had the healthcare in my spare time. learnt the basic everyday living about housing, bills, cooking, crossing road, Thank you WWHS for giving me this traffic light, etc. Looking back, it was wonderful opportunity liked a dream at that time. I was so excited and couldn’t even study for my final exams.
ANNUAL REVIEW 2013/2014 37 CLINICAL SERVICES
CHILDREN ARE ALWAYS ACUTE PATIENT CARE SPECIAL GUESTS AT WEST WIMMERA HEALTH SERVICE. West Wimmera Health Service continues to provide Bringing your child into hospital for an outstanding acute facilities. We’ve made a concerted effort operation can be quite confronting both to reduce the clinical look of our facilities providing instead for you and your child. a vibrant and inspiring décor across our sites, making We have trialled many ways to make the visit a more positive experience patients as comfortable as possible. and have found that the first step is to encourage them to bring their favourite We have also up-skilled a nurse to This equipment was funded by WWHS, toy into hospital. provide asthma care, and added a and will ensure care provided is safe in palliative care resource nurse who all facilities. DRIVING TO THE OPERATING is based in Nhill but accessible at all Exemplary screening policies mean SUITE campuses. we have a wound infection rate of Next, driving the shiny red car to the We offer a wide range of hospital and ‘nil’, as we continue to follow strict Operating Suite is the highlight of their ambulatory care with 35 beds in Nhill, guidelines set by the World Health stay. Driving themselves and ‘teddy’ to seven in Rainbow, six in Kaniva and Organisation, the Australian and New theatre also removes some of the fear four in Jeparit. Zealand College of Anaesthetists and factor out of the whole process for Australian College of Operating Room Our Admission and Discharge parents as well as the child. Big smiles Nurses and Australian/New Zealand Department provides stable and instead of tears as the child heads for Standards. comprehensive services, ensuring the Theatre Suite happy. clients know what to expect from Continuing access to these specialties When the child and ‘teddy’ arrive at the surgery, and are aware of pre- and is crucial to the wellbeing of our Theatre door the child has to answer post-operative requirements such community, reducing the need to questions for ‘Teddy’ too. Children are as preparation for the procedure travel huge distances for specialist asked what their name is and what and lifestyle restrictions during treatment which is critical to enabling “Teddy’s name is, their date of birth (if recuperation. patients to retain the support of they are old enough to know) and what family and friends at all times. operation they are having today? THEATRE LOOKING TOWARD THE Once admitted to the operating HIGHLIGHTS OF THE YEAR FUTURE Theatre ‘Teddy’ goes through the same procedures as the child such as the Our well-equipped theatre operates We will improve preparation for cardiac dots being put on to ‘Teddy’ every week, with visiting surgeons patients undergoing colonoscopies, as well. specialising in Ear Nose and Throat, working with the surgeons, pre- Orthopaedics, Oral Dental, General admission clinic and pharmacist to Another comforting touch is they wear Surgery, Ophthalmology, and achieve better outcomes for our their own favourite pyjamas rather Gynaecology. patients. than a Theatre Gown and there are DVD players for movie watching during One of our biggest achievements this The general surgeons have met with their stay. year is the introduction of a macular WWHS managers and doctors to injection service, which has assisted explain the surgery they can perform Children receive an admission pack with many people maintain their eyesight in Nhill, and make it known we intend colouring pages and word searches for a significantly longer period of to increase General Surgery for based on healthy food choices and time. next year. We will also obtain more the new children’s menu with tempting equipment to meet standards and healthy food options served in rainbow Generally, waiting times for surgery coloured bowls. are exceptional, with most people ensure patient safety. having surgery within six months of It is the intention to re-evaluate QUALITY & SAFETY ASSURED their initial consultation. the way we disinfect and sterilise A Specialist Paediatric Anaesthetist instruments to ensure such standards A range of new equipment was is a central part of the Operating Suite are best-practice and in accordance purchased to ensure we consistently Team for child patients as are General with the new Australian/New Zealand deliver optimal care to our patients, and Specialist Surgeons. including a video laryngoscope, Standards to be released. We are continually researching ways to peripheral nerve stimulator, magnets We will continue this annual audit make a trip to hospital more welcoming, for use with patients with pacemakers, program for this purpose. and biological monitoring incubator. comfortable and without fear.
38 WEST WIMMERA HEALTH SERVICE Jack Dodds in his favourite blue pyjamas can’t wait to get on the road to the Operating Suite. Nurse Pam van Kempen is hoping he doesn’t receive a speeding fine on the way.
ANNUAL REVIEW 2013/2014 39 CLINICAL SERVICES
WOUND MANAGEMENT HIGHLIGHTS OF THE YEAR WWHS continues to provide specialty wound-care services to patients in the acute setting, as well as in aged care. Specialist wound-care services increased this year, with a wound clinic providing assessment, management and advice to outpatients and community members as well as inpatients.
LOOKING TOWARD THE FUTURE Our wound-care service is set to commence exciting research this year, and has ethics approval from the Ballarat Health Services and St John of God Hospital Human Research Ethics Committee.
DIALYSIS With increased staff training, our dialysis can expand from one to two sessions per day as required. The unit continues to run three days a week, providing reliable treatment for patients, with the capacity to offer vacation care to dialysis patients travelling through the region. The refurbished unit and office space allows staff to manage treatment more effectively, facilitating discussion between clients with specialists in a more private space. It has been a challenging year in dialysis, with three much-loved patients passing away. Remaining patients and staff were grateful to receive counselling support from the Royal Melbourne Hospital.
LOOKING TOWARD THE FUTURE The dialysis unit will continue their impressive record with no infections, as well as increasing dialysis capacity by involving enrolled nurses in the unit.
Wound Care Nurse Cindy Bone had great success this year with a radically innovative regime which cured long term leg ulcers for a very grateful patient.
40 WEST WIMMERA HEALTH SERVICE ALLIED HEALTH
Our team of qualified health professionals provides services in the acute, rehabilitation, residential aged care and community settings. We will break down the barriers and health inequalities existing within our communities to enable opportunities for improved health outcomes.
HIGHLIGHTS OF THE YEAR Our Community and Allied Health team consists of expert staff in their respective fields, meaning we are able to offer and implement a wide range of initiatives designed to strengthen our community. This year, a significant achievement was working in partnership with West Wimmera, Hindmarsh and Yarriambiack Shire Councils to develop the ‘WHY Project’, offering Occupational Therapy, Physiotherapy, Podiatry and Dietetic services across all Shires, administered by WWHS. Developing and implementing a Healthy Ageing initiative across our catchment Podiatrist Bianca Jones discussing treatment options with Colleen Ross in was another key achievement. the Podiatry Consulting suite at the new Goroke Community Health Centre. This program ensures older people within our communities are connected The multidisciplinary team ensures PODIATRY to services and programs across the quality health outcomes for our clients, WWHS Podiatrists deal with the region, offering information sessions and includes the following: and programs relating to staying strong prevention, diagnosis, treatment and and living at home for longer. COUNSELLING rehabilitation of medical and surgical conditions of the feet and lower limbs. We also targeted the mental health We provide a professional and of young people in our community, accessible service dedicated to PHYSIOTHERAPY initiating and implementing a mental improving the mental, physical and Our expert staff focus on prevention, health program for school students in psychological wellbeing of individuals assessment and treatment of physical conjunction with Nhill College. who wish to improve their lives and the disorders and the promotion of These programs are effective in lives of those around them. movement and health. reducing health inequalities among our community members, enhancing MASSAGE SPEECH PATHOLOGY community participation and promoting Massage therapy improves circulation The Speech Pathology Department health across our region. by bringing oxygen and other nutrients provides effective and efficient to body tissues. It relieves muscle WWHS was involved in exciting intervention for those with tension and pain, increases flexibility major research, investigating communication and swallowing and mobility, and helps clear lactic acid the effect of different types of disorders. and other waste, which reduces pain and fluids on patients with swallowing stiffness in muscles and joints. difficulties. This research is being DISTRICT NURSING conducted in collaboration with the OCCUPATIONAL THERAPY Experienced District Nurses provide University of Melbourne and Baker nursing care which allows people to IDI, and has approval to continue until Occupational Therapists assist people remain in their own homes, maintain December 2015. to maintain or gain the skills and their independence, or have additional confidence to complete activities and The wide variety of programs delivered support after discharge from hospital. tasks that are meaningful and useful is a credit to the diversity and to the person. They can recommend District nurses assist clients strength of our Community and Allied specific tools and/or equipment that with administration of medications, Health team. can be of benefit to the client. wound management, continence management, and personal care, and thus enhance quality of life for clients.
ANNUAL REVIEW 2013/14 41 CLINICAL SERVICES
Russell Hallam, Chef in Charge, Nhill Hospital, at work early to receive delivery of the beautiful fruit and vegetables used for the freshly cooked meals served every day.
DIETETICS Planned Activity Groups are also a WWHS has committed to developing great way to stay informed about health health promoting plans over the next WWHS dietitians advance good and community services offered within three years in conjunction with the health by promoting better choices the community by West Wimmera Wimmera Primary Care Partnership around nutrition, which includes food, Health Service. and Local Governments. Priority areas menu planning and cooking methods. identified include mental health and DIABETES EDUCATION LOOKING TOWARD THE physical activity. FUTURE We will also continue our clinical Our expert staff are trained to teach research, ensuring we remain a leader in people with diabetes how to better WWHS will continue to enhance the the health industry. manage their medical condition and rehabilitation and mental health conduct a sustainable lifestyle. services available to our community clients. Planning is underway to develop GRANTS RECEIVED a Rehabilitation Centre, offering expert HOME AND COMMUNITY CARE WWHS has been allocated additional facilities for people to receive health HACC funding for: This program provides services to frail, rehabilitation in Nhill, as well as a aged, people with a disability and their Cancer Resource Centre. • PAG Care Planning - $5,435 carers, who live in the community. Minor Capital - $20,726 We will continue enhancing the mental • PLANNED ACTIVITY GROUPS health services offered for young Received $4,800 from the Department people, working more closely with of Health for Allied Health training These groups are designed to help older the schools across our catchment to of staff to attend seminars and people and people with disabilities implement programs. conferences. stay healthy and active by engaging in interesting and fun group activities.
42 WEST WIMMERA HEALTH SERVICE RADIOLOGY
HIGHLIGHTS OF THE YEAR LOOKING TOWARD THE Radiology enjoyed another very FUTURE successful year, with increasing A team approach has strengthened patient attendance in computerised our Radiology Department, improving tomography (CT), ultrasound, and service delivery. To improve patient general X-ray. confidentiality we are investigating the possibility of developing a dedicated The quality of dental images was waiting area and reception. vastly improved with the installation of a state-of-the-art dental X-ray, or orthopantomogram (OPG). This COMPLIMENT machine also enables us to perform When patient Elly took X-rays from the some procedures for the first time, Nhill hospital to her Melbourne-based saving patients trips outside the orthodontist, the orthodontist said the region for examinations such as lateral X-rays coming from Nhill were some cephalograms. of the best he has ever seen, and the We will continue to improve the use of radiographer should be commended. the OPG, developing sterilisation and infection control practices to ensure standards remain best practice.
PHARMACY
HIGHLIGHTS FROM THE YEAR LOOKING TOWARD THE Inspected by the Victorian Pharmacy FUTURE Authority this year, our pharmacy In furthering our medication service passed with flying colours. reconciliation efforts we are developing We continue to provide consistent our own hospital formulary, which will and effective pharmacy services, stabilise our existing pharmacy stock implementing recommendations from usage and help improve the system the internal audit, and introducing between doctor prescribing and a temperature data logger to all medication delivery. medication fridges. We will also investigate better patient This monitors our fridges continuously, medication summary software to assisting us to confidently evaluate the replace existing systems with the temperature to ensure safe storage of endeavour of providing more complete medications. patient care information at the time of discharge. Our pharmacy continues to be a member of the Medication Reconciliation Working Party Members auspiced by the Department of Health, ensuring correct selection of the ‘right’ medication for the ‘right patient’.
ANNUAL REVIEW 2013/14 43 CLINICAL SERVICES
DENTAL
HIGHLIGHTS FROM THE YEAR With the help of Dental Health Services Victoria, we also had access to portable Dental Services flourished this year dental equipment for two months thus with significantly increased program providing oral health services to 15 delivery. Undoubtedly the highlight primary schools during this period. of the year was opening the Kaniva and Goroke Dental Clinics in February. Our Rainbow clinic has also seen These modern facilities, together increased program delivery, moving with well-trained staff, ensures operations to weekly instead of WWHS continues to deliver the most fortnightly. comprehensive dental services in Equipment upgrades continue to our region. improve our service delivery as with Our graduate dentist program digital X-rays, we provide faster continues to be a tremendous success, imaging services and access images attracting one talented graduate to our from all four dental clinics. service every six months, with three Digital Inter-oral cameras were graduates currently being mentored by purchased, taking images in the our senior dentist. mouth so patients can gain a visual This program ensures our dentists are understanding of what the dentist has up-to-date with the latest practices and achieved. technology, keeping us at the forefront Finally, WWHS Dental Clinics are now of oral health promotion. all paperless, increasing efficiency NEW – ALTERNATIVE TO in our clinics and making them more TRADITIONAL BRACES TO environmentally friendly. ALIGN TEETH LOOKING TOWARD THE We were successful in retaining a senior FUTURE dentist on a permanent part-time basis, meaning we can offer a significantly Over the next year, Dental Services broader range of general and advanced will aim to increase promotion of good dental procedures. oral health in the region, continuing our commitment to making Dental Services Our senior dentist specialises in accessible to everyone. Invisaline, an orthodontic treatment using clear, removable aligners as As well as maintaining our four Dental an alternative to traditional metal Clinics, we will continue our partnership dental braces. with the Royal Flying Doctors, deliver free school screenings, and organise Continued investment in training made a mobile dental van to reach outlying it possible for two dentists to become areas within our region. certified to provide conscious sedation, with other dental staff undertaking We will continue to provide oral surgery programs such as Certificate IV in services in Nhill, with the ability to Health Promotion and Certificate III in treat patients in the dental chair or in Dental Assisting. the hospital theatre, and are looking to facilitate dental implant services in WWHS is committed to making dental the future. services accessible to all members of our communities. Our sustained partnership with the Royal Flying Doctors volunteer dentists helps us ensure dental services are Senior Dental Surgeon Aziz Baluch has brought a freely available, providing free checks new orthodontic treatment to our Dental Clinics. Using clear aligners as an alternative to metal and treatment through their regular dental braces has been a success as patient three-monthly visits. Alison Welsby agrees.
44 WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW 2013/2014 45 CLINICAL SERVICES
DISABILITY SERVICES
‘Cooinda’ Disability Service based at Nhill supports people with disabilities and ensures achievable individual outcomes, encouraging personal development while promoting positive interaction and participation within the wider community.
Cooinda offers individual support based Those working in the café learn the services for eligible participants, with importance of food preparation and choices of interesting programs and presentation, customer service and the activities with, supported employment importance of cleanliness and correct opportunities, for people with a food handling skills. disability who require guidance and At Snappy Seconds supported assistance to perform employment employees are given training in duties. customer service, selection of This is a special feature of our program. and display of goods for sale and deportment. DAY SERVICES The Stores Department of West HIGHLIGHTS FOR COOINDA Wimmera Health Service has now combined with Maintenance in DAY SERVICES INCLUDE: providing work opportunities in an open • Participation in the Oral Health employment environment for supported Promotion for people with employees, teaching work ethics, disabilities entitled ‘Keep the responsibilities and expectations of Wimmera Smiling’ incorporating working in a busy hospital setting. participants from Cooinda, Wimmera Uniting Care Horsham, Accreditation of the Commonwealth Woodbine Warracknabeal and funded business services in 2013 was Edenhope and District Memorial once again successfully accomplished. Hospital. In July 2014 both State and Commonwealth funded programs will Introduction of joint programs with • be audited against the new Disability Wimmera Uniting Care Day Service Standards. with each agency hosting activities on alternate weeks resulting in new and renewed friendships. LOOKING AHEAD • Competing in the Tri State Games, Cooinda staff continue to participate an annual sporting competition in information sessions showcasing held over five days in various the outcomes of the Barwon towns throughout South Australia, National Disability Insurance Scheme New South Wales and Victoria (NDIS) trials. where Cooinda participants were The NDIS is a generational reform successful medal recipients. that will deliver a national system of disability support focused on the BUSINESS SERVICES individual needs and choices of people Our supported employment sites of with unfortunate handicaps. Oliver’s Café and Snappy Seconds NDIS will progressively roll out in continue to provide valuable education Victoria from July 2016 to July 2019. and on the job training which feature support and work experience in a busy The Service will closely monitor the enterprise. reform to maximize opportunities to provide meaningful programs, Supported employees learn skills to activities and employment to people enable them to work in hospitalities with disabilities in our catchment area or retail under the guidance of trained and also capitalise on the benefits this supervisors. reform program may bring.
46 WEST WIMMERA HEALTH SERVICE “I used to do gymnastics when I lived in Melbourne and I like riding horses. Vaulting joins the two things together. It is a cool thing to do and I am proud of myself when I do the routines”
Amy Brown with very patient pony Chrystal getting ready for a fun day of riding and horsemanship in the clean clear air of the countryside.
ANNUAL REVIEW 2013/2014 47 CLINICAL SERVICES
Dr Alex Stepanov consulting with Loma Wallis in the Tristar Medical Clinic, Kaniva. The appointment of Dr Alex, a second General Practitioner for Kaniva, is the result of our close working relationship with Dr Kahled El Sheikh, which has resulted in a full complement of practitioners for West Wimmera Health Service communities – certainly against the trend for other small rural communities where doctor shortage is endemic.
48 WEST WIMMERA HEALTH SERVICE MEDICAL REPORT
EXPANDING THE DIMENSION OF CARE
West Wimmera Health Service continues to provide a broad range of medical services to the communities of the Western Wimmera. Visiting Specialist Surgeons and Anaesthetists conduct regular elective operating lists in Nhill, allowing local residents to have surgery close to home and avoid extensive journeys to Regional and Metropolitan for elective surgery.
Tristar Medical Group provides Consultant Anaesthetist, Dr Robert credentialing, definition of scope of General Practitioner services in Nhill, Ray, visits from Ballarat to Nhill on a practice and performance of general Jeparit, Rainbow and Kaniva as well as monthly basis to provide consultant practitioners, specialist Visiting supporting the Primary care Casualty anaesthetist services and provide Medical Practitioners, dentists and Units and after hours coverage for acute specialist oversight and guidance other practitioners as well as matters and emergency patients. for anaesthetic, critical care and relating to performance improvement, resuscitation services across West accreditation, legislative compliance, Dr Harsha Aluthge left the Tristar Wimmera Health Service. Dr Ray’s clinical risk management and consumer Medical Group practice in Nhill during contribution is very highly regarded a engagement. the year. Prior to his departure, we were gratefully acknowledged by staff and delighted to learn Harsha had received Over the past year a Grampians regional patients alike. his Fellowship of the Royal Australian Credentialing Committee has also been College of General Practitioners. We Maintaining this range of surgical established and West Wimmera Health wish Harsha and is family well and thank services in a small rural hospital Service is exploring how this committee him for his work at the Tristar Clinic and setting presents special challenges might be integrated with the work of the for his contribution to West Wimmera for operating room, day procedure, Clinical Quality Governance Committee. Health Service. ward and after hours staff. In order The Quality and Clinical Governance to ensure that West Wimmera Health Drs. Anthony Anachuna, Irfan Hakeem, Committee also works in close Services is addressing these challenges Aysha Rasul, Paul Moyo and Shepherd liaison with the Clinical Improvement and undertaking an appropriate range Chifura have continued to work across Committee which is responsible for of surgical services, a comprehensive the Tristar clinics and West Wimmera the implementation, operation and review of surgical services was Health Service sites. Drs Nneka (Stella) improvement of clinical processes and undertaken in 2013. This review Anachuna and Debby Chinogara have outcomes throughout West Wimmera provided expert guidance on the safe also been working in the Tristar clinics Health Service. and effective delivery of elective and have recently been joined by Drs. surgical services now and in the future All Visiting Medical Officers regularly Wei Cheng Chen and Oleksiy (Alex) at West Wimmera Health Service totally undertake continuing medical Stepanov, working in the Tristar clinics endorses the levels of competences education, attending seminars, in Jeparit and Kaniva respectively. which prevailed prior to this revision. tutorials, conferences and workshops West Wimmera Health Service (Nhill) relevant to their practice at West During 2014, regular visits to West continues to provide a comprehensive Wimmera Health Service. Wimmera Health Service from general range of specialist surgical services physicians based at Wimmera Health On behalf of the local community, including: General Surgery (Messrs. Care Group in Horsham will commence. West Wimmera Health Service thanks Stehen Clifforth, Peter Tung and Two physicians will alternate fortnightly its general practitioners and visiting Uvarasen Naidoo from Glenelg Surgical visits to Nhill Hospital to conduct specialist medical practitioners for their Clinic); Orthopaedic Surgery (Mr Chi general medical clinics as well as ongoing support and the high quality Gooi); Ophthalmic Surgery (Dr Mark providing a consultation and referral clinical services that they continue Chehade); Gynaecological Surgery (Dr service. This is a very welcome to provide. Ian Jones); and Ear, Nose and Throat development which will provide Surgery (Mr Laurie Ryan). specialist medical care in Nhill and The delivery of surgical services has reduce the need for patients to travel been facilitated by a very supportive for such specialist consultations. group of General Practitioner The West Wimmera Health Service anaesthetists including Drs Stuart Clinical Quality Governance Committee Perry, Malcolm Anderson and Kim Fielke. meets Bi monthly and reports to the Board of Governance on the
ANNUAL REVIEW 2013/14 49 CLINICAL SERVICES
MEDICAL & CLINICAL VISITING CONSULTANTS
CONSULTANT EXECUTIVE DENTAL SURGEONS SONOGRAPHERS DIRECTOR MEDICAL Dr Aziz Baluch BDS(Syd) ADOH(Ade) Ms A Kellaway BMed Radiography SERVICES MPH(Syd) MOSC(Syd) MRACDS(Syd) (Diagnostic Radiog), Dr I S Graham MBBS MHP AMEE Dr Alvin Ng BDSc(Melb) Grad Dip Medical Sonography FRACMA Dr Anamalay Ayasamy Mr S Jones BDS(Singapore) FDSRCPS(UK) FICD B App Sci (Medical Radiations), GENERAL SURGEONS Dr Lok Chern Muk (Dr Ricky Grad Dip Ultrasonography Mr S Clifforth MBBS FRACS Muk) BDSc(Melb) RADIOGRAPHERS: Mr P Tung MBBS FRACS Dr Lisa Li BDSc(Hons) Mr T Harlow Dip App Sci, Grad Dip Mr U Naidoo MBChB FCS(SA) FRACS Dr Leanne Just BOH(HONS)(Qld) App Bus ORTHOPAEDIC SURGEONS Graduate Diploma of Dentistry(Qld) Ms A Kellaway BMed Dr C Gooi MBBS FRACS ORAL HEALTH THERAPISTS Radiography(Diagnostic Radiog), Grad Mr J Patrikios MBBS MS FRACS Dip Medical Sonography Erika Alegre BOHSc Ms S Worsley Dip App Sci (Medical CONSULTANT OPHTHALMIC Hayley Downey BOHSc Radiations) PHYSICIAN AND SURGEON GENERAL PRACTITIONERS Mr S Jones B App Sci (Medical Dr M Chehade MBBS FRANZCO Radiations), Dr K El-Sheikh MBBS FRACGP Grad Dip Ultrasonography EAR, NOSE AND THROAT FACCRM DPM DPS CASA Pilot Medical Officer PRACTITIONERS LAKE IMAGING PTY LTD Dr P Moyo MB ChB Miss A Cass MBBS FRACS RADIOLOGISTS Dr S Chifura MB ChB Mr L Ryan MBBS FRACS FRCS DLO Prof A Pitman MBBS BMedSci Dr H Aluthge (from April 2014) FRANZCR MBBS DFM RCGP(UK) CONSULTANT OBSTETRICIAN Dr R House MBBS FRANZCR DDU AND GYNAECOLOGIST Dr A Anachuna (from December Dr A Firkin MBBS FRANZCR 2012) MBBS Dr I Jones MBBS FRANZCOG Dr A Meakin MBBS FRANZCR Dr I Hakeem (from December 2012) MB ChB Dr M Mittal MBBS FRCR(UK) VISITING DENTAL SURGEON FRANZCR Dr A Rasul (from March 2013) MBBS Dr A Ayasamy BDS FDSR CPS FICD Dr L Zentner MBBS BA FRANZCR Dr J Thomson MBBS ANZSNM SPECIALIST ANAESTHETIST Dr K Graham MBBS DRANZCOG Dr C Trotman BDS(UK) LDS(UK) FRACGP MPH TM Grad Dip Clin Edu Dr R Ray MBBS FANZCA FDS(UK)FRANZCR Dr D Chinogara MB ChB Dr K New MBBS FRANZCR GENERAL PRACTITIONER Dr N Anachuna MBBS Dr K King MB ChB(UK) FRANZCR ANAESTHETISTS Dr W Cheng Chen MBBS Dr A French MBBS FRANZCR Dr M Anderson Dr O Stepanov MD MBBS FRACGP DA FACRRM VISITING OPTOMETRISTS Dr K Fielke MBBS DA FACRRM CONSULTING PHARMACISTS WIMMERA EYE CARE Dr S Perry MBBS FRACGP Mr W Mascoll BPharm MAACP AACP Hannah Guyatt BOptom Therapeutical Dr N Provis-Vincent Ms D Norton BPharm AACPA Dip Med Endorsed (AHPRA) MBBS BMedSci (Hons) FACRRM Herbalism VISITING AUDIOLOGIST SPECIALIST GERIATRICIAN STAFF PHARMACIST ADELAIDE DIGITAL HEARING AND PHYSICIAN Mr M Yau BPharm MPS SOLUTIONS Dr R Shea MBBS FRACP Mr K Emmett BPharm MPS Benjamin Wood BMRad (RT), MAud, MAUDSA (CCP) SPECIALIST GERIATRIC CONSULTING RADIOLOGY NURSE SERVICE MCGRATH FOUNDATION Mr G Taylor RN Post Grad Dip CONSULTANT MANAGER BREAST CARE NURSE Psych Nurs Mr P Trenery Dip App Sci Ms Wendy Crafter RN MBCN (Med Radiog), Grad Dip Ultrasonography
Dr ‘Sammy’ visits Nhill Dental Clinic monthly for consultations and extractions in the Operating Theatre, such as Wisdom Teeth or when many teeth require removing. The Dental Team is supported by the Theatre Manager, Sharon Sanderson and the Dental Clinic Team.
50 WEST WIMMERA HEALTH SERVICE Dental Nurse Sharyn Morrison, Sharon Sanderson, Theatre Manager, Dr Stuart Perry, Dental Nurse Andrea Deckert, Dr Anamalay Ayasamy
ANNUAL REVIEW 2013/14 51 QUALITY OF CARE
STORIES OF QUALITY OF CARE IN ALLIED HEALTH
WOUND CARE Creativity is sometimes an essential element of healing. A patient, Shirley, had suffered from chronic leg ulcers for nine years, Dear John, enduring countless tests, numerous bouts of surgery, many infections, I am writing to thank you and the entire complicated treatments and lots of pain. physiotherapy and massage therapists of Nhill She was admitted to the Nhill Hospital in February 2014 with an infection in her Hospital for their magnificant care that helped right leg and three non-healing ulcers on the left leg. restore my severly damaged shoulder and arm Her General Practitioner, the West to full functionality. Wimmera Health Service Specialist Wound Nurse and her Surgeons, thought Their professionalism and human care were broadly and decided to try Negative Pressure Wound Therapy in their inspirational. Every time I walked the corridors efforts to heal the wounds. This therapy at Nhill Hospital I thought how lucky we are to entailed attaching dressings to a pump which applied pressure to the leg have such a wonderful Hospital in our town. encouraging new tissue to grow. The treatment proved successful and It is truly world class.. the ulcers began to improve to the point she was able use a smaller pump allowing My sincere thanks, her to walk freely and two months after the treatment began Shirley was able Kim to return home - her wounds completely healed after nine years! An expensive treatment but worth it. West Wimmera Health Service Wound Kim's Letter to John Smith Care Nurse provides speciality services to patients in our hospitals, as well as Hostel and Aged Care patients at all Arriving home, Kim underwent further After the surgery Kim returned home campuses of the Service. surgery at a prominent Metropolitan to continue intensive rehabilitation The role has recently expanded and this Hospital, but after eight months she was with the team at West Wimmera same specialist wound care and advice still unable to use her arm. Health Service. is now available to outpatients in the Desperate for help, she began THE OUTCOME community. working with the West Wimmera Health Service Physiotherapists Just over 15 months later through the THE ROAD TO RECOVERY – and Massage Therapists. The skill and initiative of her Surgeon, West DETERMINATION, SKILLED treatments complemented each other; Wimmera Health Service therapists and PRACTITIONERS AND physiotherapy improved her movement, her own determination, Kim achieved a INNOVATION and massage helped with scar tissue full recovery and now has full use of her and pain. Three months later, she arm. Kim’s happy ending took a while. returned to her Melbourne Specialist for Kim expressed her utmost appreciation During a long awaited holiday overseas, assessment. He was astounded with her to everyone involved in her return Kim had a nasty fall almost severing progress under the care of this team. to full movement and praised the her arm at the shoulder. The severity Given that Kim was fit and very expertise and skill of the Allied Health of her injuries meant she had to determined backed by an excellent Practitioners available at West undergo urgent surgery in less than Physiotherapy team behind her, Surgeon Wimmera Health Service. satisfactory conditions leaving her Mr Treseder, decided to undertake a with a critical infection. world-first operation on her shoulder.
52 WEST WIMMERA HEALTH SERVICE Kim Moyle has made a remarkable recovery from an extremely serious freak accident thanks to expert care from West Wimmera Health Service Physiotherapists and Massage Therapists and an eminent team as well as her own determined approach to her rehabilitation. Physiotherapist Emma Smith with Kim setting a new program of exercises to maintain the movement in Kim’s shoulder.
ANNUAL REVIEW 2013/2014 53 QUALITY OF CARE
CONSUMER CARER AND COMMUNITY PARTICIPATION
KAREN COMMUNITY DOING IT WITH US NOT FOR US HEALTH PROMOTION AT HOME IN NHILL WWHS has focused on a model of VISION WWHS has been responsive to the Karen care that ensures clients are working community needs. In order to ensure towards taking responsibility of their “Breaking down the barriers and health this community has improved access to own health outcomes. In combination inequalities that exist within our healthcare staff work with interpreters with the principles of Department community to enable opportunities for and family members to ensure that of Health “Doing it with us not for us” improved health outcomes” clients understand and are part of their Publications and applying an Active West Wimmera Health Service will treatment regime. Service Model, all Community Health strengthen its integrated health Clients are directly involved in their promoting, health service attributes by: Dieticians provide supermarket tours assessment and treatment plan. and cooking demonstrations for a • working in partnership with greater knowledge of Australian type By ensuring that clients and/or agencies and members of our food which the children were asking for. carers are directly involved we have community, witnessed a 75% increase in compliance • seeking to reduce health EXTENDING THE VARIETY OF rates of treatment meaning that inequalities among our community INGREDIENTS clients are recovering quicker from members, mental health issues requiring less We have worked with the Nhill counselling services and referrals for • enhancing community participation, Neighbourhood House and IGA specialists care. • identifying cultural differences Supermarket to ensure that products within our community members, and fresh food typical in a Karen diet is readily available in Nhill ensuring their • ensuring that health promotion nutrition and preferred ingredients are interventions focus on the available. determinants of health and; • providing evidence based health The wider range of foodstuffs available promotion initiatives to enable our has been welcomed by the whole community to take responsibility community, broadening choice and for their own health. variety for all.
54 WEST WIMMERA HEALTH SERVICE Our integrated health promotion RESEARCH CULTURAL RESPONSIVENESS vision is endorsed by organisational strategies, policies, procedures, West Wimmera Health Service is There is a very small Aboriginal and position descriptions and service proactive in the area of research and Torres Strait Islander population planning documents commit to the development. We provide treatment within WWHS catchment, however, we health promotion concepts and and services in accordance with are constantly aware of the need and frameworks of the World Health evidence based practice and are also are committed to ensuring culturally Organisation Ottawa Charter model, leaders in the area of research. appropriate services are supplied. the Department of Human Services Working in conjunction with researchers CULTURAL RESPONSIVENESS Integrated Health Promotion from the Baker IDI, to complete two FRAMEWORK STANDARDS framework, the Social Determinants studies. One relating to swallowing for Health framework and community management. The other to Wound In response to such standards WWHS capacity building models. Healing. Approval was obtained through ensures at all times best practise is Ballarat Health Service and St John of observed. MENTAL HEALTH - A PRIORITY God Hospital Human Research Ethics • 100% of staff are provided with Committee with the approval number WWHS collaborated with the Wimmera education relating to the provision HREC/11/BHSSJOG/20 Primary Care Partnership, Local of culturally appropriate services Government, Schools, Police and to clients and patients. General Practitioners in the region RESEARCH – MANAGEMENT • The Service is committed to to determine the areas of health OF SWALLOWING ensuring culturally appropriate promotion that need to be targeted. The aims of the Swallowing services are delivered and a Cultural Diversity Awareness plan As a result the areas of Mental Health Management study is to investigate exists in the form of a policy at and Physical Activity were determined. the effects of thin fluid consumption in patients who have been prescribed with organisational level. One of our major health promotion thickened fluids. As a result we expect • Accredited interpreters are activities over this financial year has that patients will benefit from increased provided for patients in need. been to work together with local schools consumption of fluid intake and better The Service has access to given it had been highlighted to WWHS • of quality of life. Currently we have interpreters available via the staff there was an increase in self investigated 22 patients, all of whom telephone or face to face. harm and negative self-esteem among have shown a marked improvement Inclusive practice in care planning students in Years 7-9. in their fluid intake and quality of life • is demonstrated, including but not measures. A total of 90% of students across the limited to Dietary, Spiritual, Family, region in these classes have access to Attitudinal, and other Cultural a counsellor with information nights WOUND HEALING RESEARCH Practices and needs. for students and their parents having In addressing Wound Healing, Culturally and Linguistically Diverse been provided. Students have been • West Wimmera Health Service is Consumers, Carers and Community given tools to deal with their everyday investigating healing wounds utilising members are involved in the situations and resilience training has Olivamine, Cream which is proven to be planning, improvement and review been offered with 85% of students a more potent and effective formula of programs and services of the reporting they have increased self- utilised in the United States of America nature on an ongoing basis esteem as a result of the program for this purpose, however not yet Professional development and self-harm rates have dropped available in Australia. • significantly by 80%. opportunities are provided for As a result we expect and have all staff. CONCLUSION witnessed in 6 patients to date that persistent wounds and have been In conclusion West Wimmera Health healing and responding to the use of Service has prioritised mental health Olivamine, where they weren’t healing and although we still have more work previously utilising other products. to do, we have increased the mental health services available for clients and This research conducted on West patients. Wimmera Health Service premises is internationally recognised and will In addition, we have increased contribute significantly to evidence the tele-health arrangements based practice methods in the between specialists and allied swallowing and wound healing fields. health practitioners meaning less Photo: Teacher, Mr Haydn Wearne surrounded These innovative and ambitious by happy students Drew, Sophie and Jordan who travel is required for member of our all agree the Guys and Gals Program presented communities to access specialist review projects, the outcomes of which may by WWHS Community Nurse Michelle Barber appointments. We will continue to transform in medical care of these at the Goroke College is a great success. It has increase our networks and connections particular health concerns. built confidence, encouraged peer support and with Metropolitan hospitals and other made them aware of their feelings and the feeling of others. specialists to consolidate and advance on the gains we have witnessed.
ANNUAL REVIEW 2013/14 55 QUALITY OF CARE
LINDA KNIGHT'S STORY
Brave, courageous, bold! How else could one describe the decision to leave one’s homeland, friends and family to move to a small rural town in a country largely unknown to Linda or her family? Linda’s intrepid decision was life changing. No doubt there has been home sickness to conquer and times of loneliness but in the end she is safe and happy in her new land and proud of her achievements.
My 10 years with WWHS
When I left Zimbabwe 10 years ago, my only thought was to survive in a foreign country, and become our main income earner. If anyone had dared mention then, that I would be capable of standing in for my manager in an aged care facility, I would have shuddered and probably turned back.
Unless you have actually done this, making a completely new life at the age of 53 is daunting. We knew no one, didn’t know the town, the banking system, or the weather pattern. Our only common ground was the fact that we spoke English. However, we are still learning to understand and speak Australian!
Not only did WWHS fund me, there was much background support that I was unaware of – endless paperwork involved with employing someone over 50, and the huge effort required for our permanent residence. I remember correspondence with Christine Dufty, John Smith and Gordon in the pay office.
This has been the most challenging and difficult thing I have ever undertaken. But 10 years on, I don’t regret one thing. I have been able to assist with the support my much loved parents, who lost everything when we did. I can support them, but we don’t need to rely on our children to support us. This would have been so, if we had continued in Zimbabwe.
I had not worked formally in the nursing profession for 30 years. It took me a long time to learn and become proficient here. Working in Aged care is a privilege. I have learnt so much from residents and work colleagues alike. I am humbled by the way I have been accepted. My greatest admiration has to be for Di. Her job is unenviable and incredibly diverse.
She had enough faith in me to try me as her replacement when she went on leave. This too, would have been impossible without support from the staff.
My time in Iona has taught me to be more patient, and compassionate.
And I have learnt to be less judgemental and impetuous.
I will always be grateful to WWHS for giving me this new start in life.
Kind regards
Linda Knight
56 WEST WIMMERA HEALTH SERVICE Dietitian Stephanie Daly explaining meal options and menu planning with Mavis Manning at Rainbow. Dietetics - a great service for small towns.
THE IMPACT OF DIETITIANS Our Dietitians have an impact in a many areas of healthcare. They are pivotal in menu planning for the acute hospitals, they work with the Karen community introducing them to unfamiliar produce in our supermarket; with the elderly to help them plan for cooking for one; conducting supermarket tours taking the mystery out of understanding food labelling.
At a time when the incidence of obesity The Dietitian, and their General This program is designed to bring in the Wimmera Region is extremely high Practitioner, from Tristar Medical about sustainable change as patients our Dietitians are an essential part of Group, Nhill, worked with the ladies to transition towards healthy eating. It’s the health promotion team promoting develop a Meal Plan which they believed not a quick fix, however, Lee-Joy and healthy eating and a healthy lifestyle. they could follow. The Plan included Sam were dedicated to the program, fortnightly appointments and regular maintaining a positive attitude and EDUCATION AND TEAM check-ups with the General Practitioner supporting each other throughout. SUPPORT - A SUCCESS STORY and the Dietitian. With ongoing education and support Obesity affects many Australians, Both ladies had a history of from West Wimmera Health Service and including Lee-Joy and her daughter Sam unsuccessful attempts to lose weight Tristar, the women have lost 17.4kg and and is a major cause of Chronic Disease over the years so it was decided to move 14.9kg respectively. in this region of Victoria. them onto a medically formulated meal replacement program containing the THE OUTCOME When Lee-Joy and Sam were referred correct balance of nutrients required to by their General Practitioner to a West Importantly, both are continuing to maintain optimum health. Wimmera Health Service Dietitian they embrace healthy eating habits and are were severely overweight. Their Four Stage Program commenced still losing weight! with an Intensive regimen, followed by Transition, Maintenance and Stabilisation phases.
ANNUAL REVIEW 2013/14 57 QUALITY OF CARE
DIMENSIONS OF QUALITY IN RESIDENTIAL AGED CARE Pressure Injuries 2013/2014 In 2006 the Department of Health introduced a suite of Quality Indicators that all public sector Residential Aged Care PRESSURE INJURIES Organisations are required to report upon on a quarterly basis. 2013/2014 0.5 These indicators relate specifically to The most likely areas susceptible to a 0.4 common risks that may impact on the pressure injury are bony areas; heels, 0.3 quality of life of those residents within elbows, the back of the head and the our aged care facilities, and include: coccyx (tailbone). 0.2 0.1 • Prevalence of pressure injuries These injuries are staged by severity, • Prevalence of falls and fall related with Stage 1 being general redness of 0.0 fractures the skin, to Stage 4 which is a wound Stage 1 Stage 2 Stage 3 Stage 4 • Use of physical restraint that involves muscle and bone. WWHS STATE • Residents prescribed nine or more The constant monitoring of our medications resident’s skin enables early detection The majority of recorded pressure • Prevalence of unplanned weight loss of the signs associated with pressure injuries were of the least severe stages, injury at the earliest stage (Stage 1), as with no stage 4 pressure injuries By collating and analysing this data the interventions required to reverse assessed during this time. we are able to compare outcomes a Stage 1 injury are simple and non- with other aged care organisations, invasive. and identify clear trends that we can PREVALENCE OF FALLS AND address to minimise the impact of Early intervention has revealed that FALL RELATED FRACTURES more serious injuries can be prevented such risks. Unfortunately falls within aged care if a stage 1 injury is identified early and residences homes are not always This enables us to improve individual treated appropriately. resident care and becomes our focus for preventable, but we are able to assess continuous improvement, to which we Residents are regularly assessed for our residents to determine likelihood aspire. risk of developing a pressure injury, of falling, and as a result implement and with skin assessments routinely interventions which will reduce the Over this period our focus on continuous conducted to identify any pressure likelihood of falling and its impact on improvement has demonstrated that injury at the earliest possible stage is their quality of life. we have sustained excellent results in where the least skin and tissue damage In order to reduce the risk of falls, whilst all five areas, with a great improvement has occurred. in the identification and management maintaining the independence of our of pressure injuries and continued low Interventions applied to facilitate good often frail elderly residents we: rates of falls and related fractures, blood supply to the skin and reduce • Assess each resident to determine physical restraint, medication use and the likelihood and severity of pressure their level of risk, and review this unplanned weight loss. injuries include: assessment if the resident’s health • Good nursing techniques which status changes. PREVALENCE OF PRESSURE involves frequent positional • Ensure the home is safe and free of INJURIES changes, moisturisation of the skin, clutter, allowing residents to walk use of aids that reduce skin pressure freely around the home. Pressure injuries can occur in anyone – heel protectors, chair cushions, Provide appropriate mobility aids. with reduced or restricted mobility. positional pads are utilised for this • Have a multidisciplinary approach A Pressure injury, the result of damage purpose. • to falls prevention, with the health to the skin and underlying tissues, is • Dietitians assess nutritional care team recommending relevant often caused by the inability to change status and recommend dietary interventions for each individual position independently. supplements that encourage healing resident who experiences a fall. of skin and surrounding tissues. Sustained pressure and associated The safety of the residents within friction can lead to damage of the skin • Occupational Therapists are able our aged care facilities is a very high and underlying tissues, and if untreated to specify aids which provide relief priority, always being very aware of the can also affect the muscles and bones. from pressure “hot spots”. need to encourage residents to be as Ill-fitting footwear is a common Prevention strategies used to reduce • independent as they can. pressure source. The Podiatrist is the likelihood of a pressure injury able to review current footwear and developing include regular position recommend appropriate footwear changes, good hygiene and skin care, for this ailment. and a healthy diet.
58 WEST WIMMERA HEALTH SERVICE Use of Physical To align such principles with this we USE OF PHYSICAL RESTRAINT Restraints 2013/2014 ensure the environment is conducive to Referenced Department of Health USE OF PHYSICAL resident activity and movement, with RESTRAINTS 2013/2014 our staff alert at all times to risks that and Ageing Decision Making Tool: Responding to issues of restraint in could cause or impact on falls. 1.20 aged care: www.health.gov.au/internet/ Resident cognitive abilities directly wcms/publishing.nsf/Content/ageing- 0.96 influence the frequency that a resident decision-restraint.htm 0.72 falls. Physical restraint is the restriction of a 0.48 Our experience reveals that we are resident’s movement or behaviour. 0.24 lower than the State average for 0.00 falls and fall related fractures for the In the past various methods of physical restraint were commonly applied in an Intent to Physical 2013/14 period. Restrain Restraint Devices attempt to reduce the number of falls To continue to reduce the number of experienced. WWHS STATE falls our residents experience and the injuries sustained the following Research has since shown that physical The table data demonstrates the interventions are routine: restraint does not reduce the number average of our use of physical restraint of falls experienced, but actually can is currently above the State average, All falls are reviewed by the “Falls increase behaviours and the severity of but relates entirely to 1 of our 123 Working Group”, formulate and injuries sustained by those falls. residents who has chosen to have bed recommend strategies to assist in rails insitu while sleeping. the reduction of fall occasions, which RESTRAINT IS NEVER include: CONSIDERED TO BE ROUTINE. RESIDENTS PRESCRIBED NINE • Programs to improve balance and West Wimmera Health Service currently OR MORE MEDICATIONS gait has an aged care resident who has • Appropriate footwear is evidenced requested to have bed rails up at night, Constant review to ensure residents are prescribed the medications to address Mobility aids – full range of frames to provide a sense of safety. • current conditions, and in a form that and sticks are available Prior to implementing this request we best meets the individual resident • Activity programs to reduce the have: requirement and is easily tolerated. impact of poor cognition are • Sought formal written consent By identifying residents prescribed incorporated in facility activity from the resident, family and plans nine or more medications we are able to treating Medical Practitioner instigate constant regular medication Alert devices – to alert staff that a • Risk assessed the use of bed rails reviews. resident deemed at risk of falling is • mobilizing unassisted • Assessed the resident’s mobility Medication reviews are regularly while in bed with rails up conducted by nursing and medical The Health Care Team, involving nursing, practitioners, in consultation with the medical practitioners and allied health Within all of our aged care residences pharmacist and Consultant Geriatrician, staff review “frequent fallers” to the use physical restraints to restrict and if required the psychogeriatric establish the impact of medications and a resident’s movement or behaviour do team. treatment regimens, and suitability to not routinely prevail. Falls 2013/2014 maintain independent good health. All such requests require all parties Our policy is to routinely review the to agree to the use of bed rails being number and type of medications appropriate and safe for each individual. prescribed for each of the residents RATE OF FALLS 2013/2014 within our aged care facilities. Assessments are undertaken by the 7 nursing, medical and allied health staff. Those residents prescribed nine or more 6 Written consents are obtained from the different medicines are identified and 5 resident and/or their family. further reviewed by the team, which 4 includes the nursing and pharmacy staff 3 Nursing staff closely observe and together with the patients’ Medical 2 monitor resident’s safety whilst in bed Practitioner. 1 with bed rails raised. 0 This group review the medicines Rate of Falls Fall related Fractures prescribed, and whether they are still WWHS STATE appropriate need to be revised or ceased.
ANNUAL REVIEW 2013/14 59 QUALITY OF CARE
Reasons why residents are prescribed This vigorous system of routine The fragility of those within our care is multiple medicines include: monitoring of unexpected weight loss clearly seen by the state rate for this • Some residents have a number has increased the awareness staff need indictor as seen in the chart. to identify early, thus implementing of chronic medical conditions No matter the circumstances we strategies prior to significant weight which require individual close and continue to provide our residents with loss having a detrimental impact on the constant management. high quality care to ensure they have a resident’s medical condition and quality Residents entering the “twilight” quality of life which will always provide • of life.- stage of life often benefit from them with comfort, choice and above all additional medication intervention Residents have their weight verified dignity. to allow them to enjoy a dignified on a monthly basis, to identify those end of life which is as pain free as experiencing unplanned weight loss, and BENEFITS possible. weight loss over a 3 consecutive month period. By collecting and monitoring this • Increased frailty, and acute illness complete suite of quality indicators we result in specific medications being Those residents which have been are able to identify at an early stage if a prescribed identified as having significant weight resident is at risk of becoming medically loss are further reviewed to determine unwell, any symptoms impacting Medication Use 2013/2014 if additional nutritional supplements INCIDENTS OF 9 OR MORE on their general welling, and thus may be appropriate. compromising their enjoyment of life. PRESCRIBED MEDICATIONS 2013/2014 A Dietitian assesses these residents and By identifying deteriorating conditions may recommend dietary supplements early we are able to implement changes 5 that have more calories, to maintain or to the care planning which can reverse 4 increase weight; being in a form that is changes in health status, whilst palatable and enjoyed by the resident. 3 ensuring resident care preferences are respected. 2 The ability to swallow often impacts on a resident’s ability to eat and drink 1 Our concerned effort to add to the adequately. quality of life of our senior citizens. 0 WWHS STATE A Speech Pathologist will determine need in this instance, and may recommend a diet which is of a PREVALENCE OF UNPLANNED consistency that the resident can easily WEIGHT LOSS swallow and digest. Resident’s weights are monitored on a A resident’s weight is inclined to monthly basis, together with significant fluctuate in times of acute illness weight loss over a 3 month period. or when entering the end of life experiences. Unexplained weight loss is reviewed by the health care team that encompasses It is vital residents are provided with a Nursing, Medical, Dietetics and Speech nutritional diet which they are able to Pathology personnel. choose and want to eat, and is also in form they can tolerate and sustain. A complete review addresses: • Current medical condition – Weight Unplanned Weight Loss 2013/2014 is often the result of an illness or by UNPLANNED WEIGHTLOSS the resident entering the “twilight” 2013/2014 stages of life 1.2 • The resident’s dietary preferences, 1.0 likes and dislikes 0.8 Caloric intake which may • 0.6 be boosted with nutritional supplements in a variety of forms 0.4 and consistencies. 0.2 • The resident’s ability to swallow 0.0 adequately, and if deficiencies Weight Loss Weight Loss of are detected then diet and fluid 3+kgs 3 Month Period consistencies may be adjusted WWHS STATE
60 WEST WIMMERA HEALTH SERVICE Betty McKenzie relaxing with Registered Nurse Ancy Bijup potting plants in the mobile "French Garden" which is the source of much enjoyment for patients and residents at Jeparit Hospital and Hostel.
ANNUAL REVIEW 2013/2014 61 QUALITY OF CARE
QUALITY AND SAFETY FOR OUR PATIENTS
At West Wimmera Health Service safety of our patients are our chief concern. High safety expectations are set and these are monitored by the examination of key indicators of quality care, these include safe use of blood and blood products, preventing falls, preventing and managing pressure injuries, medication safety, best practice concerns and all aspects associated with Occupational Health and Safety.
Meeting the needs of our community in MEDICATION SAFETY a responsive and safe manner is a key PRESSUREPressure Injuries INJURIES - a – comparison A FIVE over time objective for our Service. Safe administration of medications has YEAR COMPARISON 2013/14 a direct relationship to safe patient care 60 in our hospitals and residential aged PRESSURE INJURIES 2013-14 care facilities. 50 2012-13 The number of Pressure Injuries 40 The number of patient medication recorded across the Service increased 2011-12 incidents has remained relatively in 2014 from 16 in the previous twelve 30 2010-11 similar over the past three years as months. 2009-10 20 demonstrated by the graph below. Twenty eight (28) pressure injuries were 10 Severity of Pressure Ulcer Severity recorded in 2013/14 compared to 72 0
Stage 1 Stage 2 Stage 3 Stage 4 / Unstageable Not described MEDICATION INCIDENTS – five years previously. This reduction was MedicationA FIVE YEAR Incidents COMPARISON by primary type brought about by a mixture of thorough 2013/14 patient assessment and the use of new equipment designed to reduce the 120 injury to the tissues of the human body, 100 particularly over bony prominences of 80 Number of Pressure Injuries by type by year the body. 60 This graph demonstrates the types of pressure Patient and resident assessment of skin injuries at WWHS, emphasising that a great many 40 integrity is key to early detection of injuries have been detected and treated before 20 they become severe and require extensive 0
pressure injuries. Our aim is prevention 2009-10 2010-11 2011-12 2012-13 2013-14 treatment rather than reaction when dealing with pressure injuries with special West Wimmera Health Service mattresses, gel pads and attention commenced participation in a High to the nutritional needs of patients is Definition Three Dimensional (HD3D) Wrong Patient Wrong Dose paramount. project, funded by the Victorian Wrong Drug Omitted Dose No Stage 4 pressure injuries were Department of Health, which is being recorded in 2013/14; this is important run for 6 months across the Wimmera The rate of medication incidents per as this type of injury is the most serious Sub-region. Nurses in the field will be thousand bed days has decreased from requiring intensive and sustained care. supplied with cameras which will take 3D images of wounds. These images will 2.09 in 2012/13 to 1.21 in 2013/14. Education of our staff has again been then be uploaded to a central computer This result has been achieved through the focus of our efforts in combating where the Wound Care Specialist a combination of staff education, the number and severity of pressure employed by the Service can view the awareness of the incidents occurring injuries. Our resident wound care images and provide expert opinion across the Service and an investment of specialist nurse has instigated new regarding wound management. following up each incident with the staff resources on the Service intranet involved. so that staff can access the latest No adverse patient outcomes occurred information and education relating to as a result of a medication error during pressure injury prevention; it provides the past year. Despite this, medication an online interactive program designed errors are thoroughly investigated and by wound management experts. practices put in place to improve our performance.
62 WEST WIMMERA HEALTH SERVICE Dr Anachuna Anthony supported the initiative of a Venesection Clinic for the treatment of patients with excess red blood cells. Clive Knight listens intently as Dr Anthony explains the way his Venesection treatment will work. Venesection is used when you have too many red cells in your blood which may cause the blood flow to become sluggish which may increase the chance of developing problems such as blood clots. By removing the extra cells the risk of that happening is reduced. Venesection is the simplest method of reducing the number of red cells in your blood. The method used is similar to the procedure used for donating blood.
PREVENTING FALLS A comprehensive care plan is BLOOD AND BLOOD established with the patient and PRODUCTS Preventing falls or reducing the severity their family members to ensure that of the outcomes of falls continues to be all possible methods to prevent falls Meticulous attention is made to the a safety objective of our Service. are put in place; such efforts include need of providing blood or a blood product to a patient by our Visiting Our falls health care team comprising an environment free of obstacles, Medical Practitioners as it is usually in physiotherapists, nurses, Visiting appropriate footwear that fits the such short supply. Medical Practitioners and occupational foot well and providing the ability for therapistsNumber thoroughly of Falls examine all patients and residents to easily solicit The healthcare team take time to ensure patients who fall or have the potential staff assistance when needed. patients fully understand the need Numberof doing of Fallsso. by Year Patient cognitive ability plays a key role for Blood or Blood Products and their in falls, and as such patients are not consent must be obtained prior to its always aware of their limitations when administration; in 2013-14 this occurred NUMBER OF FALLS – A FIVE walking unaided. in 100% of occasions. YEAR COMPARISON 2013/14 During 2013-14, no incidents occurred 400 Mild discomfort and first aid for the 350 patient or resident occur in 99% of where the wrong type of blood was 300 falls but occasionally the outcome and administered to a patient. 250 treatment is more severe, sometimes 200 PERFECTION - OUR AIM 150 resulting in a fractured bone. In 2013-14, 100 four patients or residents suffered Safe, efficient clinical care, doing 50 a fracture: such incidents undergo no harm remains our number one 0 2009/10 2010/11 2011/12 2012/13 2013/14 an extensive clinical review of the priority. Our aim is to improve on circumstances leading to the fall and these indicators of quality of care and the injury sustained. strive to implement new strategies to Patient and residents requiring assist our clinical practitioners in their Dementia care remains an area of focus; endeavours. Numbers of falls have remained relatively constant over the past 12 months compared we intend to continue to introduce with previous, as indicated in the above graph . new methods of patient and resident activities to engage people living with wandering tendencies but poor physical strength.
ANNUAL REVIEW 2013/14 63 QUALITY OF CARE
PREVENTING AND CONTROLLING HEALTHCARE ASSOCIATED INFECTIONS
There are five main areas of focus to HAND HYGIENE AUSTRALIA Our staff influenza vaccination prevent infections at West Wimmera uptake rates have improved, a group Health Service – these are: West Wimmera Health Service has of Immunisation Nurses undertook participated in the auditing of hand • A clean environment workplace vaccinations at such hygiene compliance since 2007. We businesses in Nhill as Luv-a-Duck, IGA Promoting Hand Hygiene • now report this data to Hand Hygiene Supermarket, Solicitors, Nhill College compliance Australia, three times each year through and the Hindmarsh Shire • Promoting staff immunisation, VICNISS the Victorian Healthcare Associated Infection Surveillance Surveillance UNDERTAKING SURVEILLANCE • Coordinating Centre. • Staff education Auditing and reporting of practices We audit the staff as they go about their and activities are an integral part of tasks caring for patients and assess if MAINTAINING A CLEAN the Infection Control and Prevention they clean their hands by washing or ENVIRONMENT of any health service. Assessing the using Alcohol Hand Rub as frequently hand hygiene of staff, looking at the Cleaning is the prerogative The as is indicated by the Five Moments of environmental cleaning of our facilities Environmental Services Department Hand Hygiene. are responsible for the daily cleanliness and counting the number of staff who of our premises. Audits of cleaning We have achieved respectable have accepted the vaccinations offered practices are undertaken continuously compliance, with a rate that is is a small part of the total package of both by designated staff (Internal consistent and slightly above the surveillance. national average. The National Auditing) and in July each year by Surveillance is looking objectively Benchmark is 70% however the current Auditors independent of West Wimmera at what staff are doing, looking at target is now 75%. Health Service (Independent Auditors). the outcome of their activities and Results of the Internal Audit is reported We reported our Hand Hygiene assessing whether we can alter what we and submitted to the Department of Compliance in October 2013 as 78.3%, do to improve the result in the future. Health, Victoria, March and November. in March 2014 it was 77.9% and in June Throughout the year we have assessed 2014 it was 81.2%. We audit staff in how we do things in relation to infection Results of the External Audit are five areas of the health service for each control in the theatre, sterile stock submitted to the Department of Health, audit reported. department and the dental surgeries; Victoria. how we manage waste, staff exposures The average Australian compliance for and wound dressing techniques. During the Audits three categories June 2014 was 81%. are reported: Category A-very high We continue to closely monitor our risk areas such as the Operating Suite, PROMOTING IMMUNISATION Aged Care Clients. We undertook a Point Category B-high risk areas such as Prevalence Audit (an audit designed Wards and Kitchens and Category To promote immunisation for Staff and to take place on one day to obtain a C-which are medium risk areas such as in the wider community, we undertook snapshot of clients with infection and Allied Heath Consulting Rooms. an active program of influenza antibiotic treatment) of the residents vaccination clinics this year. of our nursing homes, comparing our Our results for the external audit in data and that of other hospitals in the 2014 were Category A-99%, Category In 2014 the National influenza Grampians Region. B-100% and Category C- 100%. vaccination target rate was 75%. These results will be compared with What a great result! Absolute Between March and June we were able other Regions in Victoria. The data will reinforcement of the successful to achieve a vaccination rate of 67.3% then be submitted to a European study implementation and observance of across the West Wimmera Health and will provide us with information the continuous improvement of the Service. While not reaching the 75% about how we treat this infection, how cleaning regimes by this Service and target set we did improve our Influenza our rates compare to other areas and the contribution of this department Vaccination Rate among staff from show us what we could improve. to achieving virtually zero healthcare 59.7% in 2013 associated infection at West Wimmera Health Service.
64 WEST WIMMERA HEALTH SERVICE WWHS ACUTE Acute CLEANINGCleaning % % AUDITAudit Results RESULTS by BY Category CATEGORY
100 2014 99 2013
98 2012
97
96
95 VHR HR MR
WWHS Cleaning results by category per year
WWHS NATIONAL National Hand HAND Hygiene HYGIENEAudit % Compliance AUDIT % 2011-2014 COMPLIANCE 2011-2014 Rhonda Dunham preparing to use the new Ecolab cleaning system which has reduced chemical use 120 Audit 3 and cost while achieving outstanding results 100 Audit 2 in cleaning audits. An advantage of the system 80 Audit 1 is the labels which are screen printed onto the 60 containers eliminating fading and peeling which 40 can become a safety issue. 20 0 2011 2012 2013 2014 STAFF EDUCATION Some subjects in the program are constants such as Hand Hygiene and Education targeting the crucial others are varied for each group of importance of controlling and staff. preventing infection is an important element of our education program for The formal education compliance for all employees. A basic introduction 2013-14 is for Clinical staff: 99.28% StaffSTAFF Influenza INFLUENZA Vaccination to Infection Control is included in and Non-clinical: 100%. The total staff %VACCINATION Rate 2012-2014 % RATE the Orientation package for all staff. who have attended Infection Control 2012-2014 Compliance with mandatory education education is 99.64% 80 units according to the department of 2014 Informal education is constant and may 70 employment is closely monitored. include on the spot education about 60 2013 50 2012 Education is acknowledged as an management of a specific disease or 40 essential element of the process of how to use a new product. 30 preventing and controlling infections 20 10 within a health service. It reinforces WHY DO WE PLACE SUCH 0 appropriate decisions about the care IMPORTANCE ON THE Given Refused Unknown of infected patients, while avoiding the PREVENTION OF HEALTHCARE spread of infections from one patient to ACQUIRED INFECTIONS? another. Percentage of staff vaccinated, refused As a patient or resident in a West vaccination and of unknown status Wimmera Health Service facility you can be assured the utmost effort is placed on keeping you safe from Hospital Acquired Infection.
ANNUAL REVIEW 2013/14 65 CORPORATE & QUALITY SERVICES
It takes an enormous number of departments and individuals working together towards a common goal to make an organisation as diverse as West Wimmera Health Service function effectively, safely and efficiently. Quality care comprises many facets in addition to medical, nursing and allied healthcare.
A CLEAN ENVIRONMENT Over the next year, we will introduce LOOKING TOWARD THE microfibre cleaning system into the FUTURE Providing a clean and attractive remainder of our aged care facilities, environment for patients plays an before introducing it to the acute ward A site risk survey undertaken by important part in the road to recovery. It areas. Victorian Managed Insurance Authority is also important as a means of reducing at Nhill this year provided us a good the risk of patients contracting hospital ENGINEERING AND rating, indicating that we control risks acquired infections. MAINTENANCE well. This review provided a number of recommendations we are now putting HIGHLIGHTS FROM THE YEAR The physical environment at all sites is into place. impeccably maintained and presented, This year’s external cleaning audit Predicted budgetary constraints will ensuring front-line clinical care is highlighted the immaculate cleanliness test our capacity to continue to provide always provided in a safe and pleasant and tidiness of our campuses, with our the exceptional physical infrastructure environment. Engineering staff at each four acute hospital sites at Nhill, Kaniva, we presently enjoy, but we will meet this site undertake routine repairs and Jeparit and Rainbow recording a 99% challenge head-on, striving to find ways maintenance and complete a detailed compliance result. to ‘do more with less’. preventative maintenance program This is the second consecutive year comprising daily, weekly, monthly and we’ve received this excellent result, annual checks. EDUCATION meaning WWHS is substantially Ongoing education makes sure we above the 85% benchmark set by HIGHLIGHTS OF THE YEAR remain at the forefront of modern the Department of Health regarding practices. It is very important to the cleaning standards. Our progressive capital redevelopment program replaces and improves sustainability and success of our Our nine residential aged care facilities physical infrastructure in a planned and organisation. also achieved an excellent outcome, financially sustainable manner every receiving a score of 97% for the second year. This year’s projects included: HIGHLIGHTS OF THE YEAR year in a row. Completing and officially opening the This year, we actively promoted Following a detailed tendering and Goroke Community Health Centre; education in a number of ways: Engaging review process conducted in accordance Making major upgrades to the Nhill undergraduate students by providing with Health Purchasing Victoria (HPV) nurse call system, eliminating the risk supervised placements in nursing requirements, we introduced a new of system malfunction and flow-on and allied health; Up-skilling staff cleaning system this year, resulting in a effects; Developing a Dental Clinic at in all departments to increase their 13% reduction in the use of chemicals Goroke, which included installing a new knowledge and qualifications; Ensuring and an associated saving of $3,500 per Dental Chair and suction equipment, our care is best practice by encouraging annum. and providing X-ray; Upgrading the staff to attend internal and external Kaniva and Rainbow Dental Clinics, conferences and seminars; and offering A further improvement has been noted installing new X-ray equipment mandatory training in critical areas by decreasing the size of chemical and X-ray viewers; Installing a new such as fire and evacuation, medication containers from five to two litres, commercial dishwasher in the Nhill management and manual handling for reducing manual handling risks. Hospital Kitchen, replacing the existing all staff. LOOKING TOWARD THE 30 year old unit; Upgrading our staff This year, 475 undergraduate clinical FUTURE accommodation house at Macpherson placement days were undertaken, Street in Nhill, including repairs and including a Speech Pathology placement This year, we took proactive steps painting; and Building three houses for the first time in five years. Compared toward decreasing our environmental in Nhill to provide accommodation with 45 days in 2012 13 and applications footprint, introducing a new chemical- for undergraduate and postgraduate for 2014-15 already standing at 595. free cleaning system to our Natimuk students completing placements with residential aged care facility. us, as well as other staff requiring The healthcare sector has witnessed an short-term accommodation and visiting increase in occupational violence and Microfibre cleaning has been used for medical officers. aggression and as a result we are taking several years in Iona Digby Harris Home, proactive steps to mitigate the risk of Nhill, providing residents with a clean this behaviour. and chemical free environment.
66 WEST WIMMERA HEALTH SERVICE Hilma Summerhayes, supported employee, delights in her role meeting customers at Oliver’s Café and Leanne Wallis is bringing more sweet treats for sale.
We have provided training to 209 staff, This year 183,047 meals were provided, A recent assessment of the new teaching them strategies to prevent .8% less than the previous year. This arrangement revealed general these kinds of incidents from occurring. year’s external food audit indicated dissatisfaction with the service. So all sites are fully compliant with food taking into account the cost associated Our commitment to furthering safety regulations and guidelines. with transporting the linen to and from qualifications of our staff is evident a Regional Centre and also comments with the enrolment of three Hospitality Olivers Cafe' is a commercial cafe from our clients, many of whom raised and Environmental Services staff in operating in the business precinct concerns about the poor quality, Commercial Cookery apprenticeships, of Nhill. It provides employment particularly with personal laundry. with a further three staff currently opportunities for supported employees enrolled in a Certificate IV Disability from Cooinda Disability Services and Therefore we are now investigating course. has proved very effective in showcasing the possibility and sustainability of their individual talents to the wider establishing our own laundry service Nine staff have also successfully community. covering all West Wimmera Health completed ‘barista’ coffee training, Service sites including personal laundry guaranteeing Oliver’s’ Café and Kiosk Olivers Kiosk at the Nhill Hospital for aged care residents. will continue to serve the best coffee in provides delicious light meals and Western Victoria. fabulous coffee, appreciated by If the investigation proves positive and visitors, patients and staff and another the project goes ahead it would be a FRESH FOOD SERVICES opportunity for supported employees very progressive community building to work in the community. action, providing local employment We understand that meals can be opportunities, support local businesses a highlight for many residents and MOVING FORWARD and importantly result in significant patients, and we make the effort to go cost savings and a better quality service above and beyond to cater for individual INVESTIGATING A NEW for West Wimmera Health Service. A win tastes. Patients and residents at all SERVICE? win situation for all! sites enjoy tasty, nutritious, freshly cooked meals made with locally-sourced Clean linen for patients and for use ingredients. across the service by cleaning and catering staff is a critical element for Menus are prepared in conjunction with the everyday work of our Service as is our Dietitians and Speech Pathologists, the personal laundry service for our ensuring food provided is not only tasty, aged care residents. but healthy and safe for everyone. At the end of 2013 an evaluation of the Our kitchens also provide meals for a laundry services provided by an external number of external groups including contractor was undertaken and in light Senior Citizens and Meals on Wheels. of the findings a contract was drawn up We are delighted to support these with a different provider. community partnerships.
ANNUAL REVIEW 2013/14 67 CORPORATE & QUALITY SERVICES
ENVIRONMENTAL SUSTAINABILITY
ACHIEVEMENTS OF THE YEAR ELECTRICITY HOUSE CONSTRUCTION A plan to replace incandescent and An energy auditor was engaged for the fluorescent lights in our buildings first time this year to assist us to meet has commenced, with a total of 560 our obligations for appropriate energy LED lights being installed in all new conservation in our new staff and facilities. This has decreased our energy student accommodation in Nhill. consumption by 112,420 kilowatt hours, As a result of this audit, double-glazed with a resultant saving of $33,700 gas-filled windows have been installed, per annum. reducing noise levels by at least 50% WATER while maintaining the internal thermal environment. This will significantly We ‘farm’ water from roof tops by reduce energy consumption and our directing the rainwater to three 22,000 cost of providing this accommodation. litre tanks for use in toilets, washing machines and hot water systems. Water In a first for construction at West conservation of this nature reduces our Wimmera Health Service, insulation reliance on mains water supply, reducing has been installed to the ceilings, walls our costs and also the possibility of and subfloors of all new constructions water being wasted as storm water. creating a thermal barrier. By doing this, we have created an environment WASTE requiring minimal energy input to maintain a comfortable setting for WWHS is conscious of reducing occupants. its environmental footprint, conscientiously recycling cardboard, paper and plastic products in all LOOKING TOWARD THE of our administrative, clinical and FUTURE support services. We will now focus on new methods of Equipment no longer in use and suitable managing our heating, ventilation and for resale is also recycled. Our second- cooling systems at the Nhill Hospital to hand retail outlet Snappy Seconds sells ensure maximum efficiency. a variety of items, from desks, chairs We trust that research currently and curtains to computers. underway will see innovations in the forms of heating and cooling we install DOMESTIC HOT WATER in our buildings, such as using solar The gas-fired hot water service in the and vacuum technology to preheat hot Mira Medical and Allied Health Centre waterloops. at Nhill was replaced this year with an It is anticipated that a direct result of electrical service. This has reduced these efforts will realise a reduction in our LPG consumption by 18% in three energy costs, particularly relating to months, providing a more efficient and liquid petroleum gas (LPG). stable water heating source.
68 WEST WIMMERA HEALTH SERVICE New accommodation for students and staff construction by West Wimmera Health Service Engineering & Maintenance staff – Rob Schneider, Aaron Beer, Tim Seymour busy carting material.
ANNUAL REVIEW 2013/2014 69 FINANCE AND ADMINISTRATION
Cody Gersch, Administration Clerk manning the Nhill Hospital Reception Desk. Cody is gaining experience in all areas of the Administration Department.
70 WEST WIMMERA HEALTH SERVICE STAFF 2013 - 2014
Brendon Abernethy Colleen Cook Lawrence Grayling Warrick Lang Minnie Pancho Jessica Smith Gwen Agustin Emma Cooper Jenny Grayson Janine Launder Ellen Panozzo John Smith Jillian Albrecht Jackie Cooper Dianne Green Neree Launer Lucy Paterson Keryn Smith Melanie Albrecht Annie Coustley Robyn Gregor Kristine Laverty Mick Patrick Dean Smith Erika Alegre Kerry Coyne Jennifer Greig Lisa Lawes Feby Paulose Emma Smith Karen Alexander Sophie Cramer Helen Greig Julie Leddin Peter Pearce Shirley Sproule Raelene Alexander Marianne Cramer Harsha Gunawardena Cassy Leffler Ann Pearce Sini Sreekanth Alicia Alexander Carolyn Croke Beverly Hage Barbara Leffler Mariah Peele Sree Sreekumar Michael Alexander Anthony Croke Yvonne Hall Dianne Leggo Tracie Peoples Chris Stanford Amanda Alexander Janine Dahlenburg Megan Hall Caitlin Lehmann Liz Pfeiffer Casey Stasinowsky Judy Allen Alison Dahlenburg Russell Hallam Karen Lester Bev Phillips Amanda Stephan Gary Allison Stephanie Daly Allison Halliwell Lisa Li Kate Pilgrim Vonni Stephan Wendy Altmann Jisha David Anne Hamilton Katrina Lloyd Selina Pilgrim Jackie Stevenson Sharyn Andrews Jeena David Cynthia Harberger Sally Lockwood Jess Pilgrim Elaine Stewart Sam Anthony Melissa Davis Janine Harberger Michelle Lowe Bobbie Pitt Denise Stimson Glenda Aristides Andy Davis Judith Harrington Cheryl Lowe Loata Pitt Debra Stonehouse Marie Arnold Jodie Day Steph Harris Bree Lowe Sandra Pollock Hilma Summerhayes Shirley Ashfield Sandra Decker Belinda Hartigan Bree Lowe Bec Powell-Hodges Omega Swinnerton Jenny Asplin Andrea Deckert Jess Hartridge Lindy Lowe Rhonda Preston Sue Taylor Kelvin Asplin Christine Deckert Anita Hassall Darren Lyall Courtney Preston Darren Taylor Ange Atta Alyce Deckert Elizabeth Hawker Lynne Lynch Pamela Price Sindi Taylor Dawn Austin Jim Delarue Lesley Hawker Kerri Lynch Leslie Prichard Glenn Taylor Shirley Avery Kellie Dickerson Leah Hawker Lyn Maddern Rosemary Pritchett Lucas Terry Robert Bahr Michelle Dickinson Emma Hawker Kate Maddern Tahnee Purchase Val Terry Anjali Balakrishnan Aimee Disher Tina Hayden Marion Major Samantha Purches Ann Thomas Aziz Baluch Shenae Dixon Yingying He Sharyn Makin Sally Purvis Vicki Thomas Michelle Barber Sharon Dixon Janet Heenan Shinta Manuel Katrina Rabone Basil Thomas Kaye Baron Ritchie Dodds May Hei Brooke Marra Pat Rabone Helen Thomson Anne Barry Thomas Dryburgh Trisha Heinrich Vicki Marshall Jebi Rajamani Judith Thomson Bill Bartholomew Jamie Duffy Josh Heinrich Trudy Marshall Anis Rajwani Glenis Tink Sharon Bartholomew Jennifer Dufty Craig Henley Katie Martin Reju Reghuvaran Nair Tess Toquero Rebecca Bastin Christine Dufty Debra Hill Melissa Martin Chris Reichelt Karl Towler Heather Batson Julie Dunford Sandra Hinch Fay Martion Anne Renfrew Shirley Treble Hayden Baxter Lynette Dunford Casey Hiscock John Martion Jenni Rentsch Margaret Trenery P’leh Be Nyo Rhonda Dunham Susan Hiscock Priya Mathew Carla Reodique Nick Twigg Susanne Beattie Olena Dyer Thaylor Hofmaier Brony Mathews Lynne Rethus Jarmila Tyrril Kellie Beattie Wendy Eden Terri-Ann Hogart Gaile Mayne Natasha Rich Emma Ussing Clint Beattie Nina Edmonds Rachael Hormann Mila Mazou Joylene Rich Fiona Van Den Idsert Wendy Bedford Tiarna Edwards Lyn Hourigan Dale McCartney Christine Richards Pam Van Kempen Bridie Beer Rachael Egan Cassie Howe Andrea McCartney Claire Riches Bibin Vijayakumar Aaron Beer Michelle Eldridge Than Than Htoo Karyn McCartney Judith Ridgwell Adele Vincent Ancy Biju Jessica Eldridge Jonathon Hurst Jen McDonald Christine Rintoule Amanda Von Benecke Julie Bloomfield Carol Elliott Kathleen Hutson Dianne McDonald Josh Rintoule Melanie Wagg Cindy Bone Sheryl Ellis Kellie Hyde Bonnie McEldrew Natalie Robinson Robyn Wagg Anthony Bone Susie Ellis Brenda J Jackson Michelle McGennisken Lesley Robinson Angela Walker Emiley Bone Stacey Ellis Diane Jackson Catherine McKenzie Brenda Robinson Erin Wallace Tracey Bone Kaye Emmett Phillip Jackson Sheryl McKenzie Lynley Robinson Leanne Wallis Kaye Borgelt Kevin Emmett Tracey Jarred Lynne McKenzie Angus Robinson Helen Wallis Elizabeth Both Wendy Essex Maggie Jarvis Jessica McKinley Wendy Robson Rosalie Wallis Maria Bottrell Vicki Etherton Denise Jensz Julie McLean Joylene Rohde Krystal Wallis Lisa Braybrook Kerry Exell Nakita Jewell Jane McPhee Val Roll Kirstie Ward Tony Breavington Carmel Feder Jan John Casey Mellington Rosemarie Rose Annie Watson Russell Brown Caroline Fischer Saina John Michelle Menzel Alicia Rosewall Donna Watson Shelley Brown Anne-Marie Fischer Niceson John Susan Menzel Teresa Ross Marc Watts Amanda Brownsea Jan Fisher Desley John Ann Merrett Helen Ross Valerie Webb Donna Burns Loretta Fisher Wayne John Tracey Merrett Tamhika Ross Karen Webb Connie Burns Chantelle Fisher Cheryl Johnson Maree Merrett Denise Rowe Rhys Webb Glenda Bush Wendy Flavel Matt Jones Shelley Merrett Rosie Rudd Elaine Webster Dayle Buttigieg Neena Francis Brian Jones Kevin Merton Graeme Ruse Megan Webster Lisa Buttigieg Katrina Fraser Yvonne Jones Neville Michael Jessie Rushbrooke Kerrie Webster Kim Campbell Nanette Freckleton Bianca Jones Shayne Michael Revai Rutsate Hannah Wedding Lachie Campbell Margaret Frew Kevin Jones Tracy Midgley Tania Ryan Kristen Weir Lindsay Cannell Tyrone Friebel Jerric Jose Lisa Miller Helen Ryan Chris Weir Helen Cannell Lorretta Fuller Jismon Joseph Graham Miller Melissa Ryan Phoebe Welch Sue Carracher Rhona Fulton-Drendel Saleena Joseph Jacci Mills Laurie Ryan Annmaree Wells Mark Carracher Deb Funcke Bony Joseph Sandra Millward-Coyne Sharyn Salt Alison Welsby Taryn Carter Mary Gabbe Debbie Jozeps Trudi Moar Debra Sanders Darren Welsh Katelyn Carty Laura Gabbe Leanne Just Breanna Moar Sharon Sanderson Joanna Werner Toni Casey Katrina Gagliardi Deborah Kakoschke Emma Moore Catherine Saul Karen Wheaton Barb Cavanagh Zen Garcia Martha Karagiannis Tracey Morphett Kristina Savicin Linda White Peter Cavanagh Sharon Garwood Aman Kaur Sharyn Morrison Judy Schier Tiarne Whitworth Anuja Chacko Wendy Gawith Lucy Keam Nicole Mottillo Deb Schilling Carol Willersdorf Debbie Chaston Helen Gay Vanessa Keberling Chloe Mulraney Amy Schnaars Cheryl Williams Remya Chathamparambil Carol Gebert Judith Keller Kate Munro Nicole Schneider Desiree Williams Ramesan Darren Gebert Ann Keller Sarah Murn Robert Schneider Tammy Williams Pat Chequer Kylie Gebert Rowena Keller Steve Murphy Julie Schneider Wendy Wills Rickie Chequer Alicia Gebert Karen Kennedy Jacqueline Nash Rebecca Schultz Nan Wilson Bianca Chifura Prameela George Kate Kennedy Tilley Nash Denise Schulz Kristian Wilson-Hooper Erol Chilton Sharon George Sue Kennedy Sarah Natali Wendy Schulze Elizabeth Witmitz Peter Chilton Amritha George Sunil Kesavan Lisa Newcombe Debra Schumann Norelle Witmitz Pamela Clark Geena George Fiona King Pam Newton Nicole Schumann Julie Woolcock Janine Clark Cathrine Gersch Alannah King Nicole Nicholls Kellie Lynne Schwarz Julie Worsley Robyn Clark Cody Gersch Mary King Bridget Nossack Ellen Scott Claire Wotherspoon Carolyn Clark Sandra Gilbert Amanda King Megan Nossack Janine Seater Lisa Wotherspoon Chris Clark Michelle Giles Charlotte King Jaimee Nossack Tim Seymour Stefani Wyatt Deborah Clifford Gwenda Gilpin Kayleen Kingwill Leanne O’connor Wendy Shalders Narmada Yantrapati Janice Clugston Dena Gleeson Linda Knight Semira O’heaney Karen Sherlock Martin Yau Melissa Coad Kent Goldsworthy Margaret Krelle Linda O’heaney Kerryn Shrive Janet Yong Pamela Coates Michael Goode Fiona Krelle Polly O’heaney Janet Shurdington Rhonda Zivkovic Pauline Colbert Teresa Gould Anna Krommenhoek Luke Oldaker Karen Shurdington Alexi Conboy Tennille Gould Sheena Kurisumkal Paul Brenda O’leary Julie Simpson Faye Connell Leonie Graham Jono Kyle Jayne Oliver Bree Sinclair Charles Cook Ian Graham Gladys Kyle Natalie Orriss Wendy Sleep Helene Cook Beverley Grant Libby Lacey Rhianna Paech Susan Sluggett Kerryn Cook Ashley Grant Jessica Lacey Dion Paech Melanie Smith
ANNUAL REVIEW 2013/2014 71 Kaniva the Falls Prevention Stars. All staff at Kaniva have worked hard to reduce the number of patient and resident falls or trips this year and have improved their performance immensely. Congratulations Kaniva! (L-R) Carol Willersdorf, Fiona Van Den Idsert, Lisa Buttigieg, Narmada Yantrapati, DON, Lesley Hawker, Taryn Carter, Helen Ryan, Breanne Moar.
• The Victorian Public Authorities HUMAN RESOURCE MANAGEMENT (Equal Employment Opportunity) Act 1990 • The Victorian Equal Opportunity The quality and scope of the many and varied health services Act 1995 we provide are heavily dependent on our ability to maintain a • The Victorian Public Sector motivated and properly trained workforce. Management and Employment Act 1998 Throughout the year we incurred a At 12.4% staff turnover was lower • The Commonwealth Disability total salary and wage cost of $24.7 than for the previous year (12.8%) and Discrimination Act 1992 million to employ 563 staff across a indicates a more satisfied workforce. The Commonwealth Racial variety of disciplines. We continued to Lower turnover rates also mean less • Discrimination Act 1975 make good use of basic database and costs required in order to attract and communication systems to ensure these retain new staff. • The Victorian Public Administration staff remained competent, motivated Act 2004 At 5.2% of basic wages (4.96% prior and well trained to perform their duties. year) our sick leave is higher than we Through the application of Service We achieved an average compliance rate would like but this is not an uncommon policies and protocols and monitoring of 99.56% for mandatory education result in our industry given such issues of compliance with relevant industrial elements such as police checks, fire as ageing workforces and communities relations instruments we aim to: and emergency training, CPR, basic life in general. • Ensure open competition in support and professional registration. recruitment, selection, transfer and The total of WorkCover payments promotion No days were lost to industrial action made to injured workers ($95k) throughout the year, testament to the fell significantly compared to last • Base employment decisions on merit professional relationships we maintain year ($160k) and is reflective of the • Treat employees fairly and with both Victorian Hospitals Industrial valuable work undertaken by our Injury reasonably Association (VHIA) and relevant Management Team throughout the year. Provide employees with a employee unions. • Each year the Service participates in the reasonable avenue of redress Our employees continued to enjoy free independently provided People Matter against unfair or unreasonable access to our independently provided Survey as conducted by the Victorian treatment Employee Assistance Program which Public Sector Commission. As shown • Avoid discriminating between offers a wide range of health and in the following table we continue to employees on the basis of their personal assistance giving our staff and report acceptable levels of agreement gender, age, impairment, industrial their immediate families an extra layer across a range of indicators. activity, marital status and religious of support when needed. or political beliefs WWHS is bound by the rules and regulations contained in the following We do not tolerate bullying or legislation: harassment in any form.
72 WEST WIMMERA HEALTH SERVICE LOYAL SERVICE – A PILLAR OF STRENGTH FOR WEST WIMMERA HEALTH SERVICE
30 YEARS 20 YEARS 15 YEARS 10 YEARS John Martion Cheryl Lowe Glenis Tink Phillip Jackson Kaye Emmett Janet Fisher Desiree Williams Elizabeth Witmitz Michelle Mcgennisken Carmel Feder Sharyn Morrison Michelle Dickinson Judith Thomson Linda Knight 25 YEARS Lisa Braybrook Janet Heenan Jessica Eldridge Terri-Ann Hogart Kerri Lynch Deborah Schilling Janet Shurdington Nakita Jewell Ian Graham Lorretta Fuller Karen Alexander Hilma Summerhayes Barbara Leffler Sally Lockwood Lisa Newcombe Kelvin Asplin Shirley Avery Bree Lowe Shirley Ashfield Rebecca Bastin Patricia Chequer Caroline Fischer Toni Casey Kellie Beattie Judith Keller
RISK MANAGEMENT
In the context of West Wimmera Health Service, Risk can be defined as anything likely to impact on any aspect of this Service. Such risks can be thought of in a negative light, however they can also be an opportunity to improve the health and the safety of all patients, residents, visitors and staff including the ongoing business operations of the organisation.
West Wimmera Health Service actively The detail and accuracy of the risk which is currently considered best manages risk and does this through its register and the effectiveness of practice in the United States but is yet compliance to the Risk Management its controls is informed by incidents to become available in Australia. Standard, AS/NZS ISO 31000: 2009 that are documented and complaints The research will treat participants’ Risk management – Principles and received from our consumers. A wounds with Olivamine cream products guidelines. rigorous electronic incident reporting rather than simply dressing the area. and feedback system ensures that An extensive internal and external audit The study is expected to conclude in staff are able to appropriately record system is in place to review the systems December 2017, and will ensure WWHS issues as they arise and for managers to and processes in both clinical and is at the forefront of best-practice investigate and treat then accordingly. corporate functions of the organisation. methods in Australia. In 2013-14 such audits have included The number of incidents recorded each medication management, occupational year has stabilised. Each incident is an Total number of incidents health and safety, finance and medical opportunity to learn and improve on the TOTALreported NUMBER by year OF INCIDENTS records management. care provided. REPORTED BY YEAR Nineteen (19) strategic and operational Risk management provides the Service risks have been documented on the with an opportunity to proactively 2000 Service risk register assisting managers manage potential issues even before 1800 document the controls for each risk they arise and for this reason risks 1600 thus ensuring that the organisations are examined on a monthly basis and 1400 operations are not interrupted or reported to the Board of Governance. damaged. 1200 The project will investigate the efficacy 1000
of the wound-healing cream Olivamine, 2009-10 2010-11 2011-12 2012-13 2013-14
Total Number of incidents reported by year
ANNUAL REVIEW 2013/14 73 CORPORATE & QUALITY SERVICES
OCCUPATIONAL HEALTH AND SAFETY
West Wimmera Health Service prides itself on the highest levels of safety in the workplace, a workplace where each and every staff member has a responsibility for their own safety but also for their colleagues, patients, residents and visitors to the Service. Number of OHS Our safe systems of work are The main incidents of aggression underpinned by: occur through the actions of residents incidentsNUMBER OF perOHS yearINCIDENTS PER YEAR • The Occupational Health and experiencing Dementia. Therefore Safety Act 2004 specific staff training in this area of care has also been undertaken. As an 200 Occupational Health and Safety • extra safeguard for these occasions Regulations 2007 160 enhanced referral pathways for review • Workplace Injury Rehabilitation and by our specialist geriatrician have been 120 Compensation Act 2013 introduced and the intricacies of special 80 • Dangerous Goods (Storage and caring for these residents has been Handling) Regulations 2012 successfully explored. 40 • Compliance codes We have invested significant funds in 0 • Australian/New Zealand Standard, the renewal of worn areas of carpeted 2009-10 2010-11 2011-12 2012-13 2013-14 AS/NZS 4801:2001 Occupational floor in high traffic areas to reduce Health and Safety Management slips, trips and falls. System The new electric trolley with scissor lift Manual Handling Aggression Incidents has assisted procurement staff in their Occupational Exposure Slips, Trips & Falls HOW WE PERFORM daily routine of lifting and moving the Security immense number of boxes and parcels Five key areas of health and safety which move through the Procurement are monitored through the Victorian Department each day. Health Incident Management System. In the last year, 116 incidents involving An Injury Management Team has been aggression toward staff, manual developed providing employees who handling, occupational exposures to have been injured either at work or body fluids, slips, trips and falls and at home with assistance to return to security incidents were documented; work as quickly and safely as possible; this is 4 more than for the previous 12 this is a collaborative effort between months. the employee, management and the employee’s healthcare team. Occupational Health and Safety incidents over the past three years No notifications of serious staff injuries have plateaued, as the graph below resulting in hospitalisation or death illustrates. were made to the Victorian WorkCover Authority in 2013-14; compared with Preventing and Managing Occupational two in the prior year. Violence and Aggression training has been instigated as an on-line course for FUTURE all staff. An action research project is being considered to better understand the safety culture of our organisation and its workforce which will lead to the development of a higher level of safety first, safety at all times.
74 WEST WIMMERA HEALTH SERVICE Ryan Ganz participates in Orientation Day Fire Training using the ‘BullsEye™ Laser-Driven Fire Extinguisher Training System’. The equipment, a collaborative purchase by Grampians Region healthcare organisations uses technology to bring realistic, effective Fire Training to the education program.
ANNUAL REVIEW 2013/2014 75 GOVERNANCE
Qualified, experienced, possessing skills and knowledge pertinent to setting the direction and managing the progress of West Wimmera Health Service – these are the fundamental principles required to be appointed by the Minister for Health to our Board of Governance.
Governing a health service in rural The Board is responsible to the Board of Governance remote North Western Victoria Minister for setting the strategic as at 30 June 2014 brings with it complexities and directions of this Service and challenges quite different from monitoring compliance with state Ms L.G. Clarke JP – President those faced by the Boards of and commonwealth acts, guidelines Mr R.S. Rosewall BA, SocSci – Regional and Metropolitan services. and policies. Vice President Our Board is responsible for a They are accountable to government Mr D.P. Buckley Service which spreads across and to stakeholders for ensuring Mr H.G. Champness BA, Dip Ed, 17,000 square kilometres and that the Service is managed Accredited Lay Preacher includes 6 towns. Governing for efficiently and effectively, that the 4 Acute Hospitals, an Aged Care services and care generated are of Mr R.A. Ismay Residential Centre, 127 Residential high quality and are developed to Mr L.C. Maybery Aged Care Places, a Community meet the healthcare needs of our Mr R.L. Stanford Health Centre, a Disability Service communities. and a providing a comprehensive Mrs J.M. Sudholz The Board is kept up to date Allied Health Service at all sites with developments in the health Mr D.N. Walter –a round trip of 375 kilometres industry by attendance at State and between sites - requires immense Mrs N.E. Zanker BA, Dip Ed National conferences, access to planning and ‘out of the square’ current conference papers, internet thinking Collectively the Board Audit & Quality Committee research, presentations by peak is committed to excellence in the bodies and seminars conducted by Mr J.M. Hobday LLB – Chairman provision of healthcare for the the Australian Institute of Company region of rural Victoria which relies Ms L.G. Clarke JP – President Directors. on this Service for their lifelong Mr D.P. Buckley health needs. At all Board, Committee and Mr H.G. Champness Sub Committee meetings Board Members are required to declare Mr L.C. Maybery when they may have a Conflict of Mrs J.M. Sudholz interest relating to an item on the Agenda.
76 WEST WIMMERA HEALTH SERVICE LINES OF COMMUNICATION
BOARD OF GOVERNANCE
Operations Manager
Director Capital Services Manager Disability Services
Chief Executive Officer • Cooinda Day Programs CEO Personal Assistant • Snappy Seconds • Supported Employment
Manager Dental Services
Executive Director Executive Director Executive Director Executive Director Corporate & Quality Finance & Administration Clinical Services Medical Services Services
• Financial Reporting • Pharmacy • Risk Management • Clinical Governance • Information Technology • Radiology • Security • Credentialing
Assistant Accountant Manager Clinical Manager Quality, Visiting Medical Operations Safety & Ed ucation Practitioners • Accounting • Accounts Payable • Acute Care • Occupational Health • Accounts Receivable • Central Sterilising & Safety • Reception • District Nursing • Quality Accreditation • Infection Control • Training & Development • Maternal & Child Health Manager Personnel • Residential Aged Care & Payroll • Surgical Services Manager Engineering • Human Resource & Maintenance Management • Infrastructure & Manager Community Equipment Maintenance Manager Procurement & Allied Health • Vehicle Fleet & Inventory • Centrelink • Inventory Management • Diabetes Education • Purchasing • Dietetics Manager Hospitality & • Supply • Goroke CHC Environmental Services • Health Promotion • Food & Cleaning Services • Home & Community Care • Meals on Wheels • Home Care Packages • Oliver’s Cafe • Massage Therapy • Oliver’s Kiosk • NRCP • Occupational Therapy • Physiotherapy • Podiatry • Rural Primary Health Service • Social Work • Speech Pathology • WWHS Health & Fitness Centre
ANNUAL REVIEW 2013/2014 77 GOVERNANCE
THE BOARD OF GOVERNANCE
LEONIE G. CLARKE, President RONALD S. ROSEWALL, Vice President DAVID P. BUCKLEY, JP BA SocSci Electrical Contractor, Education Support Officer Former Business Proprietor HV Field Operator Term of Appointment: 01.07.11 – 30.06.14 Term of Appointment: 01.07.13 – 30.06.16 Term of Appointment: 01.07.11 – 30.06.14 Leonie, is serving her first term as President Ron maintains his dedication to the Service David is a member of the Goroke Pre School of the Board of Governance. A Justice of the as Vice President. His depth of knowledge and Committee, the Recreation Reserve Committee Peace, Leonie has a wealth of experience significant expertise in disability services and is a Life Member of Goroke Apex Club. David having served on the Board for 17 years. She offers well rounded experience for decision serves on the WWHS Board to play his part in is acutely aware of the need for quality and making. ensuring the survival of vital medical services for small rural communities and he welcomes appropriate health care for rural communities Ron serves on the Boards of Regional the development of the New Goroke Community and the retention of medical and allied health Information & Advocacy Council and Victorian Health Centre which offers essential medical, professionals. She is interested in maintaining Advocacy League for Individuals with Disability allied health and community health services for the high quality of services offered by West Inc. He is the Chairman of Wimmera & Southern the surrounding area. Wimmera Health Service and the availability of Mallee Health Alliance. cancer services for rural people locally. WWHS Committees: Audit and Governance, WWHS Committees: Executive, Finance, Clinical Quality Governance WWHS Committees: Executive, Audit Clinical Quality Governance and Governance, Clinical Quality and Board Meeting Attendance: 100% Board Meeting Attendance: 90% Governance, Finance Board Meeting Attendance: 100%
HARVEY G. CHAMPNESS, RONALD A. ISMAY Retired Teacher, Business Proprietor Development & Environmental Worker Term of Appointment: 01.07.12 – 30.06.15 Term of Appointment:01.07.11 – 30.06.14 A long serving member of the Board of An accredited Lay Preacher, Harvey offers Governance, Ron brings expertise in financial the governing body another community and business management to the Board and perspective and is keen to maintain remains committed to the provision of quality engagement and consultation. He is a trained health services for our rural and remote areas mentor with Volunteering Western Victoria and particularly for Aged Care. Ron has strong wishes to retain quality of care and effective representation within the Rainbow community and responsive governance of our Service. as Chair of the Town Committee, President of Harvey is a committee member and Project the Rainbow College, President of Hindmarsh Manager for Kaniva District Landcare. Tourism and was recently appointed as a Councillor of Hindmarsh Shire Council. WWHS Committees: Audit and Governance, Clinical Quality Governance WWHS Committees: Clinical Quality Governance, Executive, Finance Board Meeting Attendance: 80% Board Meeting Attendance: 90%
78 WEST WIMMERA HEALTH SERVICE LESTER C. MAYBERY RODNEY L. STANFORD JANICE M. SUDHOLZ Primary Producer Merchandise Sales Farmer / Home Duties
Term of Appointment: 01.07.12 – 30.06.15 Term of Appointment: : 01.07.13 – 30.06.16 Term of Appointment: : 01.07.12 – 30.06.15 Appointed to the Board in 1998, Lester has Rodney’s commitment to serving his community A resident of Natimuk and an experienced long gained significant experience in matters continues in his commitment to West Wimmera serving member of the Board, Janice has a focus pertaining to governance of health care in our Health Service. The substantial experience on the continual development and renovation of rural catchment. He is a Past President & Life he gained with Wimmera Uniting Care and infrastructure within the Service and is highly Member of Natimuk Bush Nursing Hospital, Uniting Care PEX Geelong stands him in good aware of the need for government support with Trustee & Chair of the Tooan Cemetery Trust, stead when looking at community needs.. He is funding for the survival of Hospitals and Aged Group Officer of Natimuk Fire Brigade, a acutely aware of the need for the delivery and Care facilities in our rural areas. Director of Horsham Sports & Community Club equitable funding of appropriate and quality WWHS Committees: Audit and Governance, and a member of the Customer Committee, health services in rural remote Victoria. Rod is Clinical Quality Governance Grampians Wimmera Mallee Water. the Chair of the capital Campaign Project for Board Meeting Attendance: 90% WWHS Committees: Finance, Audit and this Service. Governance WWHS Committees: Executive, Finance Board Meeting Attendance: 80% Board Meeting Attendance: 100%
DARREN N. WALTER NAOMI ZANKER Primary Producer BA, Dip Ed, GAICD Term of Appointment: 01.07.11 – 30.06.14 Retired Secondary Teacher Darren is heavily involved in the Goroke Term of Appointment: 01.07.12 – 30.06.15 community with representation with the Naomi was appointed to West Wimmera Sporting Complex and Recreation Reserve Health Service Board in 2009 having gained Committees, Group Officer Goroke CFA and governance experience with Nhill Lutheran a Life Member of Goroke Apex Club. Darren is School and Avonlea Hostel for the Aged. Naomi interested in how funding will be affected by is the President of Gallery Central Nhill. the new Health Reforms, and is committed to Naomi maintains particular interest in the accessibility of first class medical services and financing and government support for ongoing is pleased the new Goroke Community Health rural and regional services, supply of local Centre has assured continued existence of services to minimise long distance travel. healthcare in that rural area. WWHS Committees: Clinical Quality WWHS Committees: Clinical Quality Governance, Executive Governance, Finance Board Meeting Attendance: 100% Board Meeting Attendance: 90%
ANNUAL REVIEW 2013/14 79 GOVERNANCE
THE EXECUTIVE GROUP
The Executive Directors are charged with the duty of providing exemplary leadership to their team with empathy, understanding and initiative to build an ethical workplace and to foster long term achievements.
They are accountable to the Chief Executive Officer for the performance, decisions and outcomes of their Department and must be committed to embracing the the philosophy and Mission of West Wimmera Health Service.
JOHN SMITH PSM RITCHIE DODDS MHA, GRAD DIP HSM, FAICD, AFACHSM, AFAHRI, BCOM (ACC), CA, FFIN, MBA, GAICD FAHSFMA, AFAIM, CERT III OH&S Executive Director Finance and Administration Chief Executive Officer Ritchie is responsible for the Service’s Finance, Human John provides the Board of Governance with comprehensive Resources, Information Technology, Procurement and information to enable prudent and astute decision making. Administration functions. He executes the Board’s decisions and policies and manages Since 2006 Ritchie has cemented the Service’s strong the business and human assets of the Service. financial performance and its sound financial position. John is responsible for establishing a framework of strong Ritchie is a member of the Institute of Chartered Accountants leadership and management to place the Service in a prime in Australia and deputises for the Chief Executive Officer as position to take advantage of changes in health service and when neccessary. delivery, technology and financial strategies. Ritchie represents the Service as Deputy Chairman of He serves on many Boards and working groups and the Grampians Regional Health Alliance Finance Sub amongst other representations is currently Vice President Committee. of the Australian Council on Healthcare Standards (ACHS), Treasurer of the International Board of ACHS, a Council Member of the Australian Hospital and Healthcare Association and Vice President of the Victorian Hospitals’ Industrial Association.
80 WEST WIMMERA HEALTH SERVICE DR IAN GRAHAM JANET FISHER MBBS, MHP, FRACMA RN, RCNA, GRAD DIP BUS MAN Executive Director Medical Services Executive Director Clinical Services Ian is responsible for the credentialing, appointment, Jan is responsible for the management of Medical, Surgical, definition of the scope of practice and performance Primary Care, Aged Care, Allied and Community Health and management of Visiting Medical Practitioners, including the Goroke Community Health Centre, Radiology, Central General Practitioners, Visiting Surgeons, Anaesthetists, Sterilising, Maternal & Child Health and Pharmacy. Gynaecologists, Physicians and Psychiatrists. Jan is a Registered Nurse who holds an Advanced Diploma in Ian is also Clinical Digital Education Consultant at the Business Management and has OH&S credentials. Royal Australasian College of Surgeons and privately Jan represents the Service on Regional Committees including; is a consultant in health management, education State Aged Care Committee, Grampians Regional Executive and information technology. Nurses. In 2013 Ian was appointed to the international Board of Directors of the MedBiquitous organisation based at Johns Hopkins Hospital, Baltimore, USA.
KAYE BORGELT MELANIE ALBRECHT KATRINA PILGRIM ASSOC DIP MED REC ADMIN, GRAD LLB, BIS, GRAD CERT HSM, AFCHSE CERT IV BUS MANAGEMENT CERTIFICATE MGT ORG CHANGE Operations Manager (FRONTLINE) Executive Director Corporate Appointed in April 2006 Melanie Executive Assistant to and Quality Services Chief Executive Officer is responsible for the executive Kaye manages Engineering & management of Disability Services, Katrina provides executive service Maintenance, Catering & General Dental, Aged Care Administration, to the Chief Executive Officer and Services, Education, Health Information Contracts, Compliments and attends to Executive Departmental Management, Quality & Accreditation, Complaints. requirements. O H & S , Risk Management and Security. Melanie assists the Chief Executive As Minute Secretary to the Board of Kaye is studying for a Masters of Officer with operational, organisational Governance and associated committees Health Science (Health Information and special projects. Katrina is responsible for ensuring the Management) and is a member of the corporate and strategic issues are dealt Melanie completed a Masters of Health Victorian Patient Experience State- with by the Chief Executive Officer. Administration and Masters of Business wide Reference Group, Grampians Administration with Latrobe University Regional Health Information Managers during the 2013-2014 year. and Patient Management System Operations Group.
ANNUAL REVIEW 2013/14 81 GOVERNANCE
CLINICAL GOVERNANCE AT WEST WIMMERA HEALTH SERVICE
ENHANCING CLINICAL CARE wish to tell us about – these are taken CLINICAL RISK MANAGEMENT extremely seriously with a response West Wimmera Health Service, its Board made very early as to the actions taken. Management of Clinical Risk considers of Governance, Executive, Managers patient care, the education, experience and staff strive to provide the highest Our consumers are active participants and qualifications of our staff and level of care for its patients, residents, in their care planning with the health visiting health practitioners together clients and community. Excellence in care team through discussions on with the equipment we apply and care provision requires a mindset of treatment options, care pathways, and resource. continuous improvement, responsibility advanced care directives. Conforming to the policies and and accountability and it is through a procedures of our organisation rigorous clinical governance structure CLINICAL EFFECTIVENESS as well as legislation (the law) and that this has been achieved. Clinical audit and review is standards pertaining to health care Our Service observes the four domains a cornerstone to the clinical are the cornerstones of Clinical Risk of quality and safety in the Victorian effectiveness of our Service. Clinical Management. Clinical Governance Framework to care is evaluated and reported through In 2013-14, the Service underwent a inform our clinical governance efforts, all levels of the organisation and review of Hospital Procedural Services; they are: allows clinicians to engage in policy development and improvement of the surgical procedures and operations Consumer participation • Service quality. undertaken in Nhill particularly. • Clinical effectiveness We are indeed fortunate to have an The review was endorsed by the Effective workforce • informed clinical workforce dedicated Department of Health Victoria and • Risk management to the provision of high quality and conducted by a panel of healthcare experts. In October 2013, the results of A Clinical, Quality Governance effective care. Our Visiting Medical the review were provided to the Clinical Committee has been established Practitioners, Nurses and Allied Health Quality Governance Committee (a to ensure that Visiting Medical clinicians use national and international Board of Governance sub-committee). Practitioners, Nurses, Managers, Board standards of practice in the provision of An important sentiment of the review Directors and Executive Personnel all care to our community. was that procedural services at West play a part in the safe and effective Distance from metropolitan Specialist Wimmera Health Services should not provision of care to our community. Visiting Medical Practitioners or Allied change and should continue to be Importantly this committee monitors Health Professionals is not a barrier provided. the above elements of the governance to specialist care. Innovative ways framework and ensures that the are being used for our clinicians to Fourteen (14) recommendations arose custodians of the Service, the Board, access advice and share care with our from the review and these have been are fully informed and updated on the health professionals via technology fully implemented thus ensuring the outcomes of these four domains. such as video conferencing and Skype highest possible level of care and thus reducing the tyranny of distance support to the people of the Wimmera CONSUMER PARTICIPATION although not totally eradicating the and Southern Mallee exists. Consumer forums are an effective demands of travel. means by which our community can OUR CENTRE POINT EFFECTIVE WORKFORCE provide their thoughts and ideas Clinical Governance is the centre point regarding improving the services West Credentialing and ongoing professional of the effective and safe delivery of Wimmera Health Service provides. Such development are key methods utilised care to the community we serve. Our forums also provide an effective means by the Service to ensure an effective staff, managers, executive and Board for the community to be informed of workforce. Credentialing provides all work within a framework designed current and new developments such a thorough examination of the to ensure that patients, residents and as buildings, fund raising and health qualifications and skills of a clinician clients receive the care they require in a services being offered. so that we are assured safe care will be manner that is of the highest standard Through the Victorian Health provided to our consumers. and with the best possible outcomes for their ongoing health and wellbeing. Experience Survey we obtain real Our staff participate extensive insight into the needs of our community professional development programs and their feedback as to their provided at regional, state and experience whilst in hospital. international levels, these are designed The Service has a robust compliments to provide the latest information for and complaints mechanism. This safe and effective care delivery while process provides our consumers the reaching the highest quality care opportunity to engage the Service in a outcomes for the consumer. direct conversation about issues they
82 WEST WIMMERA HEALTH SERVICE COMPLIANCE WITH GOVERNMENT REGULATIONS
COMPLIANCE WITH THE SUMMARY OF FOI ACTIVITY 2013/14 BUILDING AND MAINTENANCE PROVISIONS OF THE BUILDING Number of Personal Requests Received 4 ACT 1993 Number of Non-Personal Requests Received 9 Total Number of FOI Requests 13 In accordance with the Building Regulations 2006 under the Building Access Granted in Full 13 Act 1993,(The Act) each building in West Application Fees Collected $257.00 Wimmera Health Service is classified Application Fees Waived $7 7.10 according to its function. Charges Collected $97.10 A Building Permit is obtained for new Charges Waived $12.00 construction and redevelopment projects where required. A Certificate of Occupancy is obtained and displayed for THE APPLICATION AND • Details of changes in prices, fees, each completed project in accordance OPERATION OF THE charges, rates and levies charged with The Act. PROTECTED DISCLOSURE ACT by the Health Service. Details of any major external A comprehensive preventative 2012 (THE ACT), INCLUDING • DISCLOSURES REQUIRED BY reviews carried out on the Health maintenance program ensures essential Service. equipment and systems such as THE ACT fire systems, hot water systems, air • Details of major research and There were no incidences during development activities undertaken conditioning, emergency generators, the year of this Act being activated sterilizers and anaesthetic machines by the Health Service that are in relation to the operations of the not otherwise covered either in are serviced regularly and maintained in Service. accord with manufacturer instructions. the Report of Operations or in VICTORIAN INDUSTRY a document that contains the APPLICATION OF THE PARTICIPATION POLICY financial statements and Report of Operations. FREEDOM OF INFORMATION There was no relevant activity for this ACT (FOI) • Details of overseas visits reporting period. undertaken including a summary The Victorian Freedom of Information of the objectives and outcomes of Act provides individuals with the NATIONAL COMPETITION each visit; POLICY opportunity to access documents about • Details of major promotional, public their personal affairs and the activities Implementation and compliance with relations and marketing activities of government departments from the government policy statement, undertaken by the Health Service government agencies, including public Competitive Neutrality Policy Victoria; to develop community awareness of hospitals. and subsequent reforms were not the Health Service and its services. The Chief Executive Officer is the applicable to this Service for 2013/14. • Details of assessments and designated Freedom of Information measures undertaken to improve Officer. ADDITIONAL INFORMATION the occupational health and safety of employees. West Wimmera Health Service FOI AVAILABLE ON REQUEST application fees and access charges are (FRD 22E) • General statement on industrial in accordance with State Government In compliance with the requirements relations within the Health Service regulations. of FRD 22E Standard Disclosures in and details of time lost through industrial accidents and disputes, In 2013/14 thirteen requests, all relating the Report of Operations, details in respect of the items listed below have which is not otherwise detailed in to access to medical records, were the Report of Operations. received. Full access was granted in been retained by West Wimmera Health A list of major committees each case. Service and are available to the relevant • Ministers, Members of Parliament and sponsored by the Health Service, There were no complaints lodged with the public on request (subject to the the purposes of each committee the Ombudsman by FOI applicants, our freedom of information requirements, and the extent to which those administration of FOI matters, and no if applicable): purposes have been achieved. appeals were made to the Victorian • A statement of pecuniary interest; • Details of all consultancies and Civil and Administrative Tribunal (VCAT) contractors including consultants/ regarding access to records. • Details of shares held by senior officers as nominee or held contractors engaged, services beneficially. provided, and expenditure committed for each engagement. • Details of publications produced by the Department about the activities of the Health Service and where they can be obtained.
ANNUAL REVIEW 2013/14 83 GOVERNANCE
ACCREDITATION STATUS
WHAT IS ACCREDITATION? Added to this are a further 5 standards ACCREDITATION MATURITY developed by ACHS itself. Accreditation is an important means West Wimmera Health Service by which the Service can attain an 11. Service Delivery has endeavoured to make quality independent review of the quality and 12. Provision of Care improvement a part of our every day safety of the care it provides, against 13. Workforce Planning and work and therefore our preparation national standards. The standards Management for accreditation and the evidence determine the highest levels of care and supporting our work against each 14. Information Management management; meeting these standards accreditation standard is constantly is a clear indication to our community, 15. Corporate Systems and Safety being collected. We have established government and healthcare personnel, These five standards monitor the working groups to work through the of the excellence of the services we performance of non-clinical systems, National Safety and Quality Health deliver. thus complimenting the 10 national Service Standards with each gathering the necessary proof that we are a safe, We open our organisation to survey by Standards. efficient and effective healthcare a team of surveyors who are leaders The 10 National Standards were organisation. in their respective fields of the health introduced by the Australian industry: Nurses, Visiting Medical Commission on Safety and Quality in FUTURE: Practitioners Administrators and in Health Care in January 2013: from that some instances, consumers. The Survey date mandatory compliance with these The next 12 months will witness several Team is independent of West Wimmera standards is required by Federal and major reviews including Accreditation Health Service and therefore are able State Governments. surveys in each Residential Aged to offer an unbiased assessment of our Care Unit and a Periodic Review of our The National Standards will have a Service and its capability. Acute Hospitals against three of the profound effect on our approach to 10 National Standards and also the safety and quality for patients. ACCREDITATION METHODS mandatory elements of EQuIP National. EQUIP NATIONAL AGED CARE STANDARDS Although Accreditation reviews are compulsory, we have always In 2013, West Wimmera Health Service Aged Care Standards Accreditation is embraced them as an opportunity embarked on its preparation for a national, compulsory accreditation to confirm where we are performing accreditation under EQuIP National an audit against four standards: well and to make improvements when accreditation product of the Australian 1. Management systems, staffing, recommendations are made. Council on Health Care Standards. EQuIP and organisational development We address these audit processes National incorporates the 10 National 2. Health and personal care Safety and Quality Health Service with confidence and as an occasion to Standards (developed by the Australian 3. Resident lifestyle showcase the impressive levels of care Commission on Safety and Quality in 4. Physical environment and safe and service delivery we offer while Health Care) systems pursuing the seal of excellence we will so proudly display. The 10 National Standards are: Forty Four expected outcomes support 1. Governance for Safety and Quality the main standards – all of which must in health Service Organisation be compliant at each three year review. Residential Aged Care Facilities are 2. Partnering with Consumers reviewed against the standards by the 3. Preventing and Controling Aged Care Standards and Accreditation Healthcare Associated Infections Agency. It is likely that there will be 4. Medication Safety changes to these standards over time following the introduction of new Aged 5. Patient identification and Procedure Matching Care policies by the Commonwealth Government. e await those changes and 6. Clinical Handover will determine how best to incorporate 7. Blood and Blood Products them seamlessly across our Health 8. Preventing and Managing Pressure Service. Injuries 9. Recognising and Responding to Clinical Deterioration in Acute Health Care 10. Preventing Falls and Harm from Falls
84 WEST WIMMERA HEALTH SERVICE AGED CARE ACCREDITATION STANDARDS TYPE OF ACCREDITATION OUTCOME Australian Council of Healthcare Standards • Organisational wide survey conducted in December 2012 (EQuIP5) • Full, four year accreditation status awarded • Outstanding Achievement was conferred in two areas, Research and our work undertaken in Buildings, Signage and Equipment – an award that acknowledges the leadership West Wimmera Health Service demonstrates for others in these areas
National Safety and Quality Health Service Mid Cycle, Periodic Review against the Standards: Standards • Governance for Safety and Quality in Health Care • Partnering with consumers • Preventing and Controlling Healthcare Associated Infections; this will occur in 2015.
EQuIP National Review of mandatory criteria of the EQuIP National Standards 11-15 Aged Care Standards and Accreditation Agency • Full survey undertaken at all Residential Aged Care Facilities (ACCA) during 2012–13 resulting in full three (3) year accreditation status, with compliance in all 44 criteria; • Unannounced site visits have been conducted subsequently at all homes following full compliance achieved • In 2015 all Residential Aged Care Facilities will undergo full survey’s against the Aged Care Standards
Home and Community Care (HACC) In December 2012 the Service’s HACC programs were surveyed against the National Community Care Common Standards; full Three national standards that include: compliance was received in all standards • Effective management, • Appropriate access and service delivery • Service user rights and responsibilities Disability Services Accreditation A review by International Standards Certifications was undertaken in July 2014 against Disability Services Standards, with full and ongoing Accreditation reviews occur against the National compliance noted. Disability Service Standards and the Victorian, State Department of Human Services Standards Review of Cooinda Disability And five Statebased standards: Services against the six National • Empowerment Disability Service Standards: • Access and Engagement Rights • • Wellbeing Participation and Inclusion • • Participation Individual Outcomes • • Service management • Feedback and Complaints • Service Access and • Service Management
DIAGNOSTIC IMAGING (X-RAY) ACCREDITATION STANDARDS TYPE OF ACCREDITATION OUTCOME
National accreditation in this field has been In 2012 the Service successfully underwent a Stage II Diagnostic mandatory since 2012 and includes general Imaging Accreditation Audit conducted by Health and Disability x-ray, CT, and Ultrasound Accreditation Australia with full accreditation status granted: valid from 16 May 2012 to 16 May 2016
Community Aged Care Packages (CACP) and The Commonwealth Department of Health and Ageing reviewed the National Respite for Carers Program (NCRP) CACP and NRCP programs in September 2012 with each program successfully meeting the National Community Care Common Standards at review
ANNUAL REVIEW 2013/14 85 GLOSSARY
ACAS Aged Care Assessment System EQuIP Accreditation Evaluation RFDS Royal Flying Doctor Service ACFI Aged Care Funding Instrument Quality Improvement Program RPHS Rural Primary Health Service ACHS Australian Council on Healthcare FOI Freedom of Information Telehealth use of telecommunication Standards GCHC Goroke Community Health and information technology to provide Australian Standards National Centre clinical healthcare at a distance Standards developed by the Standards GP General Practitioner The Board The Board of Governance Association of Australia/New Zealand HACC Home and Community Care – WWHS Best Practice Measuring results funding for services and programs The Department The Department of against the best performance of other which are provided in the home or the Health Victoria groups community The Service West Wimmera Health CACS&AA Commonwealth Aged Care Inpatient A person who is admitted to Service Standards and Accreditation Agency an acute bed Values The principles and beliefs that Carers Carers of patient/clients who IT Information and Communications guide West Wimmera Health Service are not part of the Service Care Team Technology VHIA Victorian Hospitals Industrial Catchment Geographical area for LED light emitting diode Association which West Wimmera Health Service is M&CH Maternal and Child Health VMO Visiting Medical Officer responsible to provide services Medicare Local services for local W&SMHA Wimmera & Southern Mallee CEO Chief Executive Officer communities in line with local needs, a Health Alliance CT Scanner Computed Tomography National Health Reform initiative WHY Project West Wimmera, Scanner OHS Occupational Health & Safety Hindmarsh & Yarriambiack Shires - DH The Department of Health Victoria Outcome The result of a service collaboration of HACC services DHS The Department of Human provided WWHS West Wimmera Health Service Services Victoria Outpatient A patient/client who is not e-health the transfer of health admitted to a bed resources and healthcare by electronic PCP Primary Care Partnership means
86 WEST WIMMERA HEALTH SERVICE INDEX
Accreditation ...... 8, 84, 85 Dunmunkle Health Service ...... 3 Patient Experience ...... 14 Acute Care ...... 38, 39 Education & Training ...... 8,65 ,72 People Matter Survey ...... 74 Aged Care ...... 32 Engineering & Maintenance . . . . . 66 Pharmacy ...... 43 Aged Care in our Community . . . . .35 Environment ...... 68 President ...... 2 Aged Care the Changes ...... 34 Executive Team ...... 80 Quality & Safety for Patients . . . . 62 Allied & Community Health ...... 41 Finance & Administration . . . . 29, 72 Radiology ...... 43 Australian Council on Financial Performance ...... 29-31 Research ...... 40 Healthcare Standards . . . . .8, 84, 85 Freedom of Information ...... 83 Residential Aged Care ...... 32 Cancer Resources ...... 14, Fundraising ...... 4, Reviews ...... 4 Board of Governance ...... 78,79 Goroke Community Health Centre . . 8, RIPERN ...... 8 Capital Projects ...... 12, 13 Governance ...... 76 Risk Management ...... 73 Catchment ...... IBC Government Grants ...... 20 Royal Flying Doctor Service . . . . 5, 14 Chief Executive Officer ...... 3 HACC ...... 17 Rural Primary Health Service . . . . 27 Cleaning & Food Audits ...... 14, 64 Hand Hygiene ...... 64 Services ...... 16, 17 Clinical Governance ...... 82 Health Promotion ...... 54 Snappy Seconds ...... 46 Clinical Placements ...... 8 Human Resources ...... 72 Specialist Services ...... 16 Clinical Risk Management ...... 82 Infection Control ...... 64, 65 Staff ...... 73 Clinical Services ...... 32 Legislation & Compliance ...... 83 Staff Awards ...... 75 Communication ...... 1 Location ...... IFC Statement of Priorities ...... 21 Lines of Communication ...... 77 Medical Report ...... 49 Statistical Performance . . . . . 26, 28 Community Aged Care ...... 35 Medical Imaging ...... 43 Strategic Directions ...... 22-24 Community Garden ...... 4 Medical Services ...... 16 Student Housing ...... 68 Compliance ...... 83 Medicare Locals ...... 5 Surgical Services ...... 16 Consumer Carer Participation . . . .54 Mira Medical and Allied Tristar Medical Group ...... 13, Consumer Forums ...... 82 & Community Health Centre . . . . . 3 Values ...... 1 Corporate & Quality Services . . . . 66 Mission ...... 1 Venesection Clinic ...... 63 Credentialing ...... 82 Natimuk Medical & Vision ...... 1 Allied Health Centre ...... 3, 18 Cultural Awareness ...... 54, 55 Visiting Specialist Clinicians . . . . .50 National Health Reform ...... 5 CT Scanner ...... 43 Volunteers ...... 4 Dental Services ...... 10, 44 National Respite for Carers Program ...... 17 Wimmera & Southern Dialysis ...... 40 Mallee Health Alliance ...... 14, Occupational Health & Safety . . . .70 Dimensions of Quality WorkCover ...... 72 Oliver’s Café ...... 67 in Residential Care ...... 58 Wound Management ...... 40 Disability Services ...... 46 Oliver’s Kiosk ...... 67 Donations & Bequests ...... 20 OPG ...... 10
ANNUAL REVIEW 2013/14 87 ACKNOWLEDGEMENTS
THANK YOU
We acknowledge the generous sponsorship, donations and bequests and look forward to continued support as we forge further ahead to provide outstanding health services for our communities
Design and Production Motiv Brand Design (Adelaide) Co-ordination DMR Associates Pty Ltd (Nhill) Photography Robert Geh (Adelaide) Lawyers Ashurst Australia (Sydney) Health Legal (Melbourne) Russell Kennedy Pty Ltd (Melbourne) Stewart & Lipshut (Nhill) Auditor Office of the Victorian Auditor General Internal Auditor WHK (Albury) Architect Brown Falconer (Adelaide) Bankers Commonwealth Bank Westpac
Tania Ryan conducting patient observation rounds.
SPONSORS
88 WEST WIMMERA HEALTH SERVICE Notes:
ANNUAL REVIEW 2013/14 89 Notes:
90 WEST WIMMERA HEALTH SERVICE Help Support Your Service
You can help us… to make the services we provide for six communities become better and better.
YES, I am interested in supporting West Wimmera Health Service and would like further information about the following:
Becoming a Volunteer
Joining an Auxiliary
Giving financial support through a Bequest or Donation
If you wish to discuss supporting our Service in this way please contact the Chief Executive Officer who will explain in detail how arrangements can be made.
Alternatively, please complete the form below and return it to us at any one of our facilities.
Name......
Address ......
Telephone ...... Facsimile......
Mobile ...... Email...... ✁ CUT ALONG THE DOTTED LINE
ANNUAL REVIEW 2013/14 91 Reader Survey This Report is produced to inform our consumers, communities and government about the range and quality of the services we deliver. To make sure we provide the information you require and that we deliver the services most needed by the people we serve we need YOUR assistance. It would be extremely helpful to us if you could answer the following questions and return to the Service please.
Tell us… what you think
Please circle the answer which most closely reflects your opinion. Q1 I am a: a) Consumer b) Representative of Government c) WWHS Staff d) Medical Practitioner e) Health Industry Employee f) Financial Supporter g) Other (please specify)
Q2. Does this Report clearly explain West Wimmera Health Service and the services it delivers? Yes/ No Q3. How did it help your understanding or what could we improve to help your knowledge of our Health Service?...... Q4. Do you feel you know more about the QUALITY of our programs and services from reading this Report? Yes/ No Q5. Were there any other topics you feel should be included in the Quality of Care Report next year?
...... Q6. Are there other services or programs you believe should be delivered by West Wimmera Health Service?...... Q7. Have you seen or read a copy of this Report before? Yes/ No If you answered Yes, where did you see or obtain a copy?...... Q8. Do you have any other comments about the Report you have just read?......
Thank you most sincerely for assisting West Wimmera Health Service in our drive towards continued improvement in the quality and range of services needed by our communities and importantly the way in which we tell you about them.
John N. Smith PSM Chief Executive Officer LINE DOTTED THE ALONG CUT
John N. Smith, PSM, Chief Executive Officer West Wimmera Health Service PO Box 231, Nhill, Victoria 3418 Telephone 03 5391 4222 Facsimile 03 5391 4228
Email [email protected] ✁
92 WEST WIMMERA HEALTH SERVICE Hopetoun
Big Desert Wyperfield National Park National Park Rainbow KEY Residential Aged Care
Medical Centre
VICTORIA Lake Hindmarsh Hospital (Primary Care Casualty)
Hospital Jeparit (Primary Care Casualty and Surgical Centre) SOUTH AUSTRALIA
Warracknabeal Bordertown Nhill Kaniva < ADELAIDE A8 A8
Dimboola
Little Desert National Park
B240 B210 Goroke B240 Natimuk Horsham
MELBOURNE >
B240 A8
Narracorte Jilpanger Flora A200 and Fauna Reserve
Halls Gap Black Range StatePark Grampians National Park
WEST WIMMERA HEALTH SERVICE
Distance is no barrier for us as we deliver our services across On the other hand the need for a higher level of acute and the breadth of a harsh but beautiful rural setting containing aged residential care is also in our portfolio. Bringing national parks, the world renowned Mt Arapiles, a rock specialist medical and surgical services, a full complement climbers paradise, The Grampians Tourist Park and we are of General Practitioners, a state of the art Operating Suite, just across the border from the South Australian wineries. short waiting times for surgery, a range of Dental procedures meets the acute healthcare needs of these six communities. We have established expertise and skills, adapted care routines, researched our communities, and analysed the Healthcare close to home – no matter where that is in our health conditions prevalent in those communities so that catchment – West Wimmera Health Service is there to care. we are able to take our services out to the people no matter A real service for real people! where they live in our catchment. Advanced telecommunication systems, a fleet of vehicles, portable patient equipment, a robust set of policies and procedures, comprehensive ongoing education and staff WW205 / MOTIV / WW205 who are flexible and able to adapt safely to situations are the backbone of long distance caring.
ANNUAL REVIEW 2013/14 C NHILL HOSPITAL GOROKE COMMUNITY KANIVA HOSPITAL RAINBOW HOSPITAL 49 Nelson Street, HEALTH CENTRE 7 Farmers Street, 2 Swinbourne Avenue, Nhill, Victoria 3418 Natimuk Road , Kaniva, Victoria 3419 Rainbow, Victoria 3424 T (03) 5391 4222 Goroke, Victoria 3412 T (03) 5392 7000 T (03) 5396 3300 F (03) 5391 4228 T (03) 5363 2200 F (03) 5392 2203 F (03) 5395 1411 F (03) 5386 1268 COOINDA DISABILITY NATIMUK RESIDENTIAL EMAIL JEPARIT HOSPITAL SERVICES AGED CARE CENTRE [email protected] 2 Charles Street, Queen Street, 6 Schurmann Street, Jeparit, Victoria 3423 Nhill, Victoria 3418 Natimuk, Victoria 3409 T (03) 5396 5500 T (03) 5391 1095 T (03) 5363 4400 F (03) 5397 2392 F (03) 5391 1229 F (03) 5387 1303
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