YEAR IN REVIEW 2018/2019

Shaping futures changing lives Dr Bu Balalla performing the first knee surgery ISBN 1 74080 172 5 at Auburn Hospital with Dr Hedra Eskender. Copyright of Western Sydney Local Health District CONTENTS Contents 1 3 2 Auburn 2018/19 Westmead Hospital Westmead HOSPITALS OUR 2018/19 Key Activities Hospital Druitt Mount 2018/19 Blacktown Hospital Key Activities Blacktown and Hospitals Mount Druitt Auburn Hospital Key Activities Community and Patients Our PEOPLE OUR 2018/19 Numbers Staff Our Clinical Council Executive Our Staff Our Board Our Financial Sustainability Financial Health Our WHAT DO WE Hospital Key Activities Hospital

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2018/19

20 24 16 12 23 22 19 15 21 13 17 11 5 9 6 8 7

4 5 6 Glossary APPENDIX Future the Into CARING FOR YOUR TOMORROW 2018/19 Key Activities Health Population Integrated and Community Health Health Aboriginal Health Allied Health Oral Health Drug Health Mental OUR SPECIALTY SERVICES Awards Quality WSLHD Safety Patient and Health Digital Network Education and Research QUALITY INNOVATION AND

38 WSLHD YEARINREVIEW

2018/19 36 25 30 34 26 26 29 28 38 31 35 32 27 27 37

FOREWORD WSLHDWSLHD YEAR IN REVIEW CHAIR, DEPUTY CHAIREXECUTIVE AND CHIEF COMITEE EXECUTIVE 2019

Excellent year and more to do

Building new hospitals and improving clinical services energises a community and health organisations. These advances allow good culture and governance to drive renewal of our workplaces, staff wellbeing and healthcare delivery. In June 2019, the WSLHD Clinical Council was established to give clinical staff from across the district a stronger role in determining matters of material importance to the running of health services. The clinical council meetings have complemented the function of the WSLHD executive. The WSLHD executive recruited new talent to bring a broader range of skills to the table. The executive focused on Above: (L-R) Board chair Richard Alcock, chief executive Graeme Loy and the need for stronger governance, Board deputy chair Professor Jeremy Chapman at Blacktown Hospital. sustained strategic planning and improving culture. health services on their doorstep with Silver Chain Community Palliative A concerted effort to increase staff the announcement in February 2019 of Care Service continued to help our participation in the annual People the site for the new Rouse Hill Hospital. community with more than 900 people Matter survey was a cornerstone in the WSLHD staff have made important receiving care in the 2018/19 financial year. program of cultural change. A record contributions to these developments number of respondents provided One of the great health challenges in but the strength of our partnerships greater organisational insight into western Sydney is diabetes prevalence. must also be acknowledged. Health is the challenges faced. The Western Sydney Diabetes Alliance not only at the heart of a community, it grew to 120 members, increasing its Three World Café forums preceded is also part of a network of government ability to combat the condition. the survey, allowing 350 staff from and non-government alliances and Research, part of our DNA, attracted across WSLHD to articulate ways in relationships that improve healthcare. which culture and performance could millions in funding. The Research The tempo of work with the Sydney improve. Working groups have now and Education Network was deeply Children’s Hospital network and other been established around central themes involved in clinical trials in cancer and Westmead precinct partners increased. and will develop an action plan to inform haematology, supporting research in Our relationships with Sydney and a five-year program to improve culture. allied health and nursing, and lifting Western Sydney universities, University academic contributions in fields such It was also a year of infrastructure of Notre Dame at Auburn, and other as pharmacy and clinical education. development. At Blacktown, the new academic and training partners Central Acute Services Building (CASB) strengthened. Our important work All the while we tried to listen more for emergency, birthing, maternity, with Western Sydney Primary Health closely to what our patients and their newborn care, women’s health, Network continued to provide vital families had to say. The use of the My paediatrics, intensive care and collaborations with the primary Experience Matters survey tool in the perioperative services was handed health sector. acute sector to gather information was vital in making their experience better. over for hospital operational Relationships with the Aboriginal commissioning on 24 June, 2019. community strengthened through Spending wisely and investing astutely This new facility will future proof the higher-profile participation in NAIDOC, assisted in bringing the 2018/2019 ability of the district to service the Close the Gap and Reconciliation Week. end-of-year result back to a near-balanced health needs of the community. position, a significant deficit correction WSLHD was a leader in the western in the space of two years. Certainly, The development of Blacktown and the Sydney Refugee Health Coalition’s demand for public health services is evolution of that facility into the fifth work to improve access to services for increasing. There is no doubt there largest hospital in the state continues apace. refugees and asylum seekers. The first is still work to be done. The CASB is the biggest health African Health Summit was convened infrastructure project in NSW. It in Western Sydney in June 2019 to We can look back on the 2018/2019 was officially topped out in June identify the health needs of African financial year as one characterised by 2019 by Premier Gladys Berejiklian, communities and to recommend strong performance and significant ushering in a bright new future for the priority focus areas to improve health milestones. We can also look forward to Westmead campus and the Westmead outcomes and access to services. the coming year with great anticipation. health precinct.

Thousands of residents across north-west Richard Alcock Professor Jeremy Chapman Graeme Loy Sydney came closer to having world-class Board chair Board deputy chair Chief Executive

4 OUR PEOPLE

Our Patients and Community 6

Our Board 7

Our Staff 8

Our Executive 9

Our Clinical Council 10

Staff Numbers 2018/19 11

Left: Registered nurse Zahira Torres writing a message on a paper heart during National Palliative Care Week at Mount Druitt Hospital.

1 OUR PEOPLE 1 WSLHD YEAR IN REVIEW OUR PATIENTS AND COMMUNITY

Above, from left: Nimishabahen and Vijaykumar Patel with their newborn at Westmead Hospital; patient Rosa Sciamanna receives an Easter beauty package; Blacktown Hospital volunteer Terence Green; clinical midwifery educator Stephanie Bishop with students at the WSLHD Career Expo.

Our diverse Who we serve population We deliver services to a diverse community drawn from a range of countries and differentsocioeconomic backgrounds. Here is a snapshot of some of this year’s patients, volunteers and community events.

46.8% Residents born overseas

Above: Students at the Youth Voices Pitch Day.

Community spotlight 50.3% “I love helping out Residents who speak Youth Voices Pitch Day here at the hospital. a language other than Westmead Hospital was abuzz with English at home activity in October 2018 as more than I do a lot of walking 30 high school students from western Sydney came together to pitch ideas so it’s good for on how to make their communities the health.” a healthier and safer place to live. The positive atmosphere in the Cabaret Auburn Hospital volunteer Room at Westmead Hospital allowed Ivan Hamilton wheels a constructive ideas to be discussed with book and magazine trolley both education and health professionals around the hospital. at the Youth Voices Pitch Day. India The event was an extension of the WSLHD Top country of origin Students As Lifestyle Activists (SALSA) program, which gives students a platform to be advocates for healthy environments in their neighbourhoods. High schools involved in the event included Blakehurst, Chifley College Mount Druitt, Erskine Park, Rouse Hill and Rooty Hill. Panellists were made up of renowned 1.5% professionals from 7 News, WSLHD, Aboriginal people Blacktown City Council, the Australian Medical Association and NSW Education. 6 OUR PEOPLE OUR BOARD WSLHD YEAR IN REVIEW 1

Meet our Board The members of our Board are appointed by the NSW Minister for Health for a term of up to four years.

Responsibilities of our Board and chief executive include: • Improving local patient and population health • Ensuring services are provided efficiently and responsibly outcomes and responding to issues • Production of annual reports that are subject to • Delivering services and monitoring the performance state financial accountability and audit frameworks of WSLHD against measures in the local health district • Maintaining effective communication with local service agreement including an agreed budget based and state public health stakeholders. on annual strategic and operating plans

Richard Alcock AO Professor Jeremy Chapman Adjunct Professor Narelle Bell (Board chair) AC (Board deputy chair) Kathy Baker AM BA LLB BCom, LLB (UNSW) MB, BChir, MD, FRACP, FRCP MEdA, BHA, RN, CC, CT, DipNE, MAICD, ACN (DLF), Honorary Fellow UTS, Wharton Fellow

Andrew Bernard Elizabeth Crouch AM Professor Michael Edye Professor Donald Nutbeam BSc (Syd), MPH (Syd), BEc (MU), FAICD MBBS (Syd) PhD, FFPH (UK) GradCert BA (Exec) (Monash Mt Eliza), AFCHSM, MAICD

Dr Andrew Pesce Adam Stuart Adjunct Professor Michael Dr Keith Hartman AM MBBS, FRANZCOG QIP Assessor, ISO Auditor, (Mick) Reid AM MB, BS (Syd), FRCOG, Cert IV in Business Administration, BEc (ANU) FRANZCOG Graduate of Aboriginal Career & Leadership Program (AGSM).

Ex Officio WSLHD chief executive WSLHD director finance WSLHD executive Graeme Loy Barry Mitrevski director Medical Services MBA, (Hlth/HlthAdmin/Mgt), BComm (Econ), DipAcc, Dr Emma McCahon MAICD MBA, CPA MBBS, FRACP (Paed), MBA

WSLHD executive director Blacktown and Westmead Medical Professor Diana Operations Adjunct Associate Mount Druitt Medical Staff Council Professor O’Halloran AO Professor Robynne Cooke Staff Council Professor Christopher Liddle MBBS, MPHEd, RN, BN, GradDip Gerontology, Mark McLean BSc (Med), MB.BS, PhD, FRACGP, FAICD MHSM, GAICD BMed, PhD, FRACP FRACP 7 OUR PEOPLE 1 WSLHD YEAR IN REVIEW OUR STAFF

Above, from left: Midwives celebrating International Women’s Day (from left) Pratibha Dhaliwal, Matifadza Gomera, Brigitte Mcdonald and Nesrine Hatif; registered nurse Angela Vbesic receiving her flu shot at Blacktown Hospital; nurse Jessica Maher at Westmead Hospital.

“A positive change is recognising that our people are Our workforce people with strengths, successes, values, hopes and dreams.” getting younger – Luci Caswell, director, People and Culture from 2013. Our people matter Committed staff represent the heart and soul of WSLHD and this year they embraced change.

WSLHD started its culture transformation face-to-face offerings to 570 courses journey this year with its first-ever across WSLHD. This is supported by 1095 People Matter World Café on 30 January. online learning modules, an increase of Following strong interest from staff, two 265 modules on the previous year. Our % more World Cafés were held – one on focus continues to be on nurturing a positive 14 27 February and one for medical staff and supportive workplace culture; this has Total growth on 27 March. Over the three days, 350 seen the introduction of programs which staff from across WSLHD contributed include building resilience, emotional of staff more than 600 ideas on how we can intelligence, coaching community practice, make working at WSLHD the best proactive risk management of workforce possible experience it can be. issues and positively resolving workplace conflict programs. The 2019 People Matter Survey had the % highest response ever. This is an annual WSLHD is a registered training 9 survey for NSW public sector employees. organisation for NSW Health and this Growth in This year, almost 5000 (41%) of our staff year we had 136 graduates of our four shared their experience. nationally recognised qualifications on staff aged Together with the ideas gathered at offer in leadership and management, under 35 the World Cafés, People Matter Survey project management, and health feedback will be used to build a better administration. We also commenced culture at WSLHD. program delivery of the new Certificate IV in Training and Assessment, with A WSLHD Culture Change Strategic 71 educators strengthening skills % Framework has now been developed. in this area. Over the next year and beyond, eight 2 HealthRoster, the statewide rostering People Matter Action Groups will address Growth in priority areas to improve the experience system, was successfully implemented staff aged of our staff and create the best possible throughout WSLHD to replace Kronos, 35-55 workplace: wellbeing, bullying and Proact and Romulus. The system paves harassment; keeping people informed the way for continuous improvements and celebrating success; job satisfaction; and means that rostering practices strategic planning; recruitment are standardised leading to improved confidence; high performance; accuracy. The project included the % diversity and inclusion; and staffing implementation of employee online, numbers, workload and overtime. pay period confirmation and casual 3 staffing management. In excess of Growth in 2000 staff received training. More than staff aged Training in top form 900 people were supported in actively 55 and over The rate of staff participation in creating, managing and/or approving education and training has also rosters and WSLHD is now rostering increased with an additional 43 and paying more than 12,000 staff in programs introduced, bringing our 830 cost centres in the new system.

8 OUR PEOPLE OUR EXECUTIVE WSLHD YEAR IN REVIEW 1

Our Executive Back row Blacktown and Mount Druitt hospitals WSLHD director Aboriginal Health WSLHD director People and acting general manager Ned Katrib Strategy Braiden Abala Culture Luci Caswell BBus (Hons), MPA BBehSc, MHlth&IntDev DipAppSc (Nursing), GradCert (Emergency Nursing), MHA WSLHD director Finance Barry Mitrevski Front row BComm (Econ), DipAcc, MBA, CPA WSLHD executive director operations WSLHD director Allied Health Adjunct Associate Professor WSLHD executive director Medical Jacqueline Dominish Robynne Cooke Services Dr Emma McCahon BAppSc (Occupational Therapy), RN, BN, GradDip Gerontology, MHSM, GAICD MBBS, FRACP (Paed), MBA Cert IV (Education and Training), MHM Not featured WSLHD director Office of the WSLHD executive director Chief Executive Tiffany Sly Mental Health Services WSLHD acting director Redevelopment BAppPsych, MAppAnthropology Associate Professor Beth Kotze and Infrastructure Matt Sydenham MBBS, FRANZCP, FRACMA, Cert Child Psych, MBA (SGSM), DipBA (WSU), DipASc (USyd) WSLHD acting executive director MMed (Psychotherapy), MHA (UNSW) Integrated Care and Community WSLHD acting director Corporate WSLHD chief executive Graeme Loy Health Luke Felicetti Communications Sia Anthopoulos MBA (Hlth/HlthAdmin/Mgt), MAICD MHlthServMgt, BHlthSc BComms (Public Relations) WSLHD director Nursing & Midwifery, Westmead and Auburn hospitals WSLHD acting chief digital health and Clinical Governance Caroline Farmer general manager Brett Thompson officer Kieron McGarry BSc (Nutrition), GradDip (Dietetics), MBA RN, Coronary Care Certificate, BHlthSc, MHSM, EMPA, GAICD FBCS (Fellow, British Computer Society), CITP (Chartered Information Technology Professional) (UK)

9 OUR PEOPLE 1 WSLHD YEAR IN REVIEW OUR CLINICAL COUNCIL

Our Clinical Council Our Clinical Council was established in May allied health professionals and consumer might be best organised. In the future, co-chair 2019 by the WSLHD Board and chief executive representatives. Council attributes include A/Prof Michael Hollands expects the council to provide advice on clinical matters affecting clinical expertise, experience in the delivery may be asked for advice on the best use of the the district. It is co-chaired by the chief of healthcare services and an interest in new buildings at Westmead and Blacktown, executive Graeme Loy and Associate Professor postgraduate education or in research. Michael Hollands. The council supports the what clinical services should be prioritised Board and chief executive. Members include Since its inception, the council has given in the budget and what new clinical services doctors, nurses, junior medical officers, advice on how health services at WSLHD should be developed.

Back row Front row WSLHD registered nurse Integrated Auburn Hospital afterhours nurse manager BMDH & Westmead Hospital director and Community Health care facilitator nursing administration Kristina Roberts Cancer Services clinical haematologist integrated care program Nicola Cherry RN, Certified Midwife, Cert in Acute Care, Dr Helen Crowther RN/CNS2, GradCertDiabetesEd&Mgt BAAppSc, GradHlthMgmt, MClinPractice PhD, DSc, MBBS (Hons), FRACP, FRCPA (Emergency Medicine) Westmead Hospital senior staff specialist BMDH Divisional Medical VMO Acute Medicine head Anaesthesia and Perioperative Medicine BMDH staff specialist ED Dr Farnaz Omidi director Geriatric Medicine Dr Michael Datyner Dr Mark Priestley Dip Innovation Management, BSc, MBBS, BSc (Med), MB, BS, MHA, FRACP, FRACMA MBBS, FANZCA E-FAST AAA, FACEM, MClinLeadershipMgt WSLHD consumer representative Cumberland Hospital approved supervisor Dept of WSLHD chief executive co-chair Amal Etri Medical Psychology PsyBA clinical psychologist/unit Clinical Council Graeme Loy Westmead Hospital head Infectious MBA (Hlth/HlthAdmin/Mgt), MAICD lead Emotional Health Clinic and Research Unit Diseases Department senior staff NSW Leadership Program Clodagh Ross-Hamid WSLHD clinical director Perinatal, Child Youth specialist Dr Nicky Gilroy BPsych, MPsych with High Distinction (Clinical), BMBS (Hons), FRACP, MAppliedEpidemiology, Dip Clinical Services Redesign Mental Health Services Dr Ashwini Padhi MA Psychoanalytic Psychotherapy, MRCPsych, MPH (with Distinction) CCT (General Adult Addiction Psychiatry), RANZCP Westmead Hospital director Department of Nuclear Westmead & Auburn hospitals VMO Medicine Dr David Farlow Department of Plastic & Reconstructive MBBS (Hons), FRACP, DDU, FAANMS WSLHD executive director Medical Services Dr Emma McCahon Surgery Dr Thomas Lam Auburn Hospital head Anaesthetic Department MBBS, FRACP (Paed), MBA MBBS, DClinSurg, FRCS (Glasg), FRCSEd, Dr Alpha Tung FRACS (General & Plastic/Reconstructive MBBS (Hons), BSc (Med), FANZCA, Absent members Surgery), FHKAM (surgery), FCSHK, FRSM MHA, PostGradDip Perioperative WSLHD director Western Sydney Diabetes Echocardiography, FHKCA WSLHD senior staff surgeon Associate co-chair Clinical Council department senior staff specialist Endocrinology Cumberland Hospital head Occupational of surgery Professor Michael Hollands Dr Glen Maberly Therapy Department registered occupational MBBS (Hons), FRCS, FRACS, DHMSA BSc (Med) (Hons), MBBS (Hons), FRACP, MD therapist Omila Bir BMDH senior podiatrist Allied Health GradDip Forensic Behaviour Science, GradDipMgt Westmead Hospital resident medical Clare McGloin officer Intensive Care Unit Dr Kerry Chen BA, MA, BAppSc (Pod) BMDH Pharmacy lead pharmacist Emergency BA (Advanced) (Hons), MBBS, MHlthPolicy and Critical Care Medicine Stuart Binns Westmead Hospital emergency medicine BSc (Physiology, Immunobiology), BPharm (Hons) WSLHD executive director Operations advanced trainee ED Dr James Tadros Adjunct Associate Professor Robynne Cooke MBBS (ACEM Primary Examination BMDH (WSU) chair of Medicine senior clinical RN, BN, GradDip Gerontology, MHSM, GAICD academic Gastroenterology/Hepatology and progression to Advanced Trainee) WSLHD director Centre for Population Health The Westmead Institute Professor Golo Ahlenstiel WSLHD consumer representative MBBS, MD/PhD, FRACP Associate Professor Stephen Corbett Maryam Zahid MBBS, MPH, MRCGP, FAFPHM, FAICD

10 OUR PEOPLE STAFF NUMBERS 2018/19 WSLHD YEAR IN REVIEW 1

1411 4442 MEDICAL STAFF NURSING STAFF

1

1844 CORPORATE SERVICES AND HOSPITAL SUPPORT 2 3

267 1065 ORAL HEALTH ALLIED HEALTH STAFF PRACTITIONERS AND SUPPORT WORKERS 4

370 SCIENTIFIC AND TECHNICAL SUPPORT STAFF 5 6

TOTAL 906 10,305 REMAINING STAFF

7

1 Westmead Hospital anaesthetist Ann Marie McCallum. 2 Westmead Hospital radiation oncology nurses Chin Lim, Sri Grey, Meg Hughes, Noeline Rozanc (rear) and Westmead Medical Research Foundation relationship manager Alison Whittaker with Christmas pamper packs for cancer patients. 3 Registered midwife Safa El-Dadoun at Westmead Hospital’s Eid feast festival in maternity. 4 Graduates of the 2018 clinical leadership program. 5 Stephen Brown and Karen Cousins from Westmead’s Cardiology Department chat to chief executive Graeme Loy. 6 WSLHD took top spot at the Golden Scalpel Games. 7 Palliative Care and Medical Oncology doctors show off their socks for Crazy Socks for Docs Day. Contracted full time equivalent (FTE) data as at 30 June 2019 by Treasury Code. SOURCE: StaffLink Human Resource Information System. WHAT WE DO

Our Health 13

Financial Sustainability 15

Right: Registered nurse Harmandeep Kaur at Blacktown Hospital.

2 WHAT WE DO OUR HEALTH WSLHD YEAR IN REVIEW 2

Above: Blacktown Hospital nurses Erin Smith, Hyacinth Gaabucayan, Jacquelyn Santos, Alyssa Rae and Jessica Castillo after their flu vaccinations.

2018/19 WSLHD KEY ACTIVITIES About us Progress has been made in several areas including increased rates of vaccination among Aboriginal children and a decrease in hepatitis rates.

10,658 Births in hospital

55,346 Ambulance presentations Above: WSLHD immunisation control team members Valarie Hunte, Haley Carra, Shopna Bag, Dr Adrian Ong and Nicole Tolhurst.

Health hotspots The most pressing health challenge across EDs in Blacktown and Mount is diabetes. Almost half of the adult Druitt and more recently at 11 local population in the WSLHD is likely to be general practices, supported by the affected by diabetes or prediabetes Western Sydney Primary Health Network. and the mortality risk for diabetes WSLHD invests approximately $2 million is significantly higher than the annually on tackling obesity, including state average. $1.5 million for diabetes prevention and 44,770 management programs. Number of vaccine Obesity is one of the main causes of Other health issues that have a significant injections given type 2 diabetes, which represents about affect on residents of WSLHD include in high schools 90% of diabetes in Australia. More than 50% chronic obstructive pulmonary disease of the WSLHD population is overweight. (COPD) and heart disease. COPD is an WSLHD also has the lowest vegetable umbrella term for a group of progressive consumption in NSW with only 2.4% of lung conditions including emphysema, residents aged 16 years and over eating chronic bronchitis and chronic asthma. the recommended daily intake 2,794,063 The rate of people aged 65 years or more of vegetables. Hospital non-admitted hospitalised for COPD stands at 1375.7 patient services Western Sydney was the first LHD in NSW per 100,000. While similar to the NSW (occasions of service) to carry out proactive testing for diabetes average, it is still an area of concern.

13 WHAT WE DO 2 WSLHD YEAR IN REVIEW OUR HEALTH

Above: Aboriginal elders Zona Wilkinson, Jennifer Ebsworth, Elaine Gordon, Lenore Smith and Harold Hunt with chief executive Graeme Loy (back) at Mount Druitt Hospital.

Right: Wallabies player Jack Dempsey (back) dropped in to Westmead Hospital to visit rugby fan Murray Ashby and his children Myles and Caetlin.

200,508 ED presentations

44,628 Surgeries

Hospitalisation rates for coronary heart Making a difference Hepatitis C notifications for all ages are disease and heart failure in both males also decreasing with 273 notifications and females are significantly higher The proportion of children in WSLHD compared to 302 in 2012 (at a rate of in WSLHD than for the rest of NSW. who are fully immunised at five years 27.9 per 100,000 population compared There is also a significantly higher has increased since 2010. In 2018, to 34.5 per 100,000 in 2012). rate of female deaths from coronary 94.2% of all five-year-old children The average incidence (new cases) heart disease compared to their were fully immunised, which is similar to the state average. of cancer in WSLHD is between 5% state counterparts. and 6% lower for females and males WSLHD has implemented the WSLHD continues to see major respectively compared to the NSW improvements in the vaccination Integrated Chronic Care Program population. This trend has been coverage of Aboriginal children with which provides a range of services consistent over the past decade. 2018 showing the highest level of to WSLHD residents including those vaccination. There has been an increase The cancer mortality rate is also lower with COPD and heart disease. The of 15.9% in the proportion of Aboriginal in WSLHD than for the NSW population. NSW Better Value Healthcare program children aged five years fully immunised Among males, the mortality rates for COPD (inpatient care) is also in the 10 years from 2008 to 2018. decreased by 18% in WSLHD compared being implemented. This builds on our work to Close the to 13% in NSW from 2007 to 2016. Potentially preventable hospitalisations Gap. We now have a higher proportion Overall mortality rates for males in (PPH) are significantly higher for chronic of five-year-old Aboriginal children WSLHD for potentially avoidable diseases in WSLHD (934.9 per 100,000) being vaccinated than non-Aboriginal deaths, premature deaths, all cancers, than for NSW (896.4 per 100,000). children (97.8% and 94.1% respectively). melanomas, prostate cancers, all injuries, motor vehicle accidents and As well as implementing the Integrated There has also been a small reduction in suicides are significantly lower than Chronic Care Program we are providing the number of hepatitis B notifications. the rest of NSW. a range of services, including the Western The most recent statistics show that Sydney Diabetes initiative, and our there were 507 notifications compared Apart from a significantly higher rate clinicians are visiting nursing homes to 541 in 2015. The rate of 51 per of coronary heart disease deaths, the to prevent ED presentations. We are 100,000 is still higher than the NSW female death rate in WSLHD is also also looking at how we will provide average but has shown a decreasing significantly lower for a range of key more care in the home and community. trend since 2014. indicators, compared to the rest of NSW.

14 WHAT WE DO FINANCIAL SUSTAINABILITY WSLHD YEAR IN REVIEW 2

Keeping things 2018/19 FINANCE balanced STATISTICS This financial year we improved in the area of expenditure through the effective use of resources and improved purchasing processes. $1.8b WSLHD expenditure WSLHD’s expenditure for 2018/19 This represents an increase in was $1.8 billion with 68% consisting efficiency at WSLHD leading of salaries and wages for more to improvement in the area of than 10,000 full-time equivalent expenditure. In 2018/19, WSLHD employees. A total of $77 million was over budget in expenses was spent with vendors in WSLHD by $5.1 million. This is significant postcodes. Own-source revenue progress from the previous financial $283m contributed $283 million towards year when WSLHD was $12.7 million Own-source revenue funding health services. over budget in expenses. These that contributed to results were achieved despite a In 2018/19, WSLHD exceeded 4.5% increase in the number of funding health services the value of activity purchased by acute episodes and 4.4% rise in NSW Health by 1.1% or more than the number of ED presentations. 3000 National Weighted Activity Units (NWAU). This equates to Procurement initiatives continued approximately $14 million. A to provide benefits to WSLHD. NWAU is a unit of measurement Savings valued at a total of for health service activity which is $5 million were achieved in the $5m used by state and Commonwealth purchasing of clinical and medical governments to measure the supplies and in the sourcing of Savings achieved in efficiency of local health districts corporate services. Clinical purchasing clinical and (LHDs) and hospitals. The NSW supplies are now being sourced medical supplies and average cost per NWAU grew by at a less-expensive rate, allowing in the sourcing of 0.7% when compared to 2017/18, WSLHD to meet increased demand while WSLHD reduced the cost due to growth in population and corporate services per NWAU by 2.1%. a change in demographics.

WSLHD cost per NWAU vs state Revenue Expenditure 3.4% Depreciation and $4758 $4726 $4724 $4652 $4643 Amortisation $4587 $4556 72.5% 68% $4486 Sales of Goods Salary and Wages and Services 2.4% 25.7% VMOs 27.5% Other Operating Other Revenue Expenses 0.5% Grants and Affiliated Health Organisations

Between 2016/17 and 2017/18 Between 2017/18 and 2018/19 2015/2016 2016/2017 2017/2018 2018/2019

NSW Average WSLHD Average WSLHD WSLHD The complete audited financial reduced costs reduced costs statements are published in the 2018/19 NSW Health Statutory Financial Report and are available on % % our website wslhd.health.nsw.gov.au 1.6 2.1 Note: Current NWAU version used to calculate activity prices

15 OUR HOSPITALS

Westmead Hospital 17

Westmead Hospital Key Activities 2018/19 19

Auburn Hospital 20

Auburn Hospital Key Activities 2018/19 21

Blacktown and Mount Druitt hospitals 22

Blacktown Hospital Key Activities 2018/19 23

Mount Druitt Hospital Key Activities 2018/19 24

Right: Auburn Hospital administration officer Maged Nessim. 3 OUR HOSPITALS WESTMEAD HOSPITAL WSLHD YEAR IN REVIEW 3

Above, from left: The Westmead Central Acute Services Building; NSW Premier Gladys Berejiklian spoke at the topping out ceremony for the building and was joined by Minister for Health and Medical Research Brad Hazzard (left) and Treasurer Dominic Perrottet (right). We’re building on up It’s been full steam ahead for the Westmead Redevelopment project with the Central Acute Services Building reaching a milestone and the launch of the Arts and Culture Strategy.

The Westmead Redevelopment project celebrated major milestones. The refurbishment program, due to transform more than 30% of clinical areas in Westmead Hospital by 2022, began Stage 2 in September 2018. In June 2019, the new Westmead Central Acute Services Building (CASB) had its official topping out ceremony, which marked the building reaching its highest level of construction. NSW Premier Gladys Berejiklian attended the event and was joined by Treasurer Dominic Perrottet and Minister for Health and Medical Research Brad Hazzard. The building will include two EDs (one Above, from left: The former Minister for the Arts Don Harwin (far right) visited the Westmead for adults and one for children), Connectivity Centre; Aboriginal liaison officerfor WSLHD Narelle Holden takes a close look at state-of-the-art digital operating Witchetty Grub Dreaming, part of the exhibition Stories and Structures – New Connections. theatres, inpatient beds, a centralised sterilising service and a pharmacy. The first stage of the latest iteration arts projects. As part of the Arts and The University of Sydney will also of the linkway runs through the heart of Culture Strategy, 14 arts projects were occupy space across 1.5 floors of the the Central Acute Services Building to endorsed. To help select the artists to new hospital building. The construction ensure vital access between the adults’ deliver these projects an eight-person of the CASB will be completed in and children’s hospital is maintained. peer assessment panel was created. mid-2020. The new iteration of the linkway enabled After assessing the submissions, the panel made recommendations to Other Stage 2 works that are in the temporary connection to be removed the Westmead Redevelopment Arts progress include: to allow for works to continue in the hospital’s forecourt. and Culture Advisory Committee. So • Expansion of the intensive care far, 12 of the arts projects have been unit and administration area Westmead Redevelopment’s Arts commissioned and two of them are in and Culture Strategy was launched in final production. From December 2018 • A new Centre for Adolescent and August 2018. Since then, the strategy to January 2019, Stories and Structures Young Adult Health has successfully attracted a $50,000 – New Connections, an art exhibition • An upgrade of the loading docks CreateNSW grant and a $50,000 youth that combined Indigenous artwork with opportunities grant. The CreateNSW images from cutting-edge microscopy, • Refurbishment of the executive area grant was used to establish the went on display in Westmead Hospital. • A new retail link between Westmead ArtsLab@Westmead, a space for All the artworks have been purchased Hospital and the Central Acute local artists, curators and cultural to maintain the exhibition as a Services Building workers to build capacity for health permanent collection.

17 OUR HOSPITALS 3 WSLHD YEAR IN REVIEW WESTMEAD HOSPITAL

Above, from left: Westmead Hospital’s medical officer Dermatology Department Dr Rose Liu, research fellow Dr Linda Chan, department director Associate Professor Dr Pablo Fenandez-Penas, honorary fellow Dr Germana Romero and administration officer (clinical trials) Rupalben Patel; part of the team behind the Liver Wellness Outreach Centre, which was established in December 2018, in front of their mobile health van.

2018/19 WESTMEAD Greater access STATISTICS to health services

In November 2018, Westmead This service is a collaboration between Hospital’s Dermatology Department Sexual Health, Drug Health, Needle was successful in its bid for a share in and Syringe Program, Health Promotion a $10 million grant awarded by the and Pathology West. It is slowly Australian Cancer Research Foundation building relationships with community One minute (ACRF). This will enable the department groups to increase consumer to install a state-of-the art 3D imaging Time to complete a awareness and confidence in machine worth $469,400, which will the service. 3D whole body scan with significantly improve melanoma lesion Westmead Hospital’s new identification and tracking. It will The WSLHD Organ and Tissue 3D imaging machine also reduce appointment times and Donation team, based in Westmead healthcare costs. The current system Hospital’s Intensive Care Services takes 15–20 minutes to complete a (ICS), has had an increase in scan whereas the new machine will the number of referrals made in complete a 3D whole body scan the past 12 months. This is due to the in one minute. It is estimated the introduction of compulsory notification machines will be able to provide to the donation specialist nurse of 3000 examinations each year. all planned end-of-life decisions that The Liver Wellness Outreach Service occur in the ED and ICS. WSLHD has + was established in December 2018 also been involved in educating its staff 50 to provide education, screening and through training workshops and the People screened for treatment for hepatitis C and B for general community through DonateLife blood-borne viruses local residents who are at risk of Week, the bstreetsmart forum and hepatitis and face challenges attending through the mobile mass media. The WSLHD Organ traditional healthcare settings due health van and Tissue Donation Team has also to homelessness, drug and alcohol introduced the Best Practice Guideline issues, mental health, poverty and for Offering Organ and Tissue Donation other barriers. The service uses a fully in Australia. The guideline, distributed equipped mobile health van, which by The Australian Organ and Tissue has been on the road since April 2019. Authority, provides the standard for The team visits Parramatta Mission offering donation and encompasses early on a monthly basis and engages in identification of potential donors and + regular community events. More than the inclusion and presence of trained 200 50 people have been screened for staff at family donation conversations. People visited by The Liver blood-borne viruses as a result of the van being available in the community Wellness Outreach Service and in excess of 200 people have For a full list of services, visit mobile health van www.wslhd.health.nsw.gov.au/ visited the van as a result of health Westmead-Hospital/Our-Services promotion activities at local events.

18 OUR HOSPITALS WESTMEAD HOSPITAL KEY ACTIVITIES 2018/19 WSLHD YEAR IN REVIEW 3

1 2

78,510 5410 EMERGENCY DEPARTMENT BIRTHS IN HOSPITAL PRESENTATIONS 3

128,568 OCCASIONS OF DENTAL SERVICES 4 5

21,786 26,000 SURGERIES AMBULANCE PRESENTATIONS 6

7 8

1 The team behind Westmead Hospital’s Specialist Management and Acute Rehabilitation Treatment program. 2 Westmead operating suite staff appreciation day. 3 Physiotherapists Krishni Jayawardana and Jonathan Young get into the State of Origin spirit. 4 Westmead Hospital midwives Deema Taha and Nisreen Zreika alongside a Ramadan display in the maternity ward. 5 Professor David Harris AM, Westmead Hospital’s clinical nephrologist, was awarded the Member of the Order of Australia on Australia Day. 6 Finance officer Hamida Ali and Leading Better Value Care program manager Faiza Wajahat with WSLHD chief executive Graeme Loy (centre). 7 Westmead Hospital celebrates its 40th birthday on 10 November, 2018 with Minister for Health and Medical Research Brad Hazzard (centre). 8 Fun on International Nurses Day. OUR HOSPITALS 3 WSLHD YEAR IN REVIEW AUBURN HOSPITAL

Above, from left: Dr Hedra Eskender and Dr Bu Balalla performing the first knee surgery at Auburn Hospital; staff celebrate the start of the new service; physiotherapists James Chen and Jaclyn Allwood escort the first knee surgery patient, Nicholas Nahloos, after his surgery. Big steps for Auburn We performed our first knee surgery, opened an osteoarthritis clinic and introduced a fast-track service in emergency.

In September 2018, the first knee Since then, Auburn Hospital has While the program is still in its early joint elective surgery was performed performed 38 successful knee joint stages, based on patient feedback and at Auburn Hospital. This was the surgeries. This is the first step in a demand it could be rolled out to other end result of a significant amount planned program to introduce low-risk hospitals or community care centres of planning. It involved developing a joint replacement services consistent within WSLHD. model of care for orthopaedic surgery; within the high-volume short-stay setting up pre-admission criteria as hospital. The program will roll out In June 2019, a new model of care was well as instructions for preparing for to include hip joint, foot and ankle opened at Auburn Hospital ED. The aim the operation, during the operation and surgery along with a comprehensive is to ensure patients with less serious after the operation; purchasing new pre-surgical physiotherapy illnesses and injuries are treated more equipment; liaising with the Hospital conditioning program. quickly and safely. All patients are in the Home (HITH) program; working assessed upon presenting to the ED In May 2019, a new osteoarthritis clinic with the LHD clinical product team in and are streamed based on the urgency opened as part of the Osteoarthritis identifying the prosthesis and cost; and complexity of their needs. The new Chronic Care Program (OACCP) sending staff to training at other model of care, which has been operating at Auburn Hospital. The clinic is facilities in the LHD; and working at Westmead and Blacktown hospitals a one-stop shop for people to with a physiotherapist to develop a for two years, means less urgent and receive intervention from a medical, comprehensive plan for pre-operative complex patients will no longer be physiotherapy and dietetic perspective and post-operative therapy. at the one time and place rather waiting in the same queue as The service consists of a team of three than having to make individual acute patients. visiting medical officers, two surgical appointments with different specialists. registrars who perform the surgery and Under the new program, patients are supported by theatre and skilled initially attend a clinic at Auburn surgical nurses, two physiotherapists, Hospital and are subsequently For a full list of services, visit www.wslhd.health.nsw.gov.au/ a social worker and occupational followed up at three, six and 12 Auburn-Hospital/Our-Services therapist and dieticians. months to monitor their progress.

A new initiative at Auburn Hospital is helping Aboriginal patients feel more comfortable during their stay. A Welcome to Country video featuring Darug elder Greg Simms is now available to watch for free on all patient entertainment systems at the hospital. The initiative was the brainchild of Auburn Hospital surgical ward nurse unit manager Riki Richards, a proud Gadigal woman of the Eora nation.

Left: Auburn Hospital nurse unit manager Riki Richards in front of the Welcome to Country video.

20 OUR HOSPITALS AUBURN HOSPITAL KEY ACTIVITIES 2018/19 WSLHD YEAR IN REVIEW 3

1 2

29,021 1478 EMERGENCY DEPARTMENT BIRTHS IN HOSPITAL PRESENTATIONS 3

4

7386 5432 SURGERIES AMBULANCE PRESENTATIONS 2 5

6 7

1 Consumer partnerships manager Dr Coralie Wales (centre) is joined by consumer representatives and patients. 2 Midwife Lila Holman with Vika Afu and her fourth child, daughter Seini Losela Rass. 3 Auburn Hospital ED director Dr Romesh Singam (front) with his team (from left) Naresh Kc, Dr Khanh Nguyen, Keti Ristevska and Jeff Deray.4 Auburn Hospital nurse unit manager Debra Smith and director of nursing and midwifery Kate Murphy with 2019 International Nurses and Midwives Day award winners (from left) Netsai Sibanda, Clyde Sy, Cheryl Frost, Bo Fu, Sue Kelly, Saba Tedlam, Sarah Tapp, Naresh Kc. 5 Auburn Hospital registered nurse Tracey Abraham with Santa. 6 General services leading hand at Auburn Hospital Barbra Chapman, acting director of nursing and midwifery Tanya Critchlow, student Alex Roberts and Kristina Roberts, afterhours nurse manager at Auburn Hospital. 7 Nurses Kuldip Grewal, Priya Narayan and Harry Ran with nurse unit manager Melelatai Maumalanga (second from right). OUR HOSPITALS 3 WSLHDWSLHD YEAR IN REVIEW BLACKTOWN AND MOUNTEXECUTIVE DRUITT COMITEE HOSPITALS 2019

Above, from left: Blacktown Hospital’s director Emergency Medicine Associate Professor Reza Ali, deputy director of nursing Rola Tawbe, chief executive Graeme Loy, Whole of Health Program lead Leah Dawkins, director Business Analytics and Performance Luke Elias and ED nurse unit manager Camille Dooley celebrate Project RED’s win at the Premier’s Awards; volunteers at Mount Druitt Hospital’s National Palliative Care Week with palliative care volunteer coordinator Kylie Clark (second from left) and palliative care nurse educator Anne May (far right). Winners are grinners The outstanding work on the Blacktown and Mount Druitt Hospitals Expansion Project was the main focus of this year’s news and we’ve got the awards to prove it.

In the past year, the Blacktown and A video was created to showcase Mount Druitt Hospitals Expansion the construction employment Mount Druitt Hospital Project won six awards. The Mount opportunities delivered by the improves its service Druitt Hospital Community Dialysis building for people under 25, Centre won two awards – a Western Indigenous people, apprentices In November 2018, the MRI machine Sydney Leadership Dialogue and other workers as part of at Mount Druitt Hospital was Medicare BOOMTOWN! Award and a Greater a skills development program. licensed. This makes the state-of-the-art Sydney Planning Award imaging machine more accessible for In January 2019, the B3Hub (Highly Commended). AW Edwards, the all members of the community. non-clinical support area for Allied contractor for the Blacktown Hospital Health opened at Blacktown Hospital. Acute Services Building also won two In June 2019, Mount Druitt Hospital’s It is proving popular with staff for its awards – a Master Builders Association Palliative Care Service celebrated flexible and collaborative design. 1st Year Apprentice of the Year Award a 21-year milestone of providing and Safety Innovation Award. Fugen Blacktown Hospital won the Premier’s comfort and heartfelt care for Constructions won the Master Builders Award for the Project RED initiative patients at the end of their life. The Association Health Building up to in November 2018. This project has service started with four beds in 1998 $10 million Award for the MRI Unit and significantly reduced the average and treated mainly cancer patients. theatre expansion at Mount Druitt time patients spend in the ED by Over the years, the service has grown to 16 beds. It provides acute care, Hospital. Jacobs Architects received 80 minutes. assessment and symptom control for a European Healthcare Design Award Blacktown Hospital is establishing a end-of-life care and more than 400 (Highly Commended) for the Clinical new model of acute/general medicine patients spend an average of 10 days Services Building at Blacktown Hospital. to accelerate throughput in the ED. at the unit each year. It is housed in The new Acute Services Building at This unit will provide specialty training a nearby stand alone building on the Blacktown Hospital was handed over in general medicine and integrate other Mount Druitt Hospital site, providing for commissioning in June 2019 and is services such as HITH and post-acute a safe and comforting environment now opening in stages. The building care. The particular focus is on geriatric for patients and families. will house emergency, birthing, patients and streamlining their Mount Druitt Hospital was also meeting maternity, newborn care, women’s journey through the ED with a focus targets. The kiosk met 100% of NSW health, paediatrics, intensive care and on hospital admission avoidance. Health requirements for healthy food perioperative services. In preparation and drink. This was achieved by The Better Foundation, which supports for the opening, 20 arts and culture increasing healthy food options, Blacktown and Mount Druitt hospitals, projects were completed. This included having healthy portion sizes available donated close to $100,000 to establish a photo competition, installation of and marketing healthy foods favourably. murals, a Darug welcome sculpture an allergy clinic and multi therapies During 2018/19, Mount Druitt Hospital by Leanne Tobin, artworks by Angela room at Mount Druitt Hospital, provide met 100% of its elective surgical targets Nashaat, a photographic partnership equipment for paediatrics and the for categories one, two and three. with Western Sydney Parklands, special care nursery at Blacktown and a co-design car park mural Hospital as well as funding training For a full list of services, visit concept created with art students programs at Mount Druitt and www.wslhd.health.nsw.gov.au/ from Blacktown Girls High School. Blacktown EDs. Blacktown-Mount-Druitt-Hospital/ Our-Services

22 OUR HOSPITALS BLACKTOWN HOSPITAL KEY ACTIVITIES 2018/19 WSLHD YEAR IN REVIEW 3

1 2

55,603 3770 EMERGENCY DEPARTMENT BIRTHS IN HOSPITAL PRESENTATIONS 3

4218 OCCASIONS OF DENTAL SERVICES 4 5

10,299 18,576 SURGERIES AMBULANCE PRESENTATIONS 6

7 8

1 ED nurse unit manager Camille Dooley, Dr Marina Bahgat Wassif, clinical nurse consultant Helen Zaouk, director Emergency Medicine Associate Professor Reza Ali and director Business Analytics and Performance Luke Elias. 2 Aileen, Maria, Rola and Leah dress up for International Nurses Day. 3 ED staff Roseline, Zoe and Katelyn wearing festive scrubs.4 Acute Stroke and Rehabilitation nurse unit manager Maria Maniago and acting deputy director of nursing Ces Aguilar wear pyjamas for End PJ Paralysis, a health campaign that aims to get patients out of their pyjamas and into day clothes. 5 Pregnant mothers Anne Marie Scerri, Aryln Yu and Becky Edosowman with NSW Premier Gladys Berejiklian in May 2019. 6 Blacktown Hospital’s physiotherapy team on April Falls Day. 7 Blacktown Hospital midwife Georgia Duff is also a competitive ice skater.8 The B3Hub team celebrate the opening of their new activity-based working unit at Blacktown Hospital. OUR HOSPITALS 3 WSLHD YEAR IN REVIEW MOUNT DRUITT HOSPITAL KEY ACTIVITIES 2018/19

1

37,374 EMERGENCY DEPARTMENT PRESENTATIONS 2 3

ORAL HEALTH PRACTITIONERS & 4 SUPPORT WORKERS 5

5157 5338 SURGERIES AMBULANCE PRESENTATIONS 6

7

1 Mount Druitt Hospital volunteers: (front row from left) Eileen Merces, Beryl Gardiner, Jean Prior, Jean Hitches and Dulcie Harrison; (back row from left) Gail Shadbolt, John Graham, Janice Graham, Mila Holzmann and Scott Graham. 2 The Health Information Record Service (HIRS) team at Mount Druitt Hospital celebrates 10 years with cake and balloons. 3 Blacktown and Mount Druitt hospitals’ security officer Jason Noonan.4 Mount Druitt Hospital Children’s Ward nurse unit manager Kate Lowe. 5 Mount Druitt Hospital ED registered nurses Aman Dhanju and Harmanjot Kaur, clerical officer Narelle Hosking and ED registered nurse Joanna Le-Surf celebrate filling in their People Matter Surveys.6 Mount Druitt Hospital’s support and palliative care enrolled nurse Belinda Saddington and registered nurse Sunila Nand celebrate the unit’s 21st anniversary. 7 2019 International Nurses and Midwives Day award winners from Blacktown and Mount Druitt hospitals. OUR SPECIALT Y SERVICES

Mental Health 26

Drug Health 26

Oral Health 27

Allied Health 27

Aboriginal Health 28

Integrated and Community Health 29

Population Health Key Activities 2018/19 30

Left: Professor Stephen Yeung.

4 OUR SPECIALTY SERVICES WSLHDOURWSLHD SPECIALTY YEAR IN SERVICESREVIEW MENTALEXECUTIVE HEALTH, DRUG COMITEE HEALTH 2019 4 WSLHD YEAR IN REVIEW MENTAL HEALTH, DRUG HEALTH

Above, from left: Youth Council representative Stephanie D’Souza shows the wearable e-health device being used in Mental Health’s three-year unWired project which has been made possible by a donation from The Balnaves Foundation; pharmacist Geoffrey Wills. Mental Health 2018/19 In an Australian first, a new program is Project Air commenced in WSLHD in being piloted at WSLHD to test how January 2019 with three Gold Card MENTAL wearable e-health devices can improve Clinics now open within WSLHD – at HEALTH the lives of young people with severe Parramatta, Blacktown and Cumberland. KEY ACTIVITIES mental illness. The three-year unWired Gold Card Clinic treatment focuses project is supported by a donation from on providing timely, accessible The Balnaves Foundation. The funding and evidence-based psychological has supported the establishment of key intervention for people who frequently positions and purchasing of the wireless present to EDs, acute or inpatient device technology. If proven successful, services with symptoms such as new technology developed by the project emotional dysregulation, suicidal could revolutionise the care for young ideation or self-harming behaviour. people with severe mental health The clinics assist consumers to manage disorders across Australia. their mental illness in community 4146 settings and avoid the need for an Admissions WSLHD obtained nearly $1.6 million acute inpatient stay. in funding for five projects under the Mental Health therapeutic environment WSLHD has implemented an ED minor capital works program. The navigator service. The ED navigator funding covers projects in acute project provides a trauma-informed Mental Health inpatient units across approach to acute intervention in the Cumberland, Blacktown and Westmead ED for children, adolescents and youth hospitals, ranging from improved experiencing acute mental health crises sensory rooms and activity rooms to with concomitant complex needs. This courtyard spaces. The funding also innovative project aims to provide enabled a range of furniture, fixtures the right care at the right time in the 158,817 and equipment to be purchased for right place. It links young people to Hospital non-admitted the redeveloped spaces. Early feedback support in the community and prevents patient services indicates that the therapeutic environment non-urgent re-presentations to the ED (occasions of services) has been improved for consumers, while promoting suicide prevention visitors and staff. and reduction of risk of self-harm.

Drug Health This year, Drug Health participated centres for Addiction Medicine. It is results, which are very promising, in a promising trial of a new expected to continue for another 12 were published in JAMA Internal therapy for those with serious months and the research team Medicine Journal. They showed that health issues related to the use of is keen to recruit more subjects. the medication was well tolerated methamphetamine. The LiMA trial, The Cumberland Centre for with few adverse events. Both which stands for Lisdexamfetamine Addiction Medicine has been groups in the parallel double-blind in Methamphetamine, is a double-blind an important site for another randomised clinical trial had randomised control trial that is a multi-centre trial. This trial was improvements in health status. multi-centre study over several sites looking at the use of a medication Patients given Sativex had a in Australia. The trial is being offered called Sativex for the treatment significant reduction in cannabis at the Mount Druitt and Cumberland of heavy cannabis users. The use overall compared to placebo.

26 OUR SPECIALTY SERVICES ORAL HEALTH, ALLIED HEALTH THE CLINICAL COUNCILOURWSLHD SPECIALTY YEAR IN 2019SERVICES REVIEW ORAL HEALTH, ALLIED HEALTH WSLHD YEAR IN REVIEW 4

Above, from left: Associate Professor Kent Yuen and Clinical Associate Professor George Pal perform dental surgery; Westmead Hospital dental officers Dr Ying Tran and Dr Grace Liu promote World Oral Health Day with a friendly furry mascot on hand.

Oral Health Allied Health The Oral Health team has achieved good In September 2018, Jacqueline survey, strategic planning day results to bring down waiting times in Dominish joined WSLHD as and more than 50 one-on-ones some key areas. The waiting time for the director Allied Health. In with key leaders and executives. denture patients was reduced by about this role, she is a member of the This information was vital in two months as the Oral Health Service executive team and provides the development of the Allied issued an additional 103 vouchers to be the overarching strategic Health Strategic Plan 2019–2022, taken to private dental practitioners. The leadership and professional which will set the direction for Oral Health Service also scheduled an extra governance to the allied the allied health workforce in 24 general anaesthetic sessions between health workforce. Jacqueline WSLHD over the next three January and June 2019 to provide dental treatment to children, which resulted in a has significant experience in years. This plan is in the process reduction in waiting time of approximately statewide policy, workforce of being finalisedfor WSLHD four months. These extra services were due development, education and executive approval. training specific to the 23 allied to the Commonwealth National Partnership In other exciting news, the health professions employed Agreement funding received in 2018/19. Allied Health Research Inaugural by NSW Health. Oral Health has also invested in a new Report was published. This X-ray machine, the SkyView 3D Cone Beam Since commencing, she has documents achievements in Computerised Tomography Unit (CBCT). undertaken a comprehensive allied health research with One of the biggest advantages of the new horizons-scanning exercise a particular focus on research unit is that it can be used with the patient to better understand the funding success, enrolment lying down. This is especially beneficial opportunities for the allied of 24 allied health staff in for those with a disability who often health workforce in WSLHD. higher-degree research experience claustrophobia and anxiety Feedback and consultation programs, and peer-reviewed with the upright CBCT unit. It is now in occurred via a WSLHD-wide manuscript publications. the final stages of installation. The service also implemented Titanium, a new electronic information system for Oral Health, which has been rolled out over the past 18 months across NSW by the Ministry of Health.

“At Oral Health, the waiting time for denture patients was reduced by

Above, from left: Local member for Riverstone Kevin Conolly, NSW Health about two Minister Brad Hazzard, nurse unit manager Camille Dooley, member for Seven Hills Mark Taylor, clinical nurse consultant Helen Zaouk, emergency medicine director months.” Associate Professor Reza Ali, director Allied Health Jacqueline Dominish.

27 OUR SPECIALTY SERVICES 4 WSLHDWSLHD YEAR IN REVIEW EXECUTIVEABORIGINAL COMITEE HEALTH 2019

Above, from left: Silvia Sabrina with her newborn, Adrian McDonald, and registered midwife Leticia Van Der Horst; WSLHD staff have been working hard to create culturally safe spaces for the Aboriginal and Torres Strait Islander community. Aboriginal Health Services a focus

who normally disengage from services. Enhanced facilities for The AMIHS has supported these Aboriginal families individuals to link with partner agencies, including Greater Western Aboriginal In 2018, WSLHD enabled the Aboriginal Health Service (GWAHS), Centrelink, Health Hub to utilise a vacant building Housing NSW, Aboriginal family circles, to allow the service to grow and enhance other Aboriginal health professionals, culturally safe and appropriate spaces drug and alcohol support, smoking Above: Director Aboriginal Health for the local community. cessation and transportation for Strategy Braiden Abala An IT upgrade brought Aboriginal families to attend high-risk clinics. Health Services on par with the rest Three goals of the LHD. The additional space Growth of the Budjery allocated to the Aboriginal Health for Aboriginal Hub has also created an additional Manya Program training room with new technology. health strategy Once they have given birth, all clients Through this training room, WSLHD is are offered the option to participate In May 2019, Braiden Abala was delivering Respecting the Difference in the Budjery Manya Program – (New appointed as the director for training in a culturally appropriate Directions), a service focused on the Aboriginal Health Strategy. He setting. An additional child and family Aboriginal community for families with has been charged with three main clinic has also commenced operating children aged up to five years. In 2018/19, responsibilities for the coming year: from the Aboriginal Health Hub. about 250 families residing in, but not growing and embedding Aboriginal The Aboriginal Health Hub exclusive to, the Mount Druitt/Blacktown and Torres Strait Islander Health Practitioners (ATSIHPs) into the commenced the first Aboriginal- areas accessed this program. health workforce; considering supported playgroup for Aboriginal The program co-ordinated weekly opportunities to improve the and Torres Strait islander children supported playgroups in three pipeline for Aboriginal students who have disabilities or challenging locations where pproximately considering allied health professions; behaviours. The service has assisted 10–18 families participate in each and establishing a talent pool several families to successfully access program. One of the playgroups for Aboriginal people seeking the National Disability Insurance Scheme, is delivered in a women’s refuge employment in WSLHD. housing, home modifications, dieticians, and has assisted mothers with and have their social and emotional bonding and attachment. To increase the Aboriginal and wellbeing needs met. Torres Strait Islander workforce, Braiden plans to collaborate with With the additional space and ongoing Staff update colleagues in WSLHD to improve support for our Aboriginal Health Aboriginal Maternal Infant Health the numbers of Aboriginal and Services, we have seen continued growth Service midwife Jasmine Wannell was Torres Strait Islander people of the Aboriginal Maternal Infant Health Midwife of the Year for both Integrated working in the health system. Service (AMIHS). During 2018/19, the and Community Health and Blacktown Increasing the numbers of AMIHS program has provided services and Mount Druitt hospitals. Aboriginal people working in to more than 100 Aboriginal women health is important to improve who are pregnant or women who are WSLHD recruited an Aboriginal the cultural capability of the health pregnant with Aboriginal babies. The Health Education Officer to provide system, and to help close the gap AMIHS program has seen success in the health interventions and prevention in health inequalities between outreach midwifery service to support in partnership with community Aboriginal and Torres Strait Islanders extremely vulnerable pregnant women agencies and other services. and other Australian people.

28 OUR SPECIALTY SERVICES INTEGRATED AND COMMUNITY HEALTHTHE CLINICAL COUNCILWSLHD YEAR IN2019 REVIEW 4

Above: Integrated and Community Health awards. Jasmine Wannel (Nurse/Midwife of the Year), Renee Taylor (Excellence in Clinical Leadership), director of nursing and clinical governance Integrated and Community Health Jennifer Fitzsimons, Fiona Ou (New Graduate of the Year), Julie Smith (Innovation Award), Caroline Scott and Julie Mclean (People’s Choice Award, Public Health School Vaccination Team Population Health).

20-40% Integrated and Reduction in ED presentations for RASS cardiology patients Community Health

At ICH we’ve partnered with many differentdepartments to create positive outcomes for the patients and staff at WSLHD.

Throughout the year, six Rapid Access program. The nurses spend six months services in community-based settings. and Stabilisation Service (RASS) clinics at each site. The program has exposed The workshops will empower staff established under the Western Sydney the nurses to different clinical areas and and educate managers to implement Integrated Care Program (WSICP) were is giving them a greater understanding proactive prevention and dynamic risk evaluated. They have significantly of the journey for families through management strategies. Workshops improved the health outcomes both services. Planning for the 2020 will roll out to all ICH clinical staff of patients while simultaneously program has commenced with the over the next 12 months. decreasing the burden on hospitals potential to expand it. and increasing GP capacity to manage The Centre for Population Health ICH underwent a review period patients in the primary care setting. conducted mass vaccination clinics between 25–27 June, 2019 by the Aged The cardiology, respiratory and at both Westmead and Blacktown Care Quality and Safety Commission. This diabetes RASS clinics at Blacktown hospitals. These clinics had the dual review is conducted every three years. and Westmead purpose of trialling an important part hospitals provide of our WSLHD rapid access to Pandemic Influenza specialists for patients Plan and increasing with acute issues. “The Centre for Population Health influenza vaccination A recent review, using conducted mass vaccination clinics at rates in a year when data linkage and data the seasonal influenza matching to measure Westmead and Blacktown hospitals.” epidemic occurred return on investment, significantly revealed that RASS earlier than in previous years. cardiology patients ICH received a successful outcome, had a 20–40% reduction in meeting all three standards with no The priority populations stream ED presentations and an 18–30% recommendation. The review focused assisted to lead the Western Sydney reduction in unplanned hospital on Commonwealth Home Support Refugee Health Coalition to improve admissions over two years. RASS Program services, which includes access to services for refugees and diabetes patients had a 30% reduction the Chronic and Complex Program, asylum seekers. A key strategy was in ED presentations per annum. Multicultural Access Program and the Hello Doctor events, which were In March 2019 we introduced nursing Dementia Access Program. held in partnership with other health rotations between the Women’s and ICH has partnered with the Risk and social service providers, councils, Newborn team at Westmead Hospital Management Unit to develop personal settlement services and the Western and the Child and Family Health safety workshops for staff and Sydney Primary Health Network. Nursing Service, which is part of ICH. managers. The proposed Community Events have been held in Auburn, At present, two Transition to Professional Based Risk Management Workshops Blacktown and Mount Druitt across Practice (TPP) graduates and two are designed to improve the safety the year with significant numbers registered nurses are involved in the and wellbeing of staff who deliver of consumers attending.

29 OUR SPECIALTY SERVICES 4 WSLHD YEAR IN REVIEW POPULATION HEALTH KEY ACTIVITIES 2018/19

217,218 129,629 CHRONIC AND CHILD AND COMPLEX SERVICES FAMILY SERVICES 1

28,795 PRIORITY POPULATION SERVICES 2 3

4

TOTAL 410,499 OCCASIONS OF SERVICE

5 6

4751 30,106 WESTERN SYDNEY INTEGRATED CARE DIABETES SERVICES SERVICES 2 7

1 WSLHD Sexual Health nurse Tichaona Jaricha with WSLHD Youth Council members Shannen Twine and Lauren Moujalli. 2 Supportive care clinical nurse specialist Alex Rudnitsky with patient Ping Zhu at the Hello Doctor initiative for newly arrived migrants and refugees in Blacktown. 3 WSLHD Aboriginal Immunisation officer Joanne Cheatham at the healing walk during Reconciliation Week. 4 Westmead Hospital’s Speech Pathology team Sarah Drake, Sophee Keegan, Grace Hardie, Katrina Moore, Joanne McAdam, Laura Foley, Lydia Natsis, Melissa Compton, Lyndal Holme, Jodi-Anne Gibson and Kirsty Niven. 5 Clinical nurse educator Binoli Mehta, nurse unit manager Anaesthetics Alexandra Allen and senior operations assistant Sonier Talisayon at Westmead Hospital. 6 The Multicultural Health program officers Abulla Agwa, acting team leader Mohamed Keynan, Murad Hossain and Carly Copolov. 7 Stepping On coordinator Amanda Doring at the first WSLHD Seniors Health Expo for migrant and refugee communities. INNOVATION AND QUALITY

Research and Education Network 32

Digital Health and Patient Safety 34

WSLHD Quality Awards 35

Left: Registered nurses Hans Zabala and Jessica Dobson.

5 INNOVATION AND QUALITY 5 WSLHDWSLHD YEAR IN REVIEW RESEARCH ANDEXECUTIVE EDUCATION COMITEE NETWORK 2019

Above, from left: Professor Jon Iredell is leading the research team looking at ways to manage super bugs; staff specialist Dr Grahame Elder and registered nurse Sarah Tapp were the first researchers based at Auburn Hospital to be awarded REN grants.

2018/19 REN Research and STATISTICS Education Network This year our department focused its support on super bugs research, clinical trials in cancer and haematology, supporting the growth of research in allied health and nursing and growing the academic contribution to pharmacy, preventive practice and 10,000 clinical education. Staff taught clinical and life-support skills in simulated training screening rate in NSW and one of the Laboratory lowest rates in Australia. A research team at Westmead Hospital and the Westmead Institute for Medical Research, led by Professor Jon Iredell, Allied health, found that the use of bacterial viruses pharmacy and nursing (bacteriophages) is an effective add-on to antibiotics, when an infection is REN awarded 10 Kickstarter grants: four so severe or so overwhelming that in allied health, two in pharmacy and antibiotics alone wouldn’t suffice. four in nursing. REN supported several allied health research forums addressing Harnessing viruses that attack network building and collaboration. + bacteria may, one day, enable us to These forums included allied health 5500 kill super bugs such as golden staph. research in cancer; multidisciplinary Nurses, midwives, With promising early results the next approaches to neurodegenerative allied health, step is a comparative study. diseases; overcoming barriers to medical and dental research; and forming collaborations students trained Clinical in community and integrated care. REN offers training in research grant We are supporting more than writing and publication writing and, 80 large clinical trials in cancer as a consequence, several health and haematology, and smaller ones professionals applied for grants or in relation to pressure injuries and submitted ethics applications to support hip fractures. We are also trying to the translation of research into practice. better understand the risk factors in the increasing rates of caesarean section and induction of labour. Funding Total research funding in the WSLHD + General practice in 2018/19 was $63 million – a 28% increase over 2017/18. 800 Members of the Research and Doctors trained Education Network (REN) have Other grants awarded included a in specialities been working with GPs and others $100,000 grant to support the Growing to increase cervical screening rates Little Language Learners program. in Mount Druitt, which has the lowest This was a collaborative grant between

32 INNOVATION AND QUALITY RESEARCH AND EDUCATION NETWORKTHE CLINICAL COUNCILWSLHD YEAR IN2019 REVIEW 5

Above, from left: Blacktown Hospital trainee Emergency Medicine Dr Waseem Hassan, won the Buchanan Prize; Blacktown and Mount Druitt hospitals new medical interns Dr Sarada Ganesan, Dr Estelle Noonan, Dr Theresa Nguyen and Dr Ridha Akhtar.

WSLHD, preschools, local councils and the Faculty of Health Sciences “Total research funding in the academics. In addition, our nursing research fellow was awarded a National WSLHD was $63 million.” Heart Foundation Research Fellowship.

REN has provided $50,000 to Dr Waseem Hassan, a trainee in co-funded by WSLHD and the pilot projects this year, including Emergency Medicine at Blacktown University of Sydney, designing programs studying: Hospital, won the Buchanan Prize, and testing models for avoiding awarded for the highest score in • the role of maternal gut bacteria non-essential hospital admission. an objective structured clinical in gestational diabetes – looking examination – the first time the for biomarkers in urine to detect prize had been awarded at Workflow and placental dysfunction which might Blacktown Hospital. lead to pre-eclampsia in people staff resilience with diabetes; Education Another educational focus for WSLHD • health literacy education programs in 2018/19 was on safety, including: WSLHD trained more than 5500 for new parents groups; • teaching 10,000 staff clinical and nursing and midwifery, allied health, life-support skills in simulated training; • whether or not abnormal heart medical and dental students in structure, in patients with chronic 2018/19, more than 800 doctors • REN-supported perioperative kidney disease, is a marker of heart in specialties, as well as students services in major workflow changes, disease, and if the size and function of engineering and design and including changes to electronic of the left atrium determines the risk information technology in conducting medical records and electronic of blood clots in patients with atrial projects which support the changing fluid management; fibrillation; and health environment. • developing a sustainable model • portable technologies to detect WSLHD introduced a new model for for clinical supervisor training and previously undiagnosed retinal pharmacy placements, combining the capacity, to support reflective disease in eye clinic patients. “cascade of care” with research. This practice and increase professional model, giving students experience skills; and in hospital pharmacy practice and High-profile innovation, will improve clinical care • training 48 nursing and midwifery and increase research output. staff as clinical supervisors, and 10 researchers recognised staff as trainers in clinical supervision. There was a stronger academic focus in WSLHD is proud to report that the 2018/19 on pharmacy, clinical education WSLHD has supported nurses in Australian Academy of Health and and preventive practice, including: their early professional years with a Medical Sciences has elected, in • The inaugural joint Chair of Clinical new TPP program. This aligns with recognition of their outstanding Pharmacy at Westmead Hospital, contemporary evidence in fostering contributions to Australian health and Jan-Willem Alffenaar, working with engagement and resilience. medical research, three high-profile pharmacists on personalised dosing A new perioperative nursing specialty WSLHD researchers to Fellowship: strategies to reduce lengths of stay program was delivered to recently in hospital, prevent complications • Professor Stephen Leeder AO, graduated nurses, and to nurses and optimise dosing; director, REN, WSLHD; who, having completed their TPP • The new Professor of Clinical program, wanted to specialise in • Professor Donald Nutbeam, Education and REN director perioperative nursing. Professor of Public Health, of Education, Peter Hockey, aiming to WSLHD has supported culture change University of Sydney; and improve the quality of education and by equipping junior doctors with support for WSLHD clinicians; • Professor Philip John O’Connell, improved communication and feedback director of Transplantation, • In preventive practice, a public health skills for coping with their extremely Renal Unit, Westmead Hospital. academic, Professor Ben Smith, busy, high-pressure environment.

33 INNOVATION AND QUALITY 5 WSLHDWSLHD YEAR IN REVIEW DIGITAL HEALTHEXECUTIVE AND PATIENT COMITEE SAFETY 2019

Above, from left: ED nurse Tiffany Chevell, chief medical information officer Dr Naren Gunja and ED pharmacist Christopher Hidayat in front of a new eMEDs system; the WSLHD eMR and eMEDs project teams.

2018/19 Digital Health WSLHD DIGITAL STATISTICS and Patient Safety In 2018/19, the following electronic devices and access to the eMR, as well medical record (eMR) modules were as the delivery of free patient WiFi. rolled out across WSLHD: Medication Management (eMEDs), Anaesthesia, More than 160 workstations on wheels Surgery, eFluids and Cardiology. This have been enabled to assist clinicians was the culmination of a three-year to access computers at the patient’s program to uplift digital eMR capability. bedside. This ensures the most In 2019–20, this work will continue up-to-date information is available with eMR Enhance Now. The uplift to treating clinicians and significantly in eMR capability places WSLHD at decreases the length of time taken to + the leading edge of eMR capability order medications (through eMEDs). 2000 in NSW Health and is attracting eMEDs is an electronic medication significant interest both nationally management system which improves New computers and and internationally. quality, safety and effectiveness of workstations on wheels medication management. It supports WSLHD’s eMR Enhance team also doctors, nurses and pharmacists as built and implemented the First they prescribe, order, check, reconcile, Warning system in 2018, which uses a dispense and record the administration computer algorithm to automatically of medications. It also reduces scan ED patient data and immediately medication errors. alert doctors when someone may be suffering from sepsis, a potentially Another NSW Health initiative deadly infection complication. This is is digital operating theatres. These a NSW Health firstthat significantly enable images and video to be improves detection rates, an captured directly into the eMR from improvement of 20% over theatre equipment. Previously, images 20,000 the traditional pathways. would only be reported into the eMR New network ports We have delivered more than 2000 via text, with images being retained on new computers and workstations theatre equipment. With the addition of on wheels. As well as this, there video and image capture a much more are 20,000 new network ports and comprehensive and accessible medical 1000 new wireless access points in the record is stored for future reference district, primarily for the Blacktown Acute and enables richer content for research Services Building. This has improved activities and education and training network coverage to support medical where appropriate.

1000 “Workstations on wheels have New wireless been enabled to assist clinicians to access points access computers at the bedside.”

34 INNOVATION AND QUALITY WSLHD QUALITY AWARDS THE CLINICAL COUNCILWSLHD YEAR IN2019 REVIEW 5

Peak awards

Chief Executive Board Chair NewsLocal People’s Award Award Choice Award

Supply, Storage and It Takes Two – A Partnership Joining the I and MI in IMI: Administration of Approach Between WSLHD Muscle Matters! Medications (SSAM) and Blacktown City Council The purpose of this project was to have 95% of long-acting antipsychotic The aim of this project was to decrease This project aimed to embed the Munch injections administered correctly in the the time spent locating medications and Move (M&M) program in every licensed muscle sites by nursing staff during the morning medication round Kids’ Early Learning Blacktown City across Blacktown Mental Health Service on a surgical ward by 25% by childhood service by December 2018. 31 December, 2018. including Community Mental Health M&M is a NSW Health program aiming teams within 12 months. The project introduced a basket storage to reduce childhood obesity by 5% by Injection technique is not often system in the medication room for 2025. A systems approach was used to non-imprest medications as opposed cited as a factor for patient relapse, foster change, including management to using bedside drawers for each however the literature demonstrates commitment, working groups and patient. An innovative approach was that drug concentration is altered if training packages. This approach taken including focus on patient quality depot injection is administered at an had not been used before by other and safety, system-based thinking and unlicensed muscle site. PDSA cycle. The storage system was council partnerships. A baseline depot injection then replicated across three more units. By December 2018, 100% of early administration audit found only 83.6% childhood services had adopted the Nurses saved an average of almost of depot administrations were given M&M program, an increase from 60 minutes to complete the round. correctly. After implementing all the 17% in July 2017. There were This improved overall morale. There is strategies, a snapshot audit conducted significant improvements to food now extra space available on benchtops in October 2018 demonstrated an menu compliance, staff training and to prepare medications and patients improvement in correct administration policy compliance. Cooks reported are now less susceptible to medication compared to baseline. risks as the ability to self-administer children now enjoy more vegetables medications has been removed. and food waste has reduced. 16,544 3915 Votes for People’s Votes for Category winners Choice Award winner

Patients as Partners Physical Health Promotion Project

Delivering Integrated Care Providing Antenatal Care in an Outreach Setting in Riverstone

Keeping People Healthy Don't Fall For It! A Falls Prevention Initiative

Supporting our Teams Emergency Care to the Sound of Music

Education and Training Getting the Basics Right: Supplemental Oxygen

Health Research and Innovation Streamlining Bowel Cancer Screening

A Safe and Healthy Workplace Food for Thought: ‘Didn't Think We Do Healthy in the West’

Patient Safety First Saving Lives: Priorities in Action

35 CARING FOR YOUR TOMORROW

Into the Future 37

Right: WSLHD clinical governance stocktake workshops at WECC.

6 CARING FOR YOUR TOMORROW INTO THE FUTURE THE CLINICAL COUNCILWSLHD YEAR IN2019 REVIEW 6

Above, from left: Event facilitator Paul Barrie at WSLHD’s cancer services planning workshop in May 2019; Minister for Health and Medical Research Brad Hazzard visiting the Central Acute Services Building at Blacktown Hospital; the finished Central Acute Services Building. Into the future We’re putting our Health Services Plan into action and continuing with our redevelopment projects at Westmead, Blacktown and Mount Druitt hospitals.

Health Services Plan The WSLHD Health Services Plan: Growing Good Health in western “The Central Acute Services Sydney to 2026 (HSP), launched late 2018, continues to guide the changes Building at Westmead will we are making to improve services for our growing local community. This futureproof our provision includes care that is provided in the home, community, outpatient clinics of quality healthcare.” and hospitals. Work is progressing on the main recommendations of the HSP. This includes better linking all health under construction include a services that are located across New spaces, new services gastroenterology comprehensive WSLHD. We have also started looking The Blacktown and Mount Druitt care centre and an aged care at healthcare services that we might Hospitals Expansion Project has comprehensive care centre. be able to provide in the home and enabled us to introduce new services community, to make it easier for our and new ways of providing healthcare in An exciting and innovative aspect of patients and their carers to access fresh and modern spaces. The hospital the Ambulatory Care project involves care. Recent staff consultation celebrated the opening of the Acute working with the Sydney Children’s supports our focus on continuing Services Building this year, which Hospitals Network to improve the care to improve the skills of our staff so included a new ED. Its expansion will of adolescents and young adults with that they can keep giving excellent continue with the refurbishment of complex chronic conditions and/or and up-to-date healthcare. the existing hospital building including disabilities. A dedicated area is being the expansion of the imaging created, which is important for young One of the recommendations of the HSP department (including MRI), people from The Children’s Hospital is that we develop a detailed cancer ambulatory care and endoscopy. at Westmead and Westmead Hospital. services plan. In May 2019 we held a Staff from both hospitals will work large worship which brought together The Central Acute Services Building together in the new space. clinicians, patients and carers to talk (CASB) at Westmead, to be completed about the future of cancer services, next year, will not only futureproof our Following construction completion marking the start of the project. provision of quality healthcare but of the CASB at Westmead, and once We are very keen to hear from our will also house new services such operational commissioning and “go live” staff, patients and their carers as the NSW Infectious Diseases Unit. has occurred, Stage 3 of refurbishment about what they think needs to The Westmead Redevelopment will begin. This will include the expansion change. We will provide many refurbishment program, currently of ambulatory care facilities, respiratory opportunities for anyone who in Stage 2, is transforming several comprehensive care centre and upgrade would like to contribute to the plan. clinical spaces. Some of the facilities to the existing theatres and recovery.

37 APPENDIX WSLHDWSLHD YEAR IN REVIEW EXECUTIVE COMITEEGLOSSARY 2019

Glossary

ACRF Australian Cancer Research Foundation NWAU National weighted activity unit. NWAU is a measure of health service activity expressed as a common AMIHS Aboriginal Maternal Infant Health Service unit, against which the national efficient price (NEP) is paid. It provides a way of comparing and valuing ANU Australian National University each public hospital service (whether it is an admission, emergency department presentation or outpatient ATSIHPs Aboriginal and Torres Strait Islander episode), by weighting it for its clinical complexity Health Practitioners OACCP Osteoarthritis Chronic Care Program BMDH Blacktown and Mount Druitt hospitals PDSA cycle BMDH Project Plan-Do-Study-Act (PDSA) cycle. Model Blacktown and Mount Druitt Hospitals for improvement and testing changes on Expansion Project a small scale

CASB Central Acute Services Building PPH Potentially preventable hospitalisations

CBCT Cone Beam Computerised Tomography Unit Project RED Blacktown Hospital service redesign project COPD Chronic obstructive pulmonary disease RASS Rapid Access and Stabilisation Service EDs Emergency department/s REN Research and Education Network eFluids Electronic fluid management feature of eMEDs RTO Registered Training Organisation eMEDs Electronic medications management SALSA Students as Lifestyle Activists program eMR Electronic medical record SSAM Supply, Storage and Administration FTE/s Full time equivalent/s of Medications

GWAHS Greater Western Aboriginal Health Service TPP Transition to Professional Practice

HITH Hospital in the Home Uni SA University of South Australia

HSP WSLHD Health Services Plan: Growing UNSW University of NSW Good Health in western Sydney to 2026 WSLHD Western Sydney Local Health District ICH Integrated and Community Health WSU Western Sydney University IMI Intramuscular injection WSICP Western Sydney Integrated Care Program M&M Munch and Move

MDT Multidisciplinary team

MH Mental Health

LHD Local Health District For more information about out services and partners, visit www.wslhd.health.nsw.gov.au MRI Magnetic resonance imaging

38 Theatre staff at Auburn Hospital prepare for a knee replacement surgery. FACEBOOK TWITTER

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WESTERN SYDNEY LOCAL HEALTH DISTRICT PO Box 574 Wentworthville NSW 2145 +61 2 8890 9902 [email protected] www.wslhd.health.nsw.gov.au