Health matters: Vol.2 (2), Summer 2006

Item Type Report

Authors Health Service Executive (HSE)

Rights HSE

Download date 06/10/2021 09:36:26

Link to Item http://hdl.handle.net/10147/43523

Find this and similar works at - http://www.lenus.ie/hse COPD Outreach at Out and About New Country, Beaumount Hospital in Galway New Job A “hospital - at - home” CEO visits a variety of Olawale’s journey from for patients facilities Lagos to Dublin p4 p8 p11

Volume2 Issue2 Summer2006

HealthmattersNational Staff Newsletter of the Health Service Executive Green Light for €555m Capital Plan 2006

he HSE has announced its The balance will be allocated to 2006 Capital Plan which additional prioritised projects. T outlines details of the However, total expenditure will not €555.5m it will spend during 2006 exceed €555.5m during 2006. on capital projects such as building In addition, €36m, the proceeds works, equipment and facilities. of the sale of surplus assets in The Plan forms part of the HSE’s previous years, will be available 2006 – 2010 €3.48bn Capital Plan. for capital projects in the mental The breakdown of the €555.5m health area. allocation to the services within the The HSE will also have available HSE is as follows: €70m for capital investment in 1 National Hospitals information and communications Office €214m technology. Release of this money will be subject to separate proposals 2 Primary Community and from the HSE. Continuing Care (PCCC) €92m Commenting on the Capital Plan, Professor Brendan Drumm, CEO of 3 Special Initiatives the HSE, said: National Hospitals Office €25m “This plan details our priorities PCCC €108.5m and will help us meet many of our Nurse Education €35m key objectives. It includes a strong emphasis on developing our Emergency Planning €6.32m Consultant Oncologist Dr. Gregory Leonard and Registrar in Oncology Dr. Elaine Wallace of Waterford Regional Hospital who climbed €174.82m primary and community services Mount Kilimanjaro in Africa for Barretstown Castle, the children’s cancer charity in Co. Kildare. See full story on page 8. and hospital facilities.” First Responder Location for New Pilot Programme National Children’s Hospital Garda First Responder Pilot he Joint HSE/Department of Health services in Ireland’, carried out by Programme was launched and Children Task Group set up to McKinsey and Company for the HSE. A in March at Connolly T establish the most suitable location for This study illustrated that Ireland, Hospital Blanchardstown, by the the new national children’s hospital has based on its population size, can only HSE in association with An Garda selected the six hectare Mater Hospital site support one world class tertiary (specialist) Síochána. in Dublin’s north inner city. children’s hospital. It concluded that this The Programme is a pilot The Task Group’s report was endorsed by should be located in Dublin, co-located scheme whereby Connolly Hospital the HSE’s Board on June 1st last and was with a leading adult academic hospital Blanchardstown and An Garda forwarded to the Tanaiste and Minister for with space for future expansion and it Síochána have fitted Automated Health & Children, Ms Mary Harney, TD. The must be easily accessible through public External Defibrillators (AED) Task Group was established following the transport and the road network. The new equipment in on-duty Garda publication of ‘Children’s Health First: paediatric hospital should also cater for patrol cars. This is the first such International best practice in tertiary the secondary paediatric needs of the programme in Dublin. paediatric services: Implications for the greater Dublin area. continued on p7 strategic organisation of tertiary paediatric continued on p7 Healthmatters Message fromthe Editor Primary Care Focus

We hope you enjoy the Summer issue of Health Matters and that you find the newsletter useful and informative. We have included as many of your Helping People to Remain at Home contributions as possible in this 32 page edition. The editorial team is focused on improving Health Matters with each new issue and our atherine O’Reilly, in a position to refer them on. ” “It’s a wonderful job. It’s “Sometimes we will collect competition at the back of this publication is Home Care Worker, The Home Helps work good, for example to be able to young children and bring them designed to help us find out more about the kind of C says the main aim of closely with the Community give a family some help where to school in the morning. We material you would like to see. There is a great the Home Help service in Welfare Service in Ballymun a family member is terminally can help with home prize for the winner of this competition – a hotel Ballymun is to allow people to and a lot of their referrals come ill. management and parenting weekend away – and we urge you to participate remain in their own home for from this source. “In the past the Home Help skills, homework and and be in with a chance of winning. as long as possible. “Without the support of the service was not integrated with budgeting. Our main story in this issue highlights the 2006 Ballymun Home Help has 70 Community Welfare Service our other services. We were in the “There are more doors open Capital Plan which contains information on Home Helps and Family homemaking service may not background. Now I think with the Primary Care Team. If projects nationwide. Support workers who serve have started and may not have people have a better people need someone in a There is a four page supplement in the centre of almost 300 clients. grown into the family support understanding of what we do. hurry they will be seen.” the newsletter containing a Background Briefing Some people thought we were Catherine says she is very on hospital Accident and Emergency Departments. cleaners but we were never proud that the Home Help This document points out how the structures and cleaners. I don’t think a lot of service is locally driven and processes in the wider health system can have a The Team is excellent. people are aware of how much that she is part of the Primary major impact on A&E Departments and outlines we do. Care Team. the types of system wide changes that are needed. Home help has a good Our front page photograph of Dr Gregory Leonard and Dr. Elaine Wallace on the summit of “relationship with all the Mount Kilimanjaro is inspiring and you can read disciplines. inside about why they climbed Africa’s highest Swift Service mountain. With each batch of 50 copies of this edition we faster delivery of a more comprehensive service to the have inserted two wall posters containing maps Catherine represents them ”service it is today.” client is one of the major benefits brought about by the and contact information featuring the Local Health on the Ballymun Primary Care Catherine explains that A creation of the Ballymun Primary Care Team, according Managers and the hospitals (National Hospitals Team. “The Team is excellent. personal care provided by the to Angela O’Malley, Public Health Nurse (PHN). This should Office Groups). If you didn’t receive the posters Home help has a good Home Help to the client can permit early effective intervention in order to promote a and would like copies we have a limited number relationship with all the involve washing them, shaving, healthier community. available. To make a request email us at disciplines. For example I can bathing, doing their shopping, Angela has been working as a PHN in Ballymun for 25 years [email protected] ring one of the GPs and refer a collecting their pension, and has spent the past year working as a member of the Primary In conclusion we would like to say a big thank to client who has a problem and cooking a meal, taking an Care Team. the staff in the Communications offices around the he or she will be seen quickly. elderly person for a walk or “For the clients it is very good. For example, a client can country who contribute so much to making Health The relationship with the Team paying their bills for them. be treated in the community by a physiotherapist. This allows Matters a successful publication and to our is very good and very open. A client may be terminally ill, the client to remain at home and have the same treatment as in volunteer staff distributors who play a crucial role “As Home Helps we are on the may require incontinence wear the hospital. in ensuring that you can access your copy. ground constantly and see clothing, may have to use a Clients are entitled to enrol with the Team if they have been Your comments, suggestions and story ideas are people on a daily basis. We see hoist or may have had a registered with or are attending one of the GPs attached to the always welcome. The new special email address to the needs of people and we are colostomy. Team and have lived in the area for a minimum of a year. send in your contributions is “PHNs provide for total nursing care in the area of, for [email protected] The deadline for the next example, patients with cancer, heart conditions, disabilities, edition is July 31. and to the elderly. They monitor the development of infants and children. Linking in Angela believes part of the Team’s role is prevention. “We seek to promote and educate towards a healthy lifestyle and care for clients in their homes where they are With Colleagues most comfortable.”

Stephen McGrath – Editor Head of Internal Communications eing part of a multi-disciplinary team in Ballymun has Email: [email protected] helped Speech & Language Therapist Katherine McIntyre 100 Teams Bparticipate in more formalised and increased interdisciplinary liaison for the benefit of her clients. “By linking in with others you can be more aware of the issues This Year going on in a family. You can access relevant information about While every effort is made to ensure the accuracy of information published clients to inform clinical decision- making. he HSE is committed to establishing 100 Primary Care in Health Matters, the Health Service Executive accepts no responsibility for “For example family support can be arranged so that a child can Teams this year and another 100 next year. errors or omissions contained herein. Also note that inclusion of an article attend a speech and language clinic or so the family can keep an “We are delighted with the response of individual GP’s in Health Matters does not necessarily imply endorsement of the article’s T content, unless otherwise stated. appointment.” to our invitation for expressions of interest in the further Katherine has developed closer links with the G.P.’s, Public development of primary care teams,” said Aidan Browne, ©2006 Health Service Executive. Health Nurses and other allied health professionals such as National Director of the Primary, Community and Continuing All rights reserved. No part of this publication may be reproduced, stored the physiotherapist, occupational therapist and the dietician. Care Directorate. in a retrieval system or transmitted in any form or by any means electronic, “These linkages result in increased and more comprehensive In addition the HSE is establishing Community Intervention mechanical photocopying, recording or otherwise without prior permission of the publishers. referrals. Teams which will provide a rapid response to ensure these social Speaking about the Team she says: “When dealing with a and personal supports are provided in a matter of hours and Health Matters is published by Harmonia Ltd., client it gives you confidence to know that the other Team hospital admission can be avoided. The teams will cover four Clanwilliam House, Clanwilliam Place, Dublin 2. members are also working with the same family. It has allowed a areas initially, serving a population of 850,000. The first Tel: 01 240 5300 Fax: 01 661 9757 more holistic approach to working with clients and has enriched Community Intervention Team began in May in Cork City with ISSN: 1649-7996 our working lives.” further roll out shortly in Dublin West, Dublin North and Limerick. p2 Healthmatters Summer2006 Healthmatters “Primary Primary Care Focus CareTeams Great for Patients”

r. David Gibney’s experience of working as a general practitioner D with the Ballymun Primary Care Team has convinced him that more such teams are needed around the country. “It’s a good idea for a community and should be rolled out,” he says. “The patients in general find it great. They see, for example, the home help and family support workers or the occupational therapist working in their community and see them as being part of the Primary Care Team. “The concept of multi-disciplinary team work seems to benefit the patients. It’s easier for patients to access a greater variety of services. In the past patients found it difficult to access services such as physiotherapy, occupational therapy or psychology and there were long waiting lists.” Dr. Gibney also says there are benefits to team working for doctors. “As a doctor when you are part of a team you don’t have to feel you have to take on board all of the problems you are presented with. General practice can be stressful and it’s a big relief to be able to share the load. “We can often be faced with trying to help Pictured at the launch of the Ballymun Primary Care Team Strategy and Progress Report were Breedge Conlon; Dr. Brid Hollywood; Dr. Wai Sun Chan; Aileen Doyle; Dr. David people with difficult histories of problems and Gibney; Dr. Mary Jennings; Dr. Deirdre Horneck; Angela O'Malley; Orla Donnelly; Maria Kelly; Catherine O'Reilly; Seoighe Ni Rua; Kartherine McIntyre; Lavina Walsh; we can share these with the mental health Agnieszta Biedrycha; Dr. Neasa McDonagh; Edel McNamara; Peter Lennon; Mary Kenny; Phil Dunne; Anne Fahy; Michelle McKevitt; Prof. Brendan Drumm; Vanda Cummins. nurse, or the occupational therapist if it is a physical problem. Working in a team can also be fun and there is a good feeling of he Ballymun Primary Care Team has a Phil says two vital aspects that will enable improved. This is a big challenge for us.” camaraderie between us.” targeted population for enrolment of Primary Care Teams to be effective and respond She also emphasises the importance of Before the Primary Care Team was T 7,000. Team members include those to the needs of clients are the communications clinical meetings. established Dr. Gibney and other GPs shared drawn from the areas of GP Practices, Public process and investment in ICT. “Everyone learns through clinical meetings. a building with the public health nurses, and Health Nursing, Community Mental Health “How do we maintain an open and clear When the Team meets to discuss a client’s community welfare officers. Nursing, Home Help, Family Support Services, communication channel between GP surgeries, case input is received from all team “We had a good working relationship with Physiotherapy, Occupational Therapy, Health Centres and other sites where services members regarding what is available for the them before the Primary Care Team was Administration, Dietician, Speech & Language client and what services/intervention is created. The community welfare officer, public Therapy, Counselling Psychologist. available. A GP for example need no longer health nurse or social worker knows the The Team is reflective of the health needs of feel that they must deal with a problem entirely patient and they often have a good sense of the people in the Ballymun area. on their own. They can discuss the client’s what’s going on with the client.” The development of the Ballymun Primary We are problem with other members of the Dr. Gibney believes that Primary Care Care Team commenced in September 2003 multi-disciplinary team. Other members of Teams may need different models depending when Mary Kenny was appointed as Project formalising a the Team also are not working in isolation. on where they are located. Manager. Mary took up another healthcare post “lot of good work No one is working in their own silo. The Team The Team in Ballymun has taken a number in February 2006 and was replaced as Primary is client centred and there is a focused plan of of initiatives to respond to demand for Care Manager in Ballymun by Phil Dunne. already being treatment and intervention.” services. For example there are clinics for The new model of Primary Care Networks and Phil is confident that the new model gives clients prescribed methadone, diabetics, Primary Care Teams will see formal structures in done on the clients an improved service. “The way to secondary prevention of heart disease, minor place to facilitate teams of health professionals services is clearer and there is easier access surgery and sexually transmitted diseases. working in partnership to deliver services. Many ground to services.” He says the Primary Care Project Manager health professionals are already working “A big part of it is communications and is very important to the team but that there is informally as teams but the new arrangements knowing what is available and where and how to no team boss. will help link into a formal Network and Team ” access it. All members of the team can now be “We have a flat structure where there is based approach. may be delivered from? In Ballymun we are involved in the client’s care and this can only be mutual respect. We have different skills and “We are formalising a lot of good work already looking at the development of a particular of benefit to clients. The client gets the benefit of we all drive certain projects. There is a culture being done on the ground,” says Phil Dunne. software package ‘Health One’ to assist our the combined skills and knowledge of the Team. of being able to speak up and say what you “We have a client centred approach to care, communications. It will facilitate sharing of This has to result in health and social gain.” think. I don’t think there is a need for a treatment and intervention. This is facilitated by information between all team members People currently enrol to be part of the hierarchical structure.” structured clinical meetings with all team although it is appropriate that some information Ballymun Primary Care Team. To date approx. In the Ballymun Team there are three members to discuss client cases,” says Phil. will only be available to the GP. 4,000 people in Ballymun have enrolled. When a practice nurses, ten GPs, two practice The new model allows for health care Phil says one of the greatest challenges facing client fills in the form they are giving the Team managers and five reception staff. There are professionals to deliver services to the client as Primary Care Teams is the employment ceiling in the right to share and use information for the also registrars from the Royal College of part of the integrated Primary Care Network and the health services. client’s benefit. Surgeons in Ireland and Trinity College, Team comprising of GP’s and health care “Services on the ground need investment and Other family members can also be consulted Dublin and undergraduates from both professionals. staffing ratios in particular areas need to be about the client’s care when this is appropriate. colleges.

Summer2006 Healthmatters p3 Healthmatters COPD Outreach Scheme Helps Patients to ‘‘Catch Their Breath’’

wo years ago Tom O’Shea (not his real they are given appropriate medication and a name) presented once again at nebuliser if required. The GPs are immediately T Beaumont Hospital’s Emergency informed of the care plan and the patients are Department. As a sufferer of Chronic visited by a team member on the day of Obstructive Pulmonary Disease (COPD) he was discharge, if possible, and every day for the next caught up in a vicious cycle. Shortness of three days. They are visited as frequently as breath led to inactivity which led to a necessary over the first fortnight before being dependent, sedentary lifestyle and more discharged back under the care of their GPs. episodes of shortness of breath. Follow-up visits are also made at six weeks and But this time things were different. Shortly three months and patients are referred, if after arrival he agreed to join the hospital’s necessary, to the appropriate community innovative COPD Early Discharge Programme. services. Following assessment, he was prescribed Just over one in five COPD admissions to portable oxygen for low oxygen levels while Beaumont in the first six months of 2005 walking and moving about and discharged the benefited under this programme. It has also had same day. a major impact on the average length of stay in As well as keeping a close eye on him over the hospital for certain COPD patients, down from next few weeks, the team persuaded him to join 10.2 days in 2003 to 1.5 days in 2004, against the their Pulmonary Rehabilitation Programme. Tom comparable national average of 7.8 days. quickly became the life and soul of the class with a quick wit to match the often unwanted Assisted Discharge words of encouragement provided by what he The Assisted Discharge Programme, which called the “physical terrorists” of the Outreach began in January 2005, helps patients whose staff. hospital stay has been over 72 hours and Now his life has been transformed. The who will need respiratory support/aides to shortness of breath cycle has been broken, he is make the transition to home. Patients are far less dependent on others and exercises visited on average twice over a two-week regularly at home using his own exercise bike period and phoned as necessary. After the and weights. His much improved quality of life second visit they are discharged back to the includes being able to join his friends at the pub care of their GP. Just over one in ten COPD occasionally where they “exercise their biceps”. admissions in the first six months of 2005 benefited from this programme. A “hospital-at-home” Tom is one of over 400 patients who have Pulmonary Rehabilitation benefited so far from the outreach scheme The Pulmonary Rehabilitation Programme, to established by Beaumont Hospital in September which patients must be referred, is held for two 2001. This was expanded in 2003 with funds hours twice a week for seven weeks. Individually obtained under the Partnership Agreement. tailored to each patient, it increases his or her The outreach team provides a “hospital-at- knowledge and understanding of COPD. The home” service for patients diagnosed with benefits are that it improves exercise tolerance, exacerbated COPD. The service consists of a decreases symptoms and reduces hospital Respiratory Nurse Co-ordinator, a Respiratory admissions. The end result is a significant Nurse Specialist and a Senior Physiotherapist, improvement in quality of life and an improved all working under the direction of respiratory prognosis in certain COPD patients. All patients consultants. Two posts have been funded by the are fully assessed for suitability, but neither age HSE. The third post has been funded for one nor the severity of COPD are reasons for year by the Health Services National Partnership disqualification. Forum. The award winning service has The COPD Outreach service is provided significant benefits for patients and is an between 8am and 6pm, Monday to Friday. A efficient way of ensuring that they receive weekend service is provided to those patients continuing high quality care. who are deemed fit for discharge on a Friday. Under the Early Discharge Programme The team also refers patients to a Smoking patients are assessed for suitability within 72 Cessation Officer if they require assistance Beaumont Hospital patient James Brohoon exercising at home with COPD Outreach team member Brenda Deering MISCP. hours of admission. If they agree to participate, giving up cigarettes. How much salt are you eating?

t is often said that too much salt is bad for us, but how > 77% either did not add salt or only occasionally added salt much is ‘too much’? Our Lady’s Hospital, Navan, ran to their food. Ia quiz during Salt Awareness Week 2006 to promote > 10% always added salt during cooking. salt awareness. A total of 57 staff and 27 patients/ visitors > 10% add more than a level teaspoon of salt to food each day. took part. > Nearly everyone was aware of the link between salt and high blood pressure. The quiz revealed that: > Few people know that the terms sodium content and salt The results show that many people are looking after their content listed on food labels are not interchangeable eg. health by not adding salt when cooking or at the table, but 2.5 grams of salt = 1 gram of sodium. many more could benefit by improving their knowledge of Liz Timony and Claire Denning, Assistant Catering Officers at Our Lady’s Hospital, > Few staff knew that adults need 4 grams of salt a day and ideal salt intake levels. To find out more about salt, see the Navan who presented Groundsman Shane Faulkner with a basket of fruit as only 23% knew that a level teaspoon of salt is the Irish Heart Foundation’s booklet, Time To Cut Down On Salt. winner of a quiz held during Salt Awareness Week 2006. acceptable maximum level a day for adults. For a copy, log on to www.irishheart.ie. p4 Healthmatters Summer2006 Healthmatters

Care for the Terminally ill The Care for the Terminally Ill in Hospitals project has been developed by the HSE in partnership with the Irish Hospice Foundation (IHF). The aim of the project is to develop the hospice philosophy of integrated and holistic care for people in a hospital setting. The project set out to pioneer a comprehensive process of change in the culture of care in hospitals with regard to dying, death and bereavement. This has been achieved by acknowledging death and dying in the hospital context and by providing the appropriate structure, space, skill and support. A number of practical measures were introduced through the project including, a hospital-wide education programmes to all staff, staff sympathy cards are now sent to families and a Family Handover Bag has been designed to replace the practice of returning a deceased person’s belongings in a plastic bag. This process is now in use in a range of hospitals in Ireland and has generated interest in the UK and Australia.

Speech & Language Team: Caitriona Coen, Meadhbh Curley, Patricia Dowd, Caoilfhoinn Ni Chuinn, Laura Loftus who represented the “Oro-Motor” HSE West project with An Taoiseach Mr. Bertie Ahern T.D. Assertive Outreach HSEProjectsWinners Teams The Assertive Outreach Team is part of the Community Rehabilitation service for the Cavan/Monaghan Mental Health services. The inExcellence Awards team focus on patients with severe and enduring mental illnesses such as ix projects from various sectors schizophrenia. These patients tend to have low throughout the health service have been Oro-Motor Farmers Have income levels due to long periods of S acknowledged for their innovation and unemployment, high rates of homelessness, outstanding provision of care by being awarded poor states of general health and have lower prestigious Excellence in Public Service Awards. Speech Groups Hearts-Health than average life expectancy. This year there were over 150 entries from The Assertive Outreach service intervenes by across the public sector with the judging panel for Pre-School Screening assessing the total health and social needs of being chaired by RTE broadcaster Marianne the patients and working to satisfy those Finucane. The awards were presented by An Children Programme needs. This involves the development of strong Taoiseach, Bertie Ahern T.D. in Dublin Castle in working relationships with other statutory, March. Twenty award winners were selected Several “oro-motor speech” groups were This project identified farmer’s marts as voluntary and community agencies. from 153 projects submitted. successfully established for preschool children an ideal place to carry out cholesterol and This team is the only one of its kind in Ireland The winning Health Service projects were: who presented with varying types of severe blood pressure tests on the farming and evaluation has shown the benefits of the > Slán Abhaile Project – Enhanced home speech impairment in the west of Ireland. population of County Roscommon. approach, these include improved quality of life support for vulnerable older people and their The groups were targeted at children aged The service has been utilised by over for the patients, reduced hospital admissions, families - HSE Dublin Mid Leinster three to five years and ran once weekly for the 100 members of the farming community, maintained links with families and community > Cavan Monaghan Mental Health Services- duration of the six week programme. Parents with tests taking place in Elphin, Castlerea and patients maintaining higher levels of HSE Dublin North East attended the group sessions and learnt and Roscommon Marts. Height and independence than in the past. > The Newgrange Process-Care for the techniques to carry out with their children when weight measurements were performed Terminally Ill-HSE Dublin North East they had finished the programme. as well as nutritional and physical > Farmers Have Hearts-Health Screening Thirty three pre-school children availed of the activity screening. Programme-HSE West Roscommon PCCC service and notable improvements have been It is hoped that through this initiative, > “Oro-motor”- Speech Groups for Pre-school recorded. In addition the progamme has also conditions like cardiovascular disease Slán Abhaile Children- HSE West Roscommon PCCC empowered parents to educate their own will be identified at an early stage, Slán Abhaile is a project which involves a > Croi Cardiac Club- Community Cardiac children, through the skills and practices learnt thus improving the success rate unique partnership between HSE Dublin Mid- Health-HSE West –CROI West of Ireland at these sessions. of treatment. Leinster, The Royal Hospital Donnybrook, St. Cardiology Foundation Vincent’s University Hospital, and RehabCare Speaking of these awards, CEO of the HSE, and is aimed at supporting vulnerable older Professor Brendan Drumm said: “I would like to people to remain living in their own homes, compliment all of these projects. Through their The Cardiac Club-Community rather than remain in institutional care. own initiative and innovation these schemes Through the Slán Abhaile scheme, have made a real practical difference to clients coordinated teams of home support workers in their areas. This is precisely the fresh and Cardiac Health Care visit care recipients up to several times a day, pioneering thinking which is required for health Community Cardiac Rehabilitation is supported through the Croí Cardiac Club Network across ten at evenings and at weekends to provide both services in this country to develop at both a local locations in the HSE West region, and provides a vital out-of-hospital support for heart patients and personal and domestic care, meaning that and national level. I would encourage all staff their families. there is no need for these people to attend within the HSE to look at schemes such as these These Community Cardiac clubs offer advice on diet and lifestyle to those at high risk from cardiac local hospital or clinics to receive this service, ones as an example of what can be done disease. They also perform cardiac risk assessments in order to identify cardiac difficulties so that thus relieving pressure on beds in the acute through creativity and endeavour. ” they can be suitably treated. hospital sector.

Summer2006 Healthmatters p5 Healthmatters

Cancer Patients at Cork University Hospital Receive Follow up Calls After Treatment Newsbrief atients who received radiation has shown that the calls are very Side Effects- Most patient’s side Galway Seating Clinic therapy at Cork University beneficial to patients. A total of 89 effects were improving as expected. P Hospital are now receiving patients were contacted between Patients who received treatment to the Achieves IMB Licence follow-up telephone calls at home from November 2005 and mid March 2006 on pelvis area described their bowel and the radiation therapists during the first the Friday after treatment completion to bladder reactions as moderate, while 11 Galway Seating Clinic, which provides specialised wheelchairs and six weeks following treatment. check their progress. patients still had a poor appetite, mostly other seating equipment for children and adults with a physical While specialist information and Fatigue- 16 patients expressed severe those who had treatment to the head and disability, has been licensed by the Irish Medicines Board to design supportive medical staff are in regular fatigue, which is a major issue especially neck and colorectal area. and manufacture a range of medical devices including wheelchair contact with patients undergoing when combined treatment is involved. Benefit of follow-up clinic- All 89 boards for fractures, customised seats, backs, armrests and radiation treatment, this stopped once Mood- many patients expressed patients expressed satisfaction in cushions. Customised seating can make a significant difference to patients finished their therapy and unexpected feelings of loss and isolation, receiving a telephone follow-up the independence and comfort life of a disabled person and the returned home. They would have had no while 12 patients indicated a sense of describing it as reassuring and also Galway Seating Clinic has been providing this service in the west of further contact with the hospital for six to depression. stating that it cleared up their follow-up Ireland since 1999, with demand increasing each year. Situated in eight weeks, when side effects are still Call Back- seven patients asked for a queries. Merlin Park Hospital, Galway, the clinic comprises occupational occurring until they returned for a follow- further call the following week. The telephone calls are the only cost therapists who assess and prescribe equipment to meet clients’ up appointment with a radiation Referral- five patients were referred on associated with this service and staff at individual needs and an in-house clinical engineering technician oncologist. to further services following queries they the Radiation Therapy Department are who designs and makes the customised seating. stural management. A recent audit carried out on the had outside the radiation therapist’s very happy and proud of this new service, service which was introduced last year discipline. on which patients have come to rely. Challenge Day at Kilrock House Community Care Back Row (LtoR): Audrey Castles, Care Worker, Mick Crow, Workers 7th Annual Ambulance Driver, Mary Garrett, Staff Nurse, Eoin McElhenney, CNM 2, Martin Connor, Soccer Networking Director of Nursing, Pat Bowens, Staff Nurse. Front Row (LtoR): Brian Carberry, Assistant Director of Tournament Nursing, Louis Hoare, Staff Nurse, Jeudi ommunity care workers in Cork, colleagues at the Department of Applied Social McGuinness, Staff Studies, University College Cork and those working in non-governmental Nurse, Mary Aherne, organisations have discovered a novel way to network - they hold an annual Staff Nurse, Dr. Ena C Lavelle, Consultant soccer tournament. The recently held 7th annual mixed six-a-side tournament was based Psychiatrist, Jan on the philosophy of promoting physical activity in the workplace, getting to know Franklin, Staff Nurse. colleagues and indeed the fun aspect. In addition to the games, there were information stands promoting understanding and awareness of the different services the Challenge Day Physical Activity Initiative was held at Kilrock House, Howth, Dublin in May. The participating staff provide, health promotion initiatives for staff and less energetic Specialist Rehabilitation Service for St. Ita’s Hospital, Portrane and north Dublin community mental activities such as an egg and spoon race for non-soccer enthusiasts! The staff involved A health services is located at Kilrock House. The Community Rehabilitation Team (CRT) provides included: child care workers from residential units, family welfare conferencing services, specialised services for people disadvantaged by problems that can develop with mental illness. The aim of the Youth Encounter Project, Neighbourhood Youth Project workers, social workers, child Challenge Day was to raise awareness of the importance of physical activity by involving the maximum number care managers, adoption services, homeless youth services, training staff and of staff, patients, visitors and the community in 15 minutes of continuous appropriate physical activity. management as well as representatives of nongovernmental organisations. Cutting the Risk of Infection Drive to Improve he operating theatres of the three Midland Regional Hospital sites at Portlaoise, Mullingar, Quality and Safety T and Tullamore are using an alcohol rub that contains isopropanol and n-propanol alcohol. is Everyone’s The use of alcohol rubs for pre-operative skin preparation is in line with evidence based best practice and the way forward for patients and staff, according to Business Marena Burd, Assistant Director Of Nursing / Infection rofessor Brendan Drumm, Chief Executive Officer Control at the Midland Regional Hospital, Tullamore. of the HSE recently welcomed the commitment by “Alcohols are considered to be among the safest P healthcare staff to quality and risk management. antiseptics available and generally have no toxic effect on He stressed that the drive to improve quality and safety human skin. The antimicrobial activity of alcohol-based should not just be in the domain of specialist risk and quality rubs is considered to be superior to all other currently managers, it was everybody’s business. available methods of pre-operative hand preparation,” He said clinicians and managers must become familiar said Marena. with risk and its management. Training by an outside specialist to relevant staff has Professor Drumm was speaking in Dublin at the third been provided and the majority of staff have adapted very national conference of the Healthcare Risk Managers Forum well to using the alcohol rub and say they would not (HRMF) held in March. return to the traditional methods. On going education The theme of this year’s conference was ‘Quality and Collette Hannick and Dr Colm Taylor using the new alcoholic rub in Theatre about the alcohol rubs is being provided to new staff and Safety the Onward Journey’. Over 250 delegates attended at the Midland Regional Hospital at Tullamore. is well accepted. the conference. p6 Healthmatters Summer2006 Healthmatters First Benefits of Tallaght Responder Hospital Multidisciplinar y Pilot Programme Discharge Planning Team continued from p1 There is also a public access defibrillation scheme in Kilkenny that includes the Garda Síochána. Connolly Hospital, CPR (Cardiac Pulmonary Resuscitation) Department together with An Garda Síochána have trained approximately 140 Gardaí in CPR and AED and placed AED equipment in 13 uniform Garda patrol vehicles. With the support of accident and other emergency services, uniform patrol vehicles in the pilot areas will respond to emergency calls. Defibrillation within five minutes of cardiac arrest is a potentially life saving option for the thousands of Irish people who experience sudden cardiac arrest. Survival rates decrease by 10% for every minute from “drop to shock”, that is, the time between cardiac arrest and defibrillation. Location for New National Children’s Hospital continued from p1 The Task Group concluded that no one adult hospital had the full range of sub specialities Members of the Discharge Planning Team at AMNCH (LtoR): Claire Murphy (Social Worker), Barbara Ryan (Discharge Nurse), Nina Kelly (Discharge Nurse), set out in Children’s Health First. The decision Claire Broderick (Discharge Planner Team Co-ordinator) , Ciara Blair (Senior Occupational Therapist) and Susan Cox (Senior Social Worker). to select the Mater Hospital site was based on several factors relating to the current location of clinical services around the city and the he number of patients occupying an patients with greater needs or potential delayed working on this ward, Claire worked speed with which the children’s hospital acute bed while awaiting placement in a discharges at an early point in their treatment closely with a multidisciplinary team, and could be developed. TLong Term Care facility has more than enables us to resolve difficulties sooner and had weekly case conferences, where patient Through the establishment of a clinical halved at the Adelaide and Meath Incorporating release acute beds in a more timely manner,” discharges were both planned and network, with the Mater as its centre, this site the National Children’s Hospital (AMNCH) in Ms Broderick explained. discussed. was considered to be in a good geographical Tallaght during the past year. Whilst working with elderly patients who may In 2003, Claire worked on a project called the position to facilitate access to the key This is thanks in large part to the hospital’s need placement in a Long Term Care facility is a Home Support Project, where patients who specialties of cardiothoracic surgery, national commitment to discharge planning and the significant part of the job, they are not the only needed an increased amount of care were spinal injuries unit and national heart and recruitment of a Multidisciplinary Discharge patients who need the services of the identified and discharged home. This worked lung transplant programme (Mater), Planning team. Multidisciplinary Discharge Planning team. extremely well, enabling patients who would neurosurgical and kidney transplant teams This team is comprised of a variety of “Patients requiring placement in rehabilitation have been listed for Long Term Care, to be (Beaumont) and haematology/ radiotherapy professionals, including Nursing, Social Work are also part of our brief, as are patient’s discharged home with supports / home help to and burns teams (St James). and Occupational Therapy input who work who need to convalesce, and do not need suit the patient needs. effectively in planning patient discharges and to be in an acute hospital environment,” In 2004, Claire was appointed project leader, resolving issues to help facilitate the patient’s Ms Broderick added. measuring Length of Stay across diagnostic discharge once medically fit. “We work with a multidisciplinary team to groups. The result of this project was the According to Claire Broderick, the Discharge ensure that if home supports or certain development of a more action orientated Long Contributions Wanted! Planning Manager in AMNCH, there are two equipment/ appliances are needed, they will be Term Care list that ensured that each patient Why not write or suggest an article or feature major benefits to discharge planning. available, when the patient is medically fit for listed was reviewed regularly. for the next edition of Health Matters and “Firstly, discharge planning benefits the discharge home.” This Long Term Care list is now reviewed and help keep us updated on what’s happening patient. Our team helps ensure that patients are Claire stresses that communication is a key updated on a daily basis by the Multidisciplinary in health around the country? If you are in the best possible facility to suit their needs, be factor in effective discharge planning. “There Discharge Team. Previously patients were listed interested in a service, development or that at home, rehabilitation, in a convalescent has to be effective two-way communication with once a week with no key person identified to initiative being highlighted contact any bed or in a Long Term Care facility. If there are the patient, their family, the community or the follow up on each patient. Now patients who member of the HSE’s Communications team issues that need to be resolved to facilitate the HSE as required.” have complex medical or social issues can be for assistance. You can also write to us at patient’s transfer to the best possible facility we The team in AMNCH have developed close identified at an early point in their treatment and Health Matters, Internal Communications, are able to help resolve these issues. links with identified key people in the their situations can be addressed in a more Health Service Executive, Dr Steevens’ “The team can take a multidisciplinary community and the HSE enabling issues to be timely manner. Hospital, Dublin 8. Alternatively you can approach in facilitating discharges, and highlighted and addressed quickly, so time is Claire enjoys her job and sees it as a positive email us at: [email protected] Please identifying the needs of the patient, for example, not wasted trying to identify which person has development for both patients and the hospital. make sure to provide your name, work a home assessment completed at an earlier time the answers to questions. Claire also looks forward to the day, when a address and telephone number in of the patient’s stay in hospital, and can identify Claire developed her interest in discharge patient’s date of discharge will be decided upon, correspondence. Articles may be edited their requirements to enable a timely discharge. planning whilst working as a staff nurse on on the same day they are admitted and is or cut. The deadline for the next issue is “The second benefit of discharge planning is a 30 bed, acute medical, care of the elderly, delighted to say that this is currently being July 31, 2006. to the hospital. Having the facilities to highlight rehabilitation and stroke unit. Whilst actioned within the hospital.

Summer2006 Healthmatters p7 Healthmatters

briefed on various integration projects between primary care, community care and the local acute hospitals. Portiuncula Hospital, Ballinasloe, County Galway is a 204 bed hospital providing a comprehensive range of services. Professor Brendan Drumm visited the Accident and Emergency Department, St Josephs Ward/Stroke Care Unit, Theatres/ Endoscopy/ Intensive Care Unit, Oncology Unit, Special Care Baby Unit, Maternity and St Francis Ward. On a visit to Ballybane Community Resource Centre, the focus was on pre-school services and youth and family support services. The centre was officially opened in December 1989 and since then it has been used by local voluntary groups. The CEO also took in a visit to the Brothers of Charity, Galway. They provide a wide range of services to people with intellectual disability including day, residential, respite, multidisciplinary and family support services. Professor Drumm later visited Merlin Park Hospital and University College Hospital, Galway Young children on the playbus at Ballybane Community Resource Centre in Galway. where he was given an overview of Galway Regional Hospitals (GRH) which provide a range Out and About in Galway of services to patients across two sites.

rofessor Brendan Drumm, CEO of the overview of the general work relating to primary Later Professor Drumm had the opportunity to HSE visited a variety of facilities in care in Galway and briefed about the proposed meet with the Management Council of P Galway over three days in March. implementation of primary care teams including WESTDOC, an out-of-hours GP service Professor Drumm first visited the GAF, one in Oughterard, County Galway. established to provide emergency out-of-hours (Galway Youth Advice Café) a social health He also discussed the development of best GP care to patients of participating GPs in initiative for young people and part of the Health practice in relation to chronic disease counties Galway, Mayo and Roscommon. Service Executive West Drug Service. This is a management in Galway. An example of a The service, established in December 2002, multidisciplinary and multi-agency project chronic disease management initiative is the has 108 participating GPs. Some 170,000 targeting 14 – 20 year olds. recent convening of a Diabetes Services patients have accessed the service which Professor Brendan Drumm, CEO of the HSE who The programme delivery includes sexual health Advisory Group (DSAG) in the area. The Group receives on average 1,000 calls a week. The met Olivia Connaughton Healy, Technician in the programmes, drug and alcohol prevention, aims to act as an advocate on behalf of people service is currently in the process of expanding Pulmonary Function Laboratory and Dr. JJ Gilmartin, Consultant Merlin Park Regional mental health, diet, nutrition and counselling. with diabetes and be the main driver for change to incorporate 54 additional GPs. Hospital, during his visit to Galway. During his visit, the CEO was given an in diabetes services at local level. The following day Professor Drumm was Cancer Specialists Scale Summit of Mount Kilimanjaro to Help Barretstown

wo intrepid cancer care specialists The children who come to Barretstown at Waterford Regional Hospital have spent a long time in hospital and T swapped their white coats for been denied ordinary childhood walking boots as they climbed Mount experiences such as making friends, Kilimanjaro for children’s cancer charity developing independence and social Barretstown. skills. At Barretstown they are encouraged Consultant Oncologist Dr. Gregory to step outside their comfort zone and Leonard and Registrar in Oncology Dr. take on challenges such as performing on Elaine Wallace climbed what is the stage and climbing a 40ft tower. highest free standing peak, the highest Dr Leonard said: “I work with adult walkable mountain in the world and the cancer patients but when it involves highest mountain in Africa. children it is an even more tragic scenario They flew out at the end of March to and it touches the heart. I think the northern Tanzania, where the trek took Barretstown programme is fantastic and place over seven days. They experienced really worthwhile. temperatures ranging from 10° at the “To help continue the work that base camp to the summit located 5,895 Barretstown Castle provides we looked metres up where temperatures can fall as for sponsorship for the trek. The low as -20°. sponsorship did not finance our trip, so This challenge was all in aid of raising every penny raised goes directly to the money for the Barretstown centre located children and their families.” in Co Kildare. The centre provides unique To make a donation or find out programmes for children and their more, contact Sharon Murray, Oncology families from 22 European countries Data Manager, Waterford Regional who suffer from cancer and other Hospital, Dunmore Road, Waterford, Consultant Oncologist Dr. Gregory Leonard and Registrar in Oncology Dr. Elaine Wallace getting ready for the trek serious illnesses. at 051-848934. p8 Healthmatters Summer2006 Healthmatters

SE West launched a Traveller Health Unit and FAS. Tuam Primary Health Care Primary Health Care It is known that Traveller men die HTraining Programme for ten years younger than their settled Travellers in March at the Travellers counterparts and Traveller women Training Programme for Travellers Education and Development die 12 years younger than women Association in Tuam, Co. Galway. from the settled community. The Programme aims to improve The infant mortality rate is three the health of the Traveller times higher than the national population by increasing access to average with very few people living health services. into old age ie 65 years and older. This is the second project of its The Primary Health Care for kind in Galway. A pilot project is Travellers Training Programme in being undertaken in Galway city Tuam is managed by Martin Ward involving the Galway Travellers and his local management team. Support Group where there are ten The training Programme is Traveller women employed as delivered by two Community Community Health Workers. Development Workers and a The projects were developed as a Registered General Nurse with a response to health inequalities background in health promotion experienced by Travellers and there studies. Tuam Travellers Education are a total of 42 projects in and Development Association was operation nationally. responsible for the programme This Tuam programme will see 14 predevelopment work participants trained over a three- and planning. year period to become Community Within the training Programme, Health Workers. Their job will be to participants will be engaged in improve access to health services learning that has a community through the provision of development ethos. The overall information and advocacy support programme covers the following and by building partnerships with areas: service providers and the Traveller > Health community. > Personal and Group The programme is a partnership Development between the Tuam Travellers > Community Development Pictured at the launch of Primary Healthcare for Travellers Training Project in Bru Bhride, Tuam, Co. Galway were (Back LtoR): Ray Kelly, Mary Educational & Development > Traveller and Social issues Lynskey and Pat O’Hara, FAS. (Front LtoR): Donna Gleeson, Co-ordinator, Owen Ward, Co-ordinator, Laura McHugh and Frank Kelly, FAS. Association, the HSE West’s > Literacy and Numeracy Diarydates Oral Health Booklet

28th June > President Mary McAleese is Now Available scheduled to visit Clonmethan Lodge, Intellectual Disability Service at Oldtown, Co Dublin 7th & 8th September > “Violence – a Public Health Issue” 5th Population Health Summer School, Brookfield Health Sciences Complex, University College Cork. 11th September > “Celebrating Innovation – Therapeutic Work with Families and Children” conference, National Museum, Collins Barricks, Dublin. Email: [email protected]

21st September Pictured at the launch of the new oral health promotion booklet, ‘Looking after your Child’s Teeth 0-8 years’, were from (LtoR) Colette Long, Oral Health Promotion > National Nursing & Midwifery Cornmarket, Yvonne Gray, Oral Health Promotion, Crumlin, In circle Erin Burke and Victoria Denisen with Creche Owner, Nicola Erasmuz, Melissa Denisen, Olive Boran, Oral Health Promotion Naas holding CJ Boran. Informatics Conference Computers & Technology – A Driver for Nursing & Midwifery esearch contained in the WHO International Report of Health The booklet will be of benefit to various disciplines involved in Health Innovation Email: Behaviour in School Children (2000) shows that Irish children rank Promotion including Community Dieticians, Public Health Nurses and [email protected] Rmuch below other EU countries when it comes to dental care. Smoking Cessation Officers. These professionals are key workers in health Barely half of all Irish children brush their teeth more than once a day, and community settings. They are in a position to influence and make more than 75% eat sweets or chocolate at least once in the same period recommendations. Other key areas, which will benefit are the crèche and and 63% consume a can of soft drinks every 24 hours. Compared to nurseries sectors. countries like Canada and Norway our children eat almost four times more sweets and chocolate and drink three times as many soft drinks. Supplies of the booklet can be ordered from A new resource entitled “Looking after your Child’s Teeth 0-8 years” HSE Print & Design, Unit 13, Westlink Industrial Estate have been produced by the Oral Health Promotion Team in Dublin West, Kylemore Road, Ballyfermot, Dublin 10 Dublin South West, Kildare and West Wicklow. Quote reference number 20655.

Summer2006 Healthmatters p9 Healthmatters New Work Practicesin Acute Psychiatric Settings Highlighted

ew work practices in acute psychiatric settings were highlighted recently at a conference in Kerry attended by Nmore than 150 mental health professionals. The conference heard that the practice, ‘Refocusing Acute Psychiatry’, has been piloted in HSE South in the acute psychiatric unit in Kerry General Hospital, GF Unit, Cork University Hospital (CUH) and St Michael’s Unit, Mercy Hospital, Cork. The aim is to introduce change to psychiatric wards in order to improve the acute psychiatric environment for both patients and staff. The practice was developed by Nick Bowles, a senior lecturer in mental health and an independent facilitator of change in the UK. The practice involves changes to clinical practice, nurse leadership, evaluation methods and performance management of change using user friendly tracker systems easily adapted to suit a variety of applications and workplaces. Refocusing has been introduced with a view to enhancing: > Engagement between staff and in-patients, in groups and one to ones, informal and formal > Collaboration between staff and in-patients at all levels, i.e. from decisions affecting individuals to those which affect many people and concern the running of the ward > Maintenance of a calm, tranquil ward which feels (and is) safe 2,600 competitors in HSE > Ensuring a clear structure to the day and a well managed environment and subsequently to have: Community Games Festival at Mosney > Higher patient satisfaction and lower complaints > Lower levels of violence and aggression, embers of the Kerry Cross Country Team (pictured the children and their managers. > The correct lengths of stay and low readmission rates above) were among 2,600 competitors Wicklow County Secretary Mary Brett-Kelly said: “It was > A drug and alcohol free environment M who participated in the HSE Community Games great to see such a wide variety of healthy choices for > Higher levels of patient engagement in treatment Festival of Sport & Cultural Activities in Mosney in May. everybody. The fruit baskets were a particularly welcome > High staff motivation and low staff sickness They were joined by 400 managers, 250 officials and 8,000 addition.” spectators and all helped to make the Festival a very Donal Buggy, Community Games CEO said he was PJ Hartnett, A/Practice Development Co-ordinator, Kerry Mental successful event. delighted that the Festival Weekend was so successful. Health Services, said: “Refocusing is essentially about enabling The Festival is a fun way to introduce children to a variety of “By sponsoring 200 free places on our sports introduction change in acute psychiatric wards which will benefit both staff sports and cultural activities. Community Games is a unique programme we encouraged more participation in our activities and patients. This practice is new to our psychiatric units but has organisation because it concentrates on participation rather and promoted our theme of ‘active healthy lives’ ”, he said. already demonstrated positive changes. Initial results on our pilot than competition, on making friends and enjoying yourself More than 500,000 young people will participate in the HSE sites are positive and indicate changes to clinical practice that put rather than taking home medals. Community Games this year and over the next three years the greater emphasis on high levels of patient engagement and Changes to the weekend catering menus, inspired by the organisers are hoping to increase the number of participants therapeutic activities. HSE involvement with Community Games, were welcomed by to one million. Rotunda Hospital Visit 90% Success on Galway Detox Programme eople with alcohol problems are Day Hospital where the service user is benefiting from an Outpatient Alcohol requested to attend without having P Detoxification Programme at the Day consumed alcohol that day. As well as an Hospital, Brackernagh Health Centre, assessment of the individual and his/her Ballinasloe, Co. Galway. alcohol consumption history, an assessment The service was established in September of the home environment suitability and 2004 and to date 90% of those referred have adequacy of home support for outpatient successfully completed the Programme. detoxification is carried out. If the various The Programme aims to provide more inclusion and exclusion criteria are met the choice for service users and general procedure can be commenced. practitioners and reduce unnecessary Following this the patient will visit the Day admissions for inpatient treatment. The Hospital on a daily or more frequent basis Programme is provided by a team within the where continuing assessment is carried out East Galway Mental Health Services as a and there is ongoing liaison with the general service to local general practitioners. practitioner as appropriate. Patients sign a Detoxification means treatment designed to consent form and contract for the procedure. ameliorate and control the medical and Information is supplied to both the patient and psychological complications that may occur their supporter. Patients can commence temporarily after a period of heavy and medication 12 hours after last consuming sustained alcohol consumption, i.e. alcohol. Prior to completion of the Professor Brendan Drumm, CEO of the Health Service Executive recently visited the Neonatal Unit in the Rotunda interventions to help withdrawal symptoms in detoxification the patient is seen by one of the Hospital, Dublin. Dr Michael Geary, Master, Dr David Corcoran, Director of Paediatrics and Orla O’Byrne, Neonatal Clinical Midwife Manager 3 accompany him. those who are physically dependant on alcohol. addiction counselling team who will plan An initial assessment is carried out at the further appropriate rehabilitation. p10 Healthmatters Summer2006 Healthmatters Nurses and Midwives Play Pivotal Role

At the Nursing & Midwifery Planning and Development Unit, 3rd Annual Conference in Fitzpatrick’s Shannon Shamrock Hotel, were from (LtoR): Kate Tierney, Margaret Curran, Dorcas Collier, Fiona Rigney.

he Nursing and Midwifery Planning and conference held in Tullamore was ‘Managing Development Unit (NMPDU) in Limerick, and Sustaining Quality Healthcare through TClare and North Tipperary chose “Person Diversity and Skill Mix’. Centeredness” as its theme for its annual Opening the conference, Aidan Browne, New Country, conference in April. National Director, Primary Community and The two keynote speakers at the conference Continuing Care (PCCC) said that nurses and were Prof. Brendan McCormack who is attached midwives will play a pivotal role in the to the Royal Group of Hospitals, Belfast and Dr. integration of services going forward. New Job,First Keith Hurst, a Senior Lecturer in Health and Patrick Glackin, Director of the NMPDU, Social Care at Britain’s Leeds University. gave an overview of the major projects and Professor McCormack addressed the initiatives being led or facilitated by the Unit at conference on “Person- Centerdness and national and Area level. Practice Development” while the theme of Dr. Projects of a national priority include the Impressions Hurst’s address was “Selecting and Applying National Recruitment and Retention Project, Methods for Estimating the Size and Mix of addressing the skill mix agenda, and the By Olawale Olanrewaju, Senior Physiotherapist Nursing Teams within an Irish Context”. development of an Influenza Pandemic Training Meanwhile, the theme of the NMPDU programme.

inally, I had made the journey out of the health system. The rich few could afford to travel wilderness into a land of opportunity. These to the developed world for expensive treatment Fwere the words I told myself not knowing while the others were left with unaffordable and what awaited me at the other end. I had just dilapidated health care. The second problem crossed the great divide, and only two things were which seems universal is the strive for validation in my head: ‘find a job and get more education. and evidence-based practice which requires a The first thing that hit me was the cold and lot of funding and research resources. This is then nostalgia, not knowing when I was going to also very present in Ireland. see my family again and of course the tropical My life and experience took a significant turn sunshine. It was 5am in the morning and I had to when I found a new job against the odds of catch the 6am bus to work. This wasn’t a immigration, competition and with the favour of a problem as I was used to manager who believed in me. waking up early back at After four months, I was home to avoid heavy glad to be working in an area Pictured at the NMPDU Regional Conference in Tullamore were from (LtoR): Ms. Petrina Duff, Researcher and traffic on route to work. Finally, I of interest which was Ms Kathleen Griffin, Nurse Practice Development Co-ordinator for Public Health and Community Nursing, My first day at work was neurology and geriatrics. The NMPDU. interesting, as I was had made the major problem was with the familiar with the setting few incidences of xenophobia and modalities. The major “journey out of experienced, which was a big difference was in the contrast to where I came from. National Perinatal Epidemiology model of the modalities the wilderness Racism was hardly noticeable which were comparatively into a land of in Lagos and if you saw a Centre at CUMH to Monitor Irish Births more advanced than the white man on the street, you ones back at home, but opportunity waved to him. National Perinatal Epidemiology Centre each birth the same principle of Finally it is worth will be established at the newly built > Standardised data collection across all treatment applied. My mentioning that I have A Cork University Maternity Hospital. maternity units with one labour ward system colleagues at work were cordial and my wonderful colleagues, clients and recently The Centre, scheduled to open this autumn, being used throughout the country. induction was brief because they needed all resumed” studies. So how does this small town will mean that every time a mother gives birth Professor John Higgins, Chair of Obstetrics the help they could get. boy end up in one of the most vibrant economies in this country, the important interventions, the and Gynaecology Services, expessed his It was my third day and all I could remember in the world? It is at this point I remember my positive outcomes and the complications will delight at the establishment of the centre was sitting alone at my table in the canteen and mother’s words in our own dialect; ‘remember be recorded and analysed. Unusual traits will which he says “will mean that the HSE will watching my colleagues eat at the other end of the son whom you are’ (translated verbatim) be easily and quickly observed and most hold information on all Irish births in a the room. I guessed my welcome party was over meaning know where you’re coming from and importantly acted on. It has been designed central location”. and missed my friends at that point, but luckily a where you’re heading in life. based on existing Australian models This should greatly improve national Chinese house officer joined me not long after Olawale Olanrewaju is a Senior The immediate priorities for the centre will be research and innovation in this area and for a brief chat. Physiotherapist working with the HSE in North to develop: ensure that we are working in a unified manner Physiotherapy in Nigeria had two major Clarence Street in Dublin city. > A single identical maternity chart for every throughout the county,” he added. problems, one specific, and the other ubiquitous. Olawale can be contacted at maternity hospital in Ireland The Centre is being established under the The first problem was lack of funding which 086-8703588/8566419 or > National agreed perinatal data set: including auspice of the Department of Obstetrics and didn’t only affect physiotherapy but the entire [email protected] all relevant interventions and outcomes for Gynaecology, University College Cork.

Summer2006 Healthmatters p11 Healthmatters Population Health

By Dr. Pat Doorley, National Director of Population Health

What is a Population Health This means, amongst other things, Population illness like heart disease and diabetes in primary comprehensive database to support inspection approach? Health disseminating a Population Health care rather than in hospital. The evidence shows of all premises covered by tobacco legislation The overarching goals of a Population Health approach as widely as possible in the that we can prevent many complications of and the development of linkages with the approach are to maintain and improve the organisation these illnesses and that we can get equally good Environmental Protection Agency to work in health status of the entire population and to The Population Health function comprises of outcomes in Primary Care and at the same time partnership with them on threats to reduce inequities in health status in society. The the disciplines of Public Health Medicine, Health prevent hospital admissions. environmental health. Population Health approach is used in a number Promotion and the former NDSC now HPSC of well developed health systems throughout the (Health Protection Surveillence Centre). Public Catherine Murphy – Patrick Lynch – world such as the Canadian health system. Health Medicine was formerly organised around Health Promotion Transition and Change eight separate departments and Health Leads the Health Promotion The role involves working with The Population Health Approach Promotion around ten separate departments. function. Health Promotion the Population Health is about: The Health Protection function integrates this programmes are conducted in Management Team to > Planning for health and not just health work with that of the Communicable Disease settings such as schools, work > manage the immediate services Control function so that the impact of places, communities and the health service transition from the former health board > Equity as a strong value in the health system. communicable disease is minimised. itself. An important element of this work is the structures to the HSE Not simply fairer access but also reducing All these disciplines are now being brought creation of relationships with other sectors such > Plan for the longer term change programme the socio-economic gradient in health status together in one national function that will allow as Local Sports Partnerships led by John Treacy. involved in developing the new population > Applying research evidence to improve specialisation at national level and therefore Health Promotion staff also work with local health function. health outcomes. This applies to planning, greater influence on the delivery system. authorities to promote physical activity, the Patrick is also heading up a national project to policy and clinical interventions The public health function is organised almost County Development Boards, the Food Safety develop a Strategic Portfolio Management > Adopting a formal needs assessment entirely on a national basis but with a strong Promotion Board to promote healthy eating and capability for the HSE. In this regard the approach to identify gaps in services and local infectious diseases component. The the Department of Health and Children to National Population Health Directorate is identifying the best balance of investment on Assistant National Directors in this area are: support policy making. adopting a programme management the basis of anticipated outcomes and cost The HSE is conducting some innovative approach to the way it does its work. > Reorientation from hospital to primary care, Kevin Kelleher – projects in relation to tackling obesity e.g. health promotion and self management Health Protection getting GPs to prescribe physical activity for > Provision of services which are integrated He heads up the area of Health their patients, the establishment and running of within the health sector and with those of Care Acquired Infection for the low income nutrition projects and work with the other sectors HSE. His job is to integrate the Irish Heart Foundation and schools to promote > Working with other sectors to improve health national infectious disease physical activity for children. The HSE > Demonstrating a good social return for surveillance function with that of the national sponsorship of the Community Games is not just investment in health infectious disease control function. All public a communications exercise aimed at profiling health staff working in this area will come under the HSE but also offers us the opportunity to Newsbrief A key role of the Population Health Directorate is the Health Protection function. work in a more sustained way with local the provision of knowledge, information and communities to promote physical activity. evidence to support corporate decision making Dr. Marie Laffoy – Implementation and strategic planning in response to identified Planning & Evaluation Gavin Maguire - of Strategic Task needs. Approximately 700 people are now Leads on planning and Emergency Planning working in Population Health. evaluation for the Population Population Health is leading on Force on Alcohol While health status in Ireland is at an all time Health Directorate. She works the improvement of Recommendations high with life expectancy for men at 75 years with the lead Assistant Directors preparedness for an Influenza and for women at almost 81 serious inequalities and other directorates on planning issues. She Pandemic. The Directorate is The HSE has established a national remain. In addition to this, problems such as links with SPRI , whose aims the Directorate will working with the NHO and PCCC on the committee to oversee and drive the alcohol, tobacco and obesity present a major support as strongly as possible and she also development of specific plans for all hospitals implementation of the recommendations threat to future health. leads on the Estimates process and on specific and PCCC services. An Influenza Pandemic is of the Strategic Task Force on Alcohol. planning projects. possibly the single greatest area of risk for the The committee will be jointly led by How do we improve the health of HSE. Because of the threat of bio-terrorism and Health Promotion and Public Health the population? Dr. Davida De La the more immediate threat of an Influenza Medicine and will have representation > By improving outcomes of healthcare Harpe – Health Pandemic we are now improving our public from Primary Continuing and Community > By influencing the wider determinants of Intelligence Leads on health infrastructure to enhance public Care (PCCC), including Primary Care – health e.g. poverty, environmental factors. the following areas: preparedness for a possible Influenza Pandemic. General Practice, Mental Health, These are outside the traditional remit of the > The development of a health We have also participated jointly with the DoHC Addiction/Drug Services, Occupational health service but should not be outside our research strategy for the HSE in a major EU exercise to test preparedness for a Health, the National Hospital Offices sphere of influence. > The sourcing of evidence on best practice smallpox attack and for an Influenza Pandemic. (NHO) and Human Resources (HR). relating to specific interventions in planning The national and local structures for The committee will establish an The Directorate is supporting the re- and policy supporting the process of putting Emergency Planning have been agreed by the external forum to work with other sectors organisation of service delivery so that its impact this evidence into practice. This has major HSE. A lot of work has already been done in this to implement all of the on health and social wellbeing will be increased. change management implications area with approximately 200 staff throughout recommendations. A Corporate Policy on > The critical analysis of data to support the HSE involved. Alcohol and Catering is to be developed Teams planning and evaluation. by a committee led by Health Promotion. National Director – > Enhancing capacity in health technology Martin Devine - A national breastfeeding Dr. Pat Doorley assessment and health impact assessment Environmental Health implementation committee, being is supported by seven Assistant > Providing specific support to individuals and Martin has a strategic role established by the Population Health National Directors. groups within the HSE on identified priority working with the DoHC on the Directorate, will oversee the roll out of The Directorate aims to areas development of National the Department of Health and Children’s support the HSE over time to Areas where evidence might be applied to Environmental Health Planning and will have a five year Breastfeeding Strategic Action become a population health organisation ie one improve service planning and delivery include lead role in its implementation for the HSE. His Plan (2005). which sees itself as being accountable for the organisation of cancer services and the role also involves working with the Office for improving health outcomes and health status. treatment of more people who have long term Tobacco Control to ensure the development of a p12 Healthmatters Summer2006 Healthmatters Improving Outcomes for Healthcare

Health Intelligence discharge planning and the establishment of the cervical screening project which will be in the short term. The Directorate has been The Population Health Directorate has supported minor injury units rolled out nationally within the next 18 months. working with the Institute of Public Health (all the review groups on Tertiary Paediatrics and the > Re-orientation from hospital to primary care, However, any screening programme will only Ireland body) to develop the tools for formal HIA North East Hospitals with critical appraisal of the health promotion and self management. save lives if it achieves the best possible quality. and to ensure that HSE staff receive training in relevant hospital activity and has supported the There is solid evidence that patients with A variety of indicators have been developed as this process. teams in generating solutions which will yield chronic diseases such as diabetes, heart part of the quality monitoring process to ensure the best patient outcomes. disease and chronic lung disease can be that the Programme will in fact save lives. Health Care Acquired Infection The National Renal Services Review led by managed by primary care teams, with the (HCAI) Dr. Liam Plant on behalf of the National potential to achieve good or better outcomes Expert Advisory Groups and SPRI HCAI is one of the major risk management Population Health Directorate has reviewed the than in hospitals. The Directorate is currently Population Health will be strongly represented issues for the HSE. Currently a major study is epidemiology of renal disease. On the basis of working with PCCC and NHO to develop a on all the Expert Advisory Groups when they are being conducted in most hospitals in the State in this review, and also taking into account the high quality model of chronic disease established in order to support the HSE to order to get a benchmark against which we can epidemiology of diabetes and high blood management which will improve outcomes adopt this approach. measure progress. This will allow the HSE to pressure and future demographic patterns, we and prevent local admissions. One of the strongest levers for population give information to the public which will be more can predict a growth in the number of dialysis health input into the reform will be its meaningful than that which we have had to date. places needed of about 200 per year for the Cancer Care contribution to all the Expert Advisory Groups foreseeable future. We can also say that there is The evidence from all around the world and subsequently to SPRI (Strategic Planning Health Promotion a need to improve the National Transplant indicates that better cancer care is achieved and Reform Implementation Group) where Health Promotion is about empowering people programme as transplants give better quality of through the following measures recommendations from EAGs will be prioritised. to improve their own health. We can do this by life and better value for money in the long term. 1. Centralising cancer services so that you get > Giving people more information about health a critical volume of patients Model of Care for 2007 and the determinants of health, by Putting the Evidence 2. Care delivered by highly specialised multi- Estimates: conducting health promotion programmes in into Practice disciplinary teams working in an integrated In the context of the 2007 Estimates Population settings such as local communities, schools Policy and planning need to be evidence based fashion Health will be drafting a direction document on and workplaces. just as much as clinical interventions. The 3. Teams that have put in place regular quality high level priorities to enable the HSE to make > Ensuring that public policy including policies practice of evidence based health care, and audit programmes. the difficult choices as between investment in of departments other than health are therefore, is very much about change and The Directorate will be working with the NHO to different areas through SPRI. conducive to public health. reform. It requires critical appraisal skills, ensure that cancer services are organised to The Population Health Directorate is currently influencing and change management skills. yield better patient outcomes. Health Impact Assessment of establishing groups on promotion of Important areas of health service planning Policy (HIA) breastfeeding, alcohol and catering policies in where we need to do more to put the evidence Cancer Screening The Population Health Directorate made pre- the workplace, and a group to implement the into practice include the following: There is evidence that we can save lives budget submissions to the Dept. of Finance in recommendations of the strategic taskforce on > Implementing high impact measures such as through population screening for a limited relation to the positive health impact of tobacco alcohol. Major priorities identified for 2006 hospital avoidance programmes ( augmented number of conditions e.g. cervical cancer and and alcohol taxation. Increasing taxation on include smoking, alcohol and obesity. Many community supports for those most at risk of breast cancer. these two products is the single most effective problems can be prevented through better admission ), medical assessment units, early Population Health has been leading measure in reducing harm from the substances lifestyle or better public policy. Judy Waterlow updates Irish Nurses onRevised Waterlow System

udy Waterlow, who developed the world worked closely with the team. By the end of renowned Waterlow pressure ulcer risk 2004, an update of Waterlow was proposed and, Jassessment scoring system, was in Ireland as Judy was convinced that the evidence recently to update nurses on revisions to the produced by the project team was valid, she Waterlow Manual at a specially convened readily agreed to update Waterlow worldwide in conference in Tullamore, Co. Offaly. line with the Queensland findings, giving credit The Manual, originally produced in 1994, was to the work carried out by Queensland Health. revised following a large-scale research Revisions to the manual include build/weight Staff from the Nursing and Midwifery Planning and Development Unit and fellow speakers pictured with Judy programme at the Prince Charles Hospital in for height now quantified using BMI. Waterlow, who was in Ireland to update nurses on revisions to her Pressure Ulcer Prevention Manual. From Brisbane, Australia. Terminology and definitions have been updated, (LtoR): Patrick Glackin, Head of NMPDU HSE based in Tullamore, Jackie Stephen, Consultant lecturer and practitioner in tissue viability, Worcestershire Primary Care Trusts, UK, Bernadette Kerry, NMPDU Tullamore, “I was approached by the Director of Nursing of such as doubly incontinent is now referred to as Rupert Waterlow, Judy Waterlow and Anthony Fitzpatrick, Regional Nurse Practice Development Coordinator, the Prince Charles Hospital, Nancy Magoyinovic, faecal and urinary incontinence. Definitions Mental Health, HSE West. in 2000 as Queensland Health wanted to produce were added in skin type visual risk areas and guidelines for pressure ulcer management and mobility definitions were extended. on pressure ulcer risk,” Judy said. The conference was organised by the prevention. They had conducted a study The Appetite Indicator has been replaced by a The detrimental physical, psychological and Nursing and Midwifery Planning and comparing Braden, Norton and Waterlow, and malnutrition screening tool developed and social effects of pressure ulcers on patients Development Unit of the HSE based in decided to use the Waterlow system as their risk validated by an Australian research team in 1999. have been well documented. It is also accepted Tullamore. Copies of the updated Waterlow assessment tool,” Judy explained. “I was particularly pleased with this update as that pressure ulcers are in general associated Pressure Ulcer Prevention Manual are available Over a number of years, a team at the hospital over the years it had been recognised that a with considerable morbidity. Prevention is seen in both hard copy and download options by conducted the research programme and Judy person’s nutritional status is an important factor as an important clinical and humanitarian issue. visiting www.judy-waterlow.co.uk

Summer2006 Healthmatters p13 Healthmatters New Finance Structures and Goals By Liam Woods, National Director of Finance

he overall aim of the Finance Directorate will shortly be arranged in each new area Mark Fagan part of the reform of health services in the East is to provide strategic and operational where we can have an open forum for Assistant National Director of and the establishment of the ERHA and Area T financial support and advice to the discussion and I look forward to engaging Finance ( Capital and Value for Health Boards, Stephen was appointed as various streams of the Health Service Executive with you in this process. Money ). Mark Fagan joined the management accountant with the Northern Area in achieving the organisational goals of Last year was a particularly challenging year ERHA in February 2002 as Health Board in 2000 and Director of Finance in providing high quality , integrated health and for Finance staff with the preparation of Regional Financial Accountant 2002. Stephen is a Fellow of the Chartered personal social services. accounts and changes in accounting and after working in the Technology Sector for the Association of Certified Accountants and holds a To achieve this aim the Finance Directorate reporting formats. All targets in reporting and previous six years. He has an MA from Trinity post graduate certificate and diploma from Dublin has set four key objectives for the immediate audit were achieved and I would like to take College, is a member of the Chartered City University in the Management and Application future and these goals are now being actioned. this opportunity to thank each and every one Association of Certified Accountants (FCCA) of Information Technology in Accounting. The objectives are: of you for your contribution in helping us to and recently received an MBA in Health achieve and deliver on the demands placed Services Management from UCD and RCSI. Raymonde O’Sullivan > To improve the overall Financial Management on us. The Assistant National Directors of Assistant National Director of of the Health Service Executive in relation to Finance have now been formally appointed Declan Lyons Finance (Southern Area). expenditure and ensure that the level of as follows: Assistant National Director of Raymonde holds a Bachelor of voted expenditure is not exceeded. With this Finance ( Dublin Mid Leinster). Commerce degree and is a Fellow objective in mind systems and business Valerie Plant Declan joined the Public Service of the Institute of Chartered processes have been developed to enable Assistant National Director of in July 2000 as Director of Accountants. She commenced proper vote accounting reporting pending Finance ( Annual Financial Finance for the former South her career in health with the Southern Health the implementation of a National Financial Statements and Governance). Western Area Health Board. He Previously Board in 1991 as Finance Officer, having worked System. Systems have also been developed to Valerie is an ACCA graduate and worked for Borden Ireland Limited, the Irish milk previously in private practice. Raymonde was enable Income and Expenditure reporting at before joining the HSE she was powder division of Borden Inc, an American subsequently appointed Director of Finance of the National Level. This system is now up and Financial Controller in a Dutch multinational. Multinational for 19 years as Financial Southern Health Board in 1998. running and is known as the Corporate Valerie also has a background in the Fast Controller. Declan is a Fellow of the Chartered Reporting Solution (C.R.S) Moving Consumer Goods and Medical Association of Certified Accountants. Liam Minihan Currently, timely standard and consistent devices sector. Assistant National Director of reporting and forecasting is being further Stephen Mulvany Finance (Western Area) Liam developed to ensure that expenditure is Paddy McDonald Assistant National Director of Minihan B.Comm,FCCA,CPFA, recorded and monitored to facilitate Assistant National Director of Finance ( Dublin North East ) was Director of Finance with the management action as required. Finance ( Vote and Treasury) Having served in various posts in former Western Health Board Paddy holds a Bachelor of the Local Authority Service, where he also held the posts of > To assist in the delivery of enhanced Commerce degree and a Stephen joined the Health Service Finance Officer and Management Accountant. accountability and value for money. Masters degree in Public in 1998 where he initially worked as the Industrial Prior to this he gained ten years experience in To achieve this objective the implementation Administration , he is also a member of Relations Officer for the former Eastern Health the UK Public Sector in London following on of National Financial Controls is proceeding . the Chartered Institute of Management Board. Following project management roles as from some private sector experience in Ireland. Standard Accounting policies for the H.S.E. in Accountants and the Chartered Institute accordance with best business practice are of Secretaries. Paddy has worked in the being developed. A national lead has also Department of Labour, Office of the been appointed to coordinate and drive the Comptroller General and the Department Value for Money programme. of Enterprise, Trade and Employment and Performance was until recently the Director of Finance > To develop a standardised Financial in the Mid Western area. Indicators Managemet framework. A new Finance Staffing structure has now been proposed Maureen Cronin at Corporate and Local level with the aim Assistant National Director of of strengthening the business intelligence Finance (Corporate Reporting) and resource accounting together with Maureen was operating at preparing for the implementation of Finance Director level within the National Shared Sevices. Our aim is to former ERHA for six years prior build on the current Finance function to her current appointment - dealing through systematic training and development with the major voluntary providers, the of staff with clear career paths and Department of Health and former Boards opportunities for advancement. in the Eastern area. Maureen holds a Bachelor of Commerce Degree from > To provide an appropriation account in University College Dublin and is a fellow accordance with the required format for of the Chartered Institute of Certified Government Accounting and vote holders Accountants. Appropriation account formats and reporting requirements have now been agreed with the Kieran Madden Comptroller and Auditor General and the Assistant National Director of principles established for appropriation Finance (Transition to Shared accounting. Services). Kieran is a Chartered Public Finance Accountant and New Structures in addition to several years of Now that new structures have been developed experience at all levels in Corporate Finance he for Corporate and Area level I am hoping to meet has spent almost eight years at Senior as many of the Finance Staff around the country Management level in the Hospitals Network. Attending a recent healthcare conference on Performance Indicators were Geraldine Fitzpatrick, Ed Kelley, to discuss with you the challenges and Kieran was formerly the Director of Finance for Ruth Barrington, Richard Boyle, Cate Hartigan and Michael Scanlan, Secretary General of the Department of Health and Children. opportunities which are there for all. Meetings the Midland Health Board. p14 Healthmatters Summer2006 Healthmatters

Annual Report 2005 My Transition Value for Money Approach From The Will Remain a Key Driver During Hospital to 2006 - Chairperson Community he last twelve months have been very notable achievement during a period of challenging and demanding for major change. T everyone involved in the organisation, “Ensuring that efficiencies derived from the HSE Board Chairperson Liam Downey says in formation of a single organisation are applied the 2005 HSE Annual Report. to improve services and treatment for patients “I am satisfied that very positive progress is essential. This focus on a value for money has been made in establishing the HSE, in approach will remain a key driver during 2006.” managing our resources and in beginning the He gave his warm thanks to management process of reform and innovation that will and all staff throughout the HSE organisation deliver a first class healthcare system,” and health system for their enormous he said. contribution and dedication during a time of Mr. Downey said the Board is highly uncertainty and change. committed to ensuring that the HSE operates “2005 was a year in which the foundations effectively and that it will deliver on the were laid for a new approach to the purpose for which it was established. management and delivery of health care in He confirmed that for the year 2005 the Ireland. I now look forward to the year ahead ake the 2nd right past the blue house > Providing equipment to make daily Board and management of the HSE and to accelerating implementation of the which is on the left, come to a group of tasks easier succeeded in delivering health and personal reform programme for the benefit of patients T trees and then take a left at the small > Liasing with other service providers social services within the allocated budget of and clients who rely on our services,” he crossroads, be careful as it is not sign posted. Despite encountering numerous challenges like €12bn. This was a huge challenge and a concluded. Turn down the narrow road and it is the fourth bad weather, barking dogs and getting lost, I go last house with the red door on the right and out on all of my calls knowing that the there is a monkey puzzle in the garden and Occupational Therapy Manager, Occupational oh……. a crow is just after landing on the pillar Therapy colleagues and any member of the of the gate. multidisciplinary team is just a phone call away. I am sitting in my car scribbling down the Walking out of the house with the red door directions and think to myself I have driven past and monkey-puzzle I provide a card with my that house about ten minutes ago! contact details, say my goodbyes and start the Didn’t notice the crow maybe that’s why I have car. Pulling out of the driveway I look to the right driven past! and see a crow landing on the pillar. Working as a Community Occupational Now where was he earlier? Therapist in HSE West PCCC Services in Roscommon has many challenges. Getting lost Eilish Brady is by far the most familiar challenge I encounter. Senior Occupational Therapist It is times like this finding myself down a road Roscommon PCCC with grass growing up the middle that I wonder why did I ever leave the security of the hospital? Liam Downey, Chairperson of the Health Service Executive presents a copy of the HSE Annual Report 2005 After graduating from university I began my to Mary Harney TD, Tanaiste and Minister for Health and Children. career in an elderly care centre with long term care, rehab and outpatient facilities. I later moved to the hustle and bustle of the busy acute Rewards of Change hospitals. Within the confines of the secure hospital I Will be Enormous-CEO worked closely with the multidisciplinary team Newsbrief he current health transformation many parts of the health service, there are and I was surrounded by people from start programme will only be successful if it several key areas where improvements can to finish. T includes fundamental and sweeping be made.” Despite numerous times ending up on quiet Ian Carter appointed changes to the way we deliver our services, Professor Drumm said a seamless quality lanes in the remotest parts of the Roscommon CEO at St. James’s HSE CEO Professor Brendan Drumm says in service where there is no delay or interruption countryside I can’t help but smile and see the Hospital, Dublin his statement in the 2005 HSE Annual Report. to services people receive as they pass funny side of getting lost when I finally pull up He said central to this must be the between hospitals and the community, and outside the house with the monkey puzzle minus introduction of practices and processes that vica versa, is our destination. the crow! make it easier for all members of the 2005 was a year marked by great After shaking hands and introducing myself I Ian Carter has been community to access the services they need organisational and structural change. As with invariably always hear those familiar words “you appointed Chief and allow people who work in the HSE to all major change initiatives, it created unease mustn’t be from these parts”. Executive Officer of achieve their full potential. and uncertainty. The overall aim of Community Occupational St. James’s Hospital, “We will achieve this by making sure that “I want to acknowledge the impact this Therapy is to assist each individual in Dublin. He was everything we do and every decision we structural transformation programme has had maximising their independence in the activities previously the make is based on what is in the best interests on staff and their dedication to maintaining of daily living in their own home environment hospital’s Deputy of people who are depending on us, within our services during this period. While the The person may be asked to carry out CEO and Operations the resources available.” road ahead may be at times difficult and practical tasks, which gives the therapist a Manager and prior to this was General He also said: “It is our goal to ensure that challenging for people who use our services clearer picture of what the difficulties are. Manager of Acute Hospitals with the the money we spend employing people, and for staff, I am firmly convinced that the After identifying the difficulties the therapist Mid-Western Health Board. Mr. Carter buying services and investing in rewards of change will be enormous. in collaboration with the client will aim to solve has also held senior hospital infrastructure delivers the maximum possible “I would like to take this opportunity to practical problems by: management posts in the UK and Saudi return in terms of the quality of the services thank every single member of staff employed > Providing advice and information on Arabia. St. James’s Hospital is a 945-bed we provide. directly and indirectly by the HSE for their alternative methods of carrying out tasks academic teaching hospital, the largest “While we are currently achieving this in commitment and contribution.” > Providing advice and information on of its type in Ireland. adaptations to your home

Summer2006 Healthmatters p15 Healthmatters A New Direction for Healthcare in the North East

Improving Near Term community centre or local hospital. Management at Safety and The first item on the Steering Group’s agenda will be the Regional Hospital will only be for those patients who need Achieving to act promptly on the Report’s recommendations to 24/7 acute emergency care and complex planned care. Better improve patient safety in some specific areas and to better The development of these clinical networks will have a Standards: understand the current pressures within the system. significant and positive impact on the way services are delivered An Action Plan for These include: across the region. Health Services in > Improving critical care by centralising all level 3 care,where As a first step towards achieving this, the Steering Group will: the North East. patients need ventilation and other organ failure support, at > Give full and detailed consideration to the Report ’s long term Our Lady of Lourdes Hospital, Drogheda. recommendations; he Health Service Executive > Relieving pressure on general surgery services at Our Lady ’s > Engage with the different groups in the region and their (HSE) has published a report on Hospital, Navan, by arranging for emergency surgery (which representatives; Tthe provision of hospital services involves on average of only 4 admissions a day) to transfer to > Consider the most suitable location for the new Regional in the North East, covering Counties Our Lady of Lourdes Hospital, Drogheda. Hospital; and Meath, Louth, Cavan, and Monaghan. > Improving the clinical outcomes for major planned surgery, > Prepare an implementation strategy and develop a work This Report was commissioned by the HSE following a series of particularly cancer,by arranging for patients to be operated on programme to deliver world class health services in the clinical incidents in the North East region. by sub-specialist surgeons working in teams. North East. It was completed by UK-based Teamwork Management > Improving the local response to emergencies by increasing Services Ltd in May 2006. the deployment of advanced paramedics and ambulances, Background to longer term It provides an assessment of existing acute hospital starting in Cavan and Monaghan. recommendations services covering counties Meath, Louth,Cavan, and Monaghan > Commissioning a patient dependency study to establish The Report indicates that there is a clear international trend and makes a series of short, medium and long term current hospital admission patterns and basis for developing towards transferring as much routine planned care as possible recommendations. the implementation strategy. to local settings and centralising only specialist acute services The Report concludes that the present system, where five local to Regional Hospitals. It sets out the evidence from Australia, hospitals deliver acute care (services for people with severe Longer Term Canada, USA, New Zealand and the UK. illness or disease) to relatively small populations is exposing The Report ’s longer term recommendations revolve around the This is based on the principle that hospitals that have a patients to increased risks and creating additional development of clinical networks which will provide patients with sufficient ‘critical mass ’ of patients are better placed to maintain professional risks for staff. the appropriate type of care where and when they need it. Care safe, effective, high quality 24/7 services, and therefore deliver It points out that the current system with patients either being will be mostly local, within the home, primary care centre, better results for patients. treated in local hospitals or in hospitals in Dublin is not serving the community well,is unsustainable and has to change. Clinical Networks will However, the Report also highlights that there is an have a positive impact unprecedented opportunity over the next 10 years to develop on the way services a very high quality responsive emergency and planned care service, are delivered. in line with international standards, by developing local services within existing hospitals and other local centres supported by a new Regional Hospital. Action Plan The Report points out that the difficulties in the North East are largely a reflection of the shortcomings in the hospital system itself; the way it is organised and how services are distributed. In order to provide easily accessible and sustainable local and regional services, it recommends a three stranded action plan based upon international quality standards: 1. The development of local services,with the existing five hospitals and primary and community care providers playing central roles; 2. The development of a new Regional Hospital; and 3. Binding these local and regional services together through a series of clinical networks which are centred around the needs of patients,including networks for Emergency Care, Critical Care, Planned Care, Radiology, Pathology and Chronic Disease Management. Next Steps The HSE is to establish a North East Steering Group to quickly address the issues highlighted in the Report that require immediate attention and at the same time develop a longer term strategy to deliver a world class health service during the next 10 years. Led by the HSE ’s National Hospitals Office,the Group will have representation from the Department of Health and Children and key stakeholders such as clinicians and primary care providers. It will engage with community and patient advocacy groups. The Steering Group will have a full time executive with a dedicated overall Project Director and team of senior clinicians based in the region. p16 Healthmatters Summer2006 Healthmatters HSE and An Post Unite to Deliver Health Information to Older People he Health Service Executive (HSE) and An Post have collaborated in the launch of a health information resource for older people. Over a two week period, older people in the Midlands Treceived a comprehensive information pack on a number of health-related topics when they collected their pensions from their local Post Office. In total, 15,000 packs were distributed through 92 Post Offices in Laois, Offaly, Longford and Westmeath. The information resource was originally developed by the former North-Western Health Board. It was adapted by the HSE Dublin Mid-Leinster in consultation with the consumer panel for older persons and their representative bodies. The resource included useful information and contact details about: > Healthy eating > Blood pressure and cholesterol > Hearing > Slips, trips and falls > Flu vaccination > Feet > Teeth and dentures > Eyesight > Fire safety > Urinary incontinence > Coping with bereavement > Coping with Depression > Dementia > Road safety > Making a will

Contact details for the Citizen Information Centre, Carers Association, Senior Helpline, HSE Pictured at the launch of the Health Information Packs at Tullamore Post Office from (LtoR): Bill Ebbitt, Regional Information Line, out of hours doctor service and emergency services were also included. Health Promotion Director, Geraldine Delorey, Health Promotion Officer for Older People in the Health Promotion Service, HSE West. Fionn Gallagher, Chairman of the HSE’s Consumer Panel for Older People, Una O’Mally, HSE “Accessing relevant health information is a huge challenge for people, and distributing health Health Promotion, Barry Lambe, Health Promotion Officer, Barney Whelan, Marketing Manager, An Post, June information is a huge challenge for the HSE. This often leads to a situation whereby those with the Boulger, Senior Health Promotion Officer, and Patricia Slevin, HSE West. greatest need for information about preventable and treatable conditions are least likely to have access to this information,” explained June Boulger, who developed the project for the HSE. also acknowledged the work of Geraldine Delorey who was responsible for developing the resource “Older people as advocates for health and role models for younger generations play an important in the North West, as well as the project team in the Health Promotion Office in Tullamore, namely, role in communicating with families, friends and neighbours. This resource gives information and tips Barry Lambe who was responsible for editing the resource and the project planning, and Una O’ for leading a long healthy quality life, and we are delivering the information in a way which is easily Malley for communicating with all stakeholders. accessed,” she added. An audit on the effectiveness of the project is to be carried out in the near future. For further June thanked the An Post team for their cooperation in getting the project off the ground. June information contact: Barry Lambe, Health Promotion Officer 0506-57800. The History of Medicine Drop-InHealth and Related Topics

he historical Edward Worth Library, based The reasons for Worth’s decision to put his Advice Café in Dr. Steevens’ Hospital, Dublin, hosted a treasures into what amounted to an untried Tseminar called “Studies in the History of experiment in hospital provision are unclear. Medicine and Related Topics” in April when the Since November 2004, a steady programme of assessment and brief intervention for main speaker was Professor Mirjam Foot, an renewal has been under way in the Worth young people. By using the forum of a café, expert on fine book-bindings for which the Library. Maintenance staff have designed and the project hopes to attract young people, Library is famous. installed two ranges of bookshelves and 18th promote drug-free alternatives and show Professor Foot used slides to illustrate the and 19th century pictures have been restored, that it is possible to experience fun without richness and intricacy of the craftsmanship used their frames re-gilded. using alcohol, tobacco and illegal drugs. on old book bindings. More seminars are planned for January-April Good relationships between staff and Dr Edward Worth, a notable Dublin physician, 2007. Book your seat now! Meanwhile, it is clients are seen as vital to the success of the left his valuable collection of books to Dr proposed to hold a series of visits/lunch time project as is the involvement of young people. Steevens’ Hospital. talks for members of staff throughout the A youth committee comprising ten young With one brief interval, all the books have organisation. Further information will be people meets fortnightly and actively remained in their original location since 1733. circulated. participates in developing policies and activities and in the day-to-day running of the café. So far, the project seems to have struck a chord with young people. As one put it: “I like the fact that it’s a place you can chill out and forget the problems you have in the outside world”. Among the services offered at the GAF are: Professor Brendan Drumm, CEO of the HSE at > primary health care, with a full-time nurse; the GAF health advice café in Galway with > peer education, aimed at preventing the Marie Hehir, Foroige Teenage Initiative misuse of alcohol and drugs; > teen health, aimed at delaying the onset of alway Drug Services has developed an early sexual activity among teenagers; innovative drug prevention and health > support services for young asylum-seekers G awareness project targeting young and refugees; people, especially older teens who do not avail > ante-natal care; and of other services. The GAF, is a drop-in health > a Big Brother, Big Sister mentoring advice café offering a range of support programme to help disadvantaged young programmes as well as leisure activities such people develop life skills. as band nights, DJ workshops, dance, drama The GAF is open 35 hours a week and has an and yoga. average of 16 young people in the café at any Pictured at the event were Brendan Prendiville, Library Trustee, Professor Mirjam Foot, Institute of English The GAF aims to encourage healthier lifestyle time. Services are available to all, not just to Studies, University of London, who was a guest speaker, Michael Lyons, Chairman, Worth Library Trust and Professor Bill McCormack, Librarian. choices and to provide health information, risk those most at risk.

Summer2006 Healthmatters p17 Healthmatters Cross-border Approach to the Prevention and Control of Infections

nvironmental, Public Health professionals and provided by the European Union INTERREG IIIA programme, veterinarians from both sides of the border gathered in administered by the Special EU Programmes Body. ESligo in April at a two-day European Union funded event to Commenting on the importance of the event, Dr Jim Kiely, develop a cross-border approach to the prevention and control Chief Medical Officer, Department of Health and Children said: “It of infections which can be passed from animals to humans. is essential that we are prepared in the event of the outbreak of Known as ‘zoonotic diseases’, these diseases include avian any disease. Events like the conference today ensure that all influenza, E-Coli 0157, rabies and Q fever. scenarios are discussed, all parties are able to contribute to The conference was addressed by a range of experts who solutions and protocols and that we are better prepared than we focused on highlighting lessons and good practice learned from would otherwise have been.” previous experiences in relation to the monitoring, control and Welcoming the event, Dr Vinod Tohani, Consultant in management of zoonotic diseases. Attendees also participated in Communicable Diseases, Southern Health and Social Services Speakers at the Co-operation and Working Together (CAWT) European scenario workshops, exploring how they should react in the event Board said: “It is reassuring and also necessary that health Union funded cross border conference on protocols for handling of an outbreak on the island of Ireland. professionals and veterinarians are meeting on a cross border animal to human diseases. (LtoR): Dr Peter Finnegan, Specialist in The next stage will be the development of practical, formal basis to anticipate potential problems and barriers, and also to Public Health Medicine, HSE, Dr Eleanor McNamara, Consultant Microbiologist, HSE, Sally Gaynor, Senior Veterinary Inspector, Dept. protocols between the HSE and Health & Social Services Boards plan the process for handling an outbreak of a zoonotic infection. of Agriculture and Food and Shay Fanning, Public Health Dept. UCD. in Northern Ireland, to allow both jurisdictions to work together in The scenarios exercise, in particular, ensures that when an the event of a disease outbreak. incidence does occur, partnerships will have already developed and humans. Through the INTERREG IIIA programme, Organised by Co-operation and Working Together (CAWT), a across the border and the whole island, and therefore both the European Union has funded a number of these events, cross border health and social care partnership, the event was investigation and control will be more efficient and effective.” designed to ensure countries work together to prevent spread attended by over 100 experts keen to share experiences and Pat Colgan, Chief Executive of the Special EU Programmes of infectious diseases. Similar protocols have already agree common approaches in relation to the investigation and Body which provided the funding for the event said: “Borders are been developed for the control of infectious diseases and management of zoonotic diseases. Funding for the event was irrelevant when it comes to infectious diseases in animals Legionnaires Disease.” Better Patient National Electronic Dental Health Results with Record and Information System

Pulmonary Rehab new National Electronic Dental Health Record and one million clients, to be used. The project is viewed in a positive Information System has been introduced in a number of light by users (Dental staff) and ICT staff. This has been realised A dental areas around the country as part of a national by teamwork at all levels including dental teams using the Programme dental project with further implementations planned. system, the dental service/ICT alliance that has brought the This is a joint ICT/Dental Services project designed to project to fruition and the willingness of all areas to commit time ercy University Hospital (MUH) in Cork has implement a common patient management system across and resources. launched a Pulmonary Rehabilitation programme the HSE. The key to realising the full potential of this system is to ensure M designed to treat patients with any chronic This has resulted in significant benefits for patients. Dental that a team is in place to ensure the effective day to day respiratory illness. services, in common with other community based services, are management of the system so that the database is kept as valid The programme is led by Dr. Terry O’Connor, delivered across a number of geographically separated locations. on an ongoing basis, allowing it to be mined so as to provide the Consultant Physician who is supported by Rob O’Farrell - The central dental information system improves access and health and service information required to maximise the health Senior Physiotherapist, Aisling Donnelly - Pulmonary service delivery in such an environment by ensuring that a full benefit to the population we serve. Technician and Ann O’Mahony - Respiratory Nurse patient record is available to the dental team at any location and Specialist, but also involves the whole multi-disciplinary by supporting seamless transfer of patient care between team. The programme is a series of exercise programmes clinicians, even if they happen to be located at opposite ends of and lectures/education sessions over an eight-week period. the country. Patient appointments can also be made and € The patients are measured against standard outcomes changed very easily from any clinic. CUH Gets 2.8m including cardiopulmonary exercise testing, Hospital There are significant benefits for staff too. Time is no longer Anxiety and Depression Questionnaire and patient spent in filing and retrieving charts. It is also planned that the New Records satisfaction. system will send text-message appointment reminders which will Senior Physiotherapist, Rob O’Farrell says: “It is proving maximise attendance at appointed times. Department to be a highly successful programme. Our pilot study Activity data previously held in individual paper charts, showed improvements in exercise capacity.” appointment books and day books is now automatically and new €2.8m purpose built Health Records Meanwhile, a pulmonary rehabilitation programme located comprehensively derived from the electronic patient record. Department at Cork University Hospital was opened in the South Tipperary General Hospital, Clonmel has The national dental database allows the dental service to look A recently by the Tanaiste and Minister for Health succeeded in significantly reducing the number of hospital at outcomes and compare materials, methods, and interventions and Children, Mary Harney. bed days required by the patients attending it. over time. This can be used to measure performance, contribute The new department is two and a half times the size of the The programme is an eight-week course which patients to service planning or provide answers to the following previous department and has 260 staff. attend three times during week one and twice weekly questions. According to Siobhan Lynch, Health Records Manager: “The thereafter. It involves education, exercise and relaxation. > Who is using the public health dental service? new department will enable a much more efficient working Assessments are preformed during week one and repeated > Who only uses it for emergencies and what is their health environment. The remit of our service is very wide. With one-year post completion of the programme. status? additional space, storage, IT and training facilities and a better Patients are recruited from hospitals nationwide and via > How long on average does it take to provide procedures such working environment for staff, my colleagues and I are looking GP referrals following COPD exacerbations. The programme as fillings or extractions? forward to working in the department and continuing to provide is co-coordinated by a physiotherapist. > Does the type or brand of material we use affect the efficacy of an efficient service to all our colleagues in CUH”. Clonmel was the first hospital outside Dublin to have interventions? Tony McNamara, Hospital Manager said: “Investment in such a programme and was the third such programme to This is the only national project using a single client index, pre- support services such as this is vital if the hospital is to continue be established in this country. populated with PPSN, name, address, and date of birth data for providing excellent services to patients.” p18 Healthmatters Summer2006 Healthmatters

Recovery and Mental Day Care Centre Health A Vision for Change Bealtaine Project Celebrated on Dublin Bus

n art project undertaken by the clients of Cairdeas Day Care Centre, part of A Brú Chaoimhín in Cork Street, Dublin so impressed Dublin Bus that they ran a bus poster campaign during May to highlight the client’s unique craftwork. The project was undertaken for Bealtaine, the festival that celebrates creativity and art in older age. As well as impressing Dublin Bus, the project, known as “Tigín Cairdeas” was also displayed at the headquarters of the Irish Nursing Association and in the foyer of St James Hospital. The clients, along with two students from the National College of Art and Design, Niamh White and Martin Dooney, working with artist in residence, Ann Quinn, built a replica model of Brú Chaoimhín, formerly Cork Street Fever Hospital in Dublin, complete with 18 grandchildren’s toy boxes for props. One lady in individually decorated rooms. her free time crocheted bed clothes and soft “The project is really about reminiscences. furnishings for a number of the rooms. Professor Chris Stevenson, D.C.U., Dr. Margaret Webb, EVE, Limited, Joe Cahill, Chair, Board of EVE Limited Each client was asked to pick a room and “The clients and residents had an enormous decorate it as they wished. This created a lot of amount of fun while working on the House. talk about rooms in previous houses they have They reminisced while they made curtains or he radical challenges posed by the implementation of A Vision for Change, the Report of the lived. They recreated their most favourite painted the structures for the rooms in their Expert Group on Mental Health Policy, was the focus of a conference hosted by EVE Limited rooms,” explains Diane O’Toole, staff nurse at own individual styles,” said Mary Cullen, CNM2 Tentitled “Developing Meaningful Partnerships in Recovery- Oriented Services”. the centre who had the idea for the project. in charge of the Centre. Minister of State Tim O’Malley, in his opening address commended EVE Limited, a subsidiary Rooms chosen by the clients included “Our service is based on the person centred company of the HSE, for their progressive initiatives in developing innovative service models kitchens, pantries, utility rooms as well as approach. This project really proved to us that a based upon the principles of partnership and their belief that people who experience mental bedrooms, bathrooms and lounges. There person can still be artistic and creative illness can and should be facilitated in reclaiming their lives and becoming a valued member of is even an artists’ studio, a games room and regardless of their age Staff here are also society. The Minister singled out EVE’s commitment towards the development of the Clubhouse a library. conscious of and active in presenting this day model in Ireland, a community based member-led initiative for people who experience mental Clients were so enthused by the project that care centre to the wider community in a health difficulties. many spent much of their free time shopping positive light, and we are delighted that this To find out more about Recovery Initiatives in EVE Limited email: [email protected] for items for the house or searching their project has achieved that,” Mary added.

Properly address your can be difficult to read and difficult to scan. sending you emails that you are on leave and EmailEtiquette 1. email messages Fonts such as Verdana or Arial are not contactable. Most email applications, allow There are two main addresses fields, these are recommended for Accessibility reasons. you to automatically set this up. Within Microsoft the To and Cc. The To field is used for people you Outlook, this can be set as follows. are directly addressing and the Cc field is used Always properly sign mail was originally used as an for people you are indirectly addressing. It’s 5. your emails 1) From the top tool bar, select Tools and informal means of communication. important that you only copy those people that You should always sign your emails as follows: Out of Office Assistant EHowever in recent times it has become need to be copied. 2) Click the Option “I am currently out of an essential business communication tool Name, the office” used within the HSE. Because of this, it is Always include a meaningful Title, 3) Type in your message – something along important that we use the same business 2.subject line in your message Department / Section, the lines of : etiquette in our email correspondences as This will give the recipient some indication HSE Organisation, we would with all others and it is important regarding the contents of the email. Location, I am out of the office until the 22nd August. to remember that the effect is the same as Contact phone number If you have any urgent queries please contact sending a typed letter on the organisation’s Keep messages brief and to my colleague Paul Johnson at 01 6352333 notepaper. 3.the point Again fonts such as Verdana or Arial are E-mail to multiple addresses and to There is nothing worse than scrolling recommended for Accessibility reasons. Thank You mailing lists such as ‘All Users’ which exist through long replies. Where possible always Most email applications, allow you to Jim Smith for internal communications, must be summarise your points. Outline them in small automatically sign your emails. Within Microsoft Click Ok used responsibly and correctly to prevent and precise paragraphs that can be easily Outlook, this can be set as follows! a reduction in service quality to all systems read and understood by the intended recipient. 1) From the top tool bar select Tools users. and Options In addition to the general guidelines, emails Use proper English & 2) From the Options Menu, select to lists should be TEXT only. No attachments 4. Grammar Mail Format are permitted. Any additional information Use proper English and do not use all capitals, 3) Select the Signatures button should be placed on the intranet and linked as it may look like you’re shouting. To 4) Select the New button. to from the e-mail. emphasises important points use asterisks or 5) Enter your Name & Click Next If you are not set up to enter content on bold formatting. Make sure you always perform 6) Now enter your Contact Details the intranet or if you are unsure as to who a spelling and Grammar check on your message and click Finish. enters content for your area please contact before you send it. It is important that the 7) Click OK & Apply your local helpdesk. spell check Dictionary is set to English (Ireland). It can be checked by clicking on the EN near Set up Out of The following outlines a number the right hand corner of the bottom toolbar 6. Office Reply of simple tips for better email and selecting. If you are out of the office on leave, set up an etiquette: Remember eMails written in script type texts Out Of Office reply. This will notify anyone

Summer2006 Healthmatters p19 Healthmatters Online Library Services www.hselibrary.ie goes Live! Newsbrief

Access to the majority of these resources is free Denis Fenton, for all e-Library users. However, many of the Director of Human electronic journals and some of the electronic and databases require an ATHENS password, Resources HSE which is available to all staff and students South Retires working or training with Health Service Executive. It is envisaged that the range of resources Denis Fenton, HR Director, HSE South available will be extended and developed over recently retired after a 38-year career the coming months and years to provide with the health services. In 1969 he comprehensive subject coverage to reflect the started off in St. Finan’s Hospital, commitment of the HSE to supply high quality, Killarney which was under the remit of evidence based information to all staff at the Kerry County Council at that time. In point of care. 1971 the hospital was transferred to the This in turn will facilitate all staff groups - Southern Health Board by which time medicine, nursing and the allied health Denis was a staff officer. professions, management and ancillary staff to: In 1974 he moved to the North > Gain ready access to their professional Eastern Health Board (NEHB) and knowledge base worked in hospitals in Monaghan and > Provide them with the best available evidence Navan eventually becoming the NEHB’s to inform their practice training officer. Five years later he Back Row (LtoR): Bennery Rickard, Regional Librarian, National Shared Services; Tony Linnane, Regional > Sustain their continuing professional transferred to the Midland Health Librarian, HSE West; Gethan White, Hospital Librarian, National Shared Services; Jean Harrison, Regional development Board and spent time in Limerick’s Librarian, HSE Dublin/ North East; Brendan Leen, Systems Librarian, HSE South. Front Row (LtoR): Padraig Manning, Hospital Librarian, National Shared Services; Aoife Lawton, > Provide a vital support for their research hospitals until his appointment as Systems Librarian, National Shared Services; Therese Deegan, Librarian, National Shared Services. activity staff relations officer. In 1984 Denis returned to the How do I register? Southern Health Board where he >Do you need information for your clinical Key information resources available on You will need a computer with access to the remained until his recent retirement. practice? www.hse.library.ie include:- Internet to access the website. Staff throughout Cork and Kerry >Are you studying for futher qualifications or > Fulltext electronic journals Enter the URL: http://www.hselibrary.ie came out in force to honour Denis at engaged in a research project? > Databases of journal articles Select the “Create new account” link in the his farewell function and there were > Do you need help to find the right > Irish Health Publications Archive “Athens login” panel. Ensure you have your many great tributes made to him. information? > A Directory of HSE Libraries HSE personnel number to hand when His overwhelming loyalty to the health HSE Libraries Online provides 24/7 access from completing the registration form online. service and his impartiality in dealing HSE Libraries Online www.hselibrary.ie is the first work or home and also acts as a contact point for Your application for a username and with staff was reiterated by many national electronic library and information service the Irish Health Publications Archive which may password will take 1-3 working days to speakers at the occasion. to be set up in Ireland which is designed for be accessed from any computer with Internet process. healthcare staff working within the HSE. access. The resource was launched in May by The Irish Health Publications Archive is a Need help? Professor Brendan Drumm, Chief Executive of the collection of Irish Health publications including Further help on registration, searching the CT Scanner Service Health Service Executive (HSE). former area boards, Department of Health & databases or accessing the Irish Health up and Running at Professor Drumm also launched a second Children and current HSE publications. The Publications Archive can be obtained: online resource for HSE staff - the Digital Archive documents are all available in PDF format. > by contacting your local HSE Library. To Banty General of Irish healthcare information. The benefits of the Irish Health Publications find your local library search the Directory Hospital The launch took place in Dr Steevens’ Hospital, Archive include: of Libraries on the website by your county Dublin. Dr Teresa Maguire, Head of Research at >Improved access to electronic documents of employment. A new CT Scanner service is up and the Health Research Board, gave the keynote >Preservation of older material > by e-mailing [email protected] running at Bantry General Hospital address. >Preserving knowledge for future generations Published a document recently? (BGH). “This new acquisition provides a HSE Libraries Online provides a gateway to an >Provides a structure for electronic documents If you have published or are planning on speedier and more effective patient electronic library of health information and held on both Internet/Intranet sites publishing a document, perhaps you would diagnosis, which is of great benefit to displays a real commitment to the provision of >Expand awareness of material held consider sending an electronic copy to the people of west Cork and library services to HSE staff. electronically [email protected]. surrounding area,” said Dr Trevor The website is the initiative of a group of HSE Parker, Consultant Radiologist. librarians who have been working conjointly for a “The scanner will enable number of years. The members of the HSE approximately 1,000 patients initially to Regional Librarians’ Group, having looked at best be scanned locally thus avoiding the practice internationally, developed the website necessity of travelling to Cork city. It will with the aim of providing comprehensive high also reduce the demands on our quality knowledge content. ambulance service and other staff due to patient transfers and will increase The two main aims of this website efficiencies at the hospital,.” project are: commented Eleanor O’Donovan, 1. To provide a single point of access to electronic Hospital Manager. journals and databases “We would like to convey our 2. To access the Irish Health Publications Archive gratitude to the Friends of BGH for their fundraising efforts which led to the Healthcare libraries in Ireland traditionally have purchase,” added Ms. O’Donovan been one of the principal sources of information for staff working in the health service. HSE Libraries Online is continuing this tradition by pooling the resources of its libraries to form a consortium to subscribe collectively to web- Tony Linnane, Regional Librarian, HSE West; Bennery Rickard, Regional Librarian, National Shared Services and Professor Brendan Drumm, CEO, HSE. based information services. p20 Healthmatters Summer2006 Healthmatters Never judge a bookby thecover Newsbrief

Publication for HSE Print & Design

Traveller women Health Services Print & Design has changed its name to HSE Print & Design in accordance with the ongoing in East Cork corporate changeover to the HSE identity. The Unit is now the in-house printers ut yourself in my shoes. How would you feel if this was you? A for the HSE and is the primary supplier of Traveller has to make an extra effort to look well to get into a place, all printing needs within the HSE Dublin P and then you see settled people getting in ahead of you….. I would Attending the launch of Never Judge a Book by the Cover, a new resource for Mid-Leinster and Dublin North East. have butterflies in my stomach walking into places, wondering “will they Travellers, were back row (LtoR): Noreen O’Brien, Community Advocacy Worker, A wide range of services from print serve me?”...... It’s embarrassing, I feel too ashamed to walk into certain HSE South, Mary O’Brien, Traveller Visability Group (TVG), Deirdre O’Reilly, management, design, printing and print Traveller Health Co-ordinator, HSE South, Margaret McCarthy, TVG, Eileen places with my kids, for fear of being turned away. (extract from Never Quilligan, TVG, Maria Burke, Public Health Nurse, HSE South. finishing is available. A nationwide Judge A Book By The Cover, April 2006). Front row (LtoR): Cora Williams, Public Health Nurse, HSE South, Brigid O’Reilly, delivery service is offered. HSE Print and TVG and Chrissie O’Sullivan, TVG Unfortunately, the above statement reflects the experience of many Design recently made a substantial Travellers in their day-to-day lives. investment in new machinery to provide a A new information booklet has been written by Traveller women living in “This information booklet will help Travellers address issues around better service to colleagues in the HSE. east Cork, with a view to raising the awareness of their rights and to offer discrimination; something that, unfortunately, is still a regular occurrence. The scope of work produced varies from advice on how to combat discrimination when it occurs. It will be distributed to all the community, voluntary and State agencies we full colour to simple one colour jobs, The booklet contains basic and factual information on issues affecting link in with so that Travellers can easily access the information when they large format to standard size documents, Travellers such as health, the Equal Status Act, basic rights - the Irish need it.” stationery, reports, leaflets, booklets, Constitution, UN Declaration of Human Rights and local support groups. The publication was supported by the Health Service Executive (HSE) duplicate/triplicate books, forms, Noreen O’Brien, Traveller Advocacy Worker with the HSE South said: South Traveller Health Unit and East Cork Area Development (ECAD). charts etc. You can contact HSE Print & Design with any queries or for any information on the services provided at:

Address: HSE Print & Design Temple Street on 100 Unit 13, Westlink Industrial Estate Kylemore Road Ballyfermot Best Workplaces in Europe list Dublin 10 achieve the best results. In the private sector, this is usually reflected in increased productivity Phone: (01) 626 3447 and profitability. In the health care sector, we Fax: (01) 626 3159 tend to see it reflected in superior patient E-mail: [email protected] satisfaction levels, lower employee turnover, and increased cost efficiency” “The hospital is renowned for its excellence in medical care and we wish to mirror this excellence in our policies and initiatives in “Contrary to popular belief, great workplaces caring for our staff” said Mona Baker, Human aren’t defined by the pay or the perks and Resources Manager at the 134-year-old benefits on offer” says Bob Lee. hospital. This is the second year the hospital has “It’s the level of trust in the workplace that been nominated by their staff. makes the difference. We define a Great Place The hospital has initiatives such as the “Well of to Work as one where you trust the people you Wellbeing” programme which is run by its work for, have pride in what you do, and enjoy Occupational Health Department and focuses on the people you work with. And this is why so health prevention, health screening and many health sector organisations are now education together with programmes to address focussing on a ‘great workplace’ as a business work life balance. An Organisational Psychologist strategy and source of competitive advantage.” is on site to address workplace issues. “There’s a limited supply of health care The Human Resources Department have professionals in the world, and bad workplaces family friendly initiatives such as flexible working have absolutely no chance of attracting or hours and invests in ongoing staff personal and keeping them. So this is not about ‘being nice’ – professional development programmes. The it’s about survival” concludes Lee. Bernice Hogan, Ruth Hartigan and Una Ryan who work in administrative positions at Temple Street Hospital. hospital has just launched a ’Recognition of Excellence Awards’ scheme which is aimed at For further details on recognising employee individual and team Temple Street hospital contact: taff at the Children’s University Hospital, world to secure such a position on any ‘Best contributions for outstanding performance in Mona Baker, Human Resources Manager Temple Street have voted their workplace Workplaces’ list. the clinical and non clinical areas. Ph: 01 8784362 or email [email protected] S onto the list of the “100 Best Workplaces Temple Street is one of a growing number of A Diversity committee was set up in 2000 in or Lucy Nugent, Patient Services Manager in Europe”. Irish Health Sector organisations taking part in response to the changing cultural profile of both Ph: 01 8784608 or email on [email protected] Temple Street is the first-ever public hospital the annual ‘Best Companies’ study, which is patients and staff. The committee’s work in Europe to be included on this prestigious list, conducted by the Great Place to Work Institute. includes an annual Diversity week and For further details on the published annually by the Financial Times. “The best employers – including those in the formalised interpreting and translation services. Best Companies study: Earlier this year, Temple Street achieved a Health Sector – consistently win the battle to The hospital was also short listed and Bob Lee, CEO, ‘world first’ when it was named in the Top Ten attract and retain the best people.”, says Bob Lee, commended as one of the top 5 multicultural Great Place to Work Institute Ireland, of the ’50 Best Companies to Work for in CEO of the Great Place to Work Institute Ireland. institutions at this year’s Metro Eireann Media Ph 01 890 9510, Ireland’ - the only publicly funded hospital in the “Because they have the best people, they also and Multicultural Awards (MAMA). email [email protected]

Summer2006 Healthmatters p21 Healthmatters New Cardiothoracic Surgery Service for UCHG Newsbrief A Pneumatic Tube Delivery System Installed at Kerry General Hospital

In March a Pneumatic Tube Delivery System was switched on in Kerry General Hospital (KGH). The system interlinks 26 hospital locations and can transport compact items speedily and unobtrusively hospital wide. It is anticipated that over 90% of its traffic will be Pathology specimens, and in the first month of its operation its contribution to efficient laboratory specimen delivery has been enormous. A hospital wide review of the Pathology service in 2000 formally recommended such a system. A national pilot study on Pathology Demand Management – performed in KGH - reported in 2004 and among other things identified the pre- analytical phase of laboratory testing to be a major component in unnecessarily prolonging test turnaround times. A Pneumatic Tube Delivery System was again identified as the best solution. Experience from other hospitals has shown the benefits of the system: the system is already installed in 33 other acute hospitals in Ireland.

(LtoR): Dr. Kieran Daly, Cardiologist, Mary McHugh, Director of Nursing, Dr. Pat Nash, Cardiologist, Sue Hennessy, Project Manager and Bridget Howley, General Manager, Galway Regional Hospitals pictured at the opening of a second cardiac catheter laboratory at the Department of Cardiology, University College Hospital Galway (UCHG).

new Cardiothoracic Surgery service is this year being introduced at University College Hospital, Some of the staff members of the dedicated endoscopy team A Galway (UCHG). A cardiac theatre, a 10 bed ward, four high dependency beds and three intensive care beds are to be provided on a A detailed business case was compiled phased basis at UCHG with the service commencing in 2006 and funding sought. The “Friends of Kerry and commissioning expected to be completed in 2007. General Hospital” were made aware of the Funding of €3.29 million is to be provided in 2006 with a need, and they generously provided their further €9.18 million in 2007 to recruit 152 staff associated support to the project. Their help was with this development. The environmental infrastructure for invaluable, as in years past, and through the Cardiothoracic Unit was constructed on the UCHG campus their efforts the system was installed as part of the Phase II building works under the National considerably more quickly than might Development Plan. The Cardiology Department at UCHG is otherwise have been possible. The now the only fully equipped Cardiology Department outside of majority of the funding was raised through Dublin and Cork whereas prior to 1987 there were no invasive a “night at the dogs” in aid of Friends of facilities available outside of these two centres. KGH at Tralee Greyhound Track in July This new service is one of a series of initiatives at the 2005. Department of Cardiology in UCHG that have resulted in an In its first month of operation the improved service for patients in the West. success of the system has exceeded HSE West has acknowledged the pivotal role that Croí, the expectations. All specimens reach the West of Ireland Cardiology Foundation, has played in the wider laboratory within two minutes and “hard development of services and facilities. This could not have copies” of reports are returned just as happened without the ongoing support and enthusiasm of the efficiently. Great credit is due to the members of the public who support Croí. Friends of Kerry General Hospital, and also UCHG’s Cardiology Department has also developed to the hospital staff who have an active research programme closely linked with National World Champion enthusiastically embraced the new University of Ireland, Galway and the local biomedical system. World Super Bantam Weight Champion Bernard Dunne pictured with two young fans during the industry sector. Community Drug Awareness Week held by the Local Drugs Task Force recently in Dublin 12. p22 Healthmatters Summer2006 Healthmatters Crossing Language Barriers– New Course Helps

A training course, Effective Communication steadily. Julie is now working with the company ‘Language difficulties and culture clashes Across Language Barriers, aimed at helping who developed the course, Cascade often lead to misunderstandings, frustration and staff to better communicate with non-native Consultancy Ireland, to tailor the course to stress for management, staff and clients alike. English speakers has been attended by over 50 specific areas of work. This is hardly surprising, given that 750,000 staff in Kildare and west Dublin with excellent “We are hoping down the track to give a very newcomers from 211 countries have come to feedback from staff. specific course for people working in different live and work here since 2000, and that 167 “I found the course very empowering. It areas of the service. Interacting with a client in languages are now used in Ireland (source, showed me that I do have the skills and ability to an Accident and Emergency department is very Irish Times),’ Anne explained. communicate effectively with people for whom different to dealing with a client in a child care ‘Access to interpreters, translated materials, English is not their first language. It also let’s you or social work setting, so by being more specific and English classes for non-English speakers is see what the experience is like for the client and to each area of work, the more benefit staff will being improved all the time, and this is to be that was very revealing,” said Elizabeth derive from the course,” Julie explained. welcomed. However, an important third step is Hamilton, Team Leader with the Family Resource Julie said the need for such a course was first being overlooked – that of assisting front-line Clare Rooney, Medical Card Section and Lynette Centre in Tallaght who recently undertook the highlighted by reception staff. staff and management to communicate more O’Brien, Social Worker at Cherry Orchard Hospital one day course. “We need to ensure as far as possible that effectively in English with people for whom who attended the Crossing the Language Barriers course. They are pictured here with Stephen “The course teaches you to always check every interaction a client has with the health English is not a native language and even clients Martin and Anne O’Carroll from Cascade that the message has been understood. service is a positive one. That should include with no English at all,’ she added. Consultancy who run the course. Don’t assume that people understand what everything from the physical environment such The training course, which is highly interactive you’ve said, even if their body language as the buildings, to our body language and our and enjoyable, gives many practical tips that can implies they have. In social work, the attitudes towards people. Giving people the immediately be used in communication with decade ago, it would have been usual relationships we establish with people are skills to be confident in talking to people who non-native speakers of English. Verbal and for a frontline staff member to have to paramount, so we have to be respectful. do not have English as a first language is all written communication, face-to-face and A interact with someone from a non- Even if a person’s English is limited, by being part of making people feel comfortable and telephone interactions are all covered. English speaking background. Today it is a daily respectful and taking the time to communicate giving them a more positive experience of the Staff can share experiences and learning in occurance for most. properly a good relationship can develop,” health services.” what has worked for them in communicating These interactions can be fraught Elizabeth added. Anne O’Carroll, trainer with Cascade effectively. with misunderstandings, leading to an HSE Social Inclusion Manager, Julie Consultancy Ireland said the course was intimidating and negative experience for both Cruickshank, said that since the first course was designed in response to the increasing mix of For more information about the course, contact staff and clients. held last year, demand has been growing languages and cultures in Ireland’s population. Julie Cruickshank on 01 415 4700. Doctors, Dentists, Pharmacists, Opticians get new Online Service

ational Shared Services - Primary Care new system: ‘Our key customers are Doctors, There is also a facility for the GP to make the payment status of any of these claims, along Reimbursement Service has recently Dentists, Pharmacists, and Opticians. We want to adjustments to the client register in respect with explanations for any unpaid claims and a Ntaken a huge leap forward in providing transform the relationship that we have with them of his or her own patients. facility to fix any errors etc. a brand new online transaction service for their by streamlining the processes involved in making key customers - Doctors, Dentists, Pharmacists, claims, so that they can get their payments faster. Patient Validation For over 30 years PCRS has given quality service and Opticians. We can now give them access to the information PCRS now also has a system that allows all to their customers in an ever changing and Every person in the country is entitled to avail of they need to be satisfied that their payments are Primary Care Contractors, or indeed any health growing environment. As we said earlier, free or subsidised medical care in his or her own accurate and up to date. We can also give our service provider, to check the eligibility status of a developments in new technology and the dawn community through the various schemes customers online access to systems that will patient under any of the HSE schemes that PCRS of the new Health Service Structures now gives operated by the Health Service Executive. This allow them to see their list of medical card make payments for, for example the Medical Card PCRS a unique opportunity to continue to ranges from free medical services through the patients and to be involved in keeping their or the Drugs Payment Scheme. enhance the quality and availability of their Medical Card Scheme, subsidised prescription patient lists up to date. ‘ services to, and in partnership with, their drug costs through the Drugs Payment Scheme PCRS has have moved from entirely manual Online Claiming customers. National Shared Services PCRS look or free services through a range of Community processes using enormous resource hungry data PCRS also have a new system that allows GP’s forward to working together with their Drug Schemes. processing machines, to modern high technology to make their claims online. The system will even customers to make a difference. Finglas in Dublin is home to the National systems that allows all concerned to enquire from validate the claim when it’s being made, which Shared Services - Primary Care Reimbursement anywhere in the country, in real time, into will remove uncertainty around payments and Service, known as the PCRS. For over 30 years databases containing hundreds of millions of will reduce follow up queries and the need to PCRS has been processing claims and making records, with results in seconds. make reclaims. payments to Doctors, Dentists, Pharmacists and Opticians in return for the health services New Technology and Early Payment provided to people in their own communities. The Developments: PCRS are also putting systems in place to use processes carried out in PCRS help everyone in PCRS’s new system, launched on May 30th 2006, the new online claiming and validation the country to access these health services. now provides more effective management of the system for GP’s to reduce the payment With nearly 60 million business transactions to client register, and makes payments more time for these claims be delivered in 2006 to over 5,600 GPs, transparent and more efficient. Contractors can significantly. Pharmacists and other contractors, and a now use a special secure website to access data transaction value of close to €2 billion, the scale and make claims online. Claim Payment of business activity and the supporting technical Status infrastructure would be the envy of mid range Up to Date Client Register Where a GP uses the new building societies and banks. GPs, Pharmacists and other contractors can now online claiming system there will Paddy Burke, Head of NSS – PCRS explains the view the client register online, and in real time. be a new facility to let them see

Summer2006 Healthmatters p23 Healthmatters National Office for Suicide Prevention Holds First National Meeting

he National > Examine the need for a national confidential Office for Suicide enquiry into deaths from unnatural causes T Prevention was > Agree an approach to reach out to young established by the HSE people using texting, messaging and email Crisis Nursing following the launch of formats ‘Reach Out – A National Strategy for Action on The National Office held its first National Forum Suicide Prevention’ by Meeting in March. The aim of the Forum Servicefor People the Tanaiste and Meeting was to inform the 100 plus Minister for Health and organisations present of the work of the new Children Mary Harney in Geoff Day who heads National Office, to present up to date research September 2005. the National Suicide on suicide prevention and to consult with Office who Self-Harm The Strategy sets out partner organisations about how to improve our a 10 year plan of actions which aims to reduce suicide prevention. eliberate self-harm and parasuicide is sessions are an important part of the service the high levels of suicide and deliberate self The meeting was addressed by President Mary a major public health problem. The provided by the crisis nurses. The service also harm in Ireland. McAleese and Minister of State, Tim O’Malley. Dincidence of self-harm and parasuicide liaises with the client’s GP, significant others, More people die in Ireland through suicide The National Office is headed by Geoff Day is higher in Ireland than in any other European and any other service providers, which may be than are killed on our roads. Particularly, Ireland former Chair of the National Suicide Review country. The National Suicide Register (2003) involved with them during this period. If the has the fifth highest youth suicide rate in Europe Group and former Assistant Chief Officer with recorded presentations to Irish hospitals at client needs referral to any other voluntary or which makes this a serious public health issue the North Eastern Health Board. 9,839 consisting of 7,825 individuals. The HSE statutory service, the nurses will organise this not just for the health service but for all our The National Office for Suicide Prevention is South recorded 30% of the national figures for them. communities. based in the Population Health Directorate at Dr. and recorded 1,134 individuals for 1,321 The National Office has agreed a 10 point plan Steevens’ Hospital, Dublin 8. Tel.: 01-6352179, episodes of self harm. In 2001 the HSE South How does the client benefit which is funded by €1.2m additional and offices in Cork and Galway. introduced a crisis nursing service which from this service? development monies in 2006, consisted of the provision of appointing A comprehensive evaluation of this The National Office team is specialist psychiatric nurses on a 24-hour specialist nursing service was undertaken > Initiate a national mental health and well roster system for three Cork city hospitals. The in 2005. One of the tools used to evaluate being campaign through the media Geoff Day > main objective of this initiative was to improve the effectiveness of the service was a > Develop deliberate self harm services to [email protected] the quality of care delivered to individuals satisfaction survey of client’s experiences. ensure coverage in all A&E departments attending the Emergency Departments, The satisfaction survey indicated that the vast > Pilot a Primary Care response to deliberate Karen Murphy > following acts of deliberate self-harm and majority of clients are satisfied with the time self harm [email protected] attempted suicide. and help they received. > Encourage the media to improve reporting of deliberate self harm and suicide Derek Chambers > What does the crisis service Key recommendation of the > Agree a national research programme on [email protected] provide? service evaluation suicide and deliberate self harm The nursing service provides a clinical There is an obvious need following the > Complete research into the link between Anne Callanan > assessment by conducting a suicide risk publication of Reach Out (2005) The National institutional abuse and suicide [email protected] assessment, looking at levels of Strategy for Action in Suicide Prevention, for a > Begin to implement the extensive training depression/anxiety/hopelessness. The nurse Government commitment to providing quality and awareness programmes identified in Rachel Farrow > and the client then devise an overall care crisis intervention services at all HSE areas, to Reach Out [email protected] pathway, which uses problem solving and assist individuals who present in crisis and > Commission and implement actions arising management skills, where both long term and distress due to psychological and or emotional from a review of services for those bereaved Reach Out can be obtained from any of the short-term goals are incorporated. Home care issues. This should include the provision of a through suicide above offices or www.hse.ie or www.nsrg.ie follow-up and support with up to six individual 24-hour crisis support service to assess, refer and assist individuals in crisis situations and to provide crisis planning and short-term counselling at all hospital Emergency Departments. To enhance the continuum of this Hospital Watch crisis nursing service, the HSE South should continuously strive to achieve a collaborative crisis intervention practice model with Launched at Bantry interdisciplinary teams, including GPs, Psychiatric multidisciplinary teams, Emergency Department staff and other allied health General Hospital professionals. Finally, the evaluation recommended that additional client antry General Hospital in West Cork has launched “Hospital Watch”. This scheme is information is needed to increase client’s aimed at preventing crime within hospital grounds and at protecting personal and knowledge level regarding their own Bhospital property against theft or damage. Hospital Watch is a security initiative psychological problem(s)/illness. coordinated and run by staff from a number of different areas in Bantry General, with the help (Front L to R) Eleanor O’Donovan - Hospital Manager (The service evaluation was undertaken by: of An Garda Síochána. It is the hospital version of 0Neighbourhood Watch’ and since being & Breda Cronin - Director of Nursing. Angela Cocoman RPN, BScN, MSc. introduced to Cork as a pilot scheme in 1996, the scheme has been developed nationally. The (Middle L to R) Insp. Morris Walsh, Denis Fenton - FFNMRCSI.) Director of Human Resources HSE, Chief Super Ritchie Hospital Watch scheme is working effectively in BGH and promotes an increased sense of Duggan, Detective D.J. O’Shea - Liaison Office for BGH security, safety and protection for our staff, patients, patrons and also our hospital premises. Hosp Watch Committee, Jim Griffin - Head of Security Copies of the full research reports are Cork University Hospital. The scheme also encourages staff to be vigilant about criminal activities on their patch. It does (Back L to R) Sgt Eamonn Foley - Crime Prevention Unit, available from Brenda Crowley, Mental not involve intervention, but rather it is about staff being aware of possible incidents and Supt. Liam Horgan, Student Garda Cian O’Hiarlaithe and Health Resource Officer, HSE South. Tel: having systems in place to try and prevent a crime being committed, and to alert others and the Detective Bart O’Leary. 023-33297. Email: Gardaí. The close collaboration between the agencies in Bantry has benefited all in the area. [email protected] p24 Healthmatters Summer2006 Healthmatters Protect, What are the Advise, Benefits of Music ? Immunise ore than 300 health professionals attended the National Immunisation publication documenting the benefits of MConference ‘Protect, Advise, Immunise’ music within the area of care for older hosted in Cork by the HSE South in May. A people was launched recently in The conference aimed to provide up to date Mullingar. Details of a new music residency information on current immunisation issues as well scheme for the Midlands were also announced. as address many of the practical issues and The Music in Healthcare 2000 – 2004 report concerns around immunisation (e.g. boosting summarises the findings of an evaluation into the uptake, assessing information) drawing on national partnership project developed by Music Network, and international experiences. the national music development agency, and the Dr Fiona Ryan, Consultant in Public Health Midland Health Board (now part of the HSE Dublin Medicine, said: “The issue of childhood Mid-Leinster area) over a five year period. immunisation is one that stimulates much debate. From 2000 to 2004 hundreds of older people Health professionals have a duty to help parents in nine residential and day-care centres in the Staff from St Mary’s Care Centre in Mullingar attended the launch of the Evaluation Report into the Music in make an informed decision about immunisation. midlands, with support from management Healthcare Project. St Mary’s was one of nine centres for Older People which participated in the programme, Children are so vulnerable if not protected against the benefits of which are now documented in the new publication. From (LtoR): Dorrie Mangan, General and staff, participated in creative workshops Manager, Primary Community and Continuing Care Longford/Westmeath, Carmel McDonald, CNM1, Deirdre diseases which are vaccine preventable. Any with teams of professional classical, jazz and Ryan, CNM2, Helen Carley, Line Manager, Darren Bell, attendant, Lorraine Mimner, Community Artist, Patricia health professional dealing with parents on a daily traditional musicians. Carroll, HSE Project Coordinator for residential care centres, Mary Daly, Activities Coordinator, Margaret basis fully understands the very valid concerns they Feeney, HSE Director for Older People Dublin Mid-Leinster and Jim Reilly, Local Health Office Manager A range of positive personal, social and artistic Longford/Westmeath. have about vaccines and their side affects. Many of outcomes for participants, healthcare staff and these health professionals are parents themselves musicians were identified. organisations in order to establish a locally owned centres for older people in the counties of Laois, and have had to make exactly the same decisions. The benefits included physical benefits such as and sustainable Musician-in-Residence Offaly, Longford and Westmeath. We would urge parents to speak to their GP or log increased energy levels and improved fine motor programme for older people in the region; and the Jim Reilly, Local Health Office Manager for on to the HSE’s www.immunisation.ie so that they skills and concentration. But just as significant further development of training opportunities for Longford/Westmeath, said there were huge are armed with current and factual information.” were the social and mental health benefits with musicians interested in working in this context. benefits associated with the project “in terms of its Dr Kevin Kelleher, Assistant National Director participants stressing the enjoyment, the Music Network and the HSE have already begun to impact on the health and social gain of clients”. Population Health – Health Protection said: “All anticipation and the self-esteem benefits derived implement these recommendations with the Copies of Music in Healthcare 2000 – 2004 are front line staff are vital in the delivery of a from the workshops. creation of a new Midlands Partnership for Arts in available from Music Network, Coach House, successful immunisation programme. This The evaluation report prioritised two areas for Healthcare committee to oversee the recruitment Dublin Castle, Dublin 2 on 01 6719429. The conference provides a platform to acknowledge the future action: the development of a partnership of a panel of music facilitators who will deliver a publication is also available online on commitment of these and other health between HSE Dublin Mid-Leinster and local arts pilot music programme in residential and day-care www.musicnetwork.ie professionals in immunisation.” Cork Twins With Sudanese Maternity Hospitals delegation from the Omdurman maternity hospital, Khartoum visited Cork in February to sign a formal twinning arrangement A with Cork University Maternity Hospital. Doctors in Cork maternity hospitals recognised that many Sudanese doctors are working here while their own country is deprived of basic facilities, equipment and manpower. There are 16,000 registered medical doctors in Sudan. Only 4,000 doctors are currently working in the country. 1,000 Sudanese doctors are registered in Ireland. Two Sudanese doctors – consultant paediatrician Dr Sami Ahmed and consultant obstetrician Dr Murshid Ismail invited a team of maternity specialists to visit the Omdurman Maternity and Fistula Unit in 2002 in Khartoum. The team got to view the conditions at first hand and were able to assess what could be done to help as well as delivering staff training on infant resuscitation. “Conditions in Sudan are challenging with most rural areas, and some of the city of Khartoum itself, is without running water, electricity or sewerage systems,” said Cork neonatologist Professor Tony Ryan. “Many Sudanese people live in extreme poverty and daily temperatures reach 40 degrees centigrade.” “We made a commitment at that time to contribute to the hospital by way of upskilling the staff and establishing formal links with them. Since then our team has been over twice to deliver training and set up several audits - of babies dying from asphyxia in the first week of life; and of women dying in childbirth - to gauge whether outcomes could be improved.” The twinning is centralised on a five-year plan with six goals. These are to significantly improve Omdurman Maternity Hospital facilities and hygiene, to develop an appropriate hospital management structure, to develop a maternity care partnership model that can be replicated elsewhere; to develop a bilateral education and research programme to

Attending the visit made by delegates from Omburman Maternity Hospital in Khartoum, which is twinned with the Cork University Maternity Hospital, identify pertinent factors relating to infant and maternal mortality and to CUMH were Tony McNamara, General Manager, Cork University Hospital, Dr. Abdel Razik Alzain Ahmed, General Manager Consultant assess different intervention strategies; to implement evidence-based Obstetrician and Gynaecologist, Omdurman Maternity Hospital ,Sudan, Kay O’ Sullivan, Director of Nursing, Cork University Hospital, Prof. John and efficient obstetrics and gynaecology, neonatal and midwifery clinical Higgins, Chair of the Division of Obstetrics, Gynaecology & Neonatology with the HSE South’s Unified Maternity Services, Dr. Sami Ahmed, Consultant Paediatrician, Bon Secours Hospital, Cork practice to reduce maternal and perinatal mortality; and to develop existing fistula services and a new uro-gynaecology centre.

Summer2006 Healthmatters p25 Healthmatters Acquired Brain Injury Team

he South East Acquired Brain Injury (ABI) the injury occurs for adults aged 16 – 65 years people with ABI this year and there are plans Team was set up in 2002 in response to an living in the South East. The client is normally to repeat this format for parents of people T identified need for services to clients with seen for assessment / intervention in their own with ABI. Acquired Brain Injury throughout the South East. home or local health centre. To date the team has had contact with over The team has three members: a The team has close links with the local 250 individuals with ABI and continues to have Neuropsychologist, Occupational Therapist and disability teams and with voluntary bodies regular contact with many of them. The team Key worker who together provide assessment, providing services to people with ABI, from receives a steady stream of new referrals and is support, rehabilitation programme planning and therapy to day service to vocational and hopeful that services will continue to develop education to people living with an ABI, and training services. for this client group both regionally and those who support them in their local area. The team works closely with these nationally as people with ABI often have ABI encompasses both traumatic injuries to organisations to assist in the service delivery to ongoing long term needs, particularly in relation ABI team in Cashel, Barbara Rock, Keyworker (left) the brain e.g. from road traffic accidents, falls clients with ABI and has conducted many to issues of training, employment, social access and Dr Ann Moriarty, Clinical Neuropsychologist etc, and from medical conditions such as brain training / information days regionally. and integration and psychological adjustments. (right). Jacqui Stapleton, Occupation Therapist (not in photo) is the third member of the team. haemorrhage and stroke. The team accepts The team has conducted a series of meetings The South East ABI team can be contacted on referrals from any source and at any stage after addressing the specific issues of partners of 062 64908/7/6/5 for further information. Order! Order! Parliamentary Affairs Division (PAD)

ince its establishment the HSE has The PAD Offices: been involved in responding to The Central PAD Office is located within the S questions and requests for briefings Office of the CEO in Parkgate Street and can be regarding Professor Brendan Drumm, CEO contacted at [email protected] or Tel: 635 2501: of the HSE and the Tánaiste and Minister for There are a number of Area PAD offices with Health and Children Mary Harney’s dealings designated staff who have been assigned with the Oireachtas. The creation of the HSE responsibility for Parliamentary Affairs to as a single national entity has posed some prepare and compile replies. challenges for our ability to respond to questions in a timely manner. The New Structure As part of the new structures, Parliamentary The primary focus of the PAD is Affairs will operate Centrally at Corporate & > To organise, monitor and improve the Parliamentary Affairs level and at Regional processing of Parliamentary Questions Level under the Consumer Affairs Division. by the HSE When fully operational, the Parliamentary > To support Service Managers in supplying Affairs Division will comprise a Central Office timely and accurate information to formal and Four Regional Divisions. requests from members of the Oireachtas for information, Parliamentary Questions - > To ensure that requests from Oireachtas a new approach Members are afforded the appropriate level The key elements of the new approach to of priority throughout the system processing Parliamentary Questions in the > Developing the HSE’s responsiveness to, HSE are: and interaction with, members of the > dedicated resources Oireachtas and ensure that good quality > time limits on replies (with goal to reduce and timely responses are issued to periods over time) Parliamentary Questions > requirement for interim replies > Fully support the CEO in the discharge > faster route for access to readily available (Back LtoR): Darragh Purcell, Sabrina Keeler, Kilian McGrane, Assistant National Director, Corporate & of his responsibilities to the Oireachtas routine information Parliamentary Affairs, Emma Doddrill, Frank Skay. (Front LtoR): Ruth O’Callaghan, Helen Stokes (Parliamentary and its Committees, in particular the > further developments (e-mail query Affairs Project Manager), Lisa O’Neill, Bryan O’Toole. Oireachtas Committee on Health and addresses and periodic regional briefings) Children and the Public Accounts > performance monitoring/management Committee established for members of the Oireachtas to Dublin North East) on a twice yearly basis. > Reporting to the Chief Executive Update on the work of the submit queries to the HSE. The purpose of these information sessions Officer on the performance of the HSE Parliamentary Affairs Division > The PAD is working with our website will be to allow Oireachtas Members meet in this regard. to date: manager to arrange for replies to all PQs Service Managers for a specific area and The PAD has processed more than 3,000 issued by the HSE (except those which discuss with them service initiatives and The PAD also has responsibility for Parliamentary Questions and Representations refer to individual cases) to be posted on developments for the area. implementing the new Statutory Regulations that the Tanaiste and Minister for Health and the HSE website. The CEO has appeared before Oireachtas for dealing with Oireachtas Members. Children referred to the HSE for reply to the > The PAD is making arrangements for Committees on six occasions since taking up These Regulations provide a framework for Oireachtas member directly. Oireachtas Members to meet Senior office. The PAD has co-ordinated his attendance the manner in which the HSE co-ordinates In March 2006 the CEO wrote to all Oireachtas Managers responsible for service delivery at these Committee meetings and ensured that its dealings with members of the Houses of members informing them that: within the HSE’s four administrative areas matters arising from these attendances are the Oireachtas. > A dedicated e-mail facility has been (i.e. South, West, Dublin Mid Leinster and followed up. p26 Healthmatters Summer2006 Healthmatters Caring for our patients– Breast Care Nurse Specialist

The number of new patients seen in STGH Providing decisional support for women last year was 544 and all patients are seen with a diagnosis of breast cancer occupies both by Mary and the consultant breast a large part of the breast care nurse’s surgeon Mr Fiuza Castineira. time and Mary ensures that the patient has the necessary information on which to base an informed decision regarding treatment options. Newsbrief The breast care nurse specialist is a link Breast care person for them to contact at any stage of their investigations or treatments All patients Across Boundaries nursing is a most with a cancer diagnosis are given the Cross Border Event “rewarding role as opportunity to speak to a trained volunteer who has been through a similar experience it embraces not and this is arranged through the Irish Cancer Society. Patients requiring surgery are seen only the patients pre and post operatively by the breast care romoting breast health and breast nurse and those who have had a mastectomy awareness and explaining and physical but also are fitted with a temporary prosthesis before P discussing the various investigations discharge. Arrangements are then made and procedures is one of the many roles of the her psychological for a fitting of a permanent weighted breast care nurse. needs prosthesis, a service provided by Mary Mary Ryan was appointed as Breast Care in Our Lady’s Hospital. Nurse Specialist to South Tipperary General The specialist nurse performs a key Hospital (STGH) in 2002. Mary is based in Our co-ordinating role, arranging appointments Colm Donaghy, Director General, CAWT; Anne Lady’s Hospital, Cashel but also attends clinics Women with a suspicious breast lump will with other disciplines such as oncology, Mathers, Clanrye Surgery, Newry; Simon Gibson, in South Tipperary General and Waterford have triple assessment” investigations, with a radiotherapy, palliative care and support Manager, Newry and Mourne HSCG; Yvonne Regional Hospital. The nurse specialist is there mammogram, ultrasound and biopsy, groups. Mary says: “Breast care nursing is Gregory, CAWT; Jackie Baron, Louth Disabilities primarily to support women who have or fear all carried out in Waterford Regional and the a most rewarding role as it embraces not Services, HSE; Siobhan O’Driscoll, Spinal Injuries they have breast cancer and provides results discussed the following week at the only the patient’s physical but also her Ireland and Jacqueline Magee, Service User information, physical and psychological weekly multidisciplinary meeting attended psychological needs.” Facilitator, Southern Health and Social Services monitoring, counselling, and gives practical both by the surgeon and the nurse specialist Board (front centre) who attended an event to advice to patients and carers from diagnosis before meeting the patient for their follow For further information contact Mary enhance their awareness of hidden disabilities. to treatment, rehabilitation and beyond. up appointment. on 052-77000. ✃

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Summer2006 Healthmatters Message from the CEO The future must be driven by quality and safety

uring the past few months a number of significant in the region. Convenience should initiatives have come to fruition. These include the This blueprint has relevance not just for the North East, but for never be traded with Dprocess to recommend the location for the new national all our acute hospitals and how they dovetail seamlessly with our quality; there are clearly children’s hospital, the publication of the new direction for primary and community services. many specialised hospital services in counties Louth, Cavan, Monaghan and The report points out that in the future we will see more and services that can only be Meath and the establishment of the first Community Intervention more care being provided to people either within their homes or provided to international Team in Cork. communities through local service providers and local standards in large acute In relation to cancer care we announced that we would be hospitals/health centres. A huge number of the services people hospitals and for establishing a national Cancer Control Programme to implement currently have to travel to major hospitals for, should be available patients this will involve the new National Cancer Control Strategy announced by An to them closer to home; improving convenience and allowing travel. In my professional Tanaiste and Minister for Health and Children, Mary Harney. hospitals to focus on the work they should be doing. Examples of career as a clinician I We also initiated a very focused approach to addressing this are services such as dietetics, physiotherapy, Occupational have never once heard a the recurring difficulties facing some hospitals in reducing the Therapy, etc. and basic diagnostic laboratory and radiology tests patient or their family time their patients have to wait to be admitted from A&E to including warfarin clinics. complain about having acceptable levels. If we do not embrace and act to deliver this our health system to travel for what they The theme running through all of these initiatives is that they will be unable to cope with the challenges of the future and we see as the best quality care. For some quality can only be readily will have a direct impact on the quality of care we provide. will not be able to provide quality safe services. provided in hospitals, for others it can only be readily available They also illustrate the enormous benefits that the HSE’s unified The days where we ask patients to travel to acute hospitals to from within the community. approach can deliver. receive care that could easily be provided much closer to their The challenges for health professionals working in hospitals Unlike in the past, we can now apply a national focus to specific homes are coming to an end. The acute hospitals of the future will and primary and community care is to work towards devolving service shortfalls, develop plans based on international best focus on what they do very well – provide specialised care by appropriate services to the community and putting in place the practice and take the appropriate actions which are driven by our highly trained senior clinicians supported by necessary facilities to enable this to happen as soon as possible. ultimate goal – quality and safety. Importantly we can mirror these equipment 24/7. From my contact with primary care providers and consultants actions nationally as required. Some argue that this shift from hospital to community will during recent weeks I sense that there is enthusiasm for this While many of the projects outlined above are specific to somehow undermine our commitment to patients. This approach and where it is happening the benefits for patients particular aspects of our service, I believe they encapsulate suggestion is rooted in the traditional approach to healthcare and staff have been enormous. the way we need to tackle problems from now on; with focus, where the demands of the system had priority over patient The way care is provided in the 21st century is changing energy and action, and at the same time ensure their impact access issues. all over the developed world from how care was provided reverberates nationally. Today the reality is quite different. Our services must reach out in the past. In Ireland we must embrace this change; this The review of acute hospital services in the North East to patients, surround them, keep them out of acute hospitals and difficult but simply asking for more of the same is a disservice carried out by Teamwork (available at www.hse.ie) exemplifies as close to their own homes as possible. At the same time the to our patients. this approach. local and acute service should be linked together to ensure that Independently of local interests, it assessed the existing patients, GPs, therapists, specialised nurses, advanced services provided across five hospitals, highlighted the flaws paramedics and other health professionals have ready access to and recommended a series of actions which we will act on specialised expertise 24/7. without delay. Clearly we need to strike the right balance between

In a relatively short time we have committed to addressing the convenience and access to quality care. The Bristol Inquiry (2001)

problems that have held staff back for many years, acted on this sums this point very well when it said “quality and safety should Professor Brendan Drumm commitment and now have a blueprint for the future for services prevail over ease of access”. CEO, Health Service Executive ✃

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Reader Survey Contact Number (optional, but must be included if you wish to enter the prize draw) Summer2006