Patients are the reason we are here – they are the focus of what we do. Nurse Lydia D’Lasselle is part of The Alfred’s hard working cardiology team. Contents Our story About Alfred Health Across our diverse organisation, 4 we value and respect life from Chair and Chief Executive’s beginning to end. year in review 8 We provide treatment, care and compassion Fast facts to the people of Melbourne and Victoria. Our 10 research and education programs advance Our patients the science of medicine and health, and 12 contribute to innovations in treatment and care. Through partnerships we build our Our employees 19 knowledge and share it with the world. Delivering quality care Our purpose 26 To improve the lives of our patients and their families, our communities and humanity. Operational highlights 30 Our beliefs Performance Patients are the reason we are here – they are the focus of 38 what we do. How we do things is as important as what we do. Research 47 Respect, support and compassion go hand-in-hand with knowledge, skills and wisdom. Safety and care of patients and staff are fundamental. Projects and infrastructure 51 Excellence is the measure we work towards every day. Through research and education, we set new standards for tomorrow. Community and environment We work together. We all play vital roles in a team that 54 achieves extraordinary results. We share ideas and demonstrate behaviours that inspire Governance others to follow. 59 About this report Disclosure index This annual report outlines the operational and financial 70 performance for Alfred Health from 1 July 2018 to 30 June 2019. We value transparency and accountability and aim to have all our Financial statements reportable data available to the community in the one publication. 71 There were four relevant Ministers for the period: Notes to the financial statements 78 The Honourable Jill Hennessy 01/07/2018 – 29/11/2018 Minister for Health, Minister for Ambulance Services The Honourable Jenny Mikakos 29/11/2018 – 30/06/2019 Glossary Minister for Health, Minister for Ambulance Services 125 The Honourable Martin Foley 01/07/2018 – 30/06/2019 Minister for Mental Health The Honourable Martin Foley 01/07/2018 – 29/11/2018 Minister for Housing, Disability and Ageing The Honourable Luke Donnellan 29/11/2018 – 30/06/2019 Minister for Child Protection, Minister for Disability, Ageing and Carers Front cover Nurse Marc Marquez was named 2018 Australasian Emergency Nurse of the Year at the International Conference for Emergency Nursing. Alfred Health is a metropolitan health service established under Back cover section 181 of the Health Services Act 1988 (Vic) in June 2000. Nurse Grace O’Brien and doctor Juan Carlos Mora are part of The Alfred’s ICU team. This report is available online at: alfredhealth.org.au 3 About Alfred Health Alfred Health is one of Our hospitals Australia’s leading healthcare services. We have a dual role: caring for more than 700,000 The Alfred, a major tertiary Sandringham Hospital is and quaternary referral community-focused, providing locals who live in inner-southern hospital, is best known as hospital healthcare needs one of Australia’s busiest for the local area through Melbourne, and providing emergency and trauma centres emergency, paediatrics, health services for Victorians and is home to many statewide general medicine, general services including the Heart surgery, orthopaedics and experiencing the most acute and and Lung Transplant Service, outpatient services. The Victorian Melanoma Service hospital works closely with complex conditions through our and Major Trauma Service. the Royal Women’s Hospital This site is also home to the and local community 14 statewide services. Alfred Research Alliance (A+). healthcare providers. Our three hospital campuses – The Alfred, Community services Caulfield Hospital and Sandringham and clinics Hospital – as well as our community-based Caulfield Hospital specialises clinics, provide lifesaving treatments, in community services, specialist care and rehabilitation services. rehabilitation, geriatric medicine and aged mental We provide a comprehensive range of locally health. The hospital delivers Melbourne Sexual Health based services, caring for a wide range of many services through has dedicated clinics for men outpatient and community- and women, onsite testing for people from children to the elderly. based programs and plays a sexually transmitted infections statewide role in providing and provides counselling, rehabilitation services, which advice, and health information. includes the Acquired Brain A member of Injury Rehabilitation Centre. Community clinics meet the growing expectations of our patients for treatment in their communities or at home. We continue to develop new services to meet changing community needs. 4 Alfred Health Our catchments y Catchment (29 ndar 7,000 Alfred Health’s catchment reflects our role in providing tertiary, Seco +) statewide and specialised health services. Our local catchment includes the local government areas of Bayside, Glen Eira, atchment (38 ry C 0,00 ima 0+ Melbourne, Port Phillip, Kingston and Stonnington. This Pr ) primary catchment covers over 700,000 people and continues The Alfred to grow rapidly. Our statewide services provide care to those residing around Caulfield Hospital Victoria and Australia. Alfred Health’s catchments Sandringham Hospital Source: Adapted from an Australian Bureau of Statistics map Clinical services We provide the most comprehensive range of adult specialist medical and surgical services in Victoria. We offer almost every form of medical treatment across our multiple sites and three hospital campuses. Clinical services include: Aged care Emergency medicine, Palliative care Renal services (geriatric evaluation and (intensive care burns and Pathology (anatomical, (nephrology, haemodialysis, management, acute) adult major trauma) clinical biochemistry, renal transplantation) Allied health Ear, nose and throat laboratory haematology, Specialist medicine microbiology) (asthma, allergy and clinical Cancer care (head and neck surgery) immunology, dermatology, (bone marrow transplantation, Gastrointestinal Pharmacy endocrinology/diabetes, radiotherapy, oncology, (gastroenterology, Psychiatry (adult, child, hyperbaric, infectious haematology, cancer surgery) gastrointestinal surgery) adolescent, youth, aged) diseases, rheumatology) Cardiothoracic services General medicine Radiology and nuclear Specialist surgery (heart and lung General surgery medicine (dental, faciomaxillary, transplantation, cardiology, Rehabilitation plastic, vascular) cardiac surgery, cardiac Neurosciences (Acquired Brain Injury rehabilitation, respiratory (neurology, neurosurgery, Urology Rehabilitation Centre, medicine, thoracic surgery, stroke services) amputee, cardiac, spinal, adult cystic fibrosis) Ophthalmology neurological, orthopaedic, Orthopaedics burns) Annual Report 2018–19 5 About Alfred Health (continued) Alfred Health national service Paediatric Lung Transplant Service Alfred Health’s statewide services Bariatric Service Clinical Haematology Service and Haemophilia Service Cystic Fibrosis Service Heart and Lung Transplant Service Hyperbaric Medicine Service Major Trauma Service Malignant Haematology and Stem Cell Psychiatric Intensive Care Service Sexual Health Service Specialist Rehabilitation Service Victorian Adult Burns Service Victorian HIV/AIDS Service Victorian Melanoma Service Victorian Neuropathology Laboratory Service Report of operations Responsible Body Declaration In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for Alfred Health for the year ending 30 June 2019. Michael Gorton AM Chair Alfred Health Board 4 September 2019 6 Alfred Health How expert care saved Petra’s life When 35-year-old Petra Brosch’s heart A procedure connecting Petra’s heart to a stopped during a routine run on Elwood Beach, mechanical pump on the outside of her chest it was the start of a journey where The Alfred’s was performed. specialists would draw on the latest in modern To the surprise of staff, Petra stood up in the medicine to save her life. ICU – a big step to keeping muscle condition Petra was suffering irreparable heart failure. and being eligible for a heart transplant. After “To give her the best chance of survival, we put two months in ICU, a new heart became Petra on ECMO (extracorporeal membrane available. oxygenation) – a heart-lung bypass that “With our heritage of handling heart support supports vital organs,” Intensivist Dr Li Tan said. and transplant patients, we are prepared for “We were concerned about the brain, which is the long haul,” said Dr Peter Bergin, Medical vulnerable to damage without oxygen.” Director, Heart Failure and Transplant Service. Petra also suffered internal bleeding and fluid Petra is expected to get back to running and in her lungs, which a cardiothoracic surgeon work, though she has a long road ahead. relieved through surgery. “Her job now is to get strong, and we will help her,” said Dr Bergin. Annual Report 2018–19 7 Chair and Chief Executive’s year in review Leading critical care Increasing emergency presentations and high acuity were the distinguishing features of 2018 – 19. More than 9,550 trauma cases were treated and around 7,600 emergency surgeries performed. Our Intensive Care Unit (ICU) treated the most complex and unwell patients in Victoria as demand for critical care services continued to rise. To address this need in the short term, planning for a second