Annual Report 2018-19 Acknowledgement of Country Monash Health acknowledges the Traditional Custodians of the land, the Wurundjeri and Boonwurrung peoples, and we pay our respects to them, their culture and their Elders past, present and future. In this document, ‘Aboriginal’ refers to both Aboriginal and Torres Strait Islander people. ‘Indigenous’ or ‘Koori/Koorie’ is retained when part of the title of a report, program or quotation. Table of Contents Acknowledgement of Country 2 Report of Chair of Board and Chief Executive 5 The year in review 7 Jessie McPherson Private Hospital 24 Report of Operations 26 Our story 29 Our tertiary health services 30 Our campuses 31 Governance 37 Our Board of Directors 38 Our executive team 44 Our workforce 48 Clinical Governance Report 50 Environmental Sustainability Report 50 Financial Information 52 Consultancies Information 53 Disclosures required under Legislation 54 Attestations 58 Reporting of outcomes from Statement of Priorities 2018-19 60 Disclosure Index 71 Financial Statements 74 Notes to the Financial Statements 84-130 We are relentless in our pursuit of excellence Monash Health - Annual Report 2018-19 4 Report of Chair of Board and Chief Executive Welcome to the Monash Health Annual Report 2018-19 Our progress over the past year shines Our health professionals made Acknowledgements through the many achievements improvements to clinical practice across It is a privilege and honour for both of us highlighted in this report. the world, conducting world-class clinical to lead this organisation, full of dedicated and translational research, with 531 new In our 165th year, the care we provide to individuals who share a passion for research projects and 1,417 patient-focused our community continues to grow with achieving excellence. research projects currently underway. 4.1 million episodes of patient care, an We extend thanks to our Board Members increase of nine per cent over last year. We have continued to deliver our and Executive team for their leadership. Transforming Care Program of work, A highlight was the launch of our Strategic To all Monash Health employees, thank introducing initiatives across the Plan 2019-2023, which provides our you for your work and the wonderful organisation, enabling us to provide the focus for the next five years, setting out contribution you make every day to best possible care and experience for our our aspirations for the future and what we the health of our consumers. To our consumers. will do to meet the needs of the local and community, we thank you for your broader Victorian community. A stand-out for this portfolio has been our feedback, which provides us with rich work towards the introduction of our largest insights into how we can improve and Our strategic intent we are relentless technology-based transformation, the continue to grow. in our pursuit of excellence defines our Electronic Medical Record (EMR) Program, approach as a leading teaching and In addition, we recognise and honour implemented in August 2019. research health service of international the incredible strength our 377 official standing. After much consultation, we In line with our guiding principles, volunteers bring to Monash Health; along identified six guiding principles: we launched an Equity and Inclusion with more than 100 volunteers who visit Strategy. The Strategy ensures we are our hospitals from organisations such ▪ We consistently provide safe, high a place of opportunity and inclusion for as the Starlight Children’s Foundation, quality and timely care our employees. We worked with our Ronald McDonald House and Clown community, setting strategies and key We provide experiences that exceed Doctors. ▪ actions to improve and enhance the care expectations We acknowledge and thank the Victorian we provide. We work with humility, respect, Government, Department of Health and ▪ The $135 million expansion of Casey kindness and compassion in high Human Services (DHHS) and Federal Hospital continued, and we look forward performing teams Government for supporting us to serve to the phased opening of clinical spaces our diverse and evolving community. We integrate teaching, research and next year. Australia’s first Victorian Heart ▪ Together, we are delighted to share the innovation to continuously learn and Hospital and upgrades to Monash Medical Monash Health Annual Report 2018-19. improve Centre’s Emergency Department also progressed well. ▪ We orientate care towards our community to optimise access, In the following pages, you will find independence, and wellbeing highlights that reflect our large and diverse health service and demonstrate We manage our resources wisely and ▪ our principles, values and commitment to sustainably to provide value for our excellence. community Dipak Sanghvi Andrew Stripp Chair of Board Chief Executive Report of Chair of Board and Chief Executive 5 Monash Health - Annual Report 2018-19 6 The year in review 01 We consistently provide safe, high quality and timely care The implementation of the EMR Program ▪ Hospital at Night implemented which is improving the quality, is pivotal in transforming how care is the electronic Smartpage system, accuracy and efficiency of the service. provided. It will provide clinicians with improving the way clinical teams Structural reporting was implemented access to timely information about the communicate patient-related task ▪ in Perinatal Medicine and Imaging for people they are caring for, and assist requests and evenly distribute obstetric ultrasound, improving safety, them in making decisions with easier workload at night. quality and efficiency. access to best practice information. A single point of contact model was ▪ Monash Children’s Hospital gained In addition to our digital strategy, we introduced in surgery to reduce the ▪ a magnetic resonance imaging have embraced a whole-of-hospital amount of time patients waited for (MRI) licence, significantly increasing transformation with our Transforming elective surgery and pre-surgical access to this vital technology for our Care Program, enabling us to provide the appointments. This improved youngest patients. best possible care and experience for consumer experience and there was our consumers. The Program comprises a seven per cent reduction in the ▪ Enhanced team-based management 12 connected streams of work through number of patients waiting longer improved significantly, with 42 ward leadership, teamwork and redesigning than clinically recommended. governance meetings established systems and processes. monthly. Thirty five wards now have Mental Health continued to develop ▪ set ward rounds and a simple set Our achievements in this financial year its Consumer and Family Carer of discharge planning guidelines to include: Service and strengthen its Advocacy ensure patients are discharged with Committee with the addition of 12 Monash Health was the first service the information and support they ▪ new members and inpatient Peer in Victoria to implement the Neonatal require. Support Workers. Early Onset Sepsis Calculator to keep E-journey boards and patient newborn babies with their mothers so Our emergency department ▪ ▪ information technology systems in 162 that bonding and breastfeeding can implemented an Upfront Senior clinical areas were established. This be enhanced. Decision Making Model of Care to enabled timely and consistent visibility improve the length of stay and access Monash Health was the statewide of individual inpatient journeys and ▪ to Short Stay through timely delivery lead for the DHHS Maternity and identified delays in patient care. of high quality, patient-centred care. Newborn Rural and Regional This involved more efficient triage, We introduced an internal electronic Operating Model, to support women ▪ which enabled early assessment referral triage system across 46 adult in determining the safest places to of patients by senior clinicians and and paediatric specialist clinics. The deliver. the timely development of definitive time taken to process a referral from ▪ A Telehealth service was established management plans. initial receipt to booking the first across 13 adult specialties, reducing appointment has been reduced from Our Diagnostic Imaging Services patients’ travel costs by more than ▪ 16 to six days, eliminating the need for redesigned the Radiologist workforce $25,000 and travel by 450 hours. paper and reducing the risk of losing from a campus, modality-based referrals. model to a subspecialty model, The year in review 7 02 We provide experiences that exceed expectations Our Patient Experience Strategy was developed Our key achievements this financial year are: by embracing patient, family, carer and employee Partnering with our consumers to improve their health service feedback to identify where improvements were ▪ by rolling out MY Passport, which provides clear and simple needed. instructions on what they need to do when they leave hospital The strategy is being implemented through initiatives focused on and ensure safe discharge. five key areas: ▪ Continuing to facilitate regular Schwartz Rounds across all ▪ Discharge planning business rules our sites, giving clinical and clinical support employees an opportunity to discuss the social and emotional issues that Cleaning strategy ▪ arise when caring for patients. Food strategy ▪ ▪ Launching Monash Voices, which is a library of patient, family ▪ Ward processes (including effective ward rounds and nurse and employee stories that can be accessed for coaching and