QUALITY CARE BARWON HEALTH ANNUAL COMMUNITY MAGAZINE / ISSUED FEBRUARY 2010 THE MYTHS OF THE EMERGENCY DEPARTMENT ENVIRONMENTAL CHANGE FOR PERCY BAXTER LODGE Taking the fear out WIN a 12 month of a hospital visit Contours gym membership! CLINICAL QUALITY AND RISK MANAGEMENT COMMITTEE Ms Janet Farrow Assoc Prof Steve Bolsin Jo Bourke Dr Lucy Cuddihy Paul Cohen on the cover Mr Marcus Dripps Francis tells his story about a visit Mr Peter Flanagan to the Emergency Department Dr Andrew Hughes where he is pictured in Fast Track. Dr Karen Lane Dr Sarah Leach Mrs Maree Markus Perry Muncaster Dr Simon Tomlinson Prof David Watters Dr Tony Weaver QUALITY OF CARE WORKING GROUP Kate Nelson Lauren Leed Contents Welcome Your local health service Community Engagement Committee Emma Harty - Intern The Quality of Care magazine has been published every year Barwon Health is Victoria’s largest regional health service and Georgina Walton – Intern The myths of the Emergency Department 02 since 2004 and is an opportunity to showcase improvements Geelong’s biggest employer, employing over 5,440 people. We PUBLISHER Read the Play 06 across Barwon Health. Quality improvement is embedded in provide high quality, safe, people-focussed care to more than our culture and the recent Australian Council on Health Care 500,000 people in Geelong and South Western Victoria. Barwon Health Standards (ACHS) accreditation is testament to this with the Volunteers - a vital part of our health service 07 Health services available through Barwon Health cover the full WriterS assessors impressed by the dedication of our staff to continual improvement. Barwon Health was awarded four outstanding spectrum from emergency and acute care to mental health, Kate Nelson Smarter technology for Birdsey Wing 5 08 achievements (OA) by the assessors, a result unprecedented primary care, community services, aged care and Lauren Leed in Australia. To achieve one OA is excellent, to achieve four is sub-acute/rehabilitation. Physiotherapists help breathe life into the Principal Photographer fantastic and is evidence of the calibre of staff we employ. management of chronic lung disease for Helene 09 Katrina Lawrence The feature articles in this magazine showcase work that has Emergency Department Attendances been recognised at our internal Annual Quality Awards. We DESIGN What’s good for you? 10 have also taken this opportunity to showcase how constant 2004/05 38,549 Grindstone Creative innovation has resulted in a more streamlined patient journey Meet the new face of the Foundation 12 through our hospital Emergency Department and other 2005/06 40,620 DISTRIBUTION services, resulting in a truly integrated health care service. 128,000 copies are distributed through the Geelong Romping & chomping to better health 14 This integration also applies to our relationships with our 2006/07 42,305 News and The Echo and at Barwon Health’s 21 sites at partners, such as headspace Barwon. Health initiatives like a cost of 29 cents per copy. An electronic copy is also Keeping on the ball 15 this provide additional services for the youth of the region, 2007/08 42,919 available for downloading at Barwon Health’s website ensuring that their care, by all stakeholders, is integrated and www.barwonhealth.org.au Taking the fear out of a hospital visit 16 seamless. 2008/09 46,790 Disclaimer: This publication is intended as a general guide This magazine is produced every year, taking into account One stop shop for youth health needs 17 0 10,000 20,000 30,000 40,000 50,000 to the services provided by Barwon Health. It does not comments received from the community from the previous substitute for health advice from an individual’s medical year’s edition. If you have feedback we would like to hear Number of Attendances specialist, general practitioner or other health adviser. Right patient, right place... first time 18 from you and have included a survey for you to complete. Environmental change for Percy Baxter Lodge 19 We trust you enjoy reading about your health service. WHY WE produce THE QUALITY Our Emergency Department is one of the busiest in the State OF CARE MAGAZINE and has seen strong growth in usage over the past five years. Consumer, carer and community participation 20 Since the completion of the redevelopment we have seen an increase of 15% in presentations. To deal with this increase This report is produced annually as part of Monitoring quality of care 22 we have introduced new models of care such as Fast Track a commitment to the State Government to Paul Cohen and have made changes to how we manage both incoming and increase community awareness of activities and Acting CEO outgoing patients from the main wards of the hospital. achievements within Barwon Health. Readers’ survey 27 Barwon Health serves a geographically dispersed population This report profiles various projects that evolved Contact 29 through two major sites with 1016 beds and over 21 sites from an identification of areas that needed stretching from Geelong down the coast to Torquay, Anglesea improvement. Community representatives have and Lorne. been involved in the process of selecting stories to Janet Farrow feature in this magazine based on their opinion of Thanks to Town and Country Children’s Centre and case studies for allowing Chair, Clinical Quality & Risk Management Committee what the community would like to hear about. us to take photographs to accompany the stories in this magazine. mythsThe of the Emergency Department BEHIND THOSE BIG white DOORS LIES A whole different world Nurses and doctors are bustling about, patients arriving The Emergency Department has a section called ‘Fast Track’ by ambulance, and patients under careful watch in the which can be confusing for people sitting in the waiting room resuscitation bays. Well, that’s what they show on popular seeing people go before them with something less urgent like TV programs, but Doctor David Eddey, Director of Emergency a sprained wrist. Medicine, says the percentage of patients who come in needing resuscitation is only 1 per cent. “We have dedicated staff who work in the Fast Track area of the Emergency Department who specialise in those cases like “We can be busier when the Emergency Department is half sprains, simple fractures and cuts,” Dr Eddey said. full and quieter when all the cubicles are in use,” Dr Eddey explained. “It depends on the type of patients we have in on “So while it looks like people with less urgent needs are going the day – it’s not all blood and guts like they show on the TV.” through first, the Fast Track area actually frees up the main department for the urgent cases and staff aren’t taken away The most common patients who come into the Emergency from the emergencies to plaster a broken limb.” Department are cardiac patients, children, people with mental health concerns, older people, and fast track cases such as So when should you go to a GP instead of the Emergency people with fractures, cuts and minor problems that can be Department? Dr Eddey says you should visit your doctor when seen quickly and usually without complication. It’s far different you have a problem that’s not urgent or life threatening. to what we see on TV! “In the Emergency Department, we So what happens when you arrive at the Emergency Department? The first step is to see the triage nurse. This have the equipment, skills and training nurse will decide what category you fit into based on your symptoms and condition so it is important that you give the to deal with life threatening and nurse an accurate description of how you are feeling. The urgent medical conditions. GPs don’t triage nurse will put you in a category from 1 to 5, with 1 being the most urgent and 5 being non-urgent. commonly deal with these issues,” “On average, 150 patients attend the Emergency Department Dr Eddey explained. every day,” Dr Eddey said. “Patients in the Emergency Department are seen on an urgency “Our Emergency Department never goes on ambulance bypass, basis, not on an arrival basis like in a GP clinic. The situation in meaning we never send patients to another hospital because the Emergency Department is constantly changing depending we are full. We have 40 beds and we will always make room on what comes through the doors.” for the sickest patients.” Jeff Urquart, GP Liaison Officer at Barwon Health, says that Many people assume that if you come in by ambulance, you some GPs will refer their patients to the ED. will be seen to straight away. Dr Eddey explains that this isn’t always the case. “Sometimes a GP will send their patient to Emergency with a letter because urgent tests are needed to sort out “In the ideal world, the ambulance brings in emergency patients a diagnosis. Patients with severe pain, signs of significant though it’s not always the case,” he explained. infection or bleeding, or those with a heart attack, stroke or breathing difficulties will also be referred off to the Emergency “Whether you have come in by ambulance or walked through Department for further management ” said Jeff the door, everyone still goes through the same triage process and sometimes ambulance patients are sent to sit in the waiting room if their condition doesn’t require emergency treatment. Sometimes the person who has come on the trolley isn’t as sick as the person walking through the door.” mythsThe of the Emergency Department “A letter from the GP will have all the patient’s history and medications which can save a lot of time in ED but a letter doesn’t guarantee you will be seen straight away; all patients go through the same triage process.” After hours, there are options available if you need non-urgent treatment.