Melbourne Health Annual Report 2016/17 OUR OUR OUR VISION VA LUES PRIORITIES Our vision is to be First in Our values and behaviours We aim to achieve our Care, Research and Learning guide the way we work vision by focusing on six to improve outcomes for our together to achieve our vision. strategic priorities. community and Victorians. Care Caring Care and outcomes First in delivering safe and high We treat everyone with kindness We deliver outstanding care quality care and compassion and outcomes Research Excellence Patient and consumer First in evidence-based research We are committed to learning experience integrated into practice and innovation We partner with and empower our patients and consumers Learning Integrity First in developing our workforce We are open, honest and fair Innovation and transformation and community Respect We embrace innovative We treat everyone with respect thinking in everything we do and dignity at all times Workforce and culture Unity We enable our people to be We work together for the benefit the best they can be of all Collaboration We maximise the potential of our partnerships Sustainability We are recognised, respected Front cover: and sustainable health services Our cover image focuses on women in surgery. It was inspired by Malika Favre’s ‘Operating Theatre’ which featured on the cover of The New Yorker magazine in April 2017. Clockwise from top: Dr Cassandra Hidajat, Resident; Dr Liz Pemberton, Anaesthetist; Associate Professor Kate Drummond, Neurosurgeon; Abigail Ryburn, Scrub Nurse. Back cover: Top: Alice Bennett, Program Manager, Cyril Jewell House and Safety Champion. Bottom: Professor Peter Colman AM, Director, Diabetes and Endocrinology – awarded a Member of the Order of Australia in the 2017 Queen's Birthday Honours. Photography: MH Medical Illustration Contents 02 Chairman and Chief Executive’s Report 08 Report of Operations Board of Directors Melbourne Health at a Glance Organisation Structure Our Clinical Services Significant Supporters Occupational Health, Safety & Wellbeing General Information Financial Summary 23 Key Financial & Service Performance Reporting Statement of Priorities Disclosure Index 35 Financial Statements Melbourne Health Annual Report 2016/17 1 Chairman & Chief Executive’s Report We are pleased to present the 2016/17 Annual Report for Melbourne Health. This year has been exceptional in many ways. As one of the most highly regarded public health “ Melbourne Health continues services in Australia, we deliver outstanding care and treatment for individual patients, we to grow and evolve into a improve outcomes for all through a comprehensive, health service of which all The Rt Hon internationally recognised medical research program Robert Doyle AC and we provide world-class training for our current Victorians can feel proud” Chairman and future health professionals. THE RT HON ROBERT DOYLE AC, CHAIRMAN Last year we provided more than 98,900 inpatient separations across our acute, sub-acute, mental health and residential care facilities, an increase of more than 6300 on last year. “ I have been immensely Our Emergency Department at The Royal Melbourne impressed by the Hospital (RMH) provided more than 74,000 people professionalism of the Professor Christine with urgent medical treatment, compared with over Kilpatrick 68,500 the year before. More than 184,100 outpatient Melbourne Health team Chief Executive appointments were held, an increase of more than 6000 compared with the previous year. and look forward to There were more than 5000 acute admissions across continuing our very our NorthWestern Mental Health (NWMH) adult, youth and aged services and our staff provided more important contribution to than 331,000 service ‘contacts’ in the community. the Victorian community” At the Peter Doherty Institute for Infection and Immunity, $30 million in grant funding was secured PROFESSOR CHRISTINE KILPATRICK, CHIEF EXECUTIVE as it became the hosting partner for three new Centres for Research Excellence. But it’s not only the numbers that tell the story. Each year, our staff dedicate themselves to saving thousands of lives, and improving health and wellbeing outcomes for individuals and communities. We thank them for their dedication and commitment to providing safe and high quality care that is underpinned by evidence-based research and excellence in learning. We also extend a heartfelt thanks to each and every one of the over 400 volunteers who selflessly gave their time throughout the year. From helping our patients and visitors find their way around the hospital to serving cups of tea, their generosity, friendship and kindness touched the lives of many. 2 Melbourne Health Annual Report 2016/17 Strategic Plan – Progress and results These elements establish and monitor behavioural expectations, build high performing teams, develop Our vision to be First in Care, Research and Learning, strong leaders and managers, and create a culture sets the standard that we strive for, the tone of our where feedback is openly and professionally given organisational priorities and influences our values and received. and our culture. In 2016/17, we completed the second year of our five year Strategic Plan. A review of our A central feature of the program has been the progress against our strategic priorities demonstrates introduction of the Safety Culture Program – tremendous achievements including: including leadership development, training in • Care and Outcomes: even though our Emergency Speaking up for Safety and a professional accountability Department presentations grew by 8 per cent, framework, weCare, to enable feedback about we continued to improve our emergency four- unprofessional behaviour. hour length of stay and ambulance offloading Realising that up to 95 per cent of Victorian performance. In addition, our elective surgery healthcare workers have personally experienced verbal waiting list dropped significantly (from 3077 or physical assault, we are providing active support in 2015/16 to 2621 in 2016/17) due to hard work for the Occupational Violence and Aggression in across the organisation. Healthcare public awareness campaign launched by • Patient Experience: we achieved our best ever the Victorian Government. Victorian Healthcare Experience Survey (VHES) result with 95.9 per cent of RMH adult inpatients The campaign aims to improve awareness of the rating their experience as very good or good in effect occupational violence and aggression has on Quarter 3, compared with the state average of healthcare workers – with the message that violence 94.6 per cent. and aggression against healthcare workers is never okay. While supporting this campaign, we are also • Innovation and Transformation: the opening of intensifying our focus on preventing and managing the RMH Clinical Trials Centre will deliver great occupational violence and aggression through a patient care while supporting groundbreaking number of initiatives across Melbourne Health. research. • Workforce and Culture: our Speaking up for Safety program, a training program helping staff Delivering safe and high quality care respectfully raise concerns to enhance teamwork and We are very proud of the significant improvements prevent avoidable harm, continues to gain strength. we continue to make in providing safe and high • Collaboration: the Collaborative Framework, with quality care for our patients and consumers. local community partners, has continued its work During the year we began implementing the Adult on improvements to the primary care and acute Sepsis Pathway, aimed at empowering clinical staff health interface. This has included an annual forum to identify the risk factors, symptoms and signs of and projects in end of life care, diabetes and chronic sepsis (the body’s systemic response to infection) and heart failure. respond quickly with initial management actions and • Sustainability: in the Victorian Premier's escalation. Since its implementation, there has been Sustainability Awards 2016, we won the Health a reduction in mortality, length of stay and Intensive category for the program Reducing Waste, One Care admissions. Dialysis Patient at a Time, with a range of waste reduction initiatives. Our contagion rates for Staphylococcus aureus bloodstream (SAB) infection have significantly dropped over the last seven years as we continue Building and strengthening working towards our target of zero. Overall, our our workforce culture healthcare associated SAB rate has been below the Our Cultural Transformation Program was developed Department of Health and Human Services (DHHS) in response to concerns raised by staff and a growing target rate for over two years and our results compare awareness of the significant negative impact that favourably with other tertiary Victorian hospitals. culture-related issues were having on our staff, patients Since the inception of the central line associated and consumers. bloodstream infection (CLABSI) prevention The program was launched in early 2016, collaborative in 2011, our infection rates remain low commencing a long term commitment to making as we head towards a target of zero. Of note, there were Melbourne Health a great place to work and a great zero CLABSI incidents in quarter 4 of 2015/16 which place to receive care. continued into quarter 1 of 2016/17 – a great result with overall performance significantly improving in Recognising there are many variables in culture, the 2016/17 year. the program includes activity across change management, anti-bullying,