Patients as Partners
Birra li ante-natal classes
The aim of the project was to provide targeted ante-natal education in a group setting to Aboriginal families, which aligned with the services key performance indicators. The project has been conducted by Birra-li staff over the past two and a half years, with one year allocated to planning and consultation. The project aimed to break down possible barriers to clients accessing ante-natal education in a group setting, these included cultural safety, cost and known caregivers.
Data obtained from the program indicates a distinct improvement in client outcomes for three of the four key areas, breast feeding at discharge 91% (n31/34) which compares with 75% of Birra-li clients, smoking in second half of pregnancy 23% (n8/34) which compares with 38% of Birra li clients, rates of prematurity- births below thirty seven weeks 8% (n3/34) which compares with 14% of Birra li clients , 3% of infants born at term with a birth weight less than 2500g (n1/31), which compares with 1.5% of Birra li clients.
The drive for the project came from Birra-li clients whom requested that the ante-natal parenting groups be provided by Birra-li in a culturally sensitive and appropriate manner by known caregivers. Client evaluations has highlighted the strengths of the program being the diversity in the way information is provided accommodating different ways of learning, the safety of the group to openly talk without judgement, respect shown by staff and group learning.
Paula Milgate, Aboriginal Health Worker; Michelle Foster, Clinical Midwife Specialist.
Sally Graham, Lactation Consultant; Michelle Wickham, Social Worker; Sara Corrigan, Aboriginal Health Worker.
Patient led creation of Aboriginal Cancer Resources
To increase communication and engagement between Aboriginal patients and Tamworth Cancer Services through the provision of culturally safe, respectful and appropriate videos. Partnering with Aboriginal cancer patients and leaders in the Aboriginal Community to produce video resources about local cancer services. Production was performed by cancer centre staff, with reviews by local Elders and the Aboriginal Health Unit (AHU).
Videos produced for several audiences including staff. All videos endorsed by interviewees, local Elders groups and the AHU. Positive messages about Tamworth cancer services have been rapidly disseminated to local Aboriginal Communities. Project has received International acclaim.
Patient partnerships and commitment to better health outcomes for Aboriginal people have created effective resources and positive Community sentiment towards local cancer services.
Rose Wadwell, Aboriginal Chronic Disease Practice Development Officer for coordination and video production; Dave Willis, Chief Radiation Therapist, North West Cancer Centre for filming and editing.
The many patients and Elders who contributed, particularly Annie May Taylor for guidance, Len Waters for the uplifting "Welcome to Country" and Leonie Donovan for breast screen advocacy.
All the team at the North West Cancer Centre and Aboriginal Health Unit, particularly Tony Martin and Robyn Haack. Research, Innovations and Partnerships for the scholarship to backfill Dave.
Dr Tony Proietto, Jill Lack, Sharyn Tyter and Carolyn Bailey for continued support.
Written by the Mob for the Mob
To close the Gap by:
Enabling the Gamilaraay/Gomeroi Aboriginal communities of the Peel and Mehi sectors of HNELHD to develop culturally appropriate stroke resources (booklet/digital stories).
Evaluating the processes used to develop stroke resources.
A Participatory Action approach based on community engagement to develop and evaluate culturally appropriate and localised Aboriginal stroke resources. Gamilaraay/Gomeroi Elders and the Stroke Care Coordinator (SCC) have used the stroke booklet and digital stories to deliver stroke information to over 220 Gamilaraay/ Gomeroi Aboriginal people in the Peel and Mehi sector. Fifteen hundred booklets and five hundred DVD have been distributed. The processes used to develop these culturally appropriate stroke resources for Aboriginal communities can be used as a template to create resources for other diseases. Community participation and ownership in developing and evaluating health promotion materials and programs has led to successful implementation and acceptance of the stroke resources.
See Resources - Written by the Mob for the Mob
Rachel Peake, Stroke Care Coordinator; Ian Miller, Aboriginal Cultural advisor; Mary Anne Dieckmann, Aboriginal Stroke Nurse; Aunty Pam Smith, Aboriginal Elder; Coral and Bill Toomey, Aboriginal Elders; Audrey Trindall , Delphine Pitt, Slater family, Bob Faulkner Aboriginal Elder, Neville Sampson, McGrady family Toomelah; Jane Kerr, Chronic Disease Network Manager. The Gamilaraay/Gomeroi Communty.Toomelah Public School, Peel High School.
Integrated Health Care
A Telehealth Care Model for Patients with a Spinal Fracture
District wide development, implementation and evaluation of a telehealth care model for spinal fractures requiring a Thoracic Lumbar Sacral Orthotic (TLSO). Pre / post design evaluating model of care implementation across HNELHD. Surveys assessed staff educational outcomes, clinical data identified patient outcome improvements and cost efficiencies. As a result 78 patients managed with average LOS reduced by 5 days, 23638kms of travel eliminated for patients and families, significant increases in staff knowledge across 10 sites (P<0.05), 156 transfers and 390 bed days eliminated and representing $1.1 million in efficiency savings. This model streamlined patient journeys, reduced travel and transfers, enabling rural clinicians to provide specialised care addressing inequality between rural and metropolitan services, allowing the right care, in the right place, at the right time.
Project team: Ryan Gallagher, Michelle Giles, Jane Morison, Judith Henderson
Executive Supporters: Karen Kelly, Jane Gray, Kim Nguyen.
Site specific teams John Hunter Hospital: Dr John Christie Sarah Zehnder, Alison Whillets. Tamworth Hospital: Brad Hansen, Sarah Corben, Denise Grills, Julia Greaves. Maitland Hospital: Lynne Bickerstaff, Wendy Fernandes, Dr Kevin Tang, Kath Lynch. Calvary Mater Hospital: Greg Flint, Judy Holland, Lynda Liversidge. Taree Hospital: Jodie Nieass, Phillip Blenkin, Alicia Morris. Armidale Hospital: Catherine Death and Gemma Model.
Hunter Diabetes Alliance integration project
The project aimed to improve patients with Type 2 diabetes (T2DM) outcomes and experience of care by integrating care provision in the patient’s own General Practice. Each practice recruited 30 patients at moderate-high risk of complications to participate in a case conference of 40 minutes with their own GP, Practice nurse, visiting endocrinologist and diabetes educator. During the integrated consultation lifestyle, treatment options and individual preferences were discussed and an agreed management plan was made. All follow-up was undertaken by their primary care team.
A sub analysis of 109 patients seen whose HbA1c was >7% found that 75% improved. 51% of patients seen had lost weight. 100% of clinicians involved felt the experience was “satisfying or very satisfying”. Patients reported feeling involved, comfortable and supported as a result.
Dr Shamasunder Acharya, Clinical Director GNC Diabetes, Diabetes Alliance Clinical Lead;Dr Margaret Lynch, General Practitioner, Diabetes Alliance Clinical Lead; Dr Annalise Philcox, Calvary Mater, Staff Specialist General Medicine and Endocrinologist, Diabetes Alliance Clinical Lead; Dr Tracey Tay, Clinical Lead, Research, Innovation and Partnerships; Robyn Beach, Greater Newcastle Sector Diabetes Service Manager; Melissa Cromarty, Practice Development and Support Team Leader, Hunter New England and Central Coast Primary Health Network Martha Parsons, Project Offer, Diabetes Alliance; Belinda Suthers -Clinical Research Fellow, Hunter Medical Research Institute.
The VIP Program
Reducing the need for hospitalisation is a high priority for NSW Health. Analysis in 2014 of patient factors at Calvary Mater Newcastle to understand patient repeat representations and unplanned readmissions identified psycho-socioeconomic factors as key. We determined to meet the health and social care needs of patients at risk of representation and/ or readmission to improve their quality of life and reduce their need for hospitalisation. With the critical support of Executive Sponsors the model was implemented in mid-2015 and continues at Calvary Mater, Maitland and Kurri Kurri Hospitals. Diagnostics and evaluation methods included process mapping; demographic, service and performance analysis; and patient and staff interviews and surveys. Unplanned readmissions and emergency representations decreased by 44% and 17% respectively in first three months; patients and staff feedback is supportive of the model. Meeting VIPs’ health and social care needs has benefitted patients and the health care system.
Maryanne Ferreux, Deputy Director of Medical Services, The Maitland Hospital; Roslyn Barker, Whole of Health Strategy Manager, Calvary Mater Newcastle; Rosemary Aldrich, Director of Medical Services, Calvary Mater Newcastle; Katie Gordon, Medical Registrar, The Maitland Hospital; Matthew Rowlandson, Junior Medical Officer, Hunter New England LHD; Lynne Bickerstaff, General Manager, Lower Hunter Sector.
Thrombolysis and Transfer Improves Outcomes in STEMI
We examined two well described methods of reperfusion strategies for the treatment of myocardial infarction. Prehospital Thrombolysis (PHT) and Primary Percutaneous Coronary Intervention (PPCI). Previously patient’s treatment of myocardial infarction (MI) could only be commenced once the patient arrived to hospital. This project has allowed all patients, regardless of if they live in a rural or metropolitan area, to have their MI diagnosed and treatment commencement in the back of an ambulance via mobile phone with excellent clinical outcomes.
Our real world experience shows that PHT followed by early transfer to a PPCI capable centre is a safe and effective method of treating myocardial infarction for all patients across our district. This significant research project examined the major statistical endpoints that ensure this project is a robust examination of the treatment of MI. This analysis has ensured that our method of treating MI is comparable to any system worldwide.
Professor Andrew Boyle, Professor of Cardiology; Professor Peter Fletcher Professor of cardiology; Dr Arshad Khan, Advance Trainee; Mr Trent Williams, CNS Cardiology; Mr Lindsay Savage, Cardiac Liaison Officer/ Clinical Lead, Cardiac Stream; Dr Rohan Bhagwandeen Interventional Cardiologist/ Clinical Lead, Cardiac Stream; Ms Dawn Mcivor, Area Clinical Nurse Consultant Cardiology; Dr Alan Davies, Advance Trainee Cardiology; Mr Steve Faddy, NSW Ambulance Service; Mr Paul Stewart, NSW Ambulance Service; Mr James Leitch, Director Cardiology Department.
In conceiving of this project the following groups/ individuals we recognise-The Ambulance Service of NSW has been outstanding in their support and conceiving of this project; Cardiac Stream and HMRI; Dr Jim Leitch, Head of Department,John Hunter Hospital Cardiology Department; Ms Marie O Donnell- Service Manager Division of Medicine JHH Hospital & Ms Kathy Bullen Director of Nursing Division of Medicine John Hunter Hospital. We also thank the previous administration of Roz Everingham and Deb Harper.
Should we Treat Obesity in COPD? The Effects of Diet and Resistance Exercise Training
The prevalence of obesity in COPD is increasing and is now more common in COPD that in the general population. Obesity in COPD is associated with decreased exercise capacity, increased cardiovascular risk and reduced health status. However an obesity paradox exists whereby obese COPD individuals have improved survival. Clinicians are now faced with a dilemma of how to treat obesity in COPD. At present there is no level I or II evidence to guide treatment recommendations for obese COPD.
We have completed the first study evaluating the feasibility of a weight loss intervention in obese COPD participants and examined the effect on COPD outcomes. This intervention reduced weight, preserved muscle mass and led to clinically important improvements in COPD outcomes including health status, exercise tolerance and function. This novel work provides a framework for development of guidelines for the management of obese COPD patients and in guiding future research.
Professor Vanessa McDonald, Respiratory CNC (Honorary); Professor Peter Gibson, Senior Staff Specialist; Dr Hayley Scott – Dietitian and Researcher; Ms Penelope Baines – Physiotherapist and researcher officer; Dr Jeff Pretto - Scientific Director1 (deceased)
Professor Michael Hensley, Head of Department; Associate Professor Lisa Wood, Nutritional Biochemist
Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, New South Wales, Australia; Department of Respiratory and Sleep; Medicine at John Hunter Hospital in Newcastle & School of Nursing and Midwifery, The University of Newcastle.
Armidale Tele-Fracture Clinic
The Armidale Tele-Fracture Clinic is a local solution leading the nation in delivery of safe, innovative, patient centered care in managing orthopedic patients in their community. The utilisation of Telehealth has resulted in a sustainable, rapidly growing model of care that is being replicated across Australia.
Armidale commenced telehealth fracture clinic appointments to Inverell in 2013. The service currently sees around 15% of all orthopaedic appointments via telehealth, and it is close to 60% of the appointments from Inverell LGA patients (2015).
Driven by Senior Physiotherapists Gemma Model and Liz Wellard, along with Senior VMO Dr Robin Diebold, the service expanded in 2015 to include Tenterfield, and further in 2016 to Glen Innes. These towns now manage their orthopaedic patients locally, saving significant travel, inconvenience and expense, while still receiving top specialist care. Further, Armidale also offers Allied Health supported orthopaedic Telehealth follow-up appointments for patients of JJH surgeons, saving days in travel to Newcastle.
This is all at great benefit for their local patients, estimated to have saved patients over 100,000kms in travel, and approximately $85,000 in costs.
Senior Physiotherapists Gemma Model (Armidale) , Liz Wellard (Inverell) & Senior Orthopaedic Surgeon Dr Robin Diebold (Armidale VMO)
A virtual clinic: Cutting Distance, Empowering Patients
Initiating and adjusting insulin treatment involves frequent visits over many months. Face-to-face appointments can be problematic for patients living distantly from clinics, without transport or who have work or family commitments.
The telephone titration program, was established to replace face-to-face insulin adjustments offering more frequent, comprehensive and convenient patient review, with the capacity to problem-solve issues as they arise, on the spot. This virtual clinic involves Diabetes Educators adjusting insulin over the telephone. It aims to improve the diabetes control of patients on insulin therapy and enhance their care experience. The initial goal was to enrol 1000 clients into the program by the end of 2015, which has been achieved, with a further 500 patients enrolled in 2016. This innovative approach has resulted in fewer Specialist clinic consultations, reduced travel and other related costs, and reduced waiting times for new patients.
The project team comprises Clinical Nurse Consultants Marion Hawker, Susan Neuner, Michelle Kriss and Rosalie Arnold. The team wishes to acknowledge the nursing staff who have assisted with calls, Tamara Whitworth and Hilary Fejsa and all of the Diabetes Staff Specialists for supporting the project.
Hunter New England Closing the Gap Report
Five years ago the Aboriginal Health Performance Improvement Team began examining KPIs and data relating to Aboriginal Health outcomes within HNE. These processes lead to the development of the HNE Closing the Gap (CTG) Report, which monitors performance of the District against key priorities in Aboriginal Health. The Report highlights areas that are successfully closing the gap and areas that need further attention.
Data for the report is systematically extracted, cleaned, analysed and presented to show the disparities in health outcomes between Aboriginal and non-Aboriginal people. These results are presented to the ELT, Board, service managers and teams to drive accountability and identify areas requiring attention. Monitoring the results consistently has led to increased strategies and better health outcomes for Aboriginal people across HNE.
Aimee Smith, Program Manager, Aboriginal Health Performance Improvement Belinda Border, Daniel Groombridge, Kerry Rogers and Sarah Neal Health and Business Analytics Aboriginal Health Data Steering Committee
Physical Activity for Everyone: Preventing the Decline in Physical Activity
Physical Activity 4 Everyone (PA4E1) is a secondary school program that aims to reduce the decline in physical activity and to improve weight status among adolescents attending school located in disadvantaged areas. The program involved ten secondary schools (5 intervention schools and 5 control school) and involved 1,100 Year 7 students who were followed over 2 years. The Physical Activity 4 Everyone program supported secondary schools to promote physical activity through changes to the school curriculum, sport, PE and broader school policies and practices.
Evaluation using a randomised controlled trial design found that students attending schools that implemented the program performed 13% (7.0 minutes) more physical activity each day and gained 2% (0.9kg) less weight (p < 0.01) compared to student attending the control schools). The program was cost effective ($56 per additional minute of physical activity). This is the first school based physical activity program internationally to increase physical activity and reduce weight gain in disadvantaged adolescents.
If applied across NSW, the program could make a substantial contribution to achieving the Premiers Priority target of a 5% reduction in child overweight and obesity.
Rachel Sutherland, Health Promotion Program Manager; John Wiggers, Director, Hunter New England Population Health; Libby Campbell, Health Promotion Program Manager; Nicole Nathan, Health Promotion Program Manager; Lynda Davies, Project Officer; Nicole McCarthy, Project Officer; Jarrod Wiese, Project Officer; Karen Gillham, Service Director Health Promotion; Hunter New England Population Health Investigator Group: Luke Wolfenden (HNEPH), Philip Morgan (UON), David Lubans (UON), Tony Okely (UOW)
Secondary schools involved in the program. Research assistants involved in data collection. Jannah Jones, Kathryn Reilly, Kayla Lawson, Christopher Lecathelinais.
A Transdisciplinary Approach to Brain Injury Rehabilitation
Transdisciplinary practice is not widely used in specialised services, however it has the potential to increase efficiency through reducing duplication and fragmentation of care.
This project was initiated in response to staff and patient feedback during ‘rounding’ where concerns were raised over clinical duplication. A review of the Hunter Brain Injury Service (HBIS) model of care highlighted key areas where unwanted duplication was occurring and this was confirmed by clinical audit.
Implementation of the transdisciplinary approach has resulted in higher-value healthcare through increased efficiency that reduces unwanted duplication and increases clinician scope of practice.
This transdisciplinary approach could be used by any multidisciplinary team. The learnings and tools have been shared with the NSW Brain Injury Rehabilitation Directorate and with community teams within the Greater Newcastle Sector.
Chris Catchpole, Acting Service Manager;Janece Vandenberg, Speech Pathologist; Kate Mitchell, Speech Pathologist; Rebekah Pickering, Occupational Therapist.
Calories closer to theatre-Pre-Op Fasting not Starving!
A multidisciplinary approach, involving staff, patients and external stakeholders was undertaken at Armidale Rural Referral Hospital (ARRH) commencing June 2014 to reduce pre-operative starvation times and improve patient experiences.
The anaesthetists and surgeons agreed to introduce Preoperative Oral Carbohydrate Therapy (POC), revising the fasting guidelines to include a complex carbohydrate drink called preOp® (Nutricia). This clear fluid can be consumed up to two hours pre-anaesthetic ensuring an empty stomach, whilst maintaining a metabolically fed state during surgery.
Data shows a sustained 55% reduction in time since last calorie intake, and 32-39% reduction in headaches, hunger, thirst and nausea on arrival in theatre.
The introduction of POC has been successful with patients reporting reduced discomfort on arrival to the operating theatre due to decreased starvation times.
David Rowe (Anaesthetist), Alice Carter (Dietician), Michelle Widdison (Acute Pain Service) & Darlene Saladine (Quality, Excellence & Acute Pain Service) Anaesthetists, Surgeons, Dieticians, Acute Pain Service, Theatre & Surgical Ward Educators, Patient Services, Hospital Management, Emergency Department Staff & Community Pharmacies
Equipment Commitment: Supporting the Choice to Die at Home
The limited infrastructure and resources of Calvary Mater Newcastle - Department of Palliative Care (CMN-DOPC) impacted clinicians' ability to meet the equipment needs of patients who wished to palliate at home. Through collaboration with Hunter Equipment Service (HES), a new model of equipment provision was developed to support the unique needs of palliative care patients. The partnership enabled clinicians to deliver consistently equitable, efficient and responsive services to optimise the patient experience of end of life care in the home. This project resulted in increased availability of both basic and specialised equipment, improved patient and clinician satisfaction and enhanced financial sustainability for both services.
Project Team: Lisa McGavern , Jenny Gleeson and Emily Baird; Judith Swan, Research, Innovations and Partnerships; HNELHD- Hunter Equipment Service: Carole Towers, Kim Langford, Katiena Jones, Debbie Reynolds, Judy Crittenden, Jonathan Holt (Director of Allied Health, CACS-GNS), Derene Anderson (General Manager, CACS-GNS);Calvary Mater Newcastle-DOPC: Natasha Atkinson, Lisa Collins- Morgan, Barbara Bagley, Jo Davis.
Workplace Harmony Framework
The Workplace Harmony Framework is a multi-dimensional approach based on restorative justice principles aimed at;
building staff capability and confidence to discuss issues directly with colleagues;
increasing staff confidence in conflict resolution processes utilised in HNE Health;
reducing the time taken to resolve workplace conflicts thereby reducing the indirect costs associated with the conflict therefore enhancing conflict resolution outcomes
An initial targeted implementation was conducted with two clinical services. Your Say survey results have shown increases in both confidence in conflict resolution processes and agreement that conflict is resolved quickly between staff. Using the framework reduces the time taken to resolve an issue on average by 40 days compared to traditional investigations. Parties involved in facilitated conversations report high satisfaction with the process and outcomes. Manager’s report that their ability and confidence in having performance conversations with staff has increased. Evaluation data obtained from line manager interviews, workplace surveys and Human Resources Case data indicates that all the aims of the framework have been met by the approach taken.
Julie Dixon, Manager, Organisational Development (Project Lead); Robyn Liddiard and Steve Matchet, Respectful Workplace Consultants (Project team) Rebecca Brady & Donna Brown - Organisational Capability & Learning; Deb Kirchner - General Manager Belmont Hospital; Cathy McDonald, Educator Belmont Hospital; Sally Milson-Hawke - Director of Nursing John Hunter Hospital; Neridah Thomson and Leila Kuzmiuk and the Nursing Education team at John Hunter Hospital; John McDonald & Darren Robertson - Proactive Resolutions; Leanne Johnson - General Manager Mental Health & Nathan White, Senior Human Resources Consultant - Mental Health Services.
Eradicating Peripheral Intravenous Cannulation (PIVC) Infections At Belmont Hospital
An audit of PIVC insertion and ongoing care at Belmont Hospital identified several common practices that were being performed against policy and placing patient safety at risk. A questionnaire was sent out asking staff about their own practice and the practices they had observed in their unit. This provided a snapshot of the current culture within the hospital. Taking an innovative approach, the education team developed a multifaceted education program including a presentation illustrating adverse outcomes from infected PIVCs; in-service on management and care of PIVC and IV lines at the bedside and information flyers. Workshops were run to credential nursing staff in PIVC insertion and previously accredited staff were assessed on the ward. A review at the end of the project showed a sustained improvement in the care and documentation of PIVCs. Ongoing audit results have indicated that current levels of documentation and practice can be maintained over a prolonged period. The project has shown how a whole-of-hospital approach can result in significant change to culture and has resulted in improved clinical practice, with a significant decrease in healthcare associated PIVC infections.
Project Team: Greg Hays (Project Lead), Catherine McDonald, Remia Bruce, Robert Moore, Katrina Tonniges, Susan Walker, Belmont Standard 3 Committee, Gary Martin, Elizabeth Filmer, Trish Karbowiak, John Ferguson.
Arts and Health
Art and Culture at Tamworth Hospital
An interagency Tamworth Hospital Art and Culture committee, established in 2013, has collaborated to commission a range of art installations throughout the hospital which improve the experience of patients and visitors. Indigenous staff members, Elders and artists have been heavily involved in planning and delivering Indigenous art in the main entrance, the conservation and display in the main foyer of the original Aboriginal flag raised during the first NAIDOC week, and an outdoor cultural garden. Collaboration with the local regional gallery and the local Gomeroi gaaynggal womens program has resulted in loans of a large body of high quality artworks which are exhibited with little cost. Artworks produced during community health education and prevention activities are on exhibition, bringing community involvement and health together. The result is an impressive gallery of artworks at the hospital that creates a non-institutional and calming environment, with an emphasis on cultural safety for patients and visitors.
Marg Macpherson, Change Manager, Tamworth Health Service Redevelopment project; Dr Kym Rae, Gomeroi gaaynggal Program Director, University of Newcastle; Len Waters, community member and local elder; Bridget Guthrie, Director, Tamworth Regional Gallery; Sandra McMahon, former Director, Tamworth Regional Gallery; Ricki Bradbery, former Director of Nursing and Midwifery, Tamworth Hospital and all the members of the Tamworth Hospital Art and Culture Committee.
Gomeroi Gaaynggal Arts Health for Indigenous Women
The Gomeroi gaaynggal Arts Health/Research Programs work with Indigenous women to improve health literacy, access to services, and well-being during their perinatal period. An Indigenous artist guides creative activities to encourage self-expression through a variety of media. Whilst undertaking this, health professionals including; dietitians, midwives, community health, oral health as some examples, attend the art studio and engage in creative activities of their own. This innovative approach encourages two-way learning between professionals and participants. The participant can assist the health professional in developing their artistic skills and the health professional can explain aspects of health that are a part of their creative piece. Anecdotal evidence suggests that these women have reduced weight, increased exercise and improved the diet of their families.
Team: Kym Rae, Loretta Weatherall, Lyniece Keogh, Aunty Pearl Slater, Trici
Weatherall and Stella Sands.The Gomeroi gaaynggal program is supported by the HMRI, Mothers and Babies Research Centre and Priority Research of Reproduction at University of Newcastle. Its other contributors are the Radiology and Maternity services teams from Tamworth Rural Referral Hospital. The Gomeroi gaaynggal Steering Committee make outstanding contributions to the work that these programs can undertake.
JMO Award for Patient Safety & Quality Improvement
Urgent Clinical Reviews: How Well Are We Responding To Patient Deterioration?
Junior Medical Officers often find themselves at the coalface of the healthcare system and urgent clinical reviews are a significant part of their out-of-hours workload. As frontline doctors working across all acute facilities, Junior Medical Officers have a unique view of patient care and clinical risk. Clear and timely communication for deteriorating patients is vital for ensuring optimal patient outcomes. A pre-audit of the hospital’s Medical Officers’ Noticeboard (MON) was conducted in October 2014 to quantify the number of urgent clinical reviews inappropriately logged on to MON. A revised protocol for the communication of deteriorating patients between nursing staff and Junior Medical Officers was then implemented in June 2015. A new system was then developed and implemented in line with National Standard 9, which emphasises the importance of early recognition and assessment of deteriorating patient (NSQHS Standards 2010). As part of this new system, the project’s coordinators were able to provide education and training to the nursing staff and Junior Medical Officers.
Dr Rheily Wood, Dr Maryam Cassim , Dr Angel Agarwal ; Dr Melanie Smyth; Dr Carolyn Hullick; Dr Amanda Moore; Dr Sam Philips Clinical Governance, JMO Safety and Quality Committee for supervising and coordinating the project.