2018 High Value Health Care Awards Finalists
The High Value Health Care Awards reinforces our focus on High Value Health Care and ensures we recognise work that accomplishes the Triple Aim of meeting population health needs at the highest quality and lowest cost per capita.
Patients as Partners
Recognising that patients are partners in their health care, this award aims to acknowledge projects/programs which promote collaboration between the patient and the health care team to improve health.
GP Case Conferencing- the impact on patient engagement – Lead: Michelle Kriss
A case conferencing approach involving Hunter New England Health specialists, patients and their GPs is showing increased skills, confidence and knowledge in self-management for type 2 diabetes patients. Improved outcomes have especially been seen in patients that were previously disengaged and overwhelmed (95% improvement) and those still struggling to manage their disease (63%). The approach was developed as part of the Diabetes Alliance Integration Initiative and saw visiting endocrinologists and diabetes educators participate in case conferences at an initial 53 participating GP practices. Patients are partners from the outset, participating in the development of management plans as well as completing surveys prior to each appointment to track their own progress and measure improvement.
Tracheostomy Review and Care Team (TRAC team) – Lead: Linda Liversidge
Calvary Mater Newcastle’s TRAC team was developed to better support and empower head and neck cancer patients to better manage their at home care and avoid admission to hospital. The small, specialist team have developed tailored interventions, education and supports for patients who are undergoing post-surgery radiation treatment. This has in turn reduced hospitalisations and the length of stay for those patients who do need to return to hospital. The latter fell from an average of 55 days in 2015 to 14 days in 2017 – despite a three-fold increase in the number of patients.
Mental Health Consumer Participation Unit – Lead: Elizabeth Newton
The Mental Health Consumer Participation Unit is recognised by peers around NSW as a standout example of contemporary good practice and of genuine, purposeful and meaningful consumer partnership. The unit recruits, trains and supports independent consumers and carers with lived experience of mental health to collaborate with managers and staff in a range of activities including strategic and operational planning, quality improvement and service redesign, governance and reform projects. Consumers are given a “seat at the table” in decision making that affects their lives. The result is services that are increasingly designed and delivered with the needs of mental health consumers in mind and that support a culture of respect, openness and transparency.
Delivering Integrated Care
This award recognises integrated systems that deliver truly connected care, using the correct information and analytics to inform this integration.
Improving Access to JHH Neurosurgery Outpatient Service – Lead: Bridie Ingham
The John Hunter Hospital (JHH) Neurosurgery Outpatient Service receives around 60 referrals per week from Newcastle and as far north as the Queensland border, so ensuring timely access is challenging. A redesign initiative was put in place to ensure better patient access and reduce waiting times. The initiative included several innovative strategies involving multiple services with the aim to improve the care provided to patients referred to and already on the JHH Neurosurgery Outpatient wait list. Over the past two years, the number of patients awaiting a scheduled appointment has reduced by 71% making it one of the most improved outpatient services across the facility. These improvements have been sustained for over eight months.
Connecting Corrections – Lead: Jenny Rutherford
The signing of a Memorandum of Understanding (MOU), enabling the provision of telehealth services between Hunter New England Local Health District (HNELHD) and Justice Health & Forensic Mental Health Network (JH&FMHN) in 2017 has created a new and innovative partnership. This project, initiated by JHH outpatient clinic nursing staff, recognises the challenges with providing specialist services to inmates of correctional facilities. Partnerships between outpatient clinics, HNE IT and Justice Health staff at Cessnock Maximum Correctional Centre, allowed the formulation of an MOU, now signed and supported by Chief Executives of both organisations. The MOU enables telehealth connections between HNELHD and JH facilities, reducing financial and safety issues of transferring between facilities along with improving the health outcomes for these patients.
Eliminating Hepatitis C infection from the Hunter – Lead: Mel Young
In March 2016, new effective medications were listed on the Pharmaceuticals Benefits Scheme for the treatment of Hepatitis C (HCV) infection, bringing the interferon era to a close. These were oral medications with minimal side effects and cure rates of over 90%. The HNE health viral hepatitis team faced this challenge with rapid adjustment of workflow to the changing landscape, and in so doing became one of the leading Lower Health Districts in Australia in HCV treatment uptake. From a previous annual baseline of less than 100 people treated per year, our service assessed and treated 1,605 people from March 2016 to March 2017.
Patient Safety First
This award acknowledges a commitment to putting patient safety first every day.
Reducing Falls in Residential Care with Focussed Exercise Program – Lead: Melina Psychas
According to the Clinical Excellence Commission approximately 75% of residents in Residential Aged Care settings have a mobility disability, and 50-60% will fall at least once per year. Wallsend Aged Care Facility (WACF) Allied Health Team has developed an exercise program that incorporates different physical therapies with a focus on falls reduction. The aim of the project was to review falls incidence over three years from implementation of a planned exercise therapy program for balance and strength training. As a result of the program, there has been a 35% reduction in falls over three years for residents of WACF.
10 out of 10 for Nutrition – Lead: Allison Fraser
Poor nutrition status in hospitalized patients has been associated with worse patient outcomes including an increase in risk for complications such as pressure ulcers, infections, longer hospital stays and an increased risk for readmission. The 10 out of 10 for Nutrition was a facility wide quality improvement project implemented over the period from the 31st July 2017 to the 22nd April 2018 to support Nutrition Care of patients admitted to the JHH. The project aimed to identify nutrition risk on admission, treat malnutrition and monitor patients to prevent nutrition risk during their hospital admission and achieved this after following the policy for six weeks.
Keeping People Healthy
The Harry Collins Award has previously commemorated the outstanding commitment and passionate contribution Mr Henry (Harry) Collins. Harry made a particularly outstanding contribution to the "Clean Hands Save Lives" Campaign prior to his death in November 2007. This campaign is an example of a Keeping People Healthy initiative. This award aims to acknowledge similar innovative projects and programs.
Healthy Food in childcare an online solution – Lead: Sze Lin Yoong
This multi-staged primary prevention initiative aimed to improve the diets of young children and target obesity by supporting childcare centres implement nutrition guidelines to improve children’s diets. Following collaboration with a range of stakeholders including health practitioners, dietitians and consumer agencies the online menu-planning solution was born. The healthy food in childcare initiative is the first globally to use a scientifically rigorous and stepped approach to identify an effective and scalable solution and has received Federal funding for implementation to all childcare services in Australia as part of a national strategy to improve child nutrition.
‘Sweet Dreams’ managing severe complex obesity – Lead: Katie Wynne
The ‘Sweet Dreams’ team hypothesised that a multidiscipline-led (dietitian, physician, nursing and health-coaching) intensive outpatient intervention commencing with 12-week very-low energy diet would result in 10-15% weight-loss and health benefits for participants with severe complex obesity. Over 48-weeks, individualised plans to target obesity-related health conditions including insulin resistance and obstructive sleep apnoea. This program was effective in tackling obesity-related health conditions and represents a new model of care for patients with severe complex obesity.
Deadly cooking for kids - a closing the gap initiative – Lead: Carmen Burgess
Deadly cooking for kids is a closing the gap initiative that uses the Walkabout Kitchen to take healthy eating, cooking and lifestyle messages to Aboriginal school children, in a fun, interactive and culturally sensitive way. The program addresses one of the biggest barriers to providing health care to Aboriginal communities – that being access. The Walkabout Kitchen allows health care to come to the community in a safe environment with which Aboriginal families are already familiar and engaged with. Deadly cooking for kids is an example of a sustainable collaborative initiate leading to better participant outcomes and engagement in healthy lifestyle behaviours.
Supporting our People
Developing and supporting NSW Health’s people and culture is a priority for NSW Health. By supporting the people working for NSW Health, positive interactions in the workplace are inspired and health outcomes are improved.
Improving specialist outpatient service waitlists – Lead: Sush Wagner
To improve timely access for patients referred for specialist outpatient services at the John Hunter Hospital, a suite of data-informed and clinically led strategies were introduced within and across specialist outpatient services. Over the past four years, there has been a 68% reduction (5,711 patients) in the number of patients waiting more than one year without a scheduled appointment. The longest wait time for a patient without an appointment has more than halved. Patient access to specialist outpatient care has significantly improved. Improvement strategies are being progressively implemented across other services.
Improving patient and family centred care at the End-of-life – Lead: Jeanette Lacey
The introduction of an end of life care nurse practitioner (EOLCNP) in 2015 allowed for referral from all health care professionals to improve the communication and holistic assessment of needs for patients dying in the acute care sector. Patients who receive consultation from the EOLCNP at the end of life receive a comprehensive palliative care needs assessment, medication assessment, management and support for staff administering medication, and documentation of discussions and explanation of the dying process. This model of care specialising in the last weeks of life improves communication and needs assessment for patients and families in their last days of life.
Small town after hours medical services – Lead: Peter Finlayson
Rural towns rely on a small number of local doctors. When they cannot be available the local hospital and community can now depend on the Small Town After Hours (STAH) program. Collaboration between local doctors and hospitals, HealthWISE New England North West and the Hunter New England Central Coast Primary Health Network provides an on-call doctor with local knowledge who is available to either teleconference or videoconference. The system is cost-effective and reliable. The system is well received by hospital staff and community members.
A Safe and Healthy Workplace
This award aims to acknowledge the strong safety and healthy culture that underpins NSW Health’s commitment to providing a safe working environment for all staff.
Speech Pathology, Linking therapy into isolated schools – Lead: Helen Malcolm
Armidale Paediatric Speech Pathology identified that children living in remote locations with significant speech and language issues, have reduced access to services. Substantial travel is required, with children missing large amounts of school. Telehealth was trialled between the speech pathology department and the child’s school to provide therapy for isolated children. The aim was to reduce the amount of missed school time, reduce travel for families and increase access to services. Telehealth proved a viable alternative for delivering speech pathology intervention to children living in isolated areas.
Health Research and Innovation
Collaboration between researchers, policy makers, service users, health managers and clinicians in research is critical and can lead to findings that are more likely to be innovative and positively inform health decisions. This includes innovative future focused infrastructure and digital health initiatives.
Paediatric high-flow oxygen for bronchiolitis – Lead: Elizabeth Kepreotes
Viral bronchiolitis is the most common respiratory infection in infancy. A randomised controlled trial of 202 infants was undertaken with the primary aim to test whether high-flow warm humidified oxygen (HFWHO) compared to standard oxygen therapy reduced the median time on oxygen for infants aged < 24 months with moderate bronchiolitis. There was a significant difference in favour of HFWHO in the median time to treatment failure and proportion of treatment failures and HFWHO was able to reverse the deterioration of 59% of infants who failed to be supported by standard therapy.
Better Outcomes for women with Gestational Diabetes – Lead: Christopher Rowe
This innovation is a world-first insulin-infusion algorithm designed specifically for pregnant women. The team proved that existing care models expose mothers and babies to extended periods of risky hyperglycaemia and hypoglycaemia and developed a new model of care PIIGI - an insulin algorithm designed specifically for pregnancy. Following with real-world analysis of the PIIGI-model of care, PIIGI was proven to be safer and more effective for mothers and babies.
Implementation of Telestroke across HNE – Lead: Carlos Garcis Esperson
The John Hunter Stroke team has pioneered both the research validation and now the translation of the multimodal CT into clinical practice both in the major “comprehensive” stroke centres and also now, in regional or so called “primary” stroke centres. They have developed a network of primary stroke centres across HNE (Taree, Tamworth, Armidale Hospital) and Mid North Coast (Port Macquarie and Coffs Harbour) supported by multimodal CT with Telestroke. It is the first and only network worldwide that has implemented multimodal CT in regional centres for acute stroke decision.
FaceMatch - Searching for a diagnosis – Lead: Tracy Dudding-Byth
The FaceMatch project uses advanced facial recognition technology to match people with the same rare genetic conditions, helping families improve the chance of obtaining a diagnosis for their child. Stage 1 of this project was the establishment of an international web-based FaceMatch platform. In April 2018, the creative and multi-disciplinary FaceMatch team successfully launched this first-of a-kind project allowing world-wide dual parent/doctor participation. The parent-empowering model allows parents to initiate involvement and directly contribute to the development and editing of their child’s profile page. This significant and timely achievement allows to FaceMatch team to pursue stage 2 of this ground-breaking initiative.
Excellence in the Provision of Mental Health Services
Mental Health is a priority area for the NSW Government. This award recognises and showcases innovation in improving the quality and safety of mental health patient care within programs.
Police Ambulance Early Access to Mental Health Assessment via Tele Health (PAEAMHATH) – Lead: Jay Jones
PAEAMHATH provides a tele-health triage (via use of an iPad) to people who are in a degree of crisis, but who are not acutely unwell, with the aim of reducing that person’s unnecessary transportation to hospital. Police and Ambulance connect with a mental health professional located at the Mental Health Contact Centre and a triage is carried out via video link up. Recommendations of care are made by the mental health professional including transportation to hospital, follow up appointment with community mental health and an appointment with the GP. PAEAMHATH is a sustained service and in the year since its launch has seen 51 patients in their homes, 38 of those patients avoided transport to the Calvary Mater hospital and were linked into the Newcastle community Mental Health Team.
Developing a Consumer Seal of Approval: A consumer-led project – Lead: Elizabeth Newton
Hunter New England Mental Health Service (HNEMHS) develops a number of publications that provide staff, consumers, carers, families and loved ones with information about a vast range of issues pertaining to care and the service. As often as possible, this information is produced and reviewed by someone with lived experience of mental illness to ensure the language is easily understood, the material is specific and relevant to the reader and does not perpetuate stigma in any way. To ensure people reading the material would know that it had undergone this review process, a “seal of approval” was developed.
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