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WEST WIMMERA HEALTH SERVICE HEALTHCARE A SH A R ED SENSE OF P U R P OSE ANNUAL REVIEW 2013/14 CONTENTS The Value of Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Vision, Mission, Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 President's Report – From the President's View . . . . . . . . . . . . . . . . . . . . . . . . . 2 Chief Executive Officer’s Report – The Cutting Edge of Rural Healthcare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 A Noteworthy Year . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Our Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 Community, Volunteers, Donations and Fundraising . . . . . . . . . . . . . . . . . . . . 18 Statement of Priorities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 Strategic Directions Targeting Health Issues . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 Statistics Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 Financial Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29 Clinical Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Aged Care in Our Community . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35 Acute Patient Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38 Allied Health . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41 Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Dental. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44 Disability Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 Medical Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Medical and Clinical Visiting Consultants . . . . . . . . . . . . . . . . . . . . . . . . . . . 50 Quality of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Stories of Quality of Care in Allied Health . . . . . . . . . . . . . . . . . . . . . . . . . . 52 Consumer Care and Community Participation . . . . . . . . . . . . . . . . . . . . . . 54 Dimensions of Quality in Residential Aged Care . . . . . . . . . . . . . . . . . . . . 58 Quality and Safety for Our Patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 Preventing and Controlling Healthcare Associated Infections . . . . . 64 Corporate and Quality Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66 Environmental Sustainability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68 Occupational Health and Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70 Human Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Staff 2013-2014 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Human Resource Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74 Staff Service Awards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Governance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 A large number of individuals bring a multitude of skills to form an effective, professional health service. At WWHS many have joined our ranks from overseas. Linda Knight (walking next to CEO John Smith in the cover photograph), is a typical example. Linda came to work at Nhill from Zimbabwe following robust support for her migration application from the CEO and executives. Having successfully completed the move to Nhill, Linda soon discovered she was part of a multicultural team that shared a cohesive sense of purpose that characterises West Wimmera Health Service and the people who work under its aegis. Residential Aged Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 COVER STORY Lines of Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 The Board of Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78 The Executive Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80 Clinical Governance at West Wimmera Health Service . . . . . . . . . . . . . 82 Accreditation Status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 84 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87 Sponsors / Acknowledgements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 Notes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Help Support Your Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91 Reader Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92 Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC HEALTHCARE - A SHARED SENSE OF PURPOSE This Annual Review/Quality of Care Report is an all encompassing report by West Wimmera Health Service to our communities, colleagues and partners. The Report is a comprehensive overview of the achievements, successes and disappointments for the reporting period 1 July 2013 – 30 June 2014 and is a companion documents to the Annual Report 2013-2014. Items contained in this report specifically pertaining to quality satisfy the Victorian Department of Health’s guidelines for reporting the safety and quality of our care. The Report will be released at the 2014 Annual General Meeting of the Service to be held in the Nhill Community Centre at 8.00 PM on Friday 21st November 2014. The Guest Speaker at the meeting will be Dr Peter G. Habersberger AM, a renowned Cardiologist, long serving member of the Royal Australian Naval Reserve. This Report will be available at all sites of West Wimmera Health Service, by contacting 03 5391 4222 and can be found on the Internet at www. wwhs.net.au/publications Your comments on this publication would be most welcome. OUR VISION To establish a health service without peer through the pursuit of excellence and by opening the doors to innovation and technology. OUR MISSION West Wimmera Health Service is committed to the delivery of health, welfare and disability services which are compassionate, responsive, accessible and accountable to individual and community needs, which result in quality outcomes for the people of the West and South Wimmera, and Southern Mallee. THE VALUE OF COMMUNICATION OUR VALUES This Annual Review overviews the events, activities, management STRONG LEADERSHIP AND MANAGEMENT and people that represent the performance and progress of West Wimmera Health Service during the financial year 2013-2014. The accessibility of the information this publication contains and We value our organisation and will encourage exceptional professional skills and promote collaborative teamwork to drive better outcomes for our consumers. A SAFE ENVIRONMENT the manner of its presentation are important to us. Safety will always be our prime focus. As a health service it is vital that we tell our story well – to A CULTURE OF CONTINUING IMPROVEMENT our communities, to our staff and to health professionals in Australia and around the world who may consider joining us. In addition we are required to keep the government of Victoria up to date with every aspect of our Service, to make a valid call for benefactors and fundraisers to support the work we do and to an array of suppliers and business relations to demonstrate the professionalism of our organisation. The consistent quality of our communications across diverse media channels has been recognised at the highest level for its excellence. The delivery of superior care to our consumers motivates a culture of quality improvement in all we do. EFFECTIVE MANAGEMENT OF THE ENVIRONMENT Our Service is managed in ways which recognise environmental imperatives. RESPONSIVE PARTNERSHIPS WITH OUR CONSUMERS We maintain a productive relationship with our communities and stakeholders through open communication, honest reporting and a willingness to embrace constructive suggestions. More importantly it has proved to be an integral component in establishing understanding and support in our communities and helping to grow our Service in scope, scale and quality. ANNUAL REVIEW 2013/14 1 PRESIDENT’S REPORT THE PRESIDENT’S VIEW The central purpose of West Wimmera Health Service is to improve the health and wellbeing of the people in our diverse communities. This Report clearly sets out the progress made towards meeting that imperative. In my first term as Chair it is with confidence I report to our stakeholders the solid performance of West Wimmera Health Service for 2013-2014, details of which are contained in this Report. Astute financial management in a testing economic climate resulted in a small Operating Surplus which will make sure West Wimmera Health Service retains its role as a key provider of healthcare for the communities of rural remote North West Victoria. Each year the Board sets targets to meet its essential imperative by providing a broad spectrum of services. I am pleased to report our performance and degree of success against these targets. This included compliance with regulatory obligations and, in particular, the access of our communities to an essential selection of health services. The result was excellent and a true reflection of the Board's comprehensive forethought and planning. This Report also brings to the forefront the benefits of instigating our Capital Infrastructure Plan to “support the delivery of clinically appropriate and cost-effective care in the most appropriate setting” . STRATEGIES AND PROGRESS In this, the second year of addressing the Statement of Priorities, an agreement to meet objectives set by the Department of Health, Victoria, we met all and exceeded many of the targets set. Performance against our Strategic Directions 2012-2015 policy was strong and has provided a sound base for the progress expected in the coming year. Performance details against these strategies can be found on page 22. BOARD COMPOSITION There were no changes to the composition of the Board this year, however, Darren Walter, who was appointed to the board on 1st July 2011, bringing a host of community knowledge to the board-table did not seek re-appointment. Thank you for your valuable contribution Darren. WEST WIMMERA HEALTH SERVICE I express my gratitude and appreciation to you one and all and look forward to even greater achievements in the next reporting year. MOVING FORWARD Given the health reforms set to take place in the coming year this Service will continue to lead rural health care and retain the diverse nature of services currently available. In accordance with our Vision of being 'a health service without peer' the board is adamant to maintain the Service's leadership in providing broad-based, high quality healthcare for our rural and remote communities. THANK YOU I am privileged to be elected as Chair of this impressive Health Service, and I take the opportunity to thank all Board Members for their commitment of time, energy and undoubted desire to retain West Wimmera Health Service as a preeminent service being able to maintain its social, environmental and financial sustainability. 2 Of course the Board could not carry out its duties without the unparalleled support and advice of the Chief Executive Officer, the Executive Directors, Managers and the 500 plus people who form the team that makes this organisation ‘tick’. Leonie G. Clarke JP President CHIEF EXECUTIVE OFFICER’S REPORT THE CUTTING EDGE OF RURAL HEALTH The diversity of staff, services and facilities at West Wimmera Health Service unite to create an environment of exemplary hospitality and comfort. Our industry-leading systems, assets and work practices ensure our communities receive first-rate healthcare, in a timely and accessible manner close to home. SUMMARY OF OUR YEAR This report discloses the activities, achievements and challenges of West Wimmera Health Service for the reporting period 1 July 2013 to 30 June 2014. It measures performance against targets, describes the methods employed in delivering our services, and ensures conscientious compliance with regulatory and reporting standards. Financially, WWHS continues to be very well placed. This year’s operating surplus of $14,000 was an important achievement ensuring patients, residents and clients continue to experience exemplary services. BUSINESS EXPANSIONS PROPOSED MERGER OF SERVICES Our proposed amalgamation with Dunmunkle Health Service will see increased service delivery as we unite with them in the provision of top class healthcare to the communities surrounding Rupanyup, Minyip and Murtoa in the North Western Region of Victoria. ANNUAL REVIEW 2013/2014 This union is in the public interest and we envisage it will offer sustainable health services to the region and ensure a more effective and efficient use of public funds. It will also offer increased stable health-related employment in the Dunmunkle area. We now await the Government’s approval of this request. MEDICAL PRACTITIONER EXPANSION We are exploring, in conjunction with Tristar Medical Group, a very innovative concept of employing a General Practitioner to be based at Nhill Hospital. General Practitioners in our Hospitals and Residential Aged Care Units have Visiting Rights but are not directly employed by the Service. If the concept comes to fruition it will add a very different dimension to our medical services in the support for nursing and existing Tristar General Practitioners, expediting medical reviews diagnostic matters, medical administration and importantly may be a model for other small rural health services to take up. CAPITAL INVESTMENT In a busy year for capital investment we have focused on four significant infrastructure projects: • Completion of the ‘New’ Goroke Community Health Centre; • Construction of the Natimuk Medical and Allied Health Clinic; • Construction of the Allied Health, Day Centre and Community Rehabilitation Centre, Nhill; • Construction of residential accommodation for students and staff is underway. Workplaces designed specifically for the programs and activities they are to be used for promote efficient and cost effective work practices. They also provide an environment conducive to the delivery of safe, high quality care and it is our premise that our planned capital development will continue to add value to every aspect of our Service. 3 CHIEF EXECUTIVE OFFICER’S REPORT NHILL COMMUNITY GARDEN We have continued working with the Hindmarsh Shire Council and Regional Development Victoria to expand the Community Garden. The garden has doubled in size since it opened, with continued interest from a broad spectrum of community members. The garden, a very positive community project, brings many sections of the community together in a healthy, learning and enjoyable activity. It gives rise to the integration of many sections and many age groups including the Karen community and the clients of our Disability Service. We are presently investigating funding opportunities to increase rain water storage at the site to allow the garden to be expanded. FUNDRAISING FOR THE FUTURE While the Commonwealth and State Governments provide a component of our funding, they do not provide a total financial solution. It is becoming evident that we will be required to make increased financial contributions to the provision of our services in future years. Given this prospect the Board of Governance decided to embark on a major fundraising initiative, pursuing a $5 million target for use on Capital Projects. This is astute governance. 4 WEST WIMMERA HEALTH SERVICE If successful the Appeal will set the course of our ability to deliver ever improving services in the future. SURGICAL SERVICES REVIEW In June 2013 the Department of Health initiated a review of procedural services at the Nhill Hospital. The Review was conducted by an expert panel of prominent Medical Practitioners who visited Nhill to investigate first hand surgical processes, including interviewing Surgeons, General Practitioners and nursing staff. The Surgical Review provided a resounding endorsement of elective surgery at Nhill Hospital, noting that “the range of procedural services undertaken at Nhill Hospital is considerable and impressive for a rural hospital. We do not recommend ceasing or changing the range of surgical services at Nhill.” A number of recommendations were made aimed at enhancing the safety and quality of service provided including the purchase of new equipment, greater collaboration with the Regional Hospital and ensuring that some surgeons stay overnight following theatre sessions in order to supervise patients through the important first 24 hours post surgery. All such recommendations have now been implemented and we move forward confident in the knowledge that surgical services at Nhill Hospital will continue to be provided in a safe, effective and efficient manner. MEDICAL SERVICES REVIEW The result of the Surgical Services Review has encouraged us, in conjunction with the Department of Health, Ballarat Health Service and Wimmera Healthcare Group to conduct a similar review for medical services. We are presently seeking advice from the Department about how we should plan such a review and which eminent practitioners would be best suited to assist with this process. We are making unflagging efforts to ensure what we do is the best course of action to guarantee our services are impeccable! The new Goroke Community Health Centre - an example of how fundraising can ensure quality infrastructure for West Wimmera Health Service DENTAL CARE The Graduate Dentist Program funded by Dental Health Service Victoria Voluntary Dental Graduate Year Program provided two graduate dentists this year. Why was that important? The funding provided the salary for the graduates and also a mentoring allowance. The program assists us to provide ongoing clinical support for new dentists, enhancing their practice experience and professional development. It also significantly benefits the community, providing an increased dental workforce and service delivery capacity. RURAL FLYING DOCTOR SERVICE Visits from the Royal Flying Doctor Service to our smaller sites have been a welcome contribution to oral hygiene programs and more importantly for parents to have the recommendations of an experienced Dentist addressing the future dental care requirements of children. In this region where it is sometimes difficult to access dental services these visits proved to be an incredible bonus. For children to undergo a comprehensive review of the status of their teeth at no cost, in their community and for parents then to have the opportunity to act on the result is a tangible improvement within our dental services program. POLITICAL LOBBYING We have passionately lobbied the Federal Government about the proposed repeal of the Australian Charities and Not-for-profits Act 2012 (Cth) and Charities Act 2013 (Cth). We voiced our concern that abolishing these Acts would limit the ability of public hospitals to attract donations from charitable funds. We have also advocated against federal cuts to health funding and discussed our apprehension about the reallocating of funding under the Medicare Locals scheme, and the effect these initiatives will have on our services. We are committed to lobbying the Federal and State governments for better healthcare and facilities in the West Wimmera and the Southern Mallee. ANNUAL REVIEW 2013/14 LOOKING TOWARD THE FUTURE The next twelve months will involve adapting to significant issues relating to healthcare reforms in all sections of our Service, and the restructuring of our funding sources. NATIONAL HEALTHCARE REFORM The National Health Reforms put in place this year will test our capability to sustain the model of care we efficiently and effectively provide within current policy. Significant changes are on the horizon for Aged Care services. We have commenced making structural changes within our administrative staffing to ensure the requirements of the reform agenda are met. We have also endeavoured to alert our consumers to impending changes and possible implications for residential aged care and lifestyle support. Through the Rural Primary Health Services program, health and ageing services will be streamlined by consolidating 159 Commonwealth funded programs in this sector into 18 larger and more flexible funds. We look forward to seeing how this model will affect our operations. GRAMPIANS MEDICARE LOCALS The advent of Medicare Locals may well cause significant changes to our organisation in the near future, depending on the influence it will have on Primary Healthcare funding and service delivery. There is some uncertainty surrounding the future of this program, and it is important to note that we must maintain a Board of Governance in its own right, which will preserve its authority and autonomy at all times. The Review recommended replacing Medicare Locals with a smaller number of Primary Health Care Networks. As a result the Grampians Medicare Local is to be disbanded and the communities serviced by West Wimmera Health Service will be incorporated into the Grampians and Barwon South East Primary Health Care Network, which will cover an area from Geelong and Ballarat through to the South Australian border and present a significant change to how primary health care funding and services are delivered. Given the important role that primary health care plays within our Service, from district nursing through to allied health such as physiotherapy and occupational therapy and health promotion activities including community nursing and Planned Activity Groups the Board of Governance will monitor closely changes to programs and endeavour to work closely with the new Primary Health Care Network to ensure we retain current services and indeed gain new services appropriate to the needs of our individual communities. NEW SERVICES We are currently investigating the feasibility of establishing a Laundry service. This initiative will create more local employment opportunities, generate a material revenue stream and ensure we have increased control over the cost and quality of the end product. Further research will take place in the next year to ensure such a project is viable. We remain a leader in rural health services where our patients are always number one! In line with our Purpose, the common thread running through every element of this Service is to provide a platform to assist the members of the communities which form West Wimmera Health Service to manage their health and improve their lifestyle. PRIMARY HEALTH CARE NETWORKS In 2014 the Commonwealth Government undertook a Review of Medicare Locals throughout Australia. The report found that many patients were experiencing fragmented and disjointed primary health care that was impacting negatively on their health and wellbeing. 5 CHIEF EXECUTIVE OFFICER’S REPORT VISION AND CHALLENGES Looking into the next twelve months, the Service will seize every opportunity to achieve its vision, delivering health, welfare and disability services which are compassionate, responsible, accessible, and accountable to individual and community needs, and which result in quality outcomes for all. In achieving our vision, we will face many challenges, given our ageing population, which will increase the demand for broad ranging healthcare provision. We must ensure healthcare remains accessible for the significant portion of our community with a low socioeconomic status, particularly in the face of rising operating and capital costs and restricted and fragmented funding sources. We must continue to deal with distance as we deal with the seven highest health risks affecting rural areas which include arthritis, depression and anxiety, cancer, heart disease, diabetes, osteoporosis and stroke. Finally, we are tasked with ensuring our processes remain flexible, effective and progressive and that funding will be available where it is needed most! CULTURE OF SUCCESS West Wimmera Health Service has demonstrated its ability to handle change effectively servicing our patients, residents and client’s needs despite our ageing population and increasing financial constraints. Our astute management, commitment to service delivery, use of innovative practices and sheer persistence provides us with a ‘culture of success’ ensuring we will always rise to the occasion as future challenges present! John N. Smith PSM Chief Executive Officer 6 WEST WIMMERA HEALTH SERVICE Darren Gebert, Luke Oldaker, John Smith, Linda Knight, Tenille Gould, Charlotte King. John Smith, CEO, leads his dynamic staff with proficiency, reinforcing a positive culture for progress throughout this remarkable Health Service. ANNUAL REVIEW 2013/14 7 A NOTEWORTHY YEAR OPENING OF GOROKE COMMUNITY HEALTH CENTRE The new Goroke Community Health Centre was opened on Friday 4th October 2013 by Mrs Gwen Bourchier, a long standing member of the Goroke community and, with her late husband, Harry were major donors to the Centre. The Centre was constructed at a cost of $1.63 million and contains: NEW CLINICAL PLACEMENTS FOR UNIVERSITY UNDERGRADUATE STUDENTS CONTINUING EDUCATION – CONTINUED IMPROVEMENT IN CARE Clinical placements for undergraduate Speech Pathology students have been created in 2013-14 resulting in: Our workplace environment nurtures and supports continuous education and access to courses to upgrade qualifications. • A wider clinical placement experience opportunity for Speech Pathology students in a rural setting • Four Consulting rooms – for use by • Professional development in terms of student supervision for the incumbent Speech Pathologist • A combined Dental / Podiatry Clinic • Recruitment potential through rural Visiting Medical Practitioners and other Health Professionals. bringing Dental Services to Goroke for the first time in many years. • Physiotherapy unit. • Renovated Activities area, including a new covered outdoor area. • Multi-disciplinary meeting room with video‑conference facilities. • Spacious Management and Administrative Centre. The ‘new’ Goroke Community Health Centre will ensure that the community of Goroke has access to excellent quality healthcare for many years to come. FINALIST VICTORIAN PUBLIC HEALTH CARE AWARDS The Board, Executive and Staff were delighted to be chosen as a finalist in the Victorian Public Health Care Awards in the Premier's Awards for Rural Health Service of the Year. It was indeed an honour to be held above our peers and in such esteem by the review panel. To be a finalist and Highly Commended is testament to the high quality of care our Service provides. experience opportunity • Embedding clinical placement and student supervision into Speech Pathology Department profile ACCREDITATION – FULL COMPLIANCE IN ALL AREAS We undertake a series of external accreditation processes which measure our performance across Acute Inpatient Care, Residential Aged Care, Disability Services, Radiology and Diagnostic Imaging, Home and Community Care, Food Safety and general cleanliness of the healthcare environment. It is very gratifying to note that in 2013/14 full compliance was achieved across all programs confirming external endorsement that West Wimmera Health Service is providing safe and quality care to the communities it serves. RIPERN NURSES Three Registered Nurses have completed RIPERN training and another has started training and will complete the course next year. The RIPERN nursing model enables practice at a more advanced, autonomous level in collaboration with other clinicians for the benefit of the patient. Endorsed RIPERN Nurses are able to make autonomous clinical decisions for many of the patients who present at Primary Care Casualty Urgent Care and are able to obtain, supply and administer an approved limited range of medications which are indicated within the Primary Care Manual for particular clinical diagnoses thus reducing the need for a medical practitioner to review patients in Primary Care. Among the many skills gained are simple suturing and the appropriate application of a temporary support for a fractured limb before a longer lasting plaster. Each RIPERN nurse will be credentialed to undertake the advanced skills they have developed. APPRENTICESHIPS A number of staff have commenced apprenticeships and traineeships to gain qualifications which will assist the Service to continue to provide quality healthcare and facilities; Commercial Cookery, Business, Aged Care, Disability, Front Line Management, Occupational Health and Safety, Home & Community Care, Carpenter, and Electrical Tagging. Registered Nurses Judith Thomson and Trish Heinrich were awarded prestigious Sir Albert Coates’ Memorial Trust Rural Nursing Scholarships, offered specifically for the post-graduate training of rural emergency care nurses. 8 WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW 2013/14 9 A NOTEWORTHY YEAR DENTAL SERVICES INTRODUCING NEW TECHNOLOGY Progress continues in the Dental Clinic with the new intra-oral camera enabling patients to observe exactly what the Dentist sees during the course of an examination. The Orthodontic service and its use in school student screenings have also benefitted from this new equipment as has the specialist advice and care provided by our visiting Oral Surgeon. The new Orthopantogram (OPG) machine has also brought a new perspective to our Dental Services t providing a panoramic view of the mouth, teeth and bones of the upper and lower jaws allowing the Dental Surgeon to make a more informed decision on treatment. 10 WEST WIMMERA HEALTH SERVICE Demi Holcombe, Federation University Student Nurse taking advantage of the diagnostic imaging available from the new OPG machine while on work placement at Nhill Hospital . ANNUAL REVIEW 2013/2014 11 A NOTEWORTHY YEAR 12 WEST WIMMERA HEALTH SERVICE PREPARING STUDENT AND NEW STAFF ACCOMMODATION UNITS IN NHILL Construction commenced on three residential houses in Nhill which will provide quality accommodation for: • Undergraduate and Post-graduate student placements; • New staff relocating to work at West Wimmera Health Service; • Medical Practitioners taking up practice with Tristar Medical Group Embarking on this innovative project is indicative of the broader thinking necessary to make sure we are aware of emerging challenges such as attracting staff and students to our Service. When it comes to construction and maintenance at WWHS we are one step ahead. The skilled, qualified Engineering & Maintenance team are able to tackle most tasks. Here Aaron Beer with Craig Henley are installing the kitchen in the new accommodation units. ANNUAL REVIEW 2013/14 13 A NOTEWORTHY YEAR NHILL COLLEGE AND WEST WIMMERA HEALTH SERVICE IN PARTNERSHIP In consultation with the Nhill College and Nhill Police it was discovered that domestic violence and self-harm are areas for concern within our catchment. A comprehensive assessment of all Year 7 school students took place to understand self-esteem, motivation for self-harm and bullying. 75% of students were assessed to be at risk with 2% having had suicidal ideation and thoughts of self-harm. As a result intensive programs have been put into place at the school and across the community for more than 100 students. EXTERNAL CLEANING AUDITS – OUTSTANDING RESULTS Extraordinary results in external cleaning audits are the ‘norm’ for West Wimmera Health Service. We are required by the Department of Health to regularly monitor the cleanliness of each area of our facilities and measure whether we are providing a safe and clean environment for patients and residents. WHY IS MAINTAINING A CLEAN ENVIRONMENT SO IMPORTANT? Excellent results minimise risk of cross infection, increase the level of patient satisfaction and reflect a positive image of the health service: OUR RESULTS • 100% audit outcome achieved for cleaning standard audits conducted in the very high risk area of the Operating Theatre. • 98% achieved for audit in the high risk area of Acute, far exceeding the target of 85%. • 97% achieved for audit in the medium risk area of Radiology, far exceeding the target of 85%. THE WIMMERA SOUTHERN MALLEE HEALTH ALLIANCE (WSMHA) The Alliance was formed in 2010 and all member services have just re-signed the new memorandum of understanding. 14 WEST WIMMERA HEALTH SERVICE The driving force for its existence is a commitment to ensure the provision of a continuously improving, appropriate, and geographically accessible mix of high quality hospital and community based health services for residents of the Wimmera Mallee sub-regional planning area. The primary outcome in any decisions that the Alliance make will enhance services for stakeholders. Alliance members have an ongoing commitment to work as equal partners based on mutual respect thereby acknowledging the different and complementary roles and responsibilities each Health Service plays within the Region. The Governance Committee meets quarterly and members include the Board Chairs and CEO’s and other representatives of each health service. The Primary Care Partnership team also attends as the Project Managers. The Wimmera Southern Mallee Health Alliance is gratified with what it has achieved in its three short years. (WSMHA Newsletter) CANCER RESOURCE NURSES Better access to cancer services for our residents will be the result of a new program introduced through a joint project between the Grampians Integrated Cancer Service and the WSMHA to introduce this welcome resource at West Wimmera Health Service and other Services of the Alliance. Nurses have undertaken training and visited the cancer services in Ballarat and Horsham to learn from their experiences and expectations. The community is appreciative of the addition of this new role. Staff are embracing this opportunity to make a difference for someone on the difficult journey of living with cancer. While the nurses are not specialists in the area of Cancer Nursing, their training and experience add another dimension to the care and support available immediately and near to home. The Cancer Resource Nurses also maintain a Cancer Resource Hub which is a display of current brochures and pertinent information for the community. ROYAL FLYING DOCTOR SERVICE – MEETING A COMMUNITY REQUEST A survey of the Goroke Community seeking them to prioritise the services they thought were important to bring to Goroke revealed Dental services as the highest priority. The request was realised by partnering with the Royal Flying Doctor Service Mobile Dental Care Team. Dental appointments for the week of the 3rd February 2014 thirty six patients were examined and during the week of 26th May 2014, twenty eight patients were seen. This initiative has meant that patients from Goroke have had access to Dental services in their local community where none existed previously. VICTORIAN HEALTH EXPERIENCE SURVEY New in 2014, the Victorian Health Experience Survey (VHES) provides opinions from patients who have been admitted to an acute hospital bed in Victoria and is conducted by an independent Research Institute on behalf of the Victorian Department of Health. It is completely anonymous providing patients with the opportunity to contribute frank and honest responses to questions providing hospitals with a unique insight into the patient hospital experience. Importantly, the Survey enables us to compare our patient experience with like size services as well as all Victorian Hospitals. 72 randomly selected patients from our Service participated in the first survey April – June 2014, 94% rated their Overall Hospital Experience as either 'very good' or 'good’, our Overall Care was rated at 94% compared with a peer result of 97.8% and a state-wide result of 92.1%. We rated particularly well on a number of measures including; care and treatment received from nurses; short length of time on the waiting list prior to admission to hospital; care and treatment from allied health staff. The results have been analysed, including areas requiring improvement, and actions are now in place to ensure we provide an unparalleled experience for our patients at all times. Executive Director of Finance and Administration, Ritchie Dodds expressed his congratulations and that of all staff to Chief Executive Officer John Smith on being presented with the prestigious Sidney Sax Medal by the Australian Hospital and Healthcare Association. SIDNEY SAX MEDAL – A PRESTIGIOUS AWARD “A lifelong commitment to delivering high quality health services in Australia, particularly in rural communities, was acknowledged by the Australian Healthcare and Hospitals Association (AHHA), John Smith, West Wimmera Health Service Chief Executive Officer was awarded the prestigious Sidney Sax Medal for 2013. There is no doubt that John Smith has the interests of rural communities at heart and works with the utmost commitment to ensure their future is assured. It is with this sentiment and with recognition of his contributions across the health sector that the AHHA is pleased to award John with the 2013 Sidney Sax Medal.” (AHHA) The award recognises outstanding achievement in, and contribution to the development and improvement of the Australian healthcare system – and while there are many very dedicated professionals who are worthy of such recognition, John Smith stands out in the crowd. ANNUAL REVIEW 2013/14 15 OUR SERVICES AGED CARE ALLIED AND COMMUNITY SUPPORT Aged Care Assessment District Nursing Home Care Package Program National Respite for Carers Program Residential Hostels & Nursing Homes Ante/Post Natal Classes Asthma Education Cancer Council Victoria - Cancer Awareness Cancer Support Group Cardiac Rehabilitation Program Community Health Nursing Continence Education Diabetes Education Dietetics District Nursing Drug and Alcohol Program Emergency Relief Program Exercise Groups – Aerobics, Falls & Balance Group, Gentle Exercises & Tai Chi Farm Safety Education Fitness Assessments Football Practice for Farmers Fun Fit & Fabulous Gateway to GirlPower – Nhill, Kaniva, Rainbow Guys & Gals School Program Gym/Weights Program Hairdressing Health Education and Promotion Wimmera Machinery Field Days Healthy Habits Happy Life, Stroke Awareness Presentations Men’s Health Week Hearing Services Home and Community Care Hospital in the Home Hospital to Home CLINICAL Acute Hospital Care Admission and Discharge Clinic Audiology Dental Diagnostic Dental Prosthetic Dialysis Domiciliary Midwifery ENT Surgery Gastroenterology General and Specialist Medical Care General and Specialist Surgery Laparoscopic Surgery Maternity Shared Care Clinic Nursing Traineeships Obstetrics and Gynaecology Ophthalmic Surgery Oral Surgery Orthopaedic Surgery Palliative Care Pathology Pharmacy Post Acute Care Primary Care Casualty Psychiatry Reconstructive Surgery Regional Discharge Planning Strategy Immunisations staff WWHS and major local employers Kindergarten Screenings Speech Pathology, Occupational Therapy, Physiotherapy, Massage Therapy Maternal and Child Health Meals on Wheels Men’s Sheds Mother/Daughter Puberty Nights National Diabetes Service Nutrition Education Occupational Therapy Optometry Orthodontic Referral Pap Smear & Health Check Clinics Physiotherapy Planned Activity Groups - (Adult Day Centres) Podiatry Puberty Biz for Grade 6 Children and Parents Puberty Nights for Boys QUIT Trainer Radiology – CT scanning, ultrasound, X-ray Rural Primary Health Service Secret Men’s Business Social Work - Welfare and Counselling Service Speech Pathology Strutting Strollers WorkHealth Checks DISABILITY Adult Day Service Advocacy Community Access Community Inclusion Program Exercise Program Food Preparation and Sales Futures for Young Adults Garden Maintenance Program 16 WEST WIMMERA HEALTH SERVICE Individual Support Living Skills Respite Care Retail Assistant Training Supported Employment Therapy Programs Vocational Training REGIONAL SERVICE SUPPORT NURSING HOMES – HOSTELS Allambi Elderly Peoples Home, Dimboola Avonlea Hostel, Nhill Dunmunkle Health Service Edenhope Hospital Goroke P-12 College Hindmarsh Shire Council Jeparit Primary School Kaniva College Kindergartens - Nhill, Jeparit, Kaniva, Rainbow, Goroke, Lutheran Primary School (Nhill) Natimuk Primary School Nhill College Rainbow College Rainbow Primary School Rural Northwest Health St Patrick’s Primary School, Nhill West Wimmera Shire Council Woomelang Bush Nursing Centre Yarriambiack Shire Council Education Engineering and Maintenance Environmental Health Information Management Hospitality Library and Resource Centre Volunteers NHILL Iona Digby Harris Home COMMUNITY PROGRAMS NATIONAL RESPITE FOR CARERS PROGRAM (NRCP) HOSPITAL TO HOME (H2H) The program supports patients in the transition from hospital to home. Patients must live in municipalities associated with West Wimmera Health Service. HOSPITAL IN THE HOME (HITH) HITH is the provision of hospital care in the comfort of the person’s own home. Patients are regarded as hospital inpatients and remain under the care of their treating medical practitioner. TRAINING AND ALLIANCES Traineeships Universities – Australian Catholic, Charles Darwin, Charles Sturt, Deakin, Latrobe, Federation, Melbourne, South Australia Wimmera Football League – Physiotherapy Wimmera Hub Inc Work Experience Work Placements This program aims to enhance the quality of life for carers and care recipients, who are frail older people, people with dementia, young people with a disability and people with a terminal illness in need of palliative care. The program contributes to the support and maintenance of caring relationships between carers and their dependent family members or friends by facilitating access to information, respite care and other support appropriate to the individual needs of carers and those people for whom they care. KANIVA Archie Gray Nursing Home Kaniva Cottages Hostel JEPARIT Jeparit & District Nursing Home Jeparit Hostel RAINBOW Rainbow Bush Nursing Home Annexe Rainbow Bush Nursing Hospital Hostel NATIMUK Natimuk Bush Nursing Home Annexe ‘Allan W Lockwood’ Special Care Hostel Trescowthick House Hostel POST ACUTE CARE (PAC) Provides community based services such as community nursing and personal care.= HOME AND COMMUNITY CARE PROGRAM (HACC) This program provides care in home and community settings to frail older adults, younger people with disabilities and their carers, promoting independence and avoiding premature or inappropriate admission to long term Residential Aged Care. Home Care Packages are planned and coordinated packages of care to help older people remain living in their own homes. They are funded by the Australian Government to provide for the complex needs of older people. ANNUAL REVIEW 2013/2014 17 COMMUNITY, VOLUNTEERS, DONATIONS & FUNDRAISING FUNDRAISING APPEAL OFF TO A GREAT START The “Health of our Communities Appeal” began in May 2014 and to date has raised $1 million which as a result of the process adopted is a wonderful start. After a careful preparation including several months of individual discussions throughout our service region during which we received many helpful suggestions which emphasised we should not conduct a “big bang” appeal seen to be “Nhill centric”. SEVEN SEPARATE APPEALS Given such sentiment six separate fundraising campaigns addressing Natimuk, Kaniva, Nhill, Jeparit, Rainbow and Goroke communities were instigated clearly stating that funds raised in each location will be distributed in that community. With our Patron, Philip Cramer, a seventh appeal comprising high-level contacts in Melbourne to more generally fundraise for the expensive projects which are centred on and particularly pertinent to Nhill Hospital. It is important to note the appeal focuses on gathering five-year pledges so that planning of progressive expenditure of funds can be instituted. The management of seven campaigns is proving complex. Our process at this stage is centred on consultation with people we believe may lead the program and contribute in many ways themselves. It is our intention to conduct a “public appeal” embracing all communities simultaneously mid 2015. KANIVA At Kaniva the target is $1 million to provide the funding for a new Aged Care facility which will adjoin the Kaniva hospital. Local, personal leadership provided has been invaluable and the gathering of groups who with compassion have delivered the great importance of this new facility to that community.. An amount of $245,000 has been pledged in Kaniva at this early stage still leaving a substantial amount to be raised. 18 WEST WIMMERA HEALTH SERVICE The majority of the gifts to date have been “one off” with the commitment to consider further support for this project. Had gifts so far committed been five-year pledges the amount raised would be nearing half our goal. GOROKE, JEPARIT AND RAINBOW The importance of planned pledges over the entire campaign period cannot be over emphasised. To ensure this project proceeds funding intentions must be clear. Having become the proud recipients of brand new facilities, the Goroke community is being canvassed for pledges to assist with funding services at Goroke and Nhill given the importance of the care amenities being developed will assist the communities’ general needs. The Kaniva campaign is full of promise! NATIMUK In May a concerted effort was applied to attract “gap funding” of $200,000 for the New Medical & Allied Health Centre which is poised to open soon. The result has been outstanding with pledges amounting to $260,000 over the next five years received. NHILL The hub of West Wimmera Health Service, “Nhill Hospital” with many of the central services to fund, has set a target of $1.8 million for an urgent renovation of the Kitchen and Medical Record Department. 160,000 fresh meals are provided yearly from this antiquated facility. Substantial submissions and approaches have been made to the State Government for these funds, which regrettably have been unsuccessful. Given this is the case we must now turn to the generosity of our communities to ensure this vital project will proceed. $350,000 to address important renovations to upgrade facilities at Jeparit and Rainbow Hospital and Aged Care facilities is now being sought. MURRAY TO MOYNE CYCLE RELAY Twenty one cyclists entered the annual Murray to Moyne Cycle Relay in our 20th year of participation in the event. The team raised $9,251.00 through fundraising events such as the hugely successful “Loop the Lodge” Fun Run held on Sunday 13th October 2013 with 120 participants from Horsham, Bordertown, Nhill, Goroke, Kaniva, Jeparit and Rainbow. We are looking forward to this the event growing even bigger and better in November 2014. The Murray to Moyne team also took part in the ‘Friday Fiesta Program’ at the Nhill Lake for the month of February. It was great to be a part of this community event whilst promoting our team’s fundraising efforts. VOLUNTEERS To complete the MIRA (Allied Health Services) Centre we are fundraising for $1.2 million. For the Day Procedure, Surgical Unit where increasing numbers of procedures demand renovations and modernisation to accommodate facilities for this popular mode of care we seek to raise $450,000. We acknowledge the many individual volunteers and groups whose invaluable contributions are so appreciated by West Wimmera Health Service: Auxiliaries, Church Groups, Community Groups and Schools assist through fundraising, entertainment, assisting with activities, reading and outings for our residents – much appreciated. Nhill campaigning is in its infancy and in conjunction with our Patron Mr Philip Cramer, we are working diligently in Nhill, Melbourne and beyond to solicit support and funding, which to date is very encouraging given an amount of $535,000 has already been committed. Volunteers are an essential element of West Wimmera Health Service and bring joy and comfort to patients and residents. A long term volunteer of over 30 years said “It is a pleasure volunteering and being supportive of the residents whenever possible. The pleasure I receive is also reciprocated by the residents and it is always lovely to see their happy faces”. A much appreciated volunteer at Oliver's Café for over 15 years said “I enjoy mixing with the Cooinda clients and find them warm loving people. After retirement I had the time and wanted to be involved and contribute to the community in some way. I have found volunteering very rewarding.” A volunteer new to the town decided that volunteering would be a great way to meet people and to help others. She has now been volunteering at Iona for about 6 months along with her little daughter who brings such enjoyment to the residents. “As I was new to town I didn’t really know anybody and I enjoy visiting our special friends to make them feel special.” ANNUAL REVIEW 2013/14 AND NEXT YEAR... Fundraising will continue throughout the year with a special emphasis on the Capital Campaign and we look forward to the outcome. Darren Taylor, Maintenance Handyman at Natimuk Residential Aged Care Centre measuring in preparation for installing signage on the waiting area wall in the new Medical & Allied Health Centre. Our Health Service is such an important component of the six communities which make up West Wimmera Health Service. It is the major employer in most communities, it offers healthcare locally, vulnerable members of the community are quickly integrated into our programs, assisted to access services, offers such a wide variety of services – how fortunate we are. In 2014-2015 please place your strength behind the Capital Campaign which will contribute enormously to each community. It will also make sure all retain the remarkable facilities and services which we are privileged to have in place now. 19 DONATIONS 2013/14 $ Amt VV Marshman Trust Director of Nursing, Kaniva, Lesley Hawker with Alwyn Dyer, leader of the Kaniva Capital Campaign Team making suggestions for the Plans for the long awaited Hostel Units planned to be built at Kaniva if the Campaign is successful. BEQUESTS AS A FORM OF GIVING In an ageing community such as ours many people are restricted as to how they can help and are unable to make pledges of support. However, there are others who may well consider that after properly caring for family and loved ones it may be possible to make a Bequest to this appeal. Bequests are part of this campaign and those who adopt this approach are to be recognised and thanked as valuable donors now, during their lifetime. WHAT NOW? 150,000 Dyer Families 50,000 Collier Charitable Fund 45,000 JM & TF Sudholz 10,000 William Angliss Trust 5,000 Millington Family Trust 5,000 Under $200 3,496 Loop the Lodge Fun Run 2,633 Senior Citizens 2,352 Sarah Stott Trust 2,313 Murray to Moyne 2,113 Nhill Hospital Ladies Auxiliary 2,000 Nhill Duck & Jazz Committee 2,000 Cooinda Ladies Auxiliary 1,950 Avonlea 1,921 The fact that the first million dollars has come from a small number of gifts is testament to the process of working silently with prospects who have the ability to support this Campaign. Chocolate Sales 1,273 There are many of our most successful citizens and significant businesses, Philanthropic Trusts and Foundations to access yet. We anticipate they will seriously consider our submission and with their support numbers the goal in each community will be more achievable. Bequests are the fastest growing source of fundraising income in the western world today. WWHS CAPITAL GRANTS 2013 2014 Jessie Guest 812 Wood Raffles 532 Peter & Denise Ralph 500 IR & LJ Hately 500 Westvic Spares 500 Estate of Elma Graetz 500 SMI Services Pty Ltd 500 Margery Wallis 500 Estate of Mytrle Lennon 435 Caltex 400 Hugh Delahunty MLA 300 Horsham Sports & Community Centre 265 Elders Ltd 250 Jetfire Protection Pty Ltd 250 PFD Food Services Pty Ltd 250 Ahrens Group Pty Ltd 250 TC Fire 250 Source Purpose Total Department of Health Home and Community Care Minor Equipment 20,726 Department of Health Residential Aged Minor Capital 50,000 Rural Energy 250 Cec Hopper & Sons 250 Barry Johnson 250 Nhill Pharmacy 250 Bow Bakery 250 Department of Health Infrastructure Replacement 59,300 Department of Health Medical Equipment Replacement 74,700 Lake Charlegrark Country Music 250 Department of Human Services Minor Equipment 3,409 Nhill College 226 Foundation for Rural and Regional Renewal Snappy Seconds Refurbishment 3,500 Dr Mark Chehade 200 DN & HM Wilson 200 St Peters Lutheran Church Guild 200 Dulkeith Computer Solutions 200 Hindmarsh Shire Council 200 Nhill Fire Brigade 200 Australian Government / Australian Catholic University Equipment for Education Accommodation Australian Government Natimuk Medical Centre 350,000 8,000 569,635 20 WEST WIMMERA HEALTH SERVICE GRAND TOTAL (AUD) 296,970 STATEMENT OF PRIORITIES – A SUMMARY What is the Statement of Priorities? The Statement of Priorities (SoP) is a formal funding and monitoring agreement between the Health Service and the Secretary for Health. The agreement which is signed annually facilitates delivery of or substantial progress towards key shared objectives of financial viability, improved access and quality of service provision. HOW IS THE STATEMENT OF PRIORITIES DIFFERENT FROM THE STRATEGIC PLAN? The Statement of Priorities agreement has priorities based on the Victorian Governments health policy. West Wimmera Health Service then proposes deliverables which align with state policy and relevant to the community in which we operate. Agreement by both parties finalises the Statement of Priorities Charter. The deliverables set out in the Statement of Priorities closely align with the organisational Strategic Plan therefore there is similarity in the documents. ANNUAL REVIEW 2013/14 Effectively the Strategic Plan encapsulates the vision adopted by the Board of the Health Service locally, and the Statement of Priorities ensures the Health Service is working towards the larger picture of Victorian Health outcomes. LOOKING AHEAD TO 2014-2015 HOW DID THE SERVICE MEASURE UP TO THE DEPARTMENTS STATEMENT OF PRIORITIES TARGETS? West Wimmera Health Service will always strive to meet the priorities established with the Department through achieving the deliverables which are relevant to our communities. The Service was fully compliant with all targets and achieved deliverables for all priority areas. The priorities for the Statement of Priorities remain focusing on new areas such as Heart Health, concentrating on the Karen population and Board assessments. Shanae Bastin, rushed from school with a suspected fracture, was grateful to have the quick response of Dr Shepherd Chifura and Dr Wei Cheng Chen to attend to her at Jeparit Hospital. The Doctors cover the Jeparit and Rainbow communities, a far cry from the days when only one doctor was available. 21 1 2 1 3 2 4 3 4 5 5 6 6 7 9 10 7 8 10 9 8 STRATEGIC DIRECTIONS TARGETING HEALTH ISSUES STRATEGIC DIRECTIONS PERFORMANCE 2012-14 The Strategic Directions for West Wimmera Health Service adopted by the Board to cover the three year period 2012-2015 set an unwavering commitment to move towards more responsive, clinically appropriate and cost effective healthcare planned specifically to stay ahead of the dynamic environment of the health industry and importantly to target the health issues of the people who rely on us for healthcare. 1. M ATCH SERVICES WITH OUR COMMUNITIES’ CHANGING NEEDS • Full accreditation status achieved across all programmes of care delivery including: Australian Council on Healthcare Standards EQuIP Accreditation, Aged Care Standards Agency Accreditation, Home and Community Care (HACC) Community Care Common Standards, Diagnostic Imaging Accreditation and Disability Service Standards. • Recruitment and retention of Visiting Medical Practitioners across all communities. 22 WEST WIMMERA HEALTH SERVICE • Review of Surgical Services at Nhill Hospital with an outcome that “surgical services are being delivered in a safe and effective manner and that surgical services at the current level of complexity should continue to be performed at Nhill”. A resounding endorsement! • Memory Lane Cafés in conjunction with Alzheimer's Australia and Department of Health have taken place. Sessions are held monthly in Nhill and also occur at Rainbow, Goroke and Natimuk. • The WHY (West Wimmera, Hindmarsh, Yarriambiack) project has commenced in the areas of Occupational Therapy and Physiotherapy and delivering services in all regions. • A Cancer Care Nurse has been employed 0.2EFT as a resource for clients living with cancer. • The Nhill Community Garden situated on WWHS land adjacent to Cooinda is flourishing with people from the Karen Community, students from Nhill College and Nhill Lutheran School, participants from Cooinda and others from the Nhill Community making use of the garden. • Funding of $28,500 was successful through a Regional Growth Fund “Putting Locals First” grant with Stage 1 of the project which is to establish garden beds, water supply, and pathways being achieved. Dr Alvin Ng, with relaxed Karen patient Eh Kyan Kyaw Tha Ei, happy to have Registered Nurse and qualified interpreter May Hei Eh Kyaw Kyaw assisting him during his dental examination. 2. IMPROVED ACCESS TO SERVICES • Introduction of CT (Computed Tomography) Scanner at Nhill Hospital and increase in Diagnostic Radiology Services. • Increase in Dental Services through commencement of new Dental Clinics in Rainbow, Goroke & Kaniva. • Large increase in number of patients receiving Macular Degeneration Injections since commencement in June 2012. Restoration of vision provides a quality of life where the patient can safely navigate daily activities of life. Patients able to receive treatment locally, no longer having to travel to Melbourne/Adelaide every six weeks, saving overnight accommodation and 800km round trip. • Agreement signed with Wimmera Health Care Group to share a physician on site in Nhill monthly which will commence early 2014‑2015. 3. E NHANCED COMMUNICATION WITH OUR COMMUNITIES • Recognition of the importance of increasing consumer engagement with introduction of Consumer Position on the Clinical Quality Governance Committee. • Details of our Aged Care Residential facilities published on My Aged Care website to inform prospective residents of accommodation and financial options. • Ladies Auxiliaries and Friends and Relatives Groups active in all communities with Nursing Management participating in meetings. • Large presence in local and regional media platforms showcasing services, achievements and health promotion informing communities. • Community meetings held in all six townships to inform community members and listen to opportunities for enhancing services provision. • Annual General Meeting held with outstanding attendances in 2012 and 2013. ANNUAL REVIEW 2013/14 • Participation of Allied Health staff in local Agricultural shows and health expos. • Launch of modern Website and Facebook site to target the “tech savvy” generation of stakeholders. • Fundraising Appeal meetings held in each community to support and inform of capital infrastructure and associated financial imposts. 4. M AINTAIN AND ENHANCE OUR FINANCIAL SUSTAINABILITY • Contracted a specialist health economist to review our performance using bench marking parameters and industry data specifically relevant to our key service areas. • Meetings held with Federal Members of Parliament to argue the case for increased funding for rural and remote public health. • 9th consecutive surplus recorded in 2013/14. • Net surplus before capital of $14,000. • Capital investments - $ 4.37 million. 23 STRATEGIC DIRECTIONS • Current Ratio – 0.72 in line with the Department of Health’s benchmark minimum of 0.7. • Turnover $33.8 million. • Capital purpose income $722,000. • Donations totalling $493k received in 2012/2013 and 2013/14, including $250,000 from VV Marshman Trust as part of $400K total donation over three years for Mira Stage 2, received $100k in 12/13 from Marshman Trust plus another $150k in 13/14. 5. ADOPT A FLEXIBLE, COLLABORATIVE APPROACH TO RESOURCE ALLOCATION IN THE REGION • WWHS is now a member of the Wimmera Southern Mallee Health Alliance Building Capacity initiative in addition to the founding Alliance group. • Due diligence to amalgamate with Dunmunkle Health Services in responding to their invitation to consider to amalgamation with them. Submission to do so submitted to Minister of Health. 6. CONTINUE TO IMPROVE OUR FACILITIES AND EQUIPMENT • A highlight was the opening of the Goroke Community Health Centre on 4th October 2013. This community has a state of the art facility capable of providing support services for health maintenance into the next decade and includes: • Expanded clinical areas including new consulting rooms for Medical Practitioners and Allied Health Professionals. • Public Dental facility created • Expanded Day Activities Program area for elderly people of the community. • Initial planning undertaken for the real time intelligence project with Ballarat Health Services to promote sharing of patient information to more effectively manage step down process. • Clinical Executive Meetings between WWHS and Wimmera Health Care Group enhancing clinical communication and resource sharing. 24 WEST WIMMERA HEALTH SERVICE • Physiotherapy – Royal Melbourne Hospital Orthopaedics. • Wound – Tertiary Wound Specialist – Department of Health Wound Care Nurse. • Dietetics – Ballarat Health Services redevelopment project in final stages at June 2014. • Building commencement of 3 new Accommodation Houses in Macpherson Street Nhill due to be completed late 2014. • Mira Redevelopment Stage 2 Health services to neighbouring hospitals that would otherwise not receive such services, including Woomelang Bush Nursing Centre, Dunmunkle Health, Edenhope District Memorial Hospital, Rural Northwest Health and Dimboola Aged Care Facility. specialist and tertiary services offered locally via telehealth: • Improved Disability access. • Natimuk Medical Clinical • Relationship built with Ballarat • WWHS outsources significant Allied • Introduction of a number of • Residential Aged Care/Acute for community meetings, workshops, and self-help groups • Finance Department office Health Services and Edenhope District Memorial Hospital for the provision of laundry services. 8. U SE THE LATEST TECHNOLOGIES MORE EFFECTIVELY • Community access areas created • Health Promotion Plans developed in partnership with Wimmera Primary Care Partnership and Local Government Councils undertaken. Region Executive Nurse Network, Grampians Regional Health Alliance Finance Committee, Nhill Town Committee, Hindmarsh Economic Development Strategy Advisory Committee. relocated to a more central and accessible are within the Nhill Hospital. incorporating planned activity group and rehabilitation, design and planning has been finalised with construction works to begin in July 2014. 7. S TRENGTHEN AND EXPAND OUR PROFESSIONAL RELATIONSHIPS • CEO membership on a number of key stakeholder bodies including Australian Council on Healthcare Standards Board – Vice Chairman, Australian Council on Healthcare Standards International Board – Treasurer, Victorian Health Industrial Association Board – Vice Chairman, Australian Hospital & Healthcare Association Council, National Health Alliance, Friends of Alliance Council. • Executive Team represented on various Boards and Committees including: Women’s Health Grampians, Small Rural Executive Nurses Network, Grampians patients – Geriatrician/Physician Ballarat. Dietitian Mentoring. • Completion of a ‘Wireless Network” at Nhill and Kaniva hospitals has enabled staff to access and update aged care resident information including resident care plans, charts and assessments, at the bedside. • Installation of a fully integrated security system throughout the Nhill campus. 9. B UILD OUR PEOPLE’S CAPABILITIES • 13 Middle Managers have successfully completed the Advanced Diploma of Business. • 5 staff have successfully completed Certificate IV in Disability Studies. • 4 nurses are undertaking Rural and Isolated Practice Endorsed Registered Nurse (RIPERN) course with another 3 enrolled in 20142015. • Expansion of the Injury Management Team who support and educate Middle and Senior Management on effective return to work process. • 25 Occupational Health & Safety Representatives and Managers have completed the one day refresher OH&S course between 2012-2013 and 2013-2014. Tim Seymour and Nathan Ruge (foreground) checking construction levels. 10. STRENGTHEN OUR GOVERNANCE, PERFORMANCE, TRANSPARENCY AND ACCOUNTABILITY. • Introduction of an electronic Quality Register that links directly to the Risk Register providing timely and accurate information relating to Continuous Improvement throughout the organisation. • Strengthening the Clinical Quality Governance Committee membership with a specific emphasis on credentialing. • The improved performance of our credentialing process has been noted by the Department of Health in relation to Credentialing and Scope of Practice and Partnering for Performance, and identified as a good example for the application of a local performance discussion record template with guidelines for use and applicability criteria with 0.2 EFT or less Visiting Medical Officer (VMO) or General Practitioner (GP). ANNUAL REVIEW 2013/14 • Implementation of a new Committee Structure to ensure robust review and enhanced performance. • New Clinical Quality Governance Accuracy and proficiency by skilled craftsmen is setting a sound structure for the construction of the Community Rehabilitation Centre. Committee has increased clinical expertise to strengthen review of credentialing and policy development and review. • Proud to be a Finalist in the Premier’s Rural Health Service of the Year Award 2014. STRATEGY-INSPIRED As we commence the final year of this phase of Strategic Planning our minds are turning to the direction the future progression of this Service will take, and how we our planning must ensure this Service will cement its place as the central focus for healthcare for the communities of West Wimmera Health Service. Improving the health and wellbeing of the people in our diverse communities will always be the objective we pursue. 25 STATISTICS OVERVIEW Measurement of the services we deliver provides a clear insight into the inspiring outcomes achieved for our patients, clients and residents. ACUTE INPATIENT – PERCENTAGE OCCUPANCY BY SITE 2013/14 100 80 60 40 20 0 Jul Aug Rainbow Sept Jeparit Oct Nov Kaniva Dec Nhill Jan Feb Mar Apr May Jun Budget 2013/14 Percentage occupancy varied considerably across our four acute inpatient sites. Several facilities have a very small number of beds which increases occupancy volatility. Occupancy levels at Kaniva, Jeparit & Rainbow were affected by a period of time when there was no Medical Practitioner available in these communities. WWHS has worked diligently to recruit Medical Practitioners to work at these locations. RESIDENTIAL AGED CARE – PERCENTAGE OCCUPANCY 2013/14 100 Weighted Inlier Equivalent WEIGHTED SeparationINLIER (WIES)EQUIVALENT ComparisonSEPARATION (WIES) COMPARISON 2000 80 1500 60 1000 40 500 20 0 0 Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Nursing Homes Target Nursing Homes Hostels Target Hostels Nursing Homes and Hostels maintained excellent occupancy levels throughout the year. WWHS is proud to be able to offer quality residential aged care to the rural and remote communities of Nhill, Kaniva, Jeparit, Rainbow and Natimuk, communities providing elderly and vulnerable members of these communities with the opportunity to remain close to family and friends 26 WEST WIMMERA HEALTH SERVICE 2013/14 2012/13 2011/12 2010/11 2009/10 2008/09 Weighted Inlier Equivalent Separations (WIES) is the mechanism used to measure the mix or type of acute patient treated, and is also used by Government to provide funding to hospitals. Episodes of care are funded based on the condition treated, length of stay and whether a procedure was undertaken. This type of funding is known as 'casemix funding' and provides a fairer method of funding with hospitals receiving funding based on the type of patients treated.2013/14 had the highest WIES result in the past five years and 6.4% more than treated in 2012/13. ALLIED & COMMUNITY HEALTH – NON-ADMITTED OCCASIONS OF SERVICE ACUTE CARE – PERFORMANCE BY CATEGORY Note 2013/14 2012/13 Variance Department Patients Treated - Total 1 2211 2210 0.0% Occupied Bed Days - Total 2 8930 8728 2.3% Occupied Bed Days - Acute 3 8572 8071 6.2% Occupied Bed Days Nursing Home Type 3 358 588 -39.1% Note Diabetes Education Dietetics Massage Therapy Occupational Therapy 2013/14 2012/13 Variance 731 1058 -30.9% 1632 3003 -45.7% 771 712 8.3% 2381 3084 -22.8% Podiatry 3120 4175 -25.3% Physiotherapy 3928 5916 -33.6% Speech Pathology 1006 1570 -35.9% Social Work 960 627 53.1% Maternal and Child Health 1701 1670 1.9% Centrelink Percentage Occupancy 63.00% 58.50% 7.7% Average Length of Stay (Days) 3.9 3.67 6.3% Procedures Total 745 870 -14.4% 85 28 203.6% 0.7847 0.7107 10.4% 362 316 14.6% Dental - Public 2 2526 1351 87.0% DVA NHT Occupied Bed Days Dental - Private 2 957 1035 -7.5% Average DRG Weight 676 4039 -83.3% Primary Care Casualty (Emergency+Other) Visiting Surgeons 1977 1891 4.5% Radiology 3 4825 3222 49.8% Total Allied and Primary Health 1 27553 33669 -18.2% 183047 180908 1.2% Tota Meals Provided 1. T here was a decrease in allied and community health throughput with many departments experiencing periods where staff vacancies were difficult to fill. By the end of the year all departments were again fully staffed. 2. Dental throughput was substantially above the previous year with an increase in staffing levels, including the employment of a graduate dentist. Dental clinics also commenced in Kaniva, Rainbow and Goroke. 3. Radiography throughput was 50% above the previous year with strong demand for this service including CT Scan HACC Funded Activity Hours Note 2013/14 2012/13 Variance District Nursing 4503 4571 -1.5% Day Centre 36107 28027 28.8% Physiotherapy 1039 651 59.6% Podiatry 1132 1162 -2.6% Speech Pathology 68 42 61.9% Occupational Therapy 426 349 22.1% 87 76 14.5% Dietetics There was an increase in HACC Hours, particularly in the areas of Day Centre, Physiotherapy and Speech Pathology Rural Primary Health Note Service (RPHS) Program Physiotherapy Community Nursing Nhill Community Nursing Edenhope Health & Fitness Centre Social Work 1 4 WIES 5 1630.44 1500.7 8.6% DVA WIES 4 94.92 130.46 -27.2% TAC WIES 1.09 8.89 -87.7% Renal WIES (Dialysis) 39.6 58.45 -32.2% 1. The number of patients treated was similar to the previous year. 2. There was a 2.3% increase in occupied bed days due to patients at smaller sites having longer lengths of stay as a result of complex medical conditions. 3. A cute occupied bed days were above that of the previous year, nursing home type bed days continued to decline 4. Throughput in DVA programs was unpredictable with one over budget and the other below budget 5. T here was an 8.6% increase in Weighted Inlier Equivalent Separations (WIES) due to an increase in the complexity of conditions treated. Great care is taken to ensure that patients are treated safely in the most appropriate setting, however every attempt is made to ensure patients are treated close to home, if that is possible. RESIDENTIAL AGED CARE – PERFORMANCE BY CATEGORY Nursing Home Days Note 2013/14 2012/13 Variance 1 26194 27275 -4.0% 16110 16250 -0.9% Nursing Home Discharges Hostel Bed Days 80 55 45.5% Hostel Discharges 41 32 28.1% 2013/14 2012/13 Variance 752 771 -2.5% 1362 1634 -16.6% Percentage Occupancy Nursing Homes 1 93.20% 97.0% -3.9% 750 682 10% Percentage Occupancy Hostels 2 95.90% 96.80% -0.9% 699 1849 -62.2% 506 656 -22.9% 1. T here was a decrease in nursing home occupancy compared to the previous year. 2 . Hostel occupancy levels were similar to that experienced the previous year. The Rural Primary Health Program is a Commonwealth Government funded program aimed at providing additional primary health services to rural and remote locations. This program operates at all WWHS sites and also at Edenhope. 1. The Health and Fitness Centre closed midway through the year with funds from this program reallocated ANNUAL REVIEW 2013/14 27 STATISTICS OVERVIEW ADMISSIONS BY POSTCODE 2013/1 MOST COMMON REASONS FOR ADMISSION TO WWHS HOSPITALS 2013/14 WIES No. of Cases ADMISSIONS BY POSTCODE 2013/14 Nhill Goroke 388 Kaniva Dimboola Lens Procedures 143 Rainbow Jeparit Dental Extractions and Restorations 63 Horsham Warracknabeal Murtoa Edenhope Other Oesophagitis and Gastroenteritis 51 Colonscopy, Sameday 45 Knee Procedures 45 Respiratory Infections/Inflammations 38 Endoscopy Check/Follow-up, Sameday 36 Haemodialysis Other Digestive System Diagnoses 35 Respiratory Infections/Inflammations 34 Back Pain and Sciatica 34 Tonsillectomy and/or Adenoidectomy 30 Dysequilibrium 29 Chronic Obstructive Airways Disease 29 Cellulitis 29 Other Factors Influencing Health Status 28 Chest Pain 27 Otitis Media and Upper Respiratory Infections 25 Rehabilitation 24 Kidney and Urinary Tract Infections 23 Red Blood Cell Disorders 23 Heart Arrhythmia, Cardiac Arrest and Conduction Disorders 22 Bronchitis and Asthma 21 Syncope and Collapse 20 Dialysis was the most common reason for admission to hospital and comprised 17.5% of all admissions. 143 lens procedures were performed restoring the gift of sight to 143 people. Bordertown & District 85.4% of acute inpatient admissions were from our immediate catchment area, an increase from 84% the previous year. A major purpose of local hospitals is to provide services that meet the needs of local communities, we are achieving this goal evidenced by the high percentage of local people being treated in their local hospitals 9.5% of admissions were from within the Wimmera sub-region and another 2.3% from towns just over the South Australian border. Being able to provide elective surgical services to patients from the wider sub-region decreases the elective surgery burden on regional and metropolitan hospitals and assists in ensuring that patients from the Wimmera area are able to have their operation performed in a timely and safe manner without having to travel long distances. ElectiveSURGERY Surgery By Type 2013/14 ELECTIVE BY TYPE 2013/14 Orthopaedics Ophthalmology ENT Gynaecology General Surgery Dental WWHS provides a range of low risk elective surgery. This is an important service as it allows patients to be treated locally, at the same time decreasing the burden on larger regional and metropolitan hospitals. A total of 605 elective procedures were undertaken in 2013/14. General Surgery and Ophthalmology were the busiest specialties. 28 WEST WIMMERA HEALTH SERVICE FINANCIAL PERFORMANCE For the ninth consecutive year the Service has reported an operating surplus (Net Result before Capital and Specific Items). This outcome is testament to our financial agility and in particular our ability to continue to find new revenue streams while at the same time keeping a close eye on our costs. While the $14k net result before capital items is comparatively low it remains a commendable effort for the Service to have effectively balanced its budget given the difficult financial environment faced throughout the year. OPERATING INCOME ($33.75M) Victorian State Government (predominantly the Department of Health) sourced grant income comprised 54% of total operating income (2012/13: 52%) followed by Commonwealth Government Residential Aged Care Subsidies on 22% (23%). OPERATING EXPENDITURE ($33.74M) Total employee related costs made up 78% (76%) of total operating expenditure emphasising the critical role that our staff play in the level and quality of care we provide. CASH AND INVESTMENTS At 30 June 2014 the Service held total cash and investments of $7.858m comprising $4.339m for the Service’s own funds and $3.519m in residential aged care accommodation bonds. The lower result in 2014 is due primarily to capital works expenditure associated with the new Natimuk Medical Clinic and the Macpherson Street, Nhill student housing projects as well as less residential aged care bonds being held compared with the previous year. This outcome keeps the Service relatively well placed in terms of being able to meet its short to medium term operating and capital cash requirements. ANNUAL REVIEW 2013/14 FINANCIAL RATIOS CONSULTANCIES CURRENT RATIO: .72 Consultancies during the year costing less than $10,000 (exclusive of GST) per consultancy, the number and total cost (exclusive of GST) of engagements was not applicable to West Wimmera Health Service. However consultancies which exceeded $10,000 are required to be declared. The Current Ratio (Current Assets divided by Current Liabilities) is used to indicate how well the Service is able to meet its short term financial commitments. At 30 June 2014 the Service’s Current Ratio was 0.72 (1.18 at 30 June 2013) which is slightly above the Departmental benchmark level of 0.70. QUICK ASSET RATIO: 1.21 The Quick Asset Ratio is similar to the Current Ratio but provides a better indication of the Service’s short term solvency by only including those current assets and current liabilities of an easily liquefiable nature. This result means that the Service has $1.21 ($1.43) in liquid assets for every dollar of short term liabilities. ADVERTISING EXPENDITURE Declaration of this item was not applicable to WWHS this year. EX-GRATIA EXPENSES There were no ex-gratia expenses made by the Service during the financial year. DEBT TO EQUITY (GEARING) RATIO: 0.22 This ratio is used to indicate the degree to which the Service is reliant on externally sourced funding and the result at 30 June 2014 of 0.22 (0.29) shows that only a very small amount of such funding is required. DEBTORS DAYS: 32 On average it took the Service 32 days (29) to recoup money owed to it for patient, client and resident fees over the year. CREDITORS DAYS: 29 This measure shows that it took the Service on average 29 days (28) to pay its creditors over the year. 29 FINANCIAL PERFORMANCE FINANCIAL POSITION – PERFORMANCE CHANGE AND OBJECTIVES SIGNIFICANT CHANGES IN OUR FINANCIAL POSITION INCLUDING SIGNIFICANT FACTORS THAT AFFECTED OUR PERFORMANCE The Service experienced a significant reduction (10%) in Commonwealth Government Residential Aged Care Subsidy Income. This was primarily due to lower than normal occupancy rates but which had substantially recovered toward year end. The consequential negative impact on the Service’s net operating result was sufficiently offset by positive outcomes for items such as Private Inpatient Fees, Aged Care Resident Fees, Dental Grants, Radiography Income and Medical & Surgical Supplies so that a surplus Net Result before Capital and Specific Items result was achieved. Re-evaluations carried out with effect on 30 June 2014 resulted in the fair value of the Service’s property (land and buildings) and transport fleet increasing significantly over the year. The amount of these upward revaluation was $17.5m for property and $152k for transport. These revaluations had no effect on the Service’s Net Result before Capital and Specific Items as these amounts were taken directly to the Asset Revaluation Surplus in the Balance Sheet which increased from $14,341m at 30 June 2013 to $31.993m at 30 June 2014. EVENTS SUBSEQUENT TO BALANCE DATE There were not any events subsequent to balance date which had a significant effect on the operations of the Health Service in subsequent years. 10.28 525000 437500 7.3 350000 6.15 7.13 6.7 7.86 9.09 10.3 10.87 612500 262500 4.34 4 2 175000 87500 0 2010 2011 2012 2013 Including Accommodation Bonds Excluding Accommodation Bonds 30 We held some $4.4m of such monies at 30 June 2014 against its originally budgeted amount of $5.5m. The lower than expected outcome was principally due to the substantial completion of the capital works associated with the new Natimuk Medical Centre occurring earlier than was originally anticipated. 700000 10 0 We also aim to retain sufficient levels of untied cash and investments at all times so that short to medium term operational and capital objectives remain achievable from a financial aspect. NET RESULTS BEFORE CAPITAL GAINS 12 6 A key financial performance indicator for West Wimmera Health Service is the Net Result before Capital and Specific Items for which the Service budgeted to achieve a $15,227 surplus for the year. The result actually achieved was $14,204. NET RESULTS BEFORE CAPITAL GAINS FINANCIAL YEAR ENDING 30 JUNE CASH AND INVESTMENTS 8 THE OPERATIONAL AND BUDGETARY OBJECTIVES OF THE HEALTH SERVICE THIS FINANCIAL YEAR AND PERFORMANCE AGAINST THOSE OBJECTIVES INCLUDING SIGNIFICANT ACTIVITIES AND ACHIEVEMENTS DURING THE YEAR WEST WIMMERA HEALTH SERVICE 2014 2009/10 2010/11 2011/12 2012/13 2013/14 OPERATING EXPENDITURE INCOME STATEMENT – 5 YEAR COMPARISON OPERATING EXPENDITURE Financial Year Ending 30 June 2010 2011 2012 2013 2014 $'000s $'000s $'000s $'000s $'000s Revenue 28,396 29,453 32,496 33,582 33,751 Employee Related Expenditure (20,162) (21,212) (22,210) (23,937) (24,662) Non-Salary Labour Costs (1,042) (1,104) (1,458) (1,553) (1,498) Supplies & Consumables (2,208) (2,218) (2,263) (2,269) (2,099) Other Expenses (4,352) (4,722) (6,353) (5,719) (5,478) 632 197 212 104 14 Net Capital Items & (2,398) Specific Items (2,847) (2,211) (2,120) (3,839) Net Result before Capital Items Emplo Gener Admin Medic Inform Techn Food OPERATING EXPENDITURE Electr Repai Employee Related Costs 78% General Supplies & Services 5% Administrative Expenses 4% Medical & Pharmaceutical Supplies 3% Net Result for the Year (1,766) (2,650) (1,999) (2,016) (3,825) BALANCE SHEET Financial Year Ending 30 June 2010 2011 2012 2013 Information & Communication Technology 3% Food Supplies 3% Electricity, Gas & Water 2% Repairs and Maintenance 2% 2014 $'000s $'000s $'000s $'000s $'000s Current Assets 11,108 11,636 11,408 8,761 Non-Current Assets 49,944 46,885 45,842 50,013 65,783 Current Liabilities 9,941 Total Total OPERATING INCOME (9,287) (10,002) (11,391) (12,975) (12,170) Non-Current Liabilities (639) Net Assets (Equity) 49,959 (802) (897) 47,189 45,190 (981) (1,082) 47,465 61,292 CONSULTANCIES (NOT CONTRACTORS) WHOSE CONSULTANCY AMOUNTED TO $10,000+ Consultant DVA Navion Project Capital Fundraising Total Project Fee Approved $’000s Total Fees Incurred $’000s Future Commitment $’000s 163 100 63 Victorian State Government Grants 54% Victorian State Government Grants 54% Commonwealth Government Commonwealth Government Residenmal Aged Care Subsidies 22% Residenmal Aged Care Subsidies 22% Pament Fees Pament Fees Other Revenue 15% 3% 15% Other Revenue Commonwealth Government Grants 3% 3% Retail Sales 2% 3% Commonwealth Government Grants Interest Retail Sales 1% 2% Donations 1% Interest Donations ANNUAL REVIEW 2013/14 1% 1% 31 CLINICAL SERVICES RESIDENTIAL AGED CARE Our residential aged care units provide an environment in which residents feel assisted and encouraged to live their lives meaningfully. They are ‘home’ for our residents and it is the positive attitude of our staff that makes them feel at home. HIGHLIGHTS FROM THE YEAR Accreditation at all units this year was very special. Accreditation is assessed every three years on two pre-determined days by highly qualified assessors. At least one unannounced visit at each of our nine sites occurs each year. Assessors look at records, policies and procedures, interview staff, residents and families to determine our quality of care across 44 outcome standards. We received our accreditation with a score of 100%! Assessors did not find any instances of non-compliance at the unannounced visits. We are very proud of this effort. This year, we received significant funding from the Department of Health for equipment to aid lifting, mobility and early assessment for clinical management of residents’ needs. Facilities in Nhill and Natimuk received $20,000, while Rainbow, Jeparit and Kaniva received $12,000 each. This equipment has increased comfort and safety for residents and staff across our organisation. Other significant achievements include our continued access to an experienced and respected Geriatrician, installation of a breakfast bar and sensory room at ‘Iona’. The breakfast bar increases resident experiences by providing a comfortable place reminding them to sit and eat, while the sensory room is a restful environment designed to inspire the senses. Staff training throughout the year covered elements from medication management to legislative and regulative requirements, how to recognise and report situations such as elder abuse, and manual handling, ensuring our standards are industry leading. 32 WEST WIMMERA HEALTH SERVICE Montessori training was introduced in all residential units. Staff, applaud the philosophy which is an asset in developing individual care plans for residents, and assists in a meaningful way to encourage different behaviours. Broadening the scope of Montessori will continue to improve activities and lifestyle for residents living with dementia. Our residents are able to access every type of allied health professional which is a hallmark of our Service, with high calibre staff ensuring the physical, social and emotional needs of residents can be met immediately. Over the coming 12 months, we anticipate some changes to our residential aged care delivery due to the Aged Care Reforms, which will affect access, cost, and resident decision-making. LOOKING TOWARD THE FUTURE With state-wide aged-care reforms coming into play in July 2014, WWHS is in good stead, as senior staff and financial officers have attended metropolitan and regional information sessions in preparation for a smooth introduction to the changes. The reforms will see consumer choice and industry marketing promoting competition with each other to attract residents. We will also advance Montessori training with additional furnishings and equipment being planned to support the program, as well as further staff training scheduled, being ever mindful that Aged Care is our ‘core business’. Dulcie Hogan, Resident of Bowhaven Hostel, Rainbow, welcomes husband Les for his daily visit. ANNUAL REVIEW 2013/2014 33 CLINICAL SERVICES Kayleen Kingwill, Aged Care Administration Officer, West Wimmera Health Service, discussing care options for their mother with Trudy and Peter Gebert. AGED CARE – THE CHANGES BECOMING A RESIDENT West Wimmera Health Service Services provides residential aged care on a permanent or respite basis at five sites throughout the Wimmera Mallee Region. To become a resident in any aged care facility requires an assessment by an Aged Care Assessment (ACAS) Officer. The ACAS service can be accessed through any West Wimmera Health Service site. Our residents receive the individual attention they require from professional and committed staff. Our staff pride themselves on their genuine dedication to deliver the highest standard of care 24 hours a day, every day of the year. West Wimmera Health Service Services provide care that is planned to suit the individual. We encourage our residents to live their lives to the fullest and make the most of what we have to offer. As from 1st July 2014 the Commonwealth Government will introduce sweeping changes to the way residential aged care will be managed including to resident classification and funding processes. 34 WEST WIMMERA HEALTH SERVICE Referral to the ACAS service can be made by your General Practitioner, service provider, family member or carer or by self-referral. “Aged Care Assessment Services (ACAS) are independent teams who assist frail older people and their carers identify what kind of care will best meet their needs. Assessment teams are multi-disciplinary and can include health professionals such as medical officers, social workers, nurses, occupational therapists and physiotherapists. They conduct comprehensive medically based assessments for those needing community services or aged care residential services. They assess for all restorative and potential care options” (Aged Care in Victoria) YOUR FIRST INTERVIEW ABOUT PROPOSED RESIDENTIAL AGED CARE At initial interview which will usually be with the Director of Nursing you will have the opportunity to tour the facility and explain any matters that may need clarification you have. Discussion will embrace: • Best choice of facility for the care required • General Practitioner - choice of General Practitioner. If the GP is unable to visit provision is made for a choice of caring General Practitioners and medical specialists who offer services to West Wimmera Health Service residential units. A meeting with the Aged Care Finance Officer will transpire and the following items will be addressed with the intending resident, family and/or carer. • Accommodation options and appropriate facilities • Daily care fees • Accommodation payments • Out of pocket expenses Rainbow Dance Club members, Alan and Laurie Bretag enjoy their weekly dances with Rainbow aged care residents, community members and staff but not as much as our residents. Dulcie & Les Hogan, Lauris & Alan Bretag, Adele Vincent, Dorothy Gould, Joan Jones, Val Roll. AGED CARE IN OUR COMMUNITY WWHS facilitates a number of community home care packages for clients, designed to assist ageing community members to live in their homes for as long as possible. Currently, our packaged services include domestic assistance, transport, social outings, maintenance, personal care and respite care. HIGHLIGHTS OF THE YEAR Demand is increasing substantially for the 20 home care packages WWHS delivers. These packages are managed by a case manager who sets up services and monitors the client to ensure their needs are met, and are available in all of our communities. We are also providing support to carers of our clients, enabling them to enjoy breaks through the National Respite for Carers Program. This type of care is managed and tailored individually, ensuring the best outcome for both client and carer. ANNUAL REVIEW 2013/14 Caring for the aged in our communities takes many forms. High Care, Low Care, Care in the community and sometimes the integration of many elements. Volunteers from the community who visit our aged care units add so much extra to the day for our residents and visitors who appreciate their interest enormously LOOKING TOWARD THE FUTURE Home care packages are set to change with aged care reform, meaning clients will have a much bigger say in the way money allocated to their package is spent so that their goals meet both physical and social needs. This is a very innovative and challenging approach to the delivery of this specialist program. 29 specialist program. 35 Adelaide McKenzie enjoying the company of Registered Nurse May Hei Eh Kyaw Kyaw in the calm surroundings of Nhill Acute Hospital. 36 WEST WIMMERA HEALTH SERVICE MAY'S STORY A LONG JOURNEY FROM THAI-BURMA BORDER TO NHILL Hi! My name is May JH Hei and I am a Karen from Thai-Burma border. I was born in a refugee camp called Klert Koht in Thailand. This refugee camp was shut down and our family moved into a new camp nearby called Mae La Refugee Camp. I was one year old at that time. I lived there until I turned 16 years of age. Through these long years of growing up in a refugee camp, I had no idea of how the actual normal world would be outside the camp. Our camp was very crowded and barbed wires fences all around us. There are still approximately 50, 000 refugees in Mae La Camp. We were not allowed to go outside of the barbed wire. Every entry site of the camp was patrolled by soldiers. The United Nations (UN) gave us food monthly with a ration. They gave us rice, fish paste, oil, yellow peas and chilli which we made food out of these supplies. I attended school in the camp which taught by the local teachers and a few foreigners who were volunteering. In year 2005, the UN government open the door for our refugees to settle down in the developed countries such as Australia, America, England, Sweden, etc. My family chose to apply our new lives in Australia. To be able to be successful, we had to go through interviews and medical check which took a very long process depends on each family situation. It took 1 to 4 years to be able to know whether you are successful or not. For our family, it took nearly 3 years to come to Australia. A few months after the successful medical check, we had to attend an orientation week of the new life. We had learnt the basic everyday living about housing, bills, cooking, crossing road, traffic light, etc. Looking back, it was liked a dream at that time. I was so excited and couldn’t even study for my final exams. ANNUAL REVIEW 2013/2014 On the 14th of February 2008, our family which consist of my pregnant mum, dad, me and my two little brothers, we had landed safely to our now called homeland, Australia. My little sister was born after our 4 months arrival in Australia. I was lucky enough to be in an age range where I can attend the high school when I first arrived. I spent 1 term in Western English Language School to improve my English speaking and writing. After that, I started my 2nd semester year 10 in Hoppers Crossing Secondary College. I took Victorian Certificate of Education (VCE) subjects for year 11 and year 12 for the next following 2 years. After two and a half years in high school, I had made enough score to get into university. I chose to study Bachelor of Nursing because of the experience that I had in the Mae La Camp. I had witnessed many deaths of the refugees due to lack of healthcare supplies and qualified healthcare workers. After 3 years I graduated as a registered nurse in 2013. I was hoping that, one day I can go back and work in Thai-Burma border to help out the poor people and the refugees with the knowledge and the skills that I had learnt in this country as a registered nurse. And now here I am in West Wimmera Health Service (WWHS) to put the theories I learnt into practice. I am doing graduate nurse program at Nhill and very grateful that WWHS let me fulfil my dream. I am also helping the Karen people from Nhill with interpreting English related to the healthcare in my spare time. Thank you WWHS for giving me this wonderful opportunity 37 CLINICAL SERVICES ACUTE PATIENT CARE CHILDREN ARE ALWAYS SPECIAL GUESTS AT WEST WIMMERA HEALTH SERVICE. West Wimmera Health Service continues to provide outstanding acute facilities. We’ve made a concerted effort to reduce the clinical look of our facilities providing instead a vibrant and inspiring décor across our sites, making patients as comfortable as possible. Bringing your child into hospital for an operation can be quite confronting both for you and your child. We have also up-skilled a nurse to provide asthma care, and added a palliative care resource nurse who is based in Nhill but accessible at all campuses. We offer a wide range of hospital and ambulatory care with 35 beds in Nhill, seven in Rainbow, six in Kaniva and four in Jeparit. Our Admission and Discharge Department provides stable and comprehensive services, ensuring clients know what to expect from surgery, and are aware of pre- and post-operative requirements such as preparation for the procedure and lifestyle restrictions during recuperation. This equipment was funded by WWHS, and will ensure care provided is safe in all facilities. Exemplary screening policies mean we have a wound infection rate of ‘nil’, as we continue to follow strict guidelines set by the World Health Organisation, the Australian and New Zealand College of Anaesthetists and Australian College of Operating Room Nurses and Australian/New Zealand Standards. We have trialled many ways to make the visit a more positive experience and have found that the first step is to encourage them to bring their favourite toy into hospital. DRIVING TO THE OPERATING SUITE Next, driving the shiny red car to the Operating Suite is the highlight of their stay. Driving themselves and ‘teddy’ to theatre also removes some of the fear factor out of the whole process for parents as well as the child. Big smiles instead of tears as the child heads for the Theatre Suite happy. Continuing access to these specialties is crucial to the wellbeing of our community, reducing the need to travel huge distances for specialist treatment which is critical to enabling patients to retain the support of family and friends at all times. When the child and ‘teddy’ arrive at the Theatre door the child has to answer questions for ‘Teddy’ too. Children are asked what their name is and what “Teddy’s name is, their date of birth (if they are old enough to know) and what operation they are having today? HIGHLIGHTS OF THE YEAR LOOKING TOWARD THE FUTURE Our well-equipped theatre operates every week, with visiting surgeons specialising in Ear Nose and Throat, Orthopaedics, Oral Dental, General Surgery, Ophthalmology, and Gynaecology. We will improve preparation for patients undergoing colonoscopies, working with the surgeons, preadmission clinic and pharmacist to achieve better outcomes for our patients. Once admitted to the operating Theatre ‘Teddy’ goes through the same procedures as the child such as the cardiac dots being put on to ‘Teddy’ as well. One of our biggest achievements this year is the introduction of a macular injection service, which has assisted many people maintain their eyesight for a significantly longer period of time. The general surgeons have met with WWHS managers and doctors to explain the surgery they can perform in Nhill, and make it known we intend to increase General Surgery for next year. We will also obtain more equipment to meet standards and ensure patient safety. THEATRE Generally, waiting times for surgery are exceptional, with most people having surgery within six months of their initial consultation. A range of new equipment was purchased to ensure we consistently deliver optimal care to our patients, including a video laryngoscope, peripheral nerve stimulator, magnets for use with patients with pacemakers, and biological monitoring incubator. 38 WEST WIMMERA HEALTH SERVICE It is the intention to re-evaluate the way we disinfect and sterilise instruments to ensure such standards are best-practice and in accordance with the new Australian/New Zealand Standards to be released. We will continue this annual audit program for this purpose. Another comforting touch is they wear their own favourite pyjamas rather than a Theatre Gown and there are DVD players for movie watching during their stay. Children receive an admission pack with colouring pages and word searches based on healthy food choices and the new children’s menu with tempting healthy food options served in rainbow coloured bowls. QUALITY & SAFETY ASSURED A Specialist Paediatric Anaesthetist is a central part of the Operating Suite Team for child patients as are General and Specialist Surgeons. We are continually researching ways to make a trip to hospital more welcoming, comfortable and without fear. Jack Dodds in his favourite blue pyjamas can’t wait to get on the road to the Operating Suite. Nurse Pam van Kempen is hoping he doesn’t receive a speeding fine on the way. ANNUAL REVIEW 2013/2014 39 CLINICAL SERVICES WOUND MANAGEMENT HIGHLIGHTS OF THE YEAR WWHS continues to provide specialty wound-care services to patients in the acute setting, as well as in aged care. Specialist wound-care services increased this year, with a wound clinic providing assessment, management and advice to outpatients and community members as well as inpatients. LOOKING TOWARD THE FUTURE Our wound-care service is set to commence exciting research this year, and has ethics approval from the Ballarat Health Services and St John of God Hospital Human Research Ethics Committee. DIALYSIS With increased staff training, our dialysis can expand from one to two sessions per day as required. The unit continues to run three days a week, providing reliable treatment for patients, with the capacity to offer vacation care to dialysis patients travelling through the region. The refurbished unit and office space allows staff to manage treatment more effectively, facilitating discussion between clients with specialists in a more private space. It has been a challenging year in dialysis, with three much-loved patients passing away. Remaining patients and staff were grateful to receive counselling support from the Royal Melbourne Hospital. LOOKING TOWARD THE FUTURE The dialysis unit will continue their impressive record with no infections, as well as increasing dialysis capacity by involving enrolled nurses in the unit. Wound Care Nurse Cindy Bone had great success this year with a radically innovative regime which cured long term leg ulcers for a very grateful patient. 40 WEST WIMMERA HEALTH SERVICE ALLIED HEALTH Our team of qualified health professionals provides services in the acute, rehabilitation, residential aged care and community settings. We will break down the barriers and health inequalities existing within our communities to enable opportunities for improved health outcomes. HIGHLIGHTS OF THE YEAR Our Community and Allied Health team consists of expert staff in their respective fields, meaning we are able to offer and implement a wide range of initiatives designed to strengthen our community. This year, a significant achievement was working in partnership with West Wimmera, Hindmarsh and Yarriambiack Shire Councils to develop the ‘WHY Project’, offering Occupational Therapy, Physiotherapy, Podiatry and Dietetic services across all Shires, administered by WWHS. Developing and implementing a Healthy Ageing initiative across our catchment was another key achievement. This program ensures older people within our communities are connected to services and programs across the region, offering information sessions and programs relating to staying strong and living at home for longer. We also targeted the mental health of young people in our community, initiating and implementing a mental health program for school students in conjunction with Nhill College. These programs are effective in reducing health inequalities among our community members, enhancing community participation and promoting health across our region. WWHS was involved in exciting major research, investigating the effect of different types of fluids on patients with swallowing difficulties. This research is being conducted in collaboration with the University of Melbourne and Baker IDI, and has approval to continue until December 2015. The wide variety of programs delivered is a credit to the diversity and strength of our Community and Allied Health team. ANNUAL REVIEW 2013/14 Podiatrist Bianca Jones discussing treatment options with Colleen Ross in the Podiatry Consulting suite at the new Goroke Community Health Centre. The multidisciplinary team ensures quality health outcomes for our clients, and includes the following: COUNSELLING We provide a professional and accessible service dedicated to improving the mental, physical and psychological wellbeing of individuals who wish to improve their lives and the lives of those around them. PODIATRY WWHS Podiatrists deal with the prevention, diagnosis, treatment and rehabilitation of medical and surgical conditions of the feet and lower limbs. PHYSIOTHERAPY Our expert staff focus on prevention, assessment and treatment of physical disorders and the promotion of movement and health. MASSAGE SPEECH PATHOLOGY Massage therapy improves circulation by bringing oxygen and other nutrients to body tissues. It relieves muscle tension and pain, increases flexibility and mobility, and helps clear lactic acid and other waste, which reduces pain and stiffness in muscles and joints. The Speech Pathology Department provides effective and efficient intervention for those with communication and swallowing disorders. OCCUPATIONAL THERAPY Experienced District Nurses provide nursing care which allows people to remain in their own homes, maintain their independence, or have additional support after discharge from hospital. Occupational Therapists assist people to maintain or gain the skills and confidence to complete activities and tasks that are meaningful and useful to the person. They can recommend specific tools and/or equipment that can be of benefit to the client. DISTRICT NURSING District nurses assist clients with administration of medications, wound management, continence management, and personal care, and thus enhance quality of life for clients. 41 CLINICAL SERVICES Russell Hallam, Chef in Charge, Nhill Hospital, at work early to receive delivery of the beautiful fruit and vegetables used for the freshly cooked meals served every day. DIETETICS WWHS dietitians advance good health by promoting better choices around nutrition, which includes food, menu planning and cooking methods. DIABETES EDUCATION Our expert staff are trained to teach people with diabetes how to better manage their medical condition and conduct a sustainable lifestyle. HOME AND COMMUNITY CARE This program provides services to frail, aged, people with a disability and their carers, who live in the community. PLANNED ACTIVITY GROUPS These groups are designed to help older people and people with disabilities stay healthy and active by engaging in interesting and fun group activities. 42 WEST WIMMERA HEALTH SERVICE Planned Activity Groups are also a great way to stay informed about health and community services offered within the community by West Wimmera Health Service. LOOKING TOWARD THE FUTURE WWHS will continue to enhance the rehabilitation and mental health services available to our community clients. Planning is underway to develop a Rehabilitation Centre, offering expert facilities for people to receive health rehabilitation in Nhill, as well as a Cancer Resource Centre. We will continue enhancing the mental health services offered for young people, working more closely with the schools across our catchment to implement programs. WWHS has committed to developing health promoting plans over the next three years in conjunction with the Wimmera Primary Care Partnership and Local Governments. Priority areas identified include mental health and physical activity. We will also continue our clinical research, ensuring we remain a leader in the health industry. GRANTS RECEIVED WWHS has been allocated additional HACC funding for: • PAG Care Planning - $5,435 • Minor Capital - $20,726 Received $4,800 from the Department of Health for Allied Health training of staff to attend seminars and conferences. RADIOLOGY HIGHLIGHTS OF THE YEAR Radiology enjoyed another very successful year, with increasing patient attendance in computerised tomography (CT), ultrasound, and general X-ray. The quality of dental images was vastly improved with the installation of a state-of-the-art dental X-ray, or orthopantomogram (OPG). This machine also enables us to perform some procedures for the first time, saving patients trips outside the region for examinations such as lateral cephalograms. We will continue to improve the use of the OPG, developing sterilisation and infection control practices to ensure standards remain best practice. LOOKING TOWARD THE FUTURE A team approach has strengthened our Radiology Department, improving service delivery. To improve patient confidentiality we are investigating the possibility of developing a dedicated waiting area and reception. COMPLIMENT When patient Elly took X-rays from the Nhill hospital to her Melbourne-based orthodontist, the orthodontist said the X-rays coming from Nhill were some of the best he has ever seen, and the radiographer should be commended. PHARMACY HIGHLIGHTS FROM THE YEAR Inspected by the Victorian Pharmacy Authority this year, our pharmacy service passed with flying colours. We continue to provide consistent and effective pharmacy services, implementing recommendations from the internal audit, and introducing a temperature data logger to all medication fridges. This monitors our fridges continuously, assisting us to confidently evaluate the temperature to ensure safe storage of medications. Our pharmacy continues to be a member of the Medication Reconciliation Working Party Members auspiced by the Department of Health, ensuring correct selection of the ‘right’ medication for the ‘right patient’. ANNUAL REVIEW 2013/14 LOOKING TOWARD THE FUTURE In furthering our medication reconciliation efforts we are developing our own hospital formulary, which will stabilise our existing pharmacy stock usage and help improve the system between doctor prescribing and medication delivery. We will also investigate better patient medication summary software to replace existing systems with the endeavour of providing more complete patient care information at the time of discharge. 43 CLINICAL SERVICES DENTAL HIGHLIGHTS FROM THE YEAR Dental Services flourished this year with significantly increased program delivery. Undoubtedly the highlight of the year was opening the Kaniva and Goroke Dental Clinics in February. These modern facilities, together with well-trained staff, ensures WWHS continues to deliver the most comprehensive dental services in our region. Our graduate dentist program continues to be a tremendous success, attracting one talented graduate to our service every six months, with three graduates currently being mentored by our senior dentist. This program ensures our dentists are up-to-date with the latest practices and technology, keeping us at the forefront of oral health promotion. NEW – ALTERNATIVE TO TRADITIONAL BRACES TO ALIGN TEETH We were successful in retaining a senior dentist on a permanent part-time basis, meaning we can offer a significantly broader range of general and advanced dental procedures. Our senior dentist specialises in Invisaline, an orthodontic treatment using clear, removable aligners as an alternative to traditional metal dental braces. Continued investment in training made it possible for two dentists to become certified to provide conscious sedation, with other dental staff undertaking programs such as Certificate IV in Health Promotion and Certificate III in Dental Assisting. WWHS is committed to making dental services accessible to all members of our communities. Our sustained partnership with the Royal Flying Doctors volunteer dentists helps us ensure dental services are freely available, providing free checks and treatment through their regular three-monthly visits. 44 WEST WIMMERA HEALTH SERVICE With the help of Dental Health Services Victoria, we also had access to portable dental equipment for two months thus providing oral health services to 15 primary schools during this period. Our Rainbow clinic has also seen increased program delivery, moving operations to weekly instead of fortnightly. Equipment upgrades continue to improve our service delivery as with digital X-rays, we provide faster imaging services and access images from all four dental clinics. Digital Inter-oral cameras were purchased, taking images in the mouth so patients can gain a visual understanding of what the dentist has achieved. Finally, WWHS Dental Clinics are now all paperless, increasing efficiency in our clinics and making them more environmentally friendly. LOOKING TOWARD THE FUTURE Over the next year, Dental Services will aim to increase promotion of good oral health in the region, continuing our commitment to making Dental Services accessible to everyone. As well as maintaining our four Dental Clinics, we will continue our partnership with the Royal Flying Doctors, deliver free school screenings, and organise a mobile dental van to reach outlying areas within our region. We will continue to provide oral surgery services in Nhill, with the ability to treat patients in the dental chair or in the hospital theatre, and are looking to facilitate dental implant services in the future. Senior Dental Surgeon Aziz Baluch has brought a new orthodontic treatment to our Dental Clinics. Using clear aligners as an alternative to metal dental braces has been a success as patient Alison Welsby agrees. ANNUAL REVIEW 2013/2014 45 CLINICAL SERVICES DISABILITY SERVICES ‘Cooinda’ Disability Service based at Nhill supports people with disabilities and ensures achievable individual outcomes, encouraging personal development while promoting positive interaction and participation within the wider community. Cooinda offers individual support based services for eligible participants, with choices of interesting programs and activities with, supported employment opportunities, for people with a disability who require guidance and assistance to perform employment duties. This is a special feature of our program. DAY SERVICES HIGHLIGHTS FOR COOINDA DAY SERVICES INCLUDE: • Participation in the Oral Health Promotion for people with disabilities entitled ‘Keep the Wimmera Smiling’ incorporating participants from Cooinda, Wimmera Uniting Care Horsham, Woodbine Warracknabeal and Edenhope and District Memorial Hospital. • Introduction of joint programs with Wimmera Uniting Care Day Service with each agency hosting activities on alternate weeks resulting in new and renewed friendships. • Competing in the Tri State Games, an annual sporting competition held over five days in various towns throughout South Australia, New South Wales and Victoria where Cooinda participants were successful medal recipients. BUSINESS SERVICES Our supported employment sites of Oliver’s Café and Snappy Seconds continue to provide valuable education and on the job training which feature support and work experience in a busy enterprise. Supported employees learn skills to enable them to work in hospitalities or retail under the guidance of trained supervisors. 46 WEST WIMMERA HEALTH SERVICE Those working in the café learn the importance of food preparation and presentation, customer service and the importance of cleanliness and correct food handling skills. At Snappy Seconds supported employees are given training in customer service, selection of and display of goods for sale and deportment. The Stores Department of West Wimmera Health Service has now combined with Maintenance in providing work opportunities in an open employment environment for supported employees, teaching work ethics, responsibilities and expectations of working in a busy hospital setting. Accreditation of the Commonwealth funded business services in 2013 was once again successfully accomplished. In July 2014 both State and Commonwealth funded programs will be audited against the new Disability Standards. LOOKING AHEAD Cooinda staff continue to participate in information sessions showcasing the outcomes of the Barwon National Disability Insurance Scheme (NDIS) trials. The NDIS is a generational reform that will deliver a national system of disability support focused on the individual needs and choices of people with unfortunate handicaps. NDIS will progressively roll out in Victoria from July 2016 to July 2019. The Service will closely monitor the reform to maximize opportunities to provide meaningful programs, activities and employment to people with disabilities in our catchment area and also capitalise on the benefits this reform program may bring. “I used to do gymnastics when I lived in Melbourne and I like riding horses. Vaulting joins the two things together. It is a cool thing to do and I am proud of myself when I do the routines” Amy Brown with very patient pony Chrystal getting ready for a fun day of riding and horsemanship in the clean clear air of the countryside. ANNUAL REVIEW 2013/2014 47 CLINICAL SERVICES Dr Alex Stepanov consulting with Loma Wallis in the Tristar Medical Clinic, Kaniva. The appointment of Dr Alex, a second General Practitioner for Kaniva, is the result of our close working relationship with Dr Kahled El Sheikh, which has resulted in a full complement of practitioners for West Wimmera Health Service communities – certainly against the trend for other small rural communities where doctor shortage is endemic. 48 WEST WIMMERA HEALTH SERVICE MEDICAL REPORT EXPANDING THE DIMENSION OF CARE West Wimmera Health Service continues to provide a broad range of medical services to the communities of the Western Wimmera. Visiting Specialist Surgeons and Anaesthetists conduct regular elective operating lists in Nhill, allowing local residents to have surgery close to home and avoid extensive journeys to Regional and Metropolitan for elective surgery. Tristar Medical Group provides General Practitioner services in Nhill, Jeparit, Rainbow and Kaniva as well as supporting the Primary care Casualty Units and after hours coverage for acute and emergency patients. Dr Harsha Aluthge left the Tristar Medical Group practice in Nhill during the year. Prior to his departure, we were delighted to learn Harsha had received his Fellowship of the Royal Australian College of General Practitioners. We wish Harsha and is family well and thank him for his work at the Tristar Clinic and for his contribution to West Wimmera Health Service. Drs. Anthony Anachuna, Irfan Hakeem, Aysha Rasul, Paul Moyo and Shepherd Chifura have continued to work across the Tristar clinics and West Wimmera Health Service sites. Drs Nneka (Stella) Anachuna and Debby Chinogara have also been working in the Tristar clinics and have recently been joined by Drs. Wei Cheng Chen and Oleksiy (Alex) Stepanov, working in the Tristar clinics in Jeparit and Kaniva respectively. West Wimmera Health Service (Nhill) continues to provide a comprehensive range of specialist surgical services including: General Surgery (Messrs. Stehen Clifforth, Peter Tung and Uvarasen Naidoo from Glenelg Surgical Clinic); Orthopaedic Surgery (Mr Chi Gooi); Ophthalmic Surgery (Dr Mark Chehade); Gynaecological Surgery (Dr Ian Jones); and Ear, Nose and Throat Surgery (Mr Laurie Ryan). The delivery of surgical services has been facilitated by a very supportive group of General Practitioner anaesthetists including Drs Stuart Perry, Malcolm Anderson and Kim Fielke. ANNUAL REVIEW 2013/14 Consultant Anaesthetist, Dr Robert Ray, visits from Ballarat to Nhill on a monthly basis to provide consultant anaesthetist services and provide specialist oversight and guidance for anaesthetic, critical care and resuscitation services across West Wimmera Health Service. Dr Ray’s contribution is very highly regarded a gratefully acknowledged by staff and patients alike. Maintaining this range of surgical services in a small rural hospital setting presents special challenges for operating room, day procedure, ward and after hours staff. In order to ensure that West Wimmera Health Services is addressing these challenges and undertaking an appropriate range of surgical services, a comprehensive review of surgical services was undertaken in 2013. This review provided expert guidance on the safe and effective delivery of elective surgical services now and in the future at West Wimmera Health Service totally endorses the levels of competences which prevailed prior to this revision. During 2014, regular visits to West Wimmera Health Service from general physicians based at Wimmera Health Care Group in Horsham will commence. Two physicians will alternate fortnightly visits to Nhill Hospital to conduct general medical clinics as well as providing a consultation and referral service. This is a very welcome development which will provide specialist medical care in Nhill and reduce the need for patients to travel for such specialist consultations. credentialing, definition of scope of practice and performance of general practitioners, specialist Visiting Medical Practitioners, dentists and other practitioners as well as matters relating to performance improvement, accreditation, legislative compliance, clinical risk management and consumer engagement. Over the past year a Grampians regional Credentialing Committee has also been established and West Wimmera Health Service is exploring how this committee might be integrated with the work of the Clinical Quality Governance Committee. The Quality and Clinical Governance Committee also works in close liaison with the Clinical Improvement Committee which is responsible for the implementation, operation and improvement of clinical processes and outcomes throughout West Wimmera Health Service. All Visiting Medical Officers regularly undertake continuing medical education, attending seminars, tutorials, conferences and workshops relevant to their practice at West Wimmera Health Service. On behalf of the local community, West Wimmera Health Service thanks its general practitioners and visiting specialist medical practitioners for their ongoing support and the high quality clinical services that they continue to provide. The West Wimmera Health Service Clinical Quality Governance Committee meets Bi monthly and reports to the Board of Governance on the 49 CLINICAL SERVICES MEDICAL & CLINICAL VISITING CONSULTANTS CONSULTANT EXECUTIVE DIRECTOR MEDICAL SERVICES Dr I S Graham MBBS MHP AMEE FRACMA GENERAL SURGEONS DENTAL SURGEONS SONOGRAPHERS Dr Aziz Baluch BDS(Syd) ADOH(Ade) MPH(Syd) MOSC(Syd) MRACDS(Syd) Ms A Kellaway BMed Radiography (Diagnostic Radiog), Dr Alvin Ng BDSc(Melb) Grad Dip Medical Sonography Dr Anamalay Ayasamy BDS(Singapore) FDSRCPS(UK) FICD Mr S Jones B App Sci (Medical Radiations), Grad Dip Ultrasonography Mr S Clifforth MBBS FRACS Dr Lok Chern Muk (Dr Ricky Muk) BDSc(Melb) Mr P Tung MBBS FRACS Dr Lisa Li BDSc(Hons) Mr U Naidoo MBChB FCS(SA) FRACS Dr Leanne Just BOH(HONS)(Qld) Graduate Diploma of Dentistry(Qld) ORTHOPAEDIC SURGEONS Dr C Gooi MBBS FRACS Mr J Patrikios MBBS MS FRACS CONSULTANT OPHTHALMIC PHYSICIAN AND SURGEON Dr M Chehade MBBS FRANZCO EAR, NOSE AND THROAT PRACTITIONERS Miss A Cass MBBS FRACS Mr L Ryan MBBS FRACS FRCS DLO CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST Dr I Jones MBBS FRANZCOG VISITING DENTAL SURGEON Dr A Ayasamy BDS FDSR CPS FICD SPECIALIST ANAESTHETIST Dr R Ray MBBS FANZCA ORAL HEALTH THERAPISTS Erika Alegre BOHSc Hayley Downey BOHSc GENERAL PRACTITIONERS Dr K El-Sheikh MBBS FRACGP FACCRM DPM DPS CASA Pilot Medical Officer Dr P Moyo MB ChB Dr S Chifura MB ChB Dr H Aluthge (from April 2014) MBBS DFM RCGP(UK) Dr A Anachuna (from December 2012) MBBS Dr I Hakeem (from December 2012) MB ChB Dr A Rasul (from March 2013) MBBS Dr J Thomson MBBS Dr K Graham MBBS DRANZCOG FRACGP MPH TM Grad Dip Clin Edu Dr D Chinogara MB ChB GENERAL PRACTITIONER ANAESTHETISTS Dr N Anachuna MBBS Dr M Anderson MBBS FRACGP DA FACRRM Dr O Stepanov MD Dr W Cheng Chen MBBS Dr K Fielke MBBS DA FACRRM CONSULTING PHARMACISTS Dr S Perry MBBS FRACGP Mr W Mascoll BPharm MAACP AACP Dr N Provis-Vincent MBBS BMedSci (Hons) FACRRM Ms D Norton BPharm AACPA Dip Med Herbalism SPECIALIST GERIATRICIAN AND PHYSICIAN STAFF PHARMACIST Dr R Shea MBBS FRACP Mr K Emmett BPharm MPS SPECIALIST GERIATRIC NURSE CONSULTING RADIOLOGY SERVICE Mr G Taylor RN Post Grad Dip Psych Nurs CONSULTANT MANAGER Mr M Yau BPharm MPS Mr P Trenery Dip App Sci (Med Radiog), Grad Dip Ultrasonography RADIOGRAPHERS: Mr T Harlow Dip App Sci, Grad Dip App Bus Ms A Kellaway BMed Radiography(Diagnostic Radiog), Grad Dip Medical Sonography Ms S Worsley Dip App Sci (Medical Radiations) Mr S Jones B App Sci (Medical Radiations), Grad Dip Ultrasonography LAKE IMAGING PTY LTD RADIOLOGISTS Prof A Pitman MBBS BMedSci FRANZCR Dr R House MBBS FRANZCR DDU Dr A Firkin MBBS FRANZCR Dr A Meakin MBBS FRANZCR Dr M Mittal MBBS FRCR(UK) FRANZCR Dr L Zentner MBBS BA FRANZCR ANZSNM Dr C Trotman BDS(UK) LDS(UK) FDS(UK)FRANZCR Dr K New MBBS FRANZCR Dr K King MB ChB(UK) FRANZCR Dr A French MBBS FRANZCR VISITING OPTOMETRISTS WIMMERA EYE CARE Hannah Guyatt BOptom Therapeutical Endorsed (AHPRA) VISITING AUDIOLOGIST ADELAIDE DIGITAL HEARING SOLUTIONS Benjamin Wood BMRad (RT), MAud, MAUDSA (CCP) MCGRATH FOUNDATION BREAST CARE NURSE Ms Wendy Crafter RN MBCN Dr ‘Sammy’ visits Nhill Dental Clinic monthly for consultations and extractions in the Operating Theatre, such as Wisdom Teeth or when many teeth require removing. The Dental Team is supported by the Theatre Manager, Sharon Sanderson and the Dental Clinic Team. 50 WEST WIMMERA HEALTH SERVICE Dental Nurse Sharyn Morrison, Sharon Sanderson, Theatre Manager, Dr Stuart Perry, Dental Nurse Andrea Deckert, Dr Anamalay Ayasamy ANNUAL REVIEW 2013/14 51 QUALITY OF CARE STORIES OF QUALITY OF CARE IN ALLIED HEALTH WOUND CARE Creativity is sometimes an essential element of healing. A patient, Shirley, had suffered from chronic leg ulcers for nine years, enduring countless tests, numerous bouts of surgery, many infections, complicated treatments and lots of pain. She was admitted to the Nhill Hospital in February 2014 with an infection in her right leg and three non-healing ulcers on the left leg. Her General Practitioner, the West Wimmera Health Service Specialist Wound Nurse and her Surgeons, thought broadly and decided to try Negative Pressure Wound Therapy in their efforts to heal the wounds. This therapy entailed attaching dressings to a pump which applied pressure to the leg encouraging new tissue to grow. The treatment proved successful and the ulcers began to improve to the point she was able use a smaller pump allowing her to walk freely and two months after the treatment began Shirley was able to return home - her wounds completely healed after nine years! Dear John, and the entire I am writing to thank you therapists of Nhill physiotherapy and massage ant care that helped Hospital for their magnific d shoulder and arm restore my severly damage to full functionality. an care were Their professionalism and hum walked the corridors inspirational. Every time I how lucky we are to at Nhill Hospital I thoug ht spital in our town. have such a wonderful Ho It is truly world class.. My sincere thanks, Kim An expensive treatment but worth it. West Wimmera Health Service Wound Care Nurse provides speciality services to patients in our hospitals, as well as Hostel and Aged Care patients at all campuses of the Service. The role has recently expanded and this same specialist wound care and advice is now available to outpatients in the community. THE ROAD TO RECOVERY – DETERMINATION, SKILLED PRACTITIONERS AND INNOVATION Kim’s happy ending took a while. During a long awaited holiday overseas, Kim had a nasty fall almost severing her arm at the shoulder. The severity of her injuries meant she had to undergo urgent surgery in less than satisfactory conditions leaving her with a critical infection. 52 WEST WIMMERA HEALTH SERVICE Kim's Letter to John Smith Arriving home, Kim underwent further surgery at a prominent Metropolitan Hospital, but after eight months she was still unable to use her arm. After the surgery Kim returned home to continue intensive rehabilitation with the team at West Wimmera Health Service. Desperate for help, she began working with the West Wimmera Health Service Physiotherapists and Massage Therapists. The treatments complemented each other; physiotherapy improved her movement, and massage helped with scar tissue and pain. Three months later, she returned to her Melbourne Specialist for assessment. He was astounded with her progress under the care of this team. THE OUTCOME Given that Kim was fit and very determined backed by an excellent Physiotherapy team behind her, Surgeon Mr Treseder, decided to undertake a world-first operation on her shoulder. Just over 15 months later through the skill and initiative of her Surgeon, West Wimmera Health Service therapists and her own determination, Kim achieved a full recovery and now has full use of her arm. Kim expressed her utmost appreciation to everyone involved in her return to full movement and praised the expertise and skill of the Allied Health Practitioners available at West Wimmera Health Service. Kim Moyle has made a remarkable recovery from an extremely serious freak accident thanks to expert care from West Wimmera Health Service Physiotherapists and Massage Therapists and an eminent team as well as her own determined approach to her rehabilitation. Physiotherapist Emma Smith with Kim setting a new program of exercises to maintain the movement in Kim’s shoulder. ANNUAL REVIEW 2013/2014 53 QUALITY OF CARE CONSUMER CARER AND COMMUNITY PARTICIPATION KAREN COMMUNITY AT HOME IN NHILL WWHS has been responsive to the Karen community needs. In order to ensure this community has improved access to healthcare staff work with interpreters and family members to ensure that clients understand and are part of their treatment regime. Dieticians provide supermarket tours and cooking demonstrations for a greater knowledge of Australian type food which the children were asking for. EXTENDING THE VARIETY OF INGREDIENTS We have worked with the Nhill Neighbourhood House and IGA Supermarket to ensure that products and fresh food typical in a Karen diet is readily available in Nhill ensuring their nutrition and preferred ingredients are available. The wider range of foodstuffs available has been welcomed by the whole community, broadening choice and variety for all. 54 WEST WIMMERA HEALTH SERVICE DOING IT WITH US NOT FOR US HEALTH PROMOTION WWHS has focused on a model of care that ensures clients are working towards taking responsibility of their own health outcomes. In combination with the principles of Department of Health “Doing it with us not for us” Publications and applying an Active Service Model, all Community Health Clients are directly involved in their assessment and treatment plan. VISION By ensuring that clients and/or carers are directly involved we have witnessed a 75% increase in compliance rates of treatment meaning that clients are recovering quicker from mental health issues requiring less counselling services and referrals for specialists care. “Breaking down the barriers and health inequalities that exist within our community to enable opportunities for improved health outcomes” West Wimmera Health Service will strengthen its integrated health promoting, health service attributes by: • working in partnership with agencies and members of our community, • seeking to reduce health inequalities among our community members, • enhancing community participation, • identifying cultural differences within our community members, • ensuring that health promotion interventions focus on the determinants of health and; • providing evidence based health promotion initiatives to enable our community to take responsibility for their own health. Our integrated health promotion vision is endorsed by organisational strategies, policies, procedures, position descriptions and service planning documents commit to the health promotion concepts and frameworks of the World Health Organisation Ottawa Charter model, the Department of Human Services Integrated Health Promotion framework, the Social Determinants for Health framework and community capacity building models. MENTAL HEALTH - A PRIORITY WWHS collaborated with the Wimmera Primary Care Partnership, Local Government, Schools, Police and General Practitioners in the region to determine the areas of health promotion that need to be targeted. As a result the areas of Mental Health and Physical Activity were determined. One of our major health promotion activities over this financial year has been to work together with local schools given it had been highlighted to WWHS staff there was an increase in self harm and negative self-esteem among students in Years 7-9. A total of 90% of students across the region in these classes have access to a counsellor with information nights for students and their parents having been provided. Students have been given tools to deal with their everyday situations and resilience training has been offered with 85% of students reporting they have increased selfesteem as a result of the program and self-harm rates have dropped significantly by 80%. CONCLUSION In conclusion West Wimmera Health Service has prioritised mental health and although we still have more work to do, we have increased the mental health services available for clients and patients. In addition, we have increased the tele-health arrangements between specialists and allied health practitioners meaning less travel is required for member of our communities to access specialist review appointments. We will continue to increase our networks and connections with Metropolitan hospitals and other specialists to consolidate and advance on the gains we have witnessed. ANNUAL REVIEW 2013/14 RESEARCH CULTURAL RESPONSIVENESS West Wimmera Health Service is proactive in the area of research and development. We provide treatment and services in accordance with evidence based practice and are also leaders in the area of research. There is a very small Aboriginal and Torres Strait Islander population within WWHS catchment, however, we are constantly aware of the need and are committed to ensuring culturally appropriate services are supplied. Working in conjunction with researchers from the Baker IDI, to complete two studies. One relating to swallowing management. The other to Wound Healing. Approval was obtained through Ballarat Health Service and St John of God Hospital Human Research Ethics Committee with the approval number HREC/11/BHSSJOG/20 CULTURAL RESPONSIVENESS FRAMEWORK STANDARDS RESEARCH – MANAGEMENT OF SWALLOWING • The Service is committed to The aims of the Swallowing Management study is to investigate the effects of thin fluid consumption in patients who have been prescribed with thickened fluids. As a result we expect that patients will benefit from increased consumption of fluid intake and better of quality of life. Currently we have investigated 22 patients, all of whom have shown a marked improvement in their fluid intake and quality of life measures. WOUND HEALING RESEARCH In addressing Wound Healing, West Wimmera Health Service is investigating healing wounds utilising Olivamine, Cream which is proven to be a more potent and effective formula utilised in the United States of America for this purpose, however not yet available in Australia. As a result we expect and have witnessed in 6 patients to date that persistent wounds and have been healing and responding to the use of Olivamine, where they weren’t healing previously utilising other products. This research conducted on West Wimmera Health Service premises is internationally recognised and will contribute significantly to evidence based practice methods in the swallowing and wound healing fields. These innovative and ambitious projects, the outcomes of which may transform in medical care of these particular health concerns. In response to such standards WWHS ensures at all times best practise is observed. • 100% of staff are provided with education relating to the provision of culturally appropriate services to clients and patients. ensuring culturally appropriate services are delivered and a Cultural Diversity Awareness plan exists in the form of a policy at organisational level. • Accredited interpreters are provided for patients in need. • The Service has access to interpreters available via the telephone or face to face. • Inclusive practice in care planning is demonstrated, including but not limited to Dietary, Spiritual, Family, Attitudinal, and other Cultural Practices and needs. • Culturally and Linguistically Diverse Consumers, Carers and Community members are involved in the planning, improvement and review of programs and services of the nature on an ongoing basis • Professional development opportunities are provided for all staff. Photo: Teacher, Mr Haydn Wearne surrounded by happy students Drew, Sophie and Jordan who all agree the Guys and Gals Program presented by WWHS Community Nurse Michelle Barber at the Goroke College is a great success. It has built confidence, encouraged peer support and made them aware of their feelings and the feeling of others. 55 QUALITY OF CARE LINDA KNIGHT'S STORY Brave, courageous, bold! How else could one describe the decision to leave one’s homeland, friends and family to move to a small rural town in a country largely unknown to Linda or her family? Linda’s intrepid decision was life changing. No doubt there has been home sickness to conquer and times of loneliness but in the end she is safe and happy in her new land and proud of her achievements. My 10 years with WWHS ntry, and become to survive in a foreign cou ago, my only thought was rs yea 10 e babw Zim for my When I left be capable of standing in mention then, that I would ed dar had ne anyo If our main income earner. back. dered and probably turned facility, I would have shud manager in an aged care is daunting. We knew new life at the age of 53 this, making a completely e don ually act e hav und was you Unless ern. Our only common gro system, or the weather patt ing bank the n, tow the k Australian! no one, didn’t know ning to understand and spea However, we are still lear lish. Eng e spok we t tha t the fac are of – endless ound support that I was unaw me, there was much backgr fund HS WW did manent only Not effort required for our per e over 50, and the hug e eon som ng loyi emp h wit paperwork involved n in the pay office. ty, John Smith and Gordo ondence with Christine Duf resp cor er emb rem I ce. residen But 10 years on, I don’t g I have ever undertaken. thin cult diffi and ging llen lost everything This has been the most cha much loved parents, who assist with the support my to able n bee e hav I g. reg ret one thin support us. This would to rely on our children to them, but we don’t need ort supp can I did. we n whe tinued in Zimbabwe. have been so, if we had con to learn and rs. It took me a long time ing profession for 30 yea nurs the in ally form ked I had not wor so much from residents and is a privileg e. I have learnt e car d Age in g kin Wor ion has to be become proficient here. epted. My greatest admirat by the way I have been acc bled hum am I e. alik ues work colleag ble and incredibly diverse. for Di. Her job is unenvia have t on leave. This too, would replacement when she wen her as me try to me in She had enough faith ort from the staff. been impossible without supp compassionate. me to be more patient, and My time in Iona has taug ht judg emental and impetuous. And I have learnt to be less this new start in life. to WWHS for giving me I will always be grateful Kind reg ards Linda Knight 56 WEST WIMMERA HEALTH SERVICE Dietitian Stephanie Daly explaining meal options and menu planning with Mavis Manning at Rainbow. Dietetics - a great service for small towns. THE IMPACT OF DIETITIANS Our Dietitians have an impact in a many areas of healthcare. They are pivotal in menu planning for the acute hospitals, they work with the Karen community introducing them to unfamiliar produce in our supermarket; with the elderly to help them plan for cooking for one; conducting supermarket tours taking the mystery out of understanding food labelling. At a time when the incidence of obesity in the Wimmera Region is extremely high our Dietitians are an essential part of the health promotion team promoting healthy eating and a healthy lifestyle. EDUCATION AND TEAM SUPPORT - A SUCCESS STORY Obesity affects many Australians, including Lee-Joy and her daughter Sam and is a major cause of Chronic Disease in this region of Victoria. When Lee-Joy and Sam were referred by their General Practitioner to a West Wimmera Health Service Dietitian they were severely overweight. ANNUAL REVIEW 2013/14 The Dietitian, and their General Practitioner, from Tristar Medical Group, Nhill, worked with the ladies to develop a Meal Plan which they believed they could follow. The Plan included fortnightly appointments and regular check-ups with the General Practitioner and the Dietitian. Both ladies had a history of unsuccessful attempts to lose weight over the years so it was decided to move them onto a medically formulated meal replacement program containing the correct balance of nutrients required to maintain optimum health. Their Four Stage Program commenced with an Intensive regimen, followed by Transition, Maintenance and Stabilisation phases. This program is designed to bring about sustainable change as patients transition towards healthy eating. It’s not a quick fix, however, Lee-Joy and Sam were dedicated to the program, maintaining a positive attitude and supporting each other throughout. With ongoing education and support from West Wimmera Health Service and Tristar, the women have lost 17.4kg and 14.9kg respectively. THE OUTCOME Importantly, both are continuing to embrace healthy eating habits and are still losing weight! 57 QUALITY OF CARE DIMENSIONS OF QUALITY IN RESIDENTIAL AGED CARE Pressure Injuries 2013/2014 In 2006 the Department of Health introduced a suite of Quality Indicators that all public sector Residential Aged Care Organisations are required to report upon on a quarterly basis. These indicators relate specifically to common risks that may impact on the quality of life of those residents within our aged care facilities, and include: • Prevalence of pressure injuries • Prevalence of falls and fall related fractures • Use of physical restraint • Residents prescribed nine or more medications • Prevalence of unplanned weight loss By collating and analysing this data we are able to compare outcomes with other aged care organisations, and identify clear trends that we can address to minimise the impact of such risks. This enables us to improve individual resident care and becomes our focus for continuous improvement, to which we aspire. Over this period our focus on continuous improvement has demonstrated that we have sustained excellent results in all five areas, with a great improvement in the identification and management of pressure injuries and continued low rates of falls and related fractures, physical restraint, medication use and unplanned weight loss. PREVALENCE OF PRESSURE INJURIES Pressure injuries can occur in anyone with reduced or restricted mobility. A Pressure injury, the result of damage to the skin and underlying tissues, is often caused by the inability to change position independently. Sustained pressure and associated friction can lead to damage of the skin and underlying tissues, and if untreated can also affect the muscles and bones. Prevention strategies used to reduce the likelihood of a pressure injury developing include regular position changes, good hygiene and skin care, and a healthy diet. 58 WEST WIMMERA HEALTH SERVICE The most likely areas susceptible to a pressure injury are bony areas; heels, elbows, the back of the head and the coccyx (tailbone). These injuries are staged by severity, with Stage 1 being general redness of the skin, to Stage 4 which is a wound that involves muscle and bone. The constant monitoring of our resident’s skin enables early detection of the signs associated with pressure injury at the earliest stage (Stage 1), as the interventions required to reverse a Stage 1 injury are simple and noninvasive. Early intervention has revealed that more serious injuries can be prevented if a stage 1 injury is identified early and treated appropriately. Residents are regularly assessed for risk of developing a pressure injury, and with skin assessments routinely conducted to identify any pressure injury at the earliest possible stage is where the least skin and tissue damage has occurred. Interventions applied to facilitate good blood supply to the skin and reduce the likelihood and severity of pressure injuries include: • Good nursing techniques which involves frequent positional changes, moisturisation of the skin, use of aids that reduce skin pressure – heel protectors, chair cushions, positional pads are utilised for this purpose. • Dietitians assess nutritional status and recommend dietary supplements that encourage healing of skin and surrounding tissues. • Occupational Therapists are able to specify aids which provide relief from pressure “hot spots”. • Ill-fitting footwear is a common pressure source. The Podiatrist is able to review current footwear and recommend appropriate footwear for this ailment. PRESSURE INJURIES 2013/2014 0.5 0.4 0.3 0.2 0.1 0.0 Stage 1 WWHS Stage 2 Stage 3 Stage 4 STATE The majority of recorded pressure injuries were of the least severe stages, with no stage 4 pressure injuries assessed during this time. PREVALENCE OF FALLS AND FALL RELATED FRACTURES Unfortunately falls within aged care residences homes are not always preventable, but we are able to assess our residents to determine likelihood of falling, and as a result implement interventions which will reduce the likelihood of falling and its impact on their quality of life. In order to reduce the risk of falls, whilst maintaining the independence of our often frail elderly residents we: • Assess each resident to determine their level of risk, and review this assessment if the resident’s health status changes. • Ensure the home is safe and free of clutter, allowing residents to walk freely around the home. • Provide appropriate mobility aids. • Have a multidisciplinary approach to falls prevention, with the health care team recommending relevant interventions for each individual resident who experiences a fall. The safety of the residents within our aged care facilities is a very high priority, always being very aware of the need to encourage residents to be as independent as they can. To align such principles with this we ensure the environment is conducive to resident activity and movement, with our staff alert at all times to risks that could cause or impact on falls. Resident cognitive abilities directly influence the frequency that a resident falls. Our experience reveals that we are lower than the State average for falls and fall related fractures for the 2013/14 period. To continue to reduce the number of falls our residents experience and the injuries sustained the following interventions are routine: All falls are reviewed by the “Falls Working Group”, formulate and recommend strategies to assist in the reduction of fall occasions, which include: • Programs to improve balance and gait • Appropriate footwear is evidenced • Mobility aids – full range of frames and sticks are available • Activity programs to reduce the impact of poor cognition are incorporated in facility activity plans • Alert devices – to alert staff that a resident deemed at risk of falling is mobilizing unassisted The Health Care Team, involving nursing, medical practitioners and allied health staff review “frequent fallers” to establish the impact of medications and treatment regimens, and suitability to Falls 2013/2014 maintain independent good health. RATE OF FALLS 2013/2014 7 6 5 4 3 2 1 0 USE OF PHYSICAL RESTRAINT Referenced Department of Health and Ageing Decision Making Tool: Responding to issues of restraint in aged care: www.health.gov.au/internet/ wcms/publishing.nsf/Content/ageingdecision-restraint.htm WWHS STATE ANNUAL REVIEW 2013/14 Fall related Fractures USE OF PHYSICAL RESTRAINTS 2013/2014 1.20 0.96 0.72 Physical restraint is the restriction of a resident’s movement or behaviour. 0.48 In the past various methods of physical restraint were commonly applied in an attempt to reduce the number of falls experienced. 0.00 Research has since shown that physical restraint does not reduce the number of falls experienced, but actually can increase behaviours and the severity of injuries sustained by those falls. RESTRAINT IS NEVER CONSIDERED TO BE ROUTINE. West Wimmera Health Service currently has an aged care resident who has requested to have bed rails up at night, to provide a sense of safety. Prior to implementing this request we have: • Sought formal written consent from the resident, family and treating Medical Practitioner • Risk assessed the use of bed rails • Assessed the resident’s mobility while in bed with rails up Within all of our aged care residences the use physical restraints to restrict a resident’s movement or behaviour do not routinely prevail. All such requests require all parties to agree to the use of bed rails being appropriate and safe for each individual. Assessments are undertaken by the nursing, medical and allied health staff. Written consents are obtained from the resident and/or their family. Nursing staff closely observe and monitor resident’s safety whilst in bed with bed rails raised. Rate of Falls Use of Physical Restraints 2013/2014 0.24 Intent to Restrain WWHS Physical Restraint Devices STATE The table data demonstrates the average of our use of physical restraint is currently above the State average, but relates entirely to 1 of our 123 residents who has chosen to have bed rails insitu while sleeping. RESIDENTS PRESCRIBED NINE OR MORE MEDICATIONS Constant review to ensure residents are prescribed the medications to address current conditions, and in a form that best meets the individual resident requirement and is easily tolerated. By identifying residents prescribed nine or more medications we are able to instigate constant regular medication reviews. Medication reviews are regularly conducted by nursing and medical practitioners, in consultation with the pharmacist and Consultant Geriatrician, and if required the psychogeriatric team. Our policy is to routinely review the number and type of medications prescribed for each of the residents within our aged care facilities. Those residents prescribed nine or more different medicines are identified and further reviewed by the team, which includes the nursing and pharmacy staff together with the patients’ Medical Practitioner. This group review the medicines prescribed, and whether they are still appropriate need to be revised or ceased. 59 QUALITY OF CARE Reasons why residents are prescribed multiple medicines include: • Some residents have a number of chronic medical conditions which require individual close and constant management. • Residents entering the “twilight” stage of life often benefit from additional medication intervention to allow them to enjoy a dignified end of life which is as pain free as possible. • Increased frailty, and acute illness result in specific medications being prescribed Medication Use 2013/2014 INCIDENTS OF 9 OR MORE PRESCRIBED MEDICATIONS 2013/2014 5 4 3 Residents have their weight verified on a monthly basis, to identify those experiencing unplanned weight loss, and weight loss over a 3 consecutive month period. Those residents which have been identified as having significant weight loss are further reviewed to determine if additional nutritional supplements may be appropriate. A Dietitian assesses these residents and may recommend dietary supplements that have more calories, to maintain or increase weight; being in a form that is palatable and enjoyed by the resident. The ability to swallow often impacts on a resident’s ability to eat and drink adequately. 2 1 0 WWHS STATE PREVALENCE OF UNPLANNED WEIGHT LOSS Resident’s weights are monitored on a monthly basis, together with significant weight loss over a 3 month period. Unexplained weight loss is reviewed by the health care team that encompasses Nursing, Medical, Dietetics and Speech Pathology personnel. A complete review addresses: • Current medical condition – Weight is often the result of an illness or by the resident entering the “twilight” stages of life • The resident’s dietary preferences, likes and dislikes • Caloric intake which may be boosted with nutritional supplements in a variety of forms and consistencies. • The resident’s ability to swallow adequately, and if deficiencies are detected then diet and fluid consistencies may be adjusted 60 This vigorous system of routine monitoring of unexpected weight loss has increased the awareness staff need to identify early, thus implementing strategies prior to significant weight loss having a detrimental impact on the resident’s medical condition and quality of life.- WEST WIMMERA HEALTH SERVICE The fragility of those within our care is clearly seen by the state rate for this indictor as seen in the chart. No matter the circumstances we continue to provide our residents with high quality care to ensure they have a quality of life which will always provide them with comfort, choice and above all dignity. BENEFITS By collecting and monitoring this complete suite of quality indicators we are able to identify at an early stage if a resident is at risk of becoming medically unwell, any symptoms impacting on their general welling, and thus compromising their enjoyment of life. By identifying deteriorating conditions early we are able to implement changes to the care planning which can reverse changes in health status, whilst ensuring resident care preferences are respected. Our concerned effort to add to the quality of life of our senior citizens. A Speech Pathologist will determine need in this instance, and may recommend a diet which is of a consistency that the resident can easily swallow and digest. A resident’s weight is inclined to fluctuate in times of acute illness or when entering the end of life experiences. It is vital residents are provided with a nutritional diet which they are able to choose and want to eat, and is also in form they can tolerate and sustain. Unplanned Weight Loss 2013/2014 UNPLANNED WEIGHTLOSS 2013/2014 1.2 1.0 0.8 0.6 0.4 0.2 0.0 Weight Loss 3+kgs WWHS Weight Loss of 3 Month Period STATE Betty McKenzie relaxing with Registered Nurse Ancy Bijup potting plants in the mobile "French Garden" which is the source of much enjoyment for patients and residents at Jeparit Hospital and Hostel. ANNUAL REVIEW 2013/2014 61 QUALITY OF CARE QUALITY AND SAFETY FOR OUR PATIENTS At West Wimmera Health Service safety of our patients are our chief concern. High safety expectations are set and these are monitored by the examination of key indicators of quality care, these include safe use of blood and blood products, preventing falls, preventing and managing pressure injuries, medication safety, best practice concerns and all aspects associated with Occupational Health and Safety. PRESSURE INJURIES The number of Pressure Injuries recorded across the Service increased in 2014 from 16 in the previous twelve months. 10 0 Not described Number of Pressure Injuries by type by year 120 100 80 60 40 20 0 2013-14 2012-13 2011-12 West Wimmera Health Service commenced participation in a High Definition Three Dimensional (HD3D) project, funded by the Victorian Department of Health, which is being run for 6 months across the Wimmera Sub-region. Nurses in the field will be supplied with cameras which will take 3D images of wounds. These images will then be uploaded to a central computer where the Wound Care Specialist employed by the Service can view the images and provide expert opinion regarding wound management. 2013/14 2010-11 This graph demonstrates the types of pressure injuries at WWHS, emphasising that a great many injuries have been detected and treated before they become severe and require extensive treatment MEDICATION INCIDENTS – Medication Incidents by primary type A FIVE YEAR COMPARISON 2009-10 WEST WIMMERA HEALTH SERVICE 20 / Unstageable 62 30 Stage 4 Education of our staff has again been the focus of our efforts in combating the number and severity of pressure injuries. Our resident wound care specialist nurse has instigated new resources on the Service intranet so that staff can access the latest information and education relating to pressure injury prevention; it provides an online interactive program designed by wound management experts. 2012-13 The 2011-12 number of patient medication incidents has remained relatively 2010-11 similar over the past three years as 2009-10 demonstrated by the graph below. 40 Stage 3 No Stage 4 pressure injuries were recorded in 2013/14; this is important as this type of injury is the most serious requiring intensive and sustained care. 50 Stage 2 Patient and resident assessment of skin integrity is key to early detection of pressure injuries. Our aim is prevention rather than reaction when dealing with pressure injuries with special mattresses, gel pads and attention to the nutritional needs of patients is paramount. in our hospitals and residential aged 2013-14 care facilities. 60 Stage 1 Twenty eight (28) pressure injuries were recorded in 2013/14 compared to 72 five years previously. This reduction was brought about by a mixture of thorough patient assessment and the use of new equipment designed to reduce the injury to the tissues of the human body, particularly over bony prominences of the body. MEDICATION SAFETY Pressure Injuries - a–comparison over time PRESSURE INJURIES A FIVE Safe administration of medications has YEAR COMPARISON 2013/14 a direct relationship to safe patient care Severity of Pressure Ulcer Meeting the needs of our community in a responsive and safe manner is a key objective for our Service. Wrong Patient Wrong Dose Wrong Drug Omitted Dose The rate of medication incidents per thousand bed days has decreased from 2.09 in 2012/13 to 1.21 in 2013/14. This result has been achieved through a combination of staff education, awareness of the incidents occurring across the Service and an investment of following up each incident with the staff involved. No adverse patient outcomes occurred as a result of a medication error during the past year. Despite this, medication errors are thoroughly investigated and practices put in place to improve our performance. Dr Anachuna Anthony supported the initiative of a Venesection Clinic for the treatment of patients with excess red blood cells. Clive Knight listens intently as Dr Anthony explains the way his Venesection treatment will work. Venesection is used when you have too many red cells in your blood which may cause the blood flow to become sluggish which may increase the chance of developing problems such as blood clots. By removing the extra cells the risk of that happening is reduced. Venesection is the simplest method of reducing the number of red cells in your blood. The method used is similar to the procedure used for donating blood. PREVENTING FALLS Preventing falls or reducing the severity of the outcomes of falls continues to be a safety objective of our Service. Our falls health care team comprising physiotherapists, nurses, Visiting Medical Practitioners and occupational Number of Falls examine all therapists thoroughly patients who fall or have the potential of doing so. Number of Falls by Year NUMBER OF FALLS – A FIVE YEAR COMPARISON 2013/14 400 350 300 250 200 150 100 50 0 2013/14 2012/13 2011/12 2010/11 2009/10 Numbers of falls have remained relatively constant over the past 12 months compared with previous, as indicated in the above graph . ANNUAL REVIEW 2013/14 A comprehensive care plan is established with the patient and their family members to ensure that all possible methods to prevent falls are put in place; such efforts include an environment free of obstacles, appropriate footwear that fits the foot well and providing the ability for patients and residents to easily solicit staff assistance when needed. Patient cognitive ability plays a key role in falls, and as such patients are not always aware of their limitations when walking unaided. Mild discomfort and first aid for the patient or resident occur in 99% of falls but occasionally the outcome and treatment is more severe, sometimes resulting in a fractured bone. In 2013-14, four patients or residents suffered a fracture: such incidents undergo an extensive clinical review of the circumstances leading to the fall and the injury sustained. Patient and residents requiring Dementia care remains an area of focus; we intend to continue to introduce new methods of patient and resident activities to engage people living with wandering tendencies but poor physical strength. BLOOD AND BLOOD PRODUCTS Meticulous attention is made to the need of providing blood or a blood product to a patient by our Visiting Medical Practitioners as it is usually in such short supply. The healthcare team take time to ensure patients fully understand the need for Blood or Blood Products and their consent must be obtained prior to its administration; in 2013-14 this occurred in 100% of occasions. During 2013-14, no incidents occurred where the wrong type of blood was administered to a patient. PERFECTION - OUR AIM Safe, efficient clinical care, doing no harm remains our number one priority. Our aim is to improve on these indicators of quality of care and strive to implement new strategies to assist our clinical practitioners in their endeavours. 63 QUALITY OF CARE PREVENTING AND CONTROLLING HEALTHCARE ASSOCIATED INFECTIONS There are five main areas of focus to prevent infections at West Wimmera Health Service – these are: • A clean environment • Promoting Hand Hygiene compliance • Promoting staff immunisation, • Surveillance • Staff education MAINTAINING A CLEAN ENVIRONMENT Cleaning is the prerogative The Environmental Services Department are responsible for the daily cleanliness of our premises. Audits of cleaning practices are undertaken continuously both by designated staff (Internal Auditing) and in July each year by Auditors independent of West Wimmera Health Service (Independent Auditors). Results of the Internal Audit is reported and submitted to the Department of Health, Victoria, March and November. Results of the External Audit are submitted to the Department of Health, Victoria. During the Audits three categories are reported: Category A-very high risk areas such as the Operating Suite, Category B-high risk areas such as Wards and Kitchens and Category C-which are medium risk areas such as Allied Heath Consulting Rooms. Our results for the external audit in 2014 were Category A-99%, Category B-100% and Category C- 100%. What a great result! Absolute reinforcement of the successful implementation and observance of the continuous improvement of the cleaning regimes by this Service and the contribution of this department to achieving virtually zero healthcare associated infection at West Wimmera Health Service. 64 WEST WIMMERA HEALTH SERVICE HAND HYGIENE AUSTRALIA West Wimmera Health Service has participated in the auditing of hand hygiene compliance since 2007. We now report this data to Hand Hygiene Australia, three times each year through VICNISS the Victorian Healthcare Associated Infection Surveillance Coordinating Centre. We audit the staff as they go about their tasks caring for patients and assess if they clean their hands by washing or using Alcohol Hand Rub as frequently as is indicated by the Five Moments of Hand Hygiene. We have achieved respectable compliance, with a rate that is consistent and slightly above the national average. The National Benchmark is 70% however the current target is now 75%. We reported our Hand Hygiene Compliance in October 2013 as 78.3%, in March 2014 it was 77.9% and in June 2014 it was 81.2%. We audit staff in five areas of the health service for each audit reported. The average Australian compliance for June 2014 was 81%. Our staff influenza vaccination uptake rates have improved, a group of Immunisation Nurses undertook workplace vaccinations at such businesses in Nhill as Luv-a-Duck, IGA Supermarket, Solicitors, Nhill College and the Hindmarsh Shire UNDERTAKING SURVEILLANCE Auditing and reporting of practices and activities are an integral part of the Infection Control and Prevention of any health service. Assessing the hand hygiene of staff, looking at the environmental cleaning of our facilities and counting the number of staff who have accepted the vaccinations offered is a small part of the total package of surveillance. Surveillance is looking objectively at what staff are doing, looking at the outcome of their activities and assessing whether we can alter what we do to improve the result in the future. Throughout the year we have assessed how we do things in relation to infection control in the theatre, sterile stock department and the dental surgeries; how we manage waste, staff exposures and wound dressing techniques. In 2014 the National influenza vaccination target rate was 75%. We continue to closely monitor our Aged Care Clients. We undertook a Point Prevalence Audit (an audit designed to take place on one day to obtain a snapshot of clients with infection and antibiotic treatment) of the residents of our nursing homes, comparing our data and that of other hospitals in the Grampians Region. Between March and June we were able to achieve a vaccination rate of 67.3% across the West Wimmera Health Service. While not reaching the 75% target set we did improve our Influenza Vaccination Rate among staff from 59.7% in 2013 These results will be compared with other Regions in Victoria. The data will then be submitted to a European study and will provide us with information about how we treat this infection, how our rates compare to other areas and show us what we could improve. PROMOTING IMMUNISATION To promote immunisation for Staff and in the wider community, we undertook an active program of influenza vaccination clinics this year. WWHSACUTE Acute CLEANING Cleaning %% WWHS Audit byBY Category A UDITResults RESULTS CATEGORY 100 2014 2013 2012 99 98 97 96 95 VHR HR MR WWHS Cleaning results by category per year WWHS HANDHygiene WWHSNATIONAL National Hand HYGIENE A UDIT % Audit % Compliance 2011-2014 COMPLIANCE 2011-2014 120 Audit 3 100 Audit 2 80 Audit 1 60 40 Rhonda Dunham preparing to use the new Ecolab cleaning system which has reduced chemical use and cost while achieving outstanding results in cleaning audits. An advantage of the system is the labels which are screen printed onto the containers eliminating fading and peeling which can become a safety issue. 20 0 2011 2012 2013 2014 STAFF EDUCATION STAFFInfluenza INFLUENZA Staff Vaccination VACCINATION % RATE % Rate 2012-2014 2012-2014 80 70 60 50 40 30 20 10 0 2014 2013 2012 Given Refused Unknown Percentage of staff vaccinated, refused vaccination and of unknown status ANNUAL REVIEW 2013/14 Education targeting the crucial importance of controlling and preventing infection is an important element of our education program for all employees. A basic introduction to Infection Control is included in the Orientation package for all staff. Compliance with mandatory education units according to the department of employment is closely monitored. Education is acknowledged as an essential element of the process of preventing and controlling infections within a health service. It reinforces appropriate decisions about the care of infected patients, while avoiding the spread of infections from one patient to another. Some subjects in the program are constants such as Hand Hygiene and others are varied for each group of staff. The formal education compliance for 2013-14 is for Clinical staff: 99.28% and Non-clinical: 100%. The total staff who have attended Infection Control education is 99.64% Informal education is constant and may include on the spot education about management of a specific disease or how to use a new product. WHY DO WE PLACE SUCH IMPORTANCE ON THE PREVENTION OF HEALTHCARE ACQUIRED INFECTIONS? As a patient or resident in a West Wimmera Health Service facility you can be assured the utmost effort is placed on keeping you safe from Hospital Acquired Infection. 65 CORPORATE & QUALITY SERVICES It takes an enormous number of departments and individuals working together towards a common goal to make an organisation as diverse as West Wimmera Health Service function effectively, safely and efficiently. Quality care comprises many facets in addition to medical, nursing and allied healthcare. A CLEAN ENVIRONMENT Providing a clean and attractive environment for patients plays an important part in the road to recovery. It is also important as a means of reducing the risk of patients contracting hospital acquired infections. HIGHLIGHTS FROM THE YEAR This year’s external cleaning audit highlighted the immaculate cleanliness and tidiness of our campuses, with our four acute hospital sites at Nhill, Kaniva, Jeparit and Rainbow recording a 99% compliance result. This is the second consecutive year we’ve received this excellent result, meaning WWHS is substantially above the 85% benchmark set by the Department of Health regarding cleaning standards. Our nine residential aged care facilities also achieved an excellent outcome, receiving a score of 97% for the second year in a row. Following a detailed tendering and review process conducted in accordance with Health Purchasing Victoria (HPV) requirements, we introduced a new cleaning system this year, resulting in a 13% reduction in the use of chemicals and an associated saving of $3,500 per annum. A further improvement has been noted by decreasing the size of chemical containers from five to two litres, reducing manual handling risks. LOOKING TOWARD THE FUTURE This year, we took proactive steps toward decreasing our environmental footprint, introducing a new chemicalfree cleaning system to our Natimuk residential aged care facility. Microfibre cleaning has been used for several years in Iona Digby Harris Home, Nhill, providing residents with a clean and chemical free environment. 66 WEST WIMMERA HEALTH SERVICE Over the next year, we will introduce microfibre cleaning system into the remainder of our aged care facilities, before introducing it to the acute ward areas. ENGINEERING AND MAINTENANCE The physical environment at all sites is impeccably maintained and presented, ensuring front-line clinical care is always provided in a safe and pleasant environment. Engineering staff at each site undertake routine repairs and maintenance and complete a detailed preventative maintenance program comprising daily, weekly, monthly and annual checks. HIGHLIGHTS OF THE YEAR Our progressive capital redevelopment program replaces and improves physical infrastructure in a planned and financially sustainable manner every year. This year’s projects included: Completing and officially opening the Goroke Community Health Centre; Making major upgrades to the Nhill nurse call system, eliminating the risk of system malfunction and flow-on effects; Developing a Dental Clinic at Goroke, which included installing a new Dental Chair and suction equipment, and providing X-ray; Upgrading the Kaniva and Rainbow Dental Clinics, installing new X-ray equipment and X-ray viewers; Installing a new commercial dishwasher in the Nhill Hospital Kitchen, replacing the existing 30 year old unit; Upgrading our staff accommodation house at Macpherson Street in Nhill, including repairs and painting; and Building three houses in Nhill to provide accommodation for undergraduate and postgraduate students completing placements with us, as well as other staff requiring short-term accommodation and visiting medical officers. LOOKING TOWARD THE FUTURE A site risk survey undertaken by Victorian Managed Insurance Authority at Nhill this year provided us a good rating, indicating that we control risks well. This review provided a number of recommendations we are now putting into place. Predicted budgetary constraints will test our capacity to continue to provide the exceptional physical infrastructure we presently enjoy, but we will meet this challenge head-on, striving to find ways to ‘do more with less’. EDUCATION Ongoing education makes sure we remain at the forefront of modern practices. It is very important to the sustainability and success of our organisation. HIGHLIGHTS OF THE YEAR This year, we actively promoted education in a number of ways: Engaging undergraduate students by providing supervised placements in nursing and allied health; Up-skilling staff in all departments to increase their knowledge and qualifications; Ensuring our care is best practice by encouraging staff to attend internal and external conferences and seminars; and offering mandatory training in critical areas such as fire and evacuation, medication management and manual handling for all staff. This year, 475 undergraduate clinical placement days were undertaken, including a Speech Pathology placement for the first time in five years. Compared with 45 days in 2012 13 and applications for 2014-15 already standing at 595. The healthcare sector has witnessed an increase in occupational violence and aggression and as a result we are taking proactive steps to mitigate the risk of this behaviour. Hilma Summerhayes, supported employee, delights in her role meeting customers at Oliver’s Café and Leanne Wallis is bringing more sweet treats for sale. We have provided training to 209 staff, teaching them strategies to prevent these kinds of incidents from occurring. Our commitment to furthering qualifications of our staff is evident with the enrolment of three Hospitality and Environmental Services staff in Commercial Cookery apprenticeships, with a further three staff currently enrolled in a Certificate IV Disability course. Nine staff have also successfully completed ‘barista’ coffee training, guaranteeing Oliver’s’ Café and Kiosk will continue to serve the best coffee in Western Victoria. FRESH FOOD SERVICES We understand that meals can be a highlight for many residents and patients, and we make the effort to go above and beyond to cater for individual tastes. Patients and residents at all sites enjoy tasty, nutritious, freshly cooked meals made with locally-sourced ingredients. Menus are prepared in conjunction with our Dietitians and Speech Pathologists, ensuring food provided is not only tasty, but healthy and safe for everyone. Our kitchens also provide meals for a number of external groups including Senior Citizens and Meals on Wheels. We are delighted to support these community partnerships. ANNUAL REVIEW 2013/14 This year 183,047 meals were provided, .8% less than the previous year. This year’s external food audit indicated all sites are fully compliant with food safety regulations and guidelines. Olivers Cafe' is a commercial cafe operating in the business precinct of Nhill. It provides employment opportunities for supported employees from Cooinda Disability Services and has proved very effective in showcasing their individual talents to the wider community. Olivers Kiosk at the Nhill Hospital provides delicious light meals and fabulous coffee, appreciated by visitors, patients and staff and another opportunity for supported employees to work in the community. MOVING FORWARD INVESTIGATING A NEW SERVICE? A recent assessment of the new arrangement revealed general dissatisfaction with the service. So taking into account the cost associated with transporting the linen to and from a Regional Centre and also comments from our clients, many of whom raised concerns about the poor quality, particularly with personal laundry. Therefore we are now investigating the possibility and sustainability of establishing our own laundry service covering all West Wimmera Health Service sites including personal laundry for aged care residents. If the investigation proves positive and the project goes ahead it would be a very progressive community building action, providing local employment opportunities, support local businesses and importantly result in significant cost savings and a better quality service for West Wimmera Health Service. A win win situation for all! Clean linen for patients and for use across the service by cleaning and catering staff is a critical element for the everyday work of our Service as is the personal laundry service for our aged care residents. At the end of 2013 an evaluation of the laundry services provided by an external contractor was undertaken and in light of the findings a contract was drawn up with a different provider. 67 CORPORATE & QUALITY SERVICES ENVIRONMENTAL SUSTAINABILITY ACHIEVEMENTS OF THE YEAR ELECTRICITY HOUSE CONSTRUCTION A plan to replace incandescent and fluorescent lights in our buildings has commenced, with a total of 560 LED lights being installed in all new facilities. This has decreased our energy consumption by 112,420 kilowatt hours, with a resultant saving of $33,700 per annum. An energy auditor was engaged for the first time this year to assist us to meet our obligations for appropriate energy conservation in our new staff and student accommodation in Nhill. WATER We ‘farm’ water from roof tops by directing the rainwater to three 22,000 litre tanks for use in toilets, washing machines and hot water systems. Water conservation of this nature reduces our reliance on mains water supply, reducing our costs and also the possibility of water being wasted as storm water. WASTE WWHS is conscious of reducing its environmental footprint, conscientiously recycling cardboard, paper and plastic products in all of our administrative, clinical and support services. Equipment no longer in use and suitable for resale is also recycled. Our secondhand retail outlet Snappy Seconds sells a variety of items, from desks, chairs and curtains to computers. DOMESTIC HOT WATER The gas-fired hot water service in the Mira Medical and Allied Health Centre at Nhill was replaced this year with an electrical service. This has reduced our LPG consumption by 18% in three months, providing a more efficient and stable water heating source. 68 WEST WIMMERA HEALTH SERVICE As a result of this audit, double-glazed gas-filled windows have been installed, reducing noise levels by at least 50% while maintaining the internal thermal environment. This will significantly reduce energy consumption and our cost of providing this accommodation. In a first for construction at West Wimmera Health Service, insulation has been installed to the ceilings, walls and subfloors of all new constructions creating a thermal barrier. By doing this, we have created an environment requiring minimal energy input to maintain a comfortable setting for occupants. LOOKING TOWARD THE FUTURE We will now focus on new methods of managing our heating, ventilation and cooling systems at the Nhill Hospital to ensure maximum efficiency. We trust that research currently underway will see innovations in the forms of heating and cooling we install in our buildings, such as using solar and vacuum technology to preheat hot waterloops. It is anticipated that a direct result of these efforts will realise a reduction in energy costs, particularly relating to liquid petroleum gas (LPG). New accommodation for students and staff construction by West Wimmera Health Service Engineering & Maintenance staff – Rob Schneider, Aaron Beer, Tim Seymour busy carting material. ANNUAL REVIEW 2013/2014 69 FINANCE AND ADMINISTRATION Cody Gersch, Administration Clerk manning the Nhill Hospital Reception Desk. Cody is gaining experience in all areas of the Administration Department. 70 WEST WIMMERA HEALTH SERVICE STAFF 2013 - 2014 Brendon Abernethy Gwen Agustin Jillian Albrecht Melanie Albrecht Erika Alegre Karen Alexander Raelene Alexander Alicia Alexander Michael Alexander Amanda Alexander Judy Allen Gary Allison Wendy Altmann Sharyn Andrews Sam Anthony Glenda Aristides Marie Arnold Shirley Ashfield Jenny Asplin Kelvin Asplin Ange Atta Dawn Austin Shirley Avery Robert Bahr Anjali Balakrishnan Aziz Baluch Michelle Barber Kaye Baron Anne Barry Bill Bartholomew Sharon Bartholomew Rebecca Bastin Heather Batson Hayden Baxter P’leh Be Nyo Susanne Beattie Kellie Beattie Clint Beattie Wendy Bedford Bridie Beer Aaron Beer Ancy Biju Julie Bloomfield Cindy Bone Anthony Bone Emiley Bone Tracey Bone Kaye Borgelt Elizabeth Both Maria Bottrell Lisa Braybrook Tony Breavington Russell Brown Shelley Brown Amanda Brownsea Donna Burns Connie Burns Glenda Bush Dayle Buttigieg Lisa Buttigieg Kim Campbell Lachie Campbell Lindsay Cannell Helen Cannell Sue Carracher Mark Carracher Taryn Carter Katelyn Carty Toni Casey Barb Cavanagh Peter Cavanagh Anuja Chacko Debbie Chaston Remya Chathamparambil Ramesan Pat Chequer Rickie Chequer Bianca Chifura Erol Chilton Peter Chilton Pamela Clark Janine Clark Robyn Clark Carolyn Clark Chris Clark Deborah Clifford Janice Clugston Melissa Coad Pamela Coates Pauline Colbert Alexi Conboy Faye Connell Charles Cook Helene Cook Kerryn Cook Colleen Cook Emma Cooper Jackie Cooper Annie Coustley Kerry Coyne Sophie Cramer Marianne Cramer Carolyn Croke Anthony Croke Janine Dahlenburg Alison Dahlenburg Stephanie Daly Jisha David Jeena David Melissa Davis Andy Davis Jodie Day Sandra Decker Andrea Deckert Christine Deckert Alyce Deckert Jim Delarue Kellie Dickerson Michelle Dickinson Aimee Disher Shenae Dixon Sharon Dixon Ritchie Dodds Thomas Dryburgh Jamie Duffy Jennifer Dufty Christine Dufty Julie Dunford Lynette Dunford Rhonda Dunham Olena Dyer Wendy Eden Nina Edmonds Tiarna Edwards Rachael Egan Michelle Eldridge Jessica Eldridge Carol Elliott Sheryl Ellis Susie Ellis Stacey Ellis Kaye Emmett Kevin Emmett Wendy Essex Vicki Etherton Kerry Exell Carmel Feder Caroline Fischer Anne-Marie Fischer Jan Fisher Loretta Fisher Chantelle Fisher Wendy Flavel Neena Francis Katrina Fraser Nanette Freckleton Margaret Frew Tyrone Friebel Lorretta Fuller Rhona Fulton-Drendel Deb Funcke Mary Gabbe Laura Gabbe Katrina Gagliardi Zen Garcia Sharon Garwood Wendy Gawith Helen Gay Carol Gebert Darren Gebert Kylie Gebert Alicia Gebert Prameela George Sharon George Amritha George Geena George Cathrine Gersch Cody Gersch Sandra Gilbert Michelle Giles Gwenda Gilpin Dena Gleeson Kent Goldsworthy Michael Goode Teresa Gould Tennille Gould Leonie Graham Ian Graham Beverley Grant Ashley Grant ANNUAL REVIEW 2013/2014 Lawrence Grayling Jenny Grayson Dianne Green Robyn Gregor Jennifer Greig Helen Greig Harsha Gunawardena Beverly Hage Yvonne Hall Megan Hall Russell Hallam Allison Halliwell Anne Hamilton Cynthia Harberger Janine Harberger Judith Harrington Steph Harris Belinda Hartigan Jess Hartridge Anita Hassall Elizabeth Hawker Lesley Hawker Leah Hawker Emma Hawker Tina Hayden Yingying He Janet Heenan May Hei Trisha Heinrich Josh Heinrich Craig Henley Debra Hill Sandra Hinch Casey Hiscock Susan Hiscock Thaylor Hofmaier Terri-Ann Hogart Rachael Hormann Lyn Hourigan Cassie Howe Than Than Htoo Jonathon Hurst Kathleen Hutson Kellie Hyde Brenda J Jackson Diane Jackson Phillip Jackson Tracey Jarred Maggie Jarvis Denise Jensz Nakita Jewell Jan John Saina John Niceson John Desley John Wayne John Cheryl Johnson Matt Jones Brian Jones Yvonne Jones Bianca Jones Kevin Jones Jerric Jose Jismon Joseph Saleena Joseph Bony Joseph Debbie Jozeps Leanne Just Deborah Kakoschke Martha Karagiannis Aman Kaur Lucy Keam Vanessa Keberling Judith Keller Ann Keller Rowena Keller Karen Kennedy Kate Kennedy Sue Kennedy Sunil Kesavan Fiona King Alannah King Mary King Amanda King Charlotte King Kayleen Kingwill Linda Knight Margaret Krelle Fiona Krelle Anna Krommenhoek Sheena Kurisumkal Paul Jono Kyle Gladys Kyle Libby Lacey Jessica Lacey Warrick Lang Janine Launder Neree Launer Kristine Laverty Lisa Lawes Julie Leddin Cassy Leffler Barbara Leffler Dianne Leggo Caitlin Lehmann Karen Lester Lisa Li Katrina Lloyd Sally Lockwood Michelle Lowe Cheryl Lowe Bree Lowe Bree Lowe Lindy Lowe Darren Lyall Lynne Lynch Kerri Lynch Lyn Maddern Kate Maddern Marion Major Sharyn Makin Shinta Manuel Brooke Marra Vicki Marshall Trudy Marshall Katie Martin Melissa Martin Fay Martion John Martion Priya Mathew Brony Mathews Gaile Mayne Mila Mazou Dale McCartney Andrea McCartney Karyn McCartney Jen McDonald Dianne McDonald Bonnie McEldrew Michelle McGennisken Catherine McKenzie Sheryl McKenzie Lynne McKenzie Jessica McKinley Julie McLean Jane McPhee Casey Mellington Michelle Menzel Susan Menzel Ann Merrett Tracey Merrett Maree Merrett Shelley Merrett Kevin Merton Neville Michael Shayne Michael Tracy Midgley Lisa Miller Graham Miller Jacci Mills Sandra Millward-Coyne Trudi Moar Breanna Moar Emma Moore Tracey Morphett Sharyn Morrison Nicole Mottillo Chloe Mulraney Kate Munro Sarah Murn Steve Murphy Jacqueline Nash Tilley Nash Sarah Natali Lisa Newcombe Pam Newton Nicole Nicholls Bridget Nossack Megan Nossack Jaimee Nossack Leanne O’connor Semira O’heaney Linda O’heaney Polly O’heaney Luke Oldaker Brenda O’leary Jayne Oliver Natalie Orriss Rhianna Paech Dion Paech Minnie Pancho Ellen Panozzo Lucy Paterson Mick Patrick Feby Paulose Peter Pearce Ann Pearce Mariah Peele Tracie Peoples Liz Pfeiffer Bev Phillips Kate Pilgrim Selina Pilgrim Jess Pilgrim Bobbie Pitt Loata Pitt Sandra Pollock Bec Powell-Hodges Rhonda Preston Courtney Preston Pamela Price Leslie Prichard Rosemary Pritchett Tahnee Purchase Samantha Purches Sally Purvis Katrina Rabone Pat Rabone Jebi Rajamani Anis Rajwani Reju Reghuvaran Nair Chris Reichelt Anne Renfrew Jenni Rentsch Carla Reodique Lynne Rethus Natasha Rich Joylene Rich Christine Richards Claire Riches Judith Ridgwell Christine Rintoule Josh Rintoule Natalie Robinson Lesley Robinson Brenda Robinson Lynley Robinson Angus Robinson Wendy Robson Joylene Rohde Val Roll Rosemarie Rose Alicia Rosewall Teresa Ross Helen Ross Tamhika Ross Denise Rowe Rosie Rudd Graeme Ruse Jessie Rushbrooke Revai Rutsate Tania Ryan Helen Ryan Melissa Ryan Laurie Ryan Sharyn Salt Debra Sanders Sharon Sanderson Catherine Saul Kristina Savicin Judy Schier Deb Schilling Amy Schnaars Nicole Schneider Robert Schneider Julie Schneider Rebecca Schultz Denise Schulz Wendy Schulze Debra Schumann Nicole Schumann Kellie Lynne Schwarz Ellen Scott Janine Seater Tim Seymour Wendy Shalders Karen Sherlock Kerryn Shrive Janet Shurdington Karen Shurdington Julie Simpson Bree Sinclair Wendy Sleep Susan Sluggett Melanie Smith Jessica Smith John Smith Keryn Smith Dean Smith Emma Smith Shirley Sproule Sini Sreekanth Sree Sreekumar Chris Stanford Casey Stasinowsky Amanda Stephan Vonni Stephan Jackie Stevenson Elaine Stewart Denise Stimson Debra Stonehouse Hilma Summerhayes Omega Swinnerton Sue Taylor Darren Taylor Sindi Taylor Glenn Taylor Lucas Terry Val Terry Ann Thomas Vicki Thomas Basil Thomas Helen Thomson Judith Thomson Glenis Tink Tess Toquero Karl Towler Shirley Treble Margaret Trenery Nick Twigg Jarmila Tyrril Emma Ussing Fiona Van Den Idsert Pam Van Kempen Bibin Vijayakumar Adele Vincent Amanda Von Benecke Melanie Wagg Robyn Wagg Angela Walker Erin Wallace Leanne Wallis Helen Wallis Rosalie Wallis Krystal Wallis Kirstie Ward Annie Watson Donna Watson Marc Watts Valerie Webb Karen Webb Rhys Webb Elaine Webster Megan Webster Kerrie Webster Hannah Wedding Kristen Weir Chris Weir Phoebe Welch Annmaree Wells Alison Welsby Darren Welsh Joanna Werner Karen Wheaton Linda White Tiarne Whitworth Carol Willersdorf Cheryl Williams Desiree Williams Tammy Williams Wendy Wills Nan Wilson Kristian Wilson-Hooper Elizabeth Witmitz Norelle Witmitz Julie Woolcock Julie Worsley Claire Wotherspoon Lisa Wotherspoon Stefani Wyatt Narmada Yantrapati Martin Yau Janet Yong Rhonda Zivkovic 71 Kaniva the Falls Prevention Stars. All staff at Kaniva have worked hard to reduce the number of patient and resident falls or trips this year and have improved their performance immensely. Congratulations Kaniva! (L-R) Carol Willersdorf, Fiona Van Den Idsert, Lisa Buttigieg, Narmada Yantrapati, DON, Lesley Hawker, Taryn Carter, Helen Ryan, Breanne Moar. HUMAN RESOURCE MANAGEMENT The quality and scope of the many and varied health services we provide are heavily dependent on our ability to maintain a motivated and properly trained workforce. Throughout the year we incurred a total salary and wage cost of $24.7 million to employ 563 staff across a variety of disciplines. We continued to make good use of basic database and communication systems to ensure these staff remained competent, motivated and well trained to perform their duties. We achieved an average compliance rate of 99.56% for mandatory education elements such as police checks, fire and emergency training, CPR, basic life support and professional registration. No days were lost to industrial action throughout the year, testament to the professional relationships we maintain with both Victorian Hospitals Industrial Association (VHIA) and relevant employee unions. Our employees continued to enjoy free access to our independently provided Employee Assistance Program which offers a wide range of health and personal assistance giving our staff and their immediate families an extra layer of support when needed. 72 WEST WIMMERA HEALTH SERVICE At 12.4% staff turnover was lower than for the previous year (12.8%) and indicates a more satisfied workforce. Lower turnover rates also mean less costs required in order to attract and retain new staff. At 5.2% of basic wages (4.96% prior year) our sick leave is higher than we would like but this is not an uncommon result in our industry given such issues as ageing workforces and communities in general. The total of WorkCover payments made to injured workers ($95k) fell significantly compared to last year ($160k) and is reflective of the valuable work undertaken by our Injury Management Team throughout the year. Each year the Service participates in the independently provided People Matter Survey as conducted by the Victorian Public Sector Commission. As shown in the following table we continue to report acceptable levels of agreement across a range of indicators. WWHS is bound by the rules and regulations contained in the following legislation: • The Victorian Public Authorities (Equal Employment Opportunity) Act 1990 • The Victorian Equal Opportunity Act 1995 • The Victorian Public Sector Management and Employment Act 1998 • The Commonwealth Disability Discrimination Act 1992 • The Commonwealth Racial Discrimination Act 1975 • The Victorian Public Administration Act 2004 Through the application of Service policies and protocols and monitoring of compliance with relevant industrial relations instruments we aim to: • Ensure open competition in recruitment, selection, transfer and promotion • Base employment decisions on merit • Treat employees fairly and reasonably • Provide employees with a reasonable avenue of redress against unfair or unreasonable treatment • Avoid discriminating between employees on the basis of their gender, age, impairment, industrial activity, marital status and religious or political beliefs We do not tolerate bullying or harassment in any form. LOYAL SERVICE – A PILLAR OF STRENGTH FOR WEST WIMMERA HEALTH SERVICE 30 YEARS 20 YEARS 15 YEARS 10 YEARS John Martion Janet Fisher Cheryl Lowe Desiree Williams Sharyn Morrison Lisa Braybrook Deborah Schilling Karen Alexander Glenis Tink Elizabeth Witmitz Michelle Dickinson Janet Heenan Janet Shurdington Hilma Summerhayes Kelvin Asplin Rebecca Bastin Toni Casey Phillip Jackson Michelle Mcgennisken Judith Thomson Jessica Eldridge Nakita Jewell Barbara Leffler Shirley Avery Patricia Chequer Kellie Beattie 25 YEARS Kerri Lynch Lorretta Fuller Lisa Newcombe Shirley Ashfield Caroline Fischer Judith Keller Kaye Emmett Carmel Feder Linda Knight Terri-Ann Hogart Ian Graham Sally Lockwood Bree Lowe RISK MANAGEMENT In the context of West Wimmera Health Service, Risk can be defined as anything likely to impact on any aspect of this Service. Such risks can be thought of in a negative light, however they can also be an opportunity to improve the health and the safety of all patients, residents, visitors and staff including the ongoing business operations of the organisation. West Wimmera Health Service actively manages risk and does this through its compliance to the Risk Management Standard, AS/NZS ISO 31000: 2009 Risk management – Principles and guidelines. An extensive internal and external audit system is in place to review the systems and processes in both clinical and corporate functions of the organisation. In 2013-14 such audits have included medication management, occupational health and safety, finance and medical records management. Nineteen (19) strategic and operational risks have been documented on the Service risk register assisting managers document the controls for each risk thus ensuring that the organisations operations are not interrupted or damaged. The detail and accuracy of the risk register and the effectiveness of its controls is informed by incidents that are documented and complaints received from our consumers. A rigorous electronic incident reporting and feedback system ensures that staff are able to appropriately record issues as they arise and for managers to investigate and treat then accordingly. The number of incidents recorded each year has stabilised. Each incident is an opportunity to learn and improve on the care provided. Risk management provides the Service with an opportunity to proactively manage potential issues even before they arise and for this reason risks are examined on a monthly basis and reported to the Board of Governance. The research will treat participants’ wounds with Olivamine cream products rather than simply dressing the area. The study is expected to conclude in December 2017, and will ensure WWHS is at the forefront of best-practice methods in Australia. Total number of incidents TOTAL NUMBER OF INCIDENTS reported by year REPORTED BY YEAR 2000 1800 1600 1400 1200 1000 2013-14 2012-13 2011-12 2010-11 2009-10 The project will investigate the efficacy of the wound-healing cream Olivamine, which is currently considered best practice in the United States but is yet to become available in Australia. Total Number of incidents reported by year ANNUAL REVIEW 2013/14 73 CORPORATE & QUALITY SERVICES OCCUPATIONAL HEALTH AND SAFETY West Wimmera Health Service prides itself on the highest levels of safety in the workplace, a workplace where each and every staff member has a responsibility for their own safety but also for their colleagues, patients, residents and visitors to the Service. Our safe systems of work are underpinned by: • The Occupational Health and Safety Act 2004 • Occupational Health and Safety Regulations 2007 • Workplace Injury Rehabilitation and Compensation Act 2013 • Dangerous Goods (Storage and Handling) Regulations 2012 Preventing and Managing Occupational Violence and Aggression training has been instigated as an on-line course for all staff. 74 WEST WIMMERA HEALTH SERVICE No notifications of serious staff injuries resulting in hospitalisation or death were made to the Victorian WorkCover Authority in 2013-14; compared with two in the prior year. FUTURE An action research project is being considered to better understand the safety culture of our organisation and its workforce which will lead to the development of a higher level of safety first, safety at all times. 120 80 40 0 2013-14 Occupational Health and Safety incidents over the past three years have plateaued, as the graph below illustrates. An Injury Management Team has been developed providing employees who have been injured either at work or at home with assistance to return to work as quickly and safely as possible; this is a collaborative effort between the employee, management and the employee’s healthcare team. 160 2012-13 Five key areas of health and safety are monitored through the Victorian Health Incident Management System. In the last year, 116 incidents involving aggression toward staff, manual handling, occupational exposures to body fluids, slips, trips and falls and security incidents were documented; this is 4 more than for the previous 12 months. 200 2011-12 HOW WE PERFORM The new electric trolley with scissor lift has assisted procurement staff in their daily routine of lifting and moving the immense number of boxes and parcels which move through the Procurement Department each day. PER YEAR 2010-11 AS/NZS 4801:2001 Occupational Health and Safety Management System We have invested significant funds in the renewal of worn areas of carpeted floor in high traffic areas to reduce slips, trips and falls. Number of OHS incidents NUMBER OF per OHS year I NCIDENTS 2009-10 • Compliance codes • Australian/New Zealand Standard, The main incidents of aggression occur through the actions of residents experiencing Dementia. Therefore specific staff training in this area of care has also been undertaken. As an extra safeguard for these occasions enhanced referral pathways for review by our specialist geriatrician have been introduced and the intricacies of special caring for these residents has been successfully explored. Manual Handling Aggression Incidents Occupational Exposure Slips, Trips & Falls Security Ryan Ganz participates in Orientation Day Fire Training using the ‘BullsEye™ Laser-Driven Fire Extinguisher Training System’. The equipment, a collaborative purchase by Grampians Region healthcare organisations uses technology to bring realistic, effective Fire Training to the education program. ANNUAL REVIEW 2013/2014 75 GOVERNANCE Qualified, experienced, possessing skills and knowledge pertinent to setting the direction and managing the progress of West Wimmera Health Service – these are the fundamental principles required to be appointed by the Minister for Health to our Board of Governance. Governing a health service in rural remote North Western Victoria brings with it complexities and challenges quite different from those faced by the Boards of Regional and Metropolitan services. The Board is responsible to the Minister for setting the strategic directions of this Service and monitoring compliance with state and commonwealth acts, guidelines and policies. Board of Governance as at 30 June 2014 Our Board is responsible for a Service which spreads across 17,000 square kilometres and includes 6 towns. Governing for 4 Acute Hospitals, an Aged Care Residential Centre, 127 Residential Aged Care Places, a Community Health Centre, a Disability Service and a providing a comprehensive Allied Health Service at all sites –a round trip of 375 kilometres between sites - requires immense planning and ‘out of the square’ thinking Collectively the Board is committed to excellence in the provision of healthcare for the region of rural Victoria which relies on this Service for their lifelong health needs. They are accountable to government and to stakeholders for ensuring that the Service is managed efficiently and effectively, that the services and care generated are of high quality and are developed to meet the healthcare needs of our communities. Mr D.P. Buckley 76 WEST WIMMERA HEALTH SERVICE The Board is kept up to date with developments in the health industry by attendance at State and National conferences, access to current conference papers, internet research, presentations by peak bodies and seminars conducted by the Australian Institute of Company Directors. At all Board, Committee and Sub Committee meetings Board Members are required to declare when they may have a Conflict of interest relating to an item on the Agenda. Ms L.G. Clarke JP – President Mr R.S. Rosewall BA, SocSci – Vice President Mr H.G. Champness BA, Dip Ed, Accredited Lay Preacher Mr R.A. Ismay Mr L.C. Maybery Mr R.L. Stanford Mrs J.M. Sudholz Mr D.N. Walter Mrs N.E. Zanker BA, Dip Ed Audit & Quality Committee Mr J.M. Hobday LLB – Chairman Ms L.G. Clarke JP – President Mr D.P. Buckley Mr H.G. Champness Mr L.C. Maybery Mrs J.M. Sudholz LINES OF COMMUNICATION BOARD OF GOVERNANCE Operations Manager Director Capital Services Manager Disability Services Chief Executive Officer CEO Personal Assistant • Cooinda Day Programs • Snappy Seconds • Supported Employment Manager Dental Services Executive Director Executive Director Finance & Administration Clinical Services Executive Director Corporate & Quality Services Executive Director Medical Services • Financial Reporting • Information Technology • Pharmacy • Radiology • Risk Management • Security • Clinical Governance • Credentialing Assistant Accountant Manager Clinical Operations Manager Quality, Safety & Ed ucation Visiting Medical Practitioners • Acute Care • Central Sterilising • District Nursing • Infection Control • Maternal & Child Health • Residential Aged Care • Surgical Services • Occupational Health & Safety • Quality Accreditation • Training & Development • Accounting • Accounts Payable • Accounts Receivable • Reception Manager Personnel & Payroll • Human Resource Management Manager Procurement & Inventory • Inventory Management • Purchasing • Supply ANNUAL REVIEW 2013/2014 Manager Community & Allied Health • Centrelink • Diabetes Education • Dietetics • Goroke CHC • Health Promotion • Home & Community Care • Home Care Packages • Massage Therapy • NRCP • Occupational Therapy • Physiotherapy • Podiatry • Rural Primary Health Service • Social Work • Speech Pathology • WWHS Health & Fitness Centre Manager Engineering & Maintenance • Infrastructure & Equipment Maintenance • Vehicle Fleet Manager Hospitality & Environmental Services • Food & Cleaning Services • Meals on Wheels • Oliver’s Cafe • Oliver’s Kiosk 77 GOVERNANCE THE BOARD OF GOVERNANCE LEONIE G. CLARKE, President RONALD S. ROSEWALL, Vice President DAVID P. BUCKLEY, BA SocSci Former Business Proprietor Electrical Contractor, HV Field Operator Term of Appointment: 01.07.11 – 30.06.14 Term of Appointment: 01.07.13 – 30.06.16 Term of Appointment: 01.07.11 – 30.06.14 Leonie, is serving her first term as President of the Board of Governance. A Justice of the Peace, Leonie has a wealth of experience having served on the Board for 17 years. She is acutely aware of the need for quality and appropriate health care for rural communities and the retention of medical and allied health professionals. She is interested in maintaining the high quality of services offered by West Wimmera Health Service and the availability of cancer services for rural people locally. Ron maintains his dedication to the Service as Vice President. His depth of knowledge and significant expertise in disability services offers well rounded experience for decision making. David is a member of the Goroke Pre School Committee, the Recreation Reserve Committee and is a Life Member of Goroke Apex Club. David serves on the WWHS Board to play his part in ensuring the survival of vital medical services for small rural communities and he welcomes the development of the New Goroke Community Health Centre which offers essential medical, allied health and community health services for the surrounding area. JP Education Support Officer WWHS Committees: Executive, Audit and Governance, Clinical Quality and Governance, Finance Ron serves on the Boards of Regional Information & Advocacy Council and Victorian Advocacy League for Individuals with Disability Inc. He is the Chairman of Wimmera & Southern Mallee Health Alliance. WWHS Committees: Executive, Clinical Quality Governance Board Meeting Attendance: 90% WWHS Committees: Audit and Governance, Finance, Clinical Quality Governance Board Meeting Attendance: 100% Board Meeting Attendance: 100% HARVEY G. CHAMPNESS, Retired Teacher, Development & Environmental Worker Term of Appointment:01.07.11 – 30.06.14 An accredited Lay Preacher, Harvey offers the governing body another community perspective and is keen to maintain engagement and consultation. He is a trained mentor with Volunteering Western Victoria and wishes to retain quality of care and effective and responsive governance of our Service. Harvey is a committee member and Project Manager for Kaniva District Landcare. WWHS Committees: Audit and Governance, Clinical Quality Governance Board Meeting Attendance: 80% 78 WEST WIMMERA HEALTH SERVICE RONALD A. ISMAY Business Proprietor Term of Appointment: 01.07.12 – 30.06.15 A long serving member of the Board of Governance, Ron brings expertise in financial and business management to the Board and remains committed to the provision of quality health services for our rural and remote areas particularly for Aged Care. Ron has strong representation within the Rainbow community as Chair of the Town Committee, President of the Rainbow College, President of Hindmarsh Tourism and was recently appointed as a Councillor of Hindmarsh Shire Council. WWHS Committees: Clinical Quality Governance, Executive, Finance Board Meeting Attendance: 90% LESTER C. MAYBERY RODNEY L. STANFORD JANICE M. SUDHOLZ Term of Appointment: 01.07.12 – 30.06.15 Term of Appointment: : 01.07.13 – 30.06.16 Term of Appointment: : 01.07.12 – 30.06.15 Appointed to the Board in 1998, Lester has gained significant experience in matters pertaining to governance of health care in our rural catchment. He is a Past President & Life Member of Natimuk Bush Nursing Hospital, Trustee & Chair of the Tooan Cemetery Trust, Group Officer of Natimuk Fire Brigade, a Director of Horsham Sports & Community Club and a member of the Customer Committee, Grampians Wimmera Mallee Water. Rodney’s commitment to serving his community continues in his commitment to West Wimmera Health Service. The substantial experience he gained with Wimmera Uniting Care and Uniting Care PEX Geelong stands him in good stead when looking at community needs.. He is acutely aware of the need for the delivery and equitable funding of appropriate and quality health services in rural remote Victoria. Rod is the Chair of the capital Campaign Project for this Service. A resident of Natimuk and an experienced long serving member of the Board, Janice has a focus on the continual development and renovation of infrastructure within the Service and is highly aware of the need for government support with funding for the survival of Hospitals and Aged Care facilities in our rural areas. Primary Producer WWHS Committees: Finance, Audit and Governance Merchandise Sales Board Meeting Attendance: 100% DARREN N. WALTER NAOMI ZANKER Term of Appointment: 01.07.11 – 30.06.14 Darren is heavily involved in the Goroke community with representation with the Sporting Complex and Recreation Reserve Committees, Group Officer Goroke CFA and a Life Member of Goroke Apex Club. Darren is interested in how funding will be affected by the new Health Reforms, and is committed to accessibility of first class medical services and is pleased the new Goroke Community Health Centre has assured continued existence of healthcare in that rural area. WWHS Committees: Clinical Quality Governance, Finance Board Meeting Attendance: 90% ANNUAL REVIEW 2013/14 WWHS Committees: Audit and Governance, Clinical Quality Governance Board Meeting Attendance: 90% WWHS Committees: Executive, Finance Board Meeting Attendance: 80% Primary Producer Farmer / Home Duties BA, Dip Ed, GAICD Retired Secondary Teacher Term of Appointment: 01.07.12 – 30.06.15 Naomi was appointed to West Wimmera Health Service Board in 2009 having gained governance experience with Nhill Lutheran School and Avonlea Hostel for the Aged. Naomi is the President of Gallery Central Nhill. Naomi maintains particular interest in the financing and government support for ongoing rural and regional services, supply of local services to minimise long distance travel. WWHS Committees: Clinical Quality Governance, Executive Board Meeting Attendance: 100% 79 GOVERNANCE THE EXECUTIVE GROUP The Executive Directors are charged with the duty of providing exemplary leadership to their team with empathy, understanding and initiative to build an ethical workplace and to foster long term achievements. They are accountable to the Chief Executive Officer for the performance, decisions and outcomes of their Department and must be committed to embracing the the philosophy and Mission of West Wimmera Health Service. JOHN SMITH PSM MHA, GRAD DIP HSM, FAICD, AFACHSM, AFAHRI, FAHSFMA, AFAIM, CERT III OH&S Chief Executive Officer John provides the Board of Governance with comprehensive information to enable prudent and astute decision making. He executes the Board’s decisions and policies and manages the business and human assets of the Service. John is responsible for establishing a framework of strong leadership and management to place the Service in a prime position to take advantage of changes in health service delivery, technology and financial strategies. He serves on many Boards and working groups and amongst other representations is currently Vice President of the Australian Council on Healthcare Standards (ACHS), Treasurer of the International Board of ACHS, a Council Member of the Australian Hospital and Healthcare Association and Vice President of the Victorian Hospitals’ Industrial Association. 80 WEST WIMMERA HEALTH SERVICE RITCHIE DODDS BCOM (ACC), CA, FFIN, MBA, GAICD Executive Director Finance and Administration Ritchie is responsible for the Service’s Finance, Human Resources, Information Technology, Procurement and Administration functions. Since 2006 Ritchie has cemented the Service’s strong financial performance and its sound financial position. Ritchie is a member of the Institute of Chartered Accountants in Australia and deputises for the Chief Executive Officer as and when neccessary. Ritchie represents the Service as Deputy Chairman of the Grampians Regional Health Alliance Finance Sub Committee. DR IAN GRAHAM MBBS, MHP, FRACMA JANET FISHER Executive Director Medical Services Executive Director Clinical Services Ian is responsible for the credentialing, appointment, definition of the scope of practice and performance management of Visiting Medical Practitioners, including General Practitioners, Visiting Surgeons, Anaesthetists, Gynaecologists, Physicians and Psychiatrists. Jan is responsible for the management of Medical, Surgical, Primary Care, Aged Care, Allied and Community Health and the Goroke Community Health Centre, Radiology, Central Sterilising, Maternal & Child Health and Pharmacy. RN, RCNA, GRAD DIP BUS MAN Ian is also Clinical Digital Education Consultant at the Royal Australasian College of Surgeons and privately is a consultant in health management, education and information technology. In 2013 Ian was appointed to the international Board of Directors of the MedBiquitous organisation based at Johns Hopkins Hospital, Baltimore, USA. KAYE BORGELT ASSOC DIP MED REC ADMIN, GRAD CERTIFICATE MGT ORG CHANGE Executive Director Corporate and Quality Services Kaye manages Engineering & Maintenance, Catering & General Services, Education, Health Information Management, Quality & Accreditation, O H & S , Risk Management and Security. Kaye is studying for a Masters of Health Science (Health Information Management) and is a member of the Victorian Patient Experience Statewide Reference Group, Grampians Regional Health Information Managers and Patient Management System Operations Group. ANNUAL REVIEW 2013/14 Jan is a Registered Nurse who holds an Advanced Diploma in Business Management and has OH&S credentials. Jan represents the Service on Regional Committees including; State Aged Care Committee, Grampians Regional Executive Nurses. MELANIE ALBRECHT LLB, BIS, GRAD CERT HSM, AFCHSE Operations Manager KATRINA PILGRIM CERT IV BUS MANAGEMENT (FRONTLINE) Appointed in April 2006 Melanie is responsible for the executive management of Disability Services, Dental, Aged Care Administration, Contracts, Compliments and Complaints. Executive Assistant to Chief Executive Officer Melanie assists the Chief Executive Officer with operational, organisational and special projects. As Minute Secretary to the Board of Governance and associated committees Katrina is responsible for ensuring the corporate and strategic issues are dealt with by the Chief Executive Officer. Melanie completed a Masters of Health Administration and Masters of Business Administration with Latrobe University during the 2013-2014 year. Katrina provides executive service to the Chief Executive Officer and attends to Executive Departmental requirements. 81 GOVERNANCE CLINICAL GOVERNANCE AT WEST WIMMERA HEALTH SERVICE ENHANCING CLINICAL CARE West Wimmera Health Service, its Board of Governance, Executive, Managers and staff strive to provide the highest level of care for its patients, residents, clients and community. Excellence in care provision requires a mindset of continuous improvement, responsibility and accountability and it is through a rigorous clinical governance structure that this has been achieved. Our Service observes the four domains of quality and safety in the Victorian Clinical Governance Framework to inform our clinical governance efforts, they are: • Consumer participation • Clinical effectiveness • Effective workforce • Risk management A Clinical, Quality Governance Committee has been established to ensure that Visiting Medical Practitioners, Nurses, Managers, Board Directors and Executive Personnel all play a part in the safe and effective provision of care to our community. Importantly this committee monitors the above elements of the governance framework and ensures that the custodians of the Service, the Board, are fully informed and updated on the outcomes of these four domains. CONSUMER PARTICIPATION Consumer forums are an effective means by which our community can provide their thoughts and ideas regarding improving the services West Wimmera Health Service provides. Such forums also provide an effective means for the community to be informed of current and new developments such as buildings, fund raising and health services being offered. Through the Victorian Health Experience Survey we obtain real insight into the needs of our community and their feedback as to their experience whilst in hospital. The Service has a robust compliments and complaints mechanism. This process provides our consumers the opportunity to engage the Service in a direct conversation about issues they 82 WEST WIMMERA HEALTH SERVICE wish to tell us about – these are taken extremely seriously with a response made very early as to the actions taken. Our consumers are active participants in their care planning with the health care team through discussions on treatment options, care pathways, and advanced care directives. CLINICAL EFFECTIVENESS Clinical audit and review is a cornerstone to the clinical effectiveness of our Service. Clinical care is evaluated and reported through all levels of the organisation and allows clinicians to engage in policy development and improvement of Service quality. We are indeed fortunate to have an informed clinical workforce dedicated to the provision of high quality and effective care. Our Visiting Medical Practitioners, Nurses and Allied Health clinicians use national and international standards of practice in the provision of care to our community. Distance from metropolitan Specialist Visiting Medical Practitioners or Allied Health Professionals is not a barrier to specialist care. Innovative ways are being used for our clinicians to access advice and share care with our health professionals via technology such as video conferencing and Skype thus reducing the tyranny of distance although not totally eradicating the demands of travel. EFFECTIVE WORKFORCE Credentialing and ongoing professional development are key methods utilised by the Service to ensure an effective workforce. Credentialing provides a thorough examination of the qualifications and skills of a clinician so that we are assured safe care will be provided to our consumers. Our staff participate extensive professional development programs provided at regional, state and international levels, these are designed to provide the latest information for safe and effective care delivery while reaching the highest quality care outcomes for the consumer. CLINICAL RISK MANAGEMENT Management of Clinical Risk considers patient care, the education, experience and qualifications of our staff and visiting health practitioners together with the equipment we apply and resource. Conforming to the policies and procedures of our organisation as well as legislation (the law) and standards pertaining to health care are the cornerstones of Clinical Risk Management. In 2013-14, the Service underwent a review of Hospital Procedural Services; the surgical procedures and operations undertaken in Nhill particularly. The review was endorsed by the Department of Health Victoria and conducted by a panel of healthcare experts. In October 2013, the results of the review were provided to the Clinical Quality Governance Committee (a Board of Governance sub-committee). An important sentiment of the review was that procedural services at West Wimmera Health Services should not change and should continue to be provided. Fourteen (14) recommendations arose from the review and these have been fully implemented thus ensuring the highest possible level of care and support to the people of the Wimmera and Southern Mallee exists. OUR CENTRE POINT Clinical Governance is the centre point of the effective and safe delivery of care to the community we serve. Our staff, managers, executive and Board all work within a framework designed to ensure that patients, residents and clients receive the care they require in a manner that is of the highest standard and with the best possible outcomes for their ongoing health and wellbeing. COMPLIANCE WITH GOVERNMENT REGULATIONS COMPLIANCE WITH THE BUILDING AND MAINTENANCE PROVISIONS OF THE BUILDING ACT 1993 In accordance with the Building Regulations 2006 under the Building Act 1993,(The Act) each building in West Wimmera Health Service is classified according to its function. A Building Permit is obtained for new construction and redevelopment projects where required. A Certificate of Occupancy is obtained and displayed for each completed project in accordance with The Act. A comprehensive preventative maintenance program ensures essential equipment and systems such as fire systems, hot water systems, air conditioning, emergency generators, sterilizers and anaesthetic machines are serviced regularly and maintained in accord with manufacturer instructions. APPLICATION OF THE FREEDOM OF INFORMATION ACT (FOI) The Victorian Freedom of Information Act provides individuals with the opportunity to access documents about their personal affairs and the activities of government departments from government agencies, including public hospitals. The Chief Executive Officer is the designated Freedom of Information Officer. West Wimmera Health Service FOI application fees and access charges are in accordance with State Government regulations. In 2013/14 thirteen requests, all relating to access to medical records, were received. Full access was granted in each case. There were no complaints lodged with the Ombudsman by FOI applicants, our administration of FOI matters, and no appeals were made to the Victorian Civil and Administrative Tribunal (VCAT) regarding access to records. SUMMARY OF FOI ACTIVITY 2013/14 Number of Personal Requests Received Number of Non-Personal Requests Received Total Number of FOI Requests Access Granted in Full Application Fees Collected Application Fees Waived Charges Collected Charges Waived THE APPLICATION AND OPERATION OF THE PROTECTED DISCLOSURE ACT 2012 (THE ACT), INCLUDING DISCLOSURES REQUIRED BY THE ACT There were no incidences during the year of this Act being activated in relation to the operations of the Service. VICTORIAN INDUSTRY PARTICIPATION POLICY There was no relevant activity for this reporting period. NATIONAL COMPETITION POLICY Implementation and compliance with the government policy statement, Competitive Neutrality Policy Victoria; and subsequent reforms were not applicable to this Service for 2013/14. ADDITIONAL INFORMATION AVAILABLE ON REQUEST (FRD 22E) In compliance with the requirements of FRD 22E Standard Disclosures in the Report of Operations, details in respect of the items listed below have been retained by West Wimmera Health Service and are available to the relevant Ministers, Members of Parliament and the public on request (subject to the freedom of information requirements, if applicable): • A statement of pecuniary interest; • Details of shares held by senior officers as nominee or held beneficially. • Details of publications produced 4 9 13 13 $257.00 $77.10 $97.10 $12.00 • Details of changes in prices, fees, charges, rates and levies charged by the Health Service. • Details of any major external reviews carried out on the Health Service. • Details of major research and development activities undertaken by the Health Service that are not otherwise covered either in the Report of Operations or in a document that contains the financial statements and Report of Operations. • Details of overseas visits undertaken including a summary of the objectives and outcomes of each visit; • Details of major promotional, public relations and marketing activities undertaken by the Health Service to develop community awareness of the Health Service and its services. • Details of assessments and measures undertaken to improve the occupational health and safety of employees. • General statement on industrial relations within the Health Service and details of time lost through industrial accidents and disputes, which is not otherwise detailed in the Report of Operations. • A list of major committees sponsored by the Health Service, the purposes of each committee and the extent to which those purposes have been achieved. • Details of all consultancies and contractors including consultants/ contractors engaged, services provided, and expenditure committed for each engagement. by the Department about the activities of the Health Service and where they can be obtained. ANNUAL REVIEW 2013/14 83 GOVERNANCE ACCREDITATION STATUS WHAT IS ACCREDITATION? Accreditation is an important means by which the Service can attain an independent review of the quality and safety of the care it provides, against national standards. The standards determine the highest levels of care and management; meeting these standards is a clear indication to our community, government and healthcare personnel, of the excellence of the services we deliver. We open our organisation to survey by a team of surveyors who are leaders in their respective fields of the health industry: Nurses, Visiting Medical Practitioners Administrators and in some instances, consumers. The Survey Team is independent of West Wimmera Health Service and therefore are able to offer an unbiased assessment of our Service and its capability. ACCREDITATION METHODS Added to this are a further 5 standards developed by ACHS itself. 11. Service Delivery 12. Provision of Care 13. Workforce Planning and Management 14. Information Management 15. Corporate Systems and Safety These five standards monitor the performance of non-clinical systems, thus complimenting the 10 national Standards. The 10 National Standards were introduced by the Australian Commission on Safety and Quality in Health Care in January 2013: from that date mandatory compliance with these standards is required by Federal and State Governments. The National Standards will have a profound effect on our approach to safety and quality for patients. EQUIP NATIONAL AGED CARE STANDARDS In 2013, West Wimmera Health Service embarked on its preparation for accreditation under EQuIP National an accreditation product of the Australian Council on Health Care Standards. EQuIP National incorporates the 10 National Safety and Quality Health Service Standards (developed by the Australian Commission on Safety and Quality in Health Care) Aged Care Standards Accreditation is a national, compulsory accreditation audit against four standards: The 10 National Standards are: Forty Four expected outcomes support the main standards – all of which must be compliant at each three year review. Residential Aged Care Facilities are reviewed against the standards by the Aged Care Standards and Accreditation Agency. It is likely that there will be changes to these standards over time following the introduction of new Aged Care policies by the Commonwealth Government. e await those changes and will determine how best to incorporate them seamlessly across our Health Service. 1. Governance for Safety and Quality in health Service Organisation 2. Partnering with Consumers 3. Preventing and Controling Healthcare Associated Infections 4. Medication Safety 5. Patient identification and Procedure Matching 6. Clinical Handover 7. Blood and Blood Products 8. Preventing and Managing Pressure Injuries 9. Recognising and Responding to Clinical Deterioration in Acute Health Care 10. Preventing Falls and Harm from Falls 84 WEST WIMMERA HEALTH SERVICE 1. Management systems, staffing, and organisational development 2. Health and personal care 3. Resident lifestyle 4. Physical environment and safe systems ACCREDITATION MATURITY West Wimmera Health Service has endeavoured to make quality improvement a part of our every day work and therefore our preparation for accreditation and the evidence supporting our work against each accreditation standard is constantly being collected. We have established working groups to work through the National Safety and Quality Health Service Standards with each gathering the necessary proof that we are a safe, efficient and effective healthcare organisation. FUTURE: The next 12 months will witness several major reviews including Accreditation surveys in each Residential Aged Care Unit and a Periodic Review of our Acute Hospitals against three of the 10 National Standards and also the mandatory elements of EQuIP National. Although Accreditation reviews are compulsory, we have always embraced them as an opportunity to confirm where we are performing well and to make improvements when recommendations are made. We address these audit processes with confidence and as an occasion to showcase the impressive levels of care and service delivery we offer while pursuing the seal of excellence we will so proudly display. AGED CARE ACCREDITATION STANDARDS TYPE OF ACCREDITATION Australian Council of Healthcare Standards (EQuIP5) OUTCOME • Organisational wide survey conducted in December 2012 • Full, four year accreditation status awarded • Outstanding Achievement was conferred in two areas, Research and our work undertaken in Buildings, Signage and Equipment – an award that acknowledges the leadership West Wimmera Health Service demonstrates for others in these areas National Safety and Quality Health Service Standards Mid Cycle, Periodic Review against the Standards: • Governance for Safety and Quality in Health Care • Partnering with consumers • Preventing and Controlling Healthcare Associated Infections; this will occur in 2015. EQuIP National Review of mandatory criteria of the EQuIP National Standards 11-15 Aged Care Standards and Accreditation Agency (ACCA) • Full survey undertaken at all Residential Aged Care Facilities during 2012–13 resulting in full three (3) year accreditation status, with compliance in all 44 criteria; • Unannounced site visits have been conducted subsequently at all homes following full compliance achieved • In 2015 all Residential Aged Care Facilities will undergo full survey’s against the Aged Care Standards Home and Community Care (HACC) Three national standards that include: • Effective management, • Appropriate access and service delivery • Service user rights and responsibilities Disability Services Accreditation Accreditation reviews occur against the National Disability Service Standards and the Victorian, State Department of Human Services Standards In December 2012 the Service’s HACC programs were surveyed against the National Community Care Common Standards; full compliance was received in all standards A review by International Standards Certifications was undertaken in July 2014 against Disability Services Standards, with full and ongoing compliance noted. Review of Cooinda Disability Services against the six National Disability Service Standards: • Rights • Participation and Inclusion • Individual Outcomes • Feedback and Complaints • Service Access and • Service Management And five Statebased standards: • Empowerment • Access and Engagement • Wellbeing • Participation • Service management DIAGNOSTIC IMAGING (X-RAY) ACCREDITATION STANDARDS TYPE OF ACCREDITATION OUTCOME National accreditation in this field has been mandatory since 2012 and includes general x-ray, CT, and Ultrasound In 2012 the Service successfully underwent a Stage II Diagnostic Imaging Accreditation Audit conducted by Health and Disability Accreditation Australia with full accreditation status granted: valid from 16 May 2012 to 16 May 2016 Community Aged Care Packages (CACP) and National Respite for Carers Program (NCRP) The Commonwealth Department of Health and Ageing reviewed the CACP and NRCP programs in September 2012 with each program successfully meeting the National Community Care Common Standards at review ANNUAL REVIEW 2013/14 85 GLOSSARY ACAS Aged Care Assessment System ACFI Aged Care Funding Instrument ACHS Australian Council on Healthcare Standards Australian Standards National Standards developed by the Standards Association of Australia/New Zealand EQuIP Accreditation Evaluation Quality Improvement Program RFDS Royal Flying Doctor Service FOI Freedom of Information Telehealth use of telecommunication and information technology to provide clinical healthcare at a distance GCHC Goroke Community Health Centre GP General Practitioner RPHS Rural Primary Health Service The Board The Board of Governance WWHS Best Practice Measuring results against the best performance of other groups HACC Home and Community Care – funding for services and programs which are provided in the home or the community CACS&AA Commonwealth Aged Care Standards and Accreditation Agency Inpatient A person who is admitted to an acute bed Carers Carers of patient/clients who are not part of the Service Care Team IT Information and Communications Technology Catchment Geographical area for which West Wimmera Health Service is responsible to provide services LED light emitting diode VHIA Victorian Hospitals Industrial Association M&CH Maternal and Child Health VMO Visiting Medical Officer Medicare Local services for local communities in line with local needs, a National Health Reform initiative W&SMHA Wimmera & Southern Mallee Health Alliance CEO Chief Executive Officer CT Scanner Computed Tomography Scanner DH The Department of Health Victoria DHS The Department of Human Services Victoria e-health the transfer of health resources and healthcare by electronic means 86 WEST WIMMERA HEALTH SERVICE OHS Occupational Health & Safety Outcome The result of a service provided Outpatient A patient/client who is not admitted to a bed PCP Primary Care Partnership The Department The Department of Health Victoria The Service West Wimmera Health Service Values The principles and beliefs that guide West Wimmera Health Service WHY Project West Wimmera, Hindmarsh & Yarriambiack Shires collaboration of HACC services WWHS West Wimmera Health Service INDEX Accreditation . . . . . . . . . . . . . . . . . . . 8, 84, 85 Dunmunkle Health Service . . . . . . . . . . . . . 3 Patient Experience . . . . . . . . . . . . . . . . . . . 14 Acute Care . . . . . . . . . . . . . . . . . . . . . . . . 38, 39 Education & Training . . . . . . . . . . . . 8,65 ,72 People Matter Survey . . . . . . . . . . . . . . . . 74 Aged Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Engineering & Maintenance . . . . . . . . . . 66 Pharmacy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Aged Care in our Community . . . . . . . . . 35 Environment . . . . . . . . . . . . . . . . . . . . . . . . . . 68 President . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Aged Care the Changes . . . . . . . . . . . . . . . 34 Executive Team . . . . . . . . . . . . . . . . . . . . . . . 80 Quality & Safety for Patients . . . . . . . . 62 Allied & Community Health . . . . . . . . . . . 41 Finance & Administration . . . . . . . . 29, 72 Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Australian Council on Healthcare Standards . . . . . . . . . . 8, 84, 85 Financial Performance . . . . . . . . . . . 29-31 Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Freedom of Information . . . . . . . . . . . . . . 83 Residential Aged Care . . . . . . . . . . . . . . . . 32 Fundraising . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4, Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Goroke Community Health Centre . . . . 8, RIPERN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Governance . . . . . . . . . . . . . . . . . . . . . . . . . . . 76 Risk Management . . . . . . . . . . . . . . . . . . . . . 73 Government Grants . . . . . . . . . . . . . . . . . . 20 Royal Flying Doctor Service . . . . . . . . 5, 14 HACC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 Rural Primary Health Service . . . . . . . . 27 Hand Hygiene . . . . . . . . . . . . . . . . . . . . . . . . . 64 Services . . . . . . . . . . . . . . . . . . . . . . . . . . . 16, 17 Health Promotion . . . . . . . . . . . . . . . . . . . . . 54 Snappy Seconds . . . . . . . . . . . . . . . . . . . . . . 46 Human Resources . . . . . . . . . . . . . . . . . . . . .72 Specialist Services . . . . . . . . . . . . . . . . . . . 16 Infection Control . . . . . . . . . . . . . . . . . 64, 65 Staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73 Legislation & Compliance . . . . . . . . . . . . 83 Staff Awards . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Cancer Resources . . . . . . . . . . . . . . . . . . . . 14, Board of Governance . . . . . . . . . . . . . . 78,79 Capital Projects . . . . . . . . . . . . . . . . . . .12, 13 Catchment . . . . . . . . . . . . . . . . . . . . . . . . . . . IBC Chief Executive Officer . . . . . . . . . . . . . . . . 3 Cleaning & Food Audits . . . . . . . . . . . 14, 64 Clinical Governance . . . . . . . . . . . . . . . . . . . 82 Clinical Placements . . . . . . . . . . . . . . . . . . . . . 8 Clinical Risk Management . . . . . . . . . . . . 82 Clinical Services . . . . . . . . . . . . . . . . . . . . . . 32 Communication . . . . . . . . . . . . . . . . . . . . . . . . . 1 Location . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . IFC Statement of Priorities . . . . . . . . . . . . . . . 21 Medical Report . . . . . . . . . . . . . . . . . . . . . . . 49 Statistical Performance . . . . . . . . . . 26, 28 Medical Imaging . . . . . . . . . . . . . . . . . . . . . . 43 Strategic Directions . . . . . . . . . . . . . . . 22-24 Medical Services . . . . . . . . . . . . . . . . . . . . . 16 Student Housing . . . . . . . . . . . . . . . . . . . . . . 68 Medicare Locals . . . . . . . . . . . . . . . . . . . . . . . . 5 Surgical Services . . . . . . . . . . . . . . . . . . . . . 16 Consumer Forums . . . . . . . . . . . . . . . . . . . . 82 Mira Medical and Allied & Community Health Centre . . . . . . . . . . . 3 Tristar Medical Group . . . . . . . . . . . . . . . . 13, Corporate & Quality Services . . . . . . . . 66 Mission . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Credentialing . . . . . . . . . . . . . . . . . . . . . . . . . 82 Natimuk Medical & Allied Health Centre . . . . . . . . . . . . . . . . 3, 18 Venesection Clinic . . . . . . . . . . . . . . . . . . . . 63 Lines of Communication . . . . . . . . . . . . . . 77 Community Aged Care . . . . . . . . . . . . . . . . 35 Community Garden . . . . . . . . . . . . . . . . . . . . . 4 Compliance . . . . . . . . . . . . . . . . . . . . . . . . . . . 83 Consumer Carer Participation . . . . . . . 54 Cultural Awareness . . . . . . . . . . . . . . . 54, 55 CT Scanner . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43 Dental Services . . . . . . . . . . . . . . . . . . . 10, 44 Dialysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40 Dimensions of Quality in Residential Care . . . . . . . . . . . . . . . . . . . . 58 Disability Services . . . . . . . . . . . . . . . . . . . .46 Donations & Bequests . . . . . . . . . . . . . . . . 20 ANNUAL REVIEW 2013/14 National Health Reform . . . . . . . . . . . . . . . . 5 National Respite for Carers Program . . . . . . . . . . . . . . . . . . . . . . . 17 Occupational Health & Safety . . . . . . . 70 Oliver’s Café . . . . . . . . . . . . . . . . . . . . . . . . . . 67 Oliver’s Kiosk . . . . . . . . . . . . . . . . . . . . . . . . . 67 Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Vision . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Visiting Specialist Clinicians . . . . . . . . . 50 Volunteers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 Wimmera & Southern Mallee Health Alliance . . . . . . . . . . . . . . . . 14, WorkCover . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72 Wound Management . . . . . . . . . . . . . . . . . . 40 OPG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 87 ACKNOWLEDGEMENTS THANK YOU We acknowledge the generous sponsorship, donations and bequests and look forward to continued support as we forge further ahead to provide outstanding health services for our communities Design and Production Motiv Brand Design (Adelaide) Co-ordination DMR Associates Pty Ltd (Nhill) Photography Robert Geh (Adelaide) Lawyers Ashurst Australia (Sydney) Health Legal (Melbourne) Russell Kennedy Pty Ltd (Melbourne) Stewart & Lipshut (Nhill) Auditor Office of the Victorian Auditor General Internal Auditor WHK (Albury) Architect Brown Falconer (Adelaide) Bankers Commonwealth Bank Westpac Tania Ryan conducting patient observation rounds. SPONSORS 88 WEST WIMMERA HEALTH SERVICE Notes: ANNUAL REVIEW 2013/14 89 Notes: 90 WEST WIMMERA HEALTH SERVICE Help Support Your Service You can help us… to make the services we provide for six communities become better and better. YES, I am interested in supporting West Wimmera Health Service and would like further information about the following: Becoming a Volunteer Joining an Auxiliary Giving financial support through a Bequest or Donation If you wish to discuss supporting our Service in this way please contact the Chief Executive Officer who will explain in detail how arrangements can be made. Alternatively, please complete the form below and return it to us at any one of our facilities. Name.............................................................................................................................................................................................. Address . ...................................................................................................................................................................................... Facsimile.................................................................................... Mobile ........................................................................... Email............................................................................................ CUT ALONG THE DOTTED LINE ✁ Telephone . .................................................................. ANNUAL REVIEW 2013/14 91 Reader Survey This Report is produced to inform our consumers, communities and government about the range and quality of the services we deliver. To make sure we provide the information you require and that we deliver the services most needed by the people we serve we need YOUR assistance. It would be extremely helpful to us if you could answer the following questions and return to the Service please. Tell us… what you think Please circle the answer which most closely reflects your opinion. Q1 I am a: a) Consumer b) Representative of Government c) WWHS Staff d) Medical Practitioner e) Health Industry Employee g) Other (please specify) f) Financial Supporter Q2. D oes this Report clearly explain West Wimmera Health Service and the services it delivers? Yes/ No Q3. H ow did it help your understanding or what could we improve to help your knowledge of our Health Service?.................................................................................................................................................... ................................................................................................................................................................................................... ................................................................................................................................................................................................... Q4. D o you feel you know more about the QUALITY of our programs and services from reading this Report? Yes/ No Q5. Were there any other topics you feel should be included in the Quality of Care Report next year? ................................................................................................................................................................................................... Q6. A re there other services or programs you believe should be delivered by West Wimmera Health Service?................................................................................................................................ ................................................................................................................................................................................................... Q7. Have you seen or read a copy of this Report before? Yes/ No If you answered Yes, where did you see or obtain a copy?............................................................................. Q8. Do you have any other comments about the Report you have just read?............................................... ................................................................................................................................................................................................... ................................................................................................................................................................................................... Thank you most sincerely for assisting West Wimmera Health Service in our drive towards continued improvement in the quality and range of services needed by our communities and importantly the way in which we tell you about them. John N. Smith, PSM, Chief Executive Officer West Wimmera Health Service PO Box 231, Nhill, Victoria 3418 Telephone 03 5391 4222 Facsimile 03 5391 4228 92 WEST WIMMERA HEALTH SERVICE ✁ Email [email protected] CUT ALONG THE DOTTED LINE John N. Smith PSM Chief Executive Officer Hopetoun Wyperfield National Park Rainbow VICTORIA SOUTH AUSTRALIA Big Desert National Park Residential Aged Care KEY Medical Centre Lake Hindmarsh Hospital (Primary Care Casualty) Hospital Jeparit Bordertown E Warracknabeal Nhill Kaniva < ADELAID (Primary Care Casualty and Surgical Centre) A8 A8 Dimboola Little Desert National Park B240 Goroke B210 B240 Natimuk Horsham ME LB OU RN E> A8 B240 Narracorte Jilpanger Flora and Fauna Reserve A200 Black Range StatePark Halls Gap Grampians National Park WEST WIMMERA HEALTH SERVICE Distance is no barrier for us as we deliver our services across the breadth of a harsh but beautiful rural setting containing national parks, the world renowned Mt Arapiles, a rock climbers paradise, The Grampians Tourist Park and we are just across the border from the South Australian wineries. We have established expertise and skills, adapted care routines, researched our communities, and analysed the health conditions prevalent in those communities so that we are able to take our services out to the people no matter where they live in our catchment. On the other hand the need for a higher level of acute and aged residential care is also in our portfolio. Bringing specialist medical and surgical services, a full complement of General Practitioners, a state of the art Operating Suite, short waiting times for surgery, a range of Dental procedures meets the acute healthcare needs of these six communities. Healthcare close to home – no matter where that is in our catchment – West Wimmera Health Service is there to care. A real service for real people! WW205 / MOTIV Advanced telecommunication systems, a fleet of vehicles, portable patient equipment, a robust set of policies and procedures, comprehensive ongoing education and staff who are flexible and able to adapt safely to situations are the backbone of long distance caring. ANNUAL REVIEW 2013/14 C NHILL HOSPITAL 49 Nelson Street, Nhill, Victoria 3418 T (03) 5391 4222 F (03) 5391 4228 COOINDA DISABILITY SERVICES Queen Street, Nhill, Victoria 3418 T (03) 5391 1095 F (03) 5391 1229 GOROKE COMMUNITY HEALTH CENTRE Natimuk Road , Goroke, Victoria 3412 T (03) 5363 2200 F (03) 5386 1268 JEPARIT HOSPITAL 2 Charles Street, Jeparit, Victoria 3423 T (03) 5396 5500 F (03) 5397 2392 Please use, re-use & recycle. KANIVA HOSPITAL RAINBOW HOSPITAL 7 Farmers Street, Kaniva, Victoria 3419 2 Swinbourne Avenue, Rainbow, Victoria 3424 T (03) 5392 7000 F (03) 5392 2203 T (03) 5396 3300 F (03) 5395 1411 NATIMUK RESIDENTIAL AGED CARE CENTRE EMAIL [email protected] 6 Schurmann Street, Natimuk, Victoria 3409 T (03) 5363 4400 F (03) 5387 1303 wwhs.net.au