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SYDNEY ADVENTIST HOSPITAL WELCOME! Sydney Adventist Hospital (fondly referred to as the San), a 342-bed facility located in Wahroonga, is the largest single campus private hospital in New South Wales. We are a modern acute care facility with diagnostic and therapeutic services conveniently located on-site. Since its establishment in 1903, Sydney Adventist Hospital has always been a not-for-profit institution. This means all profits made by the Hospital go back into the Hospital, ensuring the best equipment and the best care. The opening of the new San Clinic in August 2003 was highly anticipated, and this facility is now a major centre of referral for general practitioners. Thank you for your support of Sydney Adventist Hospital, we look forward to working with you and taking care of your patients. DR LEON CLARK Chief Executive Officer Sydney Adventist Hospital DR JEANETTE CONLEY Director of Medical Services Sydney Adventist Hospital SYDNEY ADVENTIST HOSPITAL MISSION Overview Mission has always been an important part of the San, defining who the organisation is and what it stands for. In 1903 Sydney Adventist Hospital was founded by the Seventh-day Adventist Church to carry out Christ’s mission of care, health and healing. This special mission of care has not changed over the last 100 years and in June 2004, the Hospital’s new mission statement – Christianity In Action – was announced. This statement captures the hospital’s reason for being and the spirit in which work is carried out at the San. New Mission Statement What does ‘Christianity in Action’ mean? Christianity in Action is why the Seventh-day Adventist Church operates a Hospital. Christianity in Action is about our attitudes and the actions that we take at work that show that we care for our patients, our colleagues, the community and ourselves. If I am not a Christian, how does the new Mission statement apply to me? Being Christian is about being human in the most fulfilling and satisfying way possible. We hope that working here will be a rewarding experience that gives you a chance to offer your skills to others for their benefit whether or not you are a Christian. Our new Mission statement refers to the spirit in which we carry out our daily duties. We believe this statement is one to which all staff can relate, regardless of their religious affiliation. Your role As a member of the Hospital medical team, you play a significant role in carrying out this mission through the work that you do every day and through the interactions that you have with patients, staff, and colleagues. By integrating the spirit of Mission into your daily tasks you can engender and promote the caring, supportive environment for which the San is known. All of us working together in the spirit of Mission will carry this Hospital into the future and make life better for the patients, doctors, staff and the people in the community that we serve – enabling the San to remain the community’s favourite private hospital. The SAH Code of Ethics, Code of Behaviour and Standards of Performance provide a framework for the standards of service and behaviours that are expected at the San and are foundational documents, which define behaviours expected in carrying out the Hospital’s Mission. Copies of these policies can be found on the Intranet. Sydney Adventist Hospital Mission New Doctor’s Orientation Manual SYDNEY ADVENTIST HOSPITAL MISSION ................................................................................... I ADMITTING PROTOCOLS ............................................................................................................. 4 BOOKINGS ................................................................................................................................................... 4 MATERNITY BOOKINGS ............................................................................................................................. 5 AUSTRALASIAN RESEARCH INSTITUTE ..................................................................................... 7 CANCER SERVICES ...................................................................................................................... 8 DAY STAY UNIT (POON ONCOLOGY WARD) .................................................................................................. 8 CANCER SUPPORT CENTRE / JACARANDA LODGE ................................................................. 9 CANCER SUPPORT CENTRE ..................................................................................................................... 9 JACARANDA LODGE ................................................................................................................................ 10 CARDIAC SERVICES ................................................................................................................... 11 CARDIAC CATHETERISATION LABORATORY .......................................................................... 12 CARDIAC REHABILITATION........................................................................................................ 13 ZIPPER & STENT CLUB............................................................................................................................. 14 CORONARY CARE ...................................................................................................................... 14 ELECTROCARDIOGRAMS........................................................................................................................ 15 CASE MANAGEMENT.................................................................................................................. 16 CHAPLAINS ................................................................................................................................. 17 DAY OF SURGERY ADMISSION CENTRE (DOSAC) .................................................................. 18 DIABETES EDUCATION .............................................................................................................. 19 EMERGENCY CARE .................................................................................................................... 20 ENDOSCOPY ............................................................................................................................... 21 PANENDOSCOPY ...................................................................................................................................... 22 COLONOSCOPY ........................................................................................................................................ 22 BRONCHOSCOPY ..................................................................................................................................... 22 ENDOSCOPIC RETROGRADE CHOLANGIOGRAPHIC PANCREATOGRAPHY (ERCP) ..................... 22 FOUNDATION .............................................................................................................................. 23 FOX VALLEY MEDICAL & DENTAL CENTRE ............................................................................. 25 FUND BENEFITS AND PATIENT SERVICES .............................................................................. 27 HELP TEAM VOLUNTEERS......................................................................................................... 30 HOSPITAL IN THE HOME (HITH) ................................................................................................ 31 HUMAN RESOURCES ................................................................................................................. 32 INFECTION CONTROL PROGRAM ............................................................................................. 33 INFORMATION TECHNOLOGY ................................................................................................... 37 INTENSIVE CARE ........................................................................................................................ 38 Contents New Doctor’s Orientation Manual 2 LIBRARY ...................................................................................................................................... 39 MATERNITY UNIT ........................................................................................................................ 40 SAH MARKETING, PUBLIC RELATIONS & ................................................................................. 41 BUSINESS DEVELOPMENT DEPARTMENT SERVICES ............................................................ 41 MEDICAL RECORDS ................................................................................................................... 44 NUCLEAR MEDICINE .................................................................................................................. 45 SAN NUTRITION .......................................................................................................................... 47 PAEDIATRIC SERVICES ............................................................................................................. 49 SAN CHILDREN’S SLEEP DISORDER UNIT ............................................................................................ 49 PARKING FOR DOCTORS .......................................................................................................... 51 PATHOLOGY ............................................................................................................................... 52 PHARMACY ................................................................................................................................. 55 PHYSIOTHERAPY & AQUATIC PHYSIOTHERAPY .................................................................... 56 QUALITY CLINICAL REVIEW PROGRAM ................................................................................... 59 COORDINATOR QUALITY CLINICAL REVIEW ........................................................................... 59 RADIATION ONCOLOGY CENTRE ............................................................................................. 60 RADIOLOGY ................................................................................................................................ 62 RENAL DIALYSIS ......................................................................................................................... 67 SAN CLINIC.................................................................................................................................. 68 SAN DAY SURGERY HORNSBY ................................................................................................. 70 SAN ULTRASOUND FOR WOMEN.............................................................................................. 71 SECURITY.................................................................................................................................... 73 SOCIAL WORK ............................................................................................................................ 74 SURGICAL BOOKING PROTOCOL ............................................................................................. 75 UROLOGY CLINIC ....................................................................................................................... 77 WOUND CARE CLINIC ................................................................................................................ 78 Contents New Doctor’s Orientation Manual 3 ADMITTING PROTOCOLS As hospital services are heavily utilised, the following protocols have been designed to expedite admission procedures. Please do not hesitate to call should you have any difficulties or enquiries. BOOKINGS MEDICAL & EMERGENCY BOOKINGS Contact the Bookings Office – Phone: 9487 9908 CARDIAC CATHETER LABORATORY Contact CCL Secretary – Phone: 9487 9130 ENDOSCOPY Contact the Endoscopy Secretary – Phone: 9487 9121 X-RAY PROCEDURES Contact the Radiology Department – Phone: 9487 9850 SURGICAL & THEATRE BOOKINGS Contact the Theatre Secretary – Phone: 9487 9020 WORKERS COMPENSATION PATIENTS must be approved by the insurance company before admission. The doctor must receive approval for himself and the hospital and fax approval to the hospital on 9487 9935. PUBLIC LIABILITY AND THIRD PARTY PATIENTS must be cleared by the Patient Services Department before admission. All anticipated hospital costs must be paid in advance. VETERANS’ AFFAIRS PATIENTS – The doctor must get approval from the Department of Veterans’ Affairs prior to admission (Phone: 9213 7419). This process applies to White Card holders only, Gold Card holders do not need approval. INFORMATION REQUIRED When a booking is made the following information is required please: 1. Full name of patient 2. Date of birth 3. Provisional diagnosis 4. Patient’s home telephone number 5. Admitting doctor 6. Type of booking (I, S or D)* 7. Item number 8. Admission source e.g. Rooms / Other Hospital / Nursing Home 9. Please note all bookings must be followed by a hospital booking letter and copy of the consent form Admitting Protocols New Doctor’s Orientation Manual 4 *Patients may be booked for admission in one of the following categories: I = Inpatient – admitted the day prior to the procedure S = Same Day – admitted the day of the procedure D = Day Only – admitted and discharged on the day of the procedure Accommodation available: P+ = private room with ensuite Share = share room – two beds Every effort is made to accommodate patients in the room of their choice, however when hospital occupancy is high this is not always possible at the time of admission. Patients are transferred when a preferred room becomes available. Workers Compensation and DVA patients are only covered for a shared room so would need to pay the gap if requesting a private room. MATERNITY BOOKINGS Requires 30 min appointment with Maternity Sister Phone for appointment with Maternity Sister: 9487 9908 (Mon – Fri, 8:30am – 4pm) Maternity Sister Mon & Fri, 9:30 – 11:30am & 1:00 – 3:00pm Available: Tues, Wed & Thur, 3:00 – 4:30pm & 6:00 – 8:30pm (No bookings on Public Holidays) Please bring: Letter from your Obstetrician Medicare Number Fund details $100 Booking Fee ADMISSION FORMS Patients are required to send their Admission Forms to the Hospital prior to admission. Forms may be posted, delivered to the front desk or sent by fax on (02) 9487 9935. It is essential that anticipated item numbers and length of stay are noted on the admission form so that the patient can be sent an estimate of costs. Other papers, eg. Doctor’s Referral Letter, Consent Form and Pre-Hospital Assessment are to be sent with the admission form. Patients do not need to ring the Bookings Office to confirm their booking. All surgical booking made by the doctor’s secretary are confirmed with the doctor’s rooms. Therefore it is vital that if cancellations occur the appropriate department is notified as soon as possible. ADMISSION TIMES Inpatient admissions are generally admitted between 3:00pm and 4:00pm. However, if special work-up is required prior to surgery, arrangement may be made for admission at 12midday. Most patients are admitted on the day of surgery and are notified the night before by D/S staff. Transfers From Other Facilities are preferably undertaken on the day prior to any procedure being performed at SAH, as the Ambulance Service is not able to guarantee urgent transport. Admitting Protocols New Doctor’s Orientation Manual 5 GOING HOME: Drinking & Driving Please advise your patients that they must arrange to have a responsible person drive them home and that they must be in the company of a responsible adult for 24 hours after their procedure. They should not drive a motor vehicle or consume alcohol for at least 24 hours following an anaesthetic. The patient will be required to sign a statement regarding this. Procedures may not be undertaken if this is not guaranteed. Admitting Protocols New Doctor’s Orientation Manual 6 AUSTRALASIAN RESEARCH INSTITUTE The Australasian Research Institute (ARI) has been recently established at the Sydney Adventist Hospital to facilitate, coordinate and fund innovative and developmental research within the Adventist healthcare setting. The ARI actively strives to develop projects involving wide collaboration with a focus on human benefits. Partnership with expertise from outside the institution is actively sought. PURPOSE AND SCOPE The ARI is established to: Conduct or commission the conduct of research into patient care, and the causes, prevention or cure of disease in human beings, and to cooperate with other organizations and individuals concerned with such research. Conduct or commission the conduct of research in areas of nutrition, development of health and health food products, healthcare and related fields, and to cooperate with other organizations and individuals concerned with such research. Provide advice and support to researchers within Sydney Adventist Hospital. Act as a resource centre for researchers, i.e. for consultation with project development and grant writing, collaborator contacts, statistical analysis and writing for publication. Fund high quality research that is within the guidelines af the ARI in one of 3 categories: Student Scholarships for Honours, Masters or PhD (up to $1,500.00) Small Grants (up to $5,000.00) Large Grants (up to $30,000.00) Projects will generally be funded for one year up to a maximum of 3 years. All ARI funded activity must have a genuine collaboration with an employee or recognised associate of an ARI member corporation, for example Sydney Adventist Hospital or Avondale College. GRANT APPLICATION PROCEDURE All Grant applications must be received in electronic format only using the forms provided. Application forms can be obtained from the ARI Executive Office. Please email your request to: [email protected]. An initial consultation with the Executive Director to discuss the scope of the proposed research is encouraged before making a full application. LOCATION The ARI is located on Level 1, in the Faculty of Nursing and Health Sciences building at Sydney Adventist Hospital. FURTHER INFORMATION If you would like any further information about the Australasian Research Institute, Dr Ross Grant, the Executive Director, can be contacted on (02) 9487 9602 or by email at [email protected]. Australasian Research Institute New Doctor’s Orientation Manual 7 CANCER SERVICES The Sydney Adventist Hospital offers complete care for most forms of cancer. These services include: Haematology Radiation Oncology Oncology and Palliative Care Cancer Support Centre/Jacaranda Lodge LOCATION Level 6, Main building BOOKINGS Phone 9487 9908 Note: All bookings must be made directly to Hospital Bookings on 9487 9908. DAY STAY UNIT (Poon Oncology Ward) The day stay treatment unit has a new home in a purpose built facility on the west wing of Level 6. The unit offers up to six recliner chairs, with an adjacent suite suitable for a bed if required. Patients have access to an adjoining toilet and kitchenette as well as the Hospital’s catering service. Patients also have the choice to use the covered outdoor atrium on Level 6 which is in full view of nursing staff. All treatments are administered by a Clinical Nurse Specialist or senior Registered Nurses competent in this field. Treatments in the Day Stay Treatment Unit include: Blood Transfusion Chemotherapy Administration Aredia or Pamidronate Infusion Intragam Infusion Iron (Ferrum H) Infusion Platelet Transfusion IV cannulation for all of the above, plus blood collection if required Access and de-access of central intravenous devices (eg port-a-caths) Other day only treatments and infusions as required Forms for booking patients directly into the facility can be forwarded to you on request. Please note: Patients need to visit the admission desk on Level 4 upon arrival. Paperwork is processed here before proceeding to the day stay unit. The usual minimum time between arrival and departure from Hospital, including time spent in the unit, is approximately four hours. This time does vary and may be less in the case of rapidly infused chemotherapy, or considerably more in the case of blood transfusions. You may wish to contact unit staff to negotiate a mutually convenient arrival time for your patient. ENQUIRIES Please feel free to phone 9487 9653, 9487 9671 or 9487 9672 if you need further details or booking forms. Cancer Services New Doctor’s Orientation Manual 8 CANCER SUPPORT CENTRE / JACARANDA LODGE CANCER SUPPORT CENTRE OFFICE HOURS 8:30am – 5:00pm, Monday – Friday PHONE 9487 9061 or 9487 9062 The following services are provided free of charge: Support Groups General Groups (weekly) Meditation (weekly) Christian Meditation (weekly) Carers (2 x month) Prostate Cancer (monthly – partners included) Bowel Cancer (2 x month – partners included) Breast Cancer + Young Women’s Lung Cancer Melanoma Life After Loss Look Good…Feel Better workshops New groups develop following sufficient interest Personal & Family Support & Counselling (at diagnosis) During Treatments Associated Family Stress Education Lectures Breast Cancer Prostate Cancer Bowel Cancer Lung Cancer Stress Management Cancer and Nutrition Cancer and Sexuality Cancer and the Mind Life After Cancer Partners are welcome to attend lectures. Information Cancer Council Booklets Medical Journals Books Audio and video tapes Internet information Newsletters Home Visitation For those unable to attend the Centre. Phone-in and Drop-in - During crisis For support or information A quiet place to sit and rest or read Bereavement Support For families who lose a member through cancer. Volunteer Transport To Radiation Therapy or Doctors’ appointments if family and friends are unable to help. Margaret Adams Manager Nerolie Gate Secretary Cancer Services New Doctor’s Orientation Manual 9 JACARANDA LODGE Jacaranda Lodge is a low cost accommodation facility: For country outpatients For families of Hospital patients Two or three single beds, ensuite, share kitchen/lounge/dining rooms, recreation room, phone and laundry facilities. Linen provided. CONTACT INFORMATION OFFICE HOURS 8:30am - 4:00pm, Monday to Friday PHONE 9487 9066 Lurline Goldring Manager Cancer Services New Doctor’s Orientation Manual 10 CARDIAC SERVICES Sydney Adventist Hospital offers the following cardiac services: Intensive Care Coronary Care Cardiac Catheterisation Laboratory Cardiac Rehabilitation Major features of the new Coronary Care and Intensive Care Units include: Level 3 Intensive Care Specialist Intensivists present in the Unit during the day and on call 24 hours per day Highly experienced specialist nursing staff Latest monitoring equipment is capable of providing mechanical ventilation, continuous renal replacement therapy, intra-aortic balloon pumping and invasive cardiovascular monitoring Smooth patient flow Spacious, airy rooms designed for maximum patient privacy without compromising patient safety Recliner rocker in every room Dimmer lights in every room Family waiting rooms with separate bathroom, shower and kitchen facilities Tasteful décor to enhance patient and visitor comfort Beautiful views and natural lighting ACCOMMODATION – Outpatients & Carers Phone: 02 9487 9066 or 02 9487 9062 Jacaranda Lodge provides low cost accommodation for outpatients and carers visiting Specialist Consultants at Sydney Adventist Hospital. Carers can also stay while their patient is hospitalised. The Lodge is on grounds at the back of the Hospital, next to the tennis courts. It consists of twin bed rooms with ensuite and share kitchen/dining/lounge where the residents enjoy support and company. Country patients over 200km from Sydney obtain an isolated patients form from their referring doctor. This form is also to be signed by their Specialist Consultant in Sydney. They then have their accommodation rebated by their Health Fund and/or IPTAAS (Isolated Patients Transport and Accommodation Scheme). Persons less than 200km from Sydney either have their Health Fund refund some of the amount or pay $15 per share room or $30 per private room per night. Cardiac Services New Doctor’s Orientation Manual 11 CARDIAC CATHETERISATION LABORATORY BOOKINGS AND ENQUIRIES Bookings may be faxed on 9487 9135 For urgent bookings phone 9487 9130 Nursing Unit Manager 9487 9140 LOCATION The Cardiac Catheter Laboratory is situated on Level 5 adjacent to the Intensive Care Unit (ICU) and Coronary Care. EMERGENCY SERVICE Staff are rostered ON CALL for after hours, weekend and public holiday emergencies. This service can be accessed after hours via the Duty Managers by phoning 9487 9111. COMMONLY PERFORMED PROCEDURES Selective coronary arteriography with right or left heart catheterisation, or both (Item 38218). Right heart catheterisation, including oximetry and cardiac output measurement (Item 38200). Coronary angioplasty (Items 38300 & 38303). Intra coronary stent (Item 38306). Transvenous pacemaking electrode insertion (Item 38256). Implantation of permanent pacemakers and defibrillators (38353, 38384, 38371) Electrophysiology Studies (Items 38209 & 38212). Radio Frequency Ablations (Item 38287, 38290). Cardioversion (13400) Trans-oesophageal echocardiogram (55118) These services can be accessed after hours via the Duty Managers by phoning 9487 9111. Andrew Potts Nursing Unit Manager Cardiac Services New Doctor’s Orientation Manual 12 CARDIAC REHABILITATION BOOKINGS AND ENQUIRIES Phone: Or 9487 9473 or 9487 9470 9487 9111 and ask to page 133 Fax: 9487 9475 Location: Level 3 Main Gym, or level 5 Patient Education Office PHASE I: INPATIENT PROGRAM This program is for inpatients who have either several cardiac risk factors or known heart disease. This program consists of lifestyle and risk factor evaluation, diagnostic procedure, pre-operative and post-operative recovery information. Twice a week discussions are held on heart disease, risk factors and their control (eg stress, relaxation, exercise, smoking, hypertension, weight control and diet). Individual counselling sessions are included as required in the program. The emphasis is oriented towards encouraging a positive learning environment, with support and back-up from other disciplines, so the patient is confident and knowledgeable in reducing risk factors upon discharge. Outpatient risk factor evaluation and counselling on lifestyle is also available. PHASE II: OUTPATIENT PROGRAM HOSPITAL BASED MONITORED EXERCISE AND EDUCATION PROGRAM This is an exercise program for participants who have had a cardiac event such as MI, PTCA, Stent or surgery, or who are being medically treated for risk factor management stable angina. It usually commences two weeks post cardiac event, and assists the participant in making the transition from hospitalisation to a productive, active lifestyle once again. The program runs for six weeks, three mornings a week. This is followed by two check-ups over 12 months, to monitor the participant’s progress at home. While the participant is attending this program assistance is given with risk factor modification. Weekly education classes are held regarding risk factor management. The main benefits of this program are improved fitness, increased confidence, and the supportive environment needed to achieve and maintain lifestyle changes. This program is also a tool physicians can use to monitor arrhythmia problems, and/or medication changes over an extended period. Reports detailing the patient’s fitness progress and modification of coronary risk factors are sent to the patients’ physician throughout the course of the program. A referral is required from the attending practitioner. The program is covered by all major Health Funds. Cardiac Services New Doctor’s Orientation Manual 13 PHASE III: LIFESTYLE MAINTENANCE PROGRAM This program is available for individuals who have known cardiac risk factors, or patients who have had a cardiac event (such as in Phase II), but have now recovered and wish to join a maintenance exercise program. The Phase III program is run for an hour at 6:30am three mornings a week at North Shore Gym and three afternoons per week at the Hospital Cardiac Rehab Gym. Risk factor analysis and lifestyle education continue in this program. There is a fee for this program. ZIPPER & STENT CLUB This club was formed in July 2002 as a support group for clients and their families following a cardiac event. It offers peer support, social activities and educational opportunities. Meredyth Morris Cardiac Rehab Coordinator CORONARY CARE BOOKINGS Bookings call: 9487 9908 Enquiries call: 9487 9676 LOCATION Level 5 Main Building SERVICES An 11 bed, 24 hour acute cardiac care facility, with comprehensive monitoring equipment. Services also include trans-oesophageal and thoracic echo facilities. A Cardiologist is available 24 hours per day. Cardiac Services New Doctor’s Orientation Manual 14 ELECTROCARDIOGRAMS All electrocardiograms are reported by a consultant physician. INPATIENT Electrocardiograms are recorded by a technician, sho can be contacted via ward nursing staff. OUTPATIENTS Resting electrocardiograms on outpatients are recorded during routine consulting hours at Fox Valley Medical & Dental Centre, 187 Fox Valley Road. Monday – Thursday 8:30am – 7:00pm Friday 8:30am – 4:00pm Bookings and enquiries phone 9487 9700 AFTER HOURS Emergency ECGs are available through Emergency Care. EXERCISE ELECTROCARDIOGRAMS Exercise electrocardiograms are recorded in the Centre for Health Management. Phone 9487 9487. Exercise electrocardiograms, performed at the request of a referring practitioner, are supervised by a consultant physician with 20 years of exercise electrocardiography experience. Exercise electrocardiograms are also part of the general health assessment called Executive Health Check (Exec-Check) for company executives and other interested persons. Persons attending for exercise electrocardiograms should bring suitable clothing for exercise, eg. Shorts, jogging or walking shoes. Ladies are requested to bring a blouse, which opens in the front to facilitate electrode connection. Exercise is normally undertaken on a treadmill, but a bicycle ergometer is available. Those undertaking the electrocardiogram are requested not to eat or smoke for two hours prior to the test. Digoxin therapy renders the interpretation of the exercise electrocardiogram difficult and should be withdrawn for at least one, and preferably four weeks prior to testing. Beta blocking agents may restrict the cardiac response to exercise and, if possible should be withheld for 24 hours before testing. Cardiac Services New Doctor’s Orientation Manual 15 CASE MANAGEMENT CASE MANAGER SPECIALTIES AND CONTACT DETAILS Cardiac and Vascular Surgery Colorectal and General Surgery Neurology and Respiratory Medicine Orthopaedic Urology/Plastics/Breast and General Surgery Kerrie Ebbutt Shirley Lofgren Marilyn Algeo Warren Peers Kathryn Manning pgr 133 pgr 1230 pgr 7070 pgr 15 pgr 1030 Aged and Continuing Care Co-ordinator Continuing Care CNS Catherine Prenter Kerrie Kneen pgr 172 pgr 173 OBJECTIVES OF CASE MANAGEMENT The objectives of Case Management and the continuing Care Team at the Sydney Adventist Hospital are: To minimise adverse patient outcomes through: - The identification of ‘at risk’ patients/patient groups - Patient education and advocacy - Optimal clinical communication processes Comprehensive continuous quality improvement in clinical and financial management. To manage the length of stay (LOS) to achieve target levels in response to case based payment funding, which applies to over 60% of patients at the San. To contain costs and utilise resources more efficiently. The relevant Case Manager will automatically follow patients within the above specialities. Patients admitted under Palliative Care, Oncology and General Medicine will be followed by the Continuing Care Team. Patients are actively Case managed if they: Have had major surgery Have had a complicated clinical course Require discharge planning Require other intervention to meet the objectives above. Patients are required to attend the Pre Admission Clinic (PAC) prior to elective surgery, at which time the Case Management process will commence. Please do no hesitate to contact a Case Manger if we can be of any assistance throughout your patient’s hospitalisation. Case Management New Doctor’s Orientation Manual 16 CHAPLAINS Contact Phone: 9487 9289 The Chaplains Department at Sydney Adventist Hospital provides 24 hours a day, 365 days a year service. A chaplain can be contacted at all times on extension 9289. Chaplains provide a confidential service integrating religious care, spiritual care, and emotional support, for patients, staff, and their families, particularly in situations of stress, trauma and / or crisis. SERVICES AVAILABLE Services available include support: In life cycle crises (eg birth, migration, marriage, death) In unanticipated crises Where ethnic, cultural, and religious issues that affect patient care are present What can you expect of the Chaplain? Assessment of emotional and spiritual needs of patients and families including religious needs, and support in meeting those needs. Assessment of coping resources including social support, support by religious community, beliefs, symbols, and practices. Contact when appropriate with resources in the community including arranging for baptism, anointing, communion. Assistance in moral and ethical issues relating to case management. Debriefing and support of front-line staff. Pastoral counselling. Referral to other organisations where indicated or requested. Other Resources Family Learning Centre – A specialist lending library including books and audio visual resources on interpersonal relationships, singles, men, women, sexuality, marriage, children and parenting, divorce, grief, etc. Available on a two-week loan basis. Prayer Services – conducted regularly in the Hospital Chapel. Clinical Pastoral Education training programs. REFERRALS Patients may be referred to the Hospital Chaplains. A formal referral letter is not required. Appointments may be arranged by phoning the Chaplains secretary on 9487 9289. Roger Henley Senior Chaplain Chaplains New Doctor’s Orientation Manual 17 DAY OF SURGERY ADMISSION CENTRE (DOSAC) Streamlined facilities for the care of day-only and day of surgery admission patients are available in the DOSAC. BOOKINGS AND ENQUIRIES Phone booking office: 9487 9020 Dosac Nursing Unit Mangaer : 9487 9110 ADMISSION PROCEDURES Patients are asked to phone 9487 9113 the evening prior for appointment time. 1. Preadmission forms should be completed and submitted prior to the day of admission. 2. On arrival, patients are directed to the DOSAC where relevant papers will be ready for the prompt finalisation of admission formalities. 3. The patient is then interviewed by the RN and charts are completed in preparation for the anaesthetist’s visit prior to the procedure. 4. All patients should have a Patient History Sheet completed and forwarded ASAP to the department for review prior to admission. PREPARATION Follow the pre-admission booklet information and fasting time will be notified at the pre-op phone call the evening prior to the procedure (or Friday for Monday). THEATRE SCHEDULE It is essential that patients be informed that there may be a waiting period according to their position on the operating list. DISCHARGE PROCEDURE All patients are encouraged to take fluids after their operation and are offered a hot drink or fruit juice and a small meal prior to discharge. It is important that patients be informed that they must not drive and are to be discharged and remain in the company of a responsible adult for 24 hours. Glenys Chapman DOSAC Nursing Unit Manager Day of Surgery Admission Centre (DOSAC) New Doctor’s Orientation Manual 18 DIABETES EDUCATION Sydney Adventist Hospital provides a Diabetes Education Service, offering education for diabetes in patients and their families. This is available patients within the Hospital , and aims to provide people with the skills and strategies to keep their blood sugars within normal range. Diabetes Education is also available for all ladies with Gestational Diabetes on an out patient or in patient basis. STAFF Our Senior Diabetes Educators are Credentialed with the Australian Diabetes Educators Association (ADEA). All our educators are attending or have completed ADEA recognised Diabetes Education and Management Courses. LOCATION The Diabetes Education Service is conveniently located on Level 5, Sydney Adventist Hospital. The Service can be easily accessed directly from the car park lifts. FURTHER INFORMATION Our Diabetes Educators are happy to assist with any questions, and can be contacted Monday to Friday, 8:0am to 3:00pm. For further information, please call the Diabetes Education Department on (02) 9487 9434. Diabetes Education New Doctor’s Orientation Manual 19 EMERGENCY CARE The San Emergency Care Department opened in May 1996 – the first private Emergency Care facility on Sydney’s North Shore. Our Unit treats approximately 20,000 patients a year and is staffed by a team of specialists, career medical officers and experienced registered nurses. SERVICES With modern facilities and the backing of a large fully equipped hospital, the unit is well placed to assist your patients. We have a particular interest in cardiology. We provide a 24-hour angioplasty service for acute coronary syndromes and the San Chest Pain Hotline, which provides telephone advice to patients with chest pain, is based in Emergency Care. Approximately 15% of our patients are children, and we work closely with the paediatricians and paediatric surgeons accredited to the Hospital. We have developed outpatient treatment strategies for venous thrombo-embolic disease and nonlife threatening infections e.g. cellulitis, pneumonia. Management of acute wounds can be difficult in general practice. We have a variety of wound closure techniques and wound dressings appropriate for the individualised care of your patients. In particular, we use sedation and analgesic methods to allow us to reduce the stress and anxiety of wound care in children. We have a comprehensive on-call specialist roster, covering all of the major general specialties and sub-specialist groups. LOCATION Emergency Care is located on Level 3, Sydney Adventist Hospital and operates 24 hours a day, seven days a week. REFERRAL AND FEES A doctor’s referral is not required for treatment. Fees for Emergency Care are based on severity of illness or injury. Full-fee paying patients will have significant out-of-pocket expenses (ranging between $150 and $190). Concessions are given to pensioners, DVA patients and follow-up patients. Some smaller health funds will contribute to out-of-pocket expenses, but the major funds do not contribute to our charges. FURTHER INFORMATION For further information please phone (02) 9487 9000. San Chest Pain Hotline: (02) 9487 9444. Emergency Care New Doctor’s Orientation Manual 20 ENDOSCOPY GENERAL INFORMATION The Endoscopy Department is located on level 4 of the main building and is co-located with Day Surgery, and shares a common admissions area for day of surgery admission cases. The Endoscopy Department has a dedicated fully staffed recovery area for both inpatients and day only cases post procedure. The department has two fully functional procedure rooms, and a dedicated cleaning area utilising state of the art sterilisation systems. Endoscopic Retrograde Cholangio Pancreatography (ERCP) is performed by endoscopy medical, anaesthetic and nursing staff on level 3 radiology department. The majority of other endoscopy procedures are performed in the Endoscopy Department, but facilities exist for emergency procedures to be performed in Operating Theatres and in Intensive Care. STAFFING Endoscopy nursing staff are highly trained to levels approved by the Gastroenterological Endoscopy Nursing College of Australia (GENCA). The majority of procedures are performed under propofol assisted sedation or anaesthetic according to current guidelines approved by a tripartite body of the Australia and New Zealand College of Anaesthetics (ANZCA), Gastroenterological Society of Australia (GESA) and Royal Australasian College of Surgeons (RACS). The details of agreed safe sedation and anaesthetics for endoscopy can be viewed on the ANZCA website. See www.anzca.edu.au. Gastrointestinal endoscopy is performed by experienced gastroenterologists, upper gastrointestinal and general surgeons, and colorectal surgeons. These endoscopists have had their endoscopic training recognised by the Conjoint Committee for Recognition of Training in Gastrointestinal Endoscopy. See www.conjoint.gesa.org.au for directory of approved medical practitioners. Bronchoscopy is performed by respiratory physicians whose expertise and training has been recognised by the Thoracic Society of Australia and New Zealand (www.thoracic.org.au) BOOKINGS The Sydney Adventist Hospital does not provide an “open access” style of endoscopic service and referrals for endoscopy should be directed to individual practitioners who are credentialed to provide gastrointestinal endoscopy and bronchoscopy. The hospital executive may be able to assist in finding an accredited medical practitioner if needed. Useful telephone contact numbers Fax: 9487 9105 Phone: 9487 9120 Monday – Friday, 0730am – 4:30pm Endoscopy New Doctor’s Orientation Manual 21 The Endoscopy Department offers a wide range of gastroenterological services. These include: PANENDOSCOPY Incorporating Oesophagoscopy, Gastroscopy and Duodenoscopy Biopsy – with full pathology services Removal of polyps – with full pathology service Endoscopic mucosal resection Injection or electrocautery of bleeding lesions Argon Plasma Coagulation of bleeding lesions Banding of oesophageal varices Oesophageal dilatation Percutaneous endoscopic feeding gastrostomy tubes Insertion of oesophageal and enteral stents COLONOSCOPY Long, short or flexible sigmoidoscopy Biopsy – with full pathology services Injection or banding of haemorrhoids Stricture dilatation with or without stent insertion Argon Plasma Coagulation of bleeding lesions BRONCHOSCOPY Full range of services offered including biopsy, cytology and washings with pathology services available. ENDOSCOPIC RETROGRADE CHOLANGIOGRAPHIC PANCREATOGRAPHY (ERCP) Removal of stones from common bile duct Endoscopic sphincterotomy Biliary drainage Placement of stents FURTHER ENQUIRIES Phone 94879120 or further enquires Endoscopy New Doctor’s Orientation Manual 22 FOUNDATION Sydney Adventist Hospital Foundation was established in 1987 to coordinate all fundraising activities for the San. It exists to support the San by funding projects that will improve patient care and patient outcomes. The San Foundation is a Registered Charity with ‘Donation Gift Recipient’ status whereby all donations over $2 are fully tax-deductible. It is important to note all Foundation funds that are gifted to the hospital are not used to pay operating costs. The Foundation prides itself in the fact that 100% of all donations go to the donor’s nominated cause; it is one of the few Australian charities whose administration costs are covered by the Foundation’s fleet management business. The success of the Foundation relies on grateful patients and the support of the community and to date over $10 million has been raised to help fund life saving equipment and major building programs. This enormous support is not only of significant value to the San but testimony to the fact that the San holds a special place in the hearts of many. DONATIONS The Foundation receives income in the following ways – Through fundraising appeals – San News, April and September and a June Tax and December Christmas appeal. Through a planned giving program where donations can be made through payroll to gain immediate tax benefit Through bequests and wills ‘I’m a San Baby” teddy bears for the Maternity Unit NON-DONATION INCOME The San Foundation has a very successful Foundation Fleet Services business, whereby employees of the San lease vehicles by salary sacrifice; this may well benefit employees with vehicle purchasing and on-going requirements. In addition the Foundation hosts a number of fundraising events such as the San “Run For Life” fun run and the annual Foundation Golf Day. PAST GIFTS TO THE SAN Since 1987 the Foundation has contributed significantly to the Hospital by providing medical equipment and services for various hospital departments including Jacaranda Lodge and Cancer Support Centre Poon Oncology Ward San Child Care Centre for staff members and the community Day Treatment Room for chemotherapy patients Cardiac Catherisation Laboratory Renal Dialysis Unit Hospital In the Home Emergency Medical Unit Foundation New Doctor’s Orientation Manual 23 SPEAKERS BUREAU At various times local community groups, i.e. Probus or Rotary contact the Foundation to arrange for a speaker to address their meetings. A wide range of topics are suggested to suit many of our doctor’s specialties. Contact is made with the Heads of departments for availability. LOCATION The Foundation office is located in the ‘Foundation Building” (former Men’s Residence) between Radiation Oncology, the San Museum and tennis courts behind the Tower building. FURTHER INFORMATION If you would like any further information about the Foundation, speaking engagements or donating please contact the Managing Director on 9487 9406. Foundation New Doctor’s Orientation Manual 24 FOX VALLEY MEDICAL & DENTAL CENTRE The Fox Valley Medical & Dental Centre operates in association with the Sydney Adventist Hospital. The Centre is firmly committed to providing comprehensive quality healthcare to the community. SERVICES Male and Female General Practitioners are available and offer a full range of family health care services. Vaccinations and Immunisations, including Yellow Fever, are provided by appointment. Vaccinations for overseas travel are available at competitive rates, while some vaccinations for children are free of charge. Insurance & Workplace Medicals, Drivers License and Corporate Health/Lifestyle evaluations can also be made. A Blood Collection Service is also available. Fox Valley Medical & Dental Centre also has a Dentist on-site. A FREE Breast Screening service is available for women over the age of 50, and is run in association with Breast Screen NSW. Care, discretion and sensitivity to women’s needs are all important factors in the clinic’s success. Appointments at the Fox Valley Medical & Dental Centre’s Unit can be made by phoning (02) 9926 7236. Other Visiting Medical Specialists use Fox Valley Medical Centre facilities on a regular basis, including: Clinical Psychology Gynaecology & Obstetrics Orthopaedics Paediatric Respiratory Physician LOCATION Fox Valley Medical & Dental Centre is located next to the Sydney Adventist Hospital, at 187 Fox Valley Road. Patient parking is available adjacent to the Centre, at a minimal fee. Patients will enter through the boom gates. Disabled parking is also available. FEES Fees are set within those approved by the Australian Medical Association. Payment of account on the day of consultation is appreciated. For Pensioners/Health Care Card Holders, presentation of these cards means Medicare benefits are accepted as full payment, except on Weekends and Public Holidays. At these times an extra fee is charged. CONSULTING HOURS Monday to Thursday 8:00am – 6:30pm Friday 8:00am – 4:00pm Sunday 8:30am – 12:15pm Fox Valley Medical and Dental Centre New Doctor’s Orientation Manual 25 FURTHER INFORMATION & APPOINTMENTS Consultations at Fox Valley Medical & Dental Centre are by appointment. Appointments with GPs, Dental and Breast Screen, can be made by contacting the Centre on the following phone numbers: GP Consultations – (02) 9487 9700 Dentist – (02) 9487 9713 Breast Screen NSW – (02) 9926 7236 Fox Valley Medical & Dental Centre New Doctor’s Orientation Manual 26 FUND BENEFITS AND PATIENT SERVICES Doctors and their secretaries fulfil a very important role in the relationship between the patient and Sydney Adventist Hospital’s Patient Services. You may be the patient’s first contact when receiving relevant information regarding our hospital costs and the patient’s medical fund benefits. ENQUIRIES Customer Service: 9487 9900 Access Centre: 9487 9903 Workers Compensation and Third Party enquiries: 9487 9903 Department of Veteran’ Affairs enquiries: 9487 9903 * See notes below re Workers Compensation approval HOURS Customer Service hours: 8:30am – 5:00pm Monday to Friday Access Centre – Admissions Enquiries 8:30am – 6:00pm Monday to Friday PATIENT CLASSIFICATION The Patient Classification System, legislated by the Commonwealth Government and effective from 1 March 1987, defines a patient’s classification according to the level of surgery to be undertaken. For each procedure the degree of complexity has been determined and one of the following classifications assigned to it in the Medicare Schedule: Advanced Surgical Surgical/Obstetrical Medical Room rates for both shared and private rooms are determined by the patient classification, as above. On the recommendation of the Australian Private Hospitals Association, theatre procedures have been further sub-divided into 15 groups. Theatre fees are determined by the group to which a given procedure has been assigned. HEALTH FUND BENEFITS The Hospital has signed contracts with most major health insurers in NSW. The Hospital will confirm the level of contractual cover held with the fund prior to admission on receipt of paperwork. However, should the patient have queries regarding their level of cover, please advise them to contact their fund to obtain information relating to the level of cover and benefits payable. Patients who know exactly the name and level of their health fund cover, and can provide the procedure item numbers, may contact Patient Services on 9487 9900 for an estimate of hospitalisation costs. Fund Benefits & Patient Services New Doctor’s Orientation Manual 27 PRE-EXISTING OR EXCLUSION PROCEDURES Patients should contact their health fund before admission for further information. ESTIMATES OF HOSPITAL FEES Wherever possible, Patient Services staff will communicate (by post or telephone) with patients being admitted for major surgical procedures. Patients will be advised of the out of pocket gaps payable on admission and given an estimate of the accommodation and theatre fees. This service will be significantly improved by the cooperation of patients in returning their completed admission forms to us promptly, with details of: Procedure item numbers (if applicable) and, Estimated length of stay as assessed by their doctor. PAYMENT ON ADMISSION On admission inpatients are required to make the following payments: - If they have private health fund cover for hospital costs, they will be required to pay a gap equal to that portion of their estimated hospital account not covered by their health fund. - If they have no private health fund cover for hospital costs, they are required to pay the total estimated costs of their hospitalisation. On discharge, inpatients may be required to pay any additional costs incurred whilst in hospital, if these costs are not covered by either the gap paid on admission or by health insurance. After discharge, inpatients who had medical tests (eg. pathology, x-ray) may be required to pay their Medicare gaps. METHOD OF PAYMENT Accounts may be paid by: Cash Cheque American Express card Bankcard MasterCard Visa Card Diners Club EFTPOS (up to limit of $1,000) THIRD PARTY/PUBLIC LIABILITY All Third Party and Public Liability accounts ARE TO BE PAID IN FULL PRIOR TO ADMISSION. Fund Benefits & Patient Services New Doctor’s Orientation Manual 28 WORKERS COMPENSATION Insurance company approval must be obtained by the Doctor’s rooms and faxed to 9487 9935. Workers’ Compensation patients may be required to pay the gap between the anticipated hospital costs and the estimated insurance payment on admission. Insurance companies will pay only for shared room accommodation. Patients requesting private rooms will be required to pay the difference between a shared and private room at admission time. DEPARTMENT OF VETERAN AFFAIRS GOLD CARDS: No prior approval required. WHITE CARDS: Doctor needs to obtain approval prior to admission by contacting DVA on 9213 7419. Approval to be faxed to Hospital on 9487 9935. Doctors, including providers of Diagnostic Services, are aware and accept that, except for Anaesthetists who have elected to be remunerated under the Commission’s time-tiered fee structure for anaesthesia for surgery, it is DVA’s policy to pay no more than the CMBS Fee for inpatient consultations, procedures, specialist and diagnostic services. CERTIFICATES TYPE C CERTIFICATES: A same day certificate is required at time of booking for all procedures listed on the Commonwealth Medical Benefits Schedule (CMBS) as Type C procedures (i.e. under normal circumstances the procedure would be performed in the doctor’s rooms). This certificate is to be signed by the admitting doctor giving medical reasons as to why the procedure is required to be performed in hospital. TYPE B CERTIFICATES: When a patient is admitted for a same day procedure and for medial reasons is required to stay overnight, the admitting doctor is responsible for signing/completing both a ‘Day Only Certificate’ plus an ‘Overnight (Type B) Certificate’. Fund Benefits & Patient Services New Doctor’s Orientation Manual 29 HELP TEAM VOLUNTEERS SERVICES The Help Team Volunteers since inception 5 years ago have become an important part of the Hospital. There are over 320 Help Team Volunteer members who provide valuable assistance in most departments of the Hospital. They undertake work that assists nurses as well as in other departments of the Hospital. Help Team Volunteer members have assisted in reducing some of the stresses in nursing by relieving staff in non-medical duties. The Help Team also run the San Snax, a café which all proceeds go back to the hospital. Help Team Volunteer members come from all walks of life with many being a former patient in the Hospital. Some medical professionals have recommended clients join the Sydney Adventist Hospital Help Team Volunteers as a way of expanding their life’s interests. LOCATION 4th floor next to Maternity Services ENQUIRIES Phone: 9487-9895 Help Team Volunteers New Doctor’s Orientation Manual 30 HOSPITAL IN THE HOME (HITH) SERVICES HITH provides acute medical care to people in their own home (or nursing home) as an alternative to acute hospital admission or prolonged hospital stay. The service provides 24/7 care and support for the patient and their carers. In the trial phase, patients falling under the following criteria can participate in the pilot service: Those requiring IV antibiotics for long or short term infections Anticoagulation for peri operative requirements or for uncomplicated thrombo -embolic disease Complex wound care During the trial phase referrals will be taken from Emergency Care, Specialists and the wards. The permanency of the service will be determined at the trials end in April 2005. ENQUIRIES Please contact Dr Suhan Baskar (via the Hospital Switch Board) Hospital in the Home (HITH) New Doctor’s Orientation Manual 31 HUMAN RESOURCES SERVICES The Human Resource department of Sydney Adventist Hospital is responsible for the people strategy of SAH. This includes such things as: Attraction and retention of staff Staff benefits Payroll Safe work environment Staff health Learning and Development Employee assistance programs Reward and recognition program Sydney Adventist Hospital is committed to caring for all employees by providing a safe, caring and supportive work environment. To assist in this process, policies have been implemented in relation to: A safe work environment Safe operating procedures Harassment and violence free workplace The Director of Human Resources is also the Privacy Officer at SAH. ENQUIRIES Human Resources is always interested in hearing from AMO’s . Please contact the Director of Human Resources on Phone 02 9487 9220 or email [email protected] Human Resources New Doctor’s Orientation Manual 32 INFECTION CONTROL PROGRAM CONTACT DETAILS All enquiries should be directed to: Infection Control Coordinator Tel: 9487 9732 Mobile 0406 468 470 Clinical Nurse Consultant Tel: 9487 9433 Mobile: 0406 752 685 INFECTION CONTROL & STAFF HEALTH LANYARD RESOURCE CARD A combined Staff Health Needle Stick Injury / Body Substance Exposure & Infection Control ‘Quick Reference to TBP’ Tag are available to all Doctors to attach to their ID Lanyards, from the Medical Liaison Officer or the Infection Control Dept. The cards also contain contact phone numbers. INFECTION CONTROL DEPARTMENT INFORMATION 2 full-time staff – Monday to Friday 0800 to 1600. Corporate focus – consults with all departments throughout SAH Ltd, including San Day Surgery Hornsby. Report to the Director of Risk Management. Liaises with the Infectious Disease Consultant Physician. Quarterly Infection Control Committee meetings (multi-disciplinary). Submit 6 monthly ACHS Clinical Indicators including specific Surgical Site Infection (SSI), Central Line Associated Bacteraemias (CLABs) and MRSA Rates. Other SSI rates reported monthly to Theatre Manager. Infection Control Policy & Procedure Manual available on the Intranet. After-hours contact via the Duty Managers. INFECTION CONTROL ADMISSION POLICY SAH has an Infection Control Admission Policy available on the Intranet. To reduce the risk of infection to other patients, staff and visitors, and to ensure that the appropriate room is allocated for the patient being admitted, the following MUST occur – The Infectious Risk section on the SAH Booking Form MUST be completed. The Booking Office is to be advised by the doctor when requesting admission for, o o o o o A patient who is a transfer from another hospital (if the admission > 48 hours). A patient who has been admitted to a hospital within the last 6 months (excluding SAH). A patient is from a nursing home. A patient has a confirmed history of a Multi-Resistant Organism (MRO) e.g. MRSA, VRE, ESBL, MRAb. Any patient diagnosed or potentially infected with CJD. Infection Control New Doctor’s Orientation Manual 33 o Any other known or suspected infectious condition including infectious wounds, TB, Varicella, Shingles, Meningococcal or any other transmission based infection. To ensure correct procedure list scheduling can occur, correct admission information regarding a patient’s known or suspected infectious status is of high importance to reduce list delays. The Infection Control Department may also be contacted about any queries regarding the infectious status of a patient with regard to their admission. MRSA MRSA Pre-Admission Screening Should be performed preferably through the SAH Pre-Admission Clinic. If performed in doctor’s rooms, results are to be faxed through to Infection Control and / or Booking Office. Cardiac Surgery Orthopaedic Prosthetic Joint Replacement Surgery should not take place until MRSA screening results are known. MRSA On-Admission Screening High-Risk MRSA patients are screened either prior to or on presentation to SAH e.g. Emergency Care Dept. OR, if booking patient for transfer from another hospital, if possible the transferring hospital should perform the MRSA screening and fax results through to SAH. High-Risk patients include Transfer from Nursing Home Transfer from other Hospital (if admission > 48 hours in the other hospital) Re-admission to hospital within 6 months of discharge. Chronic Wounds and indwelling devices. IC Coordinator can be contacted to discuss any pre-admission queries regarding known or suspected infectious patients. MRSA & Other Multi-Resistant Organisms (MROs) Patients Any history of MRSA or other Multi-Resistant Organism (MRO) must be documented on the Booking / Referral Letter Vancomycin can only be used as routine antibiotic prophylaxis for previously known or newly positive MRSA patients with documented pathology result e.g. from pre-admission screening. OR, after consultation with an ID Physician. MRO’s include but are not restricted to, - Methicillin Resistant Staphylococcus aureus - MRSA - Vancomycin Resistant Enterococci - VRE - Vancomycin Intermediate Resistant Staphylococcus aureus - VISA - Multi-Resistant Acinetobacter baumannii - MRAb - Extended Spectrum Beta Lactamase organism – ESBL - Multi-Resistant Pseudomonas aeruginosa - MRPA All MRO patient electronic records are flagged with an infectious risk alert ®. Infection Control New Doctor’s Orientation Manual 34 Due to the ability of MRO’s to colonise patient’s for indefinite periods of time, all MRO patients - new or previously diagnosed, will be managed using CONTACT transmission based precautions for the entire duration of their admission and any subsequent admissions. MRSA & Other (MRO) Status Clearance 1 clear swab DOES NOT qualify a patient to be cleared of their MRSA or other MRO status. Patient’s can only be officially CLEARED of their MRSA & MRO status by Infection Control staff, or the Infectious Disease Physician. The IC Dept must be contacted to discuss any clearance of a patient’s MRSA or other MRO status PRIOR to MRSA clearance screening commencing PROCEDURE LIST SCHEDULING OF INFECTIOUS RISK PATIENTS If possible, to reduce the risk of infection to other patients it is SAH Policy to schedule, AT RISK PATIENTS (immuno-compromised) – FIRST on the list. KNOWN OR SUSPECTED INFECTIOUS PATIENTS (MRSA, other MRO and other infectious conditions) – LAST on the list. Procedure lists include – Operating Theatres, Cardiac Cath Lab, Endoscopy, Radiology, Wound Clinic, Radiation Oncology, Physiotherapy and any other list that involves multiple patients on the same day. HIV, HEPATITIS B & HEPATITIS C TESTING OF PATIENTS All doctors who perform HIV, HEP B & C testing must comply with the NSW Health Policy Directives available on the NSW Health Website; HIV Testing – Counselling Guidelines PD 2005_048. HIV Confidentiality: A Guide to Legal Requirements PD 2005_134. There is currently NO qualified Sexual Health, HIV or Harm Minimisation Nurse Consultant employed at SAH to perform Pre & Post Test Counselling, Consenting or Out-patient Services and follow-up. All patients who are tested for HIV, HEP B & C must have Pre & Post Test Counseling and consenting performed by a doctor or qualified staff member who has completed the accredited training prior to blood collection. In the event of a positive result, the patient must be fully informed in person and counselled by the doctor who ordered the HIV, HEP B & C testing. The patient must then be referred to an ID Physician for management and follow-up. HAND HYGIENE Hand Hygiene includes either hand washing with soap and water or the use of an alcohol based hand gel / rub. Hand hygiene must be performed - Before and after any direct patient contact - After contact with a contaminated surface / item. - On entering or exiting from an isolated, known or suspected, infectious patient’s room - Before donning and after removal of gloves. Infection Control New Doctor’s Orientation Manual 35 At SAH, alcohol based hand gel is available on entry into all patient rooms to facilitate easy hand hygiene when hands are not visibly soiled. All non-intact skin such as abrasions, lesions & cuts must be covered with an occlusive dressing. STANDARD PRECAUTIONS Standard Precautions (previously known as Universal Precautions) are the minimum accepted level of infection control and must be practiced with all patients regardless of their diagnosis or presumed infectious status. Standard precautions includes: hand hygiene and the wearing of the appropriate personal protective equipment (PPE) whenever there is a likelihood of contact with or splashing of; blood, all body substances (except sweat), non-intact skin and mucous membranes. Types of PPE include – gloves, eyewear, masks, gown or aprons. TRANSMISSION BASED PRECAUTIONS Transmission Based Precautions (TBP) are implemented for any patient with a known or suspected infectious condition. Patients are isolated according to the mode of transmission of the microorganism. At SAH, known or suspected infectious patients are easily identified by; A colour coded ‘PATIENT PROTECTION’ poster that will be displayed on the wall outside the patient’s room. The colour coding corresponds to the type of transmission-based precautions that have been implemented. Refer to your Infection Control ‘Quick Reference to TBP’ lanyard tag A trolley with the correct PPE to be worn and alcohol based hand gel / rub will also be outside the room. All staff, including doctors, MUST comply with the relevant transmission based precautions, wear the correct PPE and perform hand hygiene for any known or suspected infectious patient. An Infectious Risk Code appears on all patient lists. TYPE OF PRECAUTION ‘PATIENT PROTECTION’ POSTER CONTACT PINK INFECTIOUS RISK CODE C DROPLET GREEN D AIRBORNE ORANGE A STRICT – combination of all 3 above. BLUE S Multi Resistant Organism (MRO) PINK ® NEUTOPENIC NAVY BLUE N OTHER INFECTIOUS RISKS Staff and Patient Information Fact Sheets about each of the infectious conditions are available for printing on the Intranet in the Infection Control Policy & Procedure Manual. Infection Control New Doctor’s Orientation Manual 36 INFORMATION TECHNOLOGY Electronic communication of patient clinical and administrative information between the SAH and clinicians continues to grow in importance. Within the SAH, information security is a high priority. When we provide information in an electronic format, the Hospital expects that doctors and their staff will endeavour to maintain the confidentiality and integrity of the information – avoiding unauthorised disclosure – and treat the information as if it were presented on paper. It is important for all recipients of SAH data to store and use information with care to protect patients’ legislated rights to privacy. The SAH provides comparatively unrestricted access for AMOs to patient information for the purpose of providing care and consultation. Doctors should be aware that access to patient information may be logged and that the logs may be audited for security reasons. AMOs should restrict their access to information for patients in whose care they have a recognised interest. Transmission of information via the Internet – particularly through Email – is inherently insecure. The Hospital requires secure authentication and encryption of data for this communication channel. Clinicians are advised to make use of encrypted Email and strong virus protection. Clinicians must apply their own judgement as to the completeness, currency and accuracy of all information received electronically. Internal Email provided as a free Web service should not carry any patient data or other sensitive information. The SAH has an Acceptable Use Policy for minimising threats to the security of Hospital information systems assets and threats to the information itself. We strongly advise doctors (and staff) who communicate with the hospital electronically via the Internet, to read our Acceptable Use Policy and to ensure that their own systems – including portable and home computers and computers used by others – are adequately protected from external threats. The SAH Internet gateway restricts access to inappropriate sites and prevents high risk downloads. All Internet use via the SAH gateway is logged and reviewed and unacceptable use may result in withdrawal of access rights. FURTHER INFORMATION For further information please contact the IT Department on 9487 9777. Infection Control New Doctor’s Orientation Manual 37 INTENSIVE CARE BOOKINGS AND ENQUIRIES Bookings to Nursing Unit Manager/Secretary on 9487 9691 LOCATION Level 5 Main Building SERVICES The Intensive Care Unit is a Unit consisting of twelve beds. The department is staffed with skilled nursing and medical personnel, and equipped with state of the art technology for the management of patients with life-threatening or potentially life-threatening conditions. The department has 24 hour Intensive Care medical cover by a qualified Intensive Care Specialist and Intensive Care CMO. Intensive Care New Doctor’s Orientation Manual 38 LIBRARY The Library is located on Level 2. ENQUIRIES Phone Desk Head Librarian Email Fax 9487 9636 9487 9639 [email protected] 9487 9635 HOURS Monday Tuesday – Thursday Friday 8:00am – 6:00pm 8:00am – 9:00pm 8:00am – 3:00pm SERVICES Telephone enquiries. Books on 14-day loans. DVDs on 7-day loans. Medline, CINAHL and Cochrane databases. Literature searches on request. Internet and photocopying facilities. Inter-library loans of books and copies of journal articles may be requested. Michael Rigby Head Librarian Library New Doctor’s Orientation Manual 39 MATERNITY UNIT BOOKINGS - Mon - Fri 7.30am - 4pm Maternity bookings may be made by phoning 9487 9908 to make 30 min appointment with Maternity Sister. MATERNITY SISTER AVAILABLE Monday & Friday 9:30am – 12 midday & 1:00pm – 4:00pm Tuesday, Wednesday & Thursday 2.30pm– 5:00pm & 6:00pm –8.30pm Please note that bookings are taken only from patients referred by accredited obstetricians. SERVICES Pre-Natal Classes prepare prospective parents for labour, childbirth and parenting. Classes are run over 5 weeks and are generally designed for first time parents. See Maternity Pre-Admission Guide for details of this course. Start of 5 week course is around 28-30 weeks gestation. We also offer Sunday classes run over 2 Sundays for 4 hours each day. Baby care and Breastfeeding classes - Aimed for 35 weeks gestation. These are practical sessions on settling, bathing, safety, nappy changing and breastfeeding. A lactation specialist is available seven days per week for inpatients and Monday to Friday to see outpatient mothers with feeding problems. Phone 9487 9460. Also available for up to 6 weeks after birth. If returning as an outpatient, a fee is charged. An appointment is necessary for outpatient visits. In hospital there is 7 day cover for Lactation Specialist and patients are seen routinely on day 2 by a Lactation Specialist. Postnatal Classes – Run Monday – Friday at 10:30am for inpatients. Topics include settling, breastfeeding, expressing and storing breast milk, parenting and going home with baby Level 2A Special Care Nursery – The special care nursery is for premature, small and unwell babies. It has 14 accredited beds and full monitoring facilities including short-term ventilation. All babies less than 32 week gestation are transferred in utero where possible to a tertiary institution. OTHER SERVICES AVAILABLE SanBabies Photography SanBabies Online Nursery Physiotherapy Prenatal Aqua Classes Postnatal Fitness Classes In 2007, 1% of babies born at SAH required extra care in the form of long term ventilation, surgery or tests not available at SAH, so were transferred for further management to other hospitals with neonatal intensive care units. Older neonates (up to 28 days) are occasionally admitted to the special care nursery following initial discharge from hospital if they become sick and require cardiac/respiratory monitoring Maternity Unit New Doctor’s Orientation Manual 40 SAH MARKETING, PUBLIC RELATIONS & BUSINESS DEVELOPMENT DEPARTMENT SERVICES DEPARTMENT CONTACT DETAILS: Director of Marketing, PR & Business Development Ms. Julie Behrens Manager of Marketing & PR Ms. Jan Figtree Corporate Communications Specialist Ms. Leisa O’Connor Events Coordinator Mr. Marcus Fehlberg Marketing & Business Development Officer Ms. Sharlene Martin Marketing, Public Relations & Business Development Department 9487-9874 9487-9872 9487-9416 9487-9415 9487-9765 9487-9871 BUSINESS DEVELOPMENT Key functions of the SAH Business Development Unit include strategy development, process improvements, and identifying / investigating business opportunities and ideas for development of existing and new services. If you have any ideas or suggestions for strategy and service development / improvements at the San please feel free to contact the Director of Marketing, PR & Business Development. MARKETING & PUBLIC RELATIONS The Marketing & Public Relations team serves to protect and enhance the reputation of the hospital and to promote hospital services, facilities and expertise to all stakeholder groups including the community, doctors, patients, and staff. Activities are planned on an annual basis and as required to support achievement of SAH corporate objectives. The Marketing and PR activities and their implementation are designed to comply with relevant business, marketing, and privacy laws. The following is a list of SAH Marketing and PR Services of interest to doctors: FILMING & MEDIA REQUESTS Sydney Adventist Hospital is keen to raise its public profile by publicizing innovative or exceptional medical procedures and achievements carried out by our specialists within the limits of our responsibility to staff and patients in regard to their privacy. If you are aware of any medical activities that may be newsworthy, please contact the Corporate Communications Specialist. Please Note: All potential media and commercial filming activity must be reviewed by the Corporate Communications Specialist / Marketing & PR Manager with final approval required from the CEO. At least one week’s notice to Marketing & PR of any planned activity is required. SAH LOGOS, IMAGES & BRANDING Sydney Adventist Hospital has strict guidelines governing the use of its logos and hospital images. The name “Sydney Adventist Hospital”, and associated brand names “The San” and “San”, as well as the hospital logo are trademarks, and must not be used without the prior written permission of SAH. Requests to use any of the hospital’s logos or images must be directed to the Marketing & Public Relations Manager. Requests regarding use of brand names should be directed to the Director of Marketing, PR & Business Development. Marketing New Doctor’s Orientation Manual 41 SAN DOCTOR This is an educational publication produced by the hospital five times per year and sent to approximately 1100 GPs in our catchment area. Each edition provides the opportunity for three San Specialists to contribute an article of their choice. This has been a popular publication for many years and is very well received. If you are interested in contributing an article, please contact the Corporate Communications Specialist. EDUCATIONAL ACTIVITIES A number of educational activities are organized each year for both GPs and the Community. These include: GP Conferences These conferences are offered to GPs approx 5 times per year on different specialities nominated by them. Each conference is accredited by the RACGP for 4 CPD points and usually attracts 60 – 100 GPs. Public Forums Two Public Forums are offered to the community each year with different topics presented by Specialists. They are very well received attracting about 80 members of the general public to each event. If you are interested in providing an educational presentation at one of these events, please contact the Events Coordinator. Focus Groups The marketing team facilitates a number of focus groups with patients & doctors each year to gain feedback regarding our services and identify areas for innovation or improvement. If you would like to contribute to this type of information or participate in one of the doctor focus groups, please contact the Marketing & Business Development Officer. SAN SPECIALISTS AND SERVICES DIRECTORY This publication is produced every 12 to 18 months, incorporating those doctors who regularly use SAH services or are new to SAH, and have agreed to be part of the publication. Please notify the Marketing & Business Development Officer if you need additional copies or have changes to your details for inclusion in the next edition. SYDNEY ADVENTIST HOSPITAL WEBSITE www.sah.org.au The current hospital website is undergoing major redevelopment. If you have any suggestions to improve the value and usability of the site for doctors please contact the Marketing & Business Development Officer. BUSINESS CARDS Marketing & Public Relations organizes business cards using the standard hospital template for doctors who are employees of the hospital only. Doctors who are not employees requiring business cards will be required to have them developed externally. Marketing New Doctor’s Orientation Manual 42 MARKETING & ADVERTISING The marketing team promotes hospital services, facilities, collective expertise and accomplishments through a number of avenues including media, advertising and awareness campaigns. Please note: Under current marketing laws the hospital is not able to promote individual doctors or groups of doctors. All SAH advertising must be reviewed by the Marketing & PR Manager and approved by the CEO. GENERAL ENQUIRIES For general enquiries regarding Marketing, Public Relations & Business Development at Sydney Adventist Hospital – please contact the Administrative Assistant on 9487 9871. Marketing New Doctor’s Orientation Manual 43 MEDICAL RECORDS FUNCTIONS OF THE MEDICAL RECORDS DEPARTMENT Storage, maintenance and protection of patient records and the information contained within them. Prompt retrieval and supply of patient records for continuing care. Provision of medical information to approved bodies and authorized persons. Coding of diseases and procedures for all inpatient episodes of care and provision of DRGs for billing purposes. Completion of cancer notification forms. Participation and cooperation in research and quality management projects involving patient records and information. Maintenance of death register. Provision of coded clinical data to Health Funds, Department of Health and Private Hospital Data Bureau. Consultation on all matters pertaining to patient records. RELEASE OF INFORMATION All information in a patient’s medical record must be treated as confidential. The record is the property of the Hospital, however, patients have a right of access to the information they contain. The Medical Record Department follows the guidelines set down by the Privacy Act 1988/Privacy Amendment (Private Sector) Act 2000, Information Privacy Code of Practice (NSW Health 1998) and the Private Hospitals Regulation 1996 when responding to requests for information. Bev Summerville Medical Records Manager Medical Records New Doctor’s Orientation Manual 44 NUCLEAR MEDICINE Northern Nuclear Medicine is an independently run private practice that provides a comprehensive range of diagnostic and therapeutic nuclear medicine services, together with bone densitometry, at Sydney Adventist Hospital. A second practice is located in Ryde Medical Centre, adjacent to Ryde Hospital. There are two modern gamma camera and computer systems and a new DEXA bone densitometry machine located at Sydney Adventist Hospital. SERVICES A wide range of diagnostic and therapeutic services is provided to both in-patients and outpatients. This includes: Stress SestaMIBI myocardial perfusion studies (with exercise, persantin or dobutamine) Bone scans – for stress or occult fractures, bony metastases, arthritis etc Lung scans – for pulmonary embolism Biliary/gall bladder/HIDA scan – for evaluation of acute or chronic cholecystitis Renal scans – for evaluation of obstruction, renal artery stenosis Thyroid scans – for evaluation of thyrotoxicosis Parathyroid scans – for evaluation of hyperparathyroidism Gallium scans – for evaluation of lymphoma, and occult infection Lymphoscintigraphy and sentinel lymph node localisation for breast cancer and melanoma Bone densitometry measurements for detection of osteoporosis I-131 treatment for thyrotoxicosis and thyroid cancer Strontium 89 treatment as palliation for painful prostatic bone metastases Most studies do not require any preparation, apart from stress SestaMIBI myocardial perfusion studies, biliary scans, and some renal scans. Patients are informed of any special preparation required. STAFF Specialist Nuclear Medicine Physicians assess patients, supervise their scans and report the studies. Experienced Nuclear Medicine Technologists perform the scans and a Registered Nurse assists the doctor in the stress laboratory. The two principal Nuclear Medicine Physicians of the practice are: Dr John Burke (MBBS FRACP) who was the Director of Nuclear Medicine at St George Hospital prior to establishing the nuclear medicine service at Sydney Adventist Hospital in 1983. In the subsequent years he has been instrumental in developing and expanding the service. Dr Burke’s special interest is thyroid disorders. Dr David McHarg (BSc MBBS FRACP) has been a Staff Specialist at Royal Prince Alfred Hospital and Royal North Shore Hospital. Dr McHarg joined the practice in 1996, and oversaw the introduction of lymphoscintigraphy and sentinel lymph node localisation procedures in 2001. Nuclear Medicine New Doctor’s Orientation Manual 45 REFERRAL & FEES A GP or Specialist referral is required for all nuclear medicine diagnostic and therapeutic services. Out-patient services are rebated, in-part, by Medicare. Thus for most patients there is a “gap” payment. Fees for eligible Repatriation patients are paid by the Department of Veteran Affairs. In-patient services are rebated, in-part, by Medicare and the Private Health Funds, and thus there is usually still a small gap payment. Some funds offer a no gap product for these services. LOCATION In July 2003 Northern Nuclear Medicine moved to the new, large, purpose built Suite 306 on Level 3 of the new San Clinic, located at the Hospital. Parking (at a nominal fee) is available within the San Clinic building itself, with easy lift access to Level 3. The suite is located immediately adjacent to the café. HOURS OF OPERATION Monday to Friday: 8:00am – 5:00pm. The department provides an after hours emergency lung scan service to Hospital patients only. The requesting doctor can arrange this with the on-call nuclear medicine doctor, whose number can be obtained from the Hospital switchboard. FURTHER INFORMATION AND APPOINTMENTS An appointment is required for all procedures (please note that faxing a referral does not constitute the arrangement of an appointment). For further information or to make an appointment, please contact Northern Nuclear Medicine on (02) 9473 8750. Nuclear Medicine New Doctor’s Orientation Manual 46 SAN NUTRITION Dietitians are an important part of Sydney Adventist Hospital’s multidisciplinary team. San Nutrition Dietitians apply the science of human nutrition, combined with food knowledge and communication skills, to help patients achieve good health through eating well. INPATIENT SERVICES If your patients are admitted to Hospital and require specialised dietary management, one of our Clinical Dietitians will assess their needs and plan their nutritional care accordingly. Patients will be guided in the choice of appropriate foods to suit their medical requirements and lifestyle. OUTPATIENT SERVICES Our Outpatient Dietitian provides individualised attention and nutrition guidelines to a wide range of patients. We can also help with dietary problems including but not limited to the following: Weight management Lowering cholesterol levels Diabetes Renal disease Healthy eating for all the family Vegetarian eating We provide a full dietary assessment of ones food intake using an advanced computer program as well as individual consultations. Our Outpatient Dietitian is also available for group nutrition education talks in the community. OTHER ACTIVITIES Our Dietitians are involved in the education of nursing, general staff and community groups in current aspects of nutrition and diet therapy. They participate in teaching dietary sessions in courses run by the Cardiac Rehabilitation and Cancer Support Centre. Other sessions include: Introducing Solids to Babies Weight Management Vegetarian Cooking REFERRALS A written doctors referral is preferred to ensure appropriate dietary recommendations, however is not essential. Fees may be partially reimbursed by most private health funds. Pensioner and staff rates are also available. Medicare will now pay a rebate for services provided by Dietitians treating complex conditions under a care plan coordinated by a GP. This rebate service is for the treatment of medical conditions that have been present or are likely to be present for at least six months, and include diabetes, heart disease, asthma, cancer, kidney disease and other illnesses. Nutrition Services New Doctor’s Orientation Manual 47 LOCATION San Nutrition Dietitians are located on Level 4 of the Hospital near the Food Services Department. FURTHER INFORMATION AND APPOINTMENTS Our Outpatient Dietician is available for appointments from 8:00am to 5:00pm. Out-of-hours appointments may be arranged. Please call (02) 9487 9581 to arrange an appointment to suit your patients’ needs or email [email protected]. Nutrition Services New Doctor’s Orientation Manual 48 PAEDIATRIC SERVICES EMERGENCY SERVICES State-of-the-art Emergency department with two dedicated rooms for paediatric patients. Emergency Care is open 24 hours / 7 days a week. Full range of diagnostic services PAEDIATRIC SURGERY & HOSPITAL STAY We offer no waiting times for paediatric surgery. Paediatric Ward 9487-9656 Sydney Adventist Hospital’s Paediatric and Adolescent Ward is a 16-bed ward staffed with experienced and friendly paediatric nurses. We offer Children’s Menus, entertainment facilities and a playroom dedicated to our young patients. Bookings to Hospital Bookings Office 9847 9908 Paediatric surgery orientation program A special paediatric orientation is offered for children undergoing surgery to help prepare them for theatre. During the orientation children have the opportunity to visit the Hospital, meet the friendly nursing staff of the Paediatric and Adolescent Ward and become familiar with the environment. Orientation is fun and highly recommended! Family-centred care To promote speedy recovery, parents may stay with their child at all times –even overnight. It's not essential, but we do encourage it. Parents may escort their child to theatre and sit with your child in recovery. We provide foldout beds for parents with tea and coffee available on the ward. Parent meals can also be organised through Food Services or visit any of the hospital’s three eateries, including SanSnax, San Café, or Relish. Accomodation Parents coming from a long distance can also arrange to stay at Jacaranda Lodge, motel style accommodation located on the Hospital’s grounds. Phone: 9487-9066 SAN CHILDREN’S SLEEP DISORDER UNIT A sleep disorders unit, especially for kids, was opened at Sydney Adventist Hospital on Monday 19 February 2001 – the first private unit of its kind for children in Australia. Sleep disorders are a common childhood problem. The unit offers a specifically designed paediatric sleep monitoring system for use on children with conditions ranging from problems with tonsils and adenoids to sleep apnoea. The San Children’s Sleep Disorders Unit operates 5-6nights/week (Sun - Thurs & occasionally Sat) Sleep Technicians all paediatric trained. Please call 9487- 9669 if you would like more information. Bookings must be made through Hospital Bookings Office on 9487 9908. Paediatric Services New Doctor’s Orientation Manual 49 ADDITIONAL SYDNEY ADVENTIST HOSPITAL SERVICES We also offer a number of outpatient services that may be needed by you or your child, including: Pathology Radiology Nutrition Counselling Physical therapy Occupational therapy For additional information on any of these services please contact SAH at 9487-9111. Paediatric Services New Doctor’s Orientation Manual 50 PARKING FOR DOCTORS Emergency only Doctors parking is available close to the Hospital main entrance. There are only 14 dedicated parking places for doctors on the ring road at the front of the Hospital. These are available for a maximum of 2 hours and are not to be used for longer stays. Authorised Doctors parking for longer durations is available in the main car park. For further enquiries please contact the Security Department on 9487 9988. Parking for Doctors New Doctor’s Orientation Manual 51 PATHOLOGY The Sydney Adventist Hospital Pathology Laboratories - “San Pathology”, offers a comprehensive Pathology service to GP and Specialist-referred outpatients, as well as Hospital inpatients. Our full service Laboratory is accredited by the National Association of Testing Authorities (NATA) to ISO 17025 (which incorporates the elements of ISO 9000). San Pathology has been accredited by NATA (Facility number 1924) longer than any other medical laboratory in Australia. The Pathologists at San Pathology welcome calls from Physicians. They are accessible every day (and out of hours in urgent cases). Dr Suzanne Danieletto, MBBS BSc FRCPA, is the Senior Supervising Pathologist with a special interest in breast pathology. Dr Ross Bradbury, MBBS FRCPA FRACP, a consultant specialist Microbiologist who supervises the Microbiology laboratory. Dr Fay Chambers, MBBS FRCPA, specialises in surgical pathology with a special interest in Dermatopathology, Gastrointestinal pathology and teaching. Dr Eva Fong, MBBS FRCPA, specialises in surgical pathology, and has a special interest in Clinical Biochemistry. Dr Monica Peduto, MBBS FRCPA, specialises in surgical pathology with a special interest in Dermatopathology and Gastrointestinal pathology. Dr Jennifer Posen, MBBS FRCPA FRACP, a consultant specialist Haematologist, also supervises the Haematology laboratory and the Blood bank. Dr Richard Suggit, MBBS FRCPA, specialises in surgical pathology and is extensively experienced in all areas of Histology. To speak with a pathologist, call: Normal hours 1800 009 500, Out of hours (02) 9487 9500 SERVICES Blood banking including an Autologous Blood Donation service; Clinical Biochemistry, which offers a comprehensive test menu; Haematology including Flow Cytometry; Histopathology and Cytology reported by senior specialist Pathologists. Immunoassay, which enjoys an enviable reputation for reliable hormone analysis, with same day turn-a-round of results; Microbiology, proud of its reputation for thorough and complete investigations; Serology with same day turn-a-round of results including HIV Umbilical Stem Cell processing and storage Pathology New Doctor’s Orientation Manual 52 MAIN LABORATORY CONTACT DETAILS For Results and Test Information/Requests Normal hours 1800 009 500 Out of hours (02) 9487 9500 Fax (02) 9487 9535 To contact a Pathologist: Normal hours 1800 009 500 Out of hours (02) 9487 9500 (Please provide your name and contact number and a Pathologist will call you) To contact the Laboratory Director, Dr Bevan Hokin: Normal hours (02) 9487 9511 Out of hours 0414 516 114 To contact the Customer Services Coordinator, Linda Ayers: Normal Hours 1800 009 500 Out of hours 0414 879 496 To contact the Pathology Liaison Officer, Dian Kazandjian: Normal Hours 1800 009 500 To order collection consumables, courier pick up and Pathology request pads: Normal Hours 1800 009 500 E-mail: [email protected] COLLECTION CENTRE LOCATIONS AND HOURS Appointments not necessary except for: Glucose Tolerance Tests and Shillings Test. ECGs are available at all collection centres except Wahroonga Specialist Centre. Holter and blood pressure monitoring available at a number of collection centres, may be booked through the San Clinic collection centre. MAIN LABORATORY Discounted parking of $3.00 for Pathology patients. Please ask staff to validate parking voucher. Level 5, Sydney Adventist Hospital, 185 Fox Valley Road, Wahroonga 2076 Hours: 8:00am to 6:00pm. Open 24 hours, 7 days a week for urgent testing. Normal hours 1800 009 500 Out of hours (02) 9487 9500 Fax: (02) 9487 9535 SAN CLINIC Available for all outpatient testing. Easy access via lifts from undercover San Clinic car park, with discounted parking of $3.00 for Pathology patients. Please ask staff to validate parking voucher. Suite 305, Level 3, 185 Fox Valley Road, Wahroonga 2076 Hours: 8:00am to 6:00pm, Monday to Thursday 8:00am to 5:00pm, Friday Phone: (02) 9473 8858 Fax: (02) 9473 8855 Pathology New Doctor’s Orientation Manual 53 WAHROONGA SPECIALIST CENTRE Easy access, no parking fee. Suite 12, 176 Fox Valley Road, Wahroonga 2076 Hours: 8:30am to 5:30pm, Monday to Thursday 8:30am to 5:00pm Friday Phone: (02) 9489 5626 Fax: (02) 9489 0045 HORNSBY Level 1, 51 Palmerston Road, Hornsby 2077 Hours: 8:30am to 5:00pm, Monday to Thursday 8:30am to 4:30pm, Friday Phone/Fax: (02) 9482 2810 ST IVES Shop 127B, St Ives Shopping Village (Opposite Medical centre) 166 Mona Vale Road, St Ives 2075 Hours: 7:30am to 4:00pm, Monday to Friday 8:00am to 12:00 pm, Saturday Phone: (02) 9440 1534 Fax: (02) 9440 1936 TURRAMURRA Shop 2, 5-7 Rohini Street Turramurra 2074 Hours: 7:30am to 4:30pm, Monday to Friday Phone: (02) 9449 8972 Fax: (02) 9449 9576 BONNELLS BAY Bay Shopping Village, Fishery Point Road, Bonnells Bay 2264 Hours: 8:00am to 6:00pm, Monday to Friday 8:30am to 12:00 pm, Saturday Phone: (02) 4973 5846 Fax: (02) 4973 5847 MORISSET/COORANBONG Shop 4, 89 Dora Street, Morisset 2264 Hours: 8:00am to 5:30pm, Monday to Friday Phone: (02) 4973 5755 Fax: (02) 4973 5595 Mobile: 0414 950 664 HOME COLLECTION SERVICE This service is available for ill or non-ambulatory patients. All house calls are bulk-billed To arrange home collection for suburbs surrounding Sydney Adventist Hospital, St Ives and the North Western suburbs, please call (02) 9487 9500 for routine or urgent requests. To arrange home collections in Morisset, Cooranbong, Dora Creek and Bonnells Bay please call (02) 4973 5755 for routine requests, or 0414 950 664 for urgent requests. . Pathology New Doctor’s Orientation Manual 54 PHARMACY The Sydney Adventist Hospital Pharmacy is located in the main foyer on Level 4 with the inpatient dispensary at the rear The pharmacy is staffed by a Business Manager, Chief Clinical Pharmacist and ten full-time equivalent pharmacists, supported by eight pharmacy technicians who work together to help further the SAH mission of serving our patients and the community. ENQUIRIES Pharmacy Phone Number: Pharmacy Fax Number: Pharmacy Business Manager: Pharmacy E-Mail Address: Retail Shop Number: 9487 9284 9487 9278 9487 9272 [email protected] 9487 9283 RETAIL SHOP HOURS Monday – Thursday Friday Saturdays Sundays Public Holidays 8:30am – 8:00pm 8:30am – 4pm CLOSED 9:00am – 5:00pm CLOSED After hours a pharmacist is on call for in-patients of the hospital only. OUT PATIENT DISPENSING The retail pharmacy offers a full PBS dispensing service, and can process general, concession, repat and private prescriptions in the same manner as other community pharmacies. The pharmacy also offers a 10% discount to accredited doctors on all OTC lines, as well as a discounted rate on private prescriptions. All accredited SAH Doctors are able to have a pharmacy account for purchases for themselves and their dependants. Accounts can be set up by contacting the pharmacy on 9487 9283. IN PATIENT DISPENSING As well as the general dispensing of medications for in-patients, the pharmacy is also responsible for wards imprest supplies, parenteral nutrition preparations and IV fluids. The pharmacy will dispense medications for in-patient off a patient’s medication chart. This should be completed as per SAH Guidelines. Clincial Pharmacists perform daily medication reviews of patient charts, counsel patients on new medications, and provide a written discharge summary on most wards within the hospital. Clinical Pharmacists are available for consultation on medication dosages and interactions as needed. PATIENT’S OWN MEDICATIONS Patients are encouraged to bring into the hospital their own medications (including complimentary medications) from home, wherever possible. Patients may be asked to provide an Authority prescription for medications initiated prior to their admission to the hospital. Any documentation from their GP that can assist in ensuring that their medication regimen is maintained during their stay is also appreciated. Pharmacy New Doctor’s Orientation Manual 55 PHYSIOTHERAPY & AQUATIC PHYSIOTHERAPY In addition to providing the wide range of current physiotherapy and rehabilitation services necessary for an acute-care hospital, the Physiotherapy Department also offers the advantage of its long-established Aquatic Physiotherapy Unit. APPOINTMENTS Phone: 9487 9350 OFFICE HOURS Monday & Thursday Tuesday & Wednesday Friday 8:00am – 7:00pm 8:00am – 5:00pm 8:00am – 4:00pm SERVICE HOURS 8:30am – 10:00pm Monday – Thursday* 8:30am – 4:00pm Friday (* evening aquafitness classes and prenatal education - for outpatients only) 24 HOUR SERVICE AVAILABLE FOR INPATIENT CARE – 7 DAYS PER WEEK FEES (Note: Most inpatients are covered by their health fund for physiotherapy during their admission) Outpatient Physiotherapy fees are based on the recommended fee structure. Medicare does not cover physiotherapy but patients in private health funds may claim benefits, provided they are in a table which provides physiotherapy cover. The level of benefits payable varies from fund to fund. SERVICES Land and aquatic based services and classes for both inpatients and outpatients are available to treat conditions in the following areas: Back and neck pain or stiffness Headaches Shoulder, knee, ankle and other joint injuries Sports injuries and soft tissue injuries Rehabilitation following orthopaedic surgery Balance, mobility, deconditioning, falls Cancer treatment – including early intervention and education, lymphoedema treatment and exercise classes Education and exercise following breast surgery Women’s Health – including incontinence Pregnancy – Pre and Post Natal care Casting of fractures including water proof casting, Thermoplastic splinting (eg hand) Paediatric Talipes casting (Continued over page) Physiotherapy & Hydrotherapy New Doctor’s Orientation Manual 56 Acute and Chronic Respiratory conditions Work Cover, Motor Vehicle Accident (Third Party) and DVA Clients Additionally, a large supply of equipment is available such as crutches, specialised splints, braces and other items. FACILITIES, EQUIPMENT AND APPLICATIONS ELECTROTHERAPY Laser, ultrasonic, interferential, TENS, muscle stimulation (FES) and pressure pump. REHABILITATION Parallel bars, steps / stools, large neuro bed, Westminster pulleys, stationary bicycle, wobble board and Swiss balls. Hydragym exercise equipment. Continuous passive motion machine. Cybex (for upper limb). Duradisc. Profitter. Theraband. Mini-trampoline. Dumbells. All used to assist patient to return to pre injury condition or better. AQUATIC PHYSIOTHERAPY Pool – 9.2m x 4.5m – useful for re-education in musculoskeletal, orthopaedic and neurological conditions, such as: Chronic or recurrent back / spinal pain – excellent graded ‘core stability’ pool program to restore strength to these muscles General deconditioning – eg following prolonged bed rest, obesity or some progressive diseases ‘Acute’ and ‘irritable’ lower back conditions and some neck conditions Arthritic conditions – eg Osteoarthritis and Rheumatoid Arthritis Post-operative large joint replacements – eg post Total Knee Replacement Lower limb fractures where limited weight bearing status is required Post spinal fractures – eg thoracic wedge fractures or disease process such as osteoporosis The supportive water environment enables these patients to gain confidence with movement and enables appropriate strengthening and flexibility activities to commence early, thus reducing the risk of general de-conditioning due to immobility. This heated ozone filtered aquatic physiotherapy pool is considered one of Sydney’s best. Individual assessment and treatment is provided for many conditions. Clients may progress to an independent exercise program designed by their physiotherapist. Aqua fitness classes are also available, including specific classes for prenatal and post breast surgery clients. MANUAL AND OTHER TECHNIQUES Exercise – useful for strengthening and/or stretching of muscles, and mobilisation of joints Mobilisation and Manipulation – useful for increasing the range of movement in both peripheral and spinal joints Soft tissue techniques Postural education MISCELLANEOUS Heat and Ice packs – useful for reducing spasm and acute pain. Traction apparatus – useful for relieving nerve root pressure (stabilising fractures etc) Cast application equipment – thermo-plastics, fibreglass and Plaster of Paris available. DIAGNOSTIC PROCEDURES Respiratory – Spirometry (FEV, FVC) – assists in management of chest conditions. Physiotherapy & Hydrotherapy New Doctor’s Orientation Manual 57 EDUCATION/GROUP SESSIONS Pre-Natal Education – for new parents and refresher education sessions for subsequent pregnancies (offered in conjunction with Maternity department). Pre-Natal Exercise – Aqua fitness and Pilates (pre-natal specific group classes). Post Natal Exercise – Group sessions for getting back into shape after pregnancy. General Fitness – Aqua fitness classes for the general community. Get Fit to Ski Program – a great way to physically prepare for the snow season. Post Breast Cancer Surgery – Land and water based exercise groups. Ronelle Canavan Physiotherapy Manager Physiotherapy & Hydrotherapy New Doctor’s Orientation Manual 58 QUALITY CLINICAL REVIEW PROGRAM The Quality Clinical Review Program (QCR) was introduced to the Sydney Adventist Hospital in February 1997. It operates as an independent department under the direction of an appointed medical officer with the aim of promoting the peer review process. The program provides a systemic, ongoing reviewing approach not only focusing on patient outcomes but also on the multi dimensional systems that can cause adverse events and subsequent poor outcomes to occur. Issues identified by the QCR process are presented as case summaries to the relevant clinical departments for peer review or for educational purposes. Responses to the issues identified are then presented to a multi disciplinary committee. Information and results are fed back to the organisation under the committee structure, accumulated data studies and annual report findings. The committee operates under qualified legal privilege, which has been granted under division 6B of the Health Administration Act – 1982. LOCATION The QCR department is situated on the ground floor of the Foundation Building. OFFICE HOURS Office hours are from 08:00 – 16:30 Monday to Thursday. FURTHER INFORMATION Phone: (02) 9487 9743 Fax: (02) 9487 9745 E mail: [email protected] Maria Romeo Coordinator Quality Clinical Review Quality Clinical Review Program New Doctor’s Orientation Manual 59 RADIATION ONCOLOGY CENTRE BOOKINGS & ENQUIRIES Phone: 9487 9300 Facsimile: 9487 9303 HOURS Monday to Friday, 7:30am – 5:00pm SERVICES 2 Megavoltage Radiation Therapy Treatment Units (2 Linear Accelerators – one with dual energy modality) 1 Treatment Simulator 1 Computerised 3 Dimensional (3D) Treatment Planning System The first visit is usually a consultation only with the Radiation Oncologist. If Radiation Therapy is indicated, a further appointment is arranged for a planning CT at the Radiology Department, then treatment planning on the Simulator. After simulation is completed there is a week delay before treatment actually begins. This allows for customised 3D planning and dose calculation, which the Radiation Oncologist approves. Treatment is usually for five days per week and a course of radiation therapy varies from two weeks to six or seven weeks depending on the condition being treated. TRANSPORT The Radiation Oncology Centre can be reached by train from Pennant Hills, Hornsby or Turramurra stations and then a bus to the Hospital. Bus timetables are available from the Radiation Oncology Centre. Patients who have transport problems are referred to the Social Work Department for assistance. Veterans If approval has been received from the Department of Veterans’ Affairs for medical cover, the patient is entitled to DVA transport to and from home, covering the metropolitan area and as far north as the Central Coast to attend for daily treatment. This should be organised by the Radiation Oncology Centre. Country patients Patients living 200kms or more from a Radiotherapy service are eligible for the Commonwealth Government Isolated Patients Travel and Accommodation Allowance. These patients are referred to the Cancer Support Centre. Please phone 9487 9066. ACCOMMODATION There is limited accommodation at the Hospital, Jacaranda Lodge and the Nurses Residence. Patients requiring accommodation are referred to the Cancer Support Centre. Please phone 9487 9066. Veterans Patients eligible for Department of Veterans’ Affairs cover, and who are not well enough to be at home, may be accommodated at Lady Davidson Hospital, Turramurra – 4km from the Radiation Oncology Department, and transferred daily for treatment. This should be organised by the Radiation Oncology Centre. Radiation Oncology Centre New Doctor’s Orientation Manual 60 FEES This Centre charges a fee for your treatment, most of which is refunded by Medicare and the new Medicare Plus rebate. Out-of-pocket expenses NOT covered by Medicare range from $200 - $2000 for a full course of treatment. Private Health Insurance DOES NOT COVER the cost of Radiotherapy treatment, unless you are a hospital inpatient. Veterans Most veterans are eligible for medical cover for a diagnosed cancer. The account is sent directly to the Department of Veterans’ Affairs. Referring doctors who feel their patients are suffering financial hardship, should mention this in their referring letter and consideration will be given to the account. RADIATION ONCOLOGISTS Dr Richard Foster Dr Edward Sun CONSULTANTS Assoc. Prof. John Boyages Dr Jayasingham Jayamohan Radiation Oncology Centre New Doctor’s Orientation Manual 61 RADIOLOGY GENERAL INFORMATION Sydney Adventist Hospital has owned and operated its own Radiology service from the mid 1960's. Today, San Radiology provides a world-class comprehensive diagnostic and interventional radiology service to both outpatients and inpatients. San Radiology performs more than 40,000 examinations a year, and is staffed by a team of radiologists, radiographers, sonographers and experienced specialist radiology nurses and secretaries. San Radiology offers all general and specialised procedures. We also provide radiographic personnel to the Cardiac Catheterisation Laboratory, the theatre complex, and the Breast Screening Unit. SERVICES AVAILABLE 16 Multislice CT Echocardiography Ultrasound MRI Fluoroscopy General X-ray Image Guided Biopsy* Mammography IVP Digital Subtraction Angiography Interventional Radiology Doppler / Vascular Ultrasound * Note: For biopsies, a Pathologist is available to be present for instant confirmation of biopsy sample size and histological verification before the patient is released. TECHNOLOGY We are at the forefront of imaging innovation, boasting a suite of imaging modalities and software to support our radiologists in their diagnostic evaluations. This includes the most advanced 16 Multislice CT scanner technology available in Australia, and a 1.5 Tesla MR (high field) with a short bore magnet which has proven to be exceptional with claustrophobic patients. The system also has a large range of scan coils including breast. Radiology New Doctor’s Orientation Manual 62 INTEGRATION WITH HOSPITAL Patient care is our top priority. By referring to San Radiology, your patients are provided with an added layer of care. If significant or unexpected findings are discovered, the radiologist can call the referring doctor and send the patient directly to Emergency Care or recommend that more diagnostic tests be performed. For interventional procedures, the full support and availability of an acute care general surgical hospital gives patients peace of mind. We have an enterprise wide Picture Archiving system that means that doctors can access our images from a range of computers throughout the hospital and are moving toward giving this access to referring doctors in the practice rooms. This will mean that doctors can view not only reports but also images on their computers as soon as made available in the radiology system. In this way, we are partnering with our referring doctors and hospital specialists to maintain a continuum of outstanding patient care coupled with leading imaging technology. BOOKINGS AND ENQUIRIES Bookings can be made Monday to Friday from 8:00am – 5:00 pm. Bookings must be made for all procedures except general x-ray. Many booking requests can be accommodated the same day the request is made. Patients need to bring their referral and any previous relevant films to allow for clinical comparison and follow-up. Bookings: (02) 9487 9840 General Enquiries: (02) 9487 9850 Fax: (02) 9487 9845 HOURS OF OPERATION Monday to Friday: 8:30 am to 5:00 pm, full service available After hours & Public Holidays: Emergency service through Emergency Care Department DIAGNOSTIC PREPARATION Some examinations require special preparation. Appointments can be made by phone but the patient may need to visit the department or chemist prior to the appointed day to collect a preparation kit. CT prep can be mailed to the patient when arranged for and booked well enough in advance. PARKING/ACCESS San Radiology is conveniently located on Level 3, Sydney Adventist Hospital just behind SanClinic. Nearby parking is designated for Radiology outpatients, and the department can be easily accessed directly from the lifts near the car park. San Radiology offers dedicated outpatient waiting areas and parking spaces for outpatients. We give discount parking vouchers to patients so that they only need to pay $3 regardless of the amount of time having their procedures performed. Radiology New Doctor’s Orientation Manual 63 RADIOLOGISTS The radiologists providing their services to San Radiology together combine to offer a comprehensive range of expertise, with additional specialisation areas including: Interventional radiology, DSA and biopsies Breast Imaging Body imaging Musculoskeletal and Neurological MRI Multi-detector CT Imaging Paediatric Imaging Ultrasound These Radiologists include: Dr Martin Davis MB, ChB, FRANZCR, Dip. Obst., MBA Dr Avi Saks, MBCLB FRANCZR, MRI Fellowship Dr Luke Baker, MBBS FRANZCR, MRI Fellowship Dr John Harding–Smith, MBBS FRANZCR Dr Nigel Hunter, FRANCZR Dr Margaret Stewart, FRANCZR. Dr Andy Garfagnini – MBBCh, FFRAD(D) SA, FRANZCR Dr Jonathan Seeff– MBChB, Amer. Board of RAD, FRANZCR Dr Bryan Fain – MBBCh, FFRAD(D) SA Dr Julian Adler – MBBS (Hons), FRANZCR Dr Guy O’Connell – MBBS, FRANZCR, Nuclear Medicine Specialist CONTACT DETAILS The Radiologists are available Monday to Friday, 9:00am to 5:00pm for consultation, clinical guidance and information regarding any procedural concerns. The radiologist on duty can be contacted on (02) 9487 9850. For specific departmental questions contact: Radiology Manager: Mr Geoff Andrews, MBA, BHSM, MIR - on (02) 9487 9839. Chief Radiographer: Ms Rita Richter, AMS, MIR, Grad. Dip. HthSc, U/S - on (02) 9487 9838 Diagnostic Services Specialist: Katie Toomey, Dip App. Sc, M App. Ling. – on (02) 9487 9837 CUSTOMER SERVICE San Radiology is progressive, innovative and committed to providing the very best service to clinicians and patients. We welcome constructive feedback and would be happy to discuss any way in which we can improve our service to you as referrers and to your patients. To speak with our Customer Service Officer directly, call 9487 9836. Radiology New Doctor’s Orientation Manual 64 REPORTING Patients are given films to take with them upon completion of study. Radiologist reports are faxed as soon as authorised, and are faxed and mailed to referrers to ensure quickest means of getting clinical information to the referring doctors. This process ensures patients do not have lengthy waits in the department waiting for reports, and doctors receive important clinical information in a timely fashion. FEES & CONCESSIONS Our professional fees are very competitive and comparable with other providers. Concessions are given to pensioners and disadvantaged patients. Patients can choose to pay fully up-front at time of procedure or have an invoice mailed on to them. STUDIES PERFORMED Gastro-Intestinal System Barium Swallow Barium Meal Small Bowel Series Small Bowel Enema Barium Air Contrast Enema Fistulogram Needle Biopsy Procedures Percutaneous Abscess Drainage CT Colonography Biliary System Fine Needle and Core Biopsy IV – CT Cholangiography Liver Portography MRCP (MRI Cholangiography) Operative Cholangiography Percutaneous Biliary Drainage Percutaneous Biliary Stent Insertion Percutaneous Transhepatic Cholangiogram T-Tube Cholangiography Breast Mammography Core Biopsy Fine Needle Biopsy Breast Localisation Cardiac Transthoracic Echocardiography Trans-oesophageal Echocardiography CT Coronary Calcium Scoring CT Coronary artery scanning Genito – Urinary System IVP Micturating Cystourethrogram Retrograde Pyelogram Percutaneous Nephrostomy Percutaneous Ureteric Stent Insertion Spiral CT IVP Tran rectal Biopsy Ultrasound Renal MRI Lithotripsy Central Nervous System CT Brain & Spine CT Myelography Discography Lumbar Puncture MRI Brain & Spine Endocrine CT MRI Fine Needle & Core Biopsy Ultrasound Radiology New Doctor’s Orientation Manual 65 ENT CT head and neck Sialography Dental CT Dentascan Gynaecology & Obstetrics CT Pelvimetry Hysterosalpingogram Paediatric General x-ray Hip Dysplasia Ultrasound IVP Abdominal Ultrasound Pyloric Stenosis Ultrasound Micturating cystourethrogram Oncology / Radiotherapy Planning CT Localisation CT and ultrasound work-ups Skeletal System Arthrography Computed Radiography & Tomography 3D & Multiplanar CT Facet blocks Radiculotherapy Ganglion Cyst Aspiration / Injection Leg Lengths 3’ Full Spine Localisation Procedures MRI Musculoskeletal Ultrasound Shoulder Hydrodilatation Respiratory System Hi-Res Lung CT Percutaneous Biopsy Percutaneous Aspiration & Drainage Pulmonary CT Vascular System Central Line Insertion 3D CT Digital Subtraction Angiography MRA / MRV Peripheral Angioplasty Peripheral Stent Insertion CT Angiography Venography Venous/Arterial Doppler Ultrasound Radiology New Doctor’s Orientation Manual 66 RENAL DIALYSIS BOOKINGS AND ENQUIRIES Nursing Unit Manager Phone 9487 9161, 9162 or Fax 9487 9166 HOURS 6:00 am – 1:00am 7:00 am – 9:00pm Monday, Wednesday, Friday Tuesday, Thursday, Saturday 24hr RN on call, contact via switchboard SERVICES 14 Haemodialysis treatment stations Providing dialysis service to day stay and hospital in -patients including ICU. Patients holidaying from overseas and Australia are also catered for. Director of Unit – Dr Paul Collett Covered by 24 hour on call rotating roster of nephrologists Renal Dialysis New Doctor’s Orientation Manual 67 SAN CLINIC INTRODUCTION San Clinic, opened in August 2003, is the latest development in Sydney Adventist Hospital’s mission of providing excellence in comprehensive healthcare. Located adjacent to the Hospital, the San Clinic currently houses over 100 Specialists from a wide range of clinical areas. As at date of printing, this includes: Breast & Endocrine Surgery Adult & Paediatric Cardiothoracic Surgery Cardiology Colorectal Surgery Gastroenterology Gastrointestinal Surgery General Medicine General Surgery Nuclear Medicine Neurology Obstetrics & Gynaecology Orthopaedics Paediatrics Medicine & Surgery Plastic Surgery Sports Medicine & Physiotherapy Surgical Oncology Urology Vascular Surgery CLINIC FACILITIES & SERVICES The services included in the San Clinic, together with the ease of access to the facilities of the Hospital, create a convenient centre for healthcare needs. San Pathology The San Pathology Collection Centre located on Level 3 provides convenience for both patients and doctors. San Radiology The comprehensive Radiology services of the Hospital are easily accessible via an enclosed walkway from Level 3 of the San Clinic. Relish Café The onsite café offers a variety of gourmet meals, snacks and coffee. Patrons can choose a table inside or on the balcony overlooking the adjoining bushland. PARKING Undercover parking is available for San Clinic patients, with direct access to the building. A small fee is charged for parking at Sydney Adventist Hospital, both in the San Clinic and general Hospital car parks. San Clinic New Doctor’s Orientation Manual 68 FURTHER INFORMATION For more information about the facilities and services, please call San Clinic Reception on (02) 9473 8850. Appointments with doctors practicing at San Clinic should be made directly through their rooms. San Clinic New Doctor’s Orientation Manual 69 SAN DAY SURGERY HORNSBY The San Day Surgery Hornsby opened in 1986 and was the first private, freestanding and licensed Day Surgery in New South Wales. We are committed to helping promote the health and recovery of your patients by the best available means. SERVICES & FACILITIES The San Day Surgery Hornsby offers surgical services for both adults and children over the age of 2 years. We are well suited to caring for children, with facilities for parents to remain with their child at all times except during the operation. Our facility has two fully equipped theatres with the latest technology, as well as a theatre for minor surgical procedures. We were the first day surgery in Australia to be granted an Extended Recovery Care License by the NSW Department of Health. This means that patients who have undergone more advanced surgery can stay overnight for post-operative care. The San Day Surgery is a multi-specialty day surgery, currently working in the following surgical specialities: Ophthalmology Plastic / Cosmetic Surgery Hand Orthopaedic Surgery Oral Surgery General Surgery STAFF We boast a team of skilled medical professionals dedicated to providing the highest standard of care and a positive outcome for your patients. REFERRAL AND FEES For referral details and fee information please contact the San Day Surgery Hornsby. LOCATION 1a Northcote Road, Hornsby Phone: (02) 9476 2900 Fax: (02) 9476 2921 HOURS OF OPERATION San Day Surgery Hornsby office hours are 8:00am – 5:00pm, Monday to Friday. FURTHER INFORMATION The San Day Surgery Hornsby is fully accredited by the (Australian Council on Health Care Standards), a member of the Australasian Day Surgery Association, and a member of the Australian Private Hospitals Association San Day Surgery Hornsby New Doctor’s Orientation Manual 70 SAN ULTRASOUND FOR WOMEN San Ultrasound for Women, which opened in February 2000, is a specialised service for obstetric and gynaecological patients. Our doctors are fully qualified obstetricians and gynaecologists who sub-specialise in ultrasound and prenatal diagnosis procedures. The sonographers are highly qualified in obstetric and gynaecology ultrasound and they are chosen particularly for their gentle and empathetic approach. Because of the intimate nature of many of our procedures, we are extremely respectful of the patient’s comfort and privacy. OBSTETRICIANS AND GYNAECOLOGISTS The obstetricians and gynaecologists providing their services to San Ultrasound for Women are: Dr Philippa Ramsay, MBBS FRANZCOG DDU COGU, who is also a VMO to Fertility, Royal Prince Alfred Hospital for Women & Babies, a Clinical Lecturer at Sydney University and an examiner for the COGU sub-specialty. Dr Linda Atkins, MBBS FRANZCOG DDU, who is also an Honorary Fellow in Obstetric Ultrasound at Nepean Hospital. Dr Indika Alahakoon, MBBS FRANZCOG DDU CMFM, who sub-specialises in Materno-fetal Medicine. She has a Diploma of Diagnostic Ultrasound and spends much of her week as a Staff Specialist at Westmead Hospital and a Lecturer at Sydney University. CONTACT DETAILS The doctors are available Monday to Friday, 8:30am – 5:00pm for consultation, clinical guidance and information regarding any procedural concerns. Dr Philippa Ramsay can be contacted out of business hours on 0412 228 786. BOOKINGS AND ENQUIRIES Bookings can be made Monday to Friday, 8:30am – 5:00pm. Bookings must be made for all ultrasounds and procedures. Your patients must bring their referral and any previous relevant films to allow for comparison and follow-up. Bookings and Enquiries: (02) 9487 9800 Fax: (02) 9487 9803 HOURS OF OPERATION Monday to Friday: 8:30am – 5:00pm, full service available After hours and public holidays: Emergency service available through the Emergency Care Department. REPORTING Reports are faxed, emailed or mailed to referrers. San Ultrasound for Women New Doctor’s Orientation Manual 71 DIAGNOSTIC PREPARATION Most ultrasounds require patients to have a full bladder. This involves drinking 500mls of water one hour prior to their appointment. This is explained when a booking is scheduled. Some clinical problems require a transvaginal examination. FEES Our professional fees are very competitive. Concessions are given to disadvantaged patients. CUSTOMER SERVICES San Ultrasound for Women is progressive, innovative and committed to providing the very best to our patients. We welcome your feedback and would be happy to discuss any ways in which we can improve our service to you. LOCATION San Ultrasound for Women is conveniently located on Level 3 of the Hospital. Designated parking is available for ultrasound outpatients, and the department can be easily accessed from lifts located near the car park. SERVICES AVAILABLE Obstetric Ultrasound for dating, nuchal screening, morphology assessments, growth and wellbeing, and cervical length. 3D & 4D Ultrasound of the foetus. Gynaecology Ultrasound including sonohysterography and tubal patency studies. Amniocentesis, Chorionic Villus sampling, and genetic counselling. San Ultrasound for Women New Doctor’s Orientation Manual 72 SECURITY The security service operates 24 hours, 7 days a week to monitor the security of the Hospital and ensure safety. For any enquiries please phone 9487 9988. GENERAL SERVICES AVAILABLE Patrol and monitor the Hospital estate Investigate security breaches within the estate Issue Identification and Access passes Provide personal security escort after hours within the estate Assist with any parking difficulties Security New Doctor’s Orientation Manual 73 SOCIAL WORK ENQUIRIES Phone: 9487 9660 SERVICE AVAILABLE The Social Workers provide a professional service to assist patients and their families cope with the social and emotional impact of illness and hospitalisation. They undertake psychosocial assessment and counselling of patients and their support network as they adjust to grief and loss, and also address personal and lifestyle concerns that have been triggered by, or exacerbated by, their illness. The Social Workers teach relaxation and stress management skills to patients and take part in several educational programs the Hospital offers to patients and their families/carers. The Social Workers help ensure a smooth transition from hospital to home by providing information to the patient and their family on a wide range of community resources available to assist them to make choices that will best meet their needs on discharge. If a patient is no longer able to manage at home, the Social Worker provides information to the patient and family on the range of options available, be it hostels, nursing homes or other hospitals or hospices. In most instances the Social Worker coordinates arrangements for transfer. The service is a free one, as an integral part of the Hospital’s provision of holistic care. The Social Work department is located on Level 3 of the Main Hospital building. Social Work New Doctor’s Orientation Manual 74 SURGICAL BOOKING PROTOCOL Due to the heavy utilisation of the Hospital’s 12 operating theatres, adherence to the following surgical booking protocol is essential. BOOKINGS For surgical bookings please fax (02) 9487 9015 or phone (02) 9487 9020 – this is a direct line for bookings only. Fax sheets are available on request. Bookings for surgery should be made at least three business days in advance, by faxing the Hospital Booking Letter to 180009111, so that appropriate arrangements can be made for ward accommodation, diagnostic services, prostheses, etc. The prostheses to be used should be supplied to the hospital and it should be confirmed with the company to supply the prostheses at least the day before surgery, so that instruments can be sterilised and prosthetics checked in. After hours and on weekends, the Theatre Supervisor should be contacted, as the bookings department is not staffed after 5pm. The Theatre Supervisor can be contacted on (02) 9487 9025. BOOKING INFORMATION REQUIRED Full name of patient Date of birth Exact procedure, specifying side and site(s) Brand of prosthesis required (where applicable) or special instrumentation Diagnostic services required, i.e. pathology, X-ray etc (Cell Saver when required) Type of accommodation requested Anticipated length of stay Patient’s home telephone number Item Numbers - mandatory Type of booking: (I, S or D)* Allergies Co morbidities ICU bed required *Patients may be booked for admission in one of the following categories: I = Inpatients – admitted the day prior to the procedure S = Same Day – admitted the day of the procedure D = Day Only – admitted and discharged on the day of the procedure Any equipment required for a procedure that does not belong to SAH, needs to be ordered by the surgeon, or his/her representative, a least 24 hours prior to procedure(s) for processing and sterilising. SURGEONS WITH REGULAR SESSIONS Surgeons who have regular allocated sessions will receive a date listing of their sessions on a fourmonthly basis. It is necessary to indicate those sessions NOT required and return the list to the Theatre Booking Clerk as soon as possible. If a decision not to use a particular sessions is made after the lists have been returned, please notify the Theatre Booking Clerk so that the session can be reallocated. Surgical Booking Protocol New Doctor’s Orientation Manual 75 SURGEONS WITHOUT REGULAR SESSIONS Surgeons who do not have a regular operating session may book an entire session in advance on the understanding that it will be fully utilised. Bookings for a single operation may also be made with the remainder of the session being allocated to another surgeon. If additional time is required by any surgeon every effort will be made to assist. ANAESTHETISTS FOR OPEN SESSIONS If you are using an open session following another surgeon, the services of the anaesthetist attached to the session would normally be used. If no anaesthetist is allocated to the session it is the surgeon’s responsibility to arrange an anaesthetist from the Hospital’s accredited list. A listing of available anaesthetists may be obtained from the Operating Theatre Office. See also the listing of specialist practitioners in this handbook. SURGICALLY EXPLANTED ITEMS A notation is to be made in the patient’s notes. Surgically removed tissue and explanted items are classified as contaminated and should therefore be disposed of as either contaminated waste or as tissue specimen for microbiological examination. However, the rights of individuals to request retention of tissue items that have been surgically removed are acknowledged. The organisation does not support the practice of routinely giving explanted items to patients. However, under certain conditions, e.g. warranty issues, cultural requirement of special requests, an exemption may be made. For these exceptions, attention should be paid to the biohazard warning. If a patient wants to retain an explanted piece of hardware, the item must be fast-tracked through a complete sterilisation process before giving it to the patient. This is a costly process and should be avoided. We are not resourced to perform these additional requests. As 4187: 2003 Clause 1.5 states, “ WARNING: DO NOT REPROCESS EX-PLANTED MEDICAL/DENTAL DEVICES”. If the patient wants to retain surgically removed human tissue or foreign bodies, the item must be placed in a sealed container, and marked with patient details. No formalin is to be put in the container, as this a hazardous substance. It should be recommended to the patient to discard tissue as soon as possible due to the tissue decomposing. FAST-TRACKED EQUIPMENT Items required urgently will be processed using a fast-tracked procedure, which takes 3 hours. Mr Steve Johnston Theatre Manager Surgical Booking Protocol New Doctor’s Orientation Manual 76 UROLOGY CLINIC SERVICES The Urology Clinic commenced it’s out-patient services in 2003. The majority of patients attend the clinic for : Urine flow studies Self-catheterisation tuition Change of supra-pubic catheters Change of urethral catheter Removal of Catheters post surgery Urethral Dilations (Performed by Doctors) These tests or treatments are determined by the Doctor. STAFF The Urology Clinic is run by Registered Nurse Robyn Guy, who has 22 years of Urology experience. Robyn also works on Level 11 (Gee Ward) at this hospital. REFERRAL Patients are referred to the clinic by General Practitioners or Specialist Medical Practitioners within the hospital. FEES Medicare or Private Health Funds do not reimburse patients for this service. However, Department of Veteran Affairs does cover the costs for their patients. As a result the clinic’s operating costs are kept to a minimum, whilst maintaining the viability of the services. LOCATION The Urology Clinic is conveniently located on Level 3 of the Hospital, adjacent to the lift. It is well sign-posted. Parking is within the hospital parking area. Fees for parking do apply. OPERATING TIMES / APPOINTMENTS The clinic runs every Wednesday. Appointments can be made through Level 11, Ward Secretary, on 94879153 Monday to Friday between the hours of 7am and 3pm. Urology Clinic New Doctor’s Orientation Manual 77 WOUND CARE CLINIC SERVICES The Wound Care Clinic commenced its outpatient program in 1990. The majority of patients attend the Clinic with chronic ulcers and minor trauma. Ongoing wound care can be conducted in the Wound Care Clinic as the sole practice. Alternatively, this can be coordinated in liaison with community nurses. This will be determined by doctor and/or patient preference. STAFF The Wound Care Clinic is run by a small team of highly trained nurses. Gary Bain is the Clinic Manager and Clinical Nurse Consultant, and Colleen Van Senden is a Clinical Nurse Specialist. Both nurses hold Masters Degrees and have a combined experience in wound management exceeding 20 years. Clinic staff are members of the Australian Wound Management Association. REFERRAL General Practitioners, specialist medical practitioners and community nurses initiate the majority of patient consultations for the Wound Care Clinic. Referral from one of these sources is required for admission to the clinic. FEES Medicare and private health funds do not reimburse patient expenses for the Wound Care Clinic, however, the Department of Veteran Affairs does cover the costs for their patients. As a result, the Clinic’s operating costs are kept to a minimum whilst maintaining the viability of the service. LOCATION The Wound Care Clinic is conveniently located on Level 3 of the Hospital. The Clinic is accessed through the first Hospital entrance near Fox Valley Medical & Dental Centre. Patients are able to park in the Radiation Oncology designated parking directly outside the Clinic. FURTHER INFORMATION AND APPOINTMENTS There is usually a 2 to 3 week waiting period for initial consultations with new patients attending the Clinic. Any urgent consultations are attended in conjunction with the Emergency Care Department. The Wound Care Clinic can be contacted on (02) 9487 9785 on Monday, Tuesday, Thursday and Friday. Please leave a recorded message on the voicemail and a reply will be made between patient consultations. Wound Care Clinic New Doctor’s Orientation Manual 78
