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Peninsula HealthQuality of Care

Report 2007

Winner - 2007 Premier’s AWArd for most outstAnding metroPolitAn HeAltH service

Peninsula Health Quality of Care Report 2007 Organisational Structure

NursingMs Jan Child

Allied HealthDr Sara Watson

ExecutiveDirectorMedical,Frankston

Acute Care& QualityDr Peter Bradford

BOARD

Deputy Chief Executive

Executive Directors

Dr Peter BradfordChief Executive

Dr Sherene Devanesen

PROFESSIONAL ISSUES

ExecutiveDirector

Community& Continuing

Care and AlliedHealth

Dr SaraWatson

ExecutiveDirectorHuman

Resourcesand RosebudAcute Care

Mr ChrisEngland

ExecutiveDirector

Finance andInformation

Mr David Anderson

ExecutiveDirector Nursing,

FrankstonEmergency &

Intensive Careand Community

Participation

Ms Jan Child

ExecutiveDirector

Planning,Psychiatry

andInfrastructure

ActingAssociateExecutiveDirector ofPsychiatry

Mr Brendon

Ms ElaineBennett

Gardner

LegalMs Vicky Hammond

Public RelationsMr John Jukes

MedicalDr Peter Bradford

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Medicine/CardiacServicesSurgery/OperatingServicesWomen’s/Children’s/AdolescentsOncology andPalliative CareCriticalGovernance,Quality andCustomerServicesInvestigativeServicesPharmacyMedicalGovernanceHMOCoordination/SupportMedicalEducationPatientTransportFrankston sitecoordination

Peter BradfordTel: 9784 7687

Brendon GardnerTel: 9784 7593

Jan ChildTel: 9784 7593

Chris EnglandTel: 9784 7389

David AndersonTel: 9784 7704

Sara WatsonTel: 9788 1277

Elaine BennettTel: 9784 7707

Rehabilitationand Aged Care/SitesResidentialCareAllied HealthSocial Workand IntegratingCareOutpatientsHospital inthe HomeCommunityHealth ServicesResearch andEthics

HumanResourcesEmergencyResponseManagementOH&SRosebudHospital

FinancePayrollSupplyPersonal AlarmCall ServicePrintingInformationManagementInformationTechnology

FrankstonEmergencyServicesFrankstonIntensiveCare UnitNursingServices/RecruitmentNursingEducationCommunityParticipationKoori LiasonPastoral CareLibraryServicesCore of Life

PlanningCapitalProjectsPsychiatryServices/SitesInfrastructureEngineeringEnvironmentalServicesFood ServicesSecurity

ACE AssistandCareinEmergencyVolunteerProgram

ACHS AustralianCouncilonHealthcareStandards

ACSA AgedCareStandardsandAccreditationAgency

AHPACC AboriginalHealthPromotionandChronicCareProgram

BeST BetterSaferTransfusions

BMI BodyMassIndex

BPAF BloodProductAdministrationForm

BPOF BloodProductOrderingForm

CAC CommunityAdvisoryCommittee

CAT ComputerisedTomography

CDP CommunityDentalProgram

CLABSI CentralLineAssociatedBloodstreamInfection

CLEAR CommunityLiaisonEarlyInterventionandAcuteRecoveryService

CLIPS ConsultationLiaisonEarlyInterventionPsychiatricService

COAG CouncilofAustralianGovernment

CRP CommunityRehabilitationProgram

CRC CommunityRehabilitationCentre

CVC CentralVenousLine

DHS DepartmentofHumanServices-administerstheStateGovernment’shealthandwelfareprograms

ED EmergencyDepartment

EIiCD EarlyInterventioninChronicDisease

E-Prescribing ElectronicPrescribing

ESAS ElectiveSurgeryAccessService

FRAT FallsRiskAssessmentTool

GP GeneralPractitioner

HAI HospitalAcquiredInfection

HARP HospitalAdmissionsRiskProgram

ICAP ImprovingCareforAboriginalandTorresStraitIslanderPatientsProgram

ICU IntensiveCareUnit

KCAG KooriCommunityAdvisoryGroup

KLP KeyLiaisonPerson

KPI KeyPerformanceIndicator

MEC MtElizaCentre

MRI MagneticResonanceImaging

MRSA MethicillinResistantStaphylococcusAureus

MyPOD MyPersonalOncologyDiary

NASP NationalArcheryinSchoolsProgram

NAIDOC NationalAboriginalIndigenousDayofCelebration

NHMRC NationalHealthandMedicalResearchCouncil

PCCP PeninsulaComplexCareProgram

PenDAP PeninsulaDrugandAlcoholProgram

PETS Pharmacist-initiatedE-scriptTranscribingService

PUPPS PressureUlcerPointPrevalenceSurveys

RAD Response,AssessmentandDischargeTeam

RCF ResidentialCareFacility

RISCE RiskIdentification,Safety,Containment,Environment

ROSS ResidentialOutreachSupportService

RRU RosebudRehabilitationUnit

SACS SubacuteAmbulatoryCareServices

SFYS SchoolFocussedYouthServices

SHARPS SouthernHIV/HEPResourceandPreventionService

STIR SeriousTransfusionIncidentReporting

VICNISS VictorianHospitalAcquiredInfectionServeillanceSystem

VPSM VictorianPatientSatisfactionMonitor

Initials are used to refer to many terms, programs and organisations. This list of acronyms has been developed to assist you as you read this report.

Glossary of Terms Peninsula Health Quality of Care Report 2007

Statement from ceo and chair

consumers, carers and community Participants

0 3 Consumer Profile

07 Volunteers

0 8 Special Needs in the Emergency Department

Working with Partners

1 0 Improving Care for the Indigenous Community

1 2 Drug and Alcohol Services

Quality and Safety

1 5 Clinical Governance

1 7 Accreditation

2 2 Infection Prevention and Control

2 5 Clinical Pathways and Consumer Satisfaction

2 6 Transfusion Safety

2 8 Skin Integrity

2 9 Falls Prevention

3 1 Medication Safety

3 3 Dental Health

continuity of care

3 5 Complex Care Program

3 5 Community Rehabilitation Program

37 Rosebud Day Treatment Centre

3 8 Oncology Day Unit

39 Surgical Services

42 Aged Care Services

4 4 Psychiatric Services

4 6 Emergency Department

Have your Say

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Cover: ‘PossumDreaming:Agility,VersatilityandDiversity’representstheneedtobeflexiblewhendealingwiththehealthneedsoftheindigenouscommunity.ItwaspaintedbyBeaEdwards,arenownedindigenousartistandPeninsulaHealth’sAboriginalLiaisonOfficer.Seepage10.

Peninsula Health Quality of Care Report 2007 Contents

CommunitypartnershipshelptoensurethatPeninsulaHealthprovideshighquality,safehealthcareservices.

Thesepartnershipsbeginwithpatients,residents,clientsandtheirfamiliesandcarers.Theyextendtothegovernmentagenciesthatprovidefunding,tohealthcareandeducationproviders,tovolunteersandtothewidercommunity.

PeninsulaHealthreliesonthesepartnershipstocontinuallyenhancethecareofferedinitshospitals,rehabilitationunits,residentialagedcarefacilitiesandcommunityhealthandoutreachprograms.

TheemphasisonqualityandsafetystartswithTheBoardofDirectorsandflowsthroughtheseniormanagementteamtohealthcareprofessionalsandotherstaffacrosstheorganisation.ConsumersandotherpartnersareinvolvedineverystepandarerepresentedonthemostseniorcommitteesthatreporttotheBoard.

PeninsulaHealthisdevelopingaMentalHealthServicePlanthatwillidentifyanticipatedneedsoverthenext10-15years.Itwillproposeanoptimalmentalhealthplanintermsofbedandcommunity-basedadult,childandadolescentandagedcarementalhealthservices.

InSeptember2007PeninsulaHealthreceivedboththePremier’sAwardasoutstandingMetropolitanHealthServiceoftheYearandtheQualityofCareReportingAwardattheVictorianPublicHealthcareAwardspresentation.(seepage30)

ThisannualQualityofCareReportagainoutlineshowqualityandsafetyaremonitoredandmeasured,howopportunitiesareidentifiedandchangesimplementedaspartofacontinuousprogramofqualityimprovement.

Throughtext,tables,patientcommentsandstatisticstheReportexplainshowproblemsareidentifiedandsolved,standardsimproved,andbenchmarksestablishedagainstotherhealthagencies.Inadditiontooutliningachievements,thereportalsoidentifiesshortcomingsandimprovementstrategies.

Thisreportfocusesonissuesthatareimportanttothecommunity,suchaswaitingtimesforservices.ItalsofocusesonoutcomessothecommunitybetterunderstandswhatPeninsulaHealth’seffortshaveachieved.

Healthcareconsumershelpedtoselecttheareasofactivitycoveredinthisreportandwereinvolvedinplanning,writing,reviewing,producingandevaluatingthefinishedproduct.

MembersofthecommunityareencouragedtobecomeactivepartnersinPeninsulaHealth’squestforcontinuousqualityimprovementbysharingtheirviewsandideasaboutservices,performanceandthisreport.Detailsonhowyoucanparticipatearelistedonpage48.

PeninsulaHealthispleasedtopresentthe2007PeninsulaHealthQualityofCareReporttothecommunity.ItishopedthatreaderswillfindthereportinterestingandinformativeandthatitwillbehelpfulifservicesprovidedbyPeninsulaHealtharerequired.

BarryNichollsChairperson,BoardofDirectors

DrShereneDevanesenChiefExecutive

BarryNichollsChairperson,BoardofDirectors

DrShereneDevanesenChiefExecutive

In Partnership

Building a Healthy Community

0�Peninsula Health Quality of Care Report 2007

0� Peninsula Health Quality of Care Report 2007 Consumers, Carers and Community Participation

FrankstonHospital’sWard5GNVolunteerBrianWhitlow,explainsrightsandresponsibilitestopatientWilmaKneebone,aspartofPeninsulaHealth’sRightsandResponsibilitesProgram.

Consumer Profile

PeninsulaHealthprovides300,000residentsofFrankston,partofthecityofKingstonandtheMorningtonPeninsulawithhealthcareservices.

PeninsulaHealthalsorespondstotheneedsofthe80,000peoplewhoholidayannuallyonthePeninsula,andalargenumberofpeoplewhovisittheareaeachyear.

ThetopfivecountriesofbirthforpeoplelivinginthePeninsulaHealthcatchmentareaareAustralia,England,NewZealand,ScotlandandtheNetherlands.Thosebornoverseasmakeup20percentofthelocalpopulation.Approximately1,500Indigenousresidentsliveinthearea.

In2007,about32percentofthepopulationwereundertheageof25,and26percentwereovertheageof55.ThisproportionofolderpeopleisoneofthehighestinVictoria.

PeninsulaHealthoffers:acutemedical,paediatric,surgicalandmaternitycare,criticalcare,psychiatricservices,rehabilitation,palliativecare,communityhealthandhealtheducation,outpatientservices,agedcareandassessment,investigativeandmedicalsupportservices,alliedhealthandclinicaltraining.

Italsoprovidesservicesto14,000additionalVictoriansthroughthePersonalAlarmCallService.

PeninsulaHealth’s4,209employeesaresupportedbyover860volunteersandauxiliarymembers.

Consumershaveaccessto20publichealthfacilitiesacross14differentsites.Thesefacilitiesincludehospitals,nursinghomes,assistedlivinghomes,communityhealthandoutreachcentres,mentalhealthcareservicesandrehabilitation,agedandpalliative

careunits.Servicesarealsoprovidedinpeople’shomesthroughtheHospitalintheHomeprogramandotherdomiciliaryservices.

Thetop10healthriskfactorsforthispopulationaretobacco,highbloodpressure,obesity,poordiet,physicalinactivity,highcholesterol,alcohol,unsafesex,illicitdrugs,andworkinjuries.

ThemajorcausesofdeathanddisabilityamongPeninsulaHealth’sconsumersarecancer,stroke,asthma,heartdisease,accidents,emphysemaanddiabetes.

Sources: Australian Bureau of Statistics;

Burden of Disease: Victoria 1996-2016;

Southern Metropolitan Burden of Disease

Study; Department of Sustainability and

Environment: Victoria in Future 2004.

Consumer Participation

Consumerparticipationisanimportantprocess,andisofbenefittoconsumersandtoPeninsulaHealth.

Involvingconsumersintheplanningandmanagementoftheirhealthcareimprovescommunicationbetweenpatientandclinician,reducesrisks,promotesrecoveryandhealthmaintenanceandincreasesconsumers’confidenceintreatmentandcareprocesses.

Inturn,consumerrepresentativesplayanactivepartinfuturehealthserviceplanning,aswellasmonitoringthedeliveryofservices.ConsumersarerepresentedatthehighestlevelonBoardCommittees,includingtheCommunityAdvisoryCommittee,theQualityandClinicalGovernanceCommitteeandtheHumanResearchandEthicsCommittee.

PeninsulaHealthregularlyconsultswithotherhealthcareprovidersandawiderangeofcommunitygroups.TheseincludetheKooricommunityandrepresentativesofculturallyandlinguisticallydiversegroups.

ConsumerswhoarerepresentativeofthePeninsulaHealthcommunityareabletosupportthedeliveryofsafe,highqualityservicesbyestablishingcommunityconfidencethroughthesharingofknowledgeandbyensuringthatimprovementsaremade.

Community Advisory Committee

Byworkinginpartnershipwithconsumers,PeninsulaHealthcontinuestobenefitfromdirectfeedbackthatassistsinimprovingitsservices.

TheHealthServicecurrentlyhasaBoardConsumerAdvisoryCommittee(CAC)andfoursub-committees,includingSouthernHIV/AIDSResourcePreventionService(SHARPS),KooriandCulturalandLinguisticDiversitycommittees.Anadditionalfivesub-committees,includingMentalHealth,Disability,WesternportandtwoCommunityReferencePanels(forbuildingworks)willbeformedenablingbroadcommunityperspectivestobeidentified.

Thecommitteesaredrawnfromthelocalcommunity.TheyprovideinputonserviceplanninganddeliverythroughinvolvementintheStrategicPlanningprocesses.TheyalsoassistinincreasingthelevelofcommunityinvolvementacrosstheHealthService.

OverthelastyearCommunityAdvisoryCommitteemembershavehelpedtorepresentPeninsulaHealthattwomajorconferences.ThefirstwastheAustralasianConferenceonSafetyandQualityinHealthcare,whereCACmembersweresponsoredbytheVictorianQualityCouncil.

Thesecondwasthe‘ParticipateinHealth’ConferencehostedbytheDepartmentofHumanServicesinFebruary.CACmembersleddiscussionsontwoPeninsulaHealthserviceinitiatives.

Consumers, Carers and Community Participation 0�Peninsula Health Quality of Care Report 2007

OnediscussionfocusedonvolunteerssupportingstaffhandoverinformationaboutRightsandResponsibilitiesdirectlyatpatients’bedsides,asuggestiongleanedfromconsumerfocusgroupsheldearlierintheyear.

A‘PatientFriendly’labelonmedicationsissuedbyPeninsulaHealthPharmacyDepartmentwasthetopicoftheotherCACleddiscussion.Thelabellingprojectwasundertakenoriginallywiththehelpofconsumerrepresentatives.

DuringtheyearCACmemberswerealsoinvolvedinareviewofconsumerleaflets.Membersrecommendedimprovementsinreadabilityoftheleaflets,whichincludedinformationonHandHygieneandMedicationSafety.

Carers Research Group

Accommodationcanbecomeamajorproblemforpeoplewithamentalillnessandtheircarers.Somepsychiatricconditionsimpactonemploymentopportunities,theabilitytoliveindependentlyandthelevelsofcareneededatdifferentstagesinanillness.

Anewgrouphasbeenformedtodiscusscurrentissuesrelatedtofamilies,carersandservicedeliveryandtoinvestigatethetypesandavailabilityofaccommodationinFrankstonandonthePeninsulaforpeoplewithmentalillness.

TheCarersResearchForumisacollaborativeinitiativebetweenThePeninsulaCarersCouncilIncorporated,MonashUniversityandPeninsulaHealth.

OrganisersoftheResearchForumareaimingtoimproveaccesstoaffordable,appropriateandstableaccommodationforpeoplewithmentalillnessandtointegratedlocalservicestopreventhomelessnessforthistargetpopulation.

Auxiliary Groups

WhileindividualvolunteersassistinwardsandprogramsacrosstheHealthServicetherearealso34Auxiliarieseachofwhichhasmanymembers.

Theyassistbymaintainingandbuildinggardensandcommentingonpublicationsincludingbrochuresandreportstothecommunity.

Someauxiliaries,likethePinkLadiesatFrankstonandRosebudhospitalsoperatekioskswhileothersmanageOpportunityShopstoraisefundsthatenabletheHealthServicetopurchaseadditionalequipment.

In2006/07,donationsfromAuxiliarygroupsenabledPeninsulaHealthtopurchase:

aspecialisedpatienttransportbusforRosebudHospital

abariatricoperatingtableforpatientswithobesity

TheRosebudHospitalKioskAuxiliarypurchasedthispatienttransportvehicleforusebypatientsneedingtomovebetweenPeninsulaHealthsites.

recliningchairsforfamilymembersstayingwithlovedonesinPalliativeCare

monitorsforMaternityServicesandemergencyventilationequipmentforcriticallyillchildren

16PulseOximetersforvariouswardsatthehospital

ananaestheticmachineandmonitorfortheCardiacAngiographyUnit

aportablerenalmachinetobeusedonvariouswards

anuerothermradiofrequencymachinewhichisusedbypractitionersforchronicpainrelief

adeflibrillator/transportmonitorfortheEmergencyDepartment.

0� Peninsula Health Quality of Care Report 2007

Consumer, Carers and Community Participation

Human Research and Ethics Committee

ThePeninsulaHealthHumanResearchandEthicsCommitteeisresponsibleforconsideringresearchtrials,studiesandprojectsthatinvolvepatients,stafforlocalresidents.

ThemainroleofCommitteemembersistoconsideranyethicalissuesthatariseandtoprotectthewelfareandrightsofparticipantsinclinicalresearchtrials.

TheCommitteeincludesanumberofcommunitymembers,includingacommerciallawyer,aretiredspecialschoolprincipal,aChiefExecutiveOfficerofamulti-servicedisabilitysupportorganisation,acoordinatoroffoodsafetyprogramsandaministerofreligion.

Eachcommunityrepresentativebringsauniqueperspectivetoissuespresented.Forexample,throughtheexperienceofpastoralcareandmixingwidelythroughoutthecommunity,aministerofreligionisusuallyinapositiontounderstandtheviewsofmanypeople.

Thelawyer’sroleontheHumanResearchEthicsCommitteeistoadvisetheCommitteeonthelegalimplicationsofresearchbeingconsideredordecisionstakenorwhetherfurtherformallegaladviceisnecessary.

PeninsulaHealthfollowsguidelinesissuedbytheNationalHealthandMedicalResearchCouncil(NHMRC)whichdelineatetheresponsibilitiesofcommunitymembersontheCommittee.

AccordingtotheNHMRCguidelines,“thequalificationforlaymembersistheirindependencefromtheinstitutionandtheirnon-involvementinmedical,scientificorlegalwork.Thoserecruitedfromthecommunityinwhichtheinstitutionislocatedaremorelikelytounderstandthatcommunityandhowitsmemberswouldviewinvolvementinresearch.”

Community & Continuing Care - Integrating Care Program

Patientsoftenneedtheservicesofnotjustonebutmanyhealthcareprofessionalswhospecialiseindifferentfields.

Itislikelytheservicesofmedicalandnursingstaffwillberequired,buttheexpertiseofadieticianoraphysiotherapistmightalsobeneeded.Attimestherecouldbeawholeteamofhealthprofessionalslookingaftertheneedsofasinglepatient.ThiscaredeliveredbyhealthprofessionalsfromdifferentdisciplinesiscalledIntegratedCare.

PeninsulaHealth’sIntegratingCareProgramprovidesteamcareforinpatients,primarilyintheagedcarearea,whoneedrehabilitation.Theprogramfocusesonpatient-centredgoalsandoutcomesandinvolvesthepatientandfamilyinthecareplanningprocess.

TheIntegratingCareteamismadeupofmedical,nursing,occupationaltherapy,socialwork,speechpathology,dieteticsandphysiotherapystaff.

TheProgramappointsaKeyLiaisonPerson(KLP)foreachpatient.ThisLiaisonroleisthemainInterdisciplinaryTeamcontactforpatients,theirfamiliesandcarers.

TheKLPensuresthatpatientsandfamiliesareinvolvedinpreparingandmonitoringtheCarePlan,thatthepatients’perspectiveisadvocatedatteammeetingsandthatafollowupvisitismadefollowingdischarge.

PROFILE: Marilyn Rowe

Asanardentadvocateforqualityinhealthcare,MarilynRowehasputhervaluesintoactionbyvolunteeringatPeninsulaHealth.

OriginallyrecruitedasacommunityadvisortotheCommunityHealthServices,MarilynhasgoneontoserveonthePeninsulaHealth’sBoardCommunityAdvisoryCommitteesinceDecember2003.

FromthereshewasappointedtothePeninsulaHealthQualityandClinicalGovernanceCommitteeasitsConsumerRepresentative.

ThiscommitteereportsdirectlytotheBoardandisthemainconduitforreportsfromallPeninsulaHealthservicesrelatedtoqualityandsafety.Eachwardanddepartmentreportsitsgoals,actions,results,evaluationsandcomplaintstothiscommittee.

MarilynfeelsprivilegedtobeinvolvedinsuchanimportantpartofpatientcareandopenlyencouragesotherstoconsidervolunteeringatPeninsulaHealth.



Commitment to consumer, carer and community participation

The Health Service achieves a standard of MA (Moderate Achievement) in the Australian Council on Healthcare Standards (ACHS) EQuIP standard 2.4. Involving consumers in planning, provision, monitoring and evaluation of the health service to support improvement. Plus information is readily available for consumers/patients so that they are informed of their rights and responsibilities.

Peninsula Health is accredited at MA level for EQuIP Standards 2.4.1 and 2.4.2.

ACHS, an independent, not-for-profit organisation, is dedicated to improving the quality of health care in Australia through continual review of performance, assessment and accreditation.

Governance

recommended standard

IndIcator ProGress

There is participation in higher level decision making

There are consumers, carers or community members on key governance and clinical governance structures.

Consumers, carers or community members are members of the Human Research and Ethics Committee and Quality and Clinical Governance Committee. These are sub-Committees of the Board.

The Health Service has established a Community Advisory Committee in accordance with the Health Services Act 1988 section 239.

There is a Community Advisory Committee with Board of Director representation. There are also Advisory Groups: Northern and Southern Mornington Peninsula, Koori, SHARPS and Cultural & Linguistic Diversity.

A Community Advisory Committee has been established in accordance with the non-statutory guidelines.

Achieved.

The service reports openly to its communities on quality and safety, and the participation processes

The Quality of Care Report outlines quality and safety performance and systems in the key areas that address the health care needs of the service’s communities, consumers and carer populations.

This report, which exceeds the minimum reporting requirements, is produced annually and widely distributed to the community and reports on Quality, Safety and Consumer Participation.

A Community Participation Plan has been developed. There was wide community consultation in the development of the Community Participation Plan.

There is consumer, and where appropriate, carer participation in clinical care.

Consumer participation in decision making about their care and treatment is assessed on the Victorian Patient Satisfaction Monitor’s (VPSM) Consumer Participation sub index.

Each Survey is assessed and appropriate action undertaken by the relevant areas.

Appropriate information is available to enable all consumers and carers, where appropriate, to choose to share in decision making about their care.

Documents are written following guidelines in the Well Written Health Information Guide (DHS). Reinforced through the Peninsula Health Service Care Charter “Your Rights and Responsibilities”.

accountabIlIty

health care and treatment

‘Doing It With Us Not For Us’

InJanuary2006,theStateGovernmentreleasedanewconsumerparticipationpolicycalled‘Doingitwithusnotforus’

thatreinforcestheimportanceofconsumerinvolvementinhealthcaredelivery.

HealthServicesarerequiredtoreportonachievementsagainsttheparticipationindicatorsassetoutinthepolicy.

Fortheyear2006/2007PeninsulaHealthhasmetorexceededallrequirements.Achievementsagainsttheseindicatorsareasfollows:



Volunteers

VolunteersareessentialtoPeninsulaHealth’sdeliveryofqualityhealthcareservices.PeninsulaHealthbenefitsfromthestrongcommunityspiritandcommitmenttovolunteeringthatflourishesontheMorningtonPeninsula.PeopleringregularlyinquiringaboutopportunitiestoassistwithintheHealthService.

Over860menandwomenfromthecommunityworkthroughouttheHealthService.Everydayvolunteersassiststaff,supportpatientsandclientsandraisefundsforadditionalresources.

ManyoftheauxiliaryandvolunteergroupsatPeninsulaHealthhavebeencontributingtobetterhealthservicesforyears,someformorethanfourdecades.

Forthelasttwoyears,staffhavebeenrecruitingadditionalvolunteerstoworkintargetedareas,suchasthePaediatricWard,EmergencyandMentalHealthServices.AcomprehensiveorientationafternoonisprovidedforvolunteerswhichincludesFireTraining,InfectionControlissuesandorientationtothehospital.Therehavebeentwosessionsinthelast12monthswithatleast10volunteersineachgroup.

TheRedCrossACE(AssistandCareinEmergency)VolunteersbeganatFrankstonHospitalandthisyearexpandedtoRosebudHospitalwithninevolunteers.

ACEisaRedCrossprogramaimedatmeetingthepersonalandpracticalsupportneedsofpatientsandtheirattendingfamilymembersandfriendsintheEmergencyDepartment.ACEvolunteersbringacupofteaandasmilewhenitisneededmost.

SevenvolunteershavenowbeenrecruitedforFrankstonHospital’sOrthopaedicWard.Theirdutiesincludeensuringthatpatients

havereadabouttheirRightsandResponsibilitiesandadvisingnursingstaffifapatientrequiresfurtherinformation,liaisingwithhospitalstaffonbehalfofpatientsandwelcomingandorientatingpatientstotheward.

Theyalsoprovideemotionalandpracticalsupportduringthepatient’sstay,byreadingtothemorsharingafriendlychat.

FourvolunteersworkinFrankstonHospital’sPsychiatricService.Theyassistwithactivitiessuchasten-pinbowling,providinghandmassage,engaginginconversationandhelpingaroundtheward,withofficeadministrationandgeneraldutiessuchpackingbrochuresintoinformationkitsforcarers.

Toprovideanup-to-dateoverviewofPeninsulaHealth’sbroadrangeofvolunteeractivity,anewvolunteerbookletisbeingdeveloped.

Thebookletoutlineshoweachgroupsupportstheservice,whatsitetheirsupportisdirectedto,wheretheymeetandwhotocontactforfurtherinformation.

Carinya Garden Project

CarinyaResidentialAgedCareUnitreceiveda‘backyardblitz’thankstotheFriendsofCarinyaAuxiliaryandtheRotaryClubofFrankstonNorth.

JanGraham,PresidentoftheFriendsofCarinyaAuxiliary,saidthenewgardenatthefacility’sHibiscusUnitwillcreateanupliftingenvironmentforresidents,theirfamiliesandstaff.ThegardenwasfundedandredevelopedbymembersoftheFrankstonNorthRotaryClub,whowereassistedbyFriendsofCarinya.

The‘Hibiscus’gardenfeaturesaweepingcrabappletree,apergolaandnewfences.Inselectingplants,Rotarymemberschoseonlythosethatrequireminimalwatering.

Outdoorfurnishingshavebeenorderedfortheextensivegardens.

Thetransformationofthegardenisamazing.Residentsandtheirfamiliescannowsharequalitytimetogetherinabeautifulandrelaxingsetting.

VolunteersworkingontheCarinyaGardenproject



Special Needs in the Emergency Department

AnEmergencyDepartmentwaitingroomcanbeaconfrontingandconfusingplaceforanyone,butespeciallysoforchildren,andforpeoplewithdisabilitiesthatlimitcommunication.

ThisyearconsumersandcommunitypartnersassistedPeninsulaHealthinredevelopingitsEmergencyDepartmentwaitingroomsatbothRosebudandFrankstonHospitalstomakethemmoreuserfriendlyandfamilyfriendly.

Witha$490,000grantfromtheDepartmentofHumanServicestheHealthServiceundertookrenovationstoprovidepatientswithmoreprivacyandcomfortandtomeetthespecialneedsofchildrenandpeoplewithdisabilities.

FeedbackandadvicefromVicDeafandVisionAustralia,aswellasconsumerandcarerrepresentatives,helpedPeninsulaHealthstaffimprovesignage,suchasdirectionalarrows,andupgradethephysicallayoutofthewaitingrooms.Thechangesparticularlybenefitpeoplewithhearingimpairmentsandvisiondisabilities.

Auslan(signlanguage)andinterpreterscanalsobeprovidedfreeofchargeforthehearingimpairedandthosewhoarenonEnglishspeaking.

Childrenarenowaccommodatedinaspecialareathatreducesexposuretopeoplepresentingwithtrauma.Therechildrencanplaywitha‘FunCentre’,donatedbytheStarlightFoundation.

Thecompletedrenovationshaveresultedinamorecomfortable,lessstressfulenvironmentforpeoplewaitingintheEmergencyDepartments.

TheStarlightFoundationdonateda“FunCentre”toTheFrankstonHospitalEmergencyDepartmentwaitingroom



Working with Partners 0�Peninsula Health Quality of Care Report 2007

TheCoreofLifeprogramwhicheducatesteenagersonpregnancyandparentingissueshasreachedoutfromtheMorningtonPeninsulatoindigenouscommunitiesintheremotestpartsofAustralia.ProgrammanagersDebbyPattrick(left)andTracySmitharepicturedwithDjapirriMununggurritj,Women’sCentreCo-ordinatorfortheYirrkalaCommunityinGove,NT.

Improving Care for the Indigenous Community

Studiesshowthat,foravarietyofreasons,Aboriginalpeoplearereluctanttouseprimaryandcommunityhealthservices.Thisimpactsonthehealthofthemorethan1,500IndigenouspeoplelivingwithinthePeninsulaHealthcatchmentarea.

IntheKooricommunityconditionssuchasrespiratorydisease,diabeticcomplications,angina,dehydrationandgastroenteritisanddentalproblemsoccuratrateshigherthantheVictorianaverage.

Toaddressthisissue,PeninsulaHealthhasestablishedanAboriginalHealthPromotionandChronicCareProgram.TheprogramtargetschronicdiseasewithintheKooricommunity,workingtoensurethatcommunityhealthservicesareculturallysensitiveandtoidentifyandaddresssignificantriskfactorsforthistargetgroup.

Theprogramfocusesonwaystopresentinformationinaculturallyappropriateway,helpingAboriginalpeoplefeelmorecomfortableandmorewillingtousetheHealthService.

Ittargetsnotonlythosepeoplealreadyexhibitingchronicdiseasesymptoms,butalsothosewhoareatriskofdevelopingtheseconditionsinthefuture.

TheprogramsupplementsPeninsulaHealth’sexistingservicesforthelocalIndigenouscommunitywhichincludeAboriginalHospitalLiaison,KooriCommunityAlcoholandDrugServiceandKooriHealthWorkerservices.

Inadditiontothis,during2006/07theKooriCommunityAdvisoryGroup(KCAG)increaseditsmembershipfromfourto10,enhancingfeedbackfromtheKooricommunityandpromotingitsworkingrelationshipwithPeninsulaHealth.Apresentationaboutthe

AdvisorygroupwasmadeattheDHS“ParticipationinHealth’conferenceinFebruary2007.

KoorifocusgroupshavealsobeenestablishedattheNorthernandSoutherncatchmentsoftheMorningtonPeninsula.AlongwiththeKCAG,thesefocusgroupsspecificallyadviseonclinicaldirectionsforAboriginalhealthservices.

PeninsulaHealthhasaddressedthekeyfocusareasofthe‘ImprovingCareforAboriginalandTorresStraitIslanderPatients’(ICAP)programthroughaseriesofinitiativesandprojectsoverthelastyear(seetablepg.11).TheICAPprogramisdesignedtoimproveculturalidentificationandhealthcareforAboriginalpatientsacrossthehealthservice.

Koori Community Advisory Group Logo Painting

TheflexibilityandresourcefulnessoftheAustralianpossumgaveBeaEdwardstheinspirationforherlatestworkofartwhichisfeaturedonthecoverofthisreport.

Bea,arenownedindigenousartistandPeninsulaHealth’sAboriginalLiaisonOfficer,recentlydesignedtheKooriCommunityAdvisoryGrouplogo.

Thelogo,entitled‘PossumDreaming:Agility,VersatilityandDiversity’representstheneedtobeflexiblewhendealingwiththehealthneedsoftheindigenouscommunity.

Eachcornerofthepaintinghasadifferentmeaning–

theMoth–makesthemostoftoday.Mothshaveashortlifespanandneedtoliveinthenow

theGrub–stability.Grubsliveintrees,yetdonoharmtothetreeitself.Thissymbolisesthecapacitytoliveandworktogether

theWattleandAppleberry–bothrepresenttheneverendinglifecycle.

Beachosethepossumbecauseofitsagilityandadaptabilitytomanoeuvrethroughdifferentobstaclesandsetbacksinitspath.

“Sometimeswehitabrickwall.Bycallingon‘PossumDreaming’weareabletothinkofwaystobuildandopendoorsthathelpusgettotheotherside.”

“Indigenouspeopledonotnecessarilyfitintothemainstreamhealthsystem.Oftenthispreventsthemfrommakingsounddecisionsregardingtheirhealth,”Beasaid.

“Havingtheabilitytouseaflexibleapproachtothedeliveryofcarewillhelpindigenouscommunitymemberstomaketherightdecisionsabouttheirhealth.”

Beahopesthelogowillincreaseculturalunderstandingandawarenessofthespecifichealthneedsoftheindigenouscommunity.

�0 Peninsula Health Quality of Care Report 2007 Working with Partners

KEY RESULT AREAS DEMONSTRATION OF ACHIEVEMENT

Key result area �:EstablishandmaintainrelationshipswithAboriginalcommunitiesandservices

AppointmentofCommunityAccessworkerandHealthPromotionworkertoidentifyriskfactors,designculturallysensitivehealthservicesandencouragetheuseofthesehealthservicesbyIndigenouspeople.

ParticipatedinNationalAboriginalIndigenousDayofCelebration(NAIDOC)weekinJuly2007byhavingadisplayinthefoyerandco-ordinatedandsponsoreddecorationsandticketsalesfortheNAIDOCball.Transportedelderstoandfromevents.SponsoredtheartshowinDomino’sCafe.Distributed400showbagsandhatsatthefamilyfunday.NAIDOC2007celebrated50yearsofNAIDOCandthe40thanniversaryofthereferendumtogiveAboriginescitizenship.

AssistedinthedevelopmentofFrankstonCity’sIndigenousGardenatGeorgePentlandBotanicGardensaspartofthecelebrationsofHarmonyDayonMarch27.

KooriCommunityAdvisoryGroupmetsixweekly.

Key result area �:Provideorcoordinatecross-culturaltrainingforhospitalstaff

37staffmembershavecompletedahealthpromotioncourse,specificallydesignedtoaddressthehealthneedsofAboriginalpeople.

EducationintheMentalHealthandEmergencyDepartmentsisplanned.

AculturalsensitivitytrainingprogramwillbeofferedtostaffacrossPeninsulaHealthin2007/08.

StaffcontinuetoparticipateinarangeofworkshopsconductedbytheVictorianAboriginalCommunityControlledHealthOrganisation.

PeninsulaHealthKooristaffundertookworkshopsalongwithstafffromMorningtonPeninsulaShireandNgwalaWillumbong(asupportservicefortheKooricommunity)tojointlydevelopPeninsulaspecificculturalawarenesstraining.

Key result area �:SetupandmaintainserviceplanningandevaluationprocessesthatensuretheculturalneedsofAboriginalpeopleareaddressedwhenreferralsandserviceneedsarebeingconsidered,particularlyinregardtodischargeplanning.

TheKooriCommunityAdvisoryGroup(KCAG)hasadirectroleinensuringthattheneedsofAboriginesaremetatallpointswithinPeninsulaHealthservices.TheKCAGmetthroughout2006/07andworkedonensuringPeninsulaHealthservicesareaccessibleandappropriateforIndigenousclients.

Key result area �:EstablishreferralarrangementstosupportallhospitalstafftomakeeffectiveprimarycarereferralsandseektheinvolvementofAboriginalworkersandagencies.

TheAboriginalHealthPromotionandChronicCareProgram(AHPACC)wasestablishedin2006/07.ThisprogramaddressesthechronichealthneedsofAboriginesandseekstocreatesupportivecommunitybasedoptionsforAboriginesonthePeninsula.PeninsulaHealthcontinuestohavestrongrelationshipswithotherKooriserviceprovidersoperatingonthePeninsula,undertakingregularmeetingswithIndigenousservices.

Improving Care for Aboriginal and Torres Strait Islander Patients program

��Peninsula Health Quality of Care Report 2007



PartnershipswithotherhealthcareprovidersproducemanybenefitsforPeninsulaHealthanditsconsumers.

Aswell,thesepartnershipsofferopportunitiesforPeninsulaHealthtosharesuccessfulstrategiesithasdevelopedandtoinfluenceandcontributetoavastrangeofclinicalexpertiseandinnovation.

SeniorstaffmembersthroughoutPeninsulaHealthrepresentthehealthserviceanditscommunityonmanysignificantBoards,committeesandacademicassociations.

Someoftheseare:

theAustralianCouncilonHealthcareStandards

the2008NationalFallsPreventionConferenceorganisingcommittee

theAustralianandNewZealandCollegeofAnaesthetists

theRoyalAustralasianCollegeofMedicalAdministrators

theRoyalAustraliaandNewZealandCollegeofPsychiatrists

theDepartmentofHumanServices:SouthernRegionAlliedHealthTrainingCommittee;BetterSaferTransfusionAdvisoryCommitteeandStateTraumaCommittee

theVictorianAlcohol&DrugAssociation

theVictorianPharmacotherapyNetworkCommittee

MonashUniversity’sDepartmentofEpidemiologyandPreventiveMedicine

MelbourneUniversity’sCentreforPsychiatricNursingAdvisoryCommittee

PostgraduateMedicalCouncilofVictoria

ChisholmInstituteofTAFE

theWesternportLatrobeRegionalCommunicationService

theInnovativeHealthServicesforHomelessYouthRegionalNetwork

MorningtonPeninsula‘CommunitiesthatCare’

FrankstonMorningtonPeninsulaPrimaryCarePartnerships

theHealth&WellbeingCommitteesofFrankstonandMorningtonPeninsulaShire

theFrankstonCommunitySafetyManagementTeam

theFrankstonRelationshipsCentreAdvisoryCommittee

theFrankstonWorkingTogetherStrategy.

Drug and Alcohol Services

Itwas“lights,camera,action”during2007astwolocallyproducedshortfilmsonyouth,drinking,safetyandfriendshiphitcinemaanddrive-inscreensatEaster.

The2PICShortFilmProjectwasajointventurebetweenPeninsulaHealth’sPenDAP(PeninsulaDrugandAlcoholProgram)andtheMorningtonPeninsulaShire.

Thefilmswereconceived,writtenandproducedbylocalyoungpeopleandweremadepossiblebyagrantfromtheNationalCrimePreventionProgramoftheCommonwealthAttorneyGeneral’sDepartmentanddonationsfromprivatebenefactors.

ThetwelvemonthprojectinvolvedmanyyoungvolunteerswhohelpedwiththefilmsentitledAdriftandEverywhereYouGoandbothfilmsreceivedapositiveresponseontheirrelease.

�� Peninsula Health Quality of Care Report 2007


“Polly”featuredinallOpenUpDisplays

Open Up

ThisyearPenDAPalsocompletedasuccessfultrialofanoralhealthprogramfordrugusers.Theproject,called‘OpenUp’,filledanacknowledgedgapinDrugandAlcoholServices.

Drugusersusuallysufferfromaconditionthatreducestheamountofsalivaproduced.Thisinturncontributestotoothdecayandotherdentalproblems.Addedtodrugabuse,lifestyleissuessuchaspoornutritionandhygiene,andtheoralhealthimplicationsaresignificant.

OvertwoyearsPenDAPstaffdevelopedtheOpenUpprogramanddisseminateditthroughmanyavenues,includingtheSHARPSneedleexchangeprogram.

In2006postersandpamphletswereproducedwithinformationonoralhealth,andover1000oralhealthpacksweredistributedtodrugusers.Thepackscontainedtoothpaste,atoothbrush,adrinkbottle,sugarfreesweetsandinformationondentalhealth.

PenDAPstaffregularlyliaisewithlocaldentalclinics,pharmaciesandmethadoneclinicsandhavepresentedpapersontheprojectatconferencesinAustraliaandoverseas.

TheAustralianDrugFoundationnowdistributesthePenDAPpostersandpamphlets.Agencieshereandabroadhaverequestedinformationontheinnovativeapproachtothisissue.

Interpreter Services

Understandingmedicaltermsandconceptscanbedifficultfortheaveragepersontryingtogetinformationabouttheirhealthstatusandtreatment.Forpeoplewhodon’tspeakEnglish,however,virtuallyalltheinformationisincomprehensible.

Approximately10percentofallpeoplewholiveinFrankstonandontheMorningtonPeninsulacomefromnon-Englishspeakingbackgrounds.ThePeninsulaHealthInterpreterServicehelpstoensurethatpatientsofallbackgroundshaveaccesstotrainedinterpreterstohelpthemtocommunicatewiththeirmedicalteams.

Throughtheservice,interpreterswilleitherassistthepatientonsiteorwillinterpretoverthephoneatnocosttothepatient.

During2006/07therewasanaverageof60interpreterbookingspermonth.ThemainlanguagesrequestedwereGreek,Italian,Auslan(Signlanguageforhearingimpaired),Mandarin,Croatian,Dari,CantoneseandArabic.



Hitting the bullseye

Studentsfromlocalprimaryschoolsareaimingforabullseye,thankstotheNationalArcheryinSchoolsProgram(NASP).

NASPisaninschools’programwherestudentsaretaughtthepracticalandtheoreticalskillsinarchery.Theprogramoffersphysicalactivityinwhicheverystudentcantakeparttogether,regardlessofhisorherphysicaloracademicability.

Earlierthisyear,PeninsulaHealth’sFrankstonSchoolFocussedYouthServices(SFYS)distributedagrantofover$31,000toeightlocalschoolstopurchaseequipmentandtoworkwithNASPAustraliatoestablishalocalarcheryprogram.

ArcheryisahitwithschoolchildreninFrankston.TheprogramisreachingouttothemthroughtheCommunityHealthServiceandtheFrankstonSchoolFocusedYouthService.

SFYSsupportsschoolsintheFrankstonareatoaddresstheneedsofatriskyoungpeoplebetweentheagesof10-18years.

Archeryisincorporatedacrossthebroadereducationalcurriculumandisanexcitingwaytoenticestudentstotakeaninterestinothersubjects.Itcanbepromotedinrelevantareassuchasmathsbymeasuringdistancesonanarcheryrange,plusscienceandhistory.

Runningthroughoutthefirstandsecondschooltermsof2007,NASPwasofferedasaPEclassactivityforaminimumofone40minuteperiodeachweekafterschool.

HillviewBirthingUnit,NurseUnitManager,LorettaWhyteispicturedwithnewmumArleneYeohandbabyBrandon.Brandonisoneof55babiesbornin2006/07,atHillviewFrankstonsinceitsrelocationfromRosebudHospitalinApril.(seepg.19)

�� Peninsula Health Quality of Care Report 2007 Quality and Safety

Clinical Governance

“A framework through which health care organisations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”.

- G. Scally and L.J. Donaldson, ‘Clinical Governance and the drive for quality improvement in the new NHS in England’,

BMJ (4 July 1998): 61-65.

PeninsulaHealthhasinplacealongestablishedclinicalgovernanceframeworktoensurethattheHealthServicedeliverssafe,qualityhealthcare.ThismeansthattheHealthServicehaschecksandbalancestomonitorperformanceandtohighlightwhereithasperformedwellandwherethereareopportunitiesforimprovement.

TheBoardcloselymonitorsqualityandpatientsafetyperformancethroughtheQualityandClinicalGovernanceCommittee,whichmeetseveryeightweeks.TheCommitteeischairedbyaBoardDirectorandisattendedbytwootherBoardDirectorsandtheBoardChair.AmemberoftheConsumerAdvisoryCommitteeandSeniorManagers(clinicalandnon-clinical)arealsoinattendance.

TheBoardQualityandClinicalGovernanceCommitteereceivesreportsfromanumberofsubsidiarycommitteesincludingInfectionPreventionandControl,MortalityReviewandPatientSafety.TheBoardalsomonitorsperformanceagainstasuiteof25KeyPerformanceIndicators(KPIs).

TheseKPIssettargets,examplesofwhicharethecleanlinessoffacilities,therateatwhichpsychiatricpatientsareputintoseclusion,therateofpatientfallswithharmandthenumberofpressureulcersdevelopedwhileapersonisaninpatientatPeninsulaHealth.

Performanceistrackedagainstexternal‘bestpractice’standards(wherepossible)orotherwiseagainstaninternallydevelopedtarget.Inaddition,theCommitteereceivesupdatereportsoncontinuousqualityimprovementactivitieshappeningacrosstheHealthService.

TheCommitteealsoreceivesaregularreportonconsumersatisfaction.Onereportdetailsthenumberofcomplaintsreceived,trackstrendsintermsofthetypeofcomplaintreceivedandmonitorsactionstakenasaresultofacomplaint.

TherearealsoregularsurveysincludingtheVictorianPatientSatisfactionMonitor(VPSM).VPSMisanindependentsurveyofpatientsatisfactionconductedbyanexternalagencyonbehalfoftheDepartmentofHumanServices(DHS).PeninsulaHealthreceivesreportseverysixmonthsforFrankstonHospital,RosebudHospitalandAgedCareandRehabilitationServices.

ThesereportsandactionsarepresentedtotheCommittee.Examplesofactionstakenareshowninthisreport.

OneofthenewdevelopmentalcriteriadevelopedbytheAustralianCouncilonHealthcareStandards(ACHS)EQuIP4processrequireshospitalstoensure“Healthcareandservicesareappropriateanddeliveredinthemostappropriatesetting”.

PeninsulaHealthwillcontinuetoimplementstrategiesthatfocusonthedevelopmentandmonitoringofprogramsandservicesthatareappropriateforclientsandpatients,anddeliveredinthecorrectsetting,toensurethatthiscriterionisachieved.

TheongoingdevelopmentofClinicalPathwaysisoneexample

oftheprocessesbywhichappropriatenessofcareisdefinedanddelivered.Otherexamplesincludethedeterminationofpatientsinacutesettingsasnotreadyfortransferiftheystillhaveacutemedicalillnesses,andthedeterminationofsomepatientsreferredforelectivesurgeryasnotappropriatefortreatmentinanacutepublicsetting.TherelocationofHillviewMaternityServicesfromRosebudHospitaltoFrankstonHospital,theopeningofthenewmedicalimagingserviceforinterventionalangiographyandtheutilisationreviewscarriedouttoensureguidelinesforreferralforhighlevelradiologyscanningmeetguidelinesforreferralalsosupportthisprinciple.

Quality and Safety ��Peninsula Health Quality of Care Report 2007

AtPeninsulaHealthqualityandpatientsafetyaredeemedtobeeveryone’sresponsibility.TheannualQualityandPatientSafetyWeekandPeninsulaHealthQualityandPatientSafetyAwardsforstaffreinforcethismessage,asdoestheannualMedicationSafetyWeek.

ContinuousimprovementinqualityandpatientsafetyisonlypossibleatPeninsulaHealthbecauseof:

staffwillingnesstoreportincidentsornearmissesinthecontextofa‘just’culture.ThisprovidestheHealthServicewiththeopportunitytoreducethepossibilityofthesameeventhappeningagain

directconsumerfeedbackintermsofsatisfactionsurveysandcomplaints

staffproactivelyidentifyingareaswhereimprovementisrequired,puttinginplaceachangeandmonitoringtheoutcometoensureithadthedesiredeffect.TheHealthServicecurrentlyhasover1000qualityimprovementactivitiesloggedonitscentralQualityImprovementActivitydatabase.Theseareabletobeviewedbyallstaff,andthispromotescrossorganisationallearning.

Thisreportcontainsexamplesofhow,bythesemeans,PeninsulaHealthdeliverscontinuousimprovementintermsofqualityandpatientsafety.Forexample;TheThoracicMedicineDepartmentsurveyedpatientsattendingthedepartmentforLungFunctiontests.Theaveragewaitwas6.9minutes,though62percentwaitedlessthan5minutes.Thebackofthereferralslipthatissenttopatientshasamapofthelocationofthedepartment.The

surveyshowedthat61percentdidnotusethemapand31percentthoughtitwastoocomplicated.Asaresultthemaphasbeenredrawnandsimplified.100percentofpatientsreportedtheserviceasbeingwhattheyexpectedorbetterthanexpected.AnevaluationoftherevisedmapwillbepartofthegeneralsurveyinOctober2007.

Insupportofitscommitmenttocontinuousimprovement,PeninsulaHealthhasreviewedthemanagementandreportingofClinicalGovernanceandQualitytocovertheperiodto2010.Thisincorporatestheinternationalbestpracticeprinciplesof‘pursuingperfection’.Wewillprovideanupdateinnextyear’sreport.

Clinical Credentialling and Defining Scope of Practice

CredentiallingistheformalprocessusedatPeninsulaHealthtoconfirmthatseniordoctorshavetherightqualifications,training,experienceandprofessionalqualitiestoensurethatpatientsgetthehighestqualityofcareandtreatment.

Partoftheprocessisdefiningeachdoctor’sareaofexpertiseandclinicalskills,basedontheirqualificationsandexperience.Allmedicalstaffarecredentialled;allocatedascopeofpractice;andareformallyappointedbytheBoardofDirectorsontheadviceoftheSeniorMedicalandDentalStaffAppointmentsCommittee(chairedbytheChiefExecutive)beforecommencingworkatPeninsulaHealth.

ThisprocessisundertakeninaccordancewiththeNationalStandardonCredentiallingandDefiningtheScopeofClinicalPractice;thePolicyonCredentiallingandDefiningtheScopeofPracticeforMedicalPractitionersinVictorianHealthServicesrecentlyissuedbythe

DepartmentofHumanServices;andthePeninsulaHealthPolicyonCredentialling,DefiningScopeofPractice,andAppointmentofSeniorMedicalandDentalStaff.

Credentiallingisnotlimitedtomedicalstaff.NursingandAlliedHealthservicesalsoundertakestrictcompetencyassessmentswhenstaffdevelopspecialisedskills.ForexamplethePhysiotherapyDepartmentalsohasinternalcredentiallingprogramsbasedoncompetencyassessmentsforthemanagementofpatientswithintheIntensiveCareUnit(ICU).AnadvancedpractitionerframeworkhasalsoenabledsuitablyqualifiedphysiotherapiststooperateasprimarycontactpractitionerswithintheEmergencyDepartment(ED)andtoorderX-raysinternallywithinPeninsulaHealth.

Mentor Program for Junior Medical Staff

Startinganewcareerisbothexcitingandconfrontingandpresentsmanynewchallenges.Aspartofasupportiveenvironment,PeninsulaHealthoffersaMentorProgramtoitsnewdoctors.

AspartoftheHospitalMedicalOfficersUnitStrategicPlanwhichwasimplementedlastyear,theMentorProgramprovidesjuniorincludingoverseas-traineddoctorswithsupportandprofessionaladvice.Therearesixmentorswhohelpjuniordoctorsprepareforexamsandprovideguidanceonprofessionalissues.

Whennecessaryandagreed,theoverseas-traineddoctorsareassistedwithcommunicationissuesincludingaccentameliorationwhereneeded.AspartofastatewideprogramtheMedicalClinicalEducatorreviewstheskillsofthesedoctorstodeterminetheirstrengthsandweaknessesandprovidesrefreshertrainingandprofessionalguidanceasneeded.


Quality and Safety

SkipLam,DirectorofPharmacyholdingtheACHSQualityImprovementAwardwith:BobRibbons,Manager,ClinicalInformatics(left)andGaryBraun,DirectorofClinicalPracticeImprovement.

Accreditation

Communitieswanttoknowthattheirhealthservicesareperformingwellandcanbetrustedtoprovidesafe,highqualitycare.

Oneassuranceofthisisreceivingaccreditationfromanationally-recognisedorganisation.InAustraliatheimportantaccreditingbodyforhealthserviceprovidersistheAustralianCouncilonHealthcareStandards(ACHS).

Lastyearagroupof10surveyorsfromACHSreviewedallservicesatallsitesmanagedbyPeninsulaHealthandawardedtheHealthServiceafullfouryearaccreditation.ThesurveyorsfromACHScommented“Throughout Peninsula Health there is an obvious consumer focus and a widespread culture of improving performance. There is evidence of involvement of staff at all levels in quality activities which are facilitated by the strong leadership of the Executive and the Board”.ThesurveyorsawardedPeninsulaHealththehighestawardofOutstandingAchievementforitslegalcomplianceprogramandExtensiveAchievementfortwentyoneoftheareasreviewed.ThiswastheHealthService’sbesteveraccreditationsurveyresultandwas,anecdotally,oneofthebestresultsinAustraliafor2006-07.

ThenextfullACHSSurveyisscheduledforNovember2010.

Residential Care Accreditation

TheAgedCareStandardsandAccreditationAgency(ACSA)istheindependentbodyresponsibleformanagingtheaccreditationandongoingsupervisionofAustralianGovernment-fundedresidentialagedcarefacilities.

AllfourofPeninsulaHealth’sResidentialAgedCareUnitsmaintainfullACSAaccreditation.Positivefeedbackhasalsobeenreceivedfromunannouncedsupportvisits,whichmonitorfacilitiesonanongoingbasistoensurethatresidentscontinuetoreceiveahighlevelofcareandthatallstandardscontinuetobemet.

JeanTurnerNursingHomeandLotusLodgeHostelreceivedunannouncedsupportvisitsfromACSAinFebruaryandwerefoundcompliantwithallareasoftherequiredstandards.

InNovember2006,anunannouncedsupportvisittoMichaelCourtHostelscrutinisedincidentreportingindepth.Resultswereverypositiveandsurveyorsnotedthattherewasnoneedforfurthercontactvisitswithina12monthperiod.

Responding to Complaints

PeninsulaHealthcontinuestoreceivecomplimentsandcomplaintsfromconsumersviapost,emailandtelephone.ThesearesenteitherdirectlytoCustomerRelationsortothestaff/areaconcerned.Thisyearwereceived256complimentsand512complaints.Itispleasingtonoteanoverallreductionincomplaintsandparticularlyintheareasofcommunicationandtreatmentcomparedwiththepreviousyear.Theaveragetimetakentocloseacomplaintforthisyearwas24.1workingdayswhichiswithintheHealthService’stargetof28days.

Since2006,whentheConsumerSatisfactionQuestionnaireforfeedbackonthecomplaintsprocesscommenced,only16responseshavebeenreceived.However,67percentoftheseconsumersfeltthattheirissuewasdealtwithinatimelywaycomparedto50percentin2005/2006.83percentoftherecentsurveygroupfeltthattheircomplaintwashandledinaconfidential,fairandequitablemanner.

ExamplesofhowPeninsulaHealthhasrespondedtoconcernsorcomplaintsareasfollows:

Firstly,patientsandrelativesexperiencevaryinglevelsofstressandisolationduringahospitalstay.Thiscanmanifestitselfinmanywaysincludingrefusingtoeat.Afamilymembercontactedusconcernedthattheirrelativewas“starvingtodeath”whilstinhospital.

Duringtheprocessofinvestigatingandrespondingtothiscomplainttherefusaltoeatwasfoundtobecausedinsomepartbythepatient“piningforhisdog”.Thiswaseasilyremediedbyarrangementsthatledtothedogbeingbroughtintohospitaltovisitwithinguidelinessetoutintheinfectioncontrolpolicy.Thisprovidedmuchreliefandapositiveexperienceforboththepatientandfamilyconcerned.


Quality and Safety

How do you thank someone for

returning someone you love back to

you twice over?

I can only do so by acknowledging

them this way: thank you to the

Frankston Hospital Emergency

Department intensive care surgical

team, Peter Evans and Dr Paul

Simpson and their wonderful team

for their continual care and effort

given to bringing about healing.

Thank you to the wonderful staff

in 4GS for their profes sionalism

and commitment to their patients.

Not only that, but also for their

empathy and caring shown not only

to my husband, Bil l , but also to me

as we travel led together for many

Secondly,afamilymembercomplainedthatshewasunabletophonethewardatMountElizaCentre(MEC)overnight.ItwasidentifiedthatcallstoMECweredivertedtotheFrankstonHospitalswitchboardafterhours;howeverinthisparticularinstancetheswitchboardwasverybusyandunabletoattendtothecall.

AsaresultabrochurewasdevelopedforfamilieswhichprovidedirectphonenumberstothewardsattheMountElizaCentre.

Compliments

PeninsulaHealthcontinuestoreceiveunsolicitedcomplimentsfromsatisfiedconsumers.ThesecomplimentsaresenteitherdirectlytothedepartmentconcernedortoCustomerRelations.ThefollowingcomplimentsweretakenfromtheMarch/September2006VictorianPatientSatisfactionSurvey(VPSM):

“Thestaffintheemergencydepartmentwasverygoodatmakingmefeelcomfortableandateasebeforeandaftermyprocedure.IwastoldexactlywhatwasgoingtobedonesoIwasveryrelaxedaboutthewholething”.

“ThestaffandnursesweregenerallypassionateaboutbabiesandnewmumsandrespectfulasIalreadyhadababyandanideaofwhatIwasdoing.Foodgood.Informationavailabletophotocopyandtakehome-veryuseful”.

29.26%

32.78%

7.2%22.41%

3.33%

2.41%1.48%

1.11%

COMMUNICATION

TREATMENT

ACCESS

RIGHTS

ATMOSPHERE/HOTEL

COST

PRIVACY

ADMINISTRATION


Quality and Safety

Peninsula Health Complaint Issues Classification July 2006 to June 2007

I want to pass on my sincere thanks and appreciation for the treatment and care I received during my stay in Frankston Hospital . I was admitted through triage on Friday 4 May having suffered at home alone for over 42 hours with Gastro Enteritis. I have had many assoc iations over 60 years with your hospital and cannot speak highly enough. In my own right, and also as a war widow, I know when I am in medica l trouble , it is Frankston Hospital for me. Thank you and your medica l staff, Joy

We get letters

I was a patient at Frankston Hospital from June 29 to July 9 fol lowed by three days of hospital in the home.I wish to advise that the treatment and care I received whilst a patient was excel lent. The dedication and concern shown by the nursing staff and doctors on a dai ly basis was wonderful.On arrival , I was al located to the Emergency Ward. I must congratulate the Hospital staff for the way they coped during the night with some difficult situations with some patients. They must have the patience of a Saint.

I again wish to thank you

sincerely for the wonderful care,

attention and patience which you

gave to Marry Anne in January

2007 when she was brought from

an aged care facility to the

Frankston Emergency Department

in a very distressed condition.

The Paramedics, staff in

Emergency and staff in ward

5GS cared for her and treated

her magnificently, with plenty

of TLC, as they had done on a

previous admission.

I have so very much appreciation

for that.

Yours Sincerely,

Patrick

AsculpturethatfeaturesinthenewHillviewFrankstonBirthingUnit

Special Care Nursery

Babiessometimesexperiencepainandthismayaffecthowtheyrespondtosometreatments.ThestaffinSpecialCareNurseryembarkedonaprojecttoaddressthisconcern.

Anextensiveliteraturereviewfoundstrongevidencetosupportthebenefitsofgivingsucrosedirectlyintothemouthpriortoaproceduresuchasaheelpricktoobtainblood.Howothersimilarunitsworkedwasexaminedandtheirapproachsupportedthispractice.Inconsultationwiththepharmacydepartmentandpaediatricians,awrittenguidelinewasdevelopedandimplementedforuseinthespecialcarenursery.

Successiveauditshaveshowngoodstaffcompliancewiththisprotocolandbenefitstothebaby.Followingimplementation,itwasnotedthatthebabieswerelessupsetfollowingheelpricksandweremoresettledafterwards.Thepathologynursesfoundtheywerespendinglesstimecollectingbloodsamplesandthatitwaseasiertocollectthebloodsample.

Thispracticenowplaysanimportantpartinthenursery.

Hillview Maternity Unit

InresponsetotheshortageofObstetricians,therelocationoftheHillviewBirthingUnitfromRosebudtoFrankstonHospitalwascarriedoutinApril2007.ThisenhancedthecareandchoicesavailabletowomenontheMorningtonPeninsula.

BoththeFrankstonHospitalandRosebudHospitaloffermidwifeledcare.OnemajordifferencewasthatatFrankston,midwiveswouldhavegreatersupport,whenrequired,fromawiderrangeofspecialistclinicians.Thatsupportisnowavailable,ifrequired,towomenbookedwiththeHillviewBirthingUnitatFrankstonHospital.

Therelocationoftheunitprovidesasaferenvironmentformothersandtheirbabies.Italsooffersmorewomenanopportunitytochoosethemodelofcaretheypreferwithaccesstomedicalexpertiseifitisrequired.CurrentlymorethanhalfthebirthsatFrankstonHospital,andnearlyallHillviewUnitbirths,aremidwifeled.Thisisexpectedtocontinueinthefuture.

TheHillviewBirthingUnitatFrankstonHospitalwasestablishedinaseparateareaoftheexistingMaternityward.ThetwoHillviewbirthingroomsandthreepostnatalbedsduplicatethefacilitiesthatwereavailableatRosebudHospital.Thesefacilitiesaresufficientfortheanticipatedonebirthaday.StaffrotatebetweenthetwositesandtheRosebudHospitalsitecontinuestoprovidepreandpostdeliveryservices.

FrankstonHospital’smaternityward,whichoverseas2000birthsayear(2168birthsin2006/2007),currentlyhasfourbirthingsuitesand19postnatalbeds.AnexpansiontoFrankstonHospital’smaternityfacilitiesisplannedfor2008.Thiswillresultinadditionalmaternityandbirthingfacilities.

Throughtherelocation,PeninsulaHealthhas:

ensuredthatdoctors(whetheritisanobstetrician,anaesthetistorpaediatricianrequired)areonhandquickly

preservedtheRosebudmodelatFrankstonbyprovidingprimarymaternitycareinwhichmidwivesprovidecareforwomenwithoutcomplications

enabledmorewomenaccesstoprimarymaternitycarebyrelocatingthehighlyvaluedmodeltoFrankston

increasedcapacityatPeninsulaHealthsothatthebestofmidwifecarecanbeprovided.

AlthoughbirthsnolongeroccuratRosebudHospital,womenfromtheSouthernPeninsula,andtheirfamilies,onlyhavetotraveltoFrankstonfortheactualbirth.TheHillviewWingatRosebudHospitalcontinuestoofferarangeofantenatalandpostnatalprograms,anInfantFeedingService,aHomeVisitService,andaSleepClinicforinfantsandaMotherBabyUnit,whichassistsnewmothersexperiencingdifficultyinsettlingtheirbabies.

TwoexpertreportsrecommendedtherelocationoftheHillviewBirthingUnitandpreservationofitsmodelofcare.TheyconfirmedthatthiswasinlinewiththepolicyonFutureDirectionsforVictoria’smaternityservices,releasedinJune2004.


Quality and Safety

Rights and Responsibilities

UnderstandingtheirRightsandResponsibilitiesimprovespatients’experiencesinhealthcaresituations.

Knowingwhattheyhavearighttoexpectandwhatisexpectedfromthemcanenhancetheirowntreatmentandrecovery.

OverseveralyearsPeninsulaHealthhasinitiatedarangeofstrategiesdesignedtoraiseconsumerawarenessofRightsandResponsibilities.Thesehaveincludedpostersprominentlydisplayedatalllocationsandleafletsgivenoutbystafftoallconsumersonadmission.

AuditsundertakenatregularintervalsverifiedthattheRightsandResponsibilitiesmessagewasbeinggivenroutinelytoconsumers,andconsumerfeedbacktotheVictorianPatientSatisfactionMonitorshowedthatPeninsulaHealth’sperformanceinmakingthemessageavailablewasabovethestateaverage.

However,consumerfocusgroupsconductedbyPeninsulaHealthrevealedthatmanyconsumersthoughttheinformationprovidedwashardtounderstand.

Consumerswantedtheopportunitytoaskforfurtherinformationand

expressedapreferencetoreceivetheinformationverbally.

Inresponsetothisdirectfeedbackfromconsumers,staffrewrotetheinformation,reducingthenumberofwordsontheleafletsandposters.Inaddition,newinformationwasportrayedbymeansofsymbolssuchasanearaccompaniedbythewords“Youhavetherighttobeheard”.Aposterwasdesignedanddistributedandapostcard,withafeedback/furtherinformationformonthereverseside,wasproduced.

Areviewofthenewmaterialshowedthat85percentofpatientsonthewardswhereitwastrialedwere“highlysatisfied”withthenewpostersandpostcard.Thiscomparedtolessthan50percentofpatientssurveyedpriortothechanges.

Patient Satisfaction Survey

TheVictorianPatientSatisfactionMonitor(VPSM)isasurveyconductedtwiceayearbyanexternalagencyonbehalfoftheDepartmentofHumanServices(DHS).ReportsonthisaresenttoPeninsulaHealthtwiceayear.Thesereportsaimtoassisthospitalsinimprovingservicesandpatientsatisfaction.ItgivesPeninsulaHealththeopportunitytocompareitsresultswithothersimilarhealthservicesinVictoria.

Frankston Hospital

Asaresultofthesurvey:theinformationwrittenondrugchartsnowincludesindicationsandsideeffects;betterexplanationsareprovidedtopatientsaboutmedicationsondischarge;mealtemperatureswereimproved.Satisfactionsincreasedfrom73percentto76percent.

Otherimprovementactionsincluded:

improvingthecomplaintprocessintheEmergencyDepartment–RightsandResponsibilitiespostersandbrochuresarenowhighlyvisible.RedCrossvolunteerstalkwithpatientsandrefercomplaintstotheNurseUnitManager

anewleaflettoexplainwhyitisnotalwayspossibletoimmediatelyaccommodatesamegenderrooms.Howevereveryeffortismadetomeettheconsumer’sneeds.

�0 Peninsula Health Quality of Care Report 2007

Quality and Safety

75%

80%

85%

90%

95%

FRANKSTON ROSEBUD MOUNT ELIZAAGED CARE

STATE AVERAGE

Patients Informed of their Rights and Respnsibilites Sep 2006 to Feb 2007

Rosebud Hospital

Inthelastsurveyimprovementswerenotedinthefollowingareas:

qualityandquantityofmeals

patient’sawarenessoftheirrightsandresponsibilities

explanationofmedicinesneededafterdischarge

communicationwithallhealthprofessionalsabouttreatment.

Improvementactionswereasfollows:

RenovationstoEmergencyDepartmentwaitingroomstoprovidemoreprivacyandcomfortandachildren’splayarea

creatingarestfulenvironmentbyreducingthevolumeofoverheadvoicepagingandreviewingtheworkpracticesofPatientServiceAssistantseg.vacuuming.

Mt Eliza Aged Care and Rehabilitation Centre

Thisisthesecondtimethesubacuteserviceshavebeenincludedinthesurvey.Improvementsincluded:

makingtheaccessandadmissionprocessmadeconsumerfriendly

enhancingdischargeandfollowupprocesses-akeyliaisonteammembercoordinatesallrequirementspriortodischargeandfollowsuppostdischarge.

Improvementactionswillinclude:

improvinggeneralpatientinformation-aspectsontheimportanceofclearandaccuratecommunicationincorporatedintoorientationprogramsforallstaff

complaintsmanagement-ConsumerPortfolioHoldersarenowlocatedineachdepartment.Theyareresponsibleforensuringthatconsumerfeedbackcardsarereadilyavailableandthatresponsesarecollectedandcollated.Areportismadetoeachindividualdepartmentonthisconsumerfeedback

physicalenvironment-inSeptember2007thewardswillberelocatedtothenewMorningtonCentre.

Clinical Skills Centre

AnewClinicalSkillsCentrewasopenedinApril2007toprovideapositivelearningenvironmentforallmedicalofficers.Thecentrehasstateoftheartmedicalmannequins(lifesizemodels)thatareusedtopracticeclinicalskills.Therehavebeensixsessionscompletedwith25juniordoctorswhoweresupervisedbyspecialists.

RiSCE Training

PeninsulaHealthiscommittedtoprovidingaworkplaceandcareenvironmentthatensuresstaffandvisitorsandpatientsaresafeandprotectedfromharm.

TheRiSCE(Riskidentification,Safety,ContainmentandEnvironment)trainingpackagewasdevelopedincollaborationwithconsumerandcarerrepresentation.Itincorporatesfourkeypracticeandbehaviourprocessesmanagingoccupationalviolence,restraint,seclusionandbehavioursofconcernwiththeexplicitintentofensuringtheinterconnectingissuesaremanagedwellandaccordingtobestpractice.

InAugust2006,basedonapositiveevaluationoftheRiSCEpilotinthePeninsulaHealthPsychiatricServices,itwasproposedthatRiSCEbeadoptedasabestpracticemodelforallPeninsulaHealthsites.

TheRiSCEtrainingprogramhasbeenadaptedandnowoffersfourlevelsoftrainingdependingontheneedsofindividualstaffandpatientgroups.

FeedbackfromtheRiSCEtrainingprogramwasoverwhelminglypositive;forexample“Besttrainingdayseverattended”.Theoutcomeofthetraininghasbeenamoreproactiveapproachtoworkingcollaborativelywithpatientsandtheircarerstoidentifytriggersandinterventionsforpotentialstressors.


Quality and Safety

StaffparticipatinginRiSCEtrainingprogram

Infection Prevention and Control

AtPeninsulaHealth,InfectionControlis“Everybody’sBusiness”.Peoplewithawiderangeofillnessescometohospitaltobetreated.Soaspartofcaringforpatientsinhospitalandotherhealthcarefacilities,itistheroleofstafftoensurethatthevirusesandbacteriathatarebroughtinarenotspreadaround.

GuidedbyspecialistsintheInfectionPreventionandControlDepartment,staffatPeninsulaHealthareeducated,monitoredandsupportedineffortstominimisethespreadofinfectionandtopromotethecleanlinessnecessaryfora‘germ-unfriendly’environment.

Hand Hygiene

TheHealthServicehas,forseveralyears,participatedinahandhygieneprograminVictoria.Asapilotsiteforhandhygienetrials,PeninsulaHealthiscommittedtoimprovinghandhygienecomplianceandtodisseminatinginformationaboutthisvitaltopictostaffandtothecommunity.

HandhygieneisthesimplestandmosteffectivemeansofpreventingthespreadofHospitalAcquiredInfections(HAI’s).Anumberofinfectiousdiseases,likegastro-intestinalinfections,canbespreadfromonepersontoanotherbycontaminatedhands.Byperformingcorrect,timelyandappropriatehandhygienewecanallhelptoreducethespreadoftheseorganisms.TheultimategoalistoworktogetherbybeingactiverolemodelsandbyencouragingandremindingallwhoenterPeninsulaHealthtoundertakehandhygienetherebyhelpingtoreduceHAI’s.

SomeoftheinitiativesundertakenthisyearatPeninsulaHealthinclude:

triallingahandhygieneeducationpackagewhichwillbeusedforcredentiallingallPeninsulaHealthstaffannually

observationalstudiestomeasurehandhygienecompliancetogivewardsmoretimelyfeedbackoncompliancewithintheirdepartment

ThedevelopmentofabrochureinJanuary2007whichisavailablethroughoutPeninsulaHealthforconsumersandvisitorsonhandhygiene.

CurrentlyalearningpackageisbeingdesignedforusebyallstaffonthePeninsulaHealthIntranet.

Inaddition,PeninsulaHealththisyearbecamethefirstVictorianhealthservicetointroducehandhygieneeducationsessionsforlocalcommunitygroupsandschools.Theprogramaimstoinstilgoodhygienepracticeinyoungpeopleandtoincreaseawarenessoftheimportanceofhandhygieneinpromotingandmaintaininghealth.

Influenza Vaccination Campaign

Nobodyenjoysgettingtheflu,butforfrail,elderlypeopleandthosewithlittleresistancetoinfection,thediseasecanbeseriousandevenfatal.

Itisespeciallyimportantthathealthcareprovidersprotectthemselvesfromtheillness,notonlyfortheirownhealthbuttopreventthempotentiallyspreadingflutopatientsandworkcolleagues.

Internationalresearchhasshownthatclinicalpersonneloftenchoosenottobeimmunised.TocounterthistrendPeninsulaHealthconductsapro-active,service-wideinfluenzavaccinationcampaignthat:

surveysstafftodeterminereasonsfornon-vaccination

targetseducationsessionsthataddressthereasonsidentified

involvesmanagersofclinicalareasinencouragingvaccinationandsettingatargetforvaccinationrates

providesregularfeedbackofvaccinationratestodepartmentmanagers.

InfluenzavaccinationrateswerebenchmarkedforthefirsttimelastyearinVictoria,showingthatacrossthestate,therateforclinicalstaffgettingthefluvaccinationwere38.7percentandfornon-clinicalstaffwere45.2percent.AtPeninsulaHealththerateforclinicalstaffwas32.0percentbuttheratefornon-clinicalstaffwas74.3percent.

ThisyearPeninsulaHealthintroducedasuccessfulprogramtoincreasevaccinationrates.Thisresultedintheliftingoftheratesto49percentforclinicalstaffand90percentfornonclinicalstaff.


Quality and Safety

Gastroenteritis

InVictoriain2006therewereover560outbreaksofgastroenteritisinvariousfacilitiesthroughoutthestate.Suchoutbreakscanbedisruptiveanddangerous,puttingindividualsandorganisationsatrisk.

Whentheseoutbreakshappeninhospitalsorotherhealthcarefacilitiesitcanbecomenecessarytoclosewards,stopadmissionsandcutservicesinordertopreventtheinfectionfromspreading.

SomePeninsulaHealthfacilitieswereamongthoseexperiencingprolongedgastroenteritisoutbreaks.Theorganismidentifiedwasnoroviruswhichishighlyinfectiousandrequiresonlyminimalexposuretocauseillness.

AnalysisofthesesituationshasresultedinarevisionofPeninsulaHealth’sgastroenteritismanagementplanandthedevelopmentofresourcekitsforstaffthatincludeallrequirementsformanaginganyfutureoutbreaks.Thekitsincludesignage,aninformationsheet,andequipmentspecificforoutbreakmanagement.StafffoundthekitsusefulinrecentoutbreaksatthreePeninsulaHealthsites.

Preventing Infection in Intensive Care

Patientsinanintensivecareunit(ICU)areatgreaterriskofacquiringaninfectionduringtheirstay.Thisisbecausethesepatientsareveryill,andthereforelessabletofightoffinfection.Inaddition,theyoftenhavedevicesinsertedsuchascentralvenouslines(aspecialintravenoustubethatgoesintotheheart)andurinarycatheters(atubethatgoesintothebladder),whichincreasetheriskofinfectionssuchasMethicillinResistantStaphylococcusAureus(MRSA)or‘GoldenStaph’.

PeninsulaHealthhasbeencollectingMRSAdataforanumberofyearsandCentralLineAssociatedBloodstreamInfection(CLABSI)datafortwoyears.ThisprojectwasundertakentohelptoreduceinfectioninICU.LikeallVictorianICUs,PeninsulaHealth’sMRSAandCLABSIratesarecomparedtoratesatother

hospitals.ThesearecollectedbytheVictorianHospitalAcquiredInfectionSurveillanceSystemCoordinatingCentre(VICNISS)andthenreportedbacktoallhospitalsinVictoria.

Lastyear’sQualityofCareReportreviewedsomeofthechangesthatweremadetoICUpracticestoreduceinfection.Forexamplethedeviceusedforinsertingacatheter(CVC)isimpregnatedwithanantibacterialcoating.TheantisepticusedtocleantheskinisnowmoreeffectiveatreducinginfectionandthedressingcoveringtheCVChasbeenimproved.ThegraphbelowshowsthatPeninsulaHealth’seffortshaveledtoasignificantreductioninthenumberofpatientsacquiringMRSAwhilstintheICUandCVCassociatedbacteraemia(infectionintheblood)hasreduced.

JULY 05 JAN 06 FEB 06 MAR 06 APR 06 MAY 06 JUNE 06AUG 05 SEPT 05 OCT 05 NOV 05 DEC 05 JULY 06 JAN 07 FEB 07 MAR 07 APR 07 MAY 07 JUNE 07AUG 06 SEPT 06 OCT 06 NOV 06 DEC 06

25.00

20.00

15.00

10.00

5.00

0.00

MEAN RATE TRENDLINE


Quality and Safety

MRSA Acquisition in ICU July 2005 to June 2007

Peninsula Health Influenza vaccination rates July 2006 to June 2007

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2006 2007

CLINICAL STAFF NON CLINICAL STAFF

External Cleaning Audits for Peninsula Health Sites

SITE DHS TARGET �00�/0� �00�/0� �00�/0�

Frankston Hospital 85% 97.1% 93.6% 90.8%

Rosebud Hospital 85% 97.8% 95.9% 96.2%

Carinya Aged Residential Unit 85% 98% 88.1% 91%

Jean Turner Nursing Home 85% 96% 95.5% 90.3%

Lotus Lodge Hostel 85% 98.3% 91% 89.8%

Mount Eliza Centre 85% 97.3% 89.8% 90.1%

Palliative Care Unit 85% 100% 90.1% 91%

Frankston Rehabilitation Unit One 85% 99.3% 94.7% 92.5%

Frankston Rehabilitation Unit Two 85% 98.7% 94% 93.3%

Rosebud Rehabilitation Unit 85% 96% 92.6% 92.6%

Michael Court 85% 98.7% 92.5% 98.5%

Spray Street 85% 86% 88.6% 94%


Quality and Safety

AuditsbybothPeninsulaHealthstaffandexternalauditorsmonitorcleaningprocessesandratethecleanlinessoffacilitiesregularly.

ScoresforPeninsulaHealthfacilitiesimprovedagainthisyearandcontinuetobewellabovethe85percentstandardsetbytheDepartmentofHumanServices.

Arecordnumberofstafflinedupfortheirfluinjectionthisyear.

Keeping Facilities Clean

CleaningschedulesandmanualsatPeninsulaHealthareupdatedregularlyandhelptoensurethattheenvironmentinallHealthServicefacilitiesismaintainedappropriately.

Bariatric Health Services

Forobesepatients,Victorianstatisticsshowthat20percentofthepopulationisnowclassifiedasobeseandthat17,000peopledieeachyearfromobesityrelatedillnesses.ABodyMassIndex(BMI)scoreofover30indicatesobesity.Bariatricmedicinehelpspeoplemanagetheirobesity.

PeninsulaHealthhasseenanincreaseinthenumberofbariatricpatientstreatedeachyear.Toaddressthisgrowingproblem,theHealthServicehasdevelopedapolicyandmanualspecificallyforthecareofthisgroupofpatients.

Themanualandpolicyprovidestaffwithinformationonhowtoassessandweighthispatientgroup,howtosafelytransferthemfromwheelchairstobedsandontooperatingtables.

Themanualprovidesforpatientmanagementtechniquesfromtheinitialacuteadmissionrightthroughtopost-dischargecare.

AtPeninsulaHealthspecialequipmentdesignedforsafetyhasbeenpurchasedandincludesa$4,010electricwheelchair.Theeasilymanoeuvrablewheelchairmakestransporteasier,saferandmorecomfortableforthepatient.

Inaddition,anew$60,000operatingtabledesignedforbariatricpatientswaspurchasedforFrankstonHospitalthroughadonationbythePinkLadiesAuxiliary.Thetablewillprovideanincreasedlevelofcomfortandsafetyforbothstaffandpatients.

Clinical Pathways and Consumer Satisfaction

Careisdeliveredinpartnershipwiththeconsumer.

ClinicalPathwaysareaspecificplanofcaredevelopedtoprovideevidencebasedcareforspecificconditionsandprocedures.Theyarebasedonbestpracticeandlocalknowledge.

TheyprovideHealthServicestaffwithanimportanttooltomanagedaytodaycarewithinthehospitalsetting.Theaimistodevelopflexible,userfriendly,ClinicalPathwaysthatareusedbyeveryoneinvolvedinpatientcare,todeliverqualitycareinpartnershipwiththeconsumer.ThepathwaysaresupportedbyaPatientPathway.Thisgivestheconsumerinformationonadmissionrequirements,dailycareanddischargeinformation.

ClinicalPathwaysareregularlyreviewedandupdatedordevelopedbythedepartmentthatusesthedocuments;thismeansthatthoseinvolvedinreviewingordevelopingtheclinicalpathwaysarehighlyskilledinmanagingcarefortherelevantcondition.

PeninsulaHealthnowhas46ClinicalPathways.TheyarecheckedeverysixmonthstoensurethatcareforpatientswithaparticularconditionismanagedandmonitoredusingtheClinicalPathway,andalsotocollectinformationonhowtheymaybeimproved.TheClinicalPathwaycanbeadjustedorthechangesnotedmayrevealissuesthatcanbeaddressedpromptly,suchasdelaysinservicesorifwounddressingrequirementsneedtobechanged.

Theconsumer’sperceptionisalsosurveyedtogaugethelevelofsatisfactionwiththeirhospitalexperience.AsurveyintheShortStaySurgicalUnitforexample,

revealedsomeinterestinginformationaboutpatientsonaClinicalPathwaycomparedwiththosenotonaClinicalPathwayasdescribedbelow:

90percentofrespondentsonaClinicalPathwayagreedthattheyweregivenenoughinformationregardingtheirprocedureagainst70percentofrespondentsnotonaClinicalPathway

90percentofrespondentsonaClinicalPathwayagreedthattheywereencouragedtoparticipateindecisionsregardingtheirday-to-daycareagainst50percentofrespondentsnotonaClinicalPathway

100percentofrespondentsonaClinicalPathwayagreedthattheywereinformedabouttheirprogressagainst30percentofrespondentsnotonaClinicalPathway

100percentofrespondentsonaClinicalPathwayagreedthattheywereencouragedtodiscusstheirdailycareagainst60percentofrespondentsnotonaClinicalPathway

100percentofrespondentsonaClinicalPathwayagreedthattheywereconfidentingoinghomeagainst50percentofrespondentsnotonaClinicalPathway.

AsaresultaGenericSurgicalClinicalPathwayhasbeendevelopedtosupportandinformallsurgicalpatients.AconsumersurveyiscurrentlyunderwaytoassessthisnewClinicalPathway.

ArecentsnapshotconsumersurveyconductedintheAngiographySuitetomonitorthequalityandeffectivenessofpatientcareusingaClinicalPathwayfromtheconsumer’sperspectivewasverypositive.

Thesurveyreturnedanoverallpositiveevaluationoftheserviceprovidedandanimprovementfromtheprevioussurveyin2006.

91percentagreedtheywereencouragedtoparticipateindecisionsregardingtheircare,comparedwith88percentinthe2006survey

100percentagreedtheywerekeptinformedoftheirprogresswhichmaintainedtheexcellentresultsfromtheprevioussurveyin2006

100percentagreedtheywereincludedindischargediscussions,animprovementfrom94percentfromtheprevioussurveyin2006

100percentagreedtheyfeltconfidentingoinghome,againmaintainingtheexcellentresultfromthe2006survey.

Specificconsumerfeedbackobtainedregardingthepathwaydirectedcareincluded:

“Keepupyourexcellentwork,Iamsoappreciative.Notathingcouldhavebeenimproved!”

“It’sterrifictocometoahospitalandbeputateasebythenursingstaff.Theyallhadsuchwonderfulpersonalities;thatinitselfisabonusasIlovetohearpeoplehappywhilstworking”.

“Doctorssuper,staffsuperb,facilitiesfirstclass.”


Quality and Safety

Mortality Review

In2006/2007therewere1105deathsinPeninsulaHealth.Mostdeathsarereviewedatdepartment/wardlevel,andsomereferredtotheMortalityReviewCommittee.Lastyear121werereportedtotheCoroner.

ThePatientSafetyOfficercoordinatesthereviewofalldeaths.Circumstancesleadinguptoalldeathsarereviewedeverydayandlaterbyateamthatconsistsofdoctorsandnurses.Theaimofthisprocessistoreviewandimproveclinicalpractice.Ofthe829casesreviewedlastyear,24cases(2.7%)werereferredtotheMortalityReviewCommittee.Thecommitteeidentified30issuesthatneededtobeaddressedandrecommended23actionsincluding:

achangetothemethodofcommunicatingtheurgencyofCaesareanSectionstotheOperatingSuitestaff

improvedassessmentprocessforpatientspresentingtotheEmergencyDepartmentwhoareonWarfarin(bloodthinningmedication).

Adverse Events

ThePatientSafetyCommitteeanalysesactualandpotential“nearmiss”seriousclinicalincidentsandrecommendswaystominimisetheriskofthesameeventhappeningagain.

AnexamplethisyearhasbeentheredesignofformsfilledinforpatientswhoaretohaveaMRIscan(MagneticResonanceImagingwhichgetspicturesbyobservingachangeinbodystructureswheninfluencedbyamagneticfield).Thisistoensurethatpatientswithaheartpacemakerinserteddonothavethisprocedureasitwouldbedangeroustodoso(themagnetinthescannerwouldmakethepacemakermalfunction).Rigorouschecksalreadyinplacewerestrengthenedfurthertomakedoublysurethiscouldnothappen.

Transfusion Safety

Thetransfusionofbloodandbloodproducts(eg;plateletsandFreshFrozenPlasma)canprovidelifesavingtreatmenttopatients,butisnotwithoutrisk.Theinitiativetoprovide“BetterSaferTransfusions”(BeST)isjointlysupportedbytheDepartmentofHumanServices(DHS),RedCrossAustraliaandrepresentativesofclinicalandlaboratoryexperts.

PeninsulaHealthparticipatesinsurveysconductedbyBeSTwhichmeasuresourperformanceagainstotherVictorianhospitals.Thesesurveysassessmanyareasofthebloodtransfusionprocessandincludethefollowing:

documentationofindicationsandproducttypetobetransfused

patientmonitoringduringatransfusion

theidentificationprocessforunconsciouspatients

30

829 reviews

24 deaths required further investigation by the Mortality Review Committee

issues identified

23 actions taken

24

Sentinel Events

Asentineleventisaveryseriousincidentsuchasgivingapatientthewrongtypeofbloodorhavinganoperationonthewrongpartofthebody.AllSentinelEventsarereportedtotheDepartmentofHumanServices(DHS).PeninsulaHealthundertakesananalysisofthecausesoftheincidentanddevelopsplanstominimisetheriskoftheseincidentshappeningagain.In2006/07,PeninsulaHealthhasmadetworeportstoDHS.Investigationsoftheseeventshaveledtochangesinpractice.Forexamplefollowingthefirstevent,thebloodtransfusionadministrationformwasalteredtoincorporatetherateofdeliveryforbloodproductswhenbloodisprescribed.

FollowingthesecondeventanassessmentandvisualobservationpolicywasredesignedandareviewundertakenofbannedmaterialsorobjectsinthePsychiatricUnit.

Outcome of Deaths ReviewJuly 2006 to June 2007


Quality and Safety

NO ADVERSE OUTCOME

POTENTIAL LITIGATIONUNKNOWN AS YETNON ENTEREDADMITTED WITH PRESSURE ARE PROBLEMSBREAKDOWN IN SKIN INTEGRITY

DEVELOPED COMPLICATIONS BUT SURVIVEDDEVELOPED COMPLICATIONS CAUSING DEATHFRACTURE DISLOCATION

MAJOR HARMMINOR HARM

DECEASED

71%

1%0%0%5%4%

0%0%1%

0%17%

NEAR MISS 1%

0%

17%

71%

1%1%

1%

4%5%

Incidents by Outcome During the Year 2006/2007

thecorrectpatient,correctbloodproductcheckingprocess

properdocumentationoftransfusionreactions.

TheresultsforPeninsulaHealthcomparefavourablywiththeVictorianStateaverageforalloftheaboveperformanceassessments,withtheexceptionofpatientmonitoringduringatransfusion.AsaresultPeninsulaHealthhasimplementedmonthlyauditstoprovidefeedbacktoallstafftoraiseawarenessofthisparticularpoint.Staffwhodonotcomplywiththispolicyarerequiredtocompletearefreshereducationprogram.

Similarsurveysareplannedforthisyear.ThefocuswillbeontheappropriateandsafeuseofbloodproductssuchasFreshFrozenPlasma.

Serious Transfusion Incident Reporting System

PeninsulaHealthwasoneofninehealthservicesparticipatingintheSeriousTransfusionIncidentReportingSystem(STIR)pilotstudyfortheDepartmentofHumanServices.Thepilotstudy,whichranfromJulytoOctober2006,wasdesignedtocreateastatewidesystemtoidentifyandrecordtransfusionincidentsinhospitals.Incidentsreportedincludedreactionstotransfusionssuchasrashesorfever,bacterialinfectionrelatedtotheblooddonationandnearmissessuchasmislabelledbloodtubes.

Followingthepilotstudy,anumberofrecommendationsweremade.Theseincludedbanningthereuseofpatientidentificationlabels,thedevelopmentofpoliciesforensuringthesafetyofbloodproductstransferredwithpatientsfromotherhospitals,examiningboththebloodproductandpatientbloodifadversesymptomsappear.

AspartoftheSTIRproject,PeninsulaHealthdevelopedtwonewformstohelpproduceaccurateandcomprehensiverecords.TheseincludeaBloodProductAdministrationForm(BPAF)andaBloodProductOrderingForm(BPOF),whichwereadoptedbyamajorprivatehealthserviceandisnowusedinallitsfacilitiesVictoria-wide.Bothformsprovideenhancedsecuritythroughoutthetransfusionprocess,helpingtofurtherlimittheriskoferrorsandreducingthewastageofvaluablebloodproducts.

AnimportantsectionoftheBPAFisforpatientconsenttobeobtainedpriortothetransfusion.AlthoughconsentforatransfusionisnotmandatoryithasbecomeanintegralpartofthePeninsulaHealthbloodadministrationpolicyandenhancestheconsumer’sknowledgeregardingtheircare.

Adversereactionsmayoccurbecauseapatientmighthaveanabnormalantibody(aproteinintheblood)thatcausesareactiontoatransfusion.Ablooddonorcouldhaveabacterialorviralinfectionthatcontaminatesthedonation.Ormistakescanbemadeinstoring,labelling,handlingoradministeringbloodproductsatvariouspointsoftheprocessinsideandoutsideofPeninsulaHealth.

Anadversereactionwasrecordedin31transfusions(lessthan1percent)andin178casesadministrativeerrorswerediscoveredinthelabellingofthebloodtubeorcompletionoftubeslips.Thereweretwonearmisseswhenanerrorwasidentifiedjustbeforethetransfusionwasduetocommence.Therewerenocrossmatchingerrorshowever,onsixoccasionsthewrongbloodproductwastransfused.Therewerenoadverseoutcomestotheadministrationoftheproductsandtestswereconductedtoensurethattherewasnolastingeffect.PeninsulaHealthwillcontinuetoworkcloselywithcliniciansandtheBloodBanktoimproveoursystemsandmonitoroutcomes.

InformationcollectedfromallpatientshavingabloodtransfusionshowedthatPeninsulaHealthreactionrateswerelowerthanpreviousyears.Thisispossiblybecausewehaveincreasedtheuseofaleukocytefilteraspartofouroverallprogramofreducingcomplicationsfromtransfusion.

Thisfilterremovesthewhitebloodcellsthatmayberesponsibleforcausingatransfusionreaction.

AllpatientsrequiringtransfusionsatPeninsulaHealthareprovidedwithbrochuresandfactsheetsthatcoverarangeoftransfusionissues.TheTransfusionNurseConsultantisalsoavailabletodiscussanyconcernsorissuesthatthepatientorfamilymayhave.


Quality and Safety

TUBE AND SLIP ERRORS

NEAR MISS

INCORRECT BLOOD PRODUCT TRANSFUSED

MILD REACTIONS

MEDIUM REACTIONS

SEVERE REACTIONS

178

2 6

13 5

13

Adverse Transfusion Events at Peninsula HealthDuring the Year 2006/2007

Adverse Transfusion Related Events

Duringtheyearpatientsreceived3,900transfusionsofbloodproducts.Priortoanytransfusionbloodcrossmatchingtestsareperformed.

Sometimescomplicationscanhappenduringorafterabloodtransfusion.Thisiscalledatransfusionreaction.

SkinIntegrityNurses

Skin Integrity

In2003,2004and2006theVictorianQualityCounciltogetherwiththeDepartmentofHumanServices(DHS)andAustinHealthconductedthreePressureUlcerPointPrevalenceSurveys(PUPPS)inHealthServicesinVictoria.

Thepurposeofthesurveyswastodeterminethenumberofpressureulcerinjuriesthatoccurtopatientsintheacuteandsubacutesettings.Apressureulcerisusuallycausedwhenapatientliesinonepositionfortoolongandthepressureofthebonescausesinjurytotheskin.Pressureulcersaregradedbytheseverityofskintissuedamage,forexampleaStage1pressureulcerisveryminimalskindamageandaStage4pressureulceris

Skin Tear Update

LastyeartheHealthServicereportedonskintears.Aswegetolderourskintissuebecomesthinnerandasmallknockcanteartheskintissue,similartotearingtissuepaper.

Skintearsareacommoninjuryintheelderlypatient.

FollowingaskintearpreventionandmanagementeducationprogramthereisnowastandardisedpolicyandprocedureforPeninsulaHealth.The‘SkinTearpreventionandmanagement’procedurethatweusetopreventandmanageskintearswithastandardiseddressingprotocol,waspresentedatthePeninsulaHealthResearchweekawardsandwontheNursingResearchPresentationawardinNovember2006.

Educationhasraisedstaffawarenessontheimportanceofincidentreportingandappropriatemanagement.


Quality and Safety

0%

5%

10%

15%

25%

20%

2003 2004 2006 2007

PRESSURE ULCER PREVALENCE LINEAR TREND

Peninsula Health Pressure Ulcer Prevelence

PeninsulaHealthparticipatedintheexternallyledsurveys,mentionedabove,andinMay2007conducteditsowninternalfourthsurveyusingtheexactsameguidelinesandmethodology.

In2006,ourprevalencerate(thenumberofpatientswithpressureulcerspresent)was22.1percent.Thiswasreducedto14.3percentatMay2007followingstaffawarenessprogramswithposters,newslettersandstaffeducation.

AweekaftertheMay2007survey,125patientswhodidnothaveanypressureulcersatsurveytimewereresurveyed.Ofthese,11patientswerefoundtohave12veryminorpressureulcerswhichgaveanincidenceresultof8.8percent.ThisisthefirsttimePressureUlcerIncidencehasbeenmeasuredatPeninsulaHealth.Previously,onlyprevalencewhichistherateofoccurrenceinaspecificperiodoftimewasmeasured.

extensivedamagefromtheskindowntomuscleandbone.Somepatientsareadmittedtohospitalwithpressureulcers,somepatientsdeveloppressureulcersduringtheirstayinhospital.

Staffinsertingpaddingintoahipprotectorgarment

Falls Prevention Services

Oneofthegreatestriskstofrail,elderlypeopleisfalls.

Whileatumblemightcausenomorethanabruiseortwoforsomeoneyoungerandfitter,thesametypeofaccidentcouldeasilydisableanolderperson,andcomplicationscouldprovefatal.

PreventingfallsisaveryhighpriorityatPeninsulaHealth,particularlywithahigherthanaverageproportionofolderpeoplelivinginthelocalcommunity.

Asanationalleaderinfallspreventionresearchandstrategydevelopment,PeninsulaHealthprovidesawiderangeofprogramswithinitsfacilitiesandinthecommunity.

ThePeninsulaHealthFallsPreventionServiceisalsotheleadagencyforthethreeyear‘WholeofCommunity’FallsPreventionProject.TheprojectispartoftheFrankstonMorningtonPeninsulaPrimaryCarePartnershipstrategyfundedbytheDepartmentofHumanServices.

Resultsofthis‘WholeofCommunity’projectandotherworkinfallspreventionthisyearhaveproducedanumberofoutcomes,including:

Providing Services to More People

referralsforPeninsulaHealth’scommunity-basedfallspreventionassessmentincreasedfrom291in2005to325in2006.Thisisespeciallyvaluabletoclientswhoarefrailorhavelimitedaccesstotransport

sincetheintroductioninJuly2005ofhome-basedmedicalassessments,asanextensionoffallspreventionassessments,121clientshavebeenmedicallyassessedathome

throughtheFallsClinics,48clientsreceivedfalls-specificmedical,physiotherapyanddieteticsassessmentsduring2006

thewaitingperiodforplacementinaFallsClinicdecreasedoverthelasttwoyearsfromsixmonthstotwomonths

‘Agestrong’fitnessprogramshavebeenintroducedtoAgedCareWardsatMountEliza,RehabilitationWardsatGolfLinksRoad,theAgedPsychiatryUnitatFrankstonHospitalandtoPeninsulaHealthresidentialfacilitiesinSeaford,FrankstonandRosebud

throughitsResidentialOutreachSupportService(ROSS),PeninsulaHealthhastrainedstaffin36residentialcarefacilitiesthroughoutthePeninsulaarea.Thisisdeliveringbettermanagementoffallsriskto2,453residentsinthosefacilities

theuseofhipprotectors,whicharespecially-paddedgarmentsthathelptopreventhipfractures,hasbeensosuccessfulthattheprogramhasbeenexpanded.TheprojectwastrialledoriginallyatCarinyaResidentialAgedCareUnit,andnohipfractureshaveoccurredfollowingtheintroductionofresidentswearinghipprotectors

thehipprotectorshavesincebeendistributedtopatientsathighriskoffallinginotherareasofPeninsulaHealth.TheyarenowavailableinAgedCareWardsatMountEliza,thePalliativeCareUnitandRosebudRehabilitationUnit,anddistributionatGolfLinksRoadRehabilitationUnit,FrankstonHospitalandtheTransitionCareProgramwilloccursoon.Therolloutisexpectedtodeliversimilargoodresults.


Quality and Safety

Spreading the Word

talksanddisplaysonfallspreventionhavebeenofferedtoolderpeopleinPeninsulaHealth’scommunitythrough27educationsessionsatsenior’sexpos,senior’sgroupsandsupportgroups.Nearly4500peoplehaveparticipatedinthesessions

FallsPreventioneducationhasbeenprovidedto160PeninsulaHealthcliniciansand25tertiarystudents

distributionof4,155bookletsand3,380otherresourcesdevelopedbyPeninsulaHealthhasprovidedfallspreventioneducationandadvicetoGPclinics,cliniciansandcommunitygroups

aswell,afurther25CommunityFallsresourcemanualshavebeenpreparedtohelpcommunityserviceprovidersbetterdetectpeopleatriskoffallssothatappropriateassessmentandtreatmentcanbeinitiatedearly

healthprovidersat109otherhealthagenciespurchasedthePeninsulaHealthFallsRiskAssessmentTool(FRAT)Packoverthelastyear.TheAssessmentTool,developedatPeninsulaHealth,isusedacrossAustraliaandtheFRATPack,whichoutlinesstrategiesfordevelopingsuccessfulfallspreventionprograms,isregularlypurchasedbyhealthserviceshereandoverseas

inaddition,PeninsulaHealthstaffwereinvitedtopresentfallspreventioninformationatconferencesinMelbourne,Brisbane,Echuca,GoulburnValleyandMonashUniversity.

Healthproviders,olderpeople,carersandotherswhowantfurtherinformationaboutfallspreventionprogramsandsupportcancontactPeninsulaHealthon97881260.

�0 Peninsula Health Quality of Care Report 2007

Quality and Safety

Quality and Safety Indicators

TheMedicationSafetyTeamisagroupofexpertsinmedicationsafetyincludingpharmacists,doctorsandnurses,informationtechnologystaff,patientsafetystaffandconsumers.

In2006,thePharmacyDepartment’sresearchandqualityactivitieswererecognisedwithtwoawards,theVictorianPublicHealthCareAwardsinthecategoryofExcellenceinSafetyofCareandtheAustralianCouncilonHealthCareStandards(ACHS)QualityImprovementAwardsintheClinicalQualityCategory.

Premier’s Award Outstanding Metropolitan Health Service

InSeptember,asthisreportwasbeingfinalised,PeninsulaHealthreceivedboththePremier’sAwardasOutstandingMetropolitanHealthServiceoftheYearandtheQualityofCareReportingAwardattheVictorianPublicHealthcareAwardspresentation.

TheMinisterforHealth,theHon.DanielAndrews,joinedstaffataspecialmorningteaatFrankstonHospitalandapplaudedPeninsulaHealthforwinningthetwomajorawards.

“Excellentpatientcare,indigenouscommunityprogramsanda25percentreductioninwaterusehavehelpedPeninsulaHealthtakeoutthestate’stopmetropolitanhealthserviceaward,”saidMrAndrews.

TheMinisteralsopraisedotherprojects,includingtheconstructionofcommunitymulticulturalkitchens,asupportprogramforisolatedmen,andapregnancyandchildbirtheducationprogram.

“PeninsulaHealthisofficiallyVictoria’stopmetropolitanhospital–leadingthewayinacuteandalliedhealthservicesandprovidingimportantcommunitysupportprograms,”saidMrAndrews.

“Its‘can-do’culturekeepspatientandstaffsafetyasitsmainpriority,whilestillrespondingtotheevolvingneedsandexpectationsofadiversepopulationinawaythathasbecomeabenchmarkinthehealthcaresector.”

DrShereneDavenesenandtheMinisterforHealth,theHon.DanielAndrews,congratulatingstaffonwinningthetwoawards.

Consumer Empowerment and Medication Safety

Inagroundbreakinginitiative,PeninsulaHealthistellingpatientsto‘getinvolved’andshareresponsibilityforthesafeuseofmedication.

Patientsarenowencouragedtogettoknowtheirmedications,andspeakupiftheyfeelsomethingisnotright,topreventmedicationerrors.

AnewbrochurewasproducedandlaunchedduringMedicationSafetyWeek,whichtookplaceinJune2007,whichoutlineswaysthatpatientscouldgetinvolvedwiththeirmedicationuse.

Somesuggestionsinclude:

askingthedoctorornursewhyyoushouldtakeamedicationandrequestingwritteninformationaboutthebrandname,genericnameandanysideeffects

knowingwhattimeyounormallytakeamedicineandlettingthedoctorornurseknowifthatdoesn’thappen

askingafriendorrelativetogetthefactsaboutyourmedicationsifyouarenotwellenoughtodoso.

“PETS”

In2007,theVictorianDepartmentofHumanServices,BetterSkillsBestCareProgram,fundedthePETSProject(Pharmacist-initiatedE-scriptTranscribingService)atPeninsulaHealth.

ThefirstofitskindinAustralia,thisprojectinvolvesanexperiencedclinicalpharmacistgeneratingelectronicdischargeprescriptionstospeeduppatientdischargeandimproveprescribingquality.

MedicalOfficersareencouragedtoreferpatientstothePETSpharmacist24hoursbeforetheyaretobedischarged,andtheelectronicdischargeprescriptionisprepared.Theprescriptionisthencheckedbythemedicalofficer,whoissuestheprescriptiontothepatientontheward.

Medication Safety

Mostmedicationscarrysomeriskalongwiththeirbenefits.

Medicationsideeffects,allergicreactionsandmistakeswithdosageortimingputmanyAustraliansinhospitaleachyear.

ReducingtherisksofmedicationerrorshasalwaysbeenamajorpriorityatPeninsulaHealth.Aspartofthisongoingeffort,anewMedicationSafetyCommitteewassetupinDecember2006to:

monitorandanalysemedicationerrorsandidentifyproblemsorgapsinthesystemofprescribing,dispensingandadministrationofdrugs

recommendworkpracticesthatreducerisktopatients

evaluateanychangesmade

promotebest(evidence-based)practicethatfostersthesafeuseofmedicinesandminimisestherisktopatients.

TheCommitteeisdevelopingKeyPerformanceIndicators(KPIs)whichwillbeusedtomeasurecomplianceandperformancerelatedtoallmedicationissues.

OutcomesfromtheCommittee’sworkwillbereportedinnextyear’sQualityofCareReport.


Quality and Safety

Anticipatedoutcomesoftheprojectincludepatientsbeingdischargedearlier,duetoprescriptionsbeingavailableforreleaseonwardrounds,wheredischargedecisionsaremade,ratherthanbeingprescribedaftertherounds.Improvedprescribingqualitywillalsobeabenefit,asitisanticipatedthatthePETSPharmacistwillreducetheneedforclarificationandinterventionbydispensingpharmacists,makingthesystemsaferandmoreefficient.

Initialanalysisofthefirst44PETSprescriptionsindicatedmarkedimprovements,withprescriptionsrequiringthedispensingpharmacist’sinterventiondecreasingfrom33percentto2percent.

Clinical Pharmacist in the Emergency Department

Theaimofthisprojectwastoreducethelikelihoodofharmthroughmedicationerrorbyensuringtimely,accuratemedicationchartsforpatientsadmittedthroughtheEmergencyDepartment.

InJanuary2007,apharmacistwaslocatedintheEmergencyDepartmenttoobtainmedicationhistoriesfrompatientsortheirrelativesatthepointofadmissionandtoensurethatthisinformationagreedwiththehospitalmedicationchart.

ThisprojecthasnowseenaclinicalpharmacistpermanentlyassignedtotheEmergencyDepartment.

A‘MedicationandReconciliation’formwasusedasatoolforobtainingmedicationhistoriesandguidingpatientinterviews.Theaimwastoimprovemedicationchartaccuracyby50percentafter24hours.

Whenevaluatedafterthefirst24hoursofapatients’stay,the

potentialriskofharmtothepatientwasdecreasedbymorethan60percentandapatientwas70percentmorelikelytoreceivethecorrectmedication.

Training for Nurses

CompulsorycompetencybasedannualtrainingfornurseswasimplementedatPeninsulaHealthin2006toreducetheriskofmedicationadministrationerrors.

Fiveworkstationswerepreparedsimulatingarangeofreallifemedicationerrorsandnearmisses.Nurseswereinvitedtospottheerrors.Preandpostknowledgeassessmentswerecarriedout,andclinicalobservationalstudieswereusedtodeterminetheimpactonknowledgeandpractice.

94percentofDivisionOneRegisteredNursesattendedoneofeightsessionsinthefirstroundoftrainingwithfurthersessionsplanned.Theknowledgeassessmentscoreimprovedfrom69percentto86percent.Theclinicalobservationalstudiesshowedimprovedadherencetothepatientidentificationprocedurefrom28percentto82percent.

Preventing Wrong Route Errors

Traditionalsyringesareoftenusedtoaccuratelymeasureadoseofaliquidthatwillthenbegivenorallytoapatient.Onceinthesyringe,however,thiscouldbeinadvertentlyinjectedwhichcouldbeverydangerous.

Newamberoralsyringeshavebeenintroducedwithadifferenttip,whichcannotbeusedforinjection.PeninsulaHealthPharmacyhasalsoputnewcapsonoralmedicines,makingitimpossibletoforgettousetheoralsyringe,astheoldsyringeswillnotfit:helpingtoreducemedicationerrors.


Quality and Safety

Using E-prescribing to Improve Patient Safety in Sub-Acute Care

Electronicprescribing(E-prescribing)ofmedicationswasfirstintroducedtoPeninsulaHealthin2002.Itisanautomateddataentrysystemthatisdoneonacomputerratherthanwritingtheprescriptiononpaper.Itprovidesimprovedpatientsafetyastheinformationiseasytoberead.InOctober2006,thesystemwasextendedtotheRosebudRehabilitationUnit(RRU),a30bedsub-acutecareunit.

Priortoimplementation,661handwrittenmedicationorderswerereviewedattheRRU,with5.9percentcontainingerrors.FollowingtheintroductionofE-prescribing,523medicationorderswerereviewedwithjust1.3percentcontainingerrors,whichisareductionof78percent.

PharmacyDirectorSkipLamusingtheawardwinningE-prescribingprogram

Dental Health

MeetingtheeverincreasingdentalhealthneedsofHealthCareCardholdersisaconstantchallengeforpubliclyfundeddentalservicessuchasPeninsulaHealth’sCommunityDentalProgram(CDP).

ThisyeartheCDPhelpedtomeetdemandbyproviding30,229treatments.Theseservicescoveredarangeofdentalcareincludingtreatmentandrestorationofdamagedteeth,provisionofdentures,rootcanaltreatments,generaltreatmentandemergencycare.

Thisvolumeofworkwassupportedbyanumberofserviceexpansionsandimprovements,includingexpansionofthetrialOralMedicineSpecialistServicefromonehalftotwodayseachweekandareductioninthewaitinglistsfordenturesfrom309to20andforgeneraltreatment(cleaningsandcheck-ups)byapproximately2000.

Inaddition,PeninsulaHealth’sCDPfurtherprogressedplanstofullyintegratethepreschooldentalservice.

DentalstaffpromoteddentalhygieneinthecommunitythroughparticipationintheFrankstonFamilyandChildren’sExpoandthroughpreschooldentalvisitsandthe‘SmilesforMiles’children’sproject.

BenchmarkingofdentalservicesaroundthestatebyDentalHealthServicesofVictoriashowedthatPeninsulaHealth’sCommunityDentalProgramperformedbetterthanthestatewideandregionalaveragesforCDPsinthefollowingcriteria:

Restorative re-treatment within six months

Arestorationwillgenerallylastseveralyears,dependingonthetypeofmaterialused.Highratesofre-treatmentwithinsixmonthscanindicatethe

needforreviewoftreatmentapproaches.PeninsulaHealth’sCDPratewas4.5percentcomparedto6.6percentforthestate.

Repeat Emergency Care within �� days

Theaimofprovidingtreatmenttopeoplepresentingforemergencycareistoeffectivelytreatthecauseoftheproblem(egpain).Wherecarehasfailedtoresolvetheinitialemergency,apersonwouldusuallyreturnformoretreatmentwithin28days.PeninsulaHealth’sCDPhadareasonablerateof5.8percentcomparedto6.0percentforthestate.

Unplanned return within seven days following extraction

Ifcomplicationsoccurfollowingatoothextraction,itisusuallywithinsevendays.Complicationscanbeminimisedbytheactionsofthedentalteam.Again,PeninsulaHealthhadalowrateof0.8percentcomparedto1.5percentforthestate.

Root canal re-treatment in permanent teeth within six months

Failureofrootcanaltherapyisgenerallycausedbybacterialcontaminationandcanresultinsymptomsofinfectionorinflammation.Ahighrateofextractionsorre-treatmentsfollowingrootcanaltreatmentmayindicatepoorcaseselectionorpoortechnique.PeninsulaHealth’sCDPhadnore-treatmentsfollowingrootcanalproceduresagainst0.4percentforthestate.

Denture remakes within �� months

Theneedtoremakedenturesusuallyoccurswhenapersonisunabletowearthedentureduetofunctionaloraestheticproblems.PeninsulaHealthwaswellbelowthestateaverageof3.8percentforremakingdentureswith2.7percent.


Quality and Safety

TheCommunityDentalProgramprovided30,229treatments

�� Peninsula Health Quality of Care Report 2007 Continuity of Care

TheResidentialOutreachandSupportServiceshelpsprovidecontinuityofcare.

Complex Care Program

Patientswithongoing(chronic)healthproblemssuchasdiabetesorheartfailureorchroniclungproblemsmustconsistentlymanagetheirconditions.Withthehelpoftheirhealthteams,theyneedtokeepdiet,fitness,medicationandgeneralhealthissuesinbalanceinordertoavoiddeteriorationintheirconditionandtheneedforfrequenthospitalisation.

RepeatedpresentationstotheEmergencyDepartmentandadmissionstohospitalmaycausestressandhardshiptothesepatientsandtheirfamilies.Theyalsoputaddedstrainonpublichealthresourcesandmayreduceaccessforothermembersofthecommunitywithmoreurgentconditions.Helpingpeoplewithchronicconditionsstayoutofhospitalistoeveryone’sbenefit.

AspartofPeninsulaHealth’schronicdiseaseservices,thePeninsulaComplexCareProgram(PCCP)isdesignedtoprovidecarecoordination,educationandsupporttopeoplewithdiabetes,heartorbreathingproblems,drugoralcoholdependenceandotherchronicandcomplexconditions.

Anumberofdevelopmentsintheprogramthisyearhavefurtherimprovedcareforclients.

Early Intervention in Chronic Disease

Chronicdiseases,asopposedtoacuteconditions,arediseasesthatarelong-termandrequirecontinuousmanagement.Conditionssuchasdiabetesorheartfailureareconsideredtobechronicdiseases.

TheEarlyInterventioninChronicDisease(EliCD)programtargetspeoplewithchronicillness,offering

information,treatmentandselfmanagementtechniquesthatcanimprovethequalityoflife.Betteraccesstocommunityhealthservicesisafocusoftheprogram.

TheComplexCareProgramassistspatientswithchronicconditionstoavoidunnecessaryhospitaladmissions.

SincetheEliCDprogrambeganinJune2006,careplanshavebeencompletedwith323clients.Careplans,whicharereviewedtwiceayear,includepatientevaluationandtreatmentrecommendations.

InApril2007,theFrankstonCommunityHealthServiceEliCDprogramwasrecognisedasaleaderinchronicdiseasemanagementbytheDepartmentofHumanServices.Itwashighlypraisedforitscollaborationwithservicepractitionersinprovidingeffectivecareplanningandreferralfortreatment.Asaresult,thisprogramisheldupasanexampletoothermetropolitanandregionalservices.

TheEliCDProgramManagerwasakeynotespeakerattheJointDivisionsofGeneralPracticesandPrimaryCarePartnershipsmeetinginMay2007.TheprogramwasacknowledgedforitssuccessfulGPliaison,itssupportoftheAboriginalHealthPromotionandChronicCareProgram(AHPACC)initiativesandtheroleoftheGPLiaisonNurse.

Community Rehabilitation Program (CRP)

TheCommunityRehabilitationProgramispartoftheSubacuteAmbulatoryCareServices(SACS)withintheCommunityandContinuingCarecluster.Itissuitableforpeoplewhohavelimitedfunctionasaconsequenceofdisease,injury,impairmentand/ordisorder.

TheserviceoperatesfromthreePeninsulaHealthsites:Chelsea,FrankstonandRosebudCommunityRehabilitationCentres(CRCs),providingrehabilitationinthecentreorinthehome,accordingtothegoalsandneedsofclients.

Theteamconsistsofphysiotherapists,occupationaltherapists,speechtherapists,socialworkers,dieticiansandadministrationstaff.

Thisyeartheprogramhasreceived5,724referrals(4,439in2005/06)resultingin41,689visits(33,606in2005/06).ThetargetsetbyDHSwas35,085.

Clientsaretriagedaccordingtothefollowingguidelines:

Category �:clientsrequiringurgentattentionwhootherwisewouldbeatsignificantriskofadmissiontoacutecare.2139clientswereseenwithinanaveragewaitingtimeof3.5days(4.5in2005/06)and86.3percent(80.3percentin2005/06)ofclientswereseenwithinfiveworkingdaysofreferral(DHStarget80percent).

Category �:Clientswhodonotneedtobeseenwithinfiveworkingdaysbutrequiresemi-urgenttreatmentduetoriskofincreasedmorbidityorpooreroutcomesifnotseenwithin15workingdaysegpostdischargefromaninpatientrehabilitationservice.1208clientswereseenwithinanaveragewaitingtimeof8.9days(9.4daysin2005/06).81.3percent(90.9percentin2005/06)ofclientswereseenwithin15workingdaysofreferral(DHStarget80percent).

Category �:Clientswhoarenoturgentbutrequireadmissiontotheprogramwithinthreemonths.161clientswereseenwithinanaveragewaitingtimeof11.7days(14.3daysin2005/06).ThereisnoDHStargetforthiscategory.

Continuity of Care ��Peninsula Health Quality of Care Report 2007

CRPhasamandatorytargetfortimelyresponseofreferralstotheprogram.Category1clientsreceiveaphonecallwithinthreedays(DHSKPI80percent)ofreferralandcategories2and3aresentalettertoacknowledgethereferralinformingthemthattheywillbecontactedtoarrangeanappointment.CRPreceived3261referralswithanaverageacknowledgementtimeof0.9days,acompliancerateof99.3percent(88.9percentin2005/06).

Home Oxygen

ItisnowpartofthehospitaldischargeprocessthatpatientswhoaresenthomewithoxygenareautomaticallyreferredtothePCCP.Thisallowstheteamtomanageanyproblemsclientsmayhavewiththetherapy.

Complex Care Pharmacist

InJune2006,apharmacistwasassignedfulltimetothePCCPteam.ThisincreaseinhoursprovidedpharmacistsupportacrossthewholePCCPspectrum,ratherthanjustforChronicHeartFailureclients.ThepharmacistalsoliaiseswithGPsandcommunitypharmaciestofurthersupportclients’medicationregimens.AllclientsreferredtoPCCPnowreceiveacompletemedicationreview.

Reduced Hospitalisation

DataintheaccompanyinggraphillustratesthesuccessofthePCCPapproachtochronicdiseasemanagement.ThegraphcoversEmergencyDepartmentandinpatientadmissionsforPCCPclientsovera12monthperiodtoMarch2007.

ThestatisticswerecompiledbycomparingclientadmissionsbeforeandafterinterventionbythePCCP.Comparedto2006figures,therewere637fewerEmergencyDepartmentadmissions,412fewerinpatientadmissionsand1716fewerbeddaysrequiredbyPCCPclients.

SHARPS Wound Care

AnalliancebetweenPCCPandtheSouthernHIV/AIDSResourcePreventionService(SHARPS)hasseen435healthconsultationsregardingwoundcareforclientsusingSHARPS’NeedleExchangeProgram.PlannedrenovationsattheFrankstonfacilitywillcreateadedicatedclinicalareaforwoundcare.


Continuity of Care

Complex Care Program 2006-2007

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PRE

Response Assessment Discharge Team (RAD)

TheRADteamoperatesatbothFrankstonandRosebudEmergencyDepartmentsandconsistsofalliedhealthandnursingprofessionals.Theirprimarygoalistopreventunnecessaryadmissionstotheacutesettingbyprovidingmoreappropriatecareplansthatmeettheindividualneedsofthepatient.RADsaw5,100patientsacrossFrankstonandRosebudemergencydepartmentsthisyear.Withaccesstoarangeofcommunityservicesandtheabilitytofacilitatetransferstosubacuteandrespitecare,patientscanhavetheirneedsmetinthemostappropriatesetting.

TheongoinguseofBlackberrytechnologyenablestimelyalertstopatientsthatarecurrentlylinkedinwithotherPeninsulaHealthprograms.TheBlackberryisahandheldelectroniccommunicationsdevicethatprovidesanalertwhenapatientpresentstotheEDwhoisaclientoftheComplexCareprogramortheResidentialOutreachSupportService(ROSS).Earlynotificationallowsexistingcareplanstobepromptlyactedupon,whichcanprovidepatientswiththebestoutcomes.

Rosebud Day Treatment Centre

TreatmentforpatientsrequiringchemotherapyforcancerordialysisforkidneyfailurehasbeenavailableatRosebudHospitalfor10yearsand6yearsrespectively.

InJanuary2007,thethreechairhaemodialysisunitandfourchairchemotherapyprogramatRosebudHospitalwereupgraded.ThehospitalnowoffersaDayTreatmentCentrewithninechairsforhaemodialysisandfourchairsforthechemotherapyprogram.Chemotherapyserviceshavealso

increasedfromtwotofivedaysaweek.ThisnewcentrealsomeansthatclientsonthesouthernMorningtonPeninsulacanhavetheirtreatmentlocallyratherthantraveltoFrankston.

Sincethecompletionoftheredevelopment,therehasbeenclosetoa50percentincreaseinoncologypatientswhileanextra24haemodialysispatientsaweekcanreceivetreatment.

Thankstofundingandsupportbylocalcommunitygroups,includinga$250,000donationfromtheSouthernPeninsulaCommunityFund,theunitprovidesincreasedcomfortforpatientsandstaffwithmoreopenspaceandgreaternaturallighting.

PeninsulaHealthisthefirsthealthserviceinAustraliatoimplementahaemodialysispatientholidaybookingprogram.

PeopleplanningtoholidayonthePeninsulacanbookintotheRosebudhaemodialysisunitviatheinternet.Theunitreservesonetreatmentspoteachdayforapatientonholiday.Sincetheprogrambegan,22holidaypatientshaveutilisedtheservice.

InJune2006,thePrimaryNursemodelofcarewasintroducedtoFrankstonandRosebudOncologyServices.Thispatient-centredapproachtocareprovideseachpatientwithaprimarycontactandsupport,whichhasimprovedpatientcommunication,decreasedcarevariationsandimprovedpatientcomfortandnursingsatisfaction.


Continuity of Care

RosebudDayTreatmentCentrepatientreceivingdialysis

MYPODs for Cancer Patients

Beingseriouslyillmakesmostpeoplefeelthattheyhavelostcontrolovertheirlives.

Impersonalhealthcareintensifiesthosefeelings–itisdifficultforpatientsfacingthefearsandrigoursofaconditionlikecancerwithoutbeingtreatedasiftheyareonamedicalassemblyline.

Toaddressthisproblem,theDepartmentofHumanServiceshasdesignatedpriorityareastoimprovecancerservicesby:

providingsupportthatempowerspatientstomakedecisionsabouttheirtreatmentandcare

includinghealthprovidersfromarangeofspecialtiesineachpatient’scare

ensuringthateachpatienthasaPrimaryCareNursetoprovideaconsistent,familiarsupportbasethroughouttreatmentandcare

focusingonpsychosocialcareandsupportbyimprovingcommunicationbetweenallcareproviders.

InJune2006staffinPeninsulaHealth’sOncologyDayUnitinitiatedamodelofcaretheyhaddevelopedtomeetthesepriorityareas.Aspartofthenewcarestrategies,thenursesintroduced‘MyPOD’,apowerfulandeffectivecommunicationtool.

MyPOD(MyPersonalOncologyDiary)isafile,keptbythepatient,whichisusedbytheentireteamtomanagecare.Thefilecontainseducationalmaterials,chemotherapytreatmentplans,anti-nauseapremedicationregimens,contactnamesandnumbersandappointmenttimes.Italsoclearlyidentifieseachpatient’sprimarycarenurseandmembersofthecareteam.

MyPODgivespatientssomecontrolovertreatmentschedulesandhelpsthembemoreactivelyinvolvedintheirowncare.AlongwiththePrimaryNursingModelofCare,theMyPODismakingcancercareandtreatmentasmoother,simpler,morecohesiveprocess.

PatientsinfocusgroupsrespondedverypositivelywhenaskedaboutthecontinuityofcareinthePeninsulaHealthOncologyDayUnit.

Hand Therapy Service

Consideringhowcriticalhandsaretopeople’sabilitytofunction,itisnowonderthathandtherapyisamajorfocusforOccupationalTherapists.

Peoplecanrequirehandtherapyfollowingsurgeryandforconditionssuchascarpaltunnelsyndromeandarthritis.Aswell,handtherapyisoftenneededinthetreatmentofinjuries,includingfracturesandtendondamage,andinscarmanagement.

HandtherapyservicesareavailableatFrankstonHospitalthroughaPlasticSurgeryOutpatientClinicandfromRosebudHospitalthroughoutreachserviceswhichoperatetwiceaweek.

Lastyeartheserviceprovided4,046treatments.

AnadditionalserviceisavailablethroughPeninsulaHealth’srehabilitationservices.TheCommunityRehabilitationProgramHandTherapyClinicsareprovidedatCommunityRehabilitationCentresinbothFrankstonandRosebud.Thisnewserviceprovided240treatmentslastyear.

Inallthehandtherapyservices,patientsreceiveassessmentsandawidevarietyoftherapeuticinterventionssuchassplinting,useofpressuregarmentsandfunctionalretraining.

InMarchPeninsulaHealth’sOccupationalTherapistspresentedareviewofhandtherapyinterventionsforscarmanagementatthe2007InternationalFederationofHandTherapistsconferenceinSydney.


Continuity of Care

HandTherapyisamajorfocusforOccupationalTherapists

Surgical Services

Althoughtherearehundredsofdifferentsurgicalprocedures,allsurgeryfallsintotwogeneralcategories.

Thefirstissurgeryforexistinganddevelopingconditions,suchasadeterioratingkneejoint.Someonewithapoorlyfunctioningandpainfulkneeneedstohaveitrepaired,buttheconditionisnotlifethreatening,sosurgerycanbeplannedforafuturedate.Ifapersonisinacaraccident,however,andhasseriousleginjuries,theconditionrequiressurgeryimmediately.

ThefirstcategoryiscalledElectiveSurgeryandisplannedforandscheduled.EmergencySurgery,however,cannotbeanticipatedandmustbedonewheneveritisrequired.However,ifthereareanunusuallyhighnumberofpatientsrequiringemergencysurgery,thiscouldcausethecancellationofscheduledelectivesurgery.

Likepublichospitalseverywhere,PeninsulaHealthiscontinuallydevelopingmoreefficientstrategiestoreduceElectiveSurgerycancellationsandtoprovidesurgicalservicestomeeteverincreasingdemands.

During2007,PeninsulaHealth:

undertookadditionalout-of-hourstheatresessions,includingonSaturdaysandpublicholidays.Theseextrasessionsallowedstafftotreatanadditional25people

appointedaUrologyRegistrar,increasingthenumberofcomplexurologicalproceduresperformedby8sinceFebruary.

purchasedadditionalcystoscopesfortheDaySurgeryUnit.Theseareusedtodiagnosebladderproblems.Thenewequipmenthasenabledstafftoincreasecystoscopiesfromtwoto12peroperatingsessions.SincetheequipmentpurchaseinNovember2006,201cystoscopieshavebeenperformedintheUnit

introducedanorthopaedicjointreplacementinitiativethathasincreasedthenumberofjointreplacementsurgerysessionsatPeninsulaHealth.Anadditional17patientshavereceivedtheiroperationssincetheinitiativewasintroducedinApril2007


Continuity of Care

increasedthenumberofsessionsforObstetricandGynaecologicalproceduresbytwopermonthinFebruary2007

openedtheRadiologyDigitalSubtractionAngiographySuiteinNovember2006fortreatmentofcardiacandvascularconditions.Thenewservicehasperformed40angiogramsandangioplastiessinceitsinception.

TheseandotherstrategieshavehelpedPeninsulaHealththisyeartoachievean11percentreductioninthenumberofpatientswaitingforElectiveSurgery.

Elective Surgery Waiting Times (in days) by Category

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VascularsurgeonMrYew-MingKuanperformsavascularprocedureintheMedicalImagingDepartmentsnewInterventionalAngiographySuite.

�0 Peninsula Health Quality of Care Report 2007 Continuity of Care

Elective Surgery Access Service

AcoordinatedeffortamongMelbourne’spublichospitalsexpandedsurgicaloptionsforpatients.

TheElectiveSurgeryAccessService(ESAS)utilisesspaceandstaffinginhospitalsthathaveextracapacity.Patientsfromhospitalswhosesurgeryschedulesarefullcanopttohavetheirsurgerydoneatanotherfacility.

Althoughthismeansthattheywillhavetheiroperationdoneatahospitalfurtherfromhome,patientscanusuallyscheduleanearlierdateforsurgerythroughESAS.

ProceduresoroperationsavailableundertheESASprogramarebladderandprostateprocedures,herniarepairs,hipandkneesjointreplacementsandvaricoseveinoperations.

Thisyear400ESASoffersweremadetoPeninsulaHealthpatients,and182chosetoaccept.Patientsdeclinetheoffersforavarietyofreasons,includingawishtobeclosetohomeforpostoperativerecovery,difficultyintravellingandapreferencefortheirlocalhospital.

Thosewhoacceptdosobecauseofchronicpain,knowingthattheirsurgerydatewillnotbecancelledorthatPeninsulaHealthsurgeonsarealsooperatingatparticipatingESASfacilities.

ThisyearthenewAlfredCentreforelectivesurgeryopenedinsupportoftheESASprogram.PeninsulaHealthsent74patientstotheAlfredCentrethisyearandexpectstodoublethisnumbernextyear.

Orthopaedic Waiting List Project

Theneedfororthopaedicsurgery,suchashipandkneereplacements,isanareaofhighdemand.Thesejointsespeciallyvulnerabletoosteoarthritis.Manyolderpeople,particularly,findthemselvesonorthopaedicsurgerywaitinglists,oftenformanymonths.

Despitethepainanddysfunctionthatcanaccompanytheseconditions,theverylargenumbersrequiringthissurgeryexpandthewaitingtimesfortreatment.

ThisyearPeninsulaHealthsuccessfullyappliedtobeoneoffourpilotsitesintheDepartmentofHumanServices’OrthopaedicWaitingListProject.

TheprojecttargetspatientwithmoderatetosevereosteoarthritisofthehiporkneebyreferringthemtoanOrthopaedicOutpatientClinic.

AssessmentsattheClinic,usingan11itempatientquestionnaire,helpsphysiotherapistsandsurgicalstafftoimprovethemanagementandmonitoringofClinicparticipants.

Earlyface-to-faceclientcontacthelpsstafftoinvestigate,diagnoseandprioritisecasesandencouragesappropriatenon-surgicalmanagementoptionssuchasphysiotherapy,hydrotherapyanddietetics.

WithongoingmonitoringthroughtheClinics,clientswhoseconditionsdeterioratequicklycanbeidentifiedandfasttrackedforsurgery.Also,someclientsimproveenoughwithphysiotherapyandareabletoavoidsurgeryaltogether.

TheClinicsalsoprovidereviewandmanagementforpatientsfollowingorthopaedicsurgery.

TheOrthopaedicWaitingListProjectwillbeimplementedacrossVictoriain2008,usingdatacollectedfromthefourpilotsites,includingPeninsulaHealth.

Medical Imaging Services

MedicalImagingServicesatFrankstonHospitalweregivenasignificantboostwiththecompletioninSeptember2006ofamajorredevelopmentproject.

ThedepartmentprovidesarangeofinvestigativeproceduressuchasX-ray,ultrasound,computerisedtomography(CAT)scansandnuclearmedicinetesting.Theredevelopmentaddednewservices,improvedpatientwaitingareas,expandedworkspaceforstaffandcreatedmoreopportunitiesfortheintroductionofadditionalservices.

AmongthenewservicesnowavailableinMedicalImagingisinterventionalangiography,whichinvolvesviewingandtreatingproblemsinbloodvessels.Theseserviceswerepreviouslyavailableonlyinmajorcityhospitals.

TheMedicalImagingDepartmentnowincludesafivebedInterventionalAngiographySuite,reducingvascularsurgerywaitinglists,offeringpatientsvascularproceduresclosetohome,andfreeingupOperatingTheatretimeforotherprocedures.TheUnitcurrentlyaverages25procedureseachmonth.

ThenewInterventionalAngiographySuitealsosupportsthepreferenceofRadiologistsandVascularSurgeonstojointlymanagepatientswithvasculardisease.


Continuity of Care

Aged Care Services

TheMorningtonPeninsulahasahigherthanaverageproportionofpeopleover65,andlikeolderpeopleeverywhere,localseniorsusemorehealthservicesthanpeopleinotheragegroups.

Providingthislargesegmentofthecommunitywithcomprehensiveandappropriatehealthservicesisanongoingchallenge,whichPeninsulaHealthstrivestomeetthrougharangeofserviceinitiatives.

‘Improving Care for Older People’

In2005theDepartmentofHumanServicesintroducedanImprovingCareforOlderPeoplePolicyforVictorianhealthservices.FundingwasgrantedtoPeninsulaHealthtoensurethathealthservicescontinuedtorespondtotheoftencomplexneedsofolderpeople.

Aspartoftheproject,PeninsulaHealthintroducedanInterdisciplinaryCarePrograminservicessuchascommunityrehabilitation,home-basedrehabilitation,specialistclinicsandtherapy(physio,occupational,speech,etc)services.Nowallclientsareallocatedakeyliaisonpersononadmissionandnewcommunicationtoolsfacilitatebetterteamplanningforeachclient’scare.

Morefocus,throughtheappointmentofNurseSpecialistswithparticularportfolios,hasbeenputonclinicalareassuchasskinintegrity,fallsprevention,infectioncontrolandpainmanagement.Thecommencementoftheseportfolios,whichsupportmonitoringandstaffeducation,helpstofacilitatebestpracticecareforpatients‘atrisk’.

Consumerfeedbackprocesseshavebeenrevampedsothatallsub-acute(ambulatory/outpatient)servicesreceiveroutinereportsoncaredeliveryfromtheconsumers’perspective.

AnauditinApril2007ofagedcarefacilitieswasconductedtodeterminewhethertheenvironmentswere‘OlderPersonFriendly’.Inresponse,theDepartmentofHumanServicesgrantedPeninsulaHealth$137,000forimprovements,whichhaveincludednewchairsandbedsandanupdatednursecallbellsystem.

Dementia in Hospitals

Patientswhosufferfromdementiahavespecialneedswhentheyrequirehospitalisationorotherhealthcareservices.

Astate-wideinitiativewasintroducedthisyeartoimprovestaffawarenessandcommunicationskillsindealingwithpeoplewithcognitiveimpairments.TheDementiainHospitalsprojecthassofarbeenincorporatedintosub-acuteservicesandRosebudHospital,andwillberolledouttoadditionalareasacrossPeninsulaHealth.

Seniors Go For Your Life

TheMorningtonPeninsulaPrimaryCarePartnershipprovidedfundingforPeninsulaHealthtoimplementatwo-yearprojectdesignedtoencourageolderpeopletoagewell.

Amongtheinitiativessofarundertakenare:

thedevelopmentofaPhysicalActivityDirectoryforolderpeople

theestablishmentofsupportedwalkingprogramsattwolocalshoppingcentres

theproductionofaDVDandtwobrochurespromotingtheAgestrongprogramtothecommunity,and

theprovisionof60additionalplacesforAgestrongparticipantsthroughtheestablishmentoftheFrankstonSouthAgestronggroupinpartnershipwithFrankstonCityCouncil.

Ageing Well Expo

Morethan1000peopleattendedthefirstAgeingWellExpoinSeptember2006.Thefreecommunityevent,organisedbyPeninsulaHealth’sCommunityandContinuingCareandAlliedHealthservices,washeldinMorningtonandgaveolderpeopleachancetoexplorewaystoleadahealthyandactivelife.

TheExpofeatured44stallsdisplayinginformationonkeepingactive,healthmaintenance,socialinvolvement,safety,managingchronichealthconditionsandstayinginformed.

Attractionsonthedayincludedaninteractiveartdisplay,acaricaturist,massages,balancetestinganddemonstrationsofyoga,taichiandindoorbowls.

GuestspeakersTommyHafeyandProfessorDennisLowthertoldtheaudiencehowthelateryearsofone’slifecouldbesomeofthebest.TheExpowasopenedbythethenMinisterforAgedCare,GavinJennings.

TheExpo,whichreceivedpositivereviewsfromparticipants,washeldinpartnershipwithMorningtonPeninsulaShireCouncil,FrankstonCommunityHealthService,theBrotherhoodofStLaurence,theOver50sAssociation,PeninsulaCommunityHealthServiceandtheMorningtonPeninsulaDivisionofGeneralPractice.

ThesuccessofthefirstAgeingWellExpoledtoasecond,heldinSeptember2007.


Continuity of Care

Prevention of Functional Decline in Hospitals

AnewprogramhasbeendevelopedbytheDepartmentofHumanResourcestocontinuetheworkimplementedthroughthe‘ImprovingCareforOlderPeople’project.

Entitled‘PreventionofFunctionalDeclineinHospitals’,thenewprojectispartoftheCouncilofAustralianGovernment’s(COAG)‘LongStayOlderPatientsInitiative’.Theprojectaimstoassisthealthservicesinprovidingthebestpossiblecareforolderpeopleinpublichospitals.Afurthergoalistoreduceavoidablehospitaladmissionsforolderpeople.

Focusareasinthisinitiativearemobility,skinintegrity,nutrition,medications,continence,dementia,deliriumanddepression–allkeyriskfactorscontributingtonegativeoutcomesforolderpeople.

PeninsulaHealth’sCommunityandContinuingCareServiceswillleadtheprojectinwhichPeninsulaHealthwill:

serveasaninvitedmemberonDHS’sCOAGLongStayAdvisoryCommittee

actasaleadagencyfor‘Mobility,VigourandSelfCare’,oneoftheeightkeydomainstargetedaspartoftheproject

participateasapartneragencyforotherareassuchasNutritionandMedication

continuetodevelopandtrialresourcesandcontinuetodevelopportfoliosforallsignificantriskareasacrossPeninsulaHealth.

‘Well for Life’ Program

ResidentsatPeninsulaHealth’sLotusLodgeHostelinRosebudhavedonnedtheirsportsshoesto‘WalkaroundtheBay’.

AspartoftheWellforLifewalkingprogramatthefacility,residentscompletedailylapsovernewlyinstalledwalkingtracksonhostelgrounds.

Thetracks,alongwithbenchseatsandalovelysensorygarden,haveencouragedresidentstoparticipateintheprogram,withagoalofwalkingenoughkilometresforanequivalenttrekaroundPortPhillipBay.Staffkeepatallyofthecollectivedistancewalkedbyall

participantsandplotthekilometresonamapofPortPhillipBay.Sofartheresidentshavedonelapsworth100km.

TheWalkingProgramispartofaDepartmentofHumanServicesfundedprojecttoimprovethehealthandindependenceofresidentslivinginagedcarefacilities.

The‘WellforLife’projectalsoincludesahydrationawarenesscomponent,whichstaffareachievingthroughpurchaseofanewrefreshmenttrolleyofferingalternativestoteaandcoffeeandtheinclusionof‘mocktails’atAgestrongexercisesessions.

ResidentsatLotusLodgeenjoythe“WellforLifeprogram”


Continuity of Care

Psychiatric Services

Livingwithaseverementalillnessisdifficultenoughwithoutaddingprocessesthatcausebarrierswhenhelpisneeded.Thisclientpopulationoftenrequiresrapidassistance,freefromduplicatedproceduresandexcessivedocumentation.

Tohelptoachievethis,PeninsulaHealth’sPsychiatricServicesundertookbothexternalandinternalreviewsofitsservicedelivery.

Evidencewasevaluatedtodeterminethebest,moststreamlinedwaytomakeservicesavailabletothepeoplewhoneedthem.

Amongtheimprovementsthathavebeenimplementedare:

anincreaseincrisisresponseteamsfromthreetofour

theintroductionofatrainingmoduleforallcommunitymentalhealthclinicianstopreparethemforperformingtriagefunctions(whichwereformerlyonlydonebyCrisisAssessmentTeammembers)

thedevelopmentofatwo-prongedapproachtocrisisintervention.

OneinvolvesateamofclinicianswhoworkintheEmergencyDepartmenttoassistpeoplepresentingwithmentalhealthissues.TheConsultationLiaisonInpatientPsychiatricService(CLIPS)hasstaffavailable24hoursaday

Thesecondapproach,theCommunityLiaisonEarlyinterventionandAcuteRecoveryService(CLEAR),sendsstaffintothecommunitytoassistclients,theirfamiliesandcarersintheirhomesorothercommunitylocations.

Additionalimprovementsrecommendedbythereviewwillbeimplementedduringthecomingyear.

‘Discovering Dementia’

Halfoftheresidentialcarefacilities(RCFs)ontheMorningtonPeninsulaareparticipatingina‘DiscoveringDementia’educationprogramrunbyPeninsulaHealth.

A$150,000grantfromtheCommonwealthDepartmentofHealthandAgeingisfundingtheprogram.Thegrant,oneofonly16awardednation-wide,supportsresearchandeducationeffortsandtheimprovementofpracticalcareandsupporttopeoplewithdementiaandtheircarersandfamilies.

PeninsulaHealth’sResidentialOutreachSupportService(ROSS)isworkinginpartnershipwithagedcare,psychiatryandrespiteservicestoprovidean18montheducationprogramforstaffinresidentialcarefacilities(hostelsandnursinghomes)throughoutthePeninsularegion.

Theprogram,aimstohelpstaffinRCFstobetterassess,respondtoandcareforresidentswithdementia.Inaddition,dataisbeingcollectedtoassistinevaluatingtheproject.

Trendsidentifiedinthebaselinedataincludethegenerallackofdementia-specificresidentialrespitebedsontheMorningtonPeninsulaandthedifficultyinidentifyingresidentswithdementiaduetoalackofclarityregardingdiagnosis.

Stafffromthe22participatingRCFshaveratedtheprogram‘Excellent’(71percent)and‘VeryGood’(28percent).

0%

5%

10%

15%

25%

20%

2004/2005 2005/2006 2006/2007

SECLUSION RATE TREND LINE


Continuity of Care

Seclusion Reduction Project

AprojectdesignedtoreducetheneedforseclusioninPeninsulaHealth’sPsychiatricServiceshassignificantlyreducedtheneedforthepractice.

Seclusionisalegalpracticethatinvolvestheconfinementofapersonaloneinasafe,low-stimulusroom,theexitofwhichcannotbeopenedbythepersonfromtheinside.

Thedecisiontouseseclusionistakenafterother,lessrestrictiveoptionshavebeenexcluded.Whileseclusioncanprovidesafetyandcontainmentforthepersoninvolved,itcanalsobeasourceofdistressforfamilymembers,friendsandvisitors.

PeninsulaHealthPsychiatricServicesestablishedaworkinggroup,whichincludesconsumers,toexplorestrategiesthatreducetheneedtouseisolatedaccommodation.Recommendationsfromthegroupincludeddevelopmentofasensoryroomtoprovideacalmingenvironmentandimprovementofthephysicalenvironment.

ImprovementshavehelpedhalvethenumberofpatientsplacedinseclusionatPeninsulaHealth.Thenumbersdecreasedfrom16.44percentofadmissionsin2005/06toarateof10.7percentlastyear,comparedtothenationwidebenchmarkof17percent.

Seclusion Rates for Peninsula Health Psychiatric Services

“About Psychosis”

Thedevelopmentofapsychoticillnesscanbeafrighteningandconfusingexperienceforsufferersandtheirfamilies,whoneedinformation,supportandguidancefrommentalhealthprofessionals.

PeninsulaHealthPsychiatricServicesthisyearreleasedaneducationalDVDforpatientssufferingpsychiatricillnessandtheircarers.TheDVD,entitled“AboutPsychosis”,wasdevelopedbyPeninsulaHealth’sAssociateProfessorRichardNewtonusingagrantfromapharmaceuticalcompany.

Morethan10,000copiesarebeingdistributed.

TheDVDoffersinformationaboutpsychoticsymptoms,theroleofsubstanceabuseinpsychosis,medicalcomplianceandavailablesupportservicesandtreatmentoptions.

ItfeaturescliniciansandstafffromPeninsulaHealthPsychiatricServicesandincludesinputfrompatients,carersandsupportgroups.TwocarersfromthePeninsulaplayedthemselvesintheDVDwhilepaidactorsportrayedpatients.

TheDVDwaslaunchedattheCongressoftheRoyalAustralianandNewZealandCollegeofPsychiatristsinApril2007.Copieshavebeendistributedfreeofchargetogeneralpractitioners,psychiatristsandpatientandcarersupportgroupsnationally.RequestsforcopiesoftheDVDcontinuetoarrive.

Mental Health Nurse Practitioner

Anewroleinmentalhealthserviceshasexpandednursingopportunitiesandenhancedclinicalresourcesinthemedicaltreatmentofpsychiatricillness.

PeninsulaHealthnowhasVictoria’sfirstMentalHealthNursePractitioner.CayteHoppnerreceivedtheendorsementinMarchthisyearfollowinghercompletionofafouryearNursePractitionerDemonstrationProject,fundedbytheDepartmentofHumanServices.

EndorsementasaNursePractitionermeansCaytecanprovideservicespreviouslyonlyprovidedbymedicalstaff,suchasprescribingmedicationfromalimitedformulary,ordering

diagnostictests,writingsicknesscertificatesandadmittinganddischargingpatientsandreferringtospecialists.

ClinicalPracticeGuidelineshavebeendevelopedtosupporttheNursePractitionerrole.

AsaNursePractitioner,Cayteaimstoimproveaccesstotreatmentandsupportforpatientswhogenerallyhavedifficultyaccessinghealthservices.

Thisincludespatientswithchronicpsychosis,poorphysicalhealth,forensicissues,homelessness,complexpsychosocialneedsandthoserequiringinvoluntarytreatmentinthecommunity.CaytewillalsoassistGeneralPractitionersinworkingwiththisgroupofpeoplewithcomplexconditions.


Continuity of Care

CayteHoppner

Emergency Department

Intheyearunderreview,anorganisationwideresponsetolengtheningwaitingtimesintheEmergencyDepartmentatFrankstonHospitalwasdeveloped.

ManypeoplespenttoomuchtimeintheEmergencyDepartmentwaitingtobetreated,waitingforabedinanappropriatewardorwaitingtobereferredtoaprogramofcare.

PeakdemandoccurredfromSundaysthroughtoTuesdays.So,increasedafterhoursconsultingspaceforpatientslikelytobedischargedquickly,wasestablishedintheadjacentMedicalImagingDepartmentandotherareas.

Theincreasednumberofpatientsrequiringcardiacmonitoringforbetween12and36hoursresultedinsomeprolongedstaysinEmergencyDepartment.AdditionalmonitorswereorderedtoenablethesepatientstobetransferredtotheEmergencyObservationWardfreeingupbedsintheEmergencydepartmentforotherpatients.

Revisedbedmanagement,dischargemanagementandpatientflowprocesseshavebeenintroduced.Thesehavemaximisedbedavailabilitybyensuringpromptandappropriatedischargetimes;transferringidentifiedpatientsfromFrankstonHospitaltoRosebud

Hospital,andtobothagedcareandrehabilitationprograms.ThiswillresultinmorebedsbeingavailableduringpeaktimetoallowefficientpatientflowsfromtheEmergencyDepartmenttootherwardsandprograms.

Otherstrategiesdevelopedincludethefasttrackingofsomepatients,suchaschildren,tothechildren’swardfortreatmentandthefasttrackingofpatientslikelytobedischarged,toprocedureroomsanddischargeareas.

SuccessfulimplementationofthesestrategieswillenableFrankstonHospitaltomeetbothinternalandDHStargetsforthetimelytreatmentofpatientsintheEmergencyDepartmentandtheirdischargeortransfertootherwardsandprograms.


Continuity of Care

PeninsulaHealth’sperformanceforEmergencyDepartmenttargetsforinitialtreatmentareshowninthefollowinggraphs.In2006/2007onlyninepatientswaitedmorethan24hoursforadmissioncomparedto56patientsin2005/2006.

2006

/07

2000

/01

2001

/02

2002

/03

2003

/04

2004

/05

2005

/06

40000

35000

50000

45000

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Category 1 % Patients Seen Immediately

JUL AUG SEP OCT NOV DEC JAN FEB MAR APR MAY JUN0%

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100%90%

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2006/2007 DHS TARGET


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Category 2 % Patients Seen in 10 Minutes


20%

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70%

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20%

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Patients treated at Frankston Emergency Department

Have Your Say 47Peninsula Health Quality of Care Report 2007

Input into this Report

Clinicians, consumers, volunteers and carers provided feedback on the last Quality of Care Report, and assisted with the development of this report.

Distribution of this Report

We will continue to distribute the 2007 Quality of Care Report at the Annual General Meeting, and to patients, clients, residents in aged care facilities, visitors, partners in health care, local doctors and community leaders. A copy of the Quality of Care Report will also be available on the Peninsula Health website.

The distribution of the report continues through the year as Peninsula Health responds to requests made by telephone, email or ordinary mail. The report is also available in the reception areas of all Peninsula Health facilities and in visitor and patient waiting rooms.

In every case, recipients are invited to provide Peninsula Health with feedback on its services and programs.

If there are areas you would like to see included in the 2008 Quality of Care Report please fill out the feedback form and post it back to Peninsula Health. This is one way that you can help Peninsula Health meet the needs of the community.

If you would like more information about any Peninsula Health service or program, or if you would like to pass on a compliment or express a concern, there are a number of ways to reach the right person quickly.

You can contact Peninsula Health:

Public Relations Department 9784 7821 for information on Peninsula Health services or programs.

Customer Relations Department 9784 7298 to make a complaint or register a compliment.

You can also access more information about services provided on the Peninsula Health website www.peninsulahealth.org.au or use the “Contact Us” button to send an email.

Other contact numbers are listed on the inside back page. More detailed information is also available in the Annual Report and the Research Report. If you would like a copy you can ask for one using the feedback form or telephone 9784 7821 and copies will be posted to you.

Feedback

We received a small response to our request for feedback when we released the Quality of Care Report last year, so we sought additional feedback from 100 people, including patients, volunteers and carers.

Their feedback showed us that most readers were happy with the information included in the Quality of Care Report and its presentation, but some felt it was too long and too detailed.

Readers requested more information on dementia and psychiatric care, as well as information on falls prevention, and we have included articles relating to these areas in this year’s report.

We were told that our Feedback Form was difficult to remove without causing damage to the report, so this year a postage paid Feedback Form has been provided. Please complete it and mail it to us.

Peninsula Health welcomes your perspective in helping the Quality of Care Report meet the needs of the community.

HASTINGS ROAD (PO BOX 52) FRANKSTON, VICTORIA 3199PH: (03) 9784 7777For those outside the Melbourne Metropolitan Area PH: 1800 858 727www.peninsulahealth.org.au

CARINyA ReSIDeNTIAl AGeD CARe UNIT125 Golf links Road Frankston Vic 3199Tel: (03) 9783 7277 Fax: (03) 9783 7515

CHelSeA COMMUNITy ReHABIlITATION CeNTRe8 edithvale Road edithvale Vic 3196Tel: (03) 9772 6099 Fax: (03) 9772 3042

COMMUNITy CARe UNIT4 Spray Street Frankston Vic 3199Tel: (03) 9781 4288 Fax: (03) 9781 4393

FRANKSTON COMMUNITy ReHABIlITATION CeNTRe125 Golf links Road Frankston Vic 3199Tel: (03) 9783 7288 Fax: (03) 9770 5459

FRANKSTON HOSPITAlHastings Road (PO Box 52) Frankston Vic 3199Tel: (03) 9784 7777

FRANKSTON ReHABIlITATION UNIT125 Golf links Road Frankston Vic 3199Tel: (03) 9784 8666 Fax: (03) 9784 8662

FRANKSTON INTeGRATeD HeAlTH CeNTRe12-32 Hastings Road Frankston Vic 3199Tel: (03) 9784 8100

Community Health ServiceTel: (03) 9784 8100 Fax: (03) 9784 8149

MICHAel COURT ReSIDeNTIAl AGeD CARe UNIT32 Michael Court Seaford Vic 3198Tel: (03) 9785 3744 Tel: (03) 9785 3739Fax: (03) 9782 4434

ROSeBUD COMMUNITy ReHABIlITATION SeRVICe288 eastbourne Road Rosebud Vic 3939

Community Rehabilitation CentreTel: (03) 5986 3344 Fax: (03) 5981 2267

Inpatient UnitTel: (03) 5981 2166 Fax: (03) 5982 2110

ROSeBUD HOSPITAl1527 Pt. Nepean Road Rosebud Vic 3939Tel: (03) 5986 0666 Fax: (03) 5986 7589

ROSeBUD ReSIDeNTIAl AGeD CARe SeRVICeS1497 Pt. Nepean Road Rosebud Vic 3939

Jean Turner Community Nursing HomeTel: (03) 5986 2222 Fax: (03) 5982 2762

Lotus Lodge HostelTel: (03) 5986 1011 Fax: (03) 5982 2762

S.H.A.R.P.S.35-39 Ross Smith Avenue Frankston Vic 3199Tel: (03) 9781 1622 Fax: (03) 9781 3669

TATTeRSAllS PeNINSUlA PAllIATIVe CARe UNIT125 Golf links Road Frankston Vic 3199Tel: (03) 9784 8600 Fax: (03) 9784 8674

THe MORNINGTON CeNTReCnr Tyalla Grove and Separation Street Mornington Vic 3931Tel: (03) 5976 9000 Fax: (03) 5976 9136

MOUNT elIzA CeNTReJacksons Road (PO Box 192) Mount eliza Vic 3930Tel: (03) 9788 1200 Fax: (03) 9787 9954

PeNINSUlA COMMUNITy MeNTAl HeAlTH SeRVICe15-17 Davey Street Frankston Vic 3199Tel: (03) 9784 6999 Fax: (03) 9784 6900

PeNINSUlA DRUG & AlCOHOl PROGRAMRosebud Officec/o Southern Peninsula Support & Information Centre878 Nepean Road Rosebud Vic 3939Tel: (03) 5986 0709 Fax: (03) 5982 2601

Hastings Officec/o Peninsula Community Health ServicesCnr Cool Stores Road and Victoria StreetHastings 3915Tel: (03) 5979 2894 Fax: (03) 5979 4735

PeNINSUlA HeAlTH PSyCHIATRIC SeRVICeHastings Road (PO Box 52)Frankston Vic 3199Tel: 1300 792 977 Fax: (03) 9784 7192

Portsea

Sorrento Rosebud

Dromana

Flinders

Hastings

Mornington

Baxter

Mount Eliza

Frankston

Seaford

Carrum

Chelsea

Cranbourne