RCH Strategic Plan 2010 –13

MissionThe Royal Children’s Hospital improves the health and wellbeing of children and adolescents through leadership in healthcare, research and education

ValuesUnity: We work as a team and in partnership with our communities

Respect: We respect the rights of all and treat people the way we would like them to treat us

Integrity: We believe that how we work is as important as the work we do

Excellence: We are committed to achieving our goals and improving outcomes

VisionThe Royal Children’s Hospital, a GREAT children’s hospital, leading the way

Strategic Goals• Deliverexcellenceinhealthcare

• RealisethepotentialofthenewRCH

• SupportandstrengthentheRCHteam

• Enhancecommunityandstakeholdersupport

• Maximisecampus-ledresearch

• Provideexcellenteducation,development and training

ContentsIntroduction 2

Achievements 2007– 10 3

Challenges 2010 –13 9

Serviceenvironment 10

Strategicplan 12

Action plan 14

Contents1RCH Strategic Plan 2010 – 13

IntroductionIn 2010, The Royal Children’s Hospital celebrates 140 years of providing outstanding care for Victoria’s children and their families and our position as one of the world’s great children’s hospitals.

The period of 2007–10 has been a time of renewal and change for The Royal Children’s Hospital. During this period there has been significant achievement associated with the design and construction of the new RCH, development of new models of care and the attainment of clinical, research and education milestones.

Achievements 2007–10

The Royal Children’s Hospital (RCH) has always held a special place in the hearts of all Victorians and it was a significant momentin2007whenPremierJohnBrumbyandMinisterforHealthDanielAndrewsunveiledplansforanewRCH,tobebuilt in parkland adjacent to our current site in Parkville.

Thisiswithoutquestion,oneofthemostexcitingperiodsinour history. Opening in late 2011, the new RCH will provide world-classfacilitiesbefittingourgreathospitalforchildren,families,visitorsandstaff.Designedtointegrateseamlesslyintothe surrounds of Royal Park, the new RCH reflects international evidence of the importance of nature and the environment as part of the healing process.

Integral to a successful transition to the new RCH is our Strategic Plan 2010 –13. Building on the achievements of the past three years, the plan reaffirms our continuing vision as a GREAT children’s hospital, leading the way. It has been developed in the spirit of our renewed values of unity, respect, integrity andexcellence.

Toachieveourvision,ourplanisbuiltonsixstrategicgoals:

• Deliverexcellenceinhealthcare

• RealisethepotentialofthenewRCH

• SupportandstrengthentheRCHteam

• Enhancecommunityandstakeholdersupport

• Maximisecampus-ledresearch

• Provideexcellenteducation,developmentandtraining.

Developmentofourstrategicplanhasseenengagementwithabroad range of stakeholders who share our passion for providing outstanding patient care and improving the health outcomes for all children.TheRCHBoard,executive,staff,ourcampuspartnersMurdochChildrensResearchInstitute(MCRI)andTheUniversityofMelbourneDepartmentofPaediatrics,ourFamilyAdvisoryCouncil,Community Advisory Committee and broader community interest groups such as general practitioners, have participated in a six-monthjourneytoproducethisplan.

Weinviteyoutojoinwithusinwhatwillbeanexcitingthree-yearperiod for the RCH and our campus partners, as we focus on leading the way in paediatric healthcare, research and education.

Tony Beddison AO Chairman

Professor Christine Kilpatrick Chief Executive Officer

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Bioethics Centre

The Children’s Bioethics Centre is an initiative of the RCH in partnershipwiththeMurdochChildrens Research Institute and TheUniversityofMelbourne.Established in 2008, the centre’s aim is to promote and advocate for children’s interests, rights and welfare in both health care and research through an understanding of ethical issues. The centre, which is only the second of its kind in the world, has three major areas of activity:aclinicalethicsservice,aneducation program and a research program.

1. Excellence in healthcare

The New RCH ProjectInMay2005,thePremierofVictoriaannouncedthatthestatewouldbuildanewRCH and so began a journey to design and deliver the first paediatric hospital inAustraliatobebuiltusingapublicprivatepartnership(PPP)model.Followinganintensivesix-monthevaluation,thePremierJohnBrumbyandMinisterforHealthDanielAndrewsunveiledthesuccessfulbidder’sdesignforthenewRCH in November 2007. The delivery of this $1 billion project will significantly changethewayweworkonaday-to-daybasis.Byfocusingonwhatisbestforthe child and their family, the design has separated inpatients, outpatients and administrationareaswithinthehospital.Thenewhospitalwillfeature85percentsingle rooms, increased theatres and outpatient facilities and more than 2,000 car parks.

Transformation and Redesign

To achieve our vision to be a great children’s hospital, we need to do more than build a new physical structure; we need to transform the way we provide care in line withcontemporaryevidence-basedpractice and growing community demand in the health sector. Our transformation and redesign program has built an understanding of the need for change and identified key actions to mobilise and engage all staff in the change process in preparation for the move to the new RCH in late 2011.

2. Leadership in research and education

Campus Council

Working with our campus partners, the MurdochChildrensResearchInstituteandTheUniversityofMelbourne,DepartmentofPaediatrics,theRCHis committed to improving the health outcomes for children today and in the future. In 2007, The Royal Children’s Hospital joined with its campus partners to establish the Campus Council. Elizabeth Proust AO was appointed the Council’s inaugural chair, followed by The Hon. Rob KnowlesAO,inFebruary2009.

National Health and Medical Research Council (NHMRC) Accreditation

The RCH research and ethics processes were accredited by theNHMRCin2010aspartoftheNHMRC’sHarmonisationofMulti-centreEthicalReview(HoMER)initiative.HoMERaimstoenablethe recognition of a single ethical andscientificreviewofmulti-centrehealth and medical research within and/or across Australian jurisdictions. The accreditation provides significant benefit to our researchers who are now able to more efficiently participate in national multicentre research.

Australian Early Development Index (AEDI)

The RCH Centre for Community Child Health (CCCH) continues to lead research into early childhood development and behaviour with itsworkwiththeAEDI.TheAEDIisameasureofhowyoungchildrenaredevelopinginAustraliancommunities.Followingasuccessfulpilotprojectbetween2004and2008,theAustralianGovernmentprovided$24.5millionfornationalAEDIimplementationinrecognitionoftheneedforallcommunitiestohaveinformationabouttheirchildren’sdevelopment.In2009,theAEDIwascarriedoutacrossAustraliaandinvolved98percentoffive-year-oldchildren.TheAEDIhasbeenendorsedbytheCouncilofAustralianGovernments(COAG)asanational progress measure. It is conducted by CCCH in partnership with the Telethon Institute for Child Health Research in Perth.

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Clinical Governance

In 2009, the RCH approach to quality and safety was enhanced by the implementation of a structure and processes to strengthen accountability for quality improvement and clinical risk management across the organisation. Our approach reflects the Victorian Clinical GovernanceFramework:EnhancingClinicalCare(DepartmentofHealth,2008).Recentachievementsinclude:

• reductioninhospital-acquiredbloodstreaminfectionrates due to standardisation of central line management practices

• implementationofanelectronicsystemforthemanagement of incidents and consumer feedback

• introductionofacomprehensivehandhygieneprogram

• establishmentoftheFamilyAdvisoryCouncilandYouth Advisory Council to enhance patient and family-centredcare.

3. Focus on quality and safety

Primary Care Liaison Program

Our Primary Care Liaison Program, Kids Connect, is dedicated to supporting the RCH and community healthcare professionals to better connect for the improved health care of children. In 2009, the RCH undertook to develop a program designed to support general practitioners with additional skills in paediatric care. The Practical Paediatrics Program was launched in 2010 and is a series of educational eventspresentedbyDivisionsofGeneral Practice in conjunction with the RCH.

4. Partners in paediatric care

Paediatric Integrated Cancer Service (PICS)

As a partnership between the RCH, Southern Health andPeterMacCallumCancer Centre, PICS works to ensure that children with cancer and their families from across Victoria have access to high quality, safe and effective care that is well coordinated. In July 2009,theMinisterforHealthDanielAndrewslaunched the PICS Long-TermFollow-UpProgram, which provides survivors of childhood cancer with access to an individualised approach to address their ongoing healthcare needs. PICS was also jointly awarded the Premier’s Award for ExcellenceinImprovingCancer Care in Victoria in 2009 for its Regional Outreach and Shared Care Program.

Immunisation Service

TheRCHImmunisationDrop-inCentrewasofficiallyopenedinOctober2008.Thiscentre highlights the importance the RCH places on integrating preventative medicine and the acute healthcare setting. The centre opportunistically vaccinated over 6,000 patients, siblings and parents in 2008 – 09 and responded to almost over 6,400 calls from the community for immunisation advice.

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Organisational performance

The RCH has maintained a strong financial position over the past three years and has been able to achieve an operating surplus for each of these years. In 2009, the RCH implemented a new planning framework to assist the RCH achieve its vision and enable key actions to be more effectively prioritised and monitored.

Organisational stucture

Professor Christine Kilpatrick was appointed as Chief ExecutiveOfficerin2008.Strong leadership is integral to an organisation’s success, particularly through periods of significant change. Divisionshavegonethroughsubsequent change to ensure the organisation has a sustainable structure in place to support it through the transition process and beyond.

Inaugural Dame Elisabeth Murdoch AC DBE Nursing Development Scholarship

Developingaskilledworkforcethrougheducationandtrainingisanimportantcomponentofimprovingourorganisationalenvironment.In2009,theDameElisabethMurdochNursingDevelopmentScholarshipwaslaunchedasanawardforan outstanding RCH nurse to further develop their career. The prestigious award of $50,000contributestooverseastraveloreducationtofurtheranurse’scareerandenablevaluablesharingofexperienceandknowledge.DameElisabethMurdochACDBEhasgenerouslygivenhernameinperpetuityinsupportofthisscholarshipandthe advancement of nursing at the RCH.

5. Improved organisational environment

2010 –13 will be one of the most exciting, yet challenging periods in our 140 year history. Not only are we preparing to move to a brand new facility, but doing so within a context of major health reform at a national level. The reform agenda is the largest to our healthcare system since the introduction of Medicare.

Challenges 2010 – 13

National health and hospital reform: In2010,theFederalGovernment proposed far-reachingstructuralreforms to the Australian health system that would change the funding and governance model. The RCH will work to further understand the impact and identify the opportunities created by this strategy.

Increasing rates of severe disability and diabetes in children: A Picture of Australia’s Children, (Australian Institute of Health and Welfare, 2009) identified risingratesoflifestyle-related conditions in children, including diabetes and obesity, which will require ongoing assessment of our research and clinical initiatives in order to reduce the burden of the disease.

Leadership: As the only dedicated children’s hospital in Victoria, we must continue to strengthen our leadershiproleasthestate-wide provider of tertiary and quaternary paediatric healthcare services. This means working with our service partners to provide high quality services to the state’s sickest children.

The move to the new RCH: With change brings challenge and the RCH has implemented a robust governance structure to support our staff, patients and families through the move to the new RCH in late 2011. The move is a key driver of our transformation and redesign program, designed to realign programs to meet changing patient needs and the structural design of the new RCH.

Workforce: Overthenextfive years, the health sector isexpectedtogrowfasterthan any other Australian industry sector. In common with other health sector organisations, we face many challenges as populations increase and age,theexpectationsanddemands for our services increase and become morecomplexandweexperienceshortagesand competition for health workforce resources. To achieve our vision and to meet our strategic objectives, we must attract and retain an appropriately skilledandexperiencedworkforce.

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Our organisation

We are the major specialist paediatric hospital in Victoria and also provide specialist care for children from Tasmania, southern New South Wales, and other states around Australia. TheRCHisthedesignatedstate-widemajortraumacentreforpaediatrics in Victoria and, through our Paediatric Intensive Care Unit,deliversthePaediatricEmergencyTransportService(PETS)for the state’s most critically ill children. The RCH is a National FundedCentreforpaediatricheartandlivertransplantation.

Workingwithourcampuspartners,theMurdochChildrensResearchInstituteandTheUniversityofMelbourne,Departmentof Paediatrics, we are united in our goal to improve the health outcomes for children today and in the future. The strength of this campus relationship means that research discoveries can quickly become clinical practice to benefit all children

In 2008 – 09, the RCH treated more than 34,779 inpatients, delivered 228,843 outpatient occasions of service and provided surgeryfor7,740childrenfromthewaitinglist.Morethan67,000children presented at our emergency department and every dayapproximately200childrenreceivedcareinthecommunitythrough RCH@Home. The RCH has an annual budget of $370 million and close to 4,000 staff.

We recognise that a sustainable future for paediatric health care requires shared care with our community and regional partners as well as engagement with our consumers and community to ensure we are delivering optimal services in a timely and acceptable manner.

The RCH is a key member of the Victorian Paediatric Clinical Network,workingtoimplementtheDepartmentofHealth’sStrategicFrameworkforPaediatricHealthServicesinVictoria(2009). The RCH actively contributes to the implementation of Victoria’s Cancer Action Plan 2008 –11 through membership of the Paediatric Integrated Cancer Service (PICS) and the Victorian Comprehensive Cancer Centre (Victorian CCC).

Inadditiontothestate-widepaediatrictraumaservice,theRCHalsoleadsanumberofotherstate-wideservices,including:

• VictorianPaediatricRehabilitationService(withSouthernHealth,BendigoHealth,EasternHealthandBarwonHealth):deliveringpaediatric rehabilitation services to children, adolescents and their families

• VictorianPaediatricPalliativeCareProgram(withSouthernHealthandVerySpecialKids):providingamultidisciplinaryapproachtopalliative care for children across Victoria.

• VictorianForensicPaediatricMedicalService(withSouthernHealthandVictorianInstituteofForensicMedicine):providingassessment and care for abused, assaulted and neglected children and adolescents.

• VictorianInfantHearingScreeningProgram:conductinghearingscreenings of newborn babies while they are in hospital. The delivery of this service involves working with diagnostic audiology and early intervention services from across Victoria, Australian Hearing, Cochlear Implant Clinic, Royal Victorian Eye and Ear Hospital,TheUniversityofMelbourneSchoolofAudiologyandDepartmentofEducationandEarlyChildhoodDevelopment.

• VictorianPaediatricOrthopaedicNetwork(withBarwonHealth,SouthernHealthandWesternHealth):fosteringcollaborationamongst service providers to support the coordination and delivery of quality paediatric orthopaedic care in Victoria.

Through RCH International, the RCH works with hospitals in developingcountriesintheAsia-Pacificregiontoimprovechildand adolescent health.

Our community

The RCH ‘local’ catchment is not well defined. An analysis of hospital activity in 2008 – 09 revealed that the majority of our inpatients are from metropolitan Melbourne(Figure1),particularlythe northwest region of metropolitan Melbourne.Patientsfromtwentyresidential areas, identified using local government areas (LGA) were responsible for almost 66 per cent of our inpatient separations in 2008/09 (Table1).Manyoftheseareas,particularly those in the outer north west ofMelbourne,areprojectedtohavesignificant increases in the population of the 0 –18 age group by 2026.

The RCH caters for children and families from a diverse range of nationalities and cultures. In 2008 – 09, there were 13,109 patients (12 per cent) with a language other than English and RCH delivered 22,409 interpreter services. The top five languages requested were Vietnamese, Arabic, Turkish, Cantonese and Somali.

Melbourne and suburbs 80%

Regional Victoria 15%

Outside Victoria 5%

International 1%

All RCH Patients

Interstate 4%

Regional Victoria 15%

Melbourne and suburbs 80%

All RCH Patients

Outside Victoria 6%

Regional Victoria 15%

Melbourne and suburbs 80%

International 1%

All RCH Patients 100%

Interstate 4%

Regional Victoria 15%

Melbourne and suburbs 80%

Table 1: Top 20 LGA by number of separations Projected change in population 2026LGA name Separations 2008/09 %Total 0 –18 Age group Total population

Hume (C) 2783 8.0% 42% 63%

Moreland (C) 1954 5.6% 16% 18%

Moonee Valley (C) 1868 5.4% -4% 11%

Brimbank (C) 1683 4.8% -9% 11%

Wyndham (C) 1665 4.8% 127% 139%

Whittlesea (C) 1407 4.0% 92% 92%

Darebin (C) 1278 3.7% 14% 15%

Boroondara (C) 1083 3.1% 6% 14%

Melton (S) 1018 2.9% 142% 145%

Banyule (C) 966 2.8% 3% 11%

Casey (C) 890 2.6% 49% 67%

Whitehorse (C) 877 2.5% 10% 11%

Yarra Ranges (S) 784 2.3% -15% 6%

Hobsons Bay (C) 779 2.2% 2% 15%

Greater Geelong (C) 702 2.0% 24% 31%

Manningham (C) 670 1.9% 0% 11%

Knox (C) 644 1.9% -15% 10%

Yarra (C) 638 1.8% -11% 20%

Maribyrnong (C) 606 1.7% 14% 25%

Port Phillip (C) 592 1.7% 10% 31%

Source –VictoriainFuture2008–VictorianGovernmentDepartmentofPlanningandCommunityDevelopmentprojectedpopulation totals in Victoria for the years 2006 to 2026. These projections are based on analysis from the 2006 Census of Population and Housing.

C = City S = Shire

Figure 1: Inpatient separation by patient residence

Service environment

10 11RCH Strategic Plan 2010 – 13 RCH Strategic Plan 2010 – 13

The Royal Children’s Hospital improves the health and wellbeing of children and adolescents through leadership in healthcare, research and education

M

issi

on

The Royal Children’s Hospital, a GREAT children’s hospital, leading the way

V

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Provide excellent education, development and training

Maximise campus-led research

Enhance community and stakeholder support

Support and strengthen the RCH team

Realise the potential of the new RCH

Deliver excellence in healthcare

S

trate

gic

Goals

Create a world-class precinct that facilitates learning

Educate the paediatric healthcare professionals of the future

Develop our leaders

Grow our research effort

Improve patient outcomes by translating research into clinical practice

Enhance the campus reputation for delivering internationally recognised research

Ensure financial sustainability

Enhance relationships with our metro and rural service partners to improve paediatric healthcare in Victoria

Optimise our community support

Attract and retain talented and skilled team members

Promote the safety and wellbeing of our team members

Celebrate achievement

Deliver sustainable improvements to hospital systems

Relocate safely and efficiently to the new RCH

Harness the opportunities created by our new environment

Pursue perfection in healthcare quality and safety

Provide leadership in paediatric healthcare innovation

Create better experiences for patients and their families

Unity, Respect, Integrity, Excellence

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Strategic plan 2010 – 13

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12 RCH Strategic Plan 2010 – 13 13RCH Strategic Plan 2010 – 13

Enhance community and stakeholder support

Maximise campus-led research

Provide excellent education, development and training

Strategic goals

Ensure financial sustainability

Grow our research effort

Create a world-class precinct that facilitates learning

Build our revenue base to enable provision of healthcare services to the children and adolescents from our local community and across the state

Identify RCH research strategic directions in collaboration with our campus partners

Develop and implement a learning and development program for our team

2010 – 13

2010 – 11

2010 – 12

Enhance relationships with our metro and rural service partners to improve paediatric healthcare in Victoria

Improve patient outcomes by translating research into clinical practice

Educate the paediatric healthcare professionals of the future

Optimise our community support

Enhance the campus reputation for delivering internationally-recognised research

Develop our leaders

Identify opportunities created by national health and hospital reform

Increase clinical research, especially in nursing and allied health

Ensure provision of evidence-based educational support for patients in an innovative and creative patient-centred learning environment

2010 – 11

2010 – 13

2010 – 13

Continue to deliver Victoria’s most complex paediatric healthcare consistent with the service principles of the Strategic Framework for Paediatric Health Services in Victoria (2009)

Develop an approach to facilitate knowledge management and transfer into clinical practice in partnership with our campus partners

Continue to deliver high quality under-graduate and post-graduate clinical education programs in collaboration with our education partners

Expand philanthropic support in partnership with the RCH Foundation

Continue to ensure excellence in research governance

Develop and implement a framework to build leadership and management skills for managers

Collaborate with our Parkville Precinct partners to achieve precinct objectives

Enhance the system for the development, utilisation and evaluation of clinical guidelines

Work collaboratively with our campus partners to address training needs of our professional community

Enhance our reputation through the development and implementation of a stakeholder engagement plan

Work collaboratively with our campus partners to ensure globally competitive research is achieved on campus

Enhance decision-making capability of managers through the provision of timely and accurate data

2010 – 12

2010 – 12

2010 – 11

2010 – 13

2010–13

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2010 – 13

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Objectives Key actions Time-frame

Deliver excellence in healthcare

Realise the potential of the new RCH

Support and strengthen the RCH team

Strategic goals

Pursue perfection in healthcare quality and safety

Deliver sustainable improvements to hospital systems

Attract and retain talented and skilled team members

Develop and implement an annual quality plan consistent with the principles of good clinical governance

Improve hospital systems through the ongoing implementation of our transformation and redesign program

Implement the RCH Workforce Planning Framework 2010 –13

2010 – 13

2010 – 13

2010 – 13

Provide leadership in paediatric healthcare innovation

Relocate safely and efficiently to the new RCH

Promote the safety and wellbeing of our team members

Create better experiences for patients and their families

Harness the opportunities created by our new environment

Celebrate achievement

Enhance integration of systems for monitoring and managing risk

Minimise our impact on the environment through the implementation of ‘green’ practices

Develop and implement systems for succession planning

2010 – 11

2010 – 11

2010 – 11

Implement RCH Adolescent Model of Care

Develop and implement the move plan

Develop and implement a safety and wellness plan

Deliver timely treatment by improving patient flow and achieving access performance targets

Utilise information technology and other systems to improve our efficiency and effectiveness

Enhance our employee reward and recognition program

Develop and implement a health promotion and prevention strategy

Satisfy our contractual requirements associated with commissioning and handover of the new RCH

Create an organisational culture that promotes the achievement of our goals consistent with our values

Understand the patient experience and use this information to improve performance and enhance the delivery of patient and family-centred care

Refresh the RCH brand

Communicate our achievements internally and externally

2010 – 13

2010 – 11

2010 – 11

2010 – 13

2010 – 13

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Objectives Key actions Time-frame

Action plan

14 15RCH Strategic Plan 2010 – 13 RCH Strategic Plan 2010 – 13

Building a great new children’s hospital

Campus partners:

ERC

101106 Nov 2010