Michael Nicholas, Co-Chair, ACI Pain Management Network, Director, Pain Education and Pain Management Programs, Pain Management Research Institute Sydney Medical School – Northern, The University of Sydney
Pain Network consolidating gains of last four years
Since its launch in 2012 of the NSW Pain Management Plan (PMP), the ACI Pain Management Network has overseen the rapid development and extension of multidisciplinary pain services across much of NSW. These achievements are currently being evaluated by an external agency (available March, 2017), but what is clear is that almost all of the goals outlined in the original NSW Pain Management Plan (PMP) have been achieved and the focus over the last year has shifted to consolidating these gains alongside identifying and filling any gaps.
The PMP outlined an integrated, tiered model of care, aimed at providing equitable access to evidence-based services that improve quality of life for people living with pain and their families, and to minimise the burden of chronic pain on individuals and the community. Key features of the model included:
- The integration of care across all aspects of the health care system, across both public and private sectors, by increasing partnerships and the capacity of pain management services.
- With the growing concerns about the over-use of opioid medication for chronic pain, the PMP was specifically tasked with reducing reliance on opioids where their effectiveness was not clinically indicated, while promoting greater ability for those in chronic pain to self-manage their pain instead.
- A trial to determine if injured workers at risk of developing chronic pain and associated disability could be identified soon after their injury and helped to return to work earlier than might otherwise happen and to avoid long-term disability and impaired quality of life.
- Finally, the importance of accountability for the funds spent was to be reflected in the development of a process to permit the evaluation of clinical outcomes for all pain services.
This ambitious project has entailed the active collaboration of clinicians from all relevant disciplines and countless hours of meetings and consultations with different service providers, educators, administrators and consumer groups (and their representatives). While there has been an elected executive team overseeing this work, the engine-driver has been Network Manager, Jenni Johnson, and to a large extent much of the credit for the 4 year long program must belong to her.
Some of the keynote achievements include:
- The expansion of multidisciplinary pain services outside the city ‘hubs’ to encompass new services in places like Orange and Tamworth. Numerically, there has been an expansion from 11 multidisciplinary services in NSW in 2010 to 19 in 2016.
- The development of telehealth technology has further enabled these, and other, services to provide and even bigger footprint across their regions than their numbers might indicate. Recently, three more trials of telehealth services for rural patients were taken on by several city clinics: the Pain Clinics at St Vincent’s Hospital, Greenwich Hospital and Nepean Hospital.
- Not only have new, accessible services been developed, but also the new staff have been provided with advanced training in pain management by their supporting ‘hub’ hospitals (like The Hunter Integrated Pain Service, HIPS) at the John Hunter Hospital in Newcastle and the pain clinic at the Royal Prince Alfred Hospital), as well as from innovative workshops and online training from the Pain Education team at the Pain Management Research Institute (PMRI) at the Royal North Shore Hospital.
- Access to high quality educational material on pain for all those who suffer from chronic pain and their families, as well as their health care providers, has been greatly enhanced by development of the Pain Network’s website. This was developed with funding from the PMP and ACI and the freely donated time of many pain clinicians and the site has been the subject of considerable interest, both within Australia and internationally as one of the few reliable sources of up to date information about all forms of pain and their management options.
- The early intervention trial (known as the WISE study – Work Injury Screening and Early intervention study) for injured workers has recently been completed by a consortium including NSW Ministry of Health, EML insurance, icare and the PMRI (University of Sydney) and the results so far have been very encouraging. The trial involved injured health workers from 17 public hospitals in NSW and the results show that those in the intervention arm of this controlled trial had less time off work (30 vs 56 days, on average) and better work retention over the 12 month follow-up. The NSW Ministry of Health has responded by adopting the trial protocol for the management of all injured health workers across the state. The project itself has won two industry awards.
- The evaluation project, known as the electronic Persistent Pain Outcomes Collaboration (ePPOC), is funded under the PMP and managed by researchers at the University of Wollongong and two committees comprising key stakeholder representatives, has been successfully established and has even attracted the involvement of pain services in other states, as well as New Zealand. This a major achievement and it will enable us to describe for the first time the sorts of problems faced by patients with chronic pain across this country, as well as their outcomes after attending our pain services. This will provide a ‘benchmarking’ method of gradually raising the standards of our pain services and their outcomes – to ensure that all patients with chronic pain seeking help at our pain services can be confident of the standard of care and the outcomes they are likely to achieve.
The Pain Network’s work is far from complete, but it is clear that the health options for those with chronic pain in NSW (and beyond) are fundamentally greater now than was possible at all in 2012. But there is still more to do and the Pain Network is working with many agencies in the public and private sectors to further its aims.
Welcome to the December issue of Clinician Connect
by Professor Donald MacLellan – Agency for Clinical Innovation
It has been a busy year here at the ACI. We have seen many successful initiatives arise from ACI Networks, Taskforces, Institutes and other teams collaborating with Local Health Districts (LHDs) and Primary Health Networks (PHNs) across the state, and we continue to build stronger links with our stakeholders through our specialist advice and capability building programs.
In this issue the feature editorial is by ACI Pain Management Network Co-Chair Michael Nicholas, who reflects on the significant achievements of the Network since the launch of the NSW Pain Management Plan in 2012. The Plan has been a major priority for the system in the past few years and it is fantastic to see the great work of the clinicians, consumers and managers involved in our Network being translated into practice in pain services across NSW.
The ACI has recently hosted a number of forums for staff and Co-Chairs to ensure that we continue to develop an engaged and informed culture for the organisation. The new ACI operating model for LHDs, cultural competency, and the revised ACI approach to redesign were key focuses at each event as we listen to feedback from the system and continually improve how we work with our partners.
Our Networks, Taskforces and Institutes also showcase the outcomes from recent events and collaboratives including the Musculoskeletal Forum, the Trauma Forum, and the 4th Aged Health Collaborative Forum, held in partnership with the Clinical Excellence Commission (CEC), Health Education and Training Institute (HETI) and branches of the NSW Ministry of Health (MoH).
A number of our members and key initiatives are recognised in this issue for nominations or winning of awards, as well as a few fond farewells to the people who have had a significant impact on our Networks, Taskforces and Institutes. It is great to see such experienced, respected and passionate people engaging with the ACI as we work to improve the way care is provided across NSW.
Our colleagues at NSW Health and the Sax Institute also feature, showcasing some of the valuable services available to people in NSW and innovative new research being released.
On behalf of the staff at the ACI, I wish you a restful and enjoyable break over the holiday period. We look forward to working with you in 2017 to improve healthcare across NSW.
Professor Donald MacLellan
Acting Chief Executive, ACI
The ACI hosted a Co-Chairs Forum on Monday, 21 November 2016 at the ACI offices in Chatswood. All ACI Network, Taskforce and Institute Co-Chairs and Managers were invited to attend, with more than 63 present on the night.
Attendees heard more about the changes underway across the NSW public health system, workshopped the ACI Cultural Competence Framework and its significance to the work of the ACI Networks, and were presented an overview of new model for delivering services to LHDs.
The event closed with a series of short presentations from a selection of Network managers to celebrate the success of some of the key initiatives from the ACI Networks, Taskforces and Institutes.
In line with the ACI’s commitment to cultural competency as outlined in the Framework, the food for the evening was provided by Aboriginal catering company Kallico, with extremely positive feedback from all. To learn more about Kallico, visit their website at www.kallicocatering.com.
As per all of these events, attendees noted the opportunity to network with peers and other people from across the organisation as a highlight.
The ACI held a Staff Forum at Kirribilli on Monday, 14 November 2016. Staff Forums occur several times throughout the year and give ACI employees the opportunity to come together as a team to discuss issues of key importance to the continued growth and development of the ACI culture.
The theme of the November Forum was “the beat goes on”. The theme represented the period of change the ACI is undergoing, yet the ongoing commitment of the ACI to deliver outcomes while upholding the ACI values and nurturing a positive workplace culture.
A keynote presentation on ‘Innovation is a state of mind’ from James O’Loghlin had the room thinking about the many different ways innovation can manifest, which certainly brought many unique ideas and perspectives to the activities over the course of the day.
The program encouraged staff to reflect on the ACI values and behaviours; to continue to develop and refine the new LHD operating model; and to review and discuss the new ACI Cultural Competency Implementation Plan.
A highlight of the program was a session on drumming with experts from InRhythm, who put the attendees through their paces with an engaging 45 minutes of different drumming patterns, even working up to an all staff drumming harmony to close.
Values and Behaviour Award
Congratulations to Jenni Johnson, Network Manager of the ACI Pain Management Network, who was presented with the ACI Award for Values and Behaviours at the recent Staff Forum.
Promoting and recognising our shared values though the workplace is important in continuing to create a positive and supportive working environment. The ACI Values and Behaviours Awards provide an opportunity to recognise staff who consistently demonstrate our shared values and behaviours.
Nominations for the award are open to all ACI staff. People working within the organisation are given the opportunity to highlight individuals in recognition of their achievements in the demonstration of the ACI values and behaviours charter each quarter.
Jenni was nominated for the award due to her outstanding collaboration, professionalism, respect, leadership across the organisation, as well as a strong passion for her work. Congratulations Jenni!
White Ribbon Day 2016
The ACI is committed to eliminating domestic violence against women and supports the White Ribbon Movement, which works through a primary prevention approach, understanding that men must be engaged to achieve the social change necessary to prevent men’s violence against women. The movement recognises that violence is a learned, gendered and institutionally supported behaviour, and targets the sources of violence rather than accepting the world as it is.
Through education, awareness raising, creative campaigns, preventative programs and partnerships, White Ribbon Australia provides the tools for men to stop violence against women in their community and beyond.
In celebration of White Ribbon Day on Friday, 25 November 2016, the men of the ACI came together to organise an afternoon tea recognising the devastating statics associated with the movement and proudly sharing their commitment to ‘take the oath’ to stand against domestic violence against women. The morning tea was funded with donations from the men who work at the ACI, with several also trying out new baking and decorating skills to produce the final goods. As an organisation, we are proud to have such a caring and committed workforce and thank everyone involved in the event.
More information about the White Ribbon can be found at www.whiteribbon.org.au.
Becoming a culturally competent organisation is a major focus and commitment for the ACI. A strategic focus for 2016 has been examining how the ACI engages with Aboriginal and Torres Strait Islander people/s and communities, both internally and within the ACI Networks, Taskforces and Institutes.
As part of this commitment, a number of activities to build capability, knowledge, and expertise in this area have been completed recently.
A Cultural Competency Implementation Plan has been developed for the organisation, which aims to support how the ACI will implement culturally competent processes into every day work. The Implementation Plan includes objectives and initiatives such as:
- Establish a process to bring Aboriginal perspectives (from both LHD & Community Controlled experience) into ACI decision making structures.
- Maintain an ongoing collaboration process with the NSW Ministry of Health (MoH) Centre for Aboriginal Health, (MoH) Health Promotion Branch and Office of Preventative Health
- Undertake campaign/process to increase Aboriginal membership of Networks and Network Executives and/or effective input, involvement, consultation and provision of advice to Networks and portfolios.
- ACI Aboriginal Employment Strategy
- Continue Cultural Competency development activities
- Continue Facilitators Role in ACI
- Set targets to Close the Gap in Portfolio Work plans and ACI Operational Plan and Identify projects (with Directors and Managers of Aboriginal Health) to help achieve this
- Ensure effective application of Aboriginal Health Impact Statement Process
- Evidence Review – Chronic Care for Aboriginal People
- Develop respectful practices in research and evidence.
- Establish expertise to work with Aboriginal communities in relation to in Patient Experience and Community Engagement.
- Develop an approach to impact measurement e.g. PRMs
- Evaluate/Review Implementation Plan
- Communicate progress of plan to staff and stakeholders
- Update Information on Intranet.
The ACI is committed to workforce diversity and has developed an Aboriginal Employment Strategy to increase the representation of Aboriginal employees at the ACI through appropriate recruitment and retention and strategies, providing career development opportunities and ensuring that we become an organisation which demonstrates a high level of cultural competence within our staff and the work we do.
This strategy focuses on four key priorities:
- Attract Aboriginal staff
- Retain Aboriginal staff
- Support career development and progression
- Improve cultural competency in the workplace.
Development of this strategy has involved consultation with:
- Aboriginal staff at ACI
- ACI Executive
- ACI Cultural Competence and Safety Working Party
- Aboriginal Workforce Unit, NSW Ministry of Health
- National Centre for Cultural Competence (NCCC).
The ACI also continues to work with the National Centre for Cultural Competence (NCCC) to develop and roll out an Aboriginal Cultural Competency Strategy. This Strategy will continue the ACI journey to create organisational change by building a Culturally Competent (CC) workforce, with the intention of delivering culturally safe practice and care to Aboriginal and Torres Strait Islander people/s in NSW. Developing ACI staff’s cultural competency and creating a culturally safe working environment is a key organisational strategy in order to support the development and implementation of statewide culturally safe services that meet the needs of the individual, family and community as a whole.
The ACI hosted a delegation of senior health care executives 8 November 2016 from the newly formed Safer Care Victoria. In October 2016, Victorian Health Minister The Hon. Jill Hennessy released the Duckett Review, which investigated safety and quality assurance in Victorian hospitals following a cluster of tragically avoidable perinatal deaths at Djerriwarrh Health Services. A key recommendation of the review was to establish Safer Care Victoria, who will be responsible for monitoring and improving the quality and safety of care delivered across the Victorian health system, with the goal of achieving zero avoidable patient harm.
The delegation visited the ACI to obtain information regarding our approaches to quality improvement and assurance, including how we identify, analyse, re-design and monitor issues in the system.
Aged Health Network update Co-Chairs: Bill Thoo and Viki Brummell
4th NSW Aged Health Collaborative Forum
The 4th NSW Aged Health Collaborative Forum was held on 14 October 2016 at the Westmead Hospital Education and Conference Centre. More than 200 participants attended the day and a further 200 participated by live streaming.
The NSW Aged Health Collaborative is a group of NSW Health agencies whose work involves the care of older people, including:
- NSW Ministry of Health’s Aged Care Unit; Nursing and Midwifery Office; Older People’s Mental Health Policy Unit; Whole of Health Program
- NSW Agency for Clinical Innovation
- Clinical Excellence Commission
- Health Education and Training Institute
The Forum showcased local innovation and collaboration in the care of older people across the following themes:
- Collaboration and co-design with consumers and communities,
- Collaboration in aged care reforms
- Collaboration with residential care
- Promoting positive values, skills and communication amongst staff working with older people
Thank you to our forum partners, Westmead Hospital and Western Sydney Local Health District (WSLHD) for providing the venue, and to all of the presenters and people working behind the scenes to make the forum a success.
The presentations are now available to view here.
Anaesthesia Perioperative Care Network update Co-Chairs: Michael Amos and Lilon Bandler
Anaesthesia Perioperative Care Network Manager
Anaesthesia Perioperative Care Network Workshop
On Tuesday, 8 November the Anaesthesia Perioperative Care Network hosted a forum to highlight the activities of the Network and the upcoming release of the Perioperative Toolkit (2016). The Toolkit is in the final stages of review and will replace the 2007 guideline, Pre Procedure Preparation Toolkit.
The event provided attendees with the opportunity to workshop with peers around local perioperative processes. There was facilitated discussion and information sharing on existing challenges and local initiatives, as well as opportunities to discuss how the Toolkit and accompanying resources can be localised for implementation.
The workshop also provided an opportunity to highlight new initiatives underway within the Network, including an animation on central line safety and planning for an approach to the green operating theatre.
More than 65 people attended in person, with a number of participants in rural, remote and regional areas joining either individually or in groups via live streaming.
Feedback on the event was positive and will be used to inform future network events and initiatives. The Perioperative Toolkit will be finalised in December 2016 and will be available on the ACI website.
Brain Injury Rehabilitation Network update Co-Chairs: Adeline Hodgkinson and Chris Catchpole
Brain Injury Rehabilitation Network Manager
Hunter Brain Injury Service Patient Experience Videos
In early 2016, the ACI committed to building capability in co-design by supporting three Network projects using the co-design methodology.
Co-design is a way of bringing consumers, families and staff members together to improve health care. As part of the greater initiative, the NSW Brain Injury Rehabilitation Directorate (BIRD) was supported to establish a co-design project team, bringing together clinicians and consumers of brain injury rehabilitation services to solve the priority information needs identified by consumers, families and carers in the ACI review of the Service Delivery Model of Care for specialised brain injury rehabilitation services in NSW.
HBIS Manager Chris Catchpole is a member of the BIRD Co-Design Project Team and was able to share his knowledge and skills with the Hunter Brain Injury Service (HBIS) consumer engagement group, which was established in 2015. This group allows consumers, families and carers to be involved in reviewing specific service initiatives, helping with the development of resources, and providing feedback on the overall delivery of rehabilitation at HBIS. In 2016, the HBIS Consumer Engagement Group used the Co-Design Framework to form a HBIS Co-Design Group with frontline staff to develop useful information resources about HBIS.
The HBIS Co-Design Group identified that a visual medium (video) using client stories and service information would be a meaningful way of developing consumer information for reducing the anxiety experienced by clients and their families/carers when being referred for specialised brain injury rehabilitation. The co-design process enabled clients to talk about what was important to them so that others could better understand the aims of HBIS and what to expect on their rehabilitation journey. Importantly, the group process undertaken by HBIS has enabled staff to better understand the type of information needed by consumers, as well as how it should be delivered.
The HBIS video was launched on Tuesday, 15 November 2016 at their facility in Bar Beach, Newcastle. HBIS Clients, families, carers and staff featured prominently at the launch. Sincere thanks and appreciation was extended to all who participated in making the project such a success.
Flexibility in accessing the video for consumers and staff will be achieved by capacity to download to IPads and access from the ACI website. Over the coming months, HBIS will continue the co-design approach by contacting staff making referrals and consumers considering admission, to evaluate the distribution and usefulness of the video.
Vocational Intervention Program at the NSW Health Innovation Symposium
The Vocational Innovation Program (VIP) was a finalist in the ‘Collaborative Teams’ category at the NSW Health Innovation Symposium, held at Sydney Olympic Park on October 27-28, 2016.
The VIP is a pilot program implemented at six sites within the NSW Brain Injury Rehabilitation Program (BIRP), aiming to improve employment outcomes of people with brain injury. This particular submission highlighted the collaborative relationship between the Mid North Coast BIRP and CHESS, a Disability Employment Service provider based in Coffs Harbour partnered with the BIRP to implement the VIP. The ACI is providing project management, clinical resources, case mentoring and research support to the VIP.
The symposium provided a great opportunity to promote our vocational rehabilitation initiative among 30 other health finalist projects. Each finalist had a ‘booth’ for the two day event, delivered a 60-second rapid fire speech during the symposium and attended the awards ceremony on the final night.
The VIP is on track to finish in mid-2017, by which time approximately 75 clients will have participated in the employment interventions. There is an extensive evaluation being undertaken, with the results assisting in planning the sustainability of this program in the pilot regions and further roll out across the state.
Consumer Council update Co-Chair: Tomas Ratoni
Introducing the ACI Consumer Council’s new members
The ACI is pleased to welcome five new members to the ACI Consumer Council:
- Craig Cooper, CEO, Positive Life NSW
- Bridget Foley, Research and Evaluation Officer, UNSW
- Adam Johnston, Solicitor and consumer representative, Northern Sydney LHD
- Mae Rafraf, Co-Chair, Transition Care Network
- Kirsty Smith, Project Manager, Charles Sturt University
These members join existing members:
- Tomas Ratoni (Chair), Paediatric Clinical Nurse Consultant
- Patrick Frances, Co-Chair, Rural Health Network
- Shazza Taylor, Aboriginal Health Educator at Health Education and Training Institute (HETI)
- Max Simensen, Peer Worker working with adults experiencing psychosis
- Ro-Ann Stirling Kelly, Consumer Engagement/Aboriginal Identification Officer, Mid North Coast LHD Hastings Macleay Clinical Network
- Joyce van Akkeren, Multicultural Access Project Worker
- Coralie Wales, Manager Community and Consumer Engagement, Western Sydney LHD
The Consumer Council provides expert advice to the ACI and its Board on consumer engagement strategies and represents consumer members of ACI Networks, Taskforces and Institutes.
View further information about the Consumer Council.
Intellectual Disability Network update Co-Chairs: Maria Heaton, Jenny Martin and Les White
Intellectual Disability Network Manager
Say Less Show More wins Judges Choice for Implementing Evidence Based Practice
The Say Less Show More (SLSM) initiative seeks to support children, including those with a disability, their parents and carers, with a series of simple visual resources that illustrate what will happen during a dental examination, physical examination and blood tests.
The initiative was developed as part of a collaborative partnership between the ACI Intellectual Disability Network, the Disability Specialist Unit (DSU) at the Children’s Hospital at Westmead (CHW), Ageing, Disability and Home Care (ADHC), consumers, and non-government services Lifestart and Koorana, who support children and young people with a disability.
The initiative recently won Judges Choice for Implementing Evidence Based Practice at the Sydney Children’s Hospital Network (SCHN) 2016 Annual Quality and Innovation Awards.
The judges were impressed with the implementation of Say Less Show More in the Emergency Department at Children’s Hospital Westmead, where doctors and nurses were trained in the use of the resources and an elearning module was developed to assist other LHDs to train staff and develop or adapt the resources to their own local environments.
The initiative is currently being adapted for use with adults with intellectual disability.
The Say Less Show More resources and elearning tools can be accessed here.
Institute of Trauma and Injury Management
Farewell Oran Rigby
The Institute of Trauma and Injury Management (ITIM) is sad to announce that Oran Rigby is stepping down from his position as Clinical Director with the team to continue his focus on the integration of disruptive innovation and critical care in NSW.
Oran’s passion for innovation is evident in the many successful projects and programs that have been produced by ITIM over the past three years.
Oran was awarded a Churchill Fellowship, writing his report to support research into innovative applications for robotics, drones and telemedicine in trauma critical care. Oran continued his fellowship work by becoming a strong advocate for telehealth in critical care and by the use of disruptive technology solutions in NSW Health. An example of this was his sponsorship of the NSW Trauma App, developed by ITIM in 2015?.
Oran represented ITIM and the ACI on multiple national and international stages, being the NSW representative for the National Trauma Research Institute and the Australian Trauma Quality Improvement Program. A Harvard business school scholarship allowed him to pursue opportunities in international value based healthcare.
Oran was formally farewelled at the NSW Trauma Leaders Forum (see below for more details). On behalf of the trauma community we thank Oran for his dedication to trauma services in NSW.
Trauma Patient Outcome Evaluation – Qualitative Report
The objective of the Trauma Patient Outcome Evaluation is central to ACI’s core values and purpose as the leader in the health system for designing, evaluating and supporting implementation of innovative models of patient care.
ITIM recently released a Qualitative Report that will help shape the integration of systems and facilities in the NSW trauma system, the future strategic direction, and ultimately the quality of care our injured patients both expect and deserve.
This Report is the culmination of many months of clinician contributions, expert engagement and ongoing feedback from those dedicated doctors, nurses, paramedics and countless support personnel who make up the state’s trauma system.
The Report provides insights, reflections, opportunities and recommendations to continuously improve the care we provide in NSW, and the model of care within which to achieve this. This report was only made possible by the dedicated work of the ITIM team and most importantly the time volunteered by the clinicians who donated their knowledge and skills to help optimise the system we all work in.
NSW Trauma Leaders Forum
On Wednesday, 23 November 2016, ITIM hosted 79 Trauma Leaders representing services across rural and metropolitan NSW for a full day NSW Trauma Leaders Forum. The theme of the forum was a year in review that also involved a workshop. The workshop aimed to provide the framework for the ITIM & State Trauma Network Work Plan and Strategic Plan towards 2021.
The workshop items included the TPOE qualitative report recommendations and included:
- trauma services and staffing
- trauma transfers and networks
- standardised equipment, notification – (including Code Crimson) and teams
- trauma outcomes recording and reporting
- trauma clinical review
- minimum standards of care
- trauma training - minimal standards and standardisation
Three literature review papers have recently been published by the ITIM team, focusing on complications of vehicular-related injuries, prognosis factors of whiplash injury, and efficacy of back protectors for motorcyclists.
To access the review papers, click on the links below.
Sarrami, P., E. Armstrong, J. M. Naylor and I. A. Harris (2016). "Factors predicting outcome in whiplash injury: a systematic meta-review of prognostic factors." Journal of Orthopaedics and Traumatology: 1-8.
Sarrami, P., R. Ekmejian, J. M. Naylor and I. A. Harris "Complications of Vehicular-Related Injuries: A Scoping Review of Literature." Arch Trauma Res In Press(In Press): e37414.
Ekmejian, R., P. Sarrami, J. M. Naylor and I. A. Harris (2016). "A systematic review on the effectiveness of back protectors for motorcyclists." Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 24(1): 115.
Musculoskeletal Network update Co-Chairs: Matthew Jennings and Gabor Major
Musculoskeletal Network Manager
Musculoskeletal Network Forum 2016
On Friday, 28 October 2016 the Musculoskeletal Network celebrated another successful year of translating evidence into best practice musculoskeletal healthcare for people in NSW with an Annual Forum held at the The Kolling Institute in Northern Sydney Local Health District (NSLHD). Lee Gregory, A/Chief Executive of NSLHD warmly welcomed more than 120 delegates to the health precinct and was pleased the Network had chosen Northern Sydney as the venue to share their work with colleagues.
In opening the Forum, Brian McCaughan, Chair of the ACI Board, congratulated the Network for their focus on improved patient outcomes over the past seven years and the subsequent success in supporting the development of services across NSW.
The highlight of the Forum was the launch of the finalised Model of Care for the Management of People with Acute Low Back Pain (ALBP). Chris Needs presented the background to the model, which was developed by an expert working group led by Chris and Chris Maher. Chris highlighted that the model is critical for this patient group due to increasing use of unnecessary imaging, opiates and prescription of bed rest, and the need to support people with an episode of acute pain to deter them potentially spiralling into chronic pain syndrome.
The Model of Care was formally launched by guest speaker The Hon. Justice Peter Garling RFD, who is a judge of the Supreme Court of NSW and completed an enquiry into the NSW public health system in 2008, making recommendations in his report the Special Commission of Inquiry into Acute Care Services in NSW Public Hospitals (The Garling Report). Justice Garling addressed the Forum on Recommendation 67 of his report, which tasked NSW Health to “establish an organisation (now the ACI) to identify, review and enhance, or else to research and prepare standard evidence based protocols or models of care guidelines, for every common disease or syndrome treatment modalities encountered in NSW public hospitals”. Justice Garling expressed his pleasure in seeing this recommendation coming to fruition with the ACI and initiatives such as the ALBP Model of Care being developed by health professionals for implementation across NSW.
Other efforts of the Network and partners showcased at the Forum included:
- Reflections and outcomes of the Musculoskeletal Primary Health Care Initiative in three areas across NSW. A suite of presenters including Lyn March, who led the Initiative in 2014 to 2016, Sharyn White representing the Mid North Coast partnership (Northern NSW Primary Health Network (PHN) and Mid North Coast Local Health District (LHD)), and Narelle Mills representing the Murrumbidgee partnership (Murrumbidgee PHN and LHD) all presented their experiences on implementing the musculoskeletal models of care from the local perspective as well as what we saw mentoring the Initiative as a Network.
- A report from the NSW Paediatric Rheumatology Network in implementing the associated ACI Model of Care. Implementation project officer Anne Senner presented a poster on what the Steering Group has achieved to date, as well as the video developed for children with Myositis. Lynne Brodie, ACI Transition Network Manager, outlined how Transition Care can support young people transitioning from paediatric to adult services to become self-managers of their health and lifestyle needs, and the Liverpool team described how they work as an interdisciplinary team to improve access and care for these children and their families using the ACI Model of Care as the guide.
Many teams from across NSW also presented their implementation and research outcomes concerning elements of the ACI models of care, giving delegates an opportunity to discuss and debate issues that sometimes delay or hinder implementation. From these presentations, the Lyn March Award for Excellence was presented to Marie March and Genevieve Langron from Blacktown Mt Druitt Hospitals for their work in redesigning their physiotherapy support of people undergoing elective knee replacement surgery. Runner-up for this award was the Liverpool NSW Paediatric Rheumatology Network team. Congratulations to everyone nominated to the award and to the WSLHD team.
A new video in Australian sign language (Auslan) about interpreting services for the deaf community
Auslan is one of more than 120 languages for which interpreting services are offered by the NSW Health Care Interpreter Services (HCIS). The five HCIS operate across Local Health District (LHD) boundaries ensure that non-English speaking people are able to communicate safely and effectively with any provider in the NSW public health system.
The NSW Ministry of Health has produced a new video resource to raise awareness within the deaf community about the availability of Auslan interpreters. The video provides important messages related to patient safety and the experience of the deaf community as well as promoting the use of Auslan interpreters to NSW Health staff.
Consultation with stakeholders, including a consumer representative from Deaf Australia (NSW), the Multicultural Health Communication Service, Multicultural Health Managers, as well as the Deaf Society NSW was undertaken as part of the development process, with overwhelmingly positive feedback.
The video resource and further information can be accessed below or at this link.
Primary Care and Chronic Services
Participant Experience Focus Groups: Facilitation Guide
The ACI has recently released the Participant Experience Focus Groups: Facilitation Guide to support ACI Networks, health service providers from Local Health Districts and Primary Health Networks delivering integrated and chronic care services, redesign and innovation leaders, Aboriginal acute care and CALD coordinators to:
- build skills and capabilities in running focus groups
- capture key information from consumers who have received chronic care services in NSW, and identify priorities which take into account consumers’ feedback
- use information to drive change.
The Guide provides step by step information on essential issues to consider when planning a focus group. A range of templates is also provided online which can be customised to suit the program’s needs.
If you have conducted, or are planning to conduct focus groups using the Guide, the ACI is keen to hear from you to enable continuous improvement of this resource. A short online survey is available at www.surveymonkey.com/r/HCP3RFS.
Respiratory Network update Co-Chair: Sheree Smith
Respiratory Network Manager
Cystic Fibrosis Model of Care
There has been a rapid increase in survival for people with cystic fibrosis (CF) in recent decades. This has resulted in a change in demand for, and the type of, health care services needed; namely an increased number of adult patients and life years of care required, and an increase in hospitalisations rates as complexity and disease severity progresses.
The ACI Respiratory Network has worked with clinicians, managers and consumers to understand the current healthcare needs of people with CF across their lifespan. This has informed the development of a Service Model which details how effective and patient-centred care can be provided for people with CF across health settings in NSW.
“I am out of pocket $60 a fortnight just for travel and parking for CF care. I would value more options for care that does not involve me having to travel’ Adult, on transplant wait list, living in regional NSW
The Cystic Fibrosis Model of Care (CF Model) supports the integration of care across a designated network of skilled CF care providers. It recommends that the lifelong care of people with CF be led by a specialist CF service, with episodes of shared care provided by a network of other healthcare services such as a patient’s GP, Cystic Fibrosis NSW, Hospital in the Home, CF satellite services, transplant units, palliative care services and local service providers.
The CF Model was launched at the Cystic Fibrosis Inter-clinic Clinical meeting on Thursday, 3 November 2016. Members of the ACI CF Working Group met on the day to set priorities for local implementation and to form sub groups to lead work on key statewide enablers, including telehealth.
Implementation of the CF Model aims to :
- Ensure timely access to care
- Improve patient outcomes
- Reduce rates of unplanned hospitalisation
Access the Cystic Fibrosis Model of Care.
Alcohol consumption: monitoring, regulation and impact on public health
The latest issue of Public Health Research & Practice is out now, and focuses on new interventions for alcohol misuse, with a theme of ‘Alcohol consumption: monitoring, regulation and impact on public health’.
The guest editors for Issue 4 (2016) are Jo Mitchell, Executive Director of the Centre for Population Health at NSW Health, and Adrian Dunlop, Associate Professor from the School of Medicine and Public Health at the University of Newcastle.
Themed articles in this issue include a literature review that finds a growing body of Australian and international evidence to support reducing trading hours for bars and hotels late at night to reduce violence. We also look at young people and alcohol – the proportion choosing not to drink is at a 20-year high thanks to a range of factors such as reductions in supply, and taxation. Other themed articles discuss low prescribing rates of alcohol dependence medications and how this limits the effective management of alcohol use disorders in Australia; the pervasive problem of drug and alcohol presentations in hospital emergency departments; a new telephone counselling service to help people reduce risky alcohol use; and whether information on genetic susceptibility to alcohol-related cancers can change drinking behaviour.
Our non-themed articles look at the impact of loose-fill asbestos in the ACT; a battle by the WA Cancer Council against unproven breast cancer screening services; and a new tool to assess chronic disease health risk in workplaces.
Public Health Research & Practice (PHRP) is Australia’s first online-only open access peer-reviewed public health journal, published by the Sax Institute with a strong focus on the connection between research, policy and practice.
The Sax Institute hopes the journal’s focus on innovation and perspectives from policy and practice will support policy makers, program agencies and practitioners in making decisions that are informed by evidence.
Spinal Cord Injury Network update Co-Chairs: James Middleton and Louise Kelly
Spinal Cord Injury Network Manager
Launch of the Emotional Wellbeing Toolkit: A Clinician’s Guide to Working with Spinal Cord Injury
An afternoon tea was held in the Spinal Cord Injury Unit at the Prince of Wales Hospital on Tuesday, 25 October to launch the Network’s Emotional Wellbeing Toolkit.
This valuable resource was developed by the NSW State Spinal Cord Injury Service (SSCIS) Psychosocial Steering Committee and was produced thanks to funding from the David Z Burger Foundation through their generous support of the Prince of Wales Hospital Foundation.
All interactions that health professionals have with clients provide an opportunity to either hinder or enhance adjustment to a Spinal Cord Injury (SCI). When a person is in crisis, they are more likely to be influenced by others than when everything is going smoothly. Crises therefore present opportunities to promote coping ability and mental health. Successful mastery of life crises can lead to psychological growth.
The Emotional Wellbeing Toolkit is designed to educate and provide guidance to health professionals working with people with a SCI, experiencing difficulties or who may be in crisis. The Toolkit is an evidence‐based resource containing validated and standardised assessment tools to facilitate decision making about the need to call on mental health professional assistance.
The Toolkit aims to improve understanding of psychosocial issues and emphasises the critical role staff play in assisting their clients in crises and with long term adjustment. The Toolkit covers issues such as grief and trauma, common psychological and emotional problems experienced by people with spinal cord injury, and ideas for managing challenging behaviours.
The Toolkit and accompanying Brief Psychosocial Clinical Assessment Tool, an assessment sheet to be used in conjunction with the Toolkit, are available here.
Further information about the Toolkit and other psychosocial resources can be obtained by contacting the Network Manager or Annalisa Dezarnaulds, Chair NSW SSCIS Psychosocial Strategy via email Annalisa.Dezarnaulds@health.nsw.gov.au.
Stroke Network update
Farewell Nadia Burkolter
I met Nadia through the ACI (then GMTT) Stroke Coordinating Committee many years ago when she started at Royal Prince Alfred Hospital as the Stroke Clinical Nurse Consultant. As part of the Stroke Coordinating Committee, Nadia joined us in the Nursing and Allied Health Education Committee and contributed enormously to the committee’s achievements. As a “newbie” to the committee she bravely took on the role of Secretary. She was integral in our many education days and shared her enthusiasm for stroke nursing with all of us, inspiring many young and upcoming nurses to work in stroke.
Nadia has represented nursing in high level discussions regarding acute stroke treatments and management and has completed her current tenure as Nursing Co-Chair for the ACI Stroke Coordinating Committee with great respect from all of us for her professionalism.
Nadia leaves us to begin a new adventure in Canberra and we all hope that she continues to share her passion for nursing, especially stroke nursing. We wish her and her family good luck and good fortune.
On a personal note Nadia I will miss you as a colleague, a sounding board for all those “things” that annoy us and especially as a friend.
Stroke Nurse Practitioner, RNSH
On behalf of the Stroke Coordinating Committee, ACI
Surgical Services Taskforce update
Arthur Richardson: Michael Donnellan Medal Recipient
Congratulations to Arthur Richardson, Chair of the Surgical Services Taskforce and Head of Hepato-Biliary and Upper Gastro-Intestinal Surgery at Westmead Hospital, who was the recipient of the Michael Donnellan Medal this week.
The prestigious honour is awarded bi-yearly to a NSW Fellow who has made an outstanding contribution promoting the art and science of surgery, with a particular emphasis on surgical leadership in New South Wales.
The Michael Donnellan Medal was established by the NSW Regional Committee of the Royal Australasian College of Surgeons in recognition of the contributions made to the College and to cancer care in NSW by Dr Donnellan, who was heavily involved with the establishment of breast screening services; however his legacy is the doctors and surgeons he trained.
In 2010, Dr Richardson was appointed Associate Professor of Surgery at the University of Sydney and is the academic Head of the discipline of Surgery at the Sydney Adventist Hospital Clinical School.
Previous recipients of the Michael Donnellan Medal include:
2014 - David Storey
2012 - Patrick Cregan
2010 - Paul Stalley
2008 - Brian C McCaughan (Chair of the ACI Board)
Transition Care Network update
Transition Care Network Manager
Transition update from Western Sydney Local Health District
The focus for the Western Sydney Local Health District (WSLHD) Transition Planning Team has been on developing the vision and scope for adolescent, young adult (AYA) and transition care for 2016-2026. A strategic document is being developed and new AYA spaces are being planned for both Westmead Hospital and the new building to be located between the Westmead campus of Sydney Children’s Hospital Network (SCHN) and Westmead Hospital. A Western Sydney Youth Health Consultancy Group is also being formed. ACI Transition Network Coordinator Louise Charlton and Support Worker Mae Rafraf have been part of the planning team and will eventually move to the new AYA facility.
Mae was also part of the Youth Health Consultation Day held Thursday, 15 September at Parramatta Town Hall. More than 100 young people had the opportunity to have their say about future directions for AYA services in Western Sydney and their insights into issues around health, education, sex and relationships will contribute to the youth health policy and the Western Sydney Youth Consultants Group.
The Bright Alliance Move
The Bright Alliance building on the Randwick Campus is in the final stages of development and will begin operations in December 2016. Adolescent and Young Adult Health services will be situated on Level 7 – the Centre for Adolescent and Young Adult Health. Dawn Vernon, ACI Transition Coordinator for South Eastern Area, and Amanda Loughmann, Transition Support Worker, will be relocating from the Royal Prince Alfred Hospital in early January and will join the staff from Trapeze and SCHN. Discussions have begun with Trapeze and interested sub-specialty teams to establish transition clinics within the Level 7 Centre. The environment has been purpose built for adolescents and young adults, and will provide a friendly space to hold clinics, conduct assessments, discuss transition and preparation for transition, and plan for their future health needs.
Visit to HeartKids
On Thursday, 10 November 2016, Lynne Brodie, ACI Transition Network Manager and Jane Ho, Paediatrician and Acting Manager of Trapeze, met with staff at HeartKids to discuss recent initiatives to support the life journey of young people with congenital heart disease (CHD), including transition. A new MyHeart website, for teens and young people born with heart problems, has been developed through close consultation with the HeartKids Youth Advisory Committee and by engaging young people attending the Heartkids Teen Camp.
The site includes a section on transition written by Julian Ayer, a Paediatric Cardiologist at The Heart Centre for Children, The Children’s Hospital at Westmead. Following the meeting, there are plans to provide links to the Trapeze and ACI websites and to look for opportunities to collaborate on webinars and forums. HeartKids has recently launched their MyHeart Community on Facebook to reach and connect with more young people and keep them informed. Other initiatives currently being developed by HeartKids include a national Chronic Heart Disease (CHD) Registry and a media campaign planned for early 2017 to reach out to Australians of all ages living with CHD.
10th Graduation Sydney Children’s Hospital Randwick Graduation 11 Nov 216
One of the highlights for clinical staff who work with young people with chronic illnesses and disabilities and their families each year are the transition graduation ceremonies held at the Westmead and Randwick sites of the SCHN. On 16 Nov, 12 young adults and their families returned to Randwick to celebrate their time at Sydney Children’s Hospital with their treating teams, the Starlight Foundation Captains, Fairy Sparkle and other invited guests. This year, Cameron Williams, who is soon to re-join Channel 9 as sports editor and presenter and who has been a long-time supporter of SCHN, was a special guest speaker. Cameron congratulated each graduate and presented certificates and a bag of goodies that included Apple ipads.
Aside from eliciting strong emotions in all who attend, these ceremonies highlight the resilience of young people and their families, many of whom have been patients at SCHN since birth. With conditions such as cystic fibrosis, spina bifida, renal failure and severe combined immunodeficiency disease, the challenges have been huge, and for many will be ongoing. Many of the families and young people spoke at the event and the overall feeling was one of gratitude to the SCHN staff for the loving support and care provided.
Michael Brydon, Chief Executive SCHN chaired the ceremony and acknowledged the significant changes in treatment of chronic conditions that have occurred over the past 10 years, and joined all present in congratulating the young people, their families and the treating teams on this milestone.
Spina Bifida Adult Resource team (SBART) Outreach Clinics
Spina Bifida Adult Resource team (SBART) team leader Jade Johnston presented a poster on the service provided by the Spina Bifida Outreach Clinics at the Rural Health and Research Congress held 9-11 November at Tweed Heads. Funded through the Rural Health Outreach Fund, the clinics provide a specialist multidisciplinary outreach clinic for the 40% of young people and adults with spina bifida who live in regional NSW. They also provide workshops to upskill local clinicians in regional areas. In 2015, clinics commenced biannually in Dubbo, Coffs Harbour and Tamworth.
The Friendly Faces website, which was featured at the conference, provides practical support for rural families in metropolitan hospitals, such as sending them a phone so they can make calls, helping them to find parking and other services. Jade commented that this was a good reminder of how hard it is for rural families to make the trip to the city for healthcare and how important outreach is.
Jade has been a long standing member of the Transition Executive and led the most recent evaluations of SBART, funded through the ACI Transition Network. Jade and her family will be moving to Canberra in December and on behalf of the Executive we wish her all the best in her new role and thank her for her significant contribution to the Transition Network.