WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW

Transcription

1 WEST WIMMERA HEALTH SERVICE ANNUAL REVIEW 2015

2 Contents in numbers...1 The President s view... 2 Chief Executive Officer s Report... 4 WWHS The journey... 6 Corporate and Clinical Governance... 8 Lines of communication... 9 Board of Governance Highlights of our year John N Smith PSM 50 years at the helm Summary of Statement of Priorities Finance and Administration Staff awards Staff list...23 Financial performance...24 Clinical Services Acute and Surgical Care Acute and Surgical Care quality indicators A statistical overview of our performance...36 Aged Care Our core business Residential Aged Care quality indicators Dental Services Disability Services Primary and Preventative Health...52 Corporate and Quality Services...60 Environment...62 Occupational Health and Safety Accreditation Consumer engagement Consumer, carer and community participation...72 Continuity of care...74 Building our own future...76 Fundraising and volunteers...78 Key strategic goals for service improvement Glossary...85 Index...85 Capital fundraising Help support your Service...87 Reader survey Location...IBC VALE Yvonne (Leith) Hall 09/04/ /05/2015 Yvonne, known fondly as Leith, returned to her home town of Kaniva to see more of her nieces and nephew. She quickly became a valued member of our team at Kaniva Hospital where her intelligence, dry wit and dedication to her residents are well remembered as are her little ways. For example the bedspread pineapples had to be up the right way, and completion the daily quiz was so incredibly easy. Her dedication to our workplace and for those in her care is remembered and admired. So sadly missed, so lovingly remembered. Rest in Peace Leith VISION To establish a health service without peer through the pursuit of excellence and by opening the doors to innovation and technology. MISSION West Wimmera Health Service is committed to the delivery of health, welfare, and disability services which are compassionate, responsive, accessible and accountable to individual and community needs, which result in quality outcomes for the people of the West and Southern Wimmera and the Southern Mallee. VALUES Strong Leadership and Management We value our organisation and will encourage exceptional professional skills and promote collaborative teamwork to drive better outcomes for our consumers. A Safe Environment Safety will always be our prime focus. A Culture of Continuing Improvement The delivery of superior care to our consumers motivates a culture of quality improvement in all that we do. Effective Management of the Environment Our Service is managed in ways which recognise environmental imperatives. Responsive Partnerships with Our Consumers We maintain a productive relationship with our communities and stakeholders through open communication, honest reporting and a willingness to embrace constructive suggestions. WHY DO WE PRODUCE THIS REPORT? We produced this Annual Review and Quality of Care Report to bring our communities and partners up to date with our performance for the reporting period 1 July June It is a document compiled to open the doors of West Wimmera Health Service to our communities and to provide a comprehensive overview of the Service. We have taken into account the comments from readers about the Report and especially thank the Lions Club of Nhill for providing a group critique of that Report, an early initiative of the Community Liaison Officer. As a result this year we will pay attention to a more detailed Index. The Report is a companion document to the Annual Report presented to the Parliament of Victoria in October 2015 and approved compliant and available for distribution. Items contained in this Report specifically pertaining to quality and safety satisfy the Victorian Department of Health s guidelines for reporting the safety and quality of our care. The Report will be released at the 2015 Annual General Meeting of the Service to be held in the Nhill Community Centre at 8.00 PM on Friday 20 November The Guest Speaker at the Meeting will be Australian aid worker Ms Nola Henry who was one of four Australians among the 46 recipients in 2015, of nursing s highest accolade, the Florence Nightingale Award. Nola served with the International Committee of Red Cross and will share the life changing moments of her experiences. Reports are available at from the Reception Desk at every site or if you wish a copy to be mailed to you please contact (03)

3 IN NUMBERS The people of the West Wimmera region have access to the highest level of healthcare which offers a diverse range of services to the communities in which they live. Total number Acute Patients Full compliance with Cleaning Audits 2,293 7,802+ more hours of Allied & Community Health than last year $1.134M increase in Total Aged Care Revenue Full compliance achieved for all accreditation Operating surplus of $103K Employee expenses $24,803M 545 Total Staff 2,063 + more hours of Home and Community Care (HACC) than last year Average cost per Aged Care Resident per day $321 39,083 Allied Health occasions of service $6,175 Average cost per acute admission Free dental checks for 371 students ANNUAL REVIEW 2014/15 1

4 The President s view Keeping ahead Continuing growth in a changing industry Significant fine tuning in all sectors of the healthcare world, driven by the State and Commonwealth Governments and the evolution of our community profile; the aging population; growing instances of chronic diseases and higher expectations of care have occupied the Board s thoughts this year. Maintaining a flexible, forward approach to the manner in which our Service delivers care, against a background of constant movement in the way Aged Care and Bed Based Hospital Acute care is delivered, along with the changing philosophies surrounding care in the community was the basis for yet another year of strong performance. Headed by a Chief Executive Officer who is a leader respected throughout the industry, a resilient management group and a set of robust policies, the future is looking good for progress and substantial improvement in consumer services. Judgements delivered The safety and quality of our services and the management of risk remained central to the Board s deliberations, giving rise to the importance of the Accreditation process. Accreditation, the examination of every element of every section of this Service by independent assessors, is the means whereby we, as a Board, remain assured of the safety and quality of the healthcare associated with this Service. Presenting to several agencies for professional independent assessment against national standards across our Service proved to be extremely successful. Full accreditation was approved in all instances making West Wimmera Health Service the Service of choice for our communities. Our staff are commended for their continuous conscientious efforts in delivering services of the highest standard of quality and safety, which has culminated in our prolonged success within the accreditation process. The Board of Governance a time for renewal The Board remains committed to the long term expansion and evolution of West Wimmera Health Service. In this light, we await the decision of the Victorian Government to approve the merger of Dunmunkle Health Services with West Wimmera Health Service a decision which will result in many benefits for this area of the Wimmera Southern Mallee Region of Western Victoria. Board appointments Congratulations to Mrs Naomi Zanker and Mr Lester Maybery who were reappointed to the Board and we particularly welcome Mrs Anne Rogers who will join the Board in July After serving for 17 years, Janice Sudholz did not seek re-appointment to the Board, retiring on 30 June Janice was appointed to the Board on the merger of Natimuk Bush Nursing Hospital with West Wimmera Health Service. Rodney Stanford also chose not to seek reappointment after serving on the Board for 10 years. I thank them sincerely for their conscientious commitment to the Board of Governance and to West Wimmera Health Service. Unfortunately, David Buckley resigned from the Board on the 1 March Although his time on the Board was short, David brought to the table solid business knowledge and a strong commitment to the rights of small rural communities to receive an appropriate mix of health services. Thank you David. The Board, as always, has been a solid group. I value their commitment to their honorary role and the confidence they have in my Presidency. I thank them sincerely. To the Chief Executive Officer, John Smith, your guidance and support has been appreciated. Your leadership for this Service and the health industry, both nationally and internationally, is outstanding and to be honoured. We celebrated John s 50th year as Chief Executive Officer of the Nhill Hospital and West Wimmera Health Service this year. Congratulations John on a truly exceptional career. The people of West Wimmera thank you for your significant investment in our communities. The consistent performance and strong growth experienced across many divisions places this Service in a prime position to continue its steady advancement towards achieving its Vision to establish a health service without peer. Leonie G Clarke President 2 WEST WIMMERA HEALTH SERVICE

5 John N Smith PSM, Chief Executive Officer Leonie Clarke, President of the Board. ANNUAL REVIEW 2014/15 3

6 Chief Executive Officer s Report Leading the change The two decades since the amalgamations of three rural Hospitals, two Bush Nursing Centres and a Disability Service to form West Wimmera Health Service has been a very defining period for our thriving organisation. The experience gathered during this period has set a solid foundation to carry the Service through the many reforms which have occurred throughout all sections of the health industry and indeed are still on the agenda of both the State and Commonwealth Governments. Reform and renewal The emphasis in healthcare is now prevention rather than cure moving from the predominance of hospital admission to the many forms of in home care with packages of care available to support living at home safely for people experiencing conditions for which previously admission to hospital or residential aged care was the only option. Continuing reforms in all sectors of healthcare, acute care, aged care, disability services, allied health and social services have a major impact on the business and direction of this Service. We have truly embraced the opportunities these reforms have opened for us to forge ahead and make our progressive health service even more essential for the residents of this region. Change, in its many guises, as a result of reform, in response to the evolving fabric of our communities or the health status of our residents has generated a new way of thinking, of innovation, planning and fundraising within West Wimmera Health Service and indeed the entire health system. Fundraising, donations and philanthropy Tighter funding regimes, and increased competition for special government funding has placed enormous pressure on us and has highlighted the extreme necessity to continually seek other avenues of funding to meet the ever growing demand for our services. At the same time we must comply with the stringent demands of Quality and Safety Standards, Accreditation surveys and Compliance Audits. Therefore the Capital Fundraising Campaign which commenced in has been a vital element in maintaining the forward thrust of emerging plans for, among other projects, an exciting Community Health & Wellbeing Centre, a central pillar of the Capital Building Program. The Peter M. Sudholz Medical and Allied Health Centre, Natimuk, adjacent to the Residential Aged Care complex, was keenly supported in financial terms by the Natimuk community and in particular the generous commitment of Mr Peter M. Sudholz, a long term resident of Natimuk. A prime example of a government grant, fundraising and philanthropy combining to bring to fruition a vital community service. The Centre was officially opened on 1 May 2015 by Member for Mallee, Andrew Broad. The fundraising campaign at Kaniva to construct a hostel adjacent to the Kaniva Hospital is progressing slowly however plans are in place to accelerate its progress in Small Rural Health Service funding reform The Department of Health and Human Services is currently reviewing the Small Rural Health Service (SRHS) funding model. Our Chief Executive Officer, John Smith, has the privilege of serving on the Review Panel Since 2006 a large portion of our funding has been calculated under this model therefore the Board is taking a strong interest in the final report of the Review which has been submitted to Government for scrutiny. It is understood the date for the new funding model to take effect may be July 2016! The Victorian Public Healthcare Awards It was a privilege to be announced as a Finalist in the Premier s Health Service of the Year Award for Small Health Services in the Victorian Public Healthcare Awards acknowledging the progressive initiatives and innovative measures introduced to break down the barriers of isolation and hardship another effective financial year Of note is that the end of year result achieved $103,121 was the tenth successive surplus for West Wimmera Health Service a positive indication of our sustainability and a solid foundation on which to base strategic planning for Proposed merger with Dunmunkle Health Services Negotiations surrounding the merger of West Wimmera Health Service with Dunmunkle Health Services appear to have stalled however hope remains that Government endorsement of the initiative would be announced prior to 30 June. However this did not eventuate. The Board is keen to have this long standing matter resolved in order to either put in place preparations for the management of the new entity or to expend its energies on other pressing matters before them. 4 WEST WIMMERA HEALTH SERVICE

7 Management restructure The changing makeup of our communities manifested in the need to introduce a fresh mode of melding the emerging possibilities of care and the new and proposed reforms referred to previously, prompted a restructure of the management profile of the Service. Subsequently in March 2015 the Board endorsed a change to the management structure. The number of Executive Directors has increased and their roles have changed markedly to reflect the shifting nature of health care trends. While still in its infancy, the restructure was timely and effective. We are listening Including consumers in decisions and planning, inviting their recommendations about all facets of our Health Service, drawing our communities into our strategic and continuous improvement planning is the only way we will know the views of people. To ensure we involve consumers in our decisions a Community Liaison Officer was appointed in March 2015 whose responsibilities include increasing opportunities for consumer advice on all aspects of this Service. The developing Consumer Engagement Plan will establish the finer points of the role. Public consultations Forums, open to the public are conducted at each service annually at which members of each community have the opportunity to learn about developments at West Wimmera Health Service and importantly to contribute their own ideas for service improvements and innovations. We encourage people to have the confidence to ask for information and make suggestions at these gatherings we won t know if you don t say! Commonwealth restructure of Primary Healthcare delivery Following the Review instigated by the Australian Government to honour its commitment to rebuild the Primary Healthcare system it is proposed local communities will receive more appropriate access to improved health services through the establishment of the resulting Primary Health Networks (PHNs). The Networks will support services across the primary, community and specialist health sectors to work together with the key objective of increasing the efficiency and effectiveness of medical services for patients, particularly those at risk of poor health outcomes, and improving coordination of care to ensure patients receive the right care in the right place at the right time. (Australian Government Department of Health) The new National Primary Healthcare Networks will come into force on 1 July West Wimmera Health Service will rest under the umbrella of the Western Victorian Primary Health Network which stretches from the Barwon South West region through to the South Australian border. We remain positive about the changes mooted given the desire of this new Network to maintain and in fact enhance primary healthcare delivery in the rural remote areas of its designated boundaries. Board diversity Retirement by two senior Board Members and the appointment of one new Member, leaves the opportunity to restructure the Board within the number of members stipulated under the Health Services Act, 1988, if the proposed amalgamation of West Wimmera Health Service with Dunmunkle Health Services takes place. There is an element of disappointment however that the term of appointment and reappointment of Board members this year was restricted to a twelve month period only. Our advice on the reason behind this strategy is to allow Government time to examine how opportunities can be created to increase Board diversity. We will closely monitor this change in the appointment process to ensure the best outcome for this Service. A new era in health services Strategic Directions The ten Strategic Goals approved by the Board for , are the backbone of the planning and decision making which drove this Service to continue to achieve at the highest level. The Strategic Plan is available at Preparation for the Strategic Plan is currently under consideration. Our standing in the provision of rural healthcare and proven sustainability as a Service is the end product of a combination of many factors; an efficient Board of Governance, enthusiastic, skilled and passionate staff, volunteers, visiting general and specialist practitioners who willingly bring their expertise to us and finally, effective resilient management combined with strong leadership. To the people for whom we have the responsibility to provide health, welfare, and disability services which are compassionate, responsive, accessible and accountable to individual and community needs ; we confirm our commitment to further strengthening the quality and extent of the health services we deliver and will continue to act in your best interests at all times. John N Smith PSM Chief Executive Officer PROFILE Chief Executive Officer John N Smith PSM FAICD, MHA, Grad Dip HSM, AFACHSM, AFAHRI, FAHSFMA, AFAIM, Cert III OH&S John is accountable to the Board of Governance for providing strong, reliable leadership and direction in maintaining a sustainable and effective health service. His extensive experience in the health industry provides valuable, efficient and innovative management ensuring quality and safety systems uphold the very best of care and safety throughout the organisation. He is currently Vice President of the Australian Council on Healthcare Standards, Treasurer of the International Board of ACHS, a Council Member of the Australian Hospital and Healthcare Association, and Vice President of the Victorian Healthcare Industrial Association. ANNUAL REVIEW 2014/15 5

8 West Wimmera Health Service The journey On the 21 st August 1995 West Wimmera Health Service was declared a Public Hospital, an initiative that brought together the three communities of Nhill, Kaniva and Jeparit. Much has happened in the intervening 20 years. The mergers of Nhill, Kaniva and Jeparit Hospitals was the start of a momentous journey that has fundamentally changed the organisation, its management and its ability to provide extensive care within rural health services in the Wimmera. The initial merger was quickly followed by requests from the Rainbow Bush Nursing Hospital and the Natimuk Bush Nursing Centre, The Goroke Community Health Centre and Cooinda Disability Service to join the fledgling West Wimmera Health Service. The growing Service now included seven individual rural health services located in six distinct communities. As a result these six communities were able to access a much wider range of services than had hitherto been possible. As West Wimmera Health Service has progressed through the years we have pursued a very active capital works program that has transformed our inherited centres into impressive, modern and well equipped facilities. From these excellent facilities an increasingly broad range of allied and community preventative and promotional health programs are conducted for all communities. Specialist Surgeons bring their expertise to the Nhill Operating Suite, continuing education expands career opportunities for our staff and the introduction of new services into every site is a continual process. We have kept abreast with rapidly advancing technology and every facet of our Service has been reviewed and fine-tuned. In addition consistently strong results in Accreditation Surveys have given our consumers abiding confidence in the safety and quality of our care. West Wimmera Health Service has now grown to become a substantial organisation. With the increase in scope and scale the potential for negative environmental impacts became an important consideration. This has led to many innovations and new practices being introduced which have been designed to significantly improve our recycling methods, reduce our use of gas and electricity and decrease water use. We have built a well- earned reputation for providing quality, innovative healthcare for all ages centred on an appreciation and knowledge of community needs. As stated, much has happened, but we see the past 20 years of achievement as just the beginning of a continuing adventure. Bring on the next 20 years! 6 WEST WIMMERA HEALTH SERVICE Nhill Hospital (late 1960 s), Max Schlegel

9 Natimuk Peter M Sudholz Medical and Allied Health Centre 2 Jeparit Hospital 3 Goroke Community Health Centre 4 Kaniva Hospital 5 Rainbow Hospital 6 Nhill Hospital Mira and Tristar, Nhill ANNUAL REVIEW 2014/15 7

10 GOVERNANCE Corporate and Clinical Governance The Board of Governance is responsible to the Minister for Health for guaranteeing West Wimmera Health Service maintains the highest standards of accountability, compliance with all relevant Acts, Standards and Directives of Government and for delivering on all service and financial targets agreed with the Department of Health and Human Services. Members of the Board of Governance are appointed in accordance with the Health Services Act, 1988 (The Act) to provide effective corporate and clinical governance for the Service. Board members are guided by the Directors Code of Conduct of the State Services Authority. They are volunteers and are not remunerated for their services. They are appointed by the Governor in Council in accordance with The Act. Members are usually appointed for a term of three years after which it is possible to seek reappointment. However, mystifyingly, appointments this year were for one year only to 30 June The Board meets at least eight times per year and special meetings are called to address specific items. Open Community Meetings are scheduled at each site annually. To achieve effective Corporate and Clinical Governance, stringent monitoring systems for reporting to the Board are arranged throughout the organisation. This, combined with a robust Committee and Subcommittee structure keeps the Board extremely well informed to make critical decisions that guide the future of West Wimmera Health Service. Audit and Governance Committee The Audit and Governance Committee oversees and advises the Board on matters of accountability and internal control. The Committee s objective is to maximise the quality and safety of services provided in compliance with all applicable laws, rules and in accordance with the principles of effective risk management. Members Mr J M Hobday LLB* Chair Ms L G Clarke President Mr D P Buckley to 16 March 2015 Mr H G Champness Mr L C Maybery Mrs J M Sudholz *Independent Member Clinical Governance A Board of Governance responsibility Clinical governance is the system by which the Board of Governance, Managers, Clinicians and staff share responsibility and accountability for the quality of care, continuous improvement, minimisation of risks and fostering an environment of excellence across the organisation. A sound framework An extremely sound framework underpins the effective and efficient control of quality and safety in all elements of clinical care at West Wimmera Health Service. The Clinical Quality Governance Committee oversees clinical performance improvement, accreditation, legislative compliance, clinical risk management and consumer engagement across the Service. This Committee operates in close liaison with the Clinical Quality Improvement Committee which is responsible for the implementation, operation and improvement of clinical processes and outcomes throughout West Wimmera Health Service. Clinical Governance is an aspect of the Board s responsibility which is not taken lightly! Research into efficiencies, best practice governance on a National and International basis is ongoing. 8 WEST WIMMERA HEALTH SERVICE

11 GOVERNANCE Lines of communication Board of Governance Executive Assistant Chief Executive Officer Director Capital Services Manager Engineering Services Executive Director Finance & Administration Executive Director Clinical Services Assistant Accountant & Administration Staff Manager Personnel, Payroll & Human Resources Manager Procurement & Inventory- Manager Clinical Operations Radiology Pharmacy Home Care Packages & Commonwealth Home Support Program Acute Care & Surgical Services Central Sterilising & Infection Control Residential Aged Care Executive Director Medical Services Executive Director Corporate & Quality Services Visiting Medical Practitioners Quality Systems Accreditation Manager Hospitality & Environmental Services Education Occupational Health and Safety Executive Director Primary & Preventative Health Executive Director Operations & Performance Health Information Allied and Community Health Home & Community Care Goroke Community Health Centre District Nursing Maternal & Child Health Aged Care Administration CEO Special Projects Disability Services Dental Services ANNUAL REVIEW 2014/15 9

12 GOVERNANCE Board of Governance President Leonie G Clarke Education Support Officer, Rainbow P 12 College Date Appointed: A dedicated long serving member of the Board, Leonie has a vast knowledge of the healthcare system and maintains a strong focus on the provision of quality health services for our large rural and remote region. Leonie was appointed as a Justice of the Peace in 2008 and serves on the Rainbow Town Committee. WWHS Committees: Executive, Finance, Audit, Clinical Quality Governance Board Meeting Attendance: 100% Vice President Ronald S Rosewall BSocSc Former Business Proprietor Date Appointed: Ron is committed to providing access to quality healthcare and his experience and understanding of the needs of those within our rural communities, serves him well in his role as Chairman of the Wimmera Southern Mallee Health Alliance. Ron remains steadfast in his interest in disability services and is Chair of both Wimmera Disability Access Forum and the Find a Way Foundation. WWHS Committees: Executive, Clinical Quality Governance Board Meeting Attendance: 100% David P Buckley Trade Cert Electrician, Electrical Contractor Date Appointed: David s experience on committees in his local community has been a valuable contribution to the Board of Governance. He resigned his position on 16 March WWHS Committees: Audit, Clinical Quality Governance Board Meeting Attendance: 83% Harvey G Champness BA, Dip Ed Accredited Lay Preacher Retired Teacher, Environmental Consultant Date Appointed: Harvey has significant experience in education and environmental management with an interest in health research. As a Lay Preacher and service on several committees in the Kaniva district, Harvey has gained vast knowledge of community issues. He is aware of the need for community input into health delivery and for vital medical services for small rural areas. WWHS Committees: Audit, Clinical Quality Governance Board Meeting Attendance: 63% Leonie G Clarke, President 2 Ronald S Rosewall, Vice President 3 David P Buckley 4 Harvey G Champness 10 WEST WIMMERA HEALTH SERVICE

13 Ronald A Ismay Business Proprietor Date Appointed: Ron has significant financial and management experience as a business proprietor and is a Councillor with the Hindmarsh Shire. He is dedicated to maintaining quality and viable health services in our rural area. WWHS Committees: Executive, Finance Board Meeting Attendance: 100% Lester C Maybery Primary Producer Date Appointed: With his vast knowledge of rural communities Lester remains committed to ensuring viable and accessible health services to the people of the West Wimmera and was a strong supporter in the planning of the new Peter M Sudholz Medical & Allied Health Centre for Natimuk. WWHS Committees: Finance, Audit Board Meeting Attendance: 75% Rodney L Stanford Merchandise Sales Date Appointed: Rodney held the responsible position as Chair of the Capital Campaign Project and has a keen interest in the provision of equitable and accessible healthcare which meets the current and future needs of our communities. Rodney resigned his position from the Board on 30 June WWHS Committees: Executive, Finance Board Meeting Attendance: 50% Janice M Sudholz Home Duties, Farmer Date Appointed: Janice has considerable experience in governance and is committed to continued improvement and expansion of accessible, quality health services for our communities. Janice welcomed the opening of the Peter M Sudholz Medical & Allied Health Centre for Natimuk. Janice resigned her position from the Board on 30 June WWHS Committees: Audit, Clinical Quality Governance Board Meeting Attendance: 88% Naomi E Zanker BA, Dip Ed, GAICD Retired Secondary Teacher Date Appointed: With a background in education and experience in aged care governance, Naomi is a strong advocate for rural and regional health services from both tiers of government which has repercussions for services. She is also interested in the provision of cancer support services for our rural settings. Naomi is President of Gallery Central Inc, and records the Newspaper for the visually impaired. WWHS Committees: Executive, Clinical Quality Governance Board Meeting Attendance: 100% 5 Ronald A Ismay 6 Lester C Maybery 7 Rodney L Stanford 8 Janice M Sudholz 9 Naomi E Zanker ANNUAL REVIEW 2014/15 11

14 Highlights of Our Year Peter M Sudholz Medical and Allied Health Centre, Natimuk. 12 WEST WIMMERA HEALTH SERVICE

15 Capital works Peter M. Sudholz Medical and Allied Health Centre The Peter M. Sudholz Medical and Allied Health Centre in Natimuk was opened on Friday 1 May 2015 by the Member for Mallee, Andrew Broad. Accompanied by his nephews and other members of his family Mr Sudholz proudly unveiled the sign announcing the name of the new Centre. Bringing back memories. Brothers Peter (right) and Bob Sudholz (left) with old items from Peter s homestead. The Centre was made possible by the generosity of the Natimuk community, a $500,000 grant from the Commonwealth Government and the significant donation from Mr Sudholz. Completion of new accommodation Completion of the construction of three modern four bedroom houses for short term accommodation will be a positive element in attracting doctors, staff and students to West Wimmera Health Service. ANNUAL REVIEW 2014/15 13

16 HIGHLIGHTS OF OUR YEAR Goroke Community Kiosk is now open for business a meeting place for the community and a place to relax while waiting for an appointment. Goroke kiosk opening The opening of the kiosk at Goroke Community Health Centre on 25 November 2014 has provided a warm, café style meeting place for the community Annual General Meeting Over 200 people attended the 2014 Annual General Meeting of West Wimmera Health Service held at the Nhill Community Centre on Friday 21 November MC for the evening was the Chief Executive Officer, Mr John Smith PSM. President, Ms Leonie Clarke, welcomed Guest Speaker Dr Peter Habersberger who enlightened the audience about his journey through the medical profession ending as an eminent Cardiologist based in Melbourne. Staff receiving major service awards were presented with gifts and certificates to acknowledge loyalty and commitment to our Health Service. Flu prevention Wimmera Southern Mallee Health Alliance distributed Flick the Flu bags to raise awareness and increase prevention of the spread of flu across our catchment, an idea initiated by WWHS. Visiting dignitaries We hosted the Honorable Alex Chernov AC QC, Governor of Victoria on Tuesday 24 March 2015 at the Goroke Community Health Centre during a two day visit to West Wimmera Shire. Member for Mallee, Andrew Broad, visited Rainbow Hospital in April. 50 years of service Chief Executive Officer John Smith celebrated 50 Years of Service on 4 January Congratulations John on a sterling career. Continuing Education Up-skilling of staff Several RNs were upskilled to provide management of Central Venous Lines and Ports for cancer patients living locally thereby easing the burden of long distance travel to other treatment centres. A world first Earlier this year three of West Wimmera Health Service diabetes clients were among the first in the world to be educated in the use of the latest in Insulin Pump Technology called Smartguard. The new Medtronic Pump, when used in conjunction with its Continuous Glucose Monitoring accessory, helps prevent the occurrence of hypoglycaemia. Nurse training completed 5 Rural and Isolated Practice Endorsed Registered Nurses (RIPERN) are now trained and the required policy is in the process of being updated. 14 WEST WIMMERA HEALTH SERVICE

17 HIGHLIGHTS OF OUR YEAR Tooth Fairy Alison Welsby, Hygiene Therapist and Dental Nurse, preparing for Dental Healthcare Promotion in Kindergartens with sisters Amelia (left) and Saskia (right). Expansion of services More elective surgery The volume of elective surgery at Nhill Hospital has increased, highlighting the important role local health services provide in the delivery of safe, effective, low risk surgery. Dental The Goroke Dental Clinic was commissioned in March School Dental Screening Project A free program for students conducted by our dental team alerted children and parents to the importance of regular dental checks and correct method of cleaning teeth. Cardiac Rehabilitation Program commences In conjunction with Wimmera Southern Health Alliance and Wimmera Healthcare Group we began the well supported Cardiac Rehabilitation Program, designed for anyone who has had any cardiac event or surgery or is at risk of developing heart disease. Extended radiology services An additional day of radiology services was provided by our Radiologist. Accessing care close to where we live The increased provision of Home and Community Care allied health professionals providing services not previously available in rural and remote communities. These include Woomelang and Dunmunkle Health Services delivering on the promise of providing care locally. Bringing people together Introduction of regular Women s and Men s Outings as part of Planned Activity Groups at all sites, promotes socialisation while discovering new places of interest within our local area. 602 clients participated in these programs in Successful accreditation visits All unannounced Accreditation visits for Residential Aged Care units were successful and without recommendations. Acknowledgement for health, safety and wellbeing Acknowledged by Institute of Public Administration Australia as a finalist in the category Leading The Way in Health, Safety and Wellbeing Award. International Nurses Day International Nurses Day was celebrated across the Service 12 May. ANNUAL REVIEW 2014/15 15

18 HIGHLIGHTS OF OUR YEAR Improved care for cancer patients a response to patient requests Many Registered Nurses have completed further education on accessing Central Venous Access Devices or ports, an important improvement to our services. This means that patients can now have their ports attended to locally, reducing the inconvenience and cost of a two hour drive to the regional centre for this five minute procedure. Beryl, in her seventies, was diagnosed with breast cancer and in order to undergo treatment had a port inserted into her chest. At the completion of the course of treatment it is a requirement that the port is flushed and then hep-locked, a process in which medication is injected to ensure the port is secure until the next episode of treatment is required. Beryl now attends Nhill Hospital for a port flush every 6-8 weeks and is grateful for this service. It is convenient and has reduced the considerable stresses related to her having to travel a long distance for this procedure. Beryl willingly consented to be the model at the education session conducted by an experienced Oncology Nurse Practitioner. It was extremely beneficial for nurses to view the procedure. Staff have since consolidated their practical skills by spending time in the Oncology Unit at Wimmera Health Care Group. Community consultation Open community forums Forums were held in all communities throughout the year offering the opportunity for everyone to learn about the progress of our busy Service. This included what services are available in their town and importantly for them to tell us what is working for them and what is not and consequently needs to improve. Making information easier to understand The opinion of patients from the Victorian Healthcare Experience Survey was that there was too much information contained in the package given to patients preparing to go home from hospital. As a result we now provide information for the patient at each stage of the admission and discharge process rather than everything bundled into one large pack. We have also provided an information brochure to assist patients who have questions or concerns after they leave hospital. This brochure contains all follow up appointments. It is one piece of paper instead of three a much simpler process for patients. Improving understanding In recognition of the need to ensure excellent communication between clients and health professionals in the Service will investigate employing a health professional with fluent Karen language skills to work specifically as an interpreter within the Nhill Hospital, Outpatients and also assisting in the Tristar Medical Clinic. Staff Cancer Resource Nurses In conjunction with the Wimmera Southern Mallee Health Alliance, and in response to many community requests, Cancer Resource Nurses based at Nhill were appointed. They will offer support, information and links to community and specialist cancer services to those who have been touched by cancer. Executive Director appointments On March two additional Executive Directors were appointed marking a restructure and realignment of executive responsibilities. Community Liaison Officer employed A Community Liaison Officer was appointed in March to be the contact between the Service and our communities. Among the Liaison Officer s responsibilities will be that of increasing opportunities for consumer involvement in working towards improvements or additional services. Farewell and thank you We say goodbye to General Practitioners Dr Anthony Anachuna and Dr Paul Moyo. Although sorry to see Drs Moyo and Anachuna move on we are delighted they continue to serve rural communities. Dr Oleksiy (Alex) Stepanov has also recently moved from Kaniva. Sadly we farewell several long term employees who have decided to retire. We have a history of staff serving over many years bringing constancy and certainty to our Service. Denise Stimson, Wendy Altmann, Pamela Price, Elaine Webster, Lisa Newcombe, Julie Dunford, Judith Ridgwell and Ann Thomas. We salute you for your loyalty, your passion for your profession and commitment to the values of this Service and we wish you well for your future. New contracts register Installation and Commissioning of a new Contracts Register which electronically stores External Contracts and helps managers plan for contracts due to be renegotiated. The register stores all relevant contract documentation and information. Changes to the Aged Care Act The Aged Care Act 1997 (Cth) and Principles is set to be amended in The changes are planned to bring greater independence to aged care complaints management. The Aged Care Complaints Commissioner who is appointed by the Minister and is totally independent of the Department of Social Services will take over all elements of complaints relating to Aged Care Services. We will monitor the changes to make sure there is a positive perspective surrounding the process which is designed to bring greater efficiency and a clear approach to all cases. 16 WEST WIMMERA HEALTH SERVICE

19 Beryl Burnett, outpatient and Janine Clark RN, Cancer Support Nurse. ANNUAL REVIEW 2014/15 17

20 John N Smith PSM 50 YEARS AT THE HELM The 4 th January 1965 a significant date in the history of the Nhill Hospital and subsequently West Wimmera Health Service. A raw young recruit with some experience in business but none at all in the health industry, entered the Nhill Hospital as manager/secretary on probation! As John Norman Smith crossed the hospital threshold that morning he couldn t help surmising what have I got myself into? It didn t take long before John became a familiar figure in the hallways of the Victorian Department of Health seeking funding for one ground-breaking project or another, always aligned to the task of converting a small country hospital into a major modern, rural health service. The changes John instigated and implemented quickly became apparent as section by section the Nhill Hospital was redeveloped to bring it into the modern era. But this was not simply a building program. John s mind and aspirations became attuned to the changing attitudes and disciplines involved in providing effective and relevant healthcare, especially in a place that could be the very real definition of remote and rural. Allied Health professionals joined Doctors and Nurses working at the hospital, specialist Medical Practitioners undertook orthopaedic procedures and eye surgery. The list of services and unfolding plans grew rapidly, the beginning of an integrated health service. In 1974 John was elected to the District Council of what is now the Victorian Healthcare Association. So began a long history of involvement with National and International peak healthcare organisations, including; the Victorian Healthcare Association, the Australian Hospital and Healthcare Association and the Australian Council on Healthcare Standards. He was elected as the first rural Chief Executive Officer to serve as President of the Victorian Healthcare Association from and was then appointed Chair of the Australian Hospital and Healthcare Association. He is currently Vice President of the Australian Council on Healthcare Standards International and a Councillor of the Australian Hospital and Healthcare Association. Along the way John acquired a Masters in Health Administration, Fellowship of the Australian Institute of Company Directors and was a Councillor of the former Shire of Lowan. Perhaps a major highlight of John s career was Australia Day 1991 when he was awarded a Public Service Medal for servceis to the health industry. In the early 1990 s many small hospitals were struggling financially. Nhill was travelling well at the time under John s leadership - visionary as well as managerial. Surrounding hospitals were not doing so well. Another journey was imminent culminating in the merging of three rural hospitals, two Bush Nursing Centres and a Disability Service which together formed West Wimmera Health Service over the span of a few short years from 1995 to Congratulations John! Your wisdom, innovative thinking, astute financial mind, willingness to adopt new technology and tenacious persistence has left an indelible imprint on the exceptional health services available to the people in the Wimmera region. This is a story of one man s unfolding vision a story to be continued. 18 WEST WIMMERA HEALTH SERVICE

21 Summary of Statement of Priorities The Statement of Priorities is the formal funding and monitoring agreement between Victorian Small Rural Health Services and the Secretary for Health and Human Services. The Priority areas for were selected by the Department from the Victorian Health Priorities Framework which outlines key outcomes the health system should strive to achieve by West Wimmera Health Service developed proposed deliverable outcomes to meet the priorities in our catchment with outcomes measured through quarterly meetings with Department representatives. This summary provides details of our achievements towards these objectives. Priority 1 Developing a system that is responsive to people s needs: the new End of Life Decision Making Policy and Protocol were implemented to reflect best practice initiatives. a Code Grey Unarmed Violence Policy was developed and staff completed an online education module on Occupational Violence and Aggression. Relevant staff have undertaken a Cardiac Rehabilitation Training course and an agreement has been entered into with Wimmera Health Care Group for specialist physicians to visit Nhill Hospital so patients now have access to specialist physicians for cardiac and other conditions. Priority 2 Improving every Victorian s health status and experiences: To enhance our organisational focus on consumer participation and engagement a Community Liaison Officer position was created. The Service employs two Karen Graduate Nurses offering insight into cultural aspects applicable to health service engagement, the Karen population is represented on the Service s Cultural Diversity Working Group and primary health clinicians attended a Working with Interpreters and our Karen community Forum. Priority 3 Expanding service, workforce and system capacity: Substantial work has been undertaken in the financial year surrounding preparation of the 2015 Flu season including strategies for increased education of the flu vaccination benefits and increased availability through reviewed distribution schedules. Clinical Placement days in the disciplines of Registered and Enrolled Nursing, Physiotherapy, Occupational Therapy, Podiatry, Dietetics and Speech Pathology have increased by 28% from the previous financial year. Priority 4 Increasing the system s financial sustainability and productivity: RiskMan Contract Register implemented which provides an effective documentation collection and management portal for contracts. Priority 5 Implementing continuous improvements and innovation: A Service board member was appointed chair of the Wimmera Southern Mallee Health Alliance for the second consecutive year and the Service has representatives on the following Alliance groups; Persistent Pain Physio Project, Chronic Disease Network, Nurse Unit Managers Network forums and the Unplanned Presentations Steering Committee. A consolidated discharge information pack has been developed to better meet consumer requests citing too much information following a review of results from the Victorian Healthcare Experience and an additional review performed of the Acute Discharge experience. Priority 6 Increasing accountability & transparency: Annual Board assessment and education opportunities have been explored with the Australian Institute of Company Directors and will be combined with the development of the new West Wimmera Health Service Strategic Plan in An aged care focus on the Aged Care Funding Instrument (ACFI) has resulted in improved financial results and benchmarking of ACFI has commenced with Ballarat Health Services and Barwon Health. Priority 7 Improving utilisation of e-health and communications technology: The Service has endorsed in principle the implementation of an electronic clinical records system as part of a Grampians wide E-Health Business Plan. The Information and Communication Technology Plan was reviewed in conjunction with Dulkeith Computer Solutions, our IT consultant, and updated to reflect the desired outcomes for the year. West Wimmera Health Service proudly contributed to the Victorian Health Priorities Framework through this work resulting in improved communication processes with community members, business efficiencies and financial savings achieved. We look forward to meeting our Statement of Priority targets again in ANNUAL REVIEW 2014/15 19

22 Finance and Administration Executive Director, Ritchie Dodds, with Christopher Milloy, Technical Engineer, Dulkeith Computer Solutions, in the depths of the server room which drives the Information & Communication Systems for the whole Service. Human Resources Management Safe, high quality and compassionate care can only be delivered by appropriately trained and motivated employees. Over we achieved an average compliance rate of 99% for compulsory education elements such as police checks, fire and emergency training, CPR, basic life support and professional registrations. No days were lost to industrial action over the year. At 14.4% staff turnover was higher than for the previous year of 12.4%. It is always difficult to pinpoint the exact cause of changing turnover rates however both the recent divisional reorganisation together with an increasing number of students seeking gap year work will have contributed to this increase. At 5.2% of basic wages (4.96% prior year) our sick leave is slightly higher than the regional average of 5.1% and an indication of the effect the ageing workforce across Australia is beginning to have on our operations. WorkCover payments made to injured workers totalled $95k a significant fall from $160k last year and reflects the valuable work undertaken by our Injury Management Team. PROFILE Executive Director, Finance & Administration Ritchie R Dodds BCom CA FFin MBA GAICD Ritchie oversees the Finance, Administration, Procurement, Human Resource Management and Information Technology functions. He plays a key role in the ongoing financial sustainability of the Service and also in keeping the Information and Technology Department up to date with the latest in technology. Representing the Service on the Grampians Region Health Alliance Information Technology Finance Committee, Ritchie also deputises for the Chief Executive Officer as and when required. 20 WEST WIMMERA HEALTH SERVICE

23 FINANCE AND ADMINISTRATION People Matter Survey Each year staff participate voluntarily in the independent People Matter Survey conducted by the Victorian Public Sector Commission. The results of the survey tell us how well we support our employees and how satisfied they are working at WWHS. Unfortunately, the survey response rate was not as high as we would have liked to give us a fair and representative indication of the views of our whole workforce. A true overview can only be achieved with a higher percentage participation therefore we will strongly encourage all staff to complete the Survey in Planning is in place to analyse why some results are lower than expected and what we can do to improve them in a sustainable way. Personnel & Payroll With over 470 active employees at any one time and employed across nine different employment awards, an accurate and responsive payroll service is a critical element in maintaining an appropriately qualified and motivated workforce. Over the year we paid out almost $25m in employee related expenses to staff such as Nurses, Personal Care Workers, Physiotherapists, Clerks, Carpenters, Dietitians and Dentists a significant contribution to the welfare of our rural communities! The Pay Office also moved fully into the digital age during the year completing its transition to a truly paperless office. Information and Communications Technology The Service operates and maintains several mission critical information technology systems including a wide area information technology and communications network across seven separate sites IPM (Patient Management), Oracle (Financial Management) and PayGlobal (Payroll and Human Resource Management). As with last year the Service suffered no significant amounts of downtime associated with system failure. Also, importantly no loss of data or breach of data security occurred. Our basic computer and server replacement plan remained in place whereby the oldest 25% of hardware items was replaced so that at no time did the Service own any IT equipment that was greater than four years old. Victorian People Matter Survey Survey results relating specifically to safety & quality Percentage agreement Patient care errors are handled appropriately in my work area 91% 97% 95% This health service does a good job of training new and 95% 89% 100% existing staff I am encouraged by my colleagues to report any patient safety 97% 98% 98% concerns I may have The culture in my work area makes it easy to learn from the errors 84% 87% 100% of the others Trainees in my discipline are adequately supervised 88% 86% 95% My suggestions about patient safety would be acted upon if I 89% 92% 95% expressed them to my manager Management is driving us to be a safety-centred organisation 94% 96% 98% I would recommend a friend or relative to be treated as a patient here 94% 92% 91% Survey results relating specifically to Percentage agreement employee engagement I would recommend my organisation as a good place to work I am proud to tell others I work for my organisation I feel a strong personal attachment to my organisation My organisation motivates me to help achieve its objectives My organisation inspires me to do the best in my job Engagement Index Note: The employee engagement index provides an indication of employee commitment to our goals and values and their motivation to contribute to our success. We continue to make a steady improvement in this area. Victorian People Matter Survey Summary 3 year comparison Values Providing the best standards of service and advice 96% 97% 96% (Responsiveness) Earning and sustaining public trust (Integrity) 91% 93% 97% Acting objectively (Impartiality) 91% 91% 92% Accepting responsibility for decisions and actions 90% 86% 93% (Accountability) Treating others fairly and objectively (Respect) 87% 86% 91% Actively implementing, promoting and supporting the values 89% 92% 93% (Leadership) Respecting and upholding human rights of the public 97% 98% 96% (Human rights) Principles Choosing people for the right reasons (Merit) 86% 91% 90% Respecting and balancing people s needs 89% 92% 95% (Fair and reasonable treatment) Providing a fair go for all (Equal employment opportunity) 95% 97% 99% Resolving issues fairly (Reasonable avenues of redress) 86% 90% 93% Workplace wellbeing and commitment Workplace wellbeing 91% 95% 97% Change management 77% 79% 91% Patient Safety Patient Safety 92% 92% 97% Planning is in place to analyse why some results are lower than expected and what we can do to improve them in a sustainable way. ANNUAL REVIEW 2014/15 21

24 FINANCE AND ADMINISTRATION Workforce Composition Equivalent full time employees by category June Current Month Full Year Nursing Administration & Clerical Hotel & Allied Services Medical Officers Ancillary Staff Totals Legislation WWHS is bound by the rules and regulations contained in the following legislation: The Victorian Public Authorities (Equal Employment Opportunity) Act The Victorian Equal Opportunity Act The Victorian Public Sector Management and Employment Act The Commonwealth Disability Discrimination Act The Commonwealth Racial Discrimination Act The Victorian Public Administration Act Through the application of Service policies, protocols and monitoring compliance with relevant industrial relations instruments we aim to: Ensure open competition in recruitment, selection, transfer and promotion. Base employment decisions on merit. Treat employees fairly and reasonably. Provide employees with a reasonable avenue of redress against unfair or unreasonable treatment. Avoid discriminating between employees on the basis of their gender, age, impairment, industrial activity, marital status and religious or political beliefs. We do not tolerate bullying or harassment in any form! Inventory and Procurement (Stores and Supply) Inventory and procurement is tasked with supplying the consumable component of our Service across 17,000 square kilometres. Ensuring that the right supplies are delivered to the right area at the right time is an essential component of high quality healthcare saving costs and making sure the Service can do what needs to be done, when it needs to be done. During the year some 9,650 purchase orders were raised to external suppliers for a diverse range of goods and services including hip replacement prostheses, surgical gloves, computers, food, medical oxygen and fire protection. Future plans The Service is required to adopt a new suite of procurement policies and procedures as mandated by Health Purchasing Victoria (HPV). The new procurement framework adopts a risk based approach to purchasing and must be in place by 30 June The Service is part of a Grampians region wide approach to ensuring that HPV s requirements will be fully met by the due date. Work will also continue on the planning of the stores warehouse and distribution centre which is to form part of a new building to also house the Service s own commercial scale laundry. Into 2016 The completion of an employee contract audit aimed at confirming all staff have an up to date employment contract with the Service. Ensure the Service fully complies with all requirements of the new superannuation administration platform, Superstream, by the due date of 31 October Years John N Smith 30 Years Judy Allen Janine Clark Jacqueline Stevenson Denise Stimson 25 Years Julie Bloomfield Robyn Clark Jennifer Dufty Christine Dufty 20 Years Loretta Fisher Marilyn Keller Catherine McKenzie Kevin Merton Judith Ridgwell 15 Years Cindy Bone Janice Clugston Alison Connell Ritchie Dodds Leonie Graham Judith Harrington Marianne Hicks 10 Years Raelene Alexander Marlene Austin Deborah Chaston Pamela Coates Christina Hayden Cheryl Johnson Pamela Newton Nurse Graduates Wendy Eden May June Htoo Hei Breanna Sinclair Lucas Terry STAFF AWARDS Craig Henley Jayne Oliver Nicole Schneider Darren Taylor Bianca Jones Lyn Maddern Brenda O Leary Rosemary Pritchett Robert Schneider Leanne Wallis Loata Pitt Rhonda Preston Valerie Roll Catherine Saul Vicki Thomas Christopher Weir 22 WEST WIMMERA HEALTH SERVICE

25 WWHS STAFF Brendon Abernethy Mary Agustin Liam Albrecht Melanie Albrecht Alicia Alexander Amanda Alexander Karen Alexander Lola Alexander Michael Alexander Raelene Alexander Judy Allen Gary Allison Eman Alsulami Glenda Aristides Susan Arthur Shirley Ashfield Kelvin Asplin Angela Atta Marlene Austin Shirley Avery Robert Bahr Josephine Bailey Anjali Balakrishnan Aziz Baluch Emily Barber Michelle Barber Wendy Barnett Kaye Baron Christine Barry Sarah Bartholomew Sharon Bartholomew Rebecca Bastin Heather Batson Hayden Baxter P leh Be Nyo Clint Beattie Kellie Beattie Susanne Beattie Aaron Beer Ancy Biju Kelsey Birkin Julie Bloomfield Anthony Bone Cindy Bone Sharon Bone Frances Bone (V) Maurice Bone (V) Jessica Borain Kaye Borgelt Elizabeth Both Caroline Brant Lisa Braybrook Anthony Breavington Shelley Brown Joelle Browne Amanda Brownsea Concepcion Burns Donna Burns Glenda Bush Lisa Buttigieg Kim Campbell Lachlan Campbell Helen Cannell Lindsay Cannell Mark Carracher Toni Casey Barbara Cavanagh Peter Cavanagh Anuja Chacko Harvey Champness Deborah Chaston Remya Chathamparambil Ramesan Bianca Chifura Carolyn Clark Christine Clark Janine Clark Robyn Clark Janice Clugston Melissa Coad Pamela Coates Ashley Colbert Sonya Colbert Alexi Conboy Alison Connell Kyle Consadine Charles Cook Helene Cook Annie Coustley Kathleen Coutts (V) Kerry Coyne Lisa Creek (V) Anthony Croke Pawel Czupryn Alison Dahlenburg Janine Dahlenburg Stephanie Daly Jeena David Andrea Davis Melissa Davis Jodie Day Amberlie Deane Sandra Decker Alyce Deckert Andrea Deckert Christine Deckert Alan Delaney Kellie Dickerson Michelle Dickinson Sharon Dixon Shenae Dixon Ritchie Dodds Tarrah Dodds Jamie Duffy Christine Dufty Jennifer Dufty Lynette Dunford Olena Dyer Wendy Eden Jessica Eldridge Sheryl Ellis Stacey Ellis Susie Ellis Kaye Emmett Kevin Emmett Sonia Enright Wendy Essex Vicki Etherton Kerry Exell Michelle Farinha Carmel Feder Kerry Festa Anne-Marie Fischer Caroline Fischer Janine Fischer Melanie Fischer Chantelle Fisher Erin Fisher Janet Fisher Loretta Fisher Wendy Flavel Neena Francis Katrina Fraser Margaret Frew Tyrone Friebel Lorretta Fuller Barbara Fulton Deborah Funcke Laura Gabbe Mary Gabbe Ryan Ganz Zenaida Garcia Sharon Garwood Wendy Gawith Helen Gay Alicia Gebert Darren Gebert Kylie Gebert Amritha George Geena George Sharon George Cathrine Gersch Gwenda Gilpin Kent Goldsworthy Michael Goode Leonard Goodwin (V) Tennille Gould Teresa Gould Ian Graham Leonie Graham Ashley Grant Beverley Grant Jennifer Grayson Helen Greig Jennifer Greig Beverly Hage Megan Hall Russell Hallam Allison Halliwell Anne Hamilton Janine Harberger Judith Harrington Stephanie Harris Belinda Hartigan Anita Hassall Darcie Hastwell Emma Hawker Leah Hawker Lesley Hawker Christina Hayden Yingying He Robert Heaney Kevin Hedt (V) Janet Heenan May June Htoo Hei Joshua Heinrich Trisha Heinrich Craig Henley Marianne Hicks Cynthia Hicks (V) Sandra Hinch Casey Hiscock Susan Hiscock Thaylor Hofmaier Terri-Ann Hogart Cassandra Howe Than Than Htoo Tayleka Hughes Kathleen Hutson Caroline Jackson Diane Jackson Anju Jacob Sophie Jacobs Tracey Jarred Ruby Jarred (V) Margaret Jarvis Denise Jensz Nakita Jewell Desley John Cheryl Johnson Bianca Jones Brian Jones Kevin Jones Yvonne Jones Richard Jones (V) Jerric Jose Bony Joseph Saleena Joseph Gary Judd Sheila Judd (V) Deborah Kakoschke Martha Karagiannis Lucy Keam Judith Keller Marilyn Keller Phyllis Keller (V) Eliza Kelly Karen Kennedy Kathryn Kennedy Mary King Kayleen Kingwill Linda Knight Fiona Krelle Margaret Krelle Susan Krelle (V) Anna Krommenhoek Gladys Kyle Georgina Laidlaw Emma Lang Lynne Launer Kristine Laverty Lisa Lawes Cassandra Leffler Caitlin Lehmann Karen Lester Katrina Lloyd Sally Lockwood Bree. A. Lowe Bree. C. Lowe Cheryl Lowe Vicky Loyden Darren Lyall Kerrie Lynch Lynne Lynch Lyn Maddern Marion Major Sharyn Makin Shinta Manuel Trudy Marshall Vicki Marshall Katie Martin Melissa Martin Fay Martion John Martion Jessica Mason Suneeth Mathew Gaile Mayne Mila Mazou Andrea McCartney Joanne McCartney Karyn McCartney Rachael McCartney Dianne McDonald Bonnie McEldrew Michelle McGennisken Catherine McKenzie Lynne McKenzie Sheryl McKenzie Julie McLean Rodney McLean Jane McPhee Casey Mellington Michelle Menzel Susan Menzel Ann Merrett Maree Merrett Michelle Merrett Tracey Merrett Kevin Merton Shayne Michael Lisa Miller Sandra Millward-Coyne Breanna Moar Nicole Moar Trudi Moar Jennifer Morgan Tracey Morphett John Morphett (V) Sharyn Morrison Chloe Mulraney Bronwyne Nalder Jacqueline Nash Ulamila Nasokia Ami Netherway Pamela Newton Adam Nicholson Brenda Norman (V) Jaimee Nossack Megan Nossack Linda O Heaney Polly O Heaney Brenda O Leary Luke Oldaker Jayne Oliver Carol Paech Ellen Panozzo Madisson Parker Lucy Paterson Michael Patrick Feby Paulose Ann Pearce Peter Pearce Mariah Peele Janice Pekin Tracie Peoples Elizabeth Pfeiffer Beverley Phillips Jessica Pilgrim Katrina Pilgrim Selina Pilgrim Bobbie Pitt Loata Pitt Sandra Pollock Rebecca Powell-Hodges Courtney Preston Rhonda Preston Leslie Prichard Rosemary Pritchett Andrea Pumpa Lejo Punnoose Tahnee Purchase Sally Purvis Katrina Rabone Patricia Rabone John Ramsden Reju Reghuvaran Nair Christopher Reichelt Anne Renfrew Jennifer Rentsch Luisa Reodique Lynne Rethus Beverly Rethus (V) Joylene Rich Christine Richards Judith Ridgwell Christine Rintoule Joshua Rintoule Angus Robinson Brenda Robinson Lesley Robinson Lynley Robinson Natalie Robinson Wendy Robson Valerie Roll Corinne Rose Alicia Rosewall Ronald Rosewall (V) Helen Ross Tamhika Ross Denise Rowe Janet Rowe (V) Louise Rowe (V) Nathan Ruge Graeme Ruse Revai Rutsate Helen Ryan Laurence Ryan Melissa Ryan Tania Ryan Debra Sanders Sharon Sanderson Catherine Saul Kristina Savicin Judith Schier Deborah Schilling Nicole Schneider Robert Schneider Rebecca Schultz Denise Schulz Wendy Schulze Debra Schumann Adam Schwarz Janine Seater Wendy Shalders Karen Sherlock Kerryn Shrive Cally Shurdington Janet Shurdington Karen Shurdington Helen Slattery (V) Wendy Sleep Susan Sluggett Dean Smith Emma Smith John Smith Keryn Smith Shirley Sproule Christine Stanford Casey Stasinowsky Amanda Stephan Yvonne Stephan Jacqueline Stevenson Elaine Stewart Denise Stimson Debra Stonehouse Hilma Summerhayes Leenu Sunny Omega Swinnerton Eh Lar Moo Tain Thu Darren Taylor Meredith Taylor Sindi Taylor Sue Taylor Larissa Telfer Lucas Terry Valerie Terry Basil Thomas Vicki Thomas David Thompson Judith Thomson Glenis Tink Heather Tooley Margaret Trenery Jayne Tucker Leslyn Tuclaud Nicholas Twigg Jarmila Tyrril Emma Ussing Fiona Van Den Idsert Bert Van Elsen (V) Pamela Van Kempen Olivia Vegt Bibin Vijayakumar Adele Vincent Amanda Von Benecke Robyn Wagg Erin Wallace Helen Wallis Leanne Wallis Rosalie Wallis Donna Watson Marc Watts Chelsea Watts (V) Karen Webb Rhys Webb Michelle Webley Kerrie Webster Megan Webster Christopher Weir Kristen Weir Phoebe Welch Annmaree Wells Alison Welsby Darren Welsh Joanna Werner Madeline Werner Karen Wheaton Linda White Carol Willersdorf Carol Willersdorf (V) Cheryl Williams Desiree Williams Tammy Williams Elsa Williams (V) Thelma Williams (V) Eh Tha Pwee Paw Win Karen Wiseman (V) Elizabeth Witmitz Norelle Witmitz Julie Woolcock Julie Worsley Elisa Wotherspoon Stefani Wyatt Narmada Yantrapati Martin Yau Hannah Zadow (V) Volunteers ANNUAL REVIEW 2014/15 23

26 FINANCE AND ADMINISTRATION FINANCIAL PERFORMANCE For the tenth consecutive year the Service has reported an operating surplus of $103k (Net Result before Capital and Specific Items). This outcome is testament to our financial agility and in particular our ability to continue to find new revenue streams while at the same time keeping a close eye on our costs. The operating surplus of $103k is a sound result and is a continuation of the Service s ability to balance its books during increasingly difficult financial times. Operating Income ($34.447m) Victorian State Government (predominantly the Department of Health) sourced grant income comprised 54% of total operating income followed by Residential Aged Care Commonwealth Subsidies and Fees on 32%. Operating Expenditure ($34.344m) Total employee related costs made up 77% of total operating expenditure emphasising the critical role that our staff play in the level and quality of care we provide. Cash and Investments At 30 June 2015 the Service held total cash and investments of $9.3m comprising $4.6m for the Service s own funds and $4.7m in residential aged care accommodation deposits. This outcome keeps the Service relatively well placed in terms of being able to meet its short to medium term operating and capital cash requirements. Financial Ratios Current Ratio: 0.76 The Current Ratio (Current Assets divided by Current Liabilities) is used to indicate how well the Service is able to meet its short term financial commitments. At 30 June 2015 the Service s Current Ratio was 0.76 which is comfortably above the Departmental benchmark level of Quick Asset Ratio: 1.10 The Quick Asset Ratio is similar to the Current Ratio but provides a better indication of the Service s short term solvency by only including those current assets and current liabilities of an easily liquefiable nature. This result means that the Service has $1.10 in liquid assets for every dollar of short term liabilities. Debt to Equity (Gearing) Ratio: 0.22 This ratio is used to indicate the degree to which the Service is reliant on externally sourced funding and the result at 30 June 2015 of 0.22 shows that only a very small amount of such funding is required. Debtors Days: 29 On average it took the Service 29 days to recoup money owed to it for patient, client and resident fees over the year. Creditors Days: 40 This measure shows that it took the Service on average 40 days to pay its creditors over the year. 24 WEST WIMMERA HEALTH SERVICE

27 FINANCE AND ADMINISTRATION Income Statement Summary $ 000s $ 000s $ 000s $ 000s $ 000s Revenue 34,447 33,751 33,582 32,496 29,453 Employee Related (24,802) (24,662) (23,937) (22,210) (21,212) Expenditure Non-Salary Labour Costs (1,948) (1,498) (1,553) (1,458) (1,104) Supplies & Consumables (2,287) (2,099) (2,269) (2,263) (2,218) Other Expenses (5,307) (5,478) (5,719) (6,353) (4,722) Net Result before Capital Items Net Capital Items & (2,133) (3,839) (2,120) (2,211) (2,847) Specific Items Net Result for the Year (2,030) (3,825) (2,016) (1,999) (2,650) Balance sheet Financial Year Ended 30 June $ 000s $ 000s $ 000s $ 000s $ 000s Current Assets 10,333 8,761 11,408 11,636 11,108 Non-Current Assets 63,647 65,783 50,013 45,842 46,885 Current Liabilities (13,614) (12,170) (12,975) (11,391) (10,002) Non-Current Liabilities (1,104) (1,082) (981) (897) (802) Net Assets (Equity) 59,262 61,292 47,465 45,190 47,189 Operating income by category Victorian State Government Grants 54% Aged Care Commonwealth Subsidies & Fees 32% Patient Fees 6% Other 3% Commonwealth Government Grants 3% Retail Sales 1% Interest 1% Operating expenditure Cash and investments 12 $ Millions Repairs and maintenance 77% Fuel, light and power 11% Information technology 5% General administration 3% Direct patient expenditure 2% Employee related expenditure 2% Net Result before Capital Items Operating Results ($ 000s) Current ratio WWHS Benchmark ANNUAL REVIEW 2014/15 25

28 CLINICAL SERVICES 26 WEST WIMMERA HEALTH SERVICE

29 Acute and Surgical Care West Wimmera Health Service offers a diverse range of integrated and related health services in modern, comfortable and safe surroundings. Regular comments from patients and visitors praising the care and attention received from our skilled nursing staff, medical professionals and visiting specialists reflect the passion clinicians place on providing the very best of care. Compliments regarding the décor and the cleanliness of the facilities also reinforces our perfectionist attitude in planning every facet of our Service. Dr Chi Gooi, Orthopaedic Surgeon conducts joint replacement surgery at the Nhill Hospital each month. ANNUAL REVIEW 2014/15 27

30 Jan Fisher, Executive Director Clinical Services, discussing after hours management with Drs Debby Chinogara and Asif Ahmed from Tristar Medical Group Nhill. PROFILE Executive Director, Clinical Services Janet K Fisher RN, Adv Dip Bus Mgt. Jan has held the positions of Director of Nursing Rainbow Hospital, Executive Director of Aged Care and, since 2009, the administrative role as Executive Director of Clinical Services for West Wimmera Health Service. With the management restructure Jan is now responsible for the management of all Clinical services including Acute and Surgical Services, Aged Care, Central Sterilising, Infection Control, Radiology and Pharmacy. SERVICES ACUTE AND SURGICAL SERVICES Acute Hospital Care Admission Clinic Discharge Coordinator Audiology Central Sterilising Service Dialysis Domiciliary Midwifery ENT Surgery Gastroenterology (endoscopy) General and Specialist Medical Care General and Specialist Surgery Gynaecology Hospital in the Home Laparoscopic Surgery Maternity Shared Care Clinic Ophthalmic Surgery Oral Surgery Orthopaedic Surgery Palliative Care Pathology Pharmacy Physician Post Acute Care Radiology CT scanning, ultrasound, x-ray Reconstructive Surgery Regional Discharge Planning Strategy Acute Emergency Care Volunteers 28 WEST WIMMERA HEALTH SERVICE

31 CLINICAL SERVICES WWHS ACUTE CARE SITES ACCREDITED SUPPORT SERVICES JEPARIT KANIVA NHILL RAINBOW MEDICAL IMAGING PHARMACY PATHOLOGY 4 BEDS 6 BEDS 35 BEDS 7 BEDS Surgical services close to where we live how fortunate are we? The Operating Suite at the Nhill Hospital is available for surgical procedures each week day and Acute Emergency Care Departments at Rainbow, Jeparit, Nhill and Kaniva are open 24 hours, seven days per week. Our contemporary, well-equipped Nhill Hospital Operating Suite offers surgical procedures, planned and unplanned in immaculate conditions, as proved by the result of an independent cleaning audit of 99% against a target of 90% set by the Department of Health and Human Services. The rigorous criteria surrounding all aspects of surgical procedures means that care is delivered in the safest way possible with optimum results. Reducing the cost of appointments after surgery We encourage and assist patients to discuss the opportunities we offer to use video link technology rather than hours of travel for follow up appointments with their metropolitan and regional based specialists after surgery. Visiting Specialists Specialist Surgery is available only at the Nhill Hospital and includes: Ear, Nose and Throat. Orthopaedic. Oral. General Surgery. Ophthalmology. Gynaecology. A Physician consults in Nhill fortnightly and importantly provides regular education programs for Visiting Medical Officers and staff. Consultations with our visiting Geriatrician are available by video conference when required. Ready access to specialties is crucial for the wellbeing of our community. The need to travel huge distances for specialist treatment is greatly reduced which enables patients to retain the support of family and friends during a vulnerable period and at the same time avoid the considerable expense and mental stress associated with accessing surgery in a distant hospital. Admission and Discharge Service The Admission and Discharge Department operating from the Nhill Hospital and co ordinated by Division 1 and 2 Registered Nurses has two main functions the Pre Admission Clinic and Discharge Planning. Pre-admission Elective surgery patients attend a pre admission interview prior to admission for surgery at the Nhill Hospital. The interview is designed to educate, assess and inform the patient about what to expect from their surgical procedure, pre and post-operative requirements, any preparation required and lifestyle restrictions during recuperation. Discharge planning The Discharge Nurse assists in planning with the patient and clinical staff the timely discharge of patients from acute wards ensuring every assistance is offered for a safe and planned return home. Haemodialysis The Unit continues to function three days per week with the capacity to expand should the need arise. The Unit also offers vacation care for Dialysis patients visiting our region. Clinical Care Any unexpected outcomes of patient care are investigated in the form of a Clinical Review. The Review includes all Staff and Doctors involved in the care. This process had led to a reduction in the number of Reviews from eleven in 2014 to only 6 in ANNUAL REVIEW 2014/15 29

32 CLINICAL SERVICES Improvements as a result of a Clinical Review Acute Accountability for ordering and removal of medication from the ward medication cupboards has been strengthened. Lockable spaces have been provided, at sites where the doctor uses our premises, to store medications safely and be separated from WWHS stock. The admission of a mental health patient prompted a review and we have, in conjunction with specialist staff, introduced a Triage assessment and guidelines for mental health, provided education to nurses and have a flow chart to our Mental Health presentation Protocol. Following an opioid reaction (reaction to Morphine) we have changed our Policy. Medical Practitioners must consult the patient in the hospital if a patient requires an injection of opioid medication. Information is provided to the patient about the medication administered to them, including the possible side effects. After an instance where an unconscious paediatric patient arrived at hospital we have installed speaker phones in all emergency care areas to allow all clinical staff who are present to hear the consultation with the specialists Ambulance Victoria, Adult Retrieval Victoria, Paediatric Retrieval Victoria, installed white boards in all areas to have treatment documented and available for all clinicians. We have also conducted specific training with staff and Ambulance personnel. Aged Care The use of lap belts for residents, which are considered a restraint, were reviewed. The recommendation if a resident has a lap belt in place this must be noted and discussed at the clinical handover of all aspects of patient care from one shift of nurses to the next. Central Sterile Services Department (CSSD) Every day of the year we perform procedures which rely on a wide range of instruments and equipment. To ensure patient safety, and to minimise the risk of infection, equipment must be properly cleaned, disinfected and sterilised, inspected for quality to ensure good working condition, and then must be available for use where and when required. This responsibility lies with the Central Sterile Services Department (CSSD). CSSD provides sterile medical equipment and consumables to the Operating Suite, Acute Wards, Aged Care Homes, Podiatry, Dental Clinics and to our community Medical Clinics. To support infection control CSSD staff are well-trained their skill ensuring that the correct processes and practices are consistently followed. Where possible we use single use only instruments and consumables. The process of re-sterilising medical equipment includes: thorough cleaning inspection for damage air drying wrapping in a specialised fabric/paper sterilisation by autoclave, including tracking identification marked with expiry date and stored in the sterile storage area until required. Quality control Each step of the sterlisation process is carefully monitored and recorded to ensure consistency of quality. Any piece of equipment can be tracked from sterilisation to point of care, with records kept so a piece of equipment can be traced through the entire process. Pharmacy In the Pharmacy Department concentrated on refining the management of its pharmaceutical stock. In consultation with the Visiting Medical Practitioners and Clinical Staff, a Formula of Medication for prescribing was referenced. Imprest lists for individual wards were also established which reflect the differing prescribing preferences of the Visiting Medical Practitioners. Improvement in the cold storage of pharmaceuticals Refrigerated Temperature Data Loggers have been installed to more accurately document the temperature range pharmaceutical products are subjected to around the clock. This has ensured that pharmaceuticals are stored correctly, reducing the cost associated with the disposal and repurchase of pharmaceuticals that could not be used because they were stored incorrectly. To meet the increasing standards and safety requirements for the provision of Pharmaceutical services, and as part of the Capital Building program, a new Pharmacy Department is in the design construction stage. Medical Imaging Extending the hours of our Medical Imaging Services set the stage for expansion of Medical Imaging at West Wimmera Health Service. We now provide General X-rays, Dental Orthopantomograms (OPG) and Computerised Tomography (CT) scan services 5 days per week, with Ultrasound available 3-4 days each week. To maintain a smooth flowing and readily accessible service the number of radiographers increased to four, a combination which has enabled the expansion of the service. Professional development is a crucial element of maintaining modern up to date services with all Medical Imaging staff attending seminars and educational forums at a State and National level. Software associated with Computerised Tomography was upgraded resulting in a noticeable improvement in image quality, especially for X-rays of shoulders and the chest. This software also allows us to collect data each month on the number of times we need to repeat an X-ray to gain a sharp image. What next for Medical Imaging? Given the access the community now has and the uptake of this excellent, comprehensive and accredited Medical Imaging service we must now focus on keeping the technology which drives it up to date. Our challenge therefore, in the next twelve to eighteen months, must be to investigate the replacement of both the Ultrasound and Computerised Tomography equipment to maintain the excellence of imaging quality. 30 WEST WIMMERA HEALTH SERVICE

33 Graduate Nurse, RN Rebecca Powell-Hodges (right) with Trish Heinrich Unit Manager Nhill demonstrating the new Urinalysis Machine, donated by Nhill Lions Club. Rebecca s Story I had always wanted to become a nurse and decided to pursue that dream. I feel the nursing profession is not just helping people, but also enriches one s personal growth. It requires compassion, respect and humanity and I have experienced these personal lessons during my journey from a Personal Care Worker to Enrolled Nurse to Registered Nurse. As a mature aged student with 3 children, I initially became a PCW. I really enjoyed working with the elderly, but with time, felt that I wanted to develop my interest in the broader health profession. Without the love and support of my amazing family I do not think I would have been able to continue my studies. They believed in me when at times I did not believe in myself. They encouraged me to be the best I could be, which helped me keep going when I really felt like giving in. I wanted to make my family feel proud of me. My next accomplishment was to become an Enrolled Nurse. Finally after a long discussion with my mum and family I decided to take the next step in my career. I applied and was accepted into the Bachelor of Nursing course. With credits from my Enrolled Nurse course it only took 18 months to complete my degree. With a Bursary from West Wimmera Health Service and their continued support for my study I became a Registered Nurse with a Bachelor of Nursing Degree. I am now completing my graduate year with West Wimmera Health Service and feel extremely lucky as they have been very supportive and it is an excellent learning environment. Rebecca Powell-Hodges ANNUAL REVIEW 2014/15 31

34 Ophthalmologist Dr Mark Chehade - the final check before the macular injection for Ms Irene Buckley, from Wolseley, SA, proceeds. Prevention of vision loss in West Wimmera The thought of having poor vision is very scary indeed and given that so much of our existence is intertwined with sight, life without it is hard to contemplate. Previously sighted people who become blind lose independence, the convenience of driving, the engagement of reading, watching children and grandchildren grow and not knowing what arrives in the mail. The level of frustration is daunting. Blind people can become isolated and depressed. They are at increased risk of a serious fall which may result in fractured hips and potentially prolonged hospital admission and related complications. The development of poor vision in a person who lives alone will frequently result in the need to be admitted to residential care upsetting to the patient and a great burden on personal and government funds. Vision loss can it be cured? In developed countries the causes of vision loss are divided into correctable and uncorrectable. Correctable includes refractive error short and long sightedness, astigmatism and cataract. Uncorrectable causes, in order of frequency, include macular degeneration, glaucoma and diabetes related retinal disease. A successful initiative Commencing in the early 1990s, we have progressively implemented an eye health care program which has tackled all of the leading causes of vision loss. The visiting optometrist ensures that anyone with a refractive error has access to prescription spectacles and thorough screening for eye disease. 292 Lens Procedures 217 Macular Injections The visiting ophthalmologist, Dr Mark Chehade with a team of anaesthetist, skilled nurses and support staff, is able to treat at the Nhill Hospital, cataracts, glaucoma, including laser treatment, macular degeneration and other less frequent but equally important eye diseases. As a senior visiting specialist to the Royal Adelaide Hospital, Dr Chehade, a transplantation and glaucoma subspecialist, has close ties with other specialists. The initiatives continue The recent introduction of theatre based injections into the eye has resulted in the affordable and highly accessible treatment of macular degeneration, diabetes and other related retinal diseases. Skilful staff and the willingness of WWHS to invest in state-of-the-art equipment has resulted in many people remaining sighted despite threatening eye disease. 32 WEST WIMMERA HEALTH SERVICE

35 CLINICAL SERVICES End of Life Care We at West Wimmera Health Service believe that planning end of life care allows us to care for patients in a way which significantly reduces distress, grief and anxiety for both patients, family and friends. For many years we have had an End of Life Policy which guides us in the best way to deliver the very best compassionate care during this difficult period. The Policy was initially developed for our Aged Care residents and then progressed to acute care patients as the need for it developed. We support staff at each site to undertake end of life care training. Several staff have accepted this opportunity which has strengthened the quality of our care in these situations. It is a privilege to share their trust which allows us to have the conversation with residents, patients, clients and their families on what their wishes for care would be if their health situation should rapidly deteriorate. It is important to note that the plan never comes into action while the patient can make the decisions themselves they are always consulted in this phase of care. In we will: Review the number of staff at each site who undergo this training and ensure that there are adequate numbers to provide the level of service required. Review the documentation to ensure continued relevance and update it where necessary. Partnering with consumers in Acute Hospital Care The National Safety and Quality Health Service Standards recognise partnering with consumers as an element of high quality healthcare in its own right. Patients and their families are central players in improving patient care. Patient Centred Care is respectful of, and responsive to the performances, needs and values of patients and consumers 1. Recently we had the honour of caring for two palliative patients and their extended families. Caring for patients in their last weeks of life can be very difficult for the patient and also all close to them. By involving the patient, as long as they are able, and the families in all decisions about care, the families felt empowered and totally part of the caring team. At all times we respected the patient and their families and really listened to any suggestions or concerns they had about their loved one, changes in the care routines or their requests for information. We found by placing the patient and their family front and centre of care planning the experience was one that, with respect, was very rewarding for the entire team. Our experience and involvement with these two palliative patients proved so powerful that some nursing staff have decided to further their passion for palliative care by enrolling in extra study. Thank you to the families who allowed us the privilege to care for their loved ones in the final moments of life. 1 National Safety and Quality Health Service Standards ANNUAL REVIEW 2014/15 33

36 CLINICAL SERVICES Acute and Surgical Care quality indicators Medication Safety Acute All medications used in hospital for our patients are required by legislation to be ordered by a doctor. Medication Incidents over a 12 month period in our acute hospitals vary, however the largest concentration occurs in Nhill where the greatest number of patients are admitted over the year. Of the medication incidents there were none in the severe adverse category for the patient, the primary error was staff failing to sign for the medication administered. The proficiency of nurses responsible for administering medication is assessed annually to protect the safety and care of patients. However errors do occur and to minimise negative impact we have a set protocol of review and action for medication safety incidents. If the Medication Review identifies particular nurses repeatedly making errors, the staff member is counselled with the issue identified. A process for improvement is established and enacted. If incidents continue to occur supportive action is provided in the form of additional education, supervision by a senior nurse and retesting for capability and efficiency. As a further precaution to maintain the safety of administering medication, in the most extreme cases of persistent errors, disciplinary action can result in the suspension of clinical practice. Reviews undertaken following medication incidents have involved the following processes to improve medication safety: Medication errors are required to be recorded in the Victorian Health Incident Management System. Incident Reports are notified immediately to the Nurse Unit Manager and the Clinical Executive. The Incident report is analysed and actioned with direct dialogue with the staff member. Incidents of concern are presented to the Clinical Quality Improvement Committee following clinical review, demonstrating the actions introduced to prevent further occurrence of incidents of this nature. Comments or recommendations of the Clinical Quality Improvement Committee are then dealt with through the Executive Director of Clinical Services. Medication incidents by site July 2014 Aug 2014 Sept 2014 Oct 2014 Nov 2014 Dec 2014 The number of medication related incidents during this reporting period remained constant which is very unsatisfactory. We are now intensifying all efforts to ensure improvement is achieved. A challenging imperative. We will constantly improve Safety and Quality through all dimensions of care and administration of medications to patients and residents is no exception. We will: Continue to regularly and closely review patient medication charts for professional performance and outcomes. Ensure our Pharmacist visits all sites on a regular rotation to deliver rigorous education and monitor staff performance. Strengthen counselling and individual education as need demands. Ensure reporting systems reflect actual incidents, and accurately represent the regularity and the individual involved. Jan 2015 Feb 2015 Mar 2015 Apr 2015 May 2015 June 2015 Rainbow Acute Nhill Operating Theatre Nhill Dental Nhill Other Nhill Acute Kaniva Acute Jeparit Acute 34 WEST WIMMERA HEALTH SERVICE

37 Zenaida Garcia RN attending to Russel Crow as he recovers from orthopaedic surgery. Pressure injuries Pressure injuries also known as pressure ulcers or bed sores can develop when there is pressure or friction to the body, particularly over a bony area. During the financial year we implemented some changes in an attempt to reduce pressure injury occurrence and to improve pressure injury management. In addition to the Pressure Injury education included in the mandatory education program we added the Wounds West Pressure Injury e-learning module onto the Service Intranet. It is a learning module accessible by all staff enabling them to increase their knowledge on pressure injury prevention, classification and management. Training contains physical transferring and positioning using equipment to minimise pressure or friction on the patient or resident. Negative Pressure Therapy Education for nursing staff has also included the use of negative pressure therapy with advanced wound management. Negative Therapy incorporates applying a dressing which has a pump attached to a wound. The pump creates a negative pressure under the wound dressing which encourages new tissue to grow at an advanced rate. Negative pressure wound therapy can be used not only on pressure injuries but also on many other types of wounds. Education for all continues Education opportunities outside this Service have been advertised in the weekly newsletter and on notice boards. We now also provide patients and family members with information about pressure injuries and how they can help to prevent an injury occurring. We have placed a brochure into admission packs and into the patient orientation folders. This brochure provides information on how pressure injuries develop and how the patient can position and move themselves to help minimise the risk of injury occurring. Large coloured posters have also been distributed to each of our sites displaying position strategies for pressure injury prevention. In across the acute sector five pressure injuries occurred compared with nine last year positive improvement. The injuries were stage one or two which are the least in severity. 9,234 Bed days 5 Low range pressure injuries ANNUAL REVIEW 2014/15 35

38 CLINICAL SERVICES Acute and Surgical Care A statistical overview of our performance The Charts and Graphs on these pages serve to provide the reader with a comprehensive summary of the performance of our hospital based activity. Acute hospital care is available in the comfort of the modern hospitals located in Nhill, Kaniva, Rainbow and Jeparit. The breadth and depth of surgical and medical procedures covered by Visiting Specialist Surgeons and Physicians at the Nhill Hospital brings these services close to home a much better option than travelling several hundred kilometres from family and friends. Acute Care performance by category Variance % Variance Patients treated 2, % Occupied bed days 9,234 8, % Total Occupied bed days 8,864 8, % Acute Occupied bed days % Nursing Home Type Percentage 64.40% 63.00% 1% 2.18% occupancy Average length of % stay (days) Procedures total % DVA NHT % occupied bed days Average % DRG weight Non DVA WIES 1, , % DVA WIES % TAC WIES Renal WIES (Dialysis) % There was a 3.58% increase in patients treated in The number of occupied bed days was also higher than the previous year. The number of procedures was 20% higher than the previous year. Non-DVA and DVA WIES were both substantially higher than the previous year. Renal WIES was lower than the previous year with vacant dialysis chairs. Acute Care occupied bed days and percentage occupancy 10,000 9,000 8,000 7,000 6,000 5,000 4,000 3,000 2,000 1, ,400 1,300 1,200 1,100 1, , , , ,891 1, , ACUTE BED DAYS NHT BED DAYS % OCCUPANCY Percentage occupancy in acute beds was higher than the previous year. Acute Patients Treated 1,122 1, SAME DAY 1, ,122 1, MULTI DAY 871 1, , There were 2,293 acute discharges in 2014/15, the highest throughput in five years and 3.8% more than the previous year. There was a 16% increase in the number of same day patients treated. 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 36 WEST WIMMERA HEALTH SERVICE

39 CLINICAL SERVICES Weighted Inlier Equivalent Separations (WIES) Comparison by Program (Renal Separations & Renal WIES) ,000 1,800 1,600 1,400 1,200 1, , RENAL SEPARATIONS NON DVA 1, DVA , RENAL WIES , Weighted Inlier Equivalent Separations (WIES) Comparison by Program (NON DVA & DVA) , delivered a 14.7% increase in Weighted Inlier Equivalent Separations on the previous year and was the highest recorded in the last five years. Weighted Inlier Equivalent Separations (WIES) is the mechanism used to measure the mix or type of acute patients treated, and is also used by Government to fund hospitals.episodes of care are funded based on the condition treated, length of stay and whether a procedure was undertaken. This type of funding is known as casemix funding and provides a fairer method of funding with hospitals receiving funding based on the type of patients treated. Radiography occasions of service 2,400 2,000 1,600 1, ,150 1, ,331 1, ,972 1,250 1, X-RAY ULTRASOUND CT SCAN 1, Most Common Reasons for Admission No. of Cases Lens procedures 292 Haemodialysis 223 Macular injections 217 Dental extractions and restorations 102 Colonoscopy same day 91 Endoscopy check / follow-up same day 78 Knee procedures 70 Respiratory infections without complications 41 Kidney & urinary tract infections without complications 40 Red blood cell disorders same day 40 Oesophagitis and gastroenteritis without complications 37 Cellulitis 37 Gastroscopy & colonoscopy same day 36 Immunity disorders same day 36 Chronic obstructive airways disease 34 Bronchitis and asthma 33 Other digestive system disorders 33 Skin, subcutaneous tissue and breast procedures 31 Carpal tunnel release 29 Knee replacement 29 Back pain and sciatica 29 Rehabilitation 29 Gastroscopy same day 26 Tonsillectomy and adenoidectomy 25 Heart failure 25 Injuries without severe complications 22 Nasal procedures 21 Otitis media and upper respiratory infections 21 Anxiety and depression 21 Other factors influencing health status 21 Elective surgery by speciality Medical Imaging is available at the Nhill Hospital 5 days per week for X-rays, CT Scans and Ultrasound with just a short waiting time. Acute Emergency Care patients treated 4,500 4,000 3,500 3,000 2,500 2,000 1,500 1, , , ,039 4,044 3, Orthopaedics 80 Ophthalmology 203 ENT 59 Gynaecology 50 General Surgery 211 Dental 63 There was a 24% decrease in the number of patients treated in Primary Care Casualty in compared to With a full complement of GPs available in each town clients are able to get an appointment at the local clinic in a timely manner decreasing the need to present to Urgent Care Casualty for urgent medical treatment. WWHS provides a range of low risk elective surgery across a number of specialities. Having surgery locally means that patients do not have to travel long distances and also decreases the burden on larger regional and metropolitan hospitals. ANNUAL REVIEW 2014/15 37

40 CLINICAL SERVICES Achieving against the tide a medical insight General Practitioners for six communities No matter in which West Wimmera Health Service community you live, there is at least one General Practitioner ready to take care of you. The partnership with Tristar Medical Group has proved a blessing for our communities and is at the centre of our capability to have General Practitioners available for each of them. How different from other rural and city locations? Tristar provides General Practitioner services for Nhill, Jeparit, Rainbow, Kaniva and Goroke. The General Practitioners also support the Acute Casualty Centres, inpatient and after hours coverage for acute, aged care and emergency patients. A private Medical Clinic operated by Dr Jim Thomson provides medical services for Natimuk. Doctors come and go as is usual in the health industry but the point of difference for West Wimmera Health Service is that vacancies are quickly filled. This is due to Tristar Group s wide network backed by the modern medical clinics and equipment at all our locations. A service such as this is not available to many small rural communities. General Practitioners Drs. Aysha Rasul and Debby Chinogara have continued at the Tristar Clinic and Nhill Hospital while Drs Shepherd Chifura and Wei Cheng Chen practice in Jeparit and Rainbow. During the past year we have welcomed Dr Admire Nyanhemwa in Nhill and Dr Zamurd Ahmad in Kaniva who also visits Goroke. Visiting Specialist Services a luxury we enjoy Visiting Specialist Surgeons and Anaesthetists conduct regular elective specialist surgery at Nhill Hospital. After many years of outstanding service to the communities of the West Wimmera, Mr Laurie Ryan has ceased operating in Nhill but will continue consulting. Ms Anne Cass is credentialed to perform Ear, Nose and Throat surgery at Nhill Hospital from late Dr Ian Graham, Executive Director Medical Services, discussing an education program with Dr Admire Nyanhemwa, Tristar Medical Group Nhill. Support for surgery Surgery is supported by General Practitioner Anaesthetists Drs Stuart Perry, Malcolm Anderson and Kim Fielke and we welcome Dr Garry Matthews as a newly appointed General Practitioner Anaesthetist. Consultant Anaesthetist, Dr Robert Ray visits regularly to provide consultant anaesthetist services and provide specialist oversight and guidance for anaesthetics, critical care and resuscitation services across West Wimmera Health Service a very highly regarded service acknowledged by staff and patients alike. Improvements continue Physicians, Drs. Martin Ebenezer and Sanath Weerakkody from Wimmera Healthcare Group began fortnightly visits to Nhill Hospital this year for general medical clinics, consultations and referrals a very welcome development provided locally, again reducing the need to travel to regional centres for these services. PROFILE Executive Director, Medical Services Dr Ian Graham MB,BS; M. Health Planning; FRACMA; Cert. Essential Skills in Medical Education (AMEE) Dr Graham is responsible for the credentialing, appointment, definition of the scope of practice and performance management of Visiting Medical Practitioners. Ian was recently appointed to the parttime position as Dean of Education of the Australian and New Zealand College of Anaesthetists and has his own consulting practice in health management, education and information technology and is also the visiting Director of Medical Services for East Wimmera Health Service and Beaufort and Skipton Health Service. 38 WEST WIMMERA HEALTH SERVICE

41 CLINICAL SERVICES Ensuring our Doctors have the skill, qualifications and experience needed Credentialing and Scope of Clinical Practice The Executive Director of Medical Services, Dr Ian Graham is responsible for making sure all General and Specialist Medical Practitioners working at West Wimmera Health Service have appropriate qualifications and experience (credentials) to provide safe and effective medical services to the patients and communities we serve. It is essential the scope of medical and surgical practice (see p85 Glossary) is appropriate to meet the needs of patients, the capabilities of clinical staff and the nature of the facilities in which they work. The Clinical Quality Governance Committee meets bi monthly to advise the Board on the appointment and reappointment of General Practitioners, Specialist Visiting Medical Practitioners, Dentists and other health professionals. Our communities thank General Practitioners and Visiting Specialist Practitioners for their ongoing support and their high quality clinical services. Over 650+ procedures undertaken by our highly qualified specialist surgeons MEDICAL & CLINICAL VISITING PRACTITIONERS EXECUTIVE DIRECTOR MEDICAL SERVICES Dr I S Graham MBBS MHP AMEE FRACMA GENERAL SURGEONS Mr S Clifforth MBBS FRACS Mr P Tung MBBS FRACS Mr U Naidoo MBChB FCS(SA) FRACS ORTHOPAEDIC SURGEON Dr C Gooi MBBS FRACS OPHTHALMIC PHYSICIAN & SURGEON Dr M Chehade MBBS FRANZCO EAR, NOSE & THROAT PRACTITIONER Mr L Ryan MBBS FRACS FRCS DLO Ms A Cass MBBS FRACS OBSTETRICIAN & GYNAECOLOGIST Dr I Jones MBBS FRANZCOG CONSULTANT OBSTETRICS & GYNAECOLOGY Prof R Pepperell MBBS MD MGO FRACP FRCOG FRANZCOG Prof I Pettigrew MBBS FRCOG FRANZCOG VISITING DENTAL SURGEON Dr A Ayasamy BDS FDSR CPS FICD SPECIALIST ANAESTHETIST Dr R Ray MBBS FANZCA GENERAL PRACTITIONER ANAESTHETISTS Dr M Anderson MBBS FRACGP DA FACRRM Dr K Fielke MBBS DA FACRRM Dr S Perry MBBS FRACGP Dr G Matthews BMBS BAppSc SPECIALIST GERIATRICIAN & PHYSICIAN Dr R Shea MBBS FRACP GENERAL PHYSICIANS Dr M Ebenezer MBBS MD FRACP Dr K Rodrigo MBBS MDC MRCP FRACP Dr S Weerakkody MBBS MD MRCP FRACP DENTAL SURGEONS Dr M A Baluch BDS ADOH MDSC GRAD DIP (COHE) MPH MRACDS Dr G Laidlaw BHSc MOD (DENT) DENTAL THERAPISTS Ms K Roberts DT (from to ) Ms K Birkin DT (from ) ORAL HEALTH EDUCATOR Ms A Welsby OHE GENERAL PRACTITIONERS Dr K El-Sheikh MBBS FRACGP FACCRM DPM DPS CASA Pilot Medical Officer Dr S Moyo MB ChB Dr S Chifura MB ChB Dr A Anachuna MBBS Dr A Rasul MBBS Dr D Chinogara MB ChB Dr N Anachuna MBBS Dr W Chen MBBS Dr O Stepanov MD Dr A Nyanhemwa MB ChB Dr Z Ahmad MBBS Dr J Thomson MBBS Dr K Graham MBBS DRANZCOG FRACGP MPH TM Grad Dip Clin Edu CONSULTING PHARMACISTS Mr W Mascoll BPharm MAACP AACP Ms D Norton BPharm AACPA Dip Med Herbalism STAFF PHARMACISTS Mr M Yau BPharm MPS Mr K Emmett BPharm MPS RADIOLOGY SERVICE Consultant Manager Mr P Trenery Dip App Sci (Med Radiog),Grad Dip Ultrasonography Sonographer Mr S Jones B App Sci (Med Radiations), Grad Dip Ultrasonography Radiographers Ms S Worsley Dip App Sci (Med Radiog) Mr S Jones B App Sci (Med Radiations), Grad Dip Ultrasonography Ms S Enright B Med Rad Sci (Med Imaging) LAKE IMAGING Radiologists Prof A Pitman MBBS BMedSci FRANZCR Dr R House MBBS FRANZCR DDU Dr A Firkin MBBS FRANZCR Dr A Meakin MBBS FRANZCR Dr M Mittal MBBS FRCR FRANZCR Dr L Zentner MBBS BA FRANZCR ANZSNM Dr C Trotman BDS LDS FDS FRANZCR Dr K New MBBS FRANZCR Dr K King MB ChB FRANZCR Dr A French MBBS FRANZCR VISITING OPTOMETRIST Wimmera Eye Care Ms H Guyatt BOptom Therapeutical Endorsed (AHPRA) VISITING AUDIOLOGIST Adelaide Digital Hearing Solutions Mr B Wood BMRad(RT) Maud MAUDSA(CCP) McGRATH FOUNDATION BREAST CARE NURSE Ms W Crafter RN MBCN ANNUAL REVIEW 2014/15 39

42 CLINICAL SERVICES Aged Care Our Core Business 40 WEST WIMMERA HEALTH SERVICE

43 Arthur Vivian Close Hostel Kaniva the place to be! Elizabeth Stevens (seated) admiring Jean and John Meyers Garden with Doreen McKenzie. Residential aged care is an extremely important element of care in the communities we serve. Many of our residents may be frail or suffering from dementia or other age related complications and it is our central commitment to provide not only the highest levels of compassionate care but also safe, comfortable facilities and an engaging and enjoyable lifestyle. Our residents are individuals and treated as such while in our care. Any changes in their health or comfort is responded to promptly and our endeavours are focused on maintaining a sense of wellbeing and independence it s a responsibility we take very seriously. The Service has nine dedicated Residential Aged Care units across five separate sites which provide a caring, modern environment for up to 123 people. Each site offers options for permanent residence or short term residence referred to as Respite Care. ANNUAL REVIEW 2014/15 41

44 Archie Gray Nursing home resident Betty Dickinson enjoying some pampering with EN Lyn Maddern. JEPARIT KANIVA NATIMUK NHILL RAINBOW Tullyvea Nursing Home 15 residents Archie Gray Nursing Home Kaniva Cottages 26 residents Trescowthick Hostel Allen W Lockwood Hostel Natimuk Nursing Home 41 residents Iona Digby Harris Home 26 residents Weeah Lodge Nursing Home Bowhaven Hostel 20 residents How to become a resident in our Residential Aged Care homes Becoming a resident in any aged care facility requires an assessment by an Aged Care Assessment (ACAS) Officer. You or your family can ask your General Practitioner or other health practitioner for a referral to an ACAS Officer for an assessment. A busy life for all In order to keep our residents as independent as possible a great variety of activities are arranged. They include weekly visits at all Homes from a hairdresser, programs of gentle exercise, care of feet to assist balance and tending to the everyday aches and pains that accompany ageing. Hospital in the Home (HITH) HITH is the provision of hospital care in the comfort of the person s own home. Patients are regarded as hospital inpatients and remain under the care of their treating medical practitioner. Home Care Packages Home Care Packages are planned and co-ordinated packages which provide personal care services in the home for people aged 65 and over who wish to continue living independently and safely in their own homes. Packages are designed to be flexible responding to the varying needs of individuals. They may include personal care, social support, transport to appointments, home help, meal preparation and gardening. 42 WEST WIMMERA HEALTH SERVICE

45 CLINICAL SERVICES SERVICES AGED CARE SERVICES Aged Care Assessment Home Care Package Program National Respite for Carers Program Residential Hostels & Nursing Homes Commonwealth Aged Care Reform From 1 July 2014 a new Commonwealth Residential Aged Care Reform changed how entry into residential care is now managed. As a result: Residents who can afford to do so are now required to contribute more towards the cost of their care. Accommodation Bonds and the Accommodation Charge have been replaced by the Refundable Accommodation Deposit( RAD) and Refundable Accommodation Contribution (RAC). The Income Tested Fee has been replaced by the Means Tested Care Fee. These terms will be fully explained at your interview with the Aged Care Administrator prior to moving into our care. The Victorian Department of Health and Human Services requires all Aged Care providers to post their maximum RAD cost on the My Aged Care website which results in a competitive comparison between Residential Aged Care Homes. This competition places an onus on our Service to develop more effective ways to market our residential facilities to future residents and their families. It is a challenge we are fully prepared to accept. Accreditation All West Wimmera Health Service residential aged care homes are funded by the Australian Government and to receive ongoing funding each facility must achieve accreditation from The Aged Care Quality Agency against the National Aged Care Accreditation Standards and beyond Aged care is such a significant part of our Health Service particularly in the way it affects the daily lives of residents and the elderly in our community, that we are committed to continued research into best practice care and to maintain accreditation status. We will closely monitor any changes made to the administration and delivery of our residential aged care services to make sure the elderly members of our community enjoy the very best care available. Residential Aged Care performance by category Nursing Homes Bed Days Nursing Homes Discharges Nursing Homes Percentage Occupancy Variance % Variance 29,099 27, % % 97.22% 93.20% 4.02% 4.14% Hostels Bed Days 14,541 14, % Hostels Discharges % Hostels 97.17% 95.90% 1.27% 1.30% Percentage Occupancy Home Care 7,110 6, % Packages Bed Days Home Care % Packages Discharges Home Care Packages Percentage Occupancy 97.40% 93.41% 3.99% 4.09% NOTE: 5 beds at Jeparit were reallocated from Hostel to Nursing Home in Data for was revised accordingly to ensure consistency. Percentage occupancy across all aged care service delivery was higher in than the previous year. Residential Aged Care percentage occupancy NURSING HOMES HOSTELS NURSING HOME TARGET HOSTEL TARGET Occupancy levels at all nine residential aged care facilities remained at excellent levels in , continuing the trend of high occupancy ANNUAL REVIEW 2014/15 43

46 CLINICAL SERVICES Active and independent Lifestyle & Leisure Activities Co-ordinators at all Aged Care Homes are at the centre of an enjoyable busy life for our residents. Each resident is the major decision maker when choosing to participate in an activity. The co-ordinator listens to all requests and does her best to make it happen. Trips to suggested places of interest, a picnic in the park, shopping for new plants for the garden for the keen gardeners and as you can see in the image below the keen cooks enjoy making the bread rolls for dinner. Residents of Bowhaven Hostel Rainbow (left) Joan Jones, (centre) Esdale Frew (right) Stella Heinrich, enthusiastically making bread rolls for dinner under the watchful eye of PCW Alicia Gebert, Lifestyle & Leisure Activities Co-ordinator. 44 WEST WIMMERA HEALTH SERVICE

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48 CLINICAL SERVICES Residential Aged Care quality indicators Residential Aged Care Quality Indicators are a collection of data which provide a summary of the standard of our care which aligns with clinical risk factors which define resident experience and quality of life. We are able to compare results between our own Homes and also with other similar sized homes in Victoria. The Quality Indicators we measure are: Pressure injuries. Falls and fall related injuries. Use of physical restraint. Use of nine or more medications. Unplanned weight loss. The rate of each indicator is determined by calculating data against 1,000 bed days. This ensures all Residential Aged Care Services consistently use the same formula. Pressure injuries A pressure injury is a localised injury to the skin and/or underlying tissue that results from pressure, friction or a combination of these factors. Factors increasing the likelihood of developing a pressure injury include: 70 years old or over. Poor skin condition. Poor nutrition. Decreased mobility. Chronic disease. Incontinence. Pressure injuries are graded into four stages of severity from Stage One redness over a bony area to Stage Four exposed bone, tendon or muscle. Over three of our nine Residential Aged Care Homes ten Stage One pressure injuries were reported. With appropriate interventions these injuries do not become more severe. Stage Two pressure injuries were reported in three of our nine aged care homes. All three injuries were treated effectively and subsequently healed. No Stage Three pressure injuries were reported. One aged care home reported a single Stage Four pressure injury. The injury was present on admission to the home and with appropriate care and specialist wound management is now healed. Pressure injuries per 1,000 bed days Stage 1 Stage 2 Stage 3 Stage 4 WWHS Peer facilities Victoria The charts relating to Pressure Injuries and Fractures indicate WWHS rates well in these indicators when compared with our peers and Victoria as a whole. Falls and fall-related fractures Dementia, stroke, diabetes and Parkinson s disease are common conditions within an aged care home and are responsible for increasing the risk of falling. The adverse outcomes for residents who fall include: Anxiety and fear of falling. Functional decline. Decreased independence. Fractures. Death. All nine of our aged care homes reported falls, with two homes reporting four fractures as a result. Three of the four fractures were hip fractures. All fall incidents are clinically reviewed to ensure the appropriate strategies and interventions are in place to reduce the likelihood of future falls, or the impact of injury from a fall. We review: Number of daily medications. Mobility level. Vision do they need new glasses? Footwear is checked for suitability. Nutrition is their diet adequate? Individual lifestyle activities. Fall-related fractures per 1,000 bed days Falls per 1,000 bed days WWHS WWHS PEER FACILITIES PEER FACILITIES VICTORIA VICTORIA 46 WEST WIMMERA HEALTH SERVICE

49 CLINICAL SERVICES Use of physical restraint Restraint is the intentional use of a device or action that restricts free movement. Examples of physical restraint include: Removal of mobility aids. Lap belts. Table-tops. Bed rails. Deep chairs. West Wimmera Health Service does not use physical restraint with the intent to restrain. Two of our nine aged care homes reported the use of restraint, involving three residents. On all occasions the method of restraint was bed rails or bed sticks, all of which were requested by the resident to assist them to move independently when in bed. Clinical observation is undertaken when any restraint device is in place and the review resulted in two residents coping safely without any decline in their independence when the bed sticks were removed. Use of physical restraint per 1,000 bed days WWHS PEER FACILITIES Restraint used to restrict movement VICTORIA Restraint devices in use at time of audit Our rate of physical restraint is reported as above the peer and state averages in reality our numbers relate to one resident who has chosen to have bed rails in place at night to assist with his mobility whilst in bed and to provide a sense of security. Use of nine or more medications The prescribing of multiple medications is considered to be a major health issue for older people, and may impact their lifestyle by increasing falls and weight loss. Hospitalisation can also result from multiple medications. At West Wimmera Health Service we monitor and review prescribed medications on a regular basis. This review involves nursing staff, the treating Doctor, the Pharmacist and if required the Geriatrician. Nine or more medications per 1,000 bed days WWHS PEER FACILITIES Unplanned weight loss VICTORIA Many of our residents have multiple chronic medical conditions, where a reduction in prescribed medications would impact on quality of life. As residents enter the end stages of life, more complex medications are often required to manage pain effectively. Unplanned weight is a contributing factor to increasing risk for older people: Fracturing hips. Developing pressure injuries. Experiencing poor wound healing. Becoming malnourished. Older people are more prone to have unplanned weight loss if they have: Dementia. Age related anorexia. Depression. Chronic disease. Poor dental condition. Social isolation. A weight loss of 3 kilograms over a 3 month period, and / or recorded weight loss each month for 3 months is how this indicator is monitored. Unplanned weight loss per 1,000 bed days WWHS PEER FACILITIES 3kgs over 3 months 3kgs over 3 consecutive months VICTORIA We encourage our residents to remain within a familiar and homely environment as they age, even as their medical and cognitive condition declines. Residents receive their end of life or palliative care, within the homes, where their weight is monitored and managed appropriately to current care needs and choice. Contributing factors noted at West Wimmera Health Service include: Residents with advanced dementia have complex challenging behaviour including constant wandering, forgetting to or having no desire to eat, and at times paranoia regarding food. End of life stages of palliative care, or an acute illness can result in significant weight loss in a short period of time. Residents identified as being at risk of ongoing weight loss are reviewed by the Dietitian and Speech Pathologist to determine the correct nutritional diet is being provided in a form or texture the resident can manage. The variety of meals we offer to residents takes into account their individual likes and dislikes. ANNUAL REVIEW 2014/15 47

50 Dental Services PROFILE Executive Director, Operations & Performance Melanie R Albrecht LLB, BIS, MHA, MBA, GAICD Melanie has qualifications in law, health and business administration and commenced with West Wimmera Health Service in 2006 and when the new management structure was introduced she was appointed Executive Director, Operations & Performance. She is responsible for Dental and Disability Services, Aged Care Administration, Contracts and Consumer Analysis and Advice. Melanie also assists the Chief Executive Officer with Special Projects and Business Performance An outstanding year of growth Additional funds from Dental Health Services Victoria (DHSV) enabled an increase in the number of patients we were able to help in our Nhill, Rainbow, Goroke and Kaniva Clinics. The valuable partnership with the Royal Flying Doctor Service (RFDS) continued with visits to Goroke, Natimuk and Kaniva by the RFDS Mobile Dental Program which provides volunteer Dentists to rural communities to increase access to oral health services. West Wimmera Health Service Dental staff arrange the timing of visits, booking patients in and providing support during the visits. This collaboration is a step forward in our efforts to achieve positive oral health outcomes in our communities. Another step in this direction was the qualification in Oral Health Promotion obtained by a Dental Assistant this year who has already commenced educational services in the Clinics, Schools and in will extend the program to the Kindergartens in each community prevention rather than repair! 48 WEST WIMMERA HEALTH SERVICE

51 Page left Melanie Albrecht, Executive Director Operations and Performance (right), leaving a planning meeting with Dental Assistant Sharyn Morrison. Dentist Dr Georgie Laidlaw is working with WWHS as part of the Victorian Dental Graduate Year Program. A graduate experience Dr Georgie is based at the Nhill Dental Clinic and has worked with a wide range of patients providing a varying range of treatments. She has experienced emergency care, surgical extractions, paediatric care, endodontic and prosthodontics work. Our Oral Surgeon visits once a month consulting on Thursdays and conducting surgery in the Nhill Hospital Operating Suite on Fridays. Georgie considers herself fortunate to work with and learn from such an experienced Oral Surgeon. Dr Georgie is a remarkable dentist. She is professional, proactive and committed to outstanding patient centred care that really is making a difference. Dr Aziz Baluch, Senior Dentist, WWHS The VDGYP program has provided me with the opportunity to build on both my clinical and research skills this year. The staff at Nhill Dental Clinic have been very supportive while at the same time giving me the opportunity to work independently. Working in outer, remote sites and assisting the visiting oral maxillofacial surgeon in a hospital setting have also been valuable experiences. Dr Georgie Laidlaw, VDGYP Graduate, WWHS Supporting the emerging dentists Participation in the Commonwealth Graduate programs for Dentists and Oral Health Therapists has continued to bring high calibre Clinicians to our Dental Clinics enabling more patients to be treated. Receiving the mobile dental van funded by a Commonwealth Government Oral Health Therapist Graduate Year Program is not far off. We look forward to extending the programs we can take to the more remote communities. School Dental Screening Program The School Screening Program was a highlight of the year. Our Dental Team travelled to 10 Primary Schools and 2 Kindergartens screening 371 students with their portable clinic. SERVICES DENTAL SERVICES Dental Diagnostic Dental Prosthetic The purpose of the screenings is to detect if students require more extensive examination or treatment. Of the 371 students examined, 199 required follow up appointments, ranging from minor to major treatment. That is over 50% of students screened highlighting the significance of this project will bring with it an extension of mobile dental and oral health programs emanating from West Wimmera Health Service Dental Clinics. This will support our bid to raise the dental profile of this region. ANNUAL REVIEW 2014/15 49

52 Disability Services Cooinda Disability Services supports a diverse group of people with disabilities by assisting them to achieve quality of life and enhanced daily lifestyle through personal development and positive encouragement. Cooinda, located in Nhill, offers the opportunity for people to attend Day Service programs or participate in work based activities with Supported Employment enterprises Oliver s Café and Snappy Seconds providing valuable education and on the job training. It develops skills which enable them to work in hospitality or retail under the guidance of trained supervisors. The Stores and Maintenance Departments of the Service also provide work opportunities in an open employment environment for supported employees. Highlights for Cooinda include: A new social engagement activity, the Ladies and Gents outings involving 14 clients participating in activities of interest. This monthly activity is proving very popular. Hosting a Spook Fest to celebrate Halloween with Wimmera Uniting Care Day Service and Woodbine Disability Service. The commencement of a Friendship Group with Pinnacle Disability Services in Ararat involves fortnightly Skype sessions for five participants who have a buddy in Ararat to talk with. Nine Cooinda attendees are presently undertaking a Certificate I in Transition Education in Volunteering and Employment. Community Garden The Nhill Community Garden, supported by a grant from Regional Development Victoria, is situated adjacent to Cooinda Enterprises. The initiative is flourishing with people from the Karen Community, students from Nhill College and Nhill Lutheran School, participants from Cooinda and others from the Nhill Community making use of the garden. Involvement in the Community Garden provides an outdoor activity and the pleasure and educational benefits of producing flowers and vegetables. Interaction with the Karen Community is also proving socially rewarding. Accreditation a huge success! In July 2014 accreditation of both the Commonwealth funded Business Services and State funded Day Service was successfully accomplished against the new Disability standards. Only one opportunity for improvement was suggested that the Manager of Oliver s undertake studies in Disability. The Manager has already commenced Certificate III in Disability Studies. The auditors were very impressed with our Service and the range of programs offered, especially the opportunities given to supported employees to work alongside West Wimmera Health Service staff members and learn from them. The future The reality of the National Disability Insurance Scheme roll out is imminent and will offer challenges not previously encountered. The NDIS is a reform that will deliver a national system of disability support focused on the individual needs and choices of people with disability. The NDIS will provide reasonable and necessary support to live life their way, achieve personal goals and participate in social and economic life. Cooinda will move towards providing services and opportunities for people with a disability in line with the NDIS framework. However, many operational and management aspects must be considered as we address the complexities embodied and establish what it will mean for Cooinda. SERVICES DISABILITY SERVICES Adult Day Service Advocacy Community Access Community Inclusion Program Exercise Program Food Preparation and Sales Futures for Young Adults Garden Maintenance Program Individual Support Living Skills Respite Care Retail Assistant Training Supported Employment Therapy Programs Vocational Training 50 WEST WIMMERA HEALTH SERVICE

53 Wendy Flavel, Supported Employee with Tracey Morphett, Manager Snappy Seconds Wendy s story Wendy has been a Supported Employee with Snappy Seconds since Snappy Seconds, quality used clothing and collectables was relocated and revamped last year and a new manager was appointed. Since that time Wendy has blossomed. In the recent West Wimmera Health Service fundraising Extravaganza, Wendy was approached to be a model, displaying selected upmarket garments from the store. Wendy proceeded down the catwalk holding the hand of friend Rhys with a huge smile on her face. When asked what it felt like to be in the parade, Wendy said I had never been in anything like that before and I really liked it. Desiree did my hair and Tracey helped me with my outfit. It felt really good when the crowd cheered and started clapping. I think it would be fun to do it again. I had a great night. Wendy has since taken a keen interest in fashion and is enjoying upgrading her wardrobe. Manager Tracey said I was very proud of Wendy. She had an opportunity to do something different and she embraced it... and had fun. This is an example of how the supported employee program has increased the confidence and self-worth of a young lady who probably would not have done that prior to being involved with Snappy s. Janine Clark, RN ANNUAL REVIEW 2014/15 51

54 PRIMARY AND PREVENTATIVE HEALTH Primary & Preventative Health West Wimmera Health Service recognises the important role primary and preventative health plays in keeping our communities healthy, independent and vibrant. In order to adequately address this important area of service provision the newly created Primary & Preventative Health Division focuses specifically on health and wellbeing activities in the community. Health and wellbeing activities include Allied and Community Health, Maternal and Child Health incorporating antenatal and domiciliary postnatal care, District Nursing Services and Planned Activity Groups, an element of the Home and Community Care Programs. Our mission is to provide services to match the changing health needs of our communities and improve their access to our services. SERVICES PRIMARY AND PREVENTATIVE HEALTH SERVICES Ante/Post Natal Classes Asthma Education Cancer Council Victoria Cancer Awareness Cancer Resource Nurse Cancer Support Group Cardiac Rehabilitation Program Community Health Nursing Community Kitchen Continence Education Diabetes Education Dietetics District Nursing Services Emergency Relief Program Exercise Groups Aerobics, Falls & Balance Group, Gentle Exercises & Tai Chi Farm Safety Education Fitness Assessments Football Practice for Farmers Fun Fit & Fabulous Gateway to GirlPower Secondary Schools collaboration REGIONAL SERVICES Allambi Elderly Peoples Home, Dimboola Avonlea Hostel, Nhill Dunmunkle Health Services Edenhope College Edenhope Hospital Goroke P-12 College Harrow Bush Nursing Centre SERVICE SUPPORT Health Information Management Gorgeous Girls Program Primary Schools collaboration Guys & Gals Program Primary Schools collaboration Hairdressing Health Education and Promotion e.g. Wimmera Machinery Field Days, Healthy Habits Happy Life, Stroke Awareness Presentations & Men s Health Week, Healthy Legs Club Home and Community Care Immunisations WWHS staff and major local employers Kindergarten Screenings Speech Pathology, Occupational Therapy, Physiotherapy Let s Read Program Massage Therapy Maternal and Child Health Meals on Wheels Memory Lane Café Men s Sheds Hindmarsh Shire Council Jeparit Primary School Kaniva College Kindergartens - Nhill, Jeparit, Kaniva, Minyip, Murtoa, Natimuk, Rainbow, Goroke Lutheran Primary School, Nhill Natimuk Primary School Nhill College Mother/Daughter Puberty Nights National Diabetes Service Nutrition Education Occupational Therapy Optometry Orthodontic Referral Pap Smear & Health Check Clinics Physiotherapy Planned Activity Groups activities, outings & socialisation Podiatry Puberty Biz for Grade 6 Children and Parents Puberty Nights for Boys QUIT Trainer Rural Primary Health Service Safe Scooter Skills Social Work Welfare Speech Pathology Strutting Strollers Wimmera Football League Physiotherapy Rainbow College Rainbow Primary School Rural Northwest Health St Patrick s Primary School, Nhill West Wimmera Shire Council Woomelang Bush Nursing Centre Yarriambiack Shire Council 52 WEST WIMMERA HEALTH SERVICE

55 PRIMARY AND PREVENTATIVE HEALTH Executive Director Primary and Preventative Health, Mrs Kaye Borgelt discussing the new statistics collection system with Podiatrist, Eman Alsulami. PROFILE Executive Director, Primary & Preventative Health Kaye D Borgelt Assoc. Dip Med Rec Admin, Grad Certificate Mgt Org Change The Executive Division of Primary & Preventative Health was established as an element of the restructure of management within West Wimmera Health Service and is responsible for all non-bed based clinical services Allied and Community Health, District Nursing, Health Promotion and Planned Activity Groups to promote health and wellbeing within our communities. Kaye was Executive Director Corporate & Quality Services for West Wimmera Health Service prior to the management restructure. Allied Health activities In we achieved our mission by delivering primary and community services to our communities of Nhill, Kaniva, Jeparit, Rainbow, Goroke and Natimuk districts. We delivered 17,575 hours of Allied and Community Health care, 2,768 hours of District Nursing, 30,954 hours of Planned Activity Groups, 4,014 hours of Respite for Carers, and 7,110 bed days of Home Care Packages. Group activities to improve health and wellbeing are held regularly at all sites such as gentle exercise classes, tai chi and healthy cooking. We also visited schools in all communities promoting self esteem and strategies to reduce bullying and harassment for students in Years 6-9. Special after-hours women s clinics were introduced to provide the opportunity for busy women to have a health check and pap smear at a time suited to them an initiative which has proved extremely popular. Community health nurses regularly visited Pharmacies across the communities conducting free health checks for customers. Assessments and treatment were provided to acute inpatients at each site and also residents at our Aged Care homes and hostels. Rehabilitation Centre, Hydrotherapy Pool & Community Gymnasium While the majority of our sites have excellent facilities some areas of the Community & Allied Health Centre at Nhill remain under development. This is particularly true for Physiotherapy where staff and clients have spent the year in temporary and somewhat cramped conditions. The new Community Rehabilitation Centre presently under construction will include a spacious physiotherapy centre comprising a Rehabilitation Unit, Community Gymnasium and Hydrotherapy Pool. ANNUAL REVIEW 2014/15 53

56 PRIMARY AND PREVENTATIVE HEALTH Natimuk residents participating in the weekly gentle exercise class. Allied & Community Occasions of Service Department Variance % Variance Diabetes Education % Dietetics 2,157 1, % Massage Therapy 1, % Occupational Therapy 4,704 2,381 2, % Podiatry 5,764 3,120 2, % Physiotherapy 5,959 3,928 2, % Speech Pathology 2,074 1,006 1, % Social Work % Maternal & Child Health 2,356 1, % Centrelink % Dental Public 2,319 2, % Dental Private % Primary Care Casualty 3,371 4,404-1, % Visiting Surgeons 1,933 1, % Radiology 4,435 4, % Total Allied & Community Health 39,083 3,1281 7, % Total Meals Provided 183, , % Allied and Community Health staff provide a range of services across acute inpatient, residential aged care and outpatients. The majority of departments experienced a substantial increase in throughput in compared to the previous year. Caring for the older people in our communities Every resident at each of our nine Residential Aged Care homes and hostels has a complete Allied Health Assessment when first admitted and at regular intervals of at least every twelve months thereafter. Maternal and Child Health early years care An innovative shared care antenatal program has been initiated whereby mothers have regular antenatal visits to the Maternal and Child Health Nurse, who is also a midwife. On the day of their return home from hospital after delivery of their baby, the family receive a visit from their Maternal & Child Health Nurse. From that point regular visits continue as an important element of the early years maternal and child health program. This enables mothers to develop an ongoing trusting relationship with their Maternal & Child Health Nurse throughout the pregnancy and beyond. This year 45 infants were enrolled in the Early Years Program receiving regular checks at two, four and eight weeks; four, eight, twelve and 18 months; and two and three and a half years. 54 WEST WIMMERA HEALTH SERVICE

57 PRIMARY AND PREVENTATIVE HEALTH Margrete McEachran listening intently to the advice of Rhys Webb RN who, in his role as a District Nurse identified the need to address wound management and social isolation, setting up the very successful Healthy Legs Club at Goroke Community Health Centre. Collaboration increasing availability of health services Collaboration with other health service providers was achieved with WWHS allied health professionals providing services to Woomelang Bush Nursing Centre, Edenhope & District Memorial Hospital and Dunmunkle Health Services. These smaller organisations do not have the capacity to employ their own allied health staff so in collaboration with the Department of Health & Human Services Home and Community Care (HACC) program we incorporated regular visits to each of these sites as part of our service provision. Wimmera Southern Mallee Health Alliance (WSMHA) We are working collaboratively with other Wimmera Southern Mallee Health Alliance (WSMHA) organisations on several projects. Cardiac Rehabilitation A Cardiac Rehabilitation Clinic has commenced at Nhill joining forces with Wimmera Healthcare Group and Rural Northwest Health. We use video-conferencing to offer group education and physical activity for clients who have heart disease or who have recently undergone a heart operation. Healthy Leg Club There are some members of our communities who are isolated, embarrassed and debilitated by having chronic conditions which weaken the integrity of the skin on their legs and effect mobility. The Healthy Leg Club initiative, a social model of care, is a unique partnership between district nurses and the local community, in which patients are helped and encouraged to become stakeholders in their own treatment. Weekly clinics adopting a simple flexible drop in approach in a non-clinical environment provide clients with social interaction, increase in self-esteem and offer education, current medical advice and treatment at no cost. Persistent Pain Clinic We are also working with members of the WSMHA to implement a Persistent Pain Clinic, with the goal of assisting people living with chronic and consistent pain to lead a healthier and happier life with less pain. This clinic will commence in Challenges Recruitment and retention of skilled and quality staff remains a challenge in particular for Primary and Preventative Health. In Social Work/Counselling and Podiatry both experienced periods of staff shortages. We endeavoured to recruit appropriately qualified professionals, at the same time investigating different models of care to ensure we continue to cover the changing health needs in our communities. The growing number of people from culturally and linguistically diverse (CALD) backgrounds, in particular Karen refugees who now form some 10% of the Nhill population, present a new challenge and we must find ways to engage with this community to ensure they can also easily access services and indeed that the services we are providing are what they actually require. ANNUAL REVIEW 2014/15 55

58 PRIMARY AND PREVENTATIVE HEALTH WWHS Apprentice Carpenter Aaron Beer assisted by Nicole Schneider RN on a walk following knee surgery. 56 WEST WIMMERA HEALTH SERVICE

59 PRIMARY AND PREVENTATIVE HEALTH Home & Community Care (HACC) 2014/ /14 Department Hours Target Variance Hours Dietetics % 87 Occupational 1, , % 426 Therapy Podiatry 1, , % 1,132 Physiotherapy 1, , % 1,039 Speech % 68 Pathology Sub-Total 5, , % 2,752 Allied Health Nursing 5,578 2, % 4,503 Planned 30,852 30, % 3,6107 Activity Group TOTAL HOURS 41, , % 38,859 Home and Community Care (HACC) is a Commonwealth funded program that aims to provide outpatient and home based care to older members of the community, including allied health, district nursing and planned activity groups with a view to maintaining independence and being able to continue to live at home. Every discipline experienced a signficant increase in HACC hours of service delivered in , compared to the previous year. A targeted education program was provided to practitioners to ensure that statistics were collected and reported accurately. Community & Women s Health Department Hours of Service 2014/15 Target Variance Dietetics 1, , % Occupational Therapy 1, , % Podiatry 1, , % Physiotherapy 2, , % Speech Pathology % Social Work / % Counselling Nursing Diabetes 2, , % Education & Community TOTAL HOURS 12, , % The Department of Health and Human Services provides funds through the Community & Women s Health program to deliver a range of outpatient allied and community health services. A shortage of staff in some departments in meant that targets were not able to be achieved. Recruitment and retention of skilled allied health practitioners remains a challenge for our organisation. The future In we will: 1. Review and revise our Diversity and Health Promotion Plans targeting priority areas that will lead to improved health outcomes for all who live within our communities. 2. Investigate the introduction of a Community Health Nurse to interact directly with the Karen population so that we can better address their healthcare needs. 3. Investigate changing the Social Work/ Counselling model of care to focus on the mental health needs of our communities. 4. Continue to provide services locally across the Southern Mallee and West and Southern Wimmera and where appropriate continue to collaborate with smaller healthcare providers to ensure that all Victorians have access to quality health care. 5. Open the Community Rehabilitation Centre where Physiotherapy, Occupational Therapy and Medical Practitioners will return clients to maximum capacity following serious illness or trauma including strokes and heart attacks. Community programs Hospital to Home (H2H) This program supports patients in the transition from hospital to home. Patients must live in municipalities associated with West Wimmera Health Service. National Respite for Carers Program (NRCP) This program aims to enhance the quality of life for carers and care recipients, who are frail older people, people with dementia, young people with a disability and people with a terminal illness in need of palliative care. The program contributes to the support and maintenance of caring relationships between carers and their dependent family members or friends by facilitating access to information, respite care and other support appropriate to the individual needs of carers and those people for whom they care. Home Care Package Program Home Care Packages are planned and coordinated packages of care to help older people remain living in their own homes. They are funded by the Australian Government to provide for the complex needs of older people. Post Acute Care (PAC) Provides community based services such as community nursing and personal care. Home and Community Care Program (HACC) This program provides care in home and community settings to frail older adults, younger people with disabilities and their carers, promoting independence and avoiding premature or inappropriate admission to long term Residential Aged Care. ANNUAL REVIEW 2014/15 57

60 PRIMARY AND PREVENTATIVE HEALTH Planned Activity Groups Planned Activity Groups at all sites offer the opportunity for members of the community to participate in a range of activities and outings. Historically these groups have been seen by many as sitting around playing cards and bingo. Nothing could be further from the truth at our West Wimmera Health Service Groups! Activities are scheduled based on what our members wish to do, with socialisation a major theme. Our Women s and Men s Outings have grown in popularity throughout the year travelling far and wide including live entertainment in Stawell, Bee farms in Edenhope and luncheon trips to the Grampians. The Nhill Ladies Group has experienced a 300% growth in membership in 12 months. Jeparit Men s Group visit the Jeparit Machinery Museum on their monthly excursion. (L-R) George Richmond, David Livingston and Ron Smith with Jennifer Greig EN, initiator of the Men s Group. 58 WEST WIMMERA HEALTH SERVICE

61 ANNUAL REVIEW 2014/15 59

62 CORPORATE AND QUALITY SERVICES Corporate and Quality Services What are the immediate thoughts which come to mind when people are discussing hospitals and healthcare? Resoundingly, the recurring subjects which arise are doctors, nurses and other clinicians; the services available and how good they are. However, there are many other factors that impact on quality. We strive to deliver across every aspect of our organisation. So what else should we also be asking to define best care? How clean are the facilities, are the buildings up to standard and does the Service pass scrutiny by external agencies? The Corporate & Quality Services Division at West Wimmera Health Service makes sure the answers to these important questions are a emphatically YES!! Why do our hospitals need to exhibit the utmost cleanliness in every area? A scrupulously clean environment is crucial to the health of our patients, visitors and staff and are fundamental to the prevention and control of healthcare associated infection. Outstanding results of cleaning assessments by independent authorities this year are proof that this is the case at West Wimmera Health Service. The Operating Suite achieved 99% in the independent cleaning assessment which greatly exceeded the target of 90% set by the Victorian Department of Health and Human Services and all other areas in the assessment achieved 100%, also exceeding the set targets. For further proof; The Hospitality & Environmental Services department receive frequent accolades from patients: The hospital is of excellent standard. Rooms are immaculately clean with great amenities.... everything was lovely and clean The meals catered to my special diet and were tasty. The Victorian Health Experience Survey providing a patient s view of our Service Patients from our acute hospitals are randomly selected to respond to an independent survey about their experience as a patient. Question In your opinion, how clean was the hospital room or ward you were in? For the latest period 1 April 30 June 2015, this question received a positive response of 88% compared with the statewide average of 73%. Continuing education a fact of life for our staff High quality and safety standards across the entire complement of employees and activities is non-negotiable. Skills and knowledge cannot remain at the same level year-on-year. Static standards are not an option for this Service. The pervading ethos throughout this Service of being the best we can encourages strong support for participation in seminars, conferences, workshops and upgrading qualifications. There were 506 clinical and non clinical external education attendances with 3,738 hours of attendance an extraordinary commitment to lifelong learning, in particular for rural people, when travel time and accommodation costs are taken into consideration. Mandatory Education for all staff is also a major undertaking to ensure the safety of patients, residents and staff. Compliance with staff attendance at compulsory education is monitored extremely closely in areas of Fire and Emergency Training, Bullying and Harassment, Medication Safety, Food Safety, Manual Handling, Chemical Safety, Basic Life Support, Occupational Violence and Aggression and Infection Control to name a few. In June 2015, the average compliance across all these areas was measured to be 99%, an impressive performance! 60 WEST WIMMERA HEALTH SERVICE

63 CORPORATE AND QUALITY SERVICES Darren Welsh, Executive Director of Corporate and Quality Services, discussing safety measures required for the temporary Physiotherapy Rooms with Kelvin Asplin, Director of Capital Services, and Maintenance Manager, Craig Henley. Care at the highest level Nurses have graduated from Continence Management courses and the Rural and Isolated Practice Endorsed Registered Nurse Program (RIPERN), enabling nurses to provide a high level of clinical care. It is extremely encouraging to note that non-clinical staff have undertaken courses to upgrade their qualifications. These include Diploma of Accountancy, Certificate III in Commercial Cookery, Certificate IV in Disability Services and a Regional Business Leaders course. Unfortunately there has been a need to arrange training in the Management of Clinical Aggression to curb the rising incidence of aggression and violence towards staff by patients and visitors. CORPORATE AND QUALITY SERVICES Education Environmental SERVICES TRAINING AND ALLIANCES Hospitality St Laurence Traineeships Australian Catholic University Charles Darwin University Charles Sturt University Deakin University Latrobe University Federation University University of Melbourne University of South Australia Western District Employment Access Wimmera Hub Inc Work Experience Work Placements PROFILE Executive Director, Corporate & Quality Services Darren Welsh RN BN GradDipBus(Admin Mgt) GradCertOccHlthSftyMgnt GradDipOccHlthSfty AFCHSM Darren commenced in the position of Executive Director, Corporate and Quality Services on 30 March 2015 and has responsibility for Hospitality and Environmental Services, Risk Management, Occupational Health & Safety, Education, Security, Emergency Management, Legislative Compliance, Accreditation, Quality Improvement and Consumer Engagement. Darren previously held a number of senior management and executive level positions at rural and regional centres. ANNUAL REVIEW 2014/15 61

64 CORPORATE AND QUALITY SERVICES The privilege of providing experience for future health professionals We celebrate our capability to assist with the education and essential clinical experience for students from a wide variety of vocational and university institutions. Students from Nursing, Podiatry, Speech Pathology, Dietetics, Physiotherapy, Health Information, and Occupational Therapy courses have all obtained experience at West Wimmera Health Service facilities. Clinical Placement days in equated to 683 days and have increased by 28% from (535). Student feedback has been exceptionally positive with comments such as: Really enjoyed my placement. Staff were all willing to assist and educate. Always friendly and approachable. Wide range of skills achieved. Fresh, local, nutritious food how we know it is safe Nutritious, freshly cooked meals from local produce are delivered at the appropriate temperature and on time to patients and Aged Care residents. An all encompassing food safety audit was undertaken by an independent auditor. A Certificate of Compliance was achieved for all sites. Environmental Health inspections of the food preparation areas also achieved compliance with standards on each occasion. When asked What were the best things about their stay in our hospitals? patients commented... The food was great! Yum Looked after very well (good food) The staff, food and surroundings We prepared 183,743 meals this year for patients, residents and staff. Of this total, 7,583 meals were provided to elderly or disabled people in the the community as part of the Meals on Wheels program coordinated by Local Government. In addition meals are provided by Oliver s Café and Kiosks. Environmental sustainability achievements of the year Electricity Electricity remains a core energy source for heating, ventilation and cooling, lighting and clinical equipment functionality throughout West Wimmera Health Service. Energy consumption is a key evaluation factor when procuring equipment, and an essential consideration when redeveloping buildings. LED technology has now become the mainstay of lighting within the Service both internally and externally to buildings. Over the last 12 months, electricity usage over all has reduced by 3% through a combination of measures taken. Water Water usage increased throughout the Service by 15% over the last 12 months. A major factor for this increase was the lack of rain in the 2nd and 3rd quarters of the financial year, thus our hospitals relied more heavily on the reticulated water supply than our own rain water tank reserves. We do however harvest water from the roof of our buildings to eliminate the use of drinking water used in the operation of our dialysis unit and theatre complex, thus reducing our consumption of a potable resource. High level filtration at several points along the water delivery system ensures that the rain water we use provides patients with the highest quality of safety at all times. We prepared 183,743 meals this year for patients, residents, staff and in the community. LPG Provision of heating to some buildings, hot water and cooking relies on the use of Liquid Petroleum Gas. Over the last 12 months the usage of gas has reduced by 22% as the Service moves toward more efficient methods of using electricity. In many sites solar energy is actively used and this will grow in the future, further enhancing the reduction in the use of LPG. Domestic hot water In the Mira Building, Nhill, domestic hot water has been historically provided from the main hospital, a distant and energy inefficient process. The old chloroifier was removed and a new electric hot water system installed that now provides water to the closest point of use. As the purpose of the building has changed over time, we have changed the energy provision mechanisms to match its use. Building condition audit For the first time in West Wimmera Health Service under took a Building Condition audit in the Iona Nursing Home and discovered an 80% insulation coverage which thus affected the energy efficiency of the building. The thermal coverage was reinstated where the insulation had been disturbed and the building now has a 95% coverage. Whilst this is a small gain, the process is now being rolled out across the Service. Looking toward the future It is being planned that West Wimmera Health Service will embark on its most vigorous energy conservation project in with the installation of a solar thermal (hydronic balancing) system. The installation will significantly reduce the amount of Liquid Petroleum Gas that is used by the Service in Nhill by as much as %. Essentially, the heating and cooling system of the Nhill Hospital and associated buildings will be finely balanced using solar heated (and cooled) water that is circulated throughout the buildings 365 days of the year. With the redevelopment of the Mira Building and the creation of a new rehabilitation unit, new double glazed windows will be utilised to improve the building performance (energy efficiency) in terms of heating and cooling. 62 WEST WIMMERA HEALTH SERVICE

65 CORPORATE AND QUALITY SERVICES Adam Nicholson, Catering & General Services Assistant ready to start the cleaning regime that maintains our enviable results in DHHS cleaning audits. ANNUAL REVIEW 2014/15 63

66 CORPORATE AND QUALITY SERVICES Occupational Health and Safety Compliance with the Occupational Health and Safety Act 2004 and the Occupational Health and Safety Regulations 2007 are a must for every area of West Wimmera Health Service! Those who have suffered an injury that has affected their capacity to work will know how difficult it can be in terms of cost, time, inconvenience and anguish, not only for themselves but also for their employer, even if the injury occurred out of the workplace. Recognition by the Institute of Public Administration Australia (Victoria) Leadership in the Public Sector Awards We were a finalist in Leading the Way in Health, Safety and Wellbeing an award which recognised the diligence and understanding of the Injury Management Team in developing individual Return to Work Plans to support employees in their pathway back to work following injury or illness. The effectiveness of our Occupational Health and Safety strategies guarantee that the health and safety of our staff is under surveillance at all times. Reported hazards/incidents for the year per 100 full-time equivalent staff members YEAR HAZARDS / INCIDENTS HAZARDS / INCIDENTS PER 100 FTE EMPLOYEES Staff education, Risk Assessments and the controls put in place to manage Occupational Health and Safety Risks are increasingly reducing the number of incidents experienced and reported. It is reassuring to know that our systems are working and no fatalities at work have ever occurred at this Service due to Occupational Health and Safety negligence. Increased vigilance required Lost time standard claims for the year per 100 full-time equivalent staff members YEAR LOST TIME CLAIMS HAZARDS / INCIDENTS PER 100 FTE EMPLOYEES DAYS LOST Despite the Injury Management Team s work to achieve a reduction in the average number of days of lost time per claim between 2012 and 2014 the time lost has increased this year. Why? The cause was the rise in more complex claims a fact which will be monitored closely to improve outcomes for our employees. Average cost per claim for the year (including payments to date and an estimate of outstanding claim costs as advised by WorkSafe) YEAR AVERAGE COST PER CLAIM $16,049 $72, $11,130 $35, $32,952 $21,746 ESTIMATE OUTSTANDING COSTS The highest expense for claims involve those where surgery is necessary and those with lengthy periods before return to work is possible. These have affected costs this year. A thorough investigation will be instigated and new processes will be trialled to lessen these factors while maintaining total support of employees. West Wimmera Health Service participated in a Safety Performance Benchmarking Survey which was conducted across Australia, the Lost time Injury Rate (3.5) (work injury resulting in inability to work for one shift (8 hours) or more) was almost half the national average of 6.6. It is reassuring to know that our systems are working and no fatalities at work have ever occurred at this Service. 64 WEST WIMMERA HEALTH SERVICE

67 Safety in the workplace is the primary concern for apprentice carpenter Aaron Beer. ANNUAL REVIEW 2014/15 65

68 Accreditation High accolades from external experts We submit for examination of every part of our Service against a number of different accreditation standards. Accreditation is maintained in four important areas: Residential Aged Care. National Safety and Quality Health Service Standards. Disability Services. Diagnostic Imaging (X-ray, Ultrasound, CT). Residential Aged Care For Residential Aged Care Homes to receive funding and remain registered by the Commonwealth, Accreditation is compulsory. The Australian Aged Care Quality Agency (The Agency) survey Residential Aged Care Homes every three years against their four Standards and associated 44 outcomes. The four standards are Management Systems, Health and Personal Care, Resident Lifestyle and Physical Environment and Safe Systems. There were celebrations when Archie Gray Nursing Home, Kaniva, passed all standards and outcomes after their survey in February Support visits a total surprise The Agency makes one unannounced support visit to each Home per year to ensure high standards of Resident care are maintained. Eight homes received Support Visits successfully fulfilling all standards providing assurance that living in our Residential Homes means receiving the highest standard of care. The future The remaining eight Homes will undergo full accreditation review in August and September We look forward to proving our Residential Aged Care is the best you will find. National Safety and Quality Health Service Standards It has been compulsory to be compliant with these National Standards, developed by the Australian Commission on Safety and Quality in Health Care and endorsed by State and Federal Health Ministers since January Standard 1 Standard 2 Standard 3 Standard 4 Standard 5 Standard 6 Standard 7 Standard 8 Standard 9 Standard 10 Governance for Safety and Quality in Health Service Organisations Partnering with Consumers Preventing and Controlling Healthcare Associated Infections Medication Safety Patient Identification and Procedure Matching Clinical Handover Blood and Blood Products Preventing and Managing Pressure Injuries Recognising and Responding to Clinical Deterioration in Acute Health Care Preventing Falls and Harm from Falls We were surveyed in April on Standards one to three and achieved 100% compliance. This was the first survey under this new form of Accreditation hence full compliance was very satisfying and positive assurance all services and care are safe and of the highest standard. In particular, the surveyors noted we had developed substantially in partnering with our consumers especially involving advice about patient information publications, arranging community consultation forums, consumer participation in governance and planning meetings for new services such as a cancer support group. Disability Services State and Commonwealth Standards Cooinda Disability Services is reviewed under two separate sets of standards, one at a Commonwealth and the other at a Victorian Level. For the first time in 2014, Cooinda underwent assessment conducted by International Standards Certifications, against State based accreditation standards. It is reassuring to note that all aspects of the standards were met. State assessment The Victorian Department of Human Services Standards examine four key areas: Standard 1: Empowerment. Standard 2: Access and Engagement. Standard 3: Wellbeing. Standard 4: Participation. The auditors noted: The environment at Cooinda is welcoming and people appeared to gain a lot of enjoyment in whatever they were doing. The programs and activities offered are suited to service user needs. The implementation of the Personal Outcomes Measures method for determination of individual needs adopted by Cooinda is best practice and is an outstanding example of how this approach delivers on person centred outcomes for service users. Reassuring for clients and their families indeed! 66 WEST WIMMERA HEALTH SERVICE

69 Jeparit Nursing Home resident Mrs Jessie Chequer (right) with school readers Marcel (centre) and Eli (left). Commonwealth assessment Commonwealth Disability Service Standards are designed to ensure employment of people with a disability maximises their life skills and they are employed in meaningful ways within our community. Eleven supported employees work in café and hospitality, maintenance and engineering, administration and horticulture. International Standards Certification reviewed six Commonwealth Standards: 1. Rights. 2. Participation and Inclusion. 3. Individual Outcomes. 4. Feedback and Complaints. 5. Service Access. 6. Service Management. The audit team commented: West Wimmera Health Service through Cooinda continues to provide meaningful employment opportunities for supported employees who work in open employment settings within various departments at WWHS. The audit team found that people feel valued in their roles and take a lot of pride in their work and the contribution they make to the workforce. The Person Centred Approach adopted by Cooinda is best practice. The service delivery model and employment model adopted by WWHS is particularly strong due to its inclusive nature and the individual outcomes it provides for supported employees and the community. Once again Cooinda was rewarded with full compliance by demonstrating overwhelmingly its commitment to providing the highest level of support in mainstream employment for people with a disability. Future Directions Quality improvement is a continuous process and at the core of our every action every day. We will continue to maintain Our Quality Improvement base to ensure all Standards are met and we are ready at all times for assessment. ANNUAL REVIEW 2014/15 67

70 CONSUMER ENGAGEMENT Consumer engagement We need to match the healthcare services we develop with what our communities need. A new perspective, a new role We constantly examine potential ways we can keep up with emerging healthcare expectations whilst taking into account the inherent challenges of distance and diversity that affect our Service and the communities we serve. As part of this consideration a new role of Community Liaison Officer was created in March 2015 to facilitate contact, understanding and greater community engagement between the communities and the Service. Governance Provision has been made for Consumer Representation on two Governance committees the Audit Committee and the Clinical Quality Governance Committee. Representatives on these committees participate in the evaluation of financial and clinical performance. Public consultations Annual public forums are held at each site to offer community members the chance to hear about the latest developments at West Wimmera Health Service and to contribute their own ideas for service improvements. The community s voice is important and we listen attentively! Partnerships We work in partnerships with other organisations to promote the message of healthy living to as many people as possible including Local Councils, schools, kindergartens and Service Clubs. Our Community Health Nurses (CHN) initiate programs with various organisations and groups to engage in activities to improve their health. Topics such as stroke prevention, alcohol and drug use, and healthy cooking are all on the agenda as are a range of regular health checks. When issues are identified clients are referred to their local GP for follow-up tests. In % of people having health checks were referred for medical follow-up. As a member of the Wimmera Southern Mallee Health Alliance we are able to join with them to offer increased services such as the Cardiac Rehabilitation Program. Educational components of this program are delivered via video conferencing from Wimmera Health Care Group and the physical aspects of the program, such as exercise and diet, are administered by our Physiotherapists and Dietitians. A wonderful initiative based on the principles of best practice. West Wimmera Health Service and our communities Free blood pressure checks are offered at all agricultural shows in the region. High blood pressure is sometimes known as the silent killer and, left untreated, increases the risk of stroke, heart attack and kidney disease. Clients with abnormal blood pressure are referred to their General Practitioners. In fact, up to 40% of clients are referred and provided with information about the importance of diet and exercise, waist measurement, cholesterol and the significance of family history of blood pressure. Programs Falls Prevention is an important program initiative within the physiotherapy department. The Falls Prevention Working Group includes a Consumer Representative whose advice and experience is invaluable in planning this program. Cardiac Rehabilitation Program Physiotherapist Pawel Czupryn with Faye Crawford, a participant who has made great headway in the Cardiac Rehabilitation Program. 68 WEST WIMMERA HEALTH SERVICE

71 Consumer representative Mrs Jan Cole (right), adds a consumer perspective to the new Reducing Falls in Hospitals and the Community Group, with Emma Smith Physiotherapist (centre) and Dianne McDonald Iona Unit Manager (left). Balance keeping you safe How often do we hear an older person say I m a bit unsteady on my feet today? Balance is such an important element of your strength and fitness, keeping you safe and reducing the risk of injuries caused by tripping and falling. Reducing the risk of falling A falls and balance class is being implemented across all sites to ensure each community has an opportunity to increase their physical activity, reduce their risk of falls and to socialise in a group setting. The Goroke class is the only one to be evaluated and was very well received with 100% of clients reporting very positive feedback. Many clients reported that they felt their confidence and balance improved greatly and they enjoyed the structure and social component of the class. 80% of clients showed an improvement in their confidence and balance. Engaging with consumers to spread our message The WWHS Falls Prevention Working Group has engaged with a consumer representative to make sure our falls prevention strategies are relevant to consumers an invaluable involvement. We have developed an orientation brochure for acute patients during their admission to hospital containing important information about safety: A falls prevention stop sign has been implemented across all acute and aged care units to alert staff which patients are prone to falling. Individual falls prevention strategies are documented to inform staff what is required to ensure optimal safety forpatients. Continuous staff education is published weekly in the staff newsletter. Falls information for all staff is displayed in communal areas making sure all staff are aware of their responsibilities. Facts relating to falls data collected across all facets of WWHS is regularly analysed with reports commenting on emerging trends released regularly. There has been a steady decline in the number of falls occurring across all locations this year. The decline in total number of falls from 2013 to 2014 indicates that the current falls prevention strategies are working to reduce patients risk of falling. There have been no inpatient falls resulting in a fracture in the period which indicates that the falls harm minimisation strategies are effective. There is still work to do, however. We will continue developing new approaches and follow best practice initiatives to increase the safety of patients at risk of falling without unduly restricting their independence. ANNUAL REVIEW 2014/15 69

72 CONSUMER ENGAGEMENT Compliments and complaints A new role Community Liaison Officer appointed Appointed in March 2015 the Community Liaison Officer visits patients in hospital and residents in aged care services to ascertain their level of satisfaction with our services. All comments are registered to demonstrate our strengths and identify any areas of weakness in our services. Investment in this appointment has already proved to be beneficial. Were you satisfied with your care? Compliments indicate that our services are well received and that we are succeeding in what we set out to achieve. The information is recorded as part of our commitment towards continual improvement. Compliments About food: 23 Congratulate the kitchen for the lovely meals. Standard of care: 245 Thank you for treating mother with respect and wonderful care over 7 years. Specific programs and services: 17 Physiotherapist good natured well presented professional. Very impressed with all aspects of his service. General letters and cards of thanks: 40 Thank you for the High Tea for my birthday and to the management for beautiful flowers. Compliments about miscellaneous issues: 15 Thank you for allowing us to use rooms for counselling. Staff friendly and made every effort to provide a suitable area. Thank you messages from staff: 35 Thanks and gratitude for employment during my gap year. Thank you messages from other organisations: 8 Thanks for sponsoring the year 9 Dux Award In COMPLIMENTS WERE REGISTERED COMPLAINTS WERE RECEIVED AND DEALT WITH Was there something you were unhappy about during our care for you? Telling us about your criticisms and grievances are a foundation of our caring partnership with consumers and are essential in our pursuit of quality and safety. Complaints are registered and investigated by the Complaints Officer in conjunction with the relevant Manager, including discussions with the complainant, who determines what action may be necessary including the outcomes of discussions with the complainant. The complainant receives a written response detailing the manner in which the complaint has been dealt with and the outcome Categories of complaint General Care: 6 Resident not assisted in shower. Maintenance: 2 Patient s room not painted. Clinical management: 5 Toe nails cut too low. Food: 6 Sausages inedible and too spicy. Privacy: 3 Resident wandering into a patient s room. Laundry and clothing: 2 Trousers delivered from laundry crinkled. Other matters: 2 New toaster not satisfactory. Environment: 2 Signage not easy to read at night. Why is it essential that people complain when they are not happy? We are committed to the principles of continuous quality improvement. Complaints identify areas for improvement and we aim to ensure all complaints are addressed. We will work with consumers to foster an environment where consumers feel confident to voice their concerns. The future We encourage comment from consumers about our services. While it is always encouraging to receive positive advice, it is also vital that concerns voiced by patients, residents, families and carers are addressed. All are taken seriously and regarded as an important quality and safety improvement process. Linking new arrivals with healthcare. Karen & Philippine Families gather for a tour of the Nhill Hospital complex organised by Ms Meredith Taylor, (centre), Community Liaison Officer and Tha Hser Bleh Dah (far left), Interpreter from Hindmarsh Shire. 70 WEST WIMMERA HEALTH SERVICE

73 CONSUMER ENGAGEMENT Person centred care At the clinical interface the whole person is the centre of our care Person Centred Care places the patient, resident or client at the centre of decision making, including their family if appropriate. The philosophy of Person Centred Care has been adopted across all clinical sectors. It is the foundation of the Active Health Service Model which requires services to be organised around the needs and preferences of the client or patient to assist patients and clients achieve full health potential. The maxim Don t make decisions about me without me is at the centre of all care or treatment. How does Person Centred Care work in Acute Hospital Care? Bedside handovers have been initiated where patients participate in discussions about their progress and is a wonderful opportunity to ask questions about their care. Feedback from families and carers is highly valued How does Person Centred Care work in Aged Care? All Home Care Packages are now based on the principle of Consumer Directed Care. The consumer is allocated funding from the Home Care Packages Program and decides what services to buy. Families are welcome to participate if the client wishes. Trained Respecting People s Choices consultants discuss with clients their options for future care which may change over time as health condition changes. How does Person Centred Care work in with our Catering Service? Every effort is made to ensure we cater for all food sensitivities. Chefs are available to answer any enquiries or to discuss special requests. Person Centred Care in Maternal and Child Health Good communication is the foundation of best practice for fulfilling the wishes of our children and their families. Mrs Fay Lowe in her home with Cheryl Lowe EN, District Nurse, visiting her for daily assistance under the Home Care Packages Program. The Maternal and Child Health Nurses acknowledge sometimes mothers whose primary language is not English may find the Health System intimidating. To counteract this appointments are made on their behalf and assistance is provided for contact with other professionals and organisations. In the future, efforts will be made to assimilate the Multicultural Play Group into the existing Play Group in Nhill. Person Centred Care in Allied Health Occupational Therapists offer clients options for care encouraging participation in goal setting. Important functional aspects of their daily lives are identified. Jointly they plan to increase safety and independence within their home. The Occupational Therapist and client work closely to identify issues in everyday activities and regularly review goals to ensure care is client centred. Physiotherapists involve patients and clients in decisions and plans for their care acknowledging the consumer s needs at the present time are at the centre of setting goals so they are meaningful and achievable. Speech Pathologists also regard Person Centred Care as the pivotal methodology in carrying out their work. If, for example a person is experiencing difficulties with swallowing the speech pathologist will work with the client to develop a dietary plan that is suited to that individual s specific issues. Similarly when the Speech Pathologist is working with a child who has speech difficulties, the child s parents become active partners in an individual program of therapy. They play a crucial role in setting goals, implementing the program and achieving positive outcomes. Person Centred Care is not a one size fits all philosophy. It is finely tuned to provide effective treatment for specific people. This relationship between the medical professional and individual consumer naturally involves sensitivities and the recently appointed Community Liaison Officer will have an important role in ascertaining consumer responses to the standard of our services. ANNUAL REVIEW 2014/15 71

74 Consumer, carer and community participation Doing it with us, not for us The best outcomes occur when clients and carers are actively involved in decision making about the care they receive. West Wimmera Health Service recognises that partnership with clients and carers requires a number of aspects to be successful: Trust. Respect. Openness. Equal opportunity. Advocacy and support. Responsiveness. Dissemination. Evaluation. Shared ownership and accountability. At an individual care level we achieved this by: Developing Individual Care Plans for all consumers using our services Acute Inpatients, Allied And Community Health, District Nursing, Planned Activity Group, Home Based Aged Care and Residential Aged Care, so the preferred outcome of the client or patient is central to all decisions. Implementation of an Active Service Model for Home and Community Care clients based on goal-directed care planning to promote wellbeing and active ageing approach, optimise physical and mental health and assist people to live as independently as possible. Communicating with consumers and carers using language that is easy to understand including utilising interpreter services for clients for whom English is not their first language. Providing written information in a variety of languages to assist consumers and carers to understand their health care and treatment. Conducting handover at the patient bedside to include the patient in discussions regarding present and future care. Promoting the rights and responsibilities of consumers and carers. At an organisational level we have demonstrated consumer participation by: Appointment in of a Community Liaison Officer, whose role includes interacting with patients on the ward one-on-one hearing first hand feedback about how services can be improved. Providing regular training for all staff in effective communication skills, the best way to involve consumers and carers in decision making. Including a consumer representative on the Clinical Quality Governance Sub-Committee, providing consumer insight and involvement in clinical governance processes of our Service. Seeking advice from consumers to ensure that our written information is appropriate, easy to read and understand. Organising annual community consultations in each of our six communities. These are chaired by the President of the Board, attended by members of the Board and senior management enabling us to hear first-hand suggestions about desired improvements and issues of concern about any area of our Health Service. Using results from the Victorian Healthcare Experience Survey to target specific areas of improvement. In this included improving communication between doctors and nurses through the implementation of patient bedside handover and ensuring a nurse is always present during patient consultations within the hospital. Having established links with internal and external service providers, including allied and community health professionals and local government providers, to ensure that when a patient returns home after a hospital stay they continue to receive the care and services they require. Production and distribution of an annual Quality of Care Report. Our Service will continue to promote Person Centred Care which puts the client at the centre of the delivery of care and involved at every level in decision making regarding their care and treatment. At a broader level we will continue to engage with our communities to ensure viable, sustainable health services are delivered to the rural, isolated and remote areas which comprise West Wimmera Health Service. 72 WEST WIMMERA HEALTH SERVICE

75 Cultural responsiveness framework It is acknowledged that Australia is a melting pot of many cultures, a multi-cultural populace defines our modern nation. Since 2012 some 180 members of the Karen refugee community have resettled in Nhill and now comprise 10% of the population. In 2007 Karen refugees were accepted into Australia resettling first in Werribee and from there relocated to Nhill to work at Luv-A-Duck poultry manufacturer. The successful integration of the Karen community has meant that family migration to Nhill directly from the refugee camp in Thailand is now a reality with another 50 families expected to relocate in the next 18 months. This will bring the Karen population in our region to around 350, or close to 20% of the population. This change in our population has made us think about how we reconfigure, advertise and deliver our services to the community. Our effectiveness Our policies direct and guide our staff if translators are required. A Diversity Group meets bi monthly with membership from the Karen community and also representatives of our international staff to consider areas for improvement. Inclusion of the HACC and Disability Programs ensure West Wimmera Health Service has one Diversity Plan which is all encompassing. Senior management representatives on the Diversity Committee ensures Service leadership for cultural responsiveness. Training this year by the State Wide Facilitator Refugee Health Program included the Shire, local schools, Community and Allied Health staff and members of the local Karen population. Training for staff is planned for later in 2015 to provide awareness of the reality of resettling into a new country as a refugee or asylum seeker. Specific training will assist to identify and meet specific needs. Communication the biggest hurdle Communication appears to be the biggest hurdle as we seek to engage with members of the Karen community. In conjunction with local Karen representatives brochures detailing services and how to access them have been produced. Tours of the Nhill Hospital were conducted in conjunction with the Hindmarsh Shire specifically for migrant community members including those from the Karen community and the Philippines. Explanations were given about all aspects of the Health Service, including what happens when a patient is admitted to hospital, going to theatre for an operation, attending the Dental Clinic and what the different Allied Health departments can do to assist patients remain healthy. These tours will continue so all new arrivals will feel at ease when coming to our health service for the first time. We have a telephone interpreter service, however, this process can be difficult with clients preferring face-to-face interpreting. As a result interpreting services are often provided by family and friends which creates some challenges with regard to privacy, a problem we are endeavouring to solve. In recognition of the need to ensure excellent communication between clients and health professionals in the Service will investigate employing a health professional with fluent Karen language skills to work specifically as an interpreter within the Nhill Hospital, Outpatients and also assisting in the Tristar Medical Clinic. We are also investigating employing a Community Health Nurse with Karen language skills to undertake health promotion and health and wellbeing within the Karen community. Consumer participation We have a multidisciplinary, consumer and community Diversity committee bringing together people from various organisations and professional disciplines who have a common interest in the growing cultural diversity of our community. Examples of issues discussed include language differences, job opportunities and Maternal and Child Health matters. Opportunities to develop consistent understanding of concerns and strategies for migrants to live in, participate in and contribute to our society are developing. Strengthening the workforce We have participated in education as it is available but acknowledge this is an area requiring more involvement in the future. Training is to be held in Nhill in late 2015 which will do much to address this gap. Improving care for Aboriginal patients Aboriginal Victorians continue to experience poorer health and lower life expectancy than the general community. Many Aboriginal people are reluctant to present to health services and, when they do, may have greater acute and complex health issues. In addition, under-identification of Aboriginal patients continues to hamper the ability to develop policy and services based on a complete picture of health needs and service use. The WWHS catchment comprises only a very small number of people who identify as a member of the Aboriginal and Torres Strait Islander population. The Maternal & Child Health Nurse conducts clinics at Dimboola however she sees very few Aboriginal families and for those who do consult her their care is shared with the Maternal & Child Health Nurse responsible for aboriginal families in Horsham who then liaises with the Aboriginal health workers at Goolum Goolum Aboriginal Co-operative. Culturally, Aboriginal families utilise Aboriginal services which is identified as a major factor in maintaining their own individuality and identity. We are committed to ensuring culturally appropriate services are provided to all clients, including those from Culturally and Linguistically Diverse (CALD) backgrounds and those who identify as Aboriginal and Torres Strait Islander. In we will seek to enhance collaboration by engaging directly with Elders of local communities to hear first-hand what their specific needs are and investigate ways we can tailor our service delivery to meet these needs. ANNUAL REVIEW 2014/15 73

76 Continuity of care Maternal & Child Health Services looking after the younger generation and their families Continuity of care for families is a vital component of our Maternal & Child Health Service. The Maternal & Child Health Nurses (MCHN s) provide midwifery care before the birth and continuing care immediately on discharge from the birth hospital and throughout the early years of a child s life. The Maternal and Child Health Service can be accessed by all young families with additional services for vulnerable families. Every family is consulted at a child s key ages and stages of development although some families may require additional support during these times. Contented babies, toddlers and growing children are at the heart of Maternal and Child Services. 74 WEST WIMMERA HEALTH SERVICE

77 The service also provides a platform where families can work together with our M&CH Nurses to overcome vulnerabilities. Families can change over time and those who are perceived as potentially vulnerable are carefully monitored. Supporting young children and families has broad community value. It promotes social cohesiveness and allows children to grow, learn and prosper in a place where they feel they belong. Is there a more valuable investment than that directed towards our children? When vulnerable families seek our services we are all the beneficiaries. The opposite is true of families who are isolated and not supported by the service. Every day may bring functional difficulties perhaps eventually leading to an inter-generational culture of mistrust and even hopelessness. A degree of physical isolation is a consequence of geography in rural North Western Victoria but it need not lead to social isolation. Our M&CH service is a powerful force in counteracting such possibilities. Referring a family to supported Play Groups has become central to any Case Plan. Families who continue to attend Play Groups develop their own personal networks increasing selfresilience and confidence. An outcome which in itself helps to break down a cycle of isolation. In Hindmarsh Shire 63% of families identified as requiring additional support were referred into Play Groups. Of the remainder, 19% of families required additional support for medical or mental health issues which indicated referral to a Play Group would be inappropriate. 18% did not fit the criteria for various reasons such as children who did not fit the age profile of Play Groups. Once the families are referred into Play Group the additional support from the MCHS is gradually reduced. Early intervention which is targeted and accessible is vital. If these families continue to attend Play Group the possibility of requiring secondary or tertiary referrals is reduced. Dakota s Story My life seemed well set, my boys were settled at school and I could see new prospects opening up before me. Time to study leading to employment, a chance to support my family and to make independent choices. Then I discovered I was pregnant! My future vision fell apart. A new baby was no part of the hopes and aspirations I had built up and the news left me confused and depressed. I even considered termination of the pregnancy, but in the end my inner belief that the new life of a baby is a blessed gift won out. I now have a beautiful little girl called Verity. She is a joy but the journey has not been easy. At birth Verity weighed a tiny 2000grams and we were transferred to Melbourne. To be honest the experience was very stressful and in particular my great desire to breastfeed my newborn received scant support if any! Luckily staff in Horsham were strongly supportive of Verity and myself and arranged a transfer back to Horsham where a breastfeeding regime was quickly established and continues. This support indeed proved to be invaluable. On returning to my Rainbow home the support carried on through the Maternal Child and Health Nurse service and staff at the Horsham Hospital which was wonderful. Practical needs, right down to assembling a donated cot, advice and perhaps most valuable of all, the presence of a sympathetic ear and a kindly face continued. The gift of the cot was unconditional and meant I can look down on my child sleeping soundly and safely. It has become a symbol of openness and hope through the kindness and generosity of spirit of the people who helped me through that rough stage in my life. A time I had no one to turn to or call on! Dakota and family with Maternal and Child Health Nurse, Chantelle Fisher (left). They say it takes a village to raise a child and that was certainly at the front of my mind when I decided to move to a small rural community to raise my children rather than live in a city in personal isolation. I don t have the support of close family and I deal with some mental health issues involving anxiety, particularly about the security and happiness of my children. I have received great support and understanding from people in my small town teachers, the pharmacist, the Doctor and some sympathetic community members. To them, I would say My family and I are not victims. We are survivors. We aim to live our lives peacefully in the midst of this local non-isolating setting, Rainbow, for which we are extremely grateful. I do really appreciate the Hello s, support and the recognition which is helping me to eliminate the fear, stress and anxiety I have lived with in the past. Throughout this difficult period I received unconditional support from my local Maternal Child Health Nurse and a very trusting relationship with her has been developed. Her willingness to provide after hours care and companionship when I needed some mothers advice has been unwavering. Our Maternal Child Health Nurse is extremely professional and her nonjudgemental manner has comforted me at times of insecurity, stress and fear. Above all advice that related to the welfare of my children is always offered not as some standard response but based on listening sympathetically to what I say. We have formed a close bond. She knows that my children are my whole world and her support has achieved the very positive outcome of helping me to help myself and my family. My baby daughter s name means truth. When I think of Verity and when I consider my relationship with my MCHN Truth and Trust are the words that come to mind. My children are my world and without my kids I am nothing. Dakota ANNUAL REVIEW 2014/15 75

78 Building our own future A key role for our Engineering and Maintenance Services West Wimmera Health Service has an enviable reputation when it comes to the quality, contemporary design, comfort and safety of the facilities that house its many activities from Acute Care to Residential Aged Care Homes to Outpatient areas. This has been achieved, in large part, through the skill, endeavours and planning of our Engineering and Maintenance Services. A distinctive point of difference We employ a comprehensive team of highly skilled and qualified tradesmen to carry out construction work on new facilities, retro fitting and ongoing maintenance for our entire complement of building assets. Their consistent levels of skill, highest standards of safety and the insistence on using high quality, durable materials has set our Health Service apart as a benchmark for excellence in providing health care facilities in a remote and rural environment. In addition to creating fine spaces for effective care Engineering and Maintenance Services represent notably positive outcomes in cost efficiency and consideration of developmental potential within CAPEX restrictions. Following the restructure of management roles Engineering and Maintenance Services now reports directly to the Chief Executive Officer. Vision and action The ongoing redevelopment of the Mira Medical and Allied Health Building in Nhill illustrates precisely our passion for delivering high quality buildings and accommodation for our communities. In the last 12 months new consulting, treatment and office areas have been created for Occupational Therapy, Dietetics and District Nursing and work has already begun on the further completion of that facility including a Rehabilitation Unit, Community Gymnasium and Hydrotherapy pool. New services in Natimuk The new Peter M. Sudholz Medical and Allied Health Centre, Natimuk, a major building project completed this financial year, contains six Medical and Allied Health consulting rooms and a Planned Activity Group Unit, in a modern, purpose built and designed building. The Project was funded by a grant from the Australian Government and a significant donation from Mr. Peter M. Sudholz, a long term resident of the Natimuk community. Working in conjunction with the contractors for this project, the Engineering and Maintenance Services were responsible for the finishing touches and landscaping which set the Centre apart in terms of quality and practicality. Filling a void Three homes in close proximity to the Nhill Hospital were constructed to ensure newly arrived health professionals have certainty of accommodation when they arrive for employment or for student clinical placement. These modern four bedroom homes were constructed entirely by our Engineering and Maintenance Services. Keeping our buildings at the top of the tree Marrying the growing health care needs with the facilities necessary to provide the services our communities require is a continual challenge. Rising average age combined with an increase in lifestyle diseases became the motivation behind the push to complete the Mira Medical & Allied Health Centre. When it is completed by West Wimmera Health Service Engineering and Maintenance staff it will contain a new Physiotherapy area, a Rehabilitation Unit, a Community Gymnasium and a Hydrotherapy Pool. This will cater for patients recovering from joint replacement such as hip and knee surgery, as well as stroke and other acquired brain injuries and medical conditions. West Wimmera Health Service laundry Investigations are continuing into establishing our own laundry. The emerging realities of the review highlight the positives which would arise from this enterprise. They are: Increased employment. Increased supported employment opportunity for disability clients. Above all it would be a cost saving initiative which will result in a significant financial boost. A Business Plan, stringent financial calculations and the value this would present for West Wimmera Health Service will be judiciously and methodically researched prior to a final decision being taken. The years ahead Given the benefit of cost savings, quality of workmanship and control over the end product, there is no doubt West Wimmera Health Service will continue to undertake the majority of maintenance, redevelopment and Greenfield construction utilising our own Engineering and Maintenance Services. SERVICES ENGINEERING AND MAINTENANCE Qualified Builders Qualified Mechanics Carpenters Painters & Decorators Leading General Hands Trade Apprentices Trainees 76 WEST WIMMERA HEALTH SERVICE

79 Planning for the new Laundry Service is well underway and Consultant Mario Marino, discusses finer details of the plan for the new West Wimmera Health Service Laundry with CEO, John Smith and Kelvin Asplin, Director Capital Services. Natimuk receptionist Jackie Stevenson, at the Peter M Sudholz Medical and Allied Health Centre. ANNUAL REVIEW 2014/15 77

80 Fundraising and volunteers Volunteers are very special people. They dedicate their time and special talents to add another level of variety for our residents, visit hospital patients and aged homes and raise funds for special items of equipment for our hospitals. Special people with a special place in West Wimmera Health Service. West Wimmera Health Service working with the community Extravaganza 2015 was quite an undertaking. 120 people were involved in this highly successful event showcasing talents from across our communities- hair, fashion, art, photography, dance and group fitness and the initiatives of our local college students. It was a night of non stop entertainment quite unlike anything seen in previous events raising in excess of $6,000. Loop the Lodge Fun Run on Sunday 2 November 2014 at Little Desert Nature Lodge offered a range of activities for the whole family. The amazing generosity of our many sponsors and entrants assisted in raising $2,389 towards the proposed Rehabilitation, Hydrotherapy and Community Gymnasium Centre a major asset in rehabilitation services for this region. Murray to Moyne 2016 Unfortunately West Wimmera Health Service did not enter a team in the 2015 relay. However enthusiasm is running at a high level for the 2016 event which heralds the 30th year of the Murray to Moyne Cycle Relay an amazing achievement indeed. West Wimmera Heath Service will again participate with an enthusiastic team of cyclists keen to take on the 520km challenge. With fundraising about to commence once again we will rely on a high level of support. Donations, bequests and fundraising The communities of West Wimmera Health Service are fortunate indeed to have some of the best rural health services and facilities in Victoria. The Service can only provide to a certain level and then they rely on the generosity of people, businesses, Philanthropic Trusts and bequests made in our name. We sincerely thank and acknowledge everyone who has supported us with financial or in kind gifts showing very real community spirit, generosity and commitment to West Wimmera Health Service and its aspirations. Volunteers the silent support Volunteers are instrumental to our Service sharing an amazing array of special talents with residents and patients. Their contributions do not go unnoticed and we wish to acknowledge their commitment and dedication. For the first time this year we have included volunteers in the list of staff on page 23. The magnificent support West Wimmera Health Service receives from the silent band of workers behind the scenes, who so generously give of their time providing patient transport, music & entertainment, exercises activities, craft activities, shopping support, pet therapy and fundraising efforts are invaluable to our Service and are unreservedly appreciated and gratefully acknowledged. When courage, genius and generosity hold hands, all things are possible. (Unknown) Donations 1 July June 2015 $ Amt VV Marshman Charitable Trust 100,000 Roy & Evelyn Uthmeyer Memories 75,000 Peter M. Sudholz 40,000 Collier Charitable Fund 30,000 Liz & Philip Cramer 25,000 Under $500 9,379 Alan Meyer 6,000 William Angliss Charitable Fund 5,000 TR Merrett 5,000 G & A Hateley 5,000 RW Rogers 5,000 Extravaganza Event 4,990 Rainbow Combined Auxiliary 4,000 Lions Club of Nhill 3,395 Natimuk Relatives & Friends 3,000 Mrs Jan Cole 2,775 M Magrath 2,500 Estate of James Henry Northfield 2,500 Loop the Lodge 2,389 Sarah Stott Trust 2,147 Intralink Wealth Management 2,000 Rainbow Western Group Auxiliary 2,000 GA & DK Wallis 2,000 J Ubergang 2,000 P & D Ralph 2,000 Lake Charlegrark Country Music Festival 1,500 Jeparit Hospital Ladies Auxiliary 1,109 HK & BD Brown 1,000 Natimuk Nursing Home Raffle 917 Murray to Moyne 799 Lyn Taylor 750 LM Vivian 500 DL & HP Wallis 500 HG & BJ Champness 500 Jim s Butchery 500 Tristar Medical Group 500 Cooinda Ladies Auxiliary 500 The Locum Register Nurse Agency 500 Rural Energy 500 Wimmera Mallee Waste 500 Jetfire Fire Protection Pty Ltd 500 ML & BL Pohlner 500 Grand Total 354, WEST WIMMERA HEALTH SERVICE

81 Volunteers a staff perspective It is a joy to see residents who have been affected by dementia engaged in an activity familiar to them from earlier in their lives. Their eyes light up, smiles return to their faces and a connection emerges from within as if a light switch had suddenly been flicked. A good example was a resident who had been a keen and skilled pianist but could no longer play as a result of dementia. She remained calm and engrossed as she sat next to a gentleman playing familiar tunes on the keyboard, gently clapping in time to the music. The smile and comprehension that radiated across her face said it all! As Nurses in Aged Care we recognise the immense value and many attributes that volunteers bring to so many aspects of the human dimension of care in our Service. Elaine Sedgman, a skilled pianist of yesteryear and resident of Weeah Lodge Nursing Home, lights up to the music of Volunteer Darren Clugston. ANNUAL REVIEW 2014/15 79

82 KEY STRATEGIC GOALS Key strategic goals for service improvement The current Strategic Plan will conclude in December In anticipation of this event we are defining the key strategic gaols, formulated to meet the needs of our stakeholders and which will be included in the next three years. 1 Match services with our communities changing needs In West Wimmera Health Service achieved the following: 3.8% increase in patients treated in comparison to the previous year and the highest number of acute patients treated in the last five years. 16% increase in the number of same day patients treated. Performed 666 elective surgical procedures. Performed 4,435 radiography diagnostic tests, including 724 CT scans. Treated 3,371 patients in Primary Care Casualty, a 24% decrease on the previous year. Delivered 41,776 hours of Home and Community Care services, 7.5% more than the previous year. 39,083 allied and community occasions of service, an increase of 25% on the previous year. Full accreditation status achieved across all programmes of care delivery including: Australian Council on Healthcare Standards EQuIP Accreditation, Aged Care Standards Agency Accreditation, Home and Community Care (HACC) Community Care Common Standards, Diagnostic Imaging Accreditation and Disability Service Standards. Recruitment and retention of Visiting Medical Practitioners across all communities to the highest levels seen in decades. Review of Surgical Services at Nhill Hospital with an outcome that surgical services are being delivered in a safe and effective manner and that surgical services at the current level of complexity should continue to be performed at Nhill. A resounding endorsement of the quality of care delivered! Preparations commenced for a Medical Review to be conducted in 2016 focusing on Medical Admissions and Primary Care presentations across the Service. Memory Land Cafés in conjunction with Alzheimer s Australia and Department of Health have taken place. Sessions are held monthly in Nhill and also occur at Rainbow, Goroke and Natimuk. The WHY (West Wimmera, Hindmarsh, Yarriambiack) project continues to provide Occupational Therapy, Speech Pathology, Dietetics, Podiatry and Physiotherapy within the sub-region including Woomelang and Harrow Bush Nursing Centres, Dunmunkle Health Services and Yarriambiack Shire. A Cancer Care Nurse has been employed 0.2EFT as a resource for clients living with cancer with the view to intensify access to this care locally. The Nhill Community Garden situated on West Wimmera Health Service land adjacent to Cooinda is flourishing with people from the Karen Community, Nhill College and Nhill Lutheran School students, participants from Cooinda and others from the Nhill Community generally accessing the garden either using raised garden beds or planting into the ground in plots. Funding of $28,500 was received through a Regional Growth Fund Putting Locals First grant with Stage 1 of the project resulting in amenities facilities, garden beds, pathways and water supply. 80 WEST WIMMERA HEALTH SERVICE

83 KEY STRATEGIC GOALS 2 Improved access to services Introduction of CT (Computed Tomography) Scanner and ultra sound services at Nhill Hospital together with an increase in Diagnostic Radiology Services. Increase in Dental Services through commencement of new Dental Clinics in Rainbow, Goroke & Kaniva and capital infrastructure including a Mobile Dental Clinic which will provide treatment in addition to screenings for School Children in late A partnership with the Royal Flying Doctor Service Mobile Dental Care team has provided dental screenings to community members in Kaniva, Rainbow, Goroke, Natimuk & Edenhope. Commencement of macular injections for patients suffering from macular degeneration, restoration of vision providing a quality of life where the patient can safely navigate daily activities of life. Patients able to receive treatment locally, no longer having to travel to Melbourne/Adelaide every six weeks, saving overnight accommodation and the stress of an 800km round trip. A Visiting Medical Physician Specialist service provided at the Nhill Hospital on a monthly basis in collaboration with Wimmera Health Care Group resulting in improved access for patients being more convenient. Final implementation stage occurring with the Royal Flying Doctor Optometry Service to provide optometry at all sites except Nhill, where services are already provided by a visiting Optometrist. 3 Enhanced communication with our communities Appointment of a Community Liaison Officer delivering concentrated communication/consultation with community stakeholders. Informative details of Aged Care Residential facilities are available on My Aged Care website to inform prospective residents of accommodation and financial options. Ladies Auxiliaries and Friends and Relatives Groups active in all communities with Nursing Management participating in meetings. Large presence in local and regional media platforms showcasing services, achievements and health promotion informing communities. Community meetings held in all six townships to inform community members and listen to opportunities for enhancing services provision. Annual General Meeting held with outstanding attendances in 2012, 2013 and Participation of Allied Health staff in local Agricultural shows and health expos. Launch of modern Website and Facebook site to target the tech savvy generation of stakeholders. Fundraising Appeal meetings held in each community to support and inform of capital infrastructure and associated financial imposts. Annual Report published and provided to Government as scheduled. Annual Report published and provided to Government as scheduled. Annual Review published and launched at the Annual General Meeting. Annual Report published and provided to Government as scheduled. Annual Review published and launched at the Annual General Meeting. 4 Maintain and enhance our financial sustainability An operating surplus of $103k achieved for the financial year being the 10th consecutive operating surplus. Cash and investments (excluding residential aged care type deposits) totalling $4.61m were held at 30 June Commenced planning for the proposed transition to a new funding model being architected by the Department of Health & Human Services to replace the Small Rural Health Service flexible funding model which has been in use for a decade. The new model is predominantly based on actual throughput levels of various types of service provision and is currently expected to commence on 1 July Commenced planning for the proposed transition to a new suite of procurement policies as mandated by Health Purchasing Victoria and planned to take effect from 1 July Meetings held with Federal Members of Parliament allowed us to express our concerns regarding a number of financial matters including the perceived lack of funding equity between metropolitan and rural health services; the unfairness of the across the board productivity saving measure; and the ongoing erosion of our funding base with particular regard to changes to the Small Rural Health Service flexible funding model and the reduction of dental health funding from the Commonwealth. ANNUAL REVIEW 2014/15 81

84 KEY STRATEGIC GOALS 5 Adopt a flexible, collaborative approach to resource allocation in the region WWHS is now a member of the Wimmera Southern Mallee Health Alliance Building Capacity initiative in addition to the founding Alliance group. Proposed amalgamation with Dunmunkle Health Services in responding to their invitation to an amalgamation with them being considered by the Minister for Health via a review process. Health Promotion Plans developed in partnership with Wimmera Primary Care Partnership and Local Government Councils. Relationship built with Ballarat Health Services and Edenhope District Memorial Hospital for the provision of laundry services. WWHS outsources significant Allied Health services to neighbouring hospitals that would otherwise not receive such services, including Woomelang Bush Nursing Centre, Dunmunkle Health, Edenhope District Memorial Hospital, Rural Northwest Health and Dimboola Aged Care Facility. Planning has progressed for the real time intelligence project with Ballarat Health Services to promote sharing of patient information to more effectively manage step down process. Clinical Executive Meetings between WWHS and Wimmera Health Care Group enhancing clinical communication and resource sharing. Leading Residential Aged Care Financial Projects involving Rural Northwest Health, Edenhope District Memorial Hospital, Dunmunkle Health Service, East Wimmera Health Service and Ballarat Health Services focused on Aged Care Financial Governance. 6 Continue to improve our facilities and equipment Mira Redevelopment Stage 2 Community Health & Wellbeing Centre incorporating planned activity group and rehabilitation is well progressed with significant parts of the building constructed, anticipated total project to be completed July The Natimuk Medical Clinic and Allied Health Centre redevelopment project was completed and opened in May Building of three new accommodation houses in MacPherson Street Nhill was completed in 2015 they have since been occupied by health professionals. Goroke s new Community Health Centre was opened on 4 October The community has a state of the art facility capable of providing support services for health maintenance into the next decade and includes: Expanded clinical areas including new consulting rooms for Medical Practitioners and Allied Health Professionals. Public Dental facility created. Expanded Day Activities Program area for elderly people of the community. Community access areas created for community meetings, workshops, and self-help groups. Improved Disability access. 7 Strengthen and expand our professional relationships CEO membership on a number of key stakeholder bodies including: Australian Council on Healthcare Standards Board (Vice Chairman), Australian Council on Healthcare Standards International Board (Member), Victorian Health Industrial Association Board (Vice Chairman), Australian Hospital & Healthcare Association Council, National Health Alliance, Friends of Alliance Council, Grampians Rural Health Alliance Committee. Executive Team represented on various Board s and Committees including: Women s Health Grampians, Small Rural Executive Nurses Network, Grampians Region Executive Nurse Network, Grampians Regional Health Alliance Finance Committee, Nhill Town Committee, Hindmarsh Economic Development Strategy Advisory Committee, Grampians Regional Procurement Reform Steering Committee, Grampians Regional Procurement Reform Project Committee, Hindmarsh Shire Council Municipal Emergency Management Planning Committee, West Wimmera Shire Council Municipal Emergency Management Planning Committee, Hindmarsh Shire Council Chair Audit Committee, Grampians Region Health Emergency Managers Network, Grampians Region Education Group (GREG) Meeting, Victorian Healthcare Experience Survey Statewide Reference Group, Grampians Region Health Information Managers Group, GRHA Electronic Health Record Steering Committee; WSMHA Persistent Pain Project Steering Committee, Wimmera Primary Care Partnership Executive Committee, Wimmera Region HACC Transition Working Group. 82 WEST WIMMERA HEALTH SERVICE

85 KEY STRATEGIC GOALS 8 Use the latest technologies more effectively Introduction of a number of specialist and tertiary services offered locally via telehealth: Physiotherapy Royal Melbourne Hospital Orthopaedics. Wound Tertiary Wound Specialist Department of Health Wound Care Nurse. Residential Aged Care/Acute patients Geriatrician/ Physician Ballarat. Dietetics Ballarat Health Services Dietitian Mentoring. Weekly discharge meetings with Wimmera Health Care group to discuss patients in their facility from our geographical area and possible discharge strategies to get them back to WWHS. In discussion with Ballarat Base to do the same from them. Completion of a Wireless Network at Nhill and Kaniva hospitals has enabled staff to access and update aged care resident information including resident care plans, charts and assessments, at the bedside. Installation of a fully integrated security system throughout the Nhill campus. 9 Build our people s capabilities 13 Middle Managers have successfully completed the Advanced Diploma of Business. 5 staff have successfully completed the Certificate IV in Disability Studies. 5 nursing staff have completed the Rural and Isolated Practice Endorsed Registered Nurse (RIPERN) course. Expansion of the Injury Management Team who support and educate Middle and Senior Management on effective return to work process. 25 Occupational Health & Safety Representatives and Managers have completed the one day refresher OH&S course between 2012 and Individuals in the Executive Team successfully completed Masters of Business Administration and Masters of Health Administration, Advanced Diploma of Management, Graduate Certificate in Occupational Health and Safety Management and Post Graduate Diploma in Occupational Health and Safety. 10 Strengthen our governance, performance, transparency and accountability Introduction of the Riskman Contract Module to enhance contract management which is supported by the Quality Register, Feedback module, Risk Register and Incident reporting modules which have been previously introduced. Strengthening of the Clinical Quality Governance Committee membership with a specific emphasis on strengthening the credentialing process. The improved performance of our credentialing process has been noted by the Department of Health in relation to Credentialing and Scope of Practice and Partnering for Performance, and identified as a good example for the application of a local performance discussion record template with guidelines for use and applicability criteria with 0.2 EFT or less Visiting Medical Officer (VMO) or General Practitioner (GP). Proud to be a Finalist in the Premier s Rural Health Service of the Year Award 2014! Finalist in the Institute of Public Administration Australia (VIC) Leadership in the Sector Awards in the category of Leading the Way in Health, Safety and Wellbeing Award for our Injury Management Team. ANNUAL REVIEW 2014/15 83

86 Mr Frank Guy, comfortable after his visit from Dr Zamurd Ahmad, Tristar Medical Group, Kaniva. 84 WEST WIMMERA HEALTH SERVICE

87 Glossary ACAS Aged Care Assessment System ACFI Aged Care Funding Instrument ACHS Australian Council on Healthcare Standards Australian Standards National Standards developed by the Standards Association of Australia/New Zealand Best Practice Measuring results against the best performance of other groups CACS&AA Commonwealth Aged Care Standards and Accreditation Agency Carers Carers of patient/clients who are not part of the Service Care Team Catchment Geographical area for which West Wimmera Health Service is responsible to provide services CEO Chief Executive Officer CT Scanner Computed Tomography Scanner DHHS The Victorian Department of Health & Human Services Victoria e-health The transfer of health resources and healthcare by electronic means EQuIP Accreditation Evaluation Quality Improvement Program FOI Freedom of Information GCHC Goroke Community Health Centre GP General Practitioner HACC Home and Community Care funding for services and programs which are provided in the home or the community Index Accreditation... 2, 15, 43, 66 Acute Care...28 Acute Care Quality Indicators...34 Acute Surgical Performance...36 Admission & Discharge...29 Aged Care...40 Allied & Community Health...52, 54 Annual General Meeting... IFC, 14 Audit... 8 Australian Council on Healthcare Standards. 18 Board of Governance... 2, 8 Cancer Care Capital Fundraising Capital Projects...76 Cardiac Rehabilitation Catchment...IBC Chief Executive Officer... 4, 5, 18 Cleaning Audits Clinical Governance... 8 Clinical Performance Clinical Quality Governance Committee Clinical Risk Management... 8 Clinical Services... 9 Communication Line... 9 Community Forums... 5, 72 Community Gymnasium...53 Community Liaison Officer... 5, 68, 72 Compliments Suggestions & Complaints Consumer Engagement Consumer, Carer & Community Cooinda Disability Services Corporate & Quality Services Corporate Governance... 8 Credentialing Cultural Responsiveness...73 Hydronic Balancing The process of optimising the distribution of water in heating or cooling systems to produce a set temperature at optimum energy efficiency and minimal operating cost ICT Information and Communications Technology icare Software program designed for use in aged care Inpatient A person who is admitted to an acute bed LED Light emitting diode LPG Liquid Petroleum Gas M&CH Maternal and Child Health Medicare Local Services for local communities in line with local needs, a National Health Reform initiative OHS Occupational Health & Safety Outcome The result of a service provided Outpatient A patient/client who is not admitted to a bed Palliative care Care that alleviates pain and discomfort but does not cure Primary Health Care A basic level of health care that includes programs directed at the promotion of health, early diagnosis of disease or disability, and prevention of disease. Primary health care is provided in an ambulatory facility... It includes continuing health care... (Mosby s Medical Dictionary, 8th edition. 2009, Elsevier). PCC Patient Centred Care Dental Services Dialysis Disability Services Dunmunkle Health Services... 4 Education & Training... 31, 60 End of Life...33 Engineering & Maintenance...76 Environment...62 Falls Prevention...69 Finance & Administration Financial Performance Fundraising... 4, 78, 86 HACC...57 Haemodialysis Health Services Act... 8 Healthy Leg Club...28 Home Care Packages... 40, 57 Hospitality & Environmental Services Human Resources Management Hydrotherapy...53 ICAP...73 Infection Control Information & Communication Technology. 21 Insulin Pumps John N Smith Legislation...22 Leisure & Lifestyle...45 Lines of Communication... 9 Macular Injections...32 Maternal & Child Health , 74 Medical Imaging Medical Report Medical Services...39 Mission...IFC National Disability Insurance Scheme PCP Primary Care Partnership RAC Refundable Accommodation Contribution RAD Refundable Accommodation Deposit RFDS Royal Flying Doctor Service RPHS Rural Primary Health Service Schedule 11 drugs A group of medications kept in locked cupboard and can only be ordered by a Medical Practitioner Telehealth Use of telecommunication and information technology to provide clinical healthcare at a distance Tradesmen A non gender specific term and refers to male or female trade employees. The Board The Board of Governance WWHS The Department The Department of Health Victoria The Service West Wimmera Health Service Values The principles and beliefs that guide West Wimmera Health Service VDGYP Victorian Dental Graduate Year Program VHIA Victorian Hospitals Industrial Association VMO Visiting Medical Officer W&SMHA Wimmera & Southern Mallee Health Alliance WHY Project West Wimmera, Hindmarsh & Yarriambiack Shires collaboration of HACC services WWHS West Wimmera Health Service National Respite for Carers Program...57 Occupational Health & Safety Oliver s Café People Matter Survey Person Centred Care Peter M Sudholz Medical & Allied Health Centre...13, 76 Pharmacy Planned Activity Groups President... 2, 10 Primary & Preventative Health Radiology Regional Services...52 Residential Aged Care...42 Residential Aged Care Performance...43 Residential Aged Care Quality Indicators...46 RIPERN Snappy Seconds Specialist Services...38, 39 Staff... 16, 20, 23 Staff Awards...22 Statement of Priorities Strategic Direction... 5, 80 Surgical Services... 27, 28 Supported Employment Tristar Medical Group...38 Vale...IFC Values & Vision... IFC Victorian Health Experience Survey Visiting Specialist Clinicians Voluntary Dental Graduate Year Program...49 Volunteers... 5, 23, 78 Wimmera & Southern Mallee Health Alliance 55 WorkSafe...64 ANNUAL REVIEW 2014/15 85

88 Capital fundraising The Health of Our Communities appeal Philip Cramer Generous community support enables us to undertake capital works programs building modern healthcare facilities. Pledges can be made over a five year period safeguarding the future health of our communities. It is an honour to be the Patron of the fundraising initiative to complete the facilities of West Wimmera Health Service. I grew up on a wheat and sheep farm at Netherby and attended secondary school in Nhill. I wasn t the best of students and when I found myself repeating the final year, I was made the school captain! I left home at 18 to study in Melbourne, where I eventually became a founding partner of a valuation practice, now known as Charter Keck Cramer, which has grown to be a successful property consultancy business employing over 200 people. At 61 years of age, I still say that I go home to Nhill; such is my fondness of my home town. I admire the industrious nature of Nhill for no other town that I am aware of has produced successful businesses that have developed in such a small community. In recent years I have contributed to the Nhill & District Sporting Club and the Golf Club and have often walked past the impressive Nhill Hospital, which continues to expand for the community. In recent times, members of my family have spent time in the Hospital and I can vouch for the excellent care and service it provides. All WWHS facilities offer the same standard of care. I am proud of my start in country Victoria and consider it our duty to be donors to many of the community initiatives, hospitals and health services that look after our ageing people. Each of us has to make sure that living in more remote parts of this state does not mean going without the finest medical and health care support. West Wimmera Health Service is a wonderful Service providing amazing healthcare for 16,000 residents in the Western and Southern Wimmera and also the Southern Mallee. However, could it be better? Yes... and it is time for us all to help! It is time to finish what has been started and to ensure the future of health facilities for all who need us. As Patron I will do whatever I can to help this Health of Our Communities appeal that is designed to fund a wide range of projects so our people can receive treatment near their homes and families. Hindmarsh and West Wimmera may be identified as economically disadvantaged but they still have the biggest hearts. I urge you to help us by making your own generous pledge to this Appeal. Phil Cramer Patron What has the Appeal achieved so far? New Medical and Allied Health Centre delivered The Peter M. Sudholz Medical & Allied Health Centre was opened on 1st May Completion was made possible with support from the Natimuk community and a generous donation from Mr Sudholz to supplement the Commonwealth grant towards this project. Residential Aged Care fundraising in progress The Kaniva community is in the midst of raising a considerable sum to build Residential Aged Care units adjacent to the Kaniva Hospital. Health facilities for all We are asking all communities to support funding to build a Rehabilitation Unit, Hydrotherapy Pool and Community Gymnasium facilities which will benefit everyone. 86 WEST WIMMERA HEALTH SERVICE