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staff magazine of the IRISH HEALTH SERVICE vol. 11 | issue 6 | summer 2016 Building a better hea lth service features general news you section lifestyle
Welcome to the Contents
latest edition of
Health Matters You Section 28 SOILSE WINS STAR AWARD
Daytime rehabilitation programme
08 HEALTH SERVICE EXCELLENCE wins prestigious prize
I don’t think anyone could fail to be
AWARDS 29 DONEGAL AUTISM GRADUATION
impressed with the winners and the
We take a closer look at the fantastic Celebrations as staff complete their
many entrants in the recent Health
projects that made it to the final of autism studies course
Excellence Awards. In what was a
the recent awards 30 THE GENTLE APPROACH
fantastic day to be part of the Irish
16 LET ME INTRODUCE MYSELF Gentle Caesarean birth in Limerick
health service, the awards highlighted
Crumlin DON Rachel Kenna pioneers new way of thinking
the sheer number of projects that are
explains how the hospital embraced
going on the length and breadth of the
the #hellomynameis campaign
country. Well done to all involved.
In this edition, we are shining a
18 ORGAN DONATION AND
TRANSPLANT IRELAND
Features
particular light on the vast body of
New organisation helping to provide 31 ROLE OF THE PROGRAMME FOR
work that is being done to build a
training for staff in the area of organ HEALTH SERVICE IMPROVEMENT
better health service for patients and
donation Joe Ryan talks about supporting
staff alike.
20 GO GREEN AND TRAVEL CLEAN improvements in the health services
We speak to two Clinical Case
Do your bit for the environment and 32 BETTER VALUE FOR OUR SERVICES
Managers for Older People, who give
travel to work in a sustainable way Finance Division delivering new
us an insight into a typical work day
22 TRIBUTE TO GERRY COLLINS system to improve its efficiency
for them as part of the new Integrated
Family of Quit campaigner at 34 CALORIE POSTING INITIATIVE
Care Programme in that area. We also
Healthcare Masterclass as tributes No more nasty surprises in your food
look at the programme itself and how it
are made to him choices at work
is reinventing the future of senior care.
23 TECH EXCELLENCE AWARDS 38 PATIENTS ARE THE REAL WINNERS
Staff in the HSE National Information
Two major awards for the work of the First single Patient Administrative
Line talk about the work that they do
HSE and eHealth Ireland System across southern acute
manning the phone lines, dealing with
24 TAKING A TRIP TO THE JUNGLE hospitals
thousands of caller queries every week.
Healthcare workers make a difference 39 BENEFITS OF THE EHEALTH
We also take a look at advancements
to lives of refugees during their visit PROGRAMME
in the eHealth Programme, which has
to Calais camp Moving into the 21st century with the
been proving hugely successful in
26 HERO PARAMEDICS best healthcare information systems
delivering a health service for the 21st
Brian and John go above and beyond 40 FOCUS ON HOSPITAL GROUPS
century.
to help Information map on Hospital Groups
If you want to tell us your story about
28 CHARITY FUNDRAISER AT UHL 41 FOCUS ON COMMUNITY
how you or your team are improving
Fashion show in Limerick raises HEALTHCARE ORGANISATIONS
how services are delivered, then let us
€13,000 Information map on CHOs
know. If you would like to share your
story contact us at healthmatters@
hse.ie
As ever, we welcome your ideas and
feedback on the magazine.
A big thank you to all of our
contributors to this edition and I hope
you find plenty of interesting reading
in it.
Joanne Weston
Joanne Weston,
Editor
This magazine is produced by the
HSE Communications DiVISION
Publishers: Celtic Media Group
28
Soilse wins STAR award
www.celticmediagroup.ie
Feedback: Send your feedback to
healthmatters@hse.ie
HEALTH MATTERS summer 2016
42 CHANGING THE TIDE OF MENTAL
HEALTH
Surf programme in Waterford
engages local young males
43 INTRODUCING the hse TAX
DEPARTMENT
69 16
HSE has established a dedicated tax
department to answer your tax
queries
43 NEW HR AND PAYROLL SYSTEM
Tallaght Hospital set to enjoy
benefits of new SAP system
44 PROGRESS IN THE INTEGRATED
y!
CARE PROGRAMME FOR OLDER
PERSONS
iON h t st
a
ni g
Case managers for older persons
P ETIT w o
give an insight into their work M x u ry t
47 CELEBRATING 1916 IN THE HSE CO a lu
A little bit of history marked n
48 THE FUTURE OF THE INFOLINE Wi
Friendly voices on the phone
providing an invaluable information
service
50 SAFEGUARDING
THE VULNERABLE
Social Care Division launch its
79
safeguarding policy
52 NATIONAL HEPATITIS C
Wineport Lodge
TREATMENT PROGRAMME
Massive breakthrough in the
treatment of the disease
55 TACKLING DIABETES
Updated guidance on Blood Glucose
Testing for people with Type 2
diabetes published
24
Tackling refugee crisis
summer 2016 | health matters | 03
Contents
General News 63 HOW HEALTHY IS YOUR COUNTY?
Find out how your county rates in the
56 STUDY INTO MENTAL HEALTH health and fitness stakes
DEATHS 63 NORTH EAST NURSES ORGANISE
Study of untimely sudden deaths of CONFERENCE
people while in the care of Donegal Expert speakers enhance nurses’ and
Mental Health Services published midwives’ understanding of key and
57 VALUABLE LESSONS FROM relevant topics
HEALTHCARE MASTERCLASS 64 CORK CONNECTING FOR HEALTH
Programme focused on embedding the Conference describes how health is not
values the health services have just a lack of illness
committed to trying to live to every day 64 THE POSITIVE PSYCHOLOGY
58 LISTENING MEETINGS MOVEMENT
Almost 1,100 people discuss their Lauded US Professor gives talk to
experience with Irish mental health invited audience on Positive
services Psychology
59 BREASTFEEDING WELCOME 64 VOLTAGE FESTIVAL
New initiative to support mums Event platforms the many
breastfeeding in public extraordinary projects bringing artists
19
59 REFURBISHMENT UNDER WAY and older people together in Co Clare
AT ST BRIGID’S 65 SEXUAL HEALTH ADVICE
New extension and renovation for hospice Ask your pharmacist for advice, new
60 SLIGO PRIMARY CARE CENTRE BOOST campaign urges
Full range of primary care services to 65 ST ITA’S END OF LIFE CARE
be made available in Ballymote, Sligo European plaudits for Limerick
60 BEECH HAVEN TAKE AWARD initiative
Day centre of the year award given to 66 SUMMIT FOR OLDER PEOPLE
Portlaoise facility Dublin Castle event was first of its kind
61 PRE-SCHOOL AWARDS 67 KICKING THE HABIT
170 pre-school services receive the Solidarity gives women in North Dublin
Healthy Ireland award the strength to quit cigarettes
61 HAND HYGIENE 67 CLINICAL GUIDELINES FOR
67
Coláiste Cholmcille in Donegal earn PALLIATIVE CARE
Healthy Ireland Health Promoting Published guidelines supported by a
School Flag suite of resources
62 REFLECTING ON THE JOY OF 68 MIDWIFERY CONFERENCE IN THE
NURSING SOUTH
Staff from diverse selection of care Conference showcases excellent work
settings in attendance of midwives in the Irish health service
Changing the tide
26 of mental health
04 | health matters | summer 2016
HEALTH MATTERS summer 2016 online
Lifestyle
67 OPERATION TRANSFORMATION
Co Louth hospital staff take part in
weightloss programme
Sites we like www.breastfeeding.ie
68 NUTRITION WEEK
Staff of St Mary’s Hospital,
Phoenix Park organise a series
of events
69 PUBLIC HEALTH TEAM CYCLE
30 people from Ireland and UK take
part in three-day event on bike
69 STEPS TO HEALTH GOLD AWARDS
Success for Ballymahon-Forgney
Community Games Committee
70 WALKING BRINGS BENEFITS
Benefits both physically and
mentally for the older members of www.corkhealthycities.com
the new Millmount Walking Group
72 THE LUNCHTIME MILE
Join the revolution and get out and
get active on your lunchbreak
73 ST VINCENT’S STAFF GET MOVING
Employee Wellness Committee
organise events to promote physical
activity
74 HEALTHY BODY HEALTHY MIND
Some simple recipes to help you stay
away from unhealthy meals
76 GARDENING
How to get the children to use and
www.healthpromotion.ie
enjoy the garden during the summer
77 INTERIORS
Top tips for choosing a front door
and some DIY basics to keep your
home in order
78 FIRST DRIVE
Behind the wheel of the Hyundai i20
Active
www.smartertravelworkplaces.ie
42 The information in Health Matters is carefully researched and believed to
be accurate and authoritative, but neither the HSE nor the publisher can
accept responsibility for any inaccuracies, errors or omissions. Statements
and opinions expressed herein are not necessarily those of the Editor, the
HSE or of the publisher.
summer 2016 | health matters | 05
Message
A Message from the...
Director General
How we are building a better Health Service
Dear Colleagues,
The Health Service Excellence Awards have shown the enthusiasm and
appetite across the health services for new ways of working that can
lead to real improvements for patients/service users and the public as
a whole. As the needs of the population change and demand for health
services grows, innovating new and better ways of working is an impor-
tant step towards ensuring we can meet those needs into the future.
This year, we had 426 entrants. That means that there were 426 teams
of people doing things differently than they used to because they could
see a need to deliver their service in a better way. They were energised
enough to put their hands up and be counted.
There are thousands more similar teams in the system. We must cel-
ebrate them, not just to say thank you but to say clearly that we value
innovation and that we applaud people who try to improve services. They
are central to the effort of building a better health service. Not every one to catch on and to spread across the health services. There was a time
of their endeavours will be a success but failure is a vital part of innova- when innovation was stifled simply because of a fear to do anything
tion. We need to make sure that the environment in our health services without ‘sanction’. I hope we have now moved away from that belief. Im-
around the country nurtures innovation. proving the health service is an ongoing process with much work already
We reintroduced the Excellence Awards after five years and there under way both in frontline services and in putting in place the systems
was a phenomenal interest created around the competition. We will be and structures to support change and improvement in how health serv-
holding regional showcase events to spread that enthusiasm around the ices are delivered in Ireland.
regions, share the learning and support the spread and implementation A key rationale behind the establishment of the HSE was to central-
of the projects. I expect the next time we hold the awards to have even ise much decision making. Along with the economic recession, this
more entries. led to the creation of a very sterile atmosphere, with an overly central-
As healthcare staff, we work in a constantly changing field and environ- ised structure.
ment. Procedures and practices are ever changing, as are the needs of You simply cannot manage 105,000 staff from one central location.
the public. We must strive to embrace these changes and improve how To do so unavoidably stifles creativity. But we are now in the key stage
we do things. of slowly unwinding all that.
But change in healthcare is not done in a boardroom nor is it in systems We have been carefully creating the CHOs and the Hospital Groups
and structures. It occurs in the ways people work together. Often it is the and are reversing from a centralised organisation structure – maybe
little things people do – whether it is what those in leadership roles do to not as fast as we would like but going in the right direction.
make sure people are supported in what they do, or how we practice and The new set-up is intended to be more naturally staff friendly. To cre-
relate to each other. The real value is how we change what we do and re- ate an organisational level that is more relevant to you, that is closer
think how we deal with each other to improve the quality of healthcare. to you and closer to the community.
Managers have the platform to easily destroy change but rarely to build The HSE was created in a big bang. Legislatively it was easy, but not
it. Leadership is providing for a changing environment and in supporting necessarily a good idea. We are at least 2 to 3 years off the completion
those changes. Simply put, people in power must empower others. It is of the transition to a decentralised structure. Over the coming years
just like being a football manager. You don’t play the game but you must we must continue to be guided on this journey by the need to empower
ensure that the team has the right blend of skills and experience, a foot- staff, move decision making closer to the point of delivery and to en-
ball and the right training to win a match. You can’t direct innovation, or sure that the patient is at the centre of how we organise and deliver
control it centrally, you just need to create space to nurture it. health services.
At present, there are thousands of initiatives being tested in the
health services around the country. They have popped up everywhere.
The #hellomynameis campaign is just one of these ‘guerrilla’ changes.
ABOVE: Director General Tony O’Brien addresses those in attendance at the
We showcased it and since then many people right across the health Health Excellence Awards, where he was on hand to present the prizes to the
services have adopted it. There was no need for official sanctioning or winners. RIGHT: A representative of each of the seven finalists at this year’s HSE
directive. Our aim is to draw attention to good ideas and support them Health Excellence Awards. Photo: Paul Connor
06 | health matters | summer 2016
Message
It is, of course, important that the CHOs and Hospital Groups I was very proud to welcome almost 800 people from around
do not act as “mini-HSEs”, in a localised way. It is vital that our health services to the recent third Healthcare Leaders
they are empowering, not replicating the excessively hi- Masterclass. While some might see the event as ‘elitist’,
erarchical behaviours that had been the hallmark of the I think it is vital to give people in leadership roles more
HSE’s design. confidence to be better leaders. We need people who
Nationally, it will remain our role to look at population hold accountability and power to have the philosophical
needs and carry out the longer term planning for the health sense of what it is to lead. If people fail to lead well, eve-
needs of the nations. But the delivery of the services must be ryone suffers.
by the CHOs and Hospital Groups. Once a year, we expose senior leaders and managers to
And things are already better. thought leaders and well developed evidence in the area of leadership
Establishing new models of care and improving existing ones is well in healthcare, designed to assist them to create the space for building
under way in the Clinical Programmes. There is now much more clinical a better health service for patients/service users, staff and the public.
engagement, with measureable and tangible benefits to patients. Just Management and leadership development suffered badly in the reces-
one of those is the Acute Coronary Syndrome Programme (also a Health sion and that needed to be put right.
Service Excellence Award finalist). It is having a very real impact on We in healthcare are never satisfied, nor should we be. We must de-
the survival of patients, as well as paving the way for an increase in the mand more of ourselves and our colleagues, and our managers. We
number of patients treated. might not always get everything right but for when we do there are
The recently published People Strategy focuses on how we can better enormous benefits to the people we care for. With so much change al-
support our staff to be the very best that they can be, while the eHealth ready underway, and numerous innovations and improvements already
programme is developing technology-enabled solutions to bring im- evident, I am confident that if managers empower and support staff;
proved population wellbeing and to improve day-to-day working and together we all have an opportunity to play our part in building a better
information flows. We are currently working to give everyone in the HSE health service.
access to a digital identity, 30,000 people still don’t have access to a Our values of care, compassion, trust and learning, which are evident
computer at work. The implementation of Individual Health Identifiers every day in our health services, will guide us in making the changes
will also make a huge difference to connectedness. needed to deliver real and lasting improvements in health for the benefit
There have already been changes to the way our financial systems of those we serve.
work, driving efficiency and helping to make sure that the money will go
where the patients go.
Healthy Ireland has already been a major success and we have made
sure that the health services are an exemplar employer for promoting
healthy activities. Calorie posting, healthy vending machines and walking
Tony O’Brien
clubs are just three examples of how, as Ireland’s largest employer, the Tony O’Brien
HSE has put a strong emphasis on healthy eating and physical activity. Director General of the Health Service Executive.
summer 2016 | health matters | 07
You
Section
Health Service Excellence Awards 2016
An d th e win n e r i s...
top marks for health
service’s finest
he Ophthalmology Service in The awards are designed to encourage and “It’s a delight and an honour. I think it helps
T
Sligo University Hospital joined inspire our healthcare staff to develop better to reassure patients that they are benefitting
forces with colleagues working services that result in easier access and from having the right people with the right
in the community to create high quality care for patients and to promote skills in the right place, at the right time. We
an improved model of care pride among staff in relation to our services. must be doing something right!”
for patients and this excellent standard of “The awards are not simply about those The Runner Up Award was presented to
innovation and co-operation that the service projects selected as being winners and the National Clinical Programme for Acute
has achieved earned them the Overall Best finalists but about all of those that have Coronary Syndrome (ACS) which was initi-
Project at the Health Service Excellence been submitted and are contributing to the ated in 2010 to save lives by standardising
Awards. continuous improvement of health and social the care of ACS patients across the country
The award was presented to the Ophthal- care services,” said Mr O’Brien, who present- as a joint venture between the Irish Cardiac
mology Service being delivered by Sligo Uni- ed the awards. Society (under the auspices of the Royal
versity Hospital and Sligo, Leitrim and West “The on-going commitment of staff College of Physicians of Ireland (RCPI) and
Cavan Community Health Organisation. throughout the public health service contrib- the HSE.
Congratulating the winners Tony O’Brien, utes in a very significant way to the quality The Popular Choice Award, decided by an
Director General of the HSE, said, “The and satisfaction levels acknowledged by our online poll for healthcare staff, was pre-
Health Service Excellence Awards 2016 service users and the members of the public. sented to the Community Epilepsy Outreach
are designed to identify, recognise the real “The Health Service Excellence Awards Service operated by the South/South West
value we place on excellence and innovation afford us the opportunity to take pride in Hospitals Group and Community Healthcare
across all of our health service. The Awards our services, recognise and celebrate staff Organisation for Cork and Kerry.
process enabled us to identify great service commitment and dedication and to say thank The service succeeded in transforming the
developments that can be shared and imple- you to our staff for their contribution to the quality of epilepsy care for service users
mented, as appropriate, in different parts of provision of health and social care services,” through a radical redesign of the model of
our health system.” he added. care.
Seven projects were shortlisted to compete Paul Mullaney, Consultant Ophthalmology The other four shortlisted projects were
to be the Overall Winner of the 2016 Health Surgeon, Sligo University Hospital, said he ‘Start Smart’ – Improving the quality of
Service Excellence Awards. Teams repre- was thrilled to win the award. empiric antimicrobial prescribing at Temple
senting the final seven projects attended the “We get a lot of validation from our patients Street Children’s University Hospital, Little
awards ceremony in Farmleigh House in the on a day-to-day basis – and that in many Things (joint submission from Mental Health
Phoenix Park, Dublin. ways is more of an affirmation than winning Division and Communication Division), A
426 projects were entered into the awards an award. Community virtual ward to support older
overall and a longlist of 39 were selected by “But it’s beginning to intrude on my con- persons within the community with complex
our panel to make presentations detailing scious now that this is a validation, this is a health and social care needs, and Family
their projects aims and their main objectives. big thing. Summer Wheelchair Camps.
08 | health matters | summer 2016
Highly
Commended
CHO Area 1 Donegal - Social
Prescribing for Health and
Wellbeing
A structured programme which linked
people with holistic, local, non-clinical projects
and programmes and social supports in their
community in order to improve their health and
wellbeing.
St Vincent’s University Hospital
- Community Medicine for Older Per-
sons Nursing Home Liaison Service
A project established to meet the needs of a
growing number of people requiring long-term
care in both public and private nursing homes. COMMUNITY Epilepsy Outreach Service L to R: Dr Ronan McGinty, Epilepsy Outreach
Service, Cork, Ger O’Donoghue, Clinical Nurse Manager, Cope Foundation and Dr Daniel Costello,
Consultant Neurologist, Cork University Hospital who represented the Community Epilepsy Out-
Office of the Chief Information Of- reach Service, Cork and were announced as the winners of the Popular Choice Award at the Health
ficer, HSE - National Integrated Medi- Service Excellence Awards 2016.
cal Imaging System (NIMIS)
NIMIS connects all public hospitals to enable
closer collaboration between clinicians and
allows secure, electronic sharing of images
between specialists for faster and improved
diagnosis.
CHO Area 8 – Longford/Westmeath
- Transition to Secondary School
Group (for Children attending
SAT or CAMHS services)
A project which prepares children for second-
ary school – they may have a diagnosis such
as autism spectrum disorders, attention deficit
hyperactivity disorder or intellectual disabilities.
South/South West Hospitals Group
MAIN: Ophthalmology Project L to R Back: Grainne McCann, General Manager, Sligo University
- Stroke Rehabilitation & Recovery:
Hospital; Frank Morrison, General Manager, Sligo/Leitrim/ West Cavan PCCC, Brid Brady, Project
collaborative efforts of HSE & Cork Manager, Sligo/Leitrim/ West Cavan PCCC, Darren McAteer, Medical Ophthalmologist, Barry
Stroke Support Group improving McKenna, IT Manager, Sligo General Hospital, Jo Shortt, Senior Project Manager, Sligo General
patient outcomes Hospital,, Paul Mullaney, Ophthalmologist, Sligo General Hospital, Fidelma Kerrins, Clinical Nurse
Manager, Sligo University Hospital who represented the Ophthalmology Service project and were
The Cork Stroke Support Group provides
announced as Overall Best Project at the Health Service Excellence Awards 2016. ABOVE: DG Tony
education, support and social contact for O’Brien presents an awards to the ACS team at the HSE Excellence Awards in Farmleigh House.
people who have experienced stroke and for
their family and friends. The project was initiated
in St Finbarr’s Hospital by the Advanced Nurse
Practitioner in Rehabilitation of the Older Adult.
HEALTH SERVICE EXCELLENCE AWARDS
Safetynet methadone treatment service for SELECTION PANEL
homeless people, Inner City Dublin - Bringing Mary Kemple, School of Nursing, Health Sciences Centre, UCD
methadone treatment to homeless people. Geraldine Smith, HSE Assistant National Director, Internal Audit
This unique inner Dublin city programme has Chris Rudland, Complaints Governance & Learning, Quality Assurance & Verification Division, HSE
increased access to treatment by designing Dr Philip Crowley, National Director, Quality Improvement Division, HSE
services to fit the particular needs of homeless Hilary Dolan, National Co-ordinator, Health Service Excellence Awards
service users rather than requiring them to fit Joan Gallagher, Policy Analyst, Office of the HSE Director General
into the established system. Maureen Browne, Journalist, Editor of Health Manager
Dr Jerome Coffey, National Director, National Cancer Control Programme
CHO Area 3 - Partnership for Health Leo Kearns, CEO, Royal College of Physicians of Ireland
Equity Clinics in Limerick City - safe-
tynet methadone treatment
contact details
A project set up to improve access to primary
For videos on each of the shortlisted
care for marginalised groups locally, including projects, see www.hse.ie/eng/staff/
the homeless, drug users, sex workers, migrants HealthServiceExcellenceAwards/
and refugees.
summer 2016 | health matters | 09
You
Section
Health Service Excellence Awards 2016
Right People, Right Skills
Right Place, Right Time
T
he Ophthalmology Service in
Sligo University Hospital has
joined forces with colleagues
working in the community
to create an improved model of care for
patients
‘Unless we started thinking outside the
box, we were going to be left with a large
waiting list!” said Paul Mullaney, Consultant
Ophthalmology Surgeon, Sligo University
Hospital.
“We had a nearly two-year outpatient
waiting list for general ophthalmology, with
1,500 new patients waiting to be seen,” he
explained: “Traditionally, ophthalmology is The team from Sligo University Hospital/Sligo Leitrim West Cavan CHO Ophthalmology Service who
divided between Surgical Ophthalmologists claimed first prize in the HSE Excellence Awards accepting their trophy from DG Tony O’Brien.
and Medical Ophthalmologists / Community
Ophthalmic Physicians. Surgical Ophthal- tients who have had cataract surgery, thus that patients referred are directly sched-
mologists operate in theatres, while Medical avoiding the requirement for the patient uled into the most appropriate clinic for
Ophthalmologists would do non-surgical to come back to hospital for their review their needs, thus avoiding duplication and
procedures and clinical work. appointment). unnecessary clinic visits.
“Many of the Medical Ophthalmologists Optometrists are focusing on refraction “It has streamlined the Ophthalmology
throughout the country have been spend- eye tests, while Medical Ophthalmologists Service,” said Frank Morrison, General
ing considerable time on what we call have become an integral part of the clinical Manager, Primary Community Continuing
refractions – children’s and adults’ glasses team seeing new referrals from GPs, Public Care, Sligo/ Leitrim/West Cavan. “We have
prescriptions. We reasoned that if we Health Nurses and Optometrists – thus been able to have a proper division – the
were able to bring an Optometrist into the enabling surgeons to focus on surgical/ Ophthalmic Surgeons are able to deal with
service, then we would be able to use the theatre work within the service. the surgical side of things and our Medical
Optometrist to do the glasses prescrip- As a result, 1,400 additional outpatients Ophthalmologists are able to deal with the
tions and that would free up the Medical have been seen in 2015 alone, reducing the medical side. Because of the breakdown
Ophthalmologists to support us in tackling number of patients waiting by 45pc. Moreo- like that, it has allowed for a lot more peo-
outpatient appointments.” ver, the change in focus from the Commu- ple be seen through the system.”
The new model of care from Sligo Univer- nity Ophthalmic Physicians and freeing up “Whenever there’s a change in the organi-
sity Hospital, working in conjunction with the Consultant Surgeons have resulted in sation, there are challenges,” said Fidelma
community health services, has redefined 850 additional day cases within the service. Kerins, CNM 2 (Clinical Nurse Manager)
the pathway of care for patients and The initiative avoided the need to send out with Sligo University Hospital’s Ophthal-
ensured that the role of each specialist is hundreds of patients to the private sector mology Service.
optimised within the service. The initiative last year; the previous cost for this was “We have reduced our general outpatient
builds on the success of the award-win- €750,000. waiting list now to a matter of weeks,
ning Medisoft Project (the introduction of A single waiting list across community which is very respectable. And not having
an ophthalmic electronic patient record, and acute services is nearing completion to send patients out to the private sector
which enables community Optometrists to and a single administrative team will man- – away from their local hospital – is also a
follow-up, in their local practice, those pa- age the referral process. This also means big thing.”
NATIONAL CLINICAL PROGRAMME FOR OPHTHALMOLOGY
The number of people in Ireland with sight loss is projected to increase are to improve cost effectiveness and provide
substantially as the overall population ages. Both Irish and international equitable access to efficient, high-quality care,
data indicate a marked increase in the frequency of blindness and vision supports and treatment. These also include the
impairment with advancing age. development of protocols for patient referral.
The National Clinical Programme for Ophthalmology is working to Over the past year the programme has focused
increase overall capacity and access to specialist services for people with on a joint review with the Primary Care Division on
eye conditions by rebalancing the delivery of care to a more community- Primary Eye Care Services, concluding in the publica-
based model. Ultimately this will result in a reduction of the numbers tion of a report and recommendations for the future delivery of service
being referred to specialist care and reduced waiting times for eye care. in line with the strategy and model of care developed by the National
Key objectives of the programme, led by doctors, nurses and therapists, Clinical Programme for Ophthalmology.
10 | health matters | summer 2016Bringing the service NATIONAL CLINICAL
to the service user PROGRAMME
FOR Epilepsy
S
ometimes the finest ideas Dr Costello and an Epilepsy Registrar, Dr The Epilepsy Care Programme
are the simplest. When Dr Ronan McGinty, visit clients in their resi- has a vision for the transfor-
Daniel Costello, Consultant dential environment and provide ongoing mation of epilepsy care in
Neurologist/Epileptologist at telephone-based care between visits. The Ireland: to provide the best
Cork University Hospital, realised that his service currently visits 10 residential sites patient-centred care for all
patients with intellectual disabilities – who on a rotating basis, and over 200 clients people with epilepsy in the
were also experiencing epilepsy – couldn’t have been assessed to date. The sites are right place, at the right time,
come to him, he decided to go to them run by the HSE’s St Raphael’s, Cope Foun- sharing the best available infor-
“A significant proportion of individu- dation and Brothers of Charity. The service mation People with intellectual disability
als with intellectual disabilities also has succeeded in transforming the quality frequently have the most difficult-to-con-
experience epilepsy, around 30 or 40pc,” of epilepsy care through a radical redesign trol forms of epilepsy. There are particular
explained Dr Daniel Costello. “The more of the care model. needs in this group that require special
severe the intellectual disability, the more Thirty-seven-year-old Clive Condon was consideration.
severe the epilepsy, generally speaking. born with severe brain damage, resulting The Epilepsy Programme is supporting
And, the more severe the intellectual dis- in profound intellectual and physical dis- the development of a coherent and expert
ability, the less likely that someone will be abilities. A resident of the Cope Foundation, outreach service, which vastly improves
able to access epilepsy care. Clive is nonverbal, and can’t move on his the experience of those with intellectual
“Epilepsy care is usually only delivered in own, requiring assistance to perform his disability who otherwise have to attend
acute hospital settings, and it can be very everyday tasks. Clive also has epilepsy. hospital outpatient clinics or alternatively
challenging and distressing for someone Clive’s mother, Eleanor, said that the have limited or no access to specialist
with an intellectual disability to visit the Epilepsy Outreach Service has made a huge epilepsy services. The Epilepsy Programme
hospital. They might not understand why difference to them. “It can be so hard hav- recognises the specific needs of this group
they’re there. Sitting in a waiting room for ing to get an ambulance for Clive to bring and to this end, has representation from a
a long time with people they don’t know him to hospital for his appointments. He’s physician working in the area of intellectual
– they can become very frightened and in an environment with people he doesn’t disability on the governing body of the
anxious. They may not get the care they know. He gets so stressed. This service is a programme, the Clinical Advisory Group.
need because it is too distressing to come miracle.” This ensures that the needs of those with
to hospital.” Michael O’Brien, CNM 1 with the Cope intellectual disabilities who have epilepsy
The Health Service Excellence Awards Foundation, said: “The great aspect of it is are reflected in all core recommendations
Popular Choice winner Community Epilepsy that people can be seen in their home envi- of the programme. The outreach service
Outreach Service, based in Cork, was ronment, without stressing them by taking in Cork University Hospital is replicated in
established in 2014, to provide high-qual- them into an acute hospital. I also have a other areas across the country with outreach
ity specialist care to people with intellec- direct telephone link to a neurologist if one provided to Daughters of Charity and
tual disabilities living in residential care. of our service users is having difficulties.” Cheeverstown.
Dr. Ronan McGinty and Dr. Daniel Costello accepting thier prize from DG Tony O’Brien at the HSE Excellence Awards ceremony in Farmleigh House.
summer 2016 | health matters | 11You
Section
Health Service Excellence Awards 2016
heart attack...
A patients story
From a heart attack to walking 5ks five
times a week, Michael Delorey, from Car-
rick-on-Shannon, Co Leitrim, has seen his
life transformed thanks to the new ACS
programme.
“I have no family history of attacks, I
never smoked and wasn’t a big drinker,
which is why I never thought the chill on
Prof Kieran Daly, Consultant Cardiologist and National Clinical Lead of the ACS programme; Dr Siobhán my shoulders and an unusual taste in my
Jennings, Consultant in Public Health Medicine; and Brendan Cavanagh, ACS Programme Manager.
mouth were symptoms of a heart attack.
Improving treatment
I was putting it down to side effects of
new medication I had started the previous
week,” he explained. But I was feeling
for heart attacks
unwell enough to go to my local GP
surgery, where Dr Trish Noonan ordered
an ECG. I remember when the results of
the ECG came through a few minutes
he Acute Coronary Syndrome reflecting change equally across the
T
later, the doctor started making a flurry of
Programme is ensuring patients country. What’s more, this high level of PPCI
phone calls and I was told I was having a
suffering from a STEMI (major) compares favourably with England (97pc)
heart attack.
heart attack have direct access and Wales (72pc), as does the crude in-
“In a matter of minutes, I was in an am-
to standardised, high-quality hospital mortality rate of 5.9pc.
bulance on the way to the local GAA pitch
services in designated centres around Ireland Emergency Aeromedical Service support
with a Garda escort, where a helicopter
International evidence shows that an is available when a patient is further away
was waiting to take me to Galway Univer-
emergency procedure called Primary than the 90-minute travel window. The EAS
sity Hospital. Once in the helicopter, the
Percutaneous Coronary Intervention (PPCI), helicopter will get many of these patients
crew members introduced themselves, put
also referred to as an angioplasty, is the to a PPCI centre very rapidly. “There are six
a headset on me so we could hear each
most effective treatment for STEMI patients, nominated centres in the country, which have
other, and set me up with a morphine drip
if the PPCI centre can be reached within teams on-call who deal with these patients
as I had started getting pains.
90 minutes of diagnosis. PPCI involves the as they arrive,” explains Professor Kieran
“By the time I got to the hospital in
insertion of a wire into the artery to open it Daly, Clinical Lead for the National Clinical
Galway, the pain was up at around a 6 or 7
using a balloon, to allow blood to flow to the Programme for ACS. “Our new standardised
on a scale of 10. I remember the consult-
heart muscle again. protocols have had a huge impact in terms
ant cardiologist, Dr Briain MacNeill, giving
The Acute Coronary Syndrome (ACS) of early recognition, rapid transfer and rapid
instructions while cutting off my shirt. My
programme has been responsible for PPCI treatment of patients with an acute
heart was beating irregularly
being rolled out nationally and results show a heart attack.”
– and I was given a sedative
major shift towards the treatment of STEMI A novel mechanism for
before getting the electric
patients with PPCI in Ireland, earning them monitoring performance of
shock. An angiogram (an
the runner-up spot in the Health Service the programme has also been
x-ray of blood vessels)
Excellence Awards. set up, known as HeartBeat
was done on my right arm
“In 2011, we had information from most Portal, with PPCI centres
before I went on to have
hospitals which told us that about half recording data on
angioplasty. After one night
of patients were getting a thrombolytic patients brought
in Intensive Care in Galway,
drug to dissolve the clot and the other directly or referred
I was transferred by ambulance
half were having angioplasty,” says Dr from surrounding
to Sligo University Hospital, where I was
Siobhan Jennings, Consultant in Public general hospitals.
attended to by consultant cardiologist, Dr
Health Medicine and Member of the ACS Hence, performance
Donal Murray, who discovered and treated
programme. “Our most recent findings at PPCI centres reflects
a clot in my left ventricle.
show that now 92pc of eligible patients get the hinterland served, the response of the
“I was in hospital for 10 days recuperat-
angioplasty, which is the direct removal National Ambulance Service, as well as the
ing before starting cardiac rehabilitation.
of the clot. This means that with a rapid functioning of the centre.
Before the heart attack I carried a bit of
response to a blockage of the coronary The next set of challenges is to maintain
extra weight and I didn’t really do much
artery, the heart muscle is salvaged – which the service in the existing PPCI centres,
physical activity. Now I walk 5k five times
for patients means a quick removal of the ensure sustainable data collection in all
a week, and I’ve lost weight. I am getting
clot, a quick return home and subsequent centres to assist continuous improvement,
there. The whole process is amazing. It’s a
return to work. It also means a reduction in and finalise full ECG transmission. At the
brilliant service; it works because it saves
the risk of a further heart attack as well as same time, public awareness needs to be
time, bed hours, staff and resources. I was
lower death rates in these patients.” addressed so that people concerned about
only in the bed one night in hospital in
As well as attaining 92pc nationally, acute symptoms call the emergency service
Galway. I have nothing but the height of
high rates of PPCI (angioplasty) have (dial 999 or 112) rather than go to the
praise for the HSE.”
been achieved in all PPCI centres in 2014, nearest hospital.
12 | health matters | summer 2016a virtual ward in the community
Clare Lewis, Clinical Case hours for those on the cusp of a hospital day use by 81pc. This initiative is being
admission; the primary care team, includ- developed by the NMPDU in conjunction
Manager of Ireland’s first
ing the patient’s GP, community nurses, with the RCSI through a clinical academic
Community Virtual Ward for services for older persons, and allied approach – this has been critical to the
Older Persons, explains how the healthcare professionals. introduction of the change in the way care
new model can help change the Each plays a part in assisting the clients is developed, implemented and evaluated
to stay at home longer and avoid hospital to improve quality outcomes for patients,
way people are supported in
admission. including the integration of the Community
primary care setting The initiative has assisted in improv- Virtual Ward electronically aligning with
SE Primary Care Services in ing the quality of life for clients and their the eHealth strategy.”
H
North Dublin worked with the carers, including family members, and When the project was shortlisted as one
gerontology services in Beau- integrated primary and secondary care of the final seven in the Health Service
mont Hospital; Nursing and services in a patient-centred model with Excellence Awards, Clare was delighted.
Midwifery Planning Develop- the Day Hospital for Older Persons Care at “I’m thrilled because this project required
ment Unit Dublin North (NMPDU); and St Joseph’s in Raheny, Dublin as a central no additional resources- it was just about
Royal College of Surgeons Ireland (RCSI), hub. working creatively within the existing re-
to create the country’s first Community Clare explained that the clinical case sources, and looking for models that could
Virtual Ward for older people. “The Com- management service receives referrals work,” she said.
munity Virtual Ward has up to 50 patients from the day hospital, outpatient and inpa- “It’s about prioritising service interven-
who have complex health and social care tient gerontology services, and clients are tion, monitoring and supporting older
needs,” said Clare Lewis, Clinical Case assessed, triaged, and admitted to the vir- people to remain at home. It’s wonderful
Manager. tual ward. This operates on a traffic light to see that it is starting to get recogni-
“The patients live at home and the system of red (high risk), amber (moderate tion because it is very novel and new, and
project is overseen by myself and my risk) and green (low risk). people may not always understand until
colleagues to ensure that they receive “If patients are in the red virtual ward, they actually see the outcomes and the
the services they require during critical pe- then the level of assessment and types of improvements.
riods of illness and/or functional decline. services and monitoring are much higher. “To be recognised at that level has been
“With an increasing aging population, this If they do require a hospital admission, wonderful for us. There has been a lot of
new model was developed to support then the aim is to plan this to bypass the work and research involved to provide a
older people in order for them to remain Emergency Department and admit direct model that works within the existing HSE
at home for longer, to ease the burden on to the specialist gerontology ward. When system and also suits the wishes and
overstretched hospital services and to risk is reduced, the patient is then moved needs of the older people themselves and
reduce the number of unplanned hospital into the amber ward and monitored for their families.
admissions. We aim to provide care of the approximately two to four weeks. Clients “It would be wonderful to get additional
highest quality within existing resources are considered nearing discharge from leadership to roll this project out – it’s a
that meets the patient’s needs during a the service once admitted to the low-risk model that can be used in other care areas
critical event.” (green) category, for continued follow-up also, such as palliative care, for those with
Clare is supported by a multidisciplinary by the primary care team.” mental health difficulties or disabilities.
team, including specialists in gerontology Clare said there have been very good “This is a model that could really help to
and chronic disease management, pallia- outcomes in supporting people at home. change and evolve how we manage people
tive care and hospital bed management; “The number of Emergency Depart- within primary care, and give families
the Emergency Department including the ment admissions within a high-risk group the opportunity to have contact with the
Frailty Intervention Team; the Community and within system resources have been relevant professionals at the right time
Intervention Team who support out of reduced by 87pc with a reduction in bed during that critical period.”
Pictured L- R: Dr Alan Martin, Consultant Geriatrician Beaumont Hospital; Dr Linda Nugent, Lecturer and Programme Director Royal College Surgeons Nursing
and Midwifery; Louise O’Regan, Senior Occupational Therapist; Mary Walshe, Area Manager HSE CHO 9; Clare Lewis, Clinical Case Manager Older Persons;
Eithne Cusack, Area Director Nursing and Midwifery Planning and Development Unit; Joan Naughton, Clinical Nurse Manager St Joseph’s Day Hospital and Ivan
Clancy, Senior Physiotherapist.
summer 2016 | health matters | 13You
Section
Health Service Excellence Awards 2016
Wheelchair-friendly family fun
gives children independence
In 2014, Wanjiru Waweru-Kihara,
I
Clinical Specialist in Paediatric
Occupational Therapy for Louth
Disability Services, felt there
was a need for summer camps
that were accessible to children in wheel-
chairs. She explained how Family Summer
Wheelchair Camps, Co Louth, has helped to
encourage children to enjoy life, have fun and
feel more independent in their wheelchair use.
“In our local community, there are many or-
ganisations that offer children summer camps,
but most of them are not suitable or the facili-
ties are not accessible for children in wheel-
chairs,” explained Wanjiru.
“Child wheelchair-users receive an occupa-
tional therapy service but this can be dreary,
especially if provided in the same format and
facility. Two colleagues, Cathriona Reilly, Siob- wheelchair activities that lead to a healthy
TRANSFORMING LIVES –
han McGee and I sought to find creative ways lifestyle and physical fitness; teach daily living
BUILDING A BETTER HEALTH SERVICE
to revitalise the service by injecting a fun-filled skills such as cooking and shopping; develop
way of meeting clinical goals and adopting a and enhance wheelchair-use skills such as
The HSE’s ‘Transforming Lives’ programme
family-centred approach, a primary vision of wheelchair control; and allow children to have
sees the implementation of a fundamental
the HSE Progressing Disability Services for fun and enjoy being part of activities in the
reform of Disability Services in Ireland. This
Children and Young People Programme. community. “It is so important that the child’s
reform programme is about putting people
We wanted the camp to give these chil- parents and siblings partake in the wheelchair
with disabilities at the centre of service de-
dren ownership, where they feel activities, as this gives them an under-
livery and includes significant change right
it’s their camp, and also include standing of their child and a better
across a range of HSE services, including:
their families, boost their self- appreciation of the frustrations
• Children and Young People’s Disability
esteem and provide a team- and the challenges the wheel-
Services – the reform of these services aims
building experience.” After chair users may feel. It’s a level
to ensure all children and young people
conducting a survey around playing field – everyone’s playing
have one clear referral pathway irrespective
the area and realising that par- the same game from the same
of their disability, where they live or what
ents of wheelchair users were perspective.”
school they attend.
on board with the idea, Wanjiru, Wanjiru said that, since beginning
• Reconfiguring day services for adults
Cathriona and Siobhan approached the project, the team have observed
with a disability to ensure people have the
the local church (Drogheda Presbyterian increased activity participation, mastering
widest choice possible about how to spend
Church), who kindly allowed them to use their of independence skills, increased self-esteem,
their time. Services are moving away from
facilities, providing access to a spacious hall, improved use of wheelchairs and, not to men-
general group-based activities to more
changing room, toilet and kitchen. tion, an increased interest in wheelchair sports
individualised activities that are based in
The Family Summer Wheelchair Camp is held in the area - with the help of the Irish Wheel-
the community and tailored specifically for
for four full days for independent wheelchair chair Association, the parents have organised
the person and their particular interests
users (manual and powered) aged 4-18 years various wheelchair-based activities. She said
and likes.
old and their families, and the daily attendance being shortlisted to the final seven projects
• Moving away from an institutional
ranges from 35-45 participants. Activities in the Health Service Excellence Awards was
model of service to one where people
include wheelchair basketball, wheelchair ‘surreal and a big achievement in itself’.
with a disability live in the community with
dancing, javelin, wheelchair races and many “ I feel like we have already won because we
choices about where they live, who they live
more. The camp team has now expanded to are able to showcase what we do and hopefully
with and how they spend their time.
include other members of the MDT (multidisci- people in other regions who don’t have these
• The Transforming Lives Programme is
plinary team), such as a physiotherapist, social kinds of facilities will be spurred onto replicate
committed to continuous improvement
workers and mobility service managers. Go our idea on a national level – that would be the
in HSE services, engaging and involving
Kids Go!, a UK-based charity organisation, also greatest achievement of all,” she said.
service users, their families and advocates,
comes to help teach children wheelchair skills,
and working in partnership with disabil-
while adult wheelchair users, Nicola McDonell,
ity service providers and representative
Patrick McNeary and Owen Mullen, regularly
TOP: Aidan McKevitt playing with his two sons organisations to ensure that people with
visit to share their own experiences with the
Aaron and Nathan. INSET: Wanjiru Waweru-Kihara, disabilities are empowered to live ordinary
children, to motivate and inspire them. Occupational Therapist, making a smoothie with lives within their own communities.
Wanjiru said: “Our main goals are to teach Beni Shamavu and Aaron Morgan.
14 | health matters | summer 2016How do you change an
embedded culture?
or Dr Rob Cunney, Con- actly what it says on the tin: getting the
F
sultant Microbiologist people who work on the frontline, who
at Temple Street are actually prescribing antibiotics, to
Children’s University take ownership of the problem, and
Hospital, and Michelle come up with solutions. Smart Start, Temple Street: Michelle Kirrane, Senior
Kirrane, Senior Clinical Pharmacist “One key to success was that we Clinical Pharmacist and Dr Rob Cunney, Consultant
(paediatric and antimicrobial), Temple came up with a way of measuring how Microbiologist of Temple Street Children’s Universi-
ty Hospital who represented the Smart Start project
Street, it’s about face-to-face engage- well people were doing in terms of follow- for improving empiric antimicrobial prescribing at
ment with frontline staff and promoting better ing the guidelines, and then we fed that informa- the Health Service Excellence Awards 2016.
outcomes. tion back to the prescribers themselves every
Rob and Michelle spearheaded the Smart Start week at the Monday morning medical handover and the ICU were given access to quick reference
initiative at Temple Street to raise compliance meeting. “That started to get people engaged cards so that medication prescribed could be
with antibiotic prescribing guidelines for children – realising this is actually our data, our prescrib- checked easily and they could provide further
admitted via the Emergency Department. ing habits that we’re looking at. After a couple of feedback to prescribers.
From January to March last year, the pair, weeks, from people seeing the data every week, The true success of the initiative is that the
working with disciplines across the hospital, they started to ask, how are we doing? And change has been permanent – compliance has
were able to raise compliance from 30pc to that’s when Michelle and I knew we had them stayed at 100 pc since March 2015.
100pc. Infection is the most common reason hooked.” “This is tremendous because it indicates that
that children are admitted to hospital, and it is The prescribers’ competitive nature kicked there’s actually been a culture change. We’ve
crucial that children who have infections requir- in, explained Michelle. “Everyone wanted to had to do very little to keep it going. In that time-
ing antibiotics get the right drug at the right dose achieve 100pc.” Some new elements that were frame there have been three changeovers of
– to ensure a speedy recovery, while reducing the introduced, based on ideas from frontline staff, junior doctors and yet they’re all following the
risk of drug side effects and antibiotic resistance. included making updates to prescribing guide- guidelines, using the reminder cards, because
“We found that a lot of times antibiotics were lines more easily available, guideline summary that’s the way things are done here now.We’ve
not being prescribed in line with the guidelines,” cards attached to ID badges, and guideline sum- also seen secondary benefits. We knocked about
explained Rob. “So, we decided to take an ap- maries at the point of prescribing. Nursing staff €105,000 off of the antibiotics budget for last
proach called ‘frontline ownership’. This is ex- in the Emergency Department, Neonatal Ward, year,” explained Rob.
little things changed shape and role of mental health sector
Little Things is a positive mental health campaign, created by the HSE Mental increase in calls to the Samaritans and
Health Division’s National Office for Suicide Prevention, the HSE Communica- almost 40pc of respondents said they
tions Division and 32 partner organisations, which aims to promote positive did something with the intention of
mental health. looking after their mental health. “Part
“According to the World Health Organisation, approximately one in four of the success of Little Things is thanks
people will experience a mental health difficulty,” said Gerry Raleigh, Director, to the involvement of our partner
HSE’s National Office for Suicide Prevention. “However, every single one of us organisations, such as the GAA,
will experience dips in our mental health, it is part of being human. We created Samaritans, Suicide or Survive, Mental
this campaign to answer two key questions that we all need the answers to in Health Ireland, the ISPCC, SpunOut.ie
order to be able to look after our mental health and support those we care and Alcohol Action Ireland, who have
about, ‘What can I do?’ and ‘Where can I go?’. spread the campaign’s message,” said
“The Little Things campaign is designed to change the shape and tone of the Kahlil.
mental health and suicide prevention sector by encouraging everyone to work Kirsten Connolly, the HSE Deputy Director of Communications, described the
together and solve a major signposting issue for the public.” impact of the campaign for the public. “Our research clearly showed that know-
Kahlil Coyle, Little Things Campaign Manager, explained: “The #littlethings ing where to turn and what to do when experiencing a mental health dip for
campaign highlights that we all experience difficult times in our lives, and that yourself or a loved one could be confusing and was unclear for many people.
when we do, there are evidence-based things that can make a big difference to We sought to make the pathway to information, services and support clear, with
how we feel. These include talking about our problems, connecting with others, a new website yourmentalhealth.ie and the single contact number, 116 123,
drinking less alcohol, sleeping and eating well and exercising regularly – the provided by the Samaritans.
key is doing these with the intention of it being good for our mental health.” “Thanks to the support of the many partner organisations, the experience for
The Little Things campaign features the lived experience of Robert, Alan, Una the public around accessing clear and trusted information on mental health is
and Gary, who have shared their experience of life’s storms and what worked now easier for those who need it. We are very grateful for all the support and
for them in getting through tough times. Their stories have been animated and collective working that got us here and it’s great to see that recognised in the
recorded into TV and radio adverts and have been widely shared nationwide. nomination for a Health Service Excellence Award.”
Since the start of the campaign, the response has been very positive. your- For more information on the Little Things Campaign, visit
mentalhealth.ie has received more than 280,000 visitors; there has been a 20pc www.yourmentalhealth.ie
summer 2016 | health matters | 15You can also read
