Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District

 
Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Looking forward
        to 2021
  Strategic Plan for
Hunter New England
Local Health District
                        1
Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Foreword
The development of the Strategic Plan provides an opportunity to re-focus service delivery and
plan for the future health needs of our District. Our staff provide innovative, safe and high
quality care to a diverse population over a large geographical area. To meet to the challenges
of the future, we are firmly committed to providing a safe and quality care experience,
delivering best practice care and making the best use of our resources.
Hunter New England is focussed on improving the effectiveness and efficiency of our hospital
based services and ensuring that our community receives care in the most appropriate setting,
be that hospital, in the community or in their home.
We will continue to focus on Excellence, every patient, every time to ensure the standard of
care is consistent across all of our services. We are focussed on delivering the Premier’s
priority of Patient Safety First, through our local Patient Safety and Quality strategies. We
recognise the efficiencies and better standards of care that can be gained through the rollout
of the Leading Better Value Care models of care, and are committed to delivering these to the
identified patient cohorts and working closely with our partners to ensure the care delivered is
truly integrated.
Delivering high quality care within budget has been achieved with pride by Hunter New
England LHD over many years. However, it is clear we must be using our resources wisely in
order to meet increasing demand. Sustaining the health workforce, particularly in rural areas
remains a major challenge, along with the need to support all staff in maintaining their own
health and well being.
We are consistently focused on ensuring that our patients receive safe and high quality
healthcare delivered with respect, supported by open two-way communication. Continuing to
create this culture within the organisation is one of our key focus areas.
Our shared vision is build a healthier communities and provide world class care. Our priorities
are to ensure we deliver value as well as volume, we work together to minimise unwarranted
clinical variation, and we seek continuous improvement of our health services which are needs
-based and provide safe, high quality and high value care for patients.

    Michael DiRienzo                                                                                              Lyn Fragar
      Chief Executive                                                                                        Chair Hunter New
                                                                                                            England LHD Board

  This work is copyright. It may be reproduced in whole or part for study or training purposes subject to inclusion of an acknowledgement of the
  source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written
  permission from Hunter New England Local Health District.

  © Hunter New England Local Health District, 2018

  Content within this publication was accurate at the time of publication May 2018

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
About Us
Hunter New England Local Health District (HNE Health) provides a range of public health services to the
Hunter, New England and Lower Mid North Coast regions.
Hunter New England is recognised as a leader in the healthcare industry and we pride ourselves on the
following strengths:
    High quality, safe patient care
    Skilled, hard working and valued staff
    A strong commitment to improving the health and wellbeing of Aboriginal and Torres Strait
     Islander people
    A dedicated Aboriginal Employment and Equity Unit
    The best immunisation rates in the state
    Highly developed telehealth and information technology services
    Expertise in health promotion and prevention
    A focus on innovation, teaching and research
    Successful strategies to improve staff safety
    Effective models of community participation

                                       Hunter New England Local Health District provides services to:
                          920,370 people, including 52,990 Aboriginal and Torres Strait Islander people
                                                            169,846 residents who were born overseas
                                                                                     Our organisation:
                                                                                   employs 16,033 staff
                                                                      is supported by 1,600 volunteers
                                                                      spans 25 local government areas
                                                                                  Our services include:
                                                                            3 tertiary referral hospitals
                                                                               4 rural referral hospitals
                                                                                    12 District hospitals
                                                                                 8 community hospitals
                                                                              12 multipurpose services
                                                              More than 60 community health services
                                                                7 inpatient mental health facilities plus
                                                                     community mental health services
                                                                        3 residential aged care services

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
one day in Hunter New England

                            1,124                                               181
  people visit an Emergency Department in               people have surgery in our district
                               our district
                                                5 people have a life threatening condition
                  211 arrive by ambulance               requiring surgery within one hour
            4 require immediate treatment           99 are considered urgent and require
                                                                  surgery within 72 hours
621 are triaged by a clinician as not urgent
        741 are discharged to their home                 81 people have elective surgery
   11.4% are Aboriginal or Torres Strait        99.4% of people receive elective surgery
                                                       within the clinically recommended
                                    Islander
                                                       timeframe

                                                                            16,608
                                                      staff are employed to deliver hospital and
       619 are discharged from one of our                            community based services
                                   hospitals                               8,326 are Nurses
     10.4% are Aboriginal or Torres Strait                             2,040 are Medical Staff
                                    Islander
                                                            739 are Visiting Medical Officers
     18 non admitted patients receive care
                            using telehealth             1,815 are Allied Health Professionals
5,725 non admitted patients receive care                     1,428 are Clinical Support Staff
in an outpatient clinic, community centre or             3,130 are Corporate or Support Staff
                              in their home
      1,727 visit one of our facilities for a                              761 staff identify as
  diagnostic test, for example pathology or
                                                                                   Aboriginal or
                                   imaging
                                                                           Torres Strait Islander
          24 babies are born in our district

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Future Developments
Clinical Capacity                                  Information, Communication and
HNELHD will continue to prioritise on capital      Technology
improvement of our facilities to meet current      The last four years have seen rapid change in
and future health demands of our community.        the way technology is used within the clinical
Over the next four years, the following            environment. Our priority has been the
additional clinical capacity will open in our      establishment of clinical systems which
facilities:                                        optimise best practice care, patient safety
     An additional operating theatre for          and enhance communication and access to
      Belmont Hospital, Cessnock Hospital and      information for clinicians. Our major
      Armidale Hospital                            achievements in this area are the
     An additional 6 beds in the Acute General    implementation of the Electronic Record for
      Surgical Unit at John Hunter Hospital        Intensive Care (ERIC) system, completion of
     Additional renal chairs in Moree,            the wireless infrastructure in all facilities, and
      Muswellbrook, Manning, Inverell and          implementation of the electronic medication
      Singleton Hospitals                          management system (MedChart).
     Additional Chemotherapy chairs for           Over the next three years, the
      Muswellbrook and Manning                     implementation of the a new electronic
     Increase in the number of Neonatal           medical record system known as eChart
      Intensive Care cots at John Hunter           across the district will be our major focus.
      Children's Hospital                          eChart is a digital observation, assessment,
                                                   risk scoring and alerting tool. The rollout of
Upgrade of facilities
                                                   eChart will commence at The Maitland
Our District and the community will benefit from   Hospital and John Hunter Hospital. eChart is
the following major projects which are currently   supported by eHealth NSW as the part of the
in the early stages of planning and development:   Electronic Medical Record (EMR) Connect
    Second entry and exit to John Hunter          Programme.
     Hospital via the Newcastle Inner City
     Bypass which is due to
     commence work in 2019
    The New Maitland Hospital
    Health One Port Stephens
    Murrurundi MPS
    Inverell Hospital
    Clinical services plan for John
     Hunter Campus
    Refurbishment of the Nexus Unit
     at John Hunter Hospital

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Looking Forward                                         Clinical Quality and
Patient Safety                                             Patient Safety
Providing excellent care for every patient, every           Framework
time remains at the centre of everything we do.
We consistently focus on ensuring that our          Our Aims
patients receive safe and high quality healthcare
delivered with respect and supported by open        To ensure systems necessary to promote
communication. The key to embedding this            quality and safe patient outcomes are
culture is our staff, and we continue to work       embedded across the Local Health District
together to embed Excellence in our
organisation.                                       To support facilities to implement the
Our organisation will work with patients and        Australian Commission on Safety and
carers to ensure we focus on delivering care        Quality in Healthcare— National Safety and
which they value. We will work together to          Quality Health Service Standards
reduce harm and provide our community with
reliable, effective and patient-centred             To align with the Hunter New England Local
governance to manage variation in clinical          Health District Excellence Framework
treatment and adverse outcomes.
As an organisation we are not complacent, we        Our Plans
seek continuous improvement of our health           The Hunter New England Local Health
services which are needs-based and provide          District Clinical Quality and Patient Safety
safe, high quality and high value care for          Strategic priorities align with the NSW
patients.                                           Health Strategic Directions.

Through our commitment to Better Value Care
                                                    These align with :
and Patient Safety First initiatives we will work
                                                        Priority areas of the NSW Health
together with our patients, families and
                                                         Pillars—Clinical Excellence
communities to focus on the outcomes that are
                                                         Commission, Bureau of Health
most important to our patients.
                                                         Information, Health Education and
Unfortunately, despite our best efforts                  Training Institute and the Agency for
sometimes things go wrong. We are an                     Clinical Innovation
organisation that learns from its mistakes, and         System Purchasing and Performance
welcomes constructive feedback from our                  Safety and Quality Framework
patients and carers. HNELHD will continue to            Leading Better Value Care and Patient
prioritise improvement in our safety                     Safety First Initiatives
performance in order to reduce healthcare
related harm to our patients.

                                                                                                   6
Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Patient Safety and Quality Framework
                                      Core Components:
 Patient Experience Clinical Performance  Clinical Review Incident and Adverse Event
      Management  National Standards Improvement Programs  Nutrition care
                     Professional Practice Exception Reporting

The Hunter New England Local Health District Clinical Quality and Patient Safety Framework op-
 erates in accordance with the NSW Patient Safety and Clinical Quality Program (PD2008_608)

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Patient Care
Essentials

Hourly patient
rounding
Care Boards
HAIDET/ISBAR
Bedside Clinical
Handover
Follow Up Phone Calls

Excellence Tools &
Tactics
                        Patient-Centred Care
                        Our key priority at Hunter New England Health is to ensure the patient
Leader rounding with
                        and their family is at the centre of the care we provide. Our goal is to
staff and patients
                        acknowledge their care goals and provide them with a positive
Traffic Light reports
                        experience in our services.
Service rounding
90 Day Action Plans     A patient story:
Management              A mental health consumer who engaged with our service for the first
Accountability          time is one example of the patient-centred care we provide.
Meetings (MAMs)
                        The consumer has a diagnosed long term, chronic psychiatric illness. He
Performance
                        had not engaged in active treatment for over 20 years due to distrust of
Development Review
                        the system. He came to our service during an acute phase of illness. He
Key Words
                        was unwilling to be medicated for his condition due to side effects.
Managing Up
                        Working together, the consumer and his family, their care team and
Values Charter
                        their GP developed a care plan, which included monthly psychological
Standards of
                        therapy and routine review by a psychiatrist.
Behaviour
Speaking Up             The patient’s desire to avoid medication was acknowledged and
Code of Conduct         respected by his treating team. The consumer now enjoys an active and
High Middle Low         independent life with his family, and is able to complete routine daily
performance             functions such as going to the bank, attending medical and dental
conversations           appointment, eating out, maintaining good personal hygiene and has
30 and 90 day           even embarked on international travel.
conversations for new   Like our other services, HNE Mental Health Services is committed to
staff                   improving patient experience. The number of compliments received
Skills Lab              tripled in 2016, compared to the previous year. The compliments
Patient Experience      acknowledge the services commitment to the Excellence program,
Tracker System (PETS)   improved communication and improved acknowledgement of the
                        patient’s care goals in their treatment.
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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Looking Forward
Patient Experience
There is evidence that engaging consumers in shared decision making about their own health care
results in a better experience, improves outcomes and reduces costs, as people tend to choose less
costly interventions. Patient Reported Outcome Measures (PROMs) and Patient Reported Experience
Measures (PREMs) used at the point of care improve communication and shared decision making
between consumers and providers .
PREMs and PROMs are not yet routinely used in Australia as part of workflows in clinical practice for
shared decision making. To encourage greater use of patient reported measures, the Australian
Department of Health is developing new indicators in the Australian Health Performance Framework
to measure effectiveness of care (PROMs), appropriateness of care (PREMs) and safety of care
(PRIMs). The Australian Commission on Safety and Quality in Health Care (ACSQHC) is developing a
national framework and resources to encourage the use PROMs.
NSW Health is currently developing a State vision for patient reported measures to support the
provision of value-based health care, centred on what matters most to patients, including the
introduction of an integrated information system to support the inclusion of PREMs and PROMs in
care delivery and service improvement. The ACI will offer a standardised approach to collecting
PROMs and PREMs across NSW Health settings and will offer change, adoption and implementation
support.
In this context, HNE LHD is firmly committed to increasing its systematic use of PROMs and PREMs.
Already HNELHD services participate in the national registries such as the Mental Health Outcomes
and Assessment Tools (MH-OAT) the Palliative Care Outcomes Collaboration (PCOC) and the electronic
Persistent Pain Outcomes Collaboration (ePPOC).
As well as these national and state programs, HNE LHD has unique PREMs and PROMs programs and
projects that provide important information from the consumer perspective. The HNE LHD program
with the largest volume of systematically collected PROM data is Follow Up Phone Calls. This data
informs services about the safety and effectiveness of transitions of care measured from the consumer
perspective.
It’s worth noting that to participate in shared decision making people need to have a level of health
literacy that enables them to understand and act on the information being discussed. People with low
health literacy are disproportionately elderly, non-white, less educated and chronically ill and have a
death rate that is twice that of people with adequate health literacy. With 60% of Australians and up
to 80% of those aged over 65years having low health literacy, PREMs and PROMs programs need to
incorporate consideration for health literacy in order to ensure equity and improve outcomes for all
consumers. HNELHD is home to over 23% of the NSW Aboriginal and Torres Strait Islander population,
so all PROMs and PREMs need to be tailored for cultural appropriateness for Aboriginal and Torres
Strait Islander people.

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Looking forward to 2021 - Strategic Plan for Hunter New England Local Health District
Looking Forward                                                         How do we support our
                                                                        workforce?
Research and Innovation
                                                                        Supporting Positive Workplaces
HNELHD is proud to support innovative health system
                                                                         Workplace Harmony
improvement through its Partnerships, Innovation and Research
                                                                          Framework
Portfolio, including the Health Research Translation Centre,
                                                                         Respectful Workplace
Integrated Care Team, Research Ethics and Governance Office and
Hunter New England Simulation Centre. Each year dozens of
                                                                        Staff Development
teams receive Executive sponsorship, financial support, education,
                                                                         Corporate and local
coaching and mentoring to conduct studies and implement
                                                                           Orientation
projects that improve patient safety, quality of care, and health
                                                                         My Health Learning
system performance.
                                                                         Capability Frameworks
HNELHD is proud to be a founding partner of the NSW Regional             HNE Health Education
Health Partners Centre for Innovation in Regional Health.                  Framework
Accredited by the National Health and Medical Research Council,          Leadership and Management
NSW Regional Health Partners brings together the leading health            Development
and research organisations across the Hunter, New England,               Clinical and non-clinical skills
Central Coast and Mid North Coast regions of NSW to transform              development
the delivery of health care to regional, rural and remote Australia.     Tailored Education Solutions
Together, we intend to:
     Address the major health care challenges faced by our             Career Pathways
      regional, rural and remote NSW populations, by setting and         Allied Health cadetships
      maintaining a focus on strategic, priority-driven translational    School Based Trainees
      research and research translation relevant to the needs of         Prevocational Junior Medical
      the populations we serve.                                           Officer Program
                                                                         Hospital Skills Program
     Provide our regional communities with access to best-
                                                                         Centre for Medical
      evidence healthcare built on a foundation of discovery,
                                                                          Professional Development
      innovation, rigorous implementation and evaluation, by
                                                                         International Medical
      working in partnership to accelerate the pathway from
                                                                          Graduate Program
      scientific discovery and medical innovation to clinical
                                                                         Rural Nurse Exchange
      application and community benefit.
                                                                          Program
     Transform the health and wellbeing of our regional, rural          Specialty Training Programs
      and remote NSW population, by providing support and                Rural Specialty Training
      facilitate measurable improvements in the health care               Programs
      system and apply academic rigor to both prevent disease
      and to improve the patient journey                                Diversity and Equity
     Maintain sustainable delivery of the healthcare in our             Aboriginal Employment

      region, by working in partnership to promote high-value              Strategy
      healthcare that aims to improve care quality, equality,            Aboriginal Cultural Respect

      efficiency, value for money, and to close gaps in health and         Education Program
      wellbeing, especially for Aboriginal and Torres Strait Islander    Disability Action Plan

      people.
                                                                                                         10
Looking Forward
Our Staff
Our staff are pivotal to the quality of services we provide. HNE is invested in creating a workplace
culture that ensures quality patient experiences and outcomes, fosters a harmonious and equitable
workforce, and supports staff reaching their full potential.
Meet Edwina Sharrock. She wears many hats while on the job at Hunter New England Health,
including Aged Care Clinical Nurse Consultant with Tamworth Hospital Emergency Department and
Disaster Coordinator with the District’s Disaster Management Unit.
She’s also a childbirth educator, keynote speaker, volunteer, wife and mother to two young children.
“I was born and bred in Tamworth and I think this has really made me very passionate about healthy
communities. And focused on getting young people to stay in rural and regional communities. In some
rural communities there is a lack of access, equality and healthcare. If you don’t have those things
then you don’t have a real community. I believe great health services are critical for developing and
growing strong, healthy communities.
“I obtained my Registered Nursing and Midwifery degrees from the University of Sydney and Charles
Sturt University, before joining Hunter New England Health in 2007 as a midwifery student in
Tamworth.
“I moved back to Tamworth in 2006 when my Dad was unwell. I never pictured myself back in the
country yet now I absolutely love living in a vibrant rural community. In my past role at Tamworth
Hospital, I provided specific care to the elderly who presented at the Emergency Department from aged
care facilities. I’m particularly interested in advanced care planning for elderly Australians…I considered
it a privilege to support those within my care to die with dignity and in peace.
“When people hear that I am a Disaster Coordinator, they think I spend a lot of time with emergency
services running disaster exercises in our hospitals. This is partially true (and lots of fun) however there
is a large amount of planning, revision and policy work involved in this role.
“During my career with HNE Health, I have learned so much from mentors and incredible leaders and
have made the most of the professional development opportunities that have come my way. I am
                                                                about to complete Course 23 of the
                                                                Australian Rural Leadership Program
                                                                (ARLP). This focuses on developing
                                                                leaders who have a genuine
                                                                commitment for ‘greater good’ in
                                                                rural, regional and remote Australia.
                                                                      “One of the greatest things I have
                                                                      learned is the difference between a
                                                                      good manager and a leader, and
                                                                      how this can impact a team. I’ve
                                                                      always tried to say yes to each
                                                                      opportunity that’s presented itself
                                                                      because you never know what will
                                                                      happen if you don’t give it a go."  11
OUR ENABLERS
Excellence for every patient, every time is the ultimate goal of Hunter New England Local
Health District (HNELHD).
Put simply it’s about providing consistent, quality communication and consistent, quality
clinical care for all of our patients all of the time.
As a large District, it’s challenging to provide excellent care for every patient, every time.
Part of overcoming this challenge is getting everyone across the organisation on board and
moving in the same direction, making sure everyone hears the same message, knows what
they need to do and why they need to do it, and are armed with the necessary tools and
strategies to provide excellent service, every time.
Comprehensively implementing the tools and tactics is a key strategy in each facility's
operational plan and in every leader’s individual 90 day action plan.
Patients at our hospitals can now expect that:
     all health professionals involved in their care will introduce themselves
     They will be visited by a nurse every hour and see the nurse unit manager checking in with
      patients on the ward from time to time
     They will contribute to their own plan of care, have their family involved, and see key elements
      for the care plan on the care board above the bed
     They can expect to be involved in the clinical handover meetings between care professionals and
      know that when they leave they will be called 24 hours after discharge, just to see that they’re
      home safely and they’re clear on important information about medication and future
      appointments.
As well as checking on patients, leaders catch up with staff. Known as rounding, it provides an
opportunity to discuss what’s working well, ensure staff have the tools they need to do their job and
in essence make sure that our District is meeting their expectations.
Properly embedding these tools and tactics demonstrates to our staff that we’re committed to
Excellence, helps them see how they fit into the bigger picture and lets them know that they are
helping deliver the best possible experience and outcomes for our patients.
For patients, Excellence confirms that they sit squarely at the centre of their own care.
Our Board, Executive Leadership Team and leaders across the District are committed to accomplishing
Excellence by consistently applying evidence-base leadership practices and standards of care.
The full adoption of tools and tactics of Excellence will take a cultural shift and time to completely
embed, but we are committed to achieving this goal.

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13
Integrated Care Alliance
HNELHD and the Hunter New England Central Coast Primary Health Network are two

                                                                                               OUR ENABLERS
organisations united by a common wish to transform and improve our health system in
line with the Quadruple Aim; improving the health of populations, enhancing the
experience of care for individuals, reducing the per capita cost of health care, and
improving the work life of health care providers.
In 2018 the two organisations formed a new Integrated Care Alliance aimed at working
together to:
    deliver innovative, locally relevant solutions that measurably improve the health
     outcomes of our communities
    cooperate, collaborate and communicate with our partners to meet agreed health
     needs
Elements of this Alliance include:
    A formal agreement to work in Alliance
    An agreed way of prioritising and planning integrated care work together in an
     annual cycle.
    Holding ourselves accountable through a regular Integrated Care Alliance Executive
     meeting.
    Agreed ways of involving clinicians, such as HNELHD Networks/Streams and PHN
     Clinical Councils.
    Agreed ways of involving patients and families, such as PHN Consumer Advisory
     Councils and LHD Local Health Committees/Family Advisory Councils and use of our
     consumer knowledge portal: patientinfo.org.au.

Health Pathways Program
HealthPathways is an online health information and referral portal for primary care and hospital
clinicians, to be used at the point of care. It provides information on how to assess and manage medical
conditions, and how to refer patients to the next clinician in the most timely way.
HealthPathways is a dynamic collaboration between local clinicians, supported by HNE Local Health
District and HNECC Primary Health Network. The program comprises four interdependent elements:
     Community HealthPathways (hne.healthpathways.org.au) aimed at General Practitioners and
      Practice Nurses
     Hospital HealthPathways – to be launched in mid-2018 - aimed at Junior Medical Officers and GP/
      Visiting Medical Officers
     PatientInfo.org.au aimed at patients and families
     Smart eReferral – supporting electronic referrals based on agreed clinical referral pathways and
      content sources from the healthpathways portals

                                                                                                              14
OUR ENABBLERS
Telehealth
Telehealth is fundamental to improving access to services for our community and reducing
the impact of our large geographical area on our patients and their families. We will
continue to promote the use of telehealth in delivery of clinical services and administrative
services and provide the best opportunity for telehealth to be utilised by clinicians as part
of their everyday business.

Digital Clinical Information Systems
MedChart
Medchart Electronic Prescribing and Medications Administration implementation will
continue across the District in 2018/19. The acute hospitals Tamworth, Manning, Armidale
and Calvary Mater will be prioritised followed by cluster based deployments to the smaller
facilities. Upgrades to the software enabling IV infusions and outpatient prescribing will
undergo a HNE quality and safety assessment. Assuming the new capability meets HNE
requirements, an implementation plan will be developed for a 2nd phase implementation.
A feasibility assessment has been commissioned to establish Medchart as the primary
clinical information system for the recording of patient drug reactions and drug
sensitivities to improve the quality of information recorded and make it more accessible
for clinicians. Pending the outcome of the feasibility assessment, this work is expected to
proceed to implementation in 2018/19.

eCHART
eChart is a digital observation, assessment, risk scoring and alerting tool. The HNE
implementation commences with vital signs documentation and Between The Flags
protocols as well as a range of clinical assessments and recording of hourly patient
rounding. HNE will adopt eChart as the multidisciplinary clinical documentation tool in the
inpatient, emergency and outpatient settings. This work will be multi-staged and is
supported by eHealth NSW as part of the EMR Connect Programme.
eChart implementation will commence at Maitland hospital followed by John Hunter and
then a District wide implementation plan similar to Medchart and CAP eOrders will occur.
Ward level go-live support using Clinical Nurse Educators has been a key success factor in
transitioning to electronic workflows and will be adopted for the eChart implementation.
A parallel implementation planning study (IPS) will scope mental health inpatient clinical
documentation requirements necessary to achieve Mental Health Outcomes and
Assessment Tool compliance.
The implementation program is a vital component is our journey towards a District wide
Electronic Medical Record (EMR).

                                                                                                                15
CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience   16
17
18
1.1 Deliver disease prevention, early
                                intervention and health promotion across the lifespan
What will success look like in 2021?
For our patients, families and community

      Maintenance of high levels of immunisation, for Aboriginal and non Aboriginal infants and children

      Improved access to preventative care addressing lifestyle risk factors including smoking, obesity, alcohol consump-
       tion, poor diet and low physical activity

      More people with Hepatitis C treated for their condition

For our people serving the health needs of Hunter New England

      Providing services which make a difference to the health of the community

      Enhanced ability to promote healthy eating and physical activity by community organisations

      Greater investment in preventative health and health promotion

      Focus on wellness and keeping people out of hospital

 Continue implementation of the NSW Hepatitis C Strategy 2014-2020

                                                                                                                   COMMUNITY
 Continue implementation of the NSW HIV Strategy 2016-2020

 Improve infant and child immunisation rates in low coverage areas

 Improve participation in preventative care and health promotion initiatives

 Improve health outcomes for people with complex obesity

 Implement innovation strategies to reduce childhood obesity

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                       19
1.2 Support a healthy start to life

What will success look like in 2021?
For our patients, families and community

      More babies being breastfed on discharge

      More children being immunised at 1 and 4 years of age

      Parents and carers being assisted and supported by clinicians to find the right service,
       at the right time for their children and family

For our people serving the health needs of Hunter New England

      Providing services which make a difference to the health of the community

      Greater investment in preventative health and health promotion

      Focus on wellness and keeping people of out of hospital

                                                                                                           COMMUNITY
 Continue implementation of NSW Kids and Families Healthy + Safe + Well Strategic
 Health Plan 2014-2024

 Improve the health of women during pregnancy through promotion of the
       Get Healthy in Pregnancy program to all women (including healthy diet, healthy
        weight, physical activity and no alcohol consumption)
       Quit for new life program (smoking cessation during pregnancy)
       Australian Clinical Practice Guidelines on Antenatal Care

 Improve health outcomes for mothers and babies through promotion of the Baby
 Friendly Hospitals Initiative, 10 steps to promoting breastfeeding on discharge

 Focus on improving integration of services delivered during early childhood (first
 2,000 days) to improve long term health outcomes

 Use contemporary methods to improve the engagement of young people and families
 early in our services to improve health and well being outcomes

 Follow the Child Wellbeing and Child Protection—NSW Interagency Guidelines to pro-
 tect and improve the well being vulnerable children and young people
CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience               20
Youth Engagement Service (YES)               NICView brings NICU families together
A partnership between Children, Young        An innovative webcam system
People and Families and Child and            installed at John Hunter Children’s
Adolescent Mental Health to proactively      Hospital’s new Neonatal Intensive
                                             Care unit will bring families closer to
respond to and address the needs of
                                             newborn infants in the unit.
young people with complex health, mental
health, behavioural, trauma-related and/     NICView allows families of newborn
                                             babies in NICU to view and connect
or social needs.
                                             at any time by logging into a secure
The service aims to:                         web-based service from any
 Reduce frequent representations to         location, removing the barrier of
   emergency departments for                 distance for families not able to visit
   adolescents/young people with             the hospital and stay with their
                                             baby.
   significant behavioural or psychosocial
   issues where there is no medical need     Separation from newborns often
                                             causes distress for new parents and
   for admission
                                             families. This technology aims to
 Reduce unwarranted hospital                bridge a gap for families at a
   admission for adolescents/young           difficult time. To date, 32 families
   people                                    have benefited from this innovation
 Reduce behavioural issues whilst in        since its introduction in 2017. The
                                             uptake and feedback from parents
   hospital which reduce engagement in
                                             and families has been positive, there
   care plans, pose safety risks to self,    were 2,000 instances of use over a
   staff and carers, and result in           12 day period from all over Australia
   increased supervision or sedation         and logins from as far as UK, Spain
 Reduce the number of young people          and Indonesia.
   disengaging from care during transition   .

                                                                                       21
1.3 Empower communities to engage as
                                      partners in health and reduce health disadvantage
What will success look like in 2021?
For our patients, families and community

      Improved understanding of health information

      Useful information which is empowering

      Improved quality of life

      Access to the right service at the right time for people with a disability

 For our people serving the health needs of Hunter New England

       Focus on managing health and keeping people of out of hospital

       Being able to provide patients and families with information which enables them to partner in decisions about
        their care

 Work with other providers, partners and communities to improve access and health

                                                                                                                  COMMUNITY
 outcomes through integrated service delivery

 Work with Local Health Committees to maximise opportunities for the promotion and
 enhancement of the health of the community

 Respond to impacts of the National Disability Insurance Scheme to improve out-
 comes for people with a disability

 Implement the Disability Inclusion Action Plan

 Improve the health literacy environment through spreading the lessons learnt from
 the Empowering patients on discharge project

 Identify and implement strategies from the whole of government framework “It stops
 here: standing together to end domestic and family violence in NSW”, in partnership
 with other key stakeholders

 Identify opportunities to increase partnering with patients, carers and consumers to
 improve the patients experience of care

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                      22
1.4 Close the gap between Aboriginal and Non Aboriginal Health

What will success look like in 2021?
For our patients, families and community

      A reduction of the gap between Aboriginal and non Aboriginal health outcomes

      Equitable access to services

      Care experiences which recognise the cultural needs of Aboriginal people

      Aboriginal staff working in services accessed by Aboriginal people

      Earlier access to care for Aboriginal people with chronic disease

For our people serving the health needs of Hunter New England

      Culturally safe workplaces

      More Aboriginal people employed in our organisation

      Career development for Aboriginal people across all services

 Improve the health of Aboriginal mothers and babies through the promotion of the

                                                                                                           COMMUNITY
       Get Healthy in Pregnancy Program to Aboriginal mothers and babies (diet,
        weight, physical activity, no alcohol consumption)
       Quit for new life program (smoking cessation during pregnancy)
 Implement the HNE Closing the Gap Strategic Plan Towards 2020 focussing on
       Increasing breastfeeding
       Increasing immunisation
       Decreasing smoking
       1st antenatal visit with 14 weeks

 Deliver on the priorities of the Aboriginal Employment Strategy 2016 to 2020

 Improve the health outcomes of Aboriginal people with cancer by improving engage-
 ment in screening and early detection services

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience               23
24
2.1 Improve equity of access and service delivery

What will success look like in 2021?
For our patients, families and community

      Equitable access to services

      Ambulances back on the road faster

      Decreased waiting time for services

      Fewer patients returning to hospital

      More people receiving the right care, the right place, at the right time

      Less travel and time away from home

For our people serving the health needs of Hunter New England

      Coordinated referral pathways

      Collaboration and Teamwork

                                                                                                           SERVICE
 Develop and implement the Integrated Care Strategy in alliance with the Primary
 Health Network

 Deliver timely emergency care to our patients by using alternative models to meet in-
 creasing demand

 Develop and implement an integrated District wide approach to meet the surgical
 needs of our patients

 Use alternative models to deliver care to our patients out of hospital

 Deliver care to our patients using Telehealth, especially patients in rural areas under
 the guidance of the NSW Health Telehealth Framework and Implementation Strategy
 2016 to 2021

 Implement local initiatives from the Living Well Strategic Plan for Mental Health in
 NSW 2014-2024 to improve the delivery of mental health services in HNE

 Develop sustainable models so care can be delivered to our patients as close to
 home as possible

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience             25
26
2.2 Develop a culture of service and person-
                      centred care that includes the needs of families and carers
What will success look like in 2021?
For our patients, families and community

      Patients and families are involved in their care

      Patients and families feel confident and safe in our facilities

      Patients receive care that meets their needs

For our people serving the health needs of Hunter New England

      Culturally and clinically safe workplaces

      Pride in our work

      Positive workplaces

      Work in an organisation which values patient reported outcomes

 Utilisation of Excellence tools and tactics to improve patient care and experience

                                                                                                           SERVICE
 Support our patients to transition from child to adult health

 Develop and incorporate patient reported experience tools into service delivery to
 verify we are meeting the needs of our patients

 Continue implementation of the Digital Media Strategy to inform and educate our
 community about our service

 Promote opportunities to include peer workers in our workforce

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience             27
2.3 Enable clinical engagement through net-
                                 working to improve service delivery/patient outcomes
What will success look like in 2021?
For our patients, families and community

      Consistent standard of care in any location

      Access to best practice care

      Access to innovative models of care

      Better patient outcomes and experience

For our people serving the health needs of Hunter New England

      Collaboration and Teamwork

      Clear direction and priorities

 Work collaboratively with Clinical Networks and Streams, Clinical Councils and other

                                                                                                           SERVICE
 Clinician led groups to ensure their activities are aligning to organisational priorities

 Optimise the engagement of clinicians to improve service delivery and patient out-
 comes through the following mechanisms:
       District Clinical Council
       Strategic Education Committee
       Research and Innovation Advisory Council
       Clinical Networks and Streams
       Clinical Quality and Patient safety Framework
       HNE Leadership Framework

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience             28
2.4 Facilitate innovation and translational re-
                                            search to improve health outcomes/patient care
What will success look like in 2021?
For our patients, families and community

      Best practice care

      Better patient outcomes

      Effective use of health resources

      Access to contemporary care
For our people serving the health needs of Hunter New England

      Clear priorities for clinicians

      Research is aligned to strategic priorities

      Effective use of health resources

      Clinicians can access support for clinical re-design, research translation, evaluation of outcomes

                                                                                                            SERVICE
 Implement the HNE Research and Translation Plan 2018 to 2021

 Establish the process for selection of research translation, innovation and improve-
 ment priorities for the District

 In collaboration with NSW Regional Health Partners and NSW Health, enhance clinical
 and translational trial support and infrastructure

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience              29
30
3.1 Improve the patient’s experience of care

What will success look like in 2021?
For our patients, families and community

      Person and family centred care

      Improved experience of care

      Better health outcomes and reduced hospital related harm

      Consistent standards of care

For our people serving the health needs of Hunter New England

      Culturally and clinically safe workplaces

      Effective use of health resources

      Job satisfaction

      Work in an organisation where patient and staff feedback is valued

 Ensure Patient Care Essentials are included in every patient’s experience of

                                                                                                           PATIENT SAFETY, QUALITY
                                                                                                            AND EXPERIENCE
 care

 Develop and implement strategies to reduce the incidence of hospital acquired
 complications

 Incorporate patient reported outcome tools into service delivery to verify we are
 meeting the needs of our patients

 Improve end of life care for our patients

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                         31
3.2 Deliver safe, evidence-based effective and appropriate healthcare

What will success look like in 2021?
For our patients, families and community

      Coordinated and consistent care

      Feeling safer in our hospitals

      Better health outcomes and reduced hospital related harm

      Consistent standards of care

For our people serving the health needs of Hunter New England

      Culturally and clinically safe workplaces

      Effective use of health resources

      Job satisfaction

 Improve patient outcomes and reduce unwarranted clinical variation for speci-

                                                                                                           PATIENT SAFETY, QUALITY
                                                                                                            AND EXPERIENCE
 fied conditions through the introduction of:
       Hospital Pathways
       Leading Better Value Care Models of Care
       ACSQHC Clinical Care Standards
       Auditing and Data Review

 Improve medication management through:
       Rollout of MedChart to all facilities
       Anti-Microbial Stewardship program
       Auditing and Data Review

 Utilise clinical technology and systems (like eChart) to standardise and improve
 patient monitoring and escalation of care

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                         32
3.3 Provide strong corporate and clinical governance

What will success look like in 2021?
For our patients, families and community

      Facilities and services which are safe and deliver quality care

      Reliable and consistent responses when things go wrong

For our people serving the health needs of Hunter New England

      Confidence in the system where we work

      Pride in our organisation

      Sustainability of services

 Implement systems to support consistent application of the Australian Commis-

                                                                                                           PATIENT SAFETY, QUALITY
                                                                                                            AND EXPERIENCE
 sion on Safety and Quality National Safety and Quality Health Service Stand-
 ards Second Edition, being eight evidence based standards:
       Clinical governance standard
       Partnering with consumers
       Preventing and controlling healthcare associated infections
       Medication safety
       Comprehensive care
       Communicating for safety
       Blood management
       Recognising and responding to acute deterioration

 Work together with CEC and ACI and other government agencies to deliver on
 shared priorities

 Have systems in place to ensure we meet our regulatory requirements

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                         33
34
4.1 Make the most effective use if the finite resources
              available and ensure that costs are kept under control to promote sustainability

What will success look like in 2021?
For our patients, families and community

      Effective use of resources

      Less waste

      Opportunity to invest in contemporary care models to improve service delivery

      Better patient outcomes and experience

      New and upgraded buildings and equipment

For our people serving the health needs of Hunter New England

      Contemporary facilities

      Contemporary equipment

      Contemporary models of care

 Use the principles of Excellence (90 DAP, MAMs) to cascade accountability to all staff

                                                                                                           RESOURCES
 for the efficient use of resources

 Improve data management across the District to inform decision making, service
 planning and drive best practice care

 Align funding to service delivery and program development to promote efficient use
 of resources and sustainability of services

 Pursue sustainable workforce models which reduce reliance on premium cost labour

 Work together as clinicians and managers on strategies to reduce low value
 healthcare to best utilise resources and reduce unintended harm

 Reduce the HNE environmental footprint

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience               35
4.2 Cooperate, collaborate and communicate
                                    with our partners to best meet agreed health needs
What will success look like in 2021?
For our patients, families and community

      Able to easily find information about local health services and how to access them

      Feel supported to understand and care for their own health and stay well in their own communities

      Have access to information that demonstrates that local health services are high quality and cost-effective

For our people serving the health needs of Hunter New England

      Be able to provide patients and families with clear information to guide them through the health system (public,
       private, primary, secondary and tertiary care)

      Be able to support patients and families so they understand and care for their own health

 Work together with our partners (Primary Health Network, Department of Premier and

                                                                                                                     RESOURCES
 Cabinet, Community Managed Organisations and Non Government agencies) to:
       Enhance access to integrated models of care
       Undertake collaborative service planning
       Support HNE to focus on core business
                                                                                Integrated Care Alliance

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                         36
5.1 Plan and invest in future health needs

What will success look like in 2021?
For our patients, families and community

      New or upgraded facilities

      Access to diagnostic services closer to home

      Engagement with community

For our people serving the health needs of Hunter New England

      Contemporary facilities to work in

      Up to date equipment to care for patients

 Coordinate and govern planning on new and existing infrastructure

                                                                                                           POSITIONING FOR THE FUTURE
 Identify and plan infrastructure development for priority areas including the New Mait-
 land Hospital and John Hunter Campus

 Deliver additional clinical capacity at:
       Belmont, Cessnock, John Hunter Hospital, Armidale, Moree, Muswellbrook,
        Tomaree, Manning, Tamworth, Inverell and Singleton and John Hunter Chil-
        dren’s Hospital

 Align governance structures, senior management and workforce to support and en-
 hance service delivery

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                                37
5.2 Encourage new sustainable technology to support clinical needs

What will success look like in 2021?
For our patients, families and community

      Access to best practice clinical information systems

      Clinical information is accessible across all facilities and services

      Timely information is available to drive best practice care

      Reduces the need to travel to receive care

For our people serving the health needs of Hunter New England

      Integrated clinical systems which prioritise quality and safety

      Streamlined access to clinical information across our systems and facilities

 Work closely with eHealth to implement:

                                                                                                           POSITIONING FOR THE FUTURE
       Enterprise Data Warehouse (EDW) transition from HIE
       Electronic Medication Management
       Electronic diagnostic orders
       Digital Clinical information Systems (eChart)

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                                38
6.1 Attract, develop and retain competent,
                                                         capable staff with the right cultural fit
What will success look like in 2021?
For our patients, families and community

      Having the right staff to deliver care as close to home as possible

      Feeling safe, confident, secure and empowered in our facilities

      Patients and families culture and diversity is considered and respected as an integral part of care delivery

For our people serving the health needs of Hunter New England

      Job Satisfaction

      Feel supported and empowered to perform role

      Positive and respectful workplace culture with shared values

      Feel safe at work

                                                                                                                      Our staff and workplace culture
 Explore alternate models of staffing and service delivery in areas with vacancies
 which are affecting the delivery of services

 Focus on succession planning at all levels (corporate and clinical)

 Implement local priorities from the Health Professionals Workforce Plan 2012 to 2022

 Continue implementation of the Aboriginal Employment Strategy 2016 to 2020

 Address issues raised through the People Matters Survey to improve staff culture and
 engagement

 Encourage and support continuous learning and development

 Provide support for alternative workforce models in rural areas

 Consider issues related to culture, diversity, disability and Aboriginality in the devel-
 opment of strategies which improve workplace harmony

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                                                39
Our staff and workplace culture
                                             6.2 Be ethical and accountable for
                                        demonstrating our shared (CORE) values

  Continue to hardwire Excellence principles and promote CORE Values in the work-
  place through the application of strategies such as the Workplace Harmony Frame-
  work

  Set clear responsibilities, standards and expectations for all staff to ensure they are
  accountable for their performance

                                            6.3 Ensure a safe working environment

  Develop and implement strategies to reduce workplace injuries

  Develop and implement staff well being strategy

  Ensure infrastructure and equipment is fit for purpose

  Implement the JMO Wellbeing and Support Plan Initiatives

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                                     40
Achievement of our Strategic Priorities will be measured through a combination of service agreement KPIs (mandated),
 Improvement Measures and Operational measures. Performance against measures is monitored using the District Strate-
 gic Monitoring and Reporting tool SMARTaViewer. The range of measures encompasses:

 Safety and Quality (for example falls, delirium, hospital acquired complications including pres-
 sure injuries and surgical site infections, mental health seclusion and mental health absconded
 patients)

 Access to services (for example surgical waiting times, access to surgery for elective and emer-
 gency patients, emergency department treatment time)

 Utilisation of services (for example unplanned readmission rates, potentially preventable hospi-
 tal admissions, activity for admitted and non admitted services)

 Population Health (for example immunisation rates, smoking rates, testing rates for communi-
 cable diseases)

 Patient and Carer’s Experience (PETS, BHI survey, follow up phone calls)

 Community Engagement (complaints and compliments, community partnership forums)

 Employee Engagement and Staff Safety (for example People Matters survey, performance re-
 views and workplace injuries)

 Financial performance (for example performance against budget, performance against activity
 targets)

 Less hospital related harm

 Better health outcomes

 Better patient experience

 Less travel and care as close to home as possible

 Better access to out of hospital services

 More resources for clinical care and service delivery

 Increased employee engagement

 Healthier communities

CORE VALUES: Collaboration Openness Respect Empowerment
All HNE Health Strategic Priorities incorporate the principles of Patient Safety, Quality and Experience                41
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