QUALITY ACCOUNT YARRAWONGA HEALTH 2018-2019
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WELCOME PAGE 1 WELCOME FROM CEO & BOARD We are so proud of our achievements made this year. Congratulations to everyone! Yarrawonga Health welcomes you to the of everything we do and the aim of the 2018- 2019 Quality Account our annual quality account is for us to report the ways scorecard showing you exactly how we we can partner with you to improve patient performed in our key quality measures safety, care, and your experience. against patient expectations. Your feedback on this report is warmly Every year we compile this report and we are astounded by the achievements our small welcomed and can be provided to us on the leading rural health service has achieved, the last page via a feedback slip, to tailor this dedication of our staff and volunteer’s and publication to your needs. their commitment to enhancing health care for the community. On that note thank you to our Community Advisory Committee for giving this We are immensely proud of all our publication their tick of approval and the achievements this year and would like to say continual service they provide to our health thank you to all our staff and volunteers for service. the differences they make everyday to our patients and their families. We hope you enjoy reading. At Yarrawonga Health we place our patients, consumers and our community at the heart Yours in service, Elaine Mallows Erin York Chief Executive Officer Board Chair
PAGE 2 TABLE OF CONTENTS To help you find your way! Welcome from the CEO and Board......................................................................................................Page 1 Consumer Carer and Community Participation..............................................................................Page 3 Your Feedback Our Actions ..................................................................................................................Page 4 Your words to us .....................................................................................................................................Page 5 Our Quality Team.....................................................................................................................................Page 6 Embracing diversity and working with our community ................................................................Page 7 Community Voices...................................................................................................................................Page 11 Quality and safety for every patient ...................................................................................................Page 15 Residential aged care .............................................................................................................................Page 20 Community Health Services Victorian Healthcare experience Survey......................................Page 22 Your experience with our team............................................................................................................Page 24 What did you think about this publication........................................................................................Page 27 A warm welcome from our reception staff.
PAGE 3 CONSUMER CARER AND COMMUNITY PARTICIPATION Putting smiles on the faces of our consumers! Yarrawonga Health is committed to discharge process and how we can providing safe and high-quality care better partner with our consumers to for all our patients. We are always improve our results, refine our reviewing our services and seeking ways to improve. consumer discharge information in consultation with our Consumer The following table displays results Advisory Committee and increase taken from the Victorian Healthcare patients perception of cleanliness via Experience Survey (VHES) in both the Acute Service and Community reviewing and continually auditing for Services. cleanliness in our health service. We are very proud of these results, We have also increased staff education but the hard work for us doesn’t stop on the use of care boards to foster more there we are continually looking for ways to improve our health service. collaborative goal setting to partner with our In Acute, we are focusing on the consumers. VHES SURVEY RESULTS Question Yarrawonga Health Score State Target Overall how would you rate Quarter 1 – 98% 95% the care you received in Quarter 2 – 100% the hospital? Quarter 3 – 100% Answered Very good or good Overall, the rating for the Quarter 1 – 88% 75% discharge process Quarter 2 – 89% Quarter 3 – 90% Answered Very good or good Patient perception of Quarter 1 – 96% Full compliance with cleanliness Quarter 2 – 90% Internal audit. Quarter 3 – 93% Nil target set- State Answered Very good or good average 75% VHES
PAGE 4 YOUR FEEDBACK OUR ACTIONS See how we respond to your feedback! Victorian Healthcare Experience Survey cost, increased signage at the reception 2017-2018 Community Survey desk and in the waiting room to inform clients of costs of service. In Community Services we have still focused on the improvements identified in our action Overall (Q 43-49) plan from the 2017-2018 VHES Community • 100% of respondents felt they were treated Survey. with dignity and respect (Vic 92%). • 0% of respondents felt that they were ever From October to December 2017 we received more than 35 responses to the VHES treated unfairly by the health service (Vic Community Survey with the grand finding 91%) being that 100% of our respondents indicated • 97% of respondents rated the care that they they had extremely positive results accessing received as ‘very good’ or ‘good’. our community services. Improvements made (Q43) For results less than 80% or that fell If you need to, do you know how to make a below the state average we have made complaint at the health service? improvements in the following areas: • Dec 2017 – 64% • Dec 2018 – 73% (Vic 57%) Information (Q 36-42) This section was very positive in the Actions Taken responses. • 100% of respondents stated that they Updated information provided to clients in received ‘The Right Amount’ of information written and verbal forms during the intake about their care or issue (compared to Vic process to be more clearly collect feedback State 88%). processes. Signage in the waiting room and • 100% of respondents stated that they knew feedback box a more prominent. who to contact if they had any questions about their care (Vic 85%) Improvements made (Q 38) If there was a cost for the health services you used, were you aware of how much it would be? • Dec 2017 = 67% positive • Dec 2018 = 79% positive (Vic state = 69%) • Actions taken – updating of our community services information booklet with pricing information. Ensuring that during intake phone calls clients are aware of the service
PAGE 5 YOUR WORDS TO US Consumer Experience Quotes 2018-2019 Feedback from community members “Thank you to our lovely district nurses, with accessing after hours emergency services much appreciation - a huge thank you” was that access was not well known and - District Nursing assessment was inconsistent. “Really glad we were able to have our baby so A revision of the admission, assessment, close to home and have one on one support care pathways and improvements in Sepsis for our first baby” recognition and timelines of care contributed - Maternity. to a patient’s mother saying. This quote after her son was seen at our Urgent Care Centre with urgency to triage for escalation of care – “if I could think of a greater word than thank you, fantastic, extraordinary, amazing… that would be for all of you” “The attention and care you gave me was exceptional” - Urgent Care Centre “I am exceptionally impressed regarding the standard of care, along with the consistent kindness, compassion and attention to detail that I have observed.” - Aged care “We are so appreciative of your time, care and support” - Aged care “I can only thank and praise all the staff that looked after me” - Theatre “A patient made a note to thank the dialysis nurse on the clinical decisions she made” - Dialysis “Staff were very professional, but friendly and reassuring in their treatment of me” - Acute services “Compliment from a relative of the aged care newsletter about the attention and the happiness it bought a resident” - Administration
PAGE 6 OUR QUALITY TEAM Yarrawonga Health would like to thank our exceptional team of highly skilled doctors for the important work they do! Yarrawonga Health would like to thank our Our Doctors have an exceptional exceptional team of highly skilled doctors for commitment to quality and safety the important work they do providing care to participating in learning reviews of clinical our community. cases and in the provision of input and advice They are an integral part of the into procedural and clinical pathways. They multidisciplinary team providing care to our patients and residents. They are highly are part of the very fabric and DNA that skilled, local and responsive to Yarrawonga makes our great community thrive. Our Health’s needs balancing their workloads medical workforce strengthens health in our from local medical centers and clinics with community and safeguards the wellbeing of Yarrawonga Health patients. each and every one of us on a daily basis. In our rural community, every person counts, and everyone looks out for each other. Having good access to healthcare, made possible by our team of doctors, is such a fundamental part of what makes our small town thrive, we thank all of them for their commitment and celebrate them as part of our community and part of the Yarrawonga Health team. Congratulations to Dr Clyde Ronan The first recognises general practitioners Dr Clyde Ronan received two esteemed and medical specialists who have shown awards at the Rural Doctors Conference in professional and personal commitment May this year, taking away the Outstanding to regional and rural communities, often Rural GP award as well as a Length of Service going above and beyond with services and for his 35 years in practice. involvement in the community. The length of service award is presented to general practitioners and medical specialists The second category recognises doctors who who have served rural and regional Victoria are establishing their careers in rural health for over 35 years, recognising their extensive and have demonstrated an outstanding commitment to providing health services, contribution to their profession and often to many generations of the same family community. and their continued involvement in the community. Yarrawonga Health is very proud to have The second of Dr Ronan’s awards, the Dr. Ronan as part of our team and the Rural Doctor award has two subcategories: contribution he has made to rural medicine Outstanding Contribution and New Rural locally in Yarrawonga and surrounding Doctor. communities.
PAGE 7 EMBRACING DIVERSITY & WORKING WITH OUR COMMUNITY Interpreter Services developing strategies and actions to As part of the admission process, all patients encourage access for people within our or their families/ carers are asked whether community with one or more disabilities and they require access to interpreters to ensure to eliminate practices that may discriminate optional communication. Interpretation against these people. and translation services are provided to all patients and residents when required at There are multiple actions within this no cost to them. In 2017-2018 one patient plan which will benefit people accessing identified as requiring an interpreter. Our Yarrawonga Health including an Access Audit language service procedure was up to to assess our infrastructure and buildings, date, and staff knew how to access this investigating opportunities for employment service. We also publish an icon on all or volunteering for people with a disability our publications to show our support and and community engagement specifically for willingness to use this service. people with a disability. Disability Action Plan In 2018-2019 the Yarrawonga Health Senior As part of this plan, Yarrawonga Health will Operational Committee has worked to engage and develop a disability reference develop a Disability Action Plan that forms group of community members, staff and part of the Yarrawonga Health Diversity Plan. health consumers to ensure that regular engagement and feedback is provided into The purpose of this plan is to provide actions and evaluation of the plan over the direction for Yarrawonga Health in next three years.
PAGE 8 MANY MOBS Improving Aboriginal Health Yarrawonga Health has continued a strong • Ensuring that Acknowledgments of Country partnership with the local Many Mobs are included at Board level and community Aboriginal Community Group over the 2018- – attending meetings 2019 year. Our organisation has a strong • The provision of cultural competence commitment to Reconciliation, and to training that is available for staff at all levels working in partnership with Aboriginal and across the health service. Torres Strait Islander people to ensure that • Engagement with local Aboriginal artists the services we are providing are welcoming, and the procurement of numerous pieces appropriate and provide equitable access to all people at all times. of artwork that are displayed with pride around our health service, along with flags This year we continued to support our at each entrance. local Aboriginal community in holding their • And of course, a display of public monthly meetings on site, and worked commitment each year at our NAIDOC together to provide the community with celebrations. our third annual NAIDOC celebration with more than 250 people in attendance. The This year we where also proud to unveil a community attended a walk across the couple of new additions to our health service traffic bridge from Mulwala to Yarrawonga, in the form of Acknowledgment plaques that lunch on the Yarrawonga Health front lawn, will be displayed on the two main external and then an afternoon of traditional Daya entrances to our health service and are a games at Kennedy Park for local school and kindergarten children. permanent and visible acknowledgement of country for all who enter into our We have also completed many other actions organisation. We also have future plans to that formed part of our Diversity Plan include similar plaques on the additional including; entrances.
PAGE 9 LGBTI A Health Priority Community Group Over the past twelve months, Yarrawonga • Multiple on-site ‘Listening lunch’ meetings Health has undertaken many actions to with LGBTI community members and the improve the service experience for the development of the LGBTI Community Lesbian, Gay, Bisexual, Transgender, and Catch-Up meetings. Intersex (LGBTI) community who access • All male/female designated toilet and our health services. The LGBTI community bathroom facilities within the health service is a priority population for Community have had signs removed and replaced with Health services as it is recognised that they unisex toilet signage. often have poorer health outcomes and are • Implemented rainbow stickers at entrance less likely to access health services when and rainbow symbols on publications. compared to the general population. The Yarrawonga Health Inclusive LGBTI action plan was endorsed in September 2017 and since then the following actions have been completed: • Training provided for staff in LGBTI inclusive practice. • LGBTI-inclusive practice principles added to staff orientation. • Links created with local LGBTI organisations and services.
PAGE 10 FAMILY VIOLENCE Central Hume Strengthening Hospital Response to Family Violence project Yarrawonga Health is proud to be a partner of the Central Hume Strengthening Hospital Response to Family Violence project, a regional health group partnership led by North East Health Wangaratta and including Benalla Health, Mansfield Health, and Alpine Health to improve our response and support people experiencing family violence. We have been part of this project since it’s commencement in 2018 and are committed to raising the knowledge and recognition of family violence within our community. Key achievements have included working with community members, local organisations and service providers to improve the coordination and ability to respond by local and referral support systems currently working in this space. As a health service, we know we have a significant role to play in potentially being the earliest point of contact for victims and in early identification of this issue. So far more than 90% of our staff have attended family violence training and we have visiting trained counselors from Primary Care Connect and Goulburn Valley Centre Against Sexual Assault on- site by appointment, who specialise in family violence and offer a free confidential support service.
PAGE 11 COMMUNITY VOICES Our Community Engagement Strategy Yarrawonga Health Community Engagement • Increasing patient experience surveys and Strategy provides a clear structure and • Providing consumers with opportunities to pathway for consumer participation at be directly involved in those committees Yarrawonga Health. The Community Advisory where quality and safety decision- making Committee sits at the top of our consumer occur. participation organisational structure and is supported by our maternity, fundraising, You can pick up a copy of our Consumer seniors and youth reference groups. Engagement Strategy at Yarrawonga Health or download it from our website www.yh.org. Together these groups, along with au/aboutus community groups, and individuals give all consumers a voice and input into how things are done at Yarrawonga Health. This year we have consulted with these groups, residents and our community to inform service change improvements to: HEALTH • Review Acute Unit access, assessment and care planning management Consumer and • Make improvements to our food options Community in the aged care sector via direct feedback Engagement Strategy 2018-2020 from residents. • Support the Community Advisory Committee to coordinate our Consumer Engagement strategy and offer support/ training to formally use their voice across the organisation. When we asked how consumers would like to engage more with us – you told us that you would like to have more of say in how services are planned and delivered. Themes included: • Delivering news about Yarrawonga Health RESPECT • EXCELLENCE • COMPASSION • INTEGRITY • TEAMWORK more frequently via a variety of different mediums
PAGE 12 VOLUNTEERS Our Heroes Each year over 60 volunteers give their time “I like it for a social occasion and that I am to our health service and provide invaluable giving back to our community through support and assistance to families, patients, building friendships with the residents residents and staff at Yarrawonga Health. in Karana that I do knitting with – it’s Our volunteers freely give their time to like sharing a mutual passion and doing support our organisation and our community something good at the same time” and are involved in many areas of Yarrawonga Health such as the Community Advisory “Volunteering for me on Yarrawonga Health Committee, Helping Hands Fundraising Senior Advisory Committee is an opportunity Committee, Aged Care, Acute and many other areas. to speak and learn more about what is going on in Aged Care services, that will impact People of all ages and from all walks of life me one day, help me to support a loved one become volunteers. It can provide a sense and allows me to hear what my local health of purpose and meaning, keeping people service is doing” connected and engaged in their local community. “I like getting out amongst the community So if becoming a volunteer appeals to you and making a residents day in aged care, its please direct your inquiry to Deidre Poll on just the little things I do like reading that 03 5743 8538 or email firstname.lastname@example.org gives them so much joy and pleasure for such Here are some quotes about why some of our a simple act. It’s the smiles on their faces you volunteers love volunteering with us: just can’t beat”.
PAGE 13 YARRAWONGA HEALTH COMMUNITY ADVISORY COMMITTEE Yarrawonga Health Community Advisory inform the broader community Committee is comprised of interested • Provide a consumer voice to the delivery of members of our community who meet bi- health care at Yarrawonga Health. monthly to: • Advise on any concern or identified If you are interested in being part of this improvement from the community committee, please contact Nedean Clarke, perspective. Executive Assistant, on 03 5743 8130. • Review patient information to make sure it Members of this committee assist with the is easy to read and understand production of the Quality Account each year • Provide a comment about services which are being introduced or reviewed and we give heartfelt thanks to our members • Receive information about the general for their wonderful assistance with this business of Yarrawonga Health so they can report! Taking a walk in the shoes of our consumers – Margaret Duff video This year Yarrawonga Health produced a walk in my shoes training video for staff to educate them on the importance of partnering with the consumer in healthcare and what the consumer values as important. In a short six minute video shown to all staff Margaret Duff an established member of our Consumer Advisory Committee bravely told staff about her experience in a variety of different hospitals and how important communication and the simple act of kindness can be to consumers in transforming their stay in a hospital setting. Thank you Margaret Duff for allowing us to film you and for sharing your experience in healthcare contributing to our staff training and ability to respond to the needs of our patients.
PAGE 14 HELPING HANDS HELPING HANDS HEALTH Donations Yarrawonga Health is so proud of the Bernadette achievements of its Helping Hands volunteer “I am just starting to explore my new bed fundraising committee who has successfully and its features – it’s great that it can adjust raised over $100,000 for our health service to different heights and I can’t wait to get allowing us to purchase over 50 new beds the land lifter to attach. Thank you so much for our patients since being established over Helping Hands”. three years ago by Yarrawonga Health Board. DONATIONS REGISTER 2018/2019 Yarrawonga Health is most grateful for the generous support The committee is comprised of Vivian Spilva received from our community and beyond during 2018/2019. We (Co-Chair), Andrew Shell (Co-Chair), Racheal recognise and greatly appreciate the contribution by the following individuals, businesses, service groups and clubs. Cartwright, Debbie Cooper, Liz Seeliger, CWA Yarrawonga and Border Yarrawonga Lions Club Jackie Smith, Jeanette Bennett, Micheal Sister Schneider Hadar Homes O’Neil, Robin Wall and Gill Cunningham. This Estate John James Saunders Mulwala Water Ski Club Lake Mulwala Community Action Group Yarrawonga Mulwala Multi Sport Festival group does an incredible job reaching out Club Mulwala Thyme for Coffee Yarrawonga Mulwala Golf Club Resort Gary Wise to our community and fundraising for our Rotary Club of Yarrawonga/Mulwala Yarrawonga Lawn Tennis – Tuesday equipment needs that can be fast-tracked Rosa Marshall Yarrawonga & Border Country Competition Bundalong Tavern through community donations. Woman’s Association Criterion Hotel Yarrawonga/Mulwala Combined Ritchies IGA Supermarket For more information on Helping Hands Churches McBurnie Group Uniting Church Bundalong Yarrawonga Yarrawonga Football Netball Club please contact Yarrawonga Health. Memory of A Tufvesson T & J Bradshaw Roger MacDonald Eric Scott Memory of L Goldsack Robert Vessio John Dunstan U Campbell J. Ramsdale B McDonald Central Murray Credit Union “Thank you to the Helping Hands team and Warrina Craft Ladies AIM Breakfast community for fundraising to get me a new Northeast 60 & Over Bowlers Group Inc Memory of G Moyle Yarrawonga Garden Club Kennedy Builders bed this year – the bed provides me with Yarrawonga Medical Clinic Yarrawonga Denis Medical Group Tungamah Auxiliary Steve Buckley such a better nights sleep, is extremely T & K Hargreaves O’Meara Kennedy First National Real D. Smith Estate manageable, comfortable and even allows me Yarrawonga Innerwheel Jodie Cartwright and Melissa Ritches to move it in multiple ways so I can have my Purtle Electrical Memory of T Booth morning coffee- such an improvement. I can Thank you to all members of the community who have nominated now even make my bed in the morning as it Yarrawonga Health through Ritchies IGA Supermarket. We also thank all those members of the community who have lowers to different heights so I can regain supported Helping Hands and contributed to their many some independence.” fundraising events. Dani Kennedy O’Meara Kennedy First Ritchies IGA Yarrawonga. Alan Rowe CEO ClubMulwala. National Real Estate.
PAGE 15 QUALITY AND SAFETY – FOR EVERY PATIENT Your Feedback And Our Actions This financial year YH received a total of 104 compliments which has doubled from 2018 (52) from patients, students, residents carers and loves one, reflecting the culture of Yarrawonga Health as supported by the organisational values. At Yarrawonga Health we pride ourselves on having strong and robust processes to capture feedback and the following are some of the actions initiated by your feedback: Area for Improvement Outcome Refurbishment of Warrina We redecorated rooms in Warrina and outdoors areas – based – feedback received from on resident feedback including a residence focus group, residents and family individual review of lighting options members at Warrina. Urgent Care Centre (UCC) YH received complaints over the year 2018 regarding our UCC. – feedback received from A UCC Working Group has been created and overseen the consumers UCC Consumer revised registration of presentations, assessments, and triage Advisory Committee and the education support of Registered Nurses working within this area. Food Services When a food complaint is made, the complaint is distributed to the Support Services Supervisor and the manager of the area that the complaint has been made and whom from. Discussion occurs with the consumer to endeavor to look towards improvement in the service. The nutrition portfolio project works hard to review all food compliments and complaints to ensure better improved meals. Laundry Services A process of the delivery of clothing to the residents. Reduced lost personal items. Complaint system Review complaints/Compliment and suggestion form - educate staff - the entry of a complaint can now be entered directly on YH Website We appreciate all feedback as it assists Yarrawonga Health to further improve our services. To provide feedback, forms are available at all health service entry points and on our website at www.yh.org.au.
PAGE 16 LISTENING TO OUR TEAM Safety Is Everyone’s Business Our staff are the most important patient acknowledge this we created a Yarrawonga safety advocate we have, and it is through Health Occupational Violence and our people that high standards of care are Aggression (0VA) project-working group delivered 24 hours a day, 7 days a week. commenced in 2017,with a cross section of our organisation staff to strengthen Each year, every member of our team is Yarrawonga Health response to security in invited to participate in the People Matter this area. We increased staff education in Survey conducted by the Victorian Public the areas of reporting Occupational Violence Sector Commission. The survey measures and Aggression and on how to respond to various aspects of workforce culture and unarmed and armed violence, and invested patient safety culture within our workforce. capital for equipment such as CCTV, Duress It focuses on employees’ perspectives on Alarms, UHF radios and major refurbishments not only the principles and values of the in the areas of Urgent care, Acute secure workplace but also on the public sector medication room, and Yarrawonga Health values. This year 136 people responded to Memory Support facilities to ensure staff and this survey out of 25O staff and 85% of them consumer safety. agreed that as an organisation, we make patient safety a priority in comparison to the State target of 80%. The People Matter Survey for 2018 found that workplace wellbeing was an area of opportunity for improvement as health workers are amongst the top 10 occupations most likely to be exposed to incidents of Occupational Violence & Aggression. So to Debbie Gleeson, Deputy Director of Nursing and Education, clinical lead of YH’s OVA Working Group.
PAGE 17 NETWORKING FOR SAFETY Accreditations One way that we can assure the community that we are doing our best to achieve excellent standards of safety and quality is by demonstrating continuous improvement through our accreditation processes. Accreditation is the ongoing review of our performance against standards across a range of areas to make sure we are doing our best to keep our patients safe as well as improve our services. Yarrawonga Health is accredited by the Australian Council on Healthcare Standards (ACHS) and against other key standards as outlined in the table below. AREA ACCREDITATION BODY STATUS National Safety & Quality Australian Council on 3-year accreditation achieved Health Standards Healthcare Standards National Standards - March 2017 Expiry - June 2020 Home & Community Australian Council on Home Care Standards Healthcare Standards 3-year accreditation achieved -May 2017 Due June 2020 Residential Aged Care - Aged Care Standards and 3-year accreditation achieved Karana, Warrina & Allawah Accreditation Agency Nov 2017 Expiry - Nov 2020 New Aged Care Standards July 2019 – This includes an annual announced visit supporting the current accreditation status. Supported Accommodation Quality Improvement 18-month Submission – Assistance Program and Community Services Due June 2019 – Compliant Accreditation Department Next submission - 31 Dec 2021 of Health Food Safety Plan Review Paul Maggs Food Safety May 2019 - Full compliance - Nil ACS recommendations Due May 2020
PAGE 18 MANAGING ADVERSE EVENTS It’s serious business to prevent adverse Infection Prevention events in health care. They include infections, falls resulting in injuries, and problems Staphylococcus Aureus Bacteraemia – with medication and medical devices which Golden Staph directly impact the patient. In 2018-2019 Yarrawonga Health reported Yarrawonga Health has a low rate of adverse zero Staphylococcus Aureus Bacteraemia also events in comparison with its peers recording commonly called “golden staph”. We monitor 36 events in 2018 – 2019. closely for this infection that can commonly occur in IV lines and that needs to be Any significant incident is comprehensively treated immediately or as soon as possible. reported to our Clinical Governance At Yarrawonag Health we are proud of this Committee including any strategies identified result and that as a small rural health service for improvement. Some examples of actions we have a robust Infection Preventable made to our quality and monitoring systems, Program. following an incident include: Vaccinating against Influenza • Clinical Review of the case/incident identifying areas of improvement attended This year Yarrawonga Health 2018-2019 by both clinical and medical staff achieved a 94% compliance rate of Health • Review of Occupational Violence and Care Workers (HCW) vaccinated against Aggression incidents against staff - influenza (flu). Smashing the DHHS improvements include new safer entrance compliance rate of 84% for the 2017-2018 to UCC. period. • Targeted education to both Nursing and Medical Teams A huge flu-fighting campaign was led by • Policy and Procedure review/development Yarrawonga Health Executives and the Board • Review of high-risk fallers to ensure all focussing on being prepared and getting interventions are in place protected for Yourself, Your Family & Your Patients – we aimed to achieve a goal of 95% to exceed our 2018 result of 94%. To achieve this result - static and mobile influenza vaccination clinics were held from 2018 May to July providing flexibility for staff to attend clinics when convenient, and a significant internal education awareness program, including individual information sessions, were held across both the Acute and Aged Care Sectors.
PAGE 19 MUMS AND BUBS SAFETY In 2018-2019 Yarrawonga Health recorded 40 women initially booked to delivery at 26 births with zero percentage of singleton Yarrawonga Health during their pregnancy, babies with severe fetal growth restriction through antenatal care their risk factor had delivered at 40 or more weeks gestation increased and therefore were referred to and only 1/26 (3.8%) singleton full-term higher level of care to continue with their baby (without congenital anomalies) was pregnancy. considered in poor condition shortly after birth with a low Apgar score. From this single Yarrawonga Health achieved compliance birth a review with clinical staff including with the Better Care Incentive Program expected management and monitoring of which demonstrates the maternity workforce birthing process was conducted. compliance to successfully completing maternity emergency response training, As part of best practice Yarrawonga Health fetal surveillance training and neonatal introduced routine third trimester pregnancy resuscitation ultra scans are attended with follow-up ultra sound for those with an initial indication of With ongoing education using PROMPT suspected foetal growth reduction. Where (Practical Obstetrics Multi Professional abnormalities are detected referral and Training) we have now identified, upgrades assessment by a Obstetrician occurs to to our systems and policies to ensure that we confirm appropriateness for delivery in a low can manage obstetrics emergencies and meet risk model at Yarrawonga Health. our maternity services capability framework.
PAGE 20 RESIDENTIAL AGED CARE Monitoring Resident Care DHHS: Public Residential Aged Care Service (PRACS) Physical Restraint individual care plans. Significant weight loss Yarrawonga Health Aged Care does not may result in residents with reduced appetites, support the use of physical restraint. Both complications of their complex aging clinical Warrina and Allawah demonstrate compliance needs. The monitoring of nutritional needs, to this goal. In response to resident choice age related complications and the expertise Karana has resident who request the use of a of the multidiscipline team including GP, concave mattress. This is not recommended Speech pathologist, Dietitian, Registered as the safest option. Therefore Yarrawonga Nurses and the clinical care team recommend health provides a risk reduction approach with interventions including food and behavioural to additional observation, regular review of the limit the impact of weight loss on the resident resident/families goals to the safest use of this quality of life. equipment that may hinder bed access. Pressure Injury Unplanned Weight Loss Yarrawonga Health actively reviews any The management of residents weight both residents care that reports any level of increase and loss are monitored and managed pressure injury. Through this process low in partnership with the residents and their level injuries are identified and interventions
PAGE 21 RESIDENTIAL AGED CARE Monitoring Resident Care activated as part of the residents care. External Medication reviews of the three services reports ongoing A review of the designated pharmacy improvement’s in the skin integrity and dispensing system has assisted in reducing management of pressure injuries. key errors in the use of Webster packs (administration aide) across the aged care Falls area. Errors involving high risk medications Resident’s with complex aged care needs ie use of patches, insulin, thrombolytics may be at risk of falls due to the debilitation, and S8 & S4 medications are investigated to impaired memory, risk taking behaviour for identify the causative factors to the error. example choosing to walk unsupervised while Interventions including additional education, on medications. Yarrawonga Health attempts staff competency and the auditing systems to minimize potential falls and the impact of have all been used to improve the safety of the falls by providing individual assessments and medication administration system. plan for each resident with consideration for their personal input. This will include consideration of the risk associated with falls including fractures and skin soft tissue trauma.
PAGE 22 COMMUNITY HEALTH SERVICES VICTORIAN HEALTHCARE EXPERIENCE SURVEY Patients Story service and the environment and facilities Unfortunately, Clinton has spent a bit of time provided within the health service. The at Yarrawonga Health in the past 12 months results from these questions are used to so he is a familiar face to YH Urgent Care inform the actions and quality improvement Staff. On one occasion, Clinton presented initiatives undertaken within the Community unwell for elective surgery and was taken to Services Health division throughout the year. our Urgent Care Centre then transferred out Overall, Yarrawonga Health receives very to Wangaratta for escalation of care. positive results for all questions within these areas, however, we have also made some improvements based upon actions from our Clinton speaks very highly of this experience 2017 survey. and says that he “has always found the staff respectful and accommodating at YH in all Accessing the Health Service (Q 1-9) his experiences with them – and that they • 100% of respondents reported that the have been effective and helpful in escalating politeness and helpfulness of the reception my care needs when required” staff at the health service were ‘Very Good’ or ‘Good’. • 100% of respondents thought the time Community Health Services Victorian they spent in the waiting area before their Healthcare Experience Survey appointment was ‘About Right’ (Vic 78%). The Community Health Services Victorian • Actions – way-finding maps and Healthcare Experience survey includes many numbered entrances were implemented questions regarding Access to the health around the health service to improve
PAGE 23 COMMUNITY HEALTH SERVICES VICTORIAN HEALTHCARE EXPERIENCE SURVEY the accessibility of different areas. Maps implemented many initiatives to were included in intake paperwork improve how welcoming the health mailed to clients on admission to service. service is, especially for community In addition to this, an application was groups. Aboriginal artwork has been made to the council to implement two hung throughout the service, along with and four-hour parking restriction zones Aboriginal and Torres Strait Islander flags surrounding health services. • ‘Was it easy for you to find the being displayed at all entrances. Rainbow location of the health service?’ stickers and signage are displayed to • Dec 2017 – 84% welcome the LGBTI community. All of • Dec 2018 – 94% (VIC 84%). our publications include symbols for diverse groups to improve inclusion. Environment and Facilities (Q 10-14) We have also implemented a children’s • 97% of clients reported that the health corner in the waiting area to provide a service was ‘Very Clean’ (VIC 80%). distraction for children while waiting for • 100% of clients reported that they felt appointments. physically safe at the health service (VIC 93%). • ‘Did the health service feel • 100% of clients were given enough privacy welcoming?’ during their appointment (VIC 94%). • Dec 2017 – 87% • Actions – the health service has • Dec 2018 – 100% (Vic 89%).
PAGE 24 YOUR EXPERIENCE WITH OUR TEAM The VHES Community survey includes • Team Work responses regarding the client experience • 100% of respondents were referred to with community health care workers, other services where appropriate to planning of care and the teamwork of the improve their health and wellbeing (VIC service. Many positive results were received for these aspects, and multiple improvements 89%). continue to be made. • 100% of respondents stated that all necessary information was provided to other relevant services (GP, hospital staff, etc) (VIC 77%). • Actions – reduced duplication of information gathered from clients by streamlining intake and assessment processes. Work instructions provided to staff regarding care planning and documentation to improve communication between health service staff. • ‘Were there times you had to repeat information that should be in your • Your Experience with Health Workers record at this health service?’ • 97% of respondents stated that the health • Dec 2017 – 72% said no worker introduced themselves and their • Dec 2018 – 87% said no (Vic 70%) role (Vic 86%). • ‘Did people at the health service work • 100% of respondents stated that the together to help you with your health health workers were compassionate (Vic and wellbeing?’ 87%). • 100% of respondents felt that health • Dec 2017 – 83% workers took their concerns seriously • Dec 2018 – 92% (Vic 77%) (Vic 88%).
PAGE 25 YOUR EXPERIENCE WITH OUR TEAM Acute Services – Sepsis Improvement with training continuing across the 3 aged Project care facilities. • Education ofmedical staffincluding Sepsis is a medical condition that kills a simulation exercise around sepsis more people in Australia per year than the identification and management for nursing national road toll. The objective of the Sepsis Improvement Project was to introduce an and medical staff. adult sepsis pathway to decrease the number • Inclusion of the Sepsis pathway into of related deaths to sepsis, ICU admissions, orientation process for clinical staff. length of stay and decreased time to • Significant reduction (1 hour and 31 antibiotic administration. minutes) in average time to antibiotics for patients meeting sepsis criteria. Yarrawonga Health was invited to partner • 38% reduction in length of stay for treated for the project with Albury Wodonga Health (lead agency), Northeast Health Wangaratta, patients. Beechworth Health Service and Corryong • Compliance with state-wide best practice Health, as well as being part of a wider guidelines significantly improved, with collaborative with Better Care Victoria and increases in blood cultures collected, Safer Care Victoria. lactates attended and more appropriate antibiotic prescribing Key achievements of this project included: • Creation of “Sepsis Packs” for UCC to • The implementation of Sepsis pathway ensure convenient access to equipment across Yarrawonga Health required for patients meeting criteria and to • Training of acute staff- 98% completed, prompt staff to complete all 6 key actions.
PAGE 27 WHAT DID YOU THINK OF THIS PUBLICATION? We would like to hear from you what you think. 1. What do you think of the information in this Quality Account? (please circle) Poor 1 2 3 4 5 Excellent 2. What do you think of the way we have presented this information? please circle Poor 1 2 3 4 5 Excellent 3. Is there any other information you would like to see in the Quality Account? ..................................................................................................................................................................................... ..................................................................................................................................................................................... ..................................................................................................................................................................................... ..................................................................................................................................................................................... Post the completed form to: Community Engagement Manager Yarrawonga Health 33 Piper Street Yarrawonga Vic, 3730 You can also leave feedback by contacting us on: 03 5743 8193 email@example.com www.yh.org.au/feedback Yarrawonga Health Director of Clinical Services Kaye Gall and Nursing Unit Managers
HEALTH 33 Piper Street, Yarrawonga VIC 3730 Phone: (03) 5743 8111 Feedback to: firstname.lastname@example.org or phone: (03) 5743 8198 www.yh.org.au
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