SAFETY & QUALITY ACCOUNT 2019 2020 - WESTERN SYDNEY LOCAL HEALTH DISTRICT - Western ...
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WESTERN SYDNEY LOCAL HEALTH DISTRICT SAFETY & QUALITY ACCOUNT 2019 – 2020
Acknowledgement
Western Sydney Local Health District acknowledges the first people of the land. The
overarching Aboriginal nation in Western Sydney is the Darug nation.
We pay our respect to Elders past, present and emerging
We acknowledge the significance of land, water, spirit, kinship and culture, and the
importance that these elements have to the health, well-being and future of the
Aboriginal community.
Sean Choolburra launches the Legacy Strategy in 2018
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 2
Contents
Introduction 4
Achievements in Safety and Quality 5
About Western Sydney Local Health District 15
Planned and Realised Actions 29
Formal Results 44
Future Plans 49
WSLHD Board Attestation Statement 56
Contributors to the Safety & Quality Account 2019 – 2020 58
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 3
Introduction
Western Sydney Local Health • Safety and Quality we are doing to ensure we are
District (WSLHD) is privileged Improvement Strategy really listening, and that key
and entrusted with the 2016-2020 messages are getting out to
care of people living in the our community. This year we
• Better West: WSLHD
Auburn, Blacktown, Hills Shire, will be placing more emphasis
Strategic Priorities
Holroyd and Parramatta Local and focus on:
Government Areas (LGAs). • Health Services Plan to
WSLHD also provides tertiary 2026: Growing Good Health • Aboriginal people
care to residents of the Greater in Western Sydney • Diverse cultural groups
Western Region. With this
comes the requirement for WSLHD is committed to • Older people
accountability, transparency making safety and quality
• People with chronic &
and commitment to our highest priority. The
complex conditions
continuous quality and safety 18/19 WSLHD Safety and
improvement. Quality Account received • Workplace culture
good feedback from the NSW
Ministry of Health (MOH), • Mental health issues and/or
Our Vision and was a leader in the form illness
Safe reliable healthcare free of inclusion of the Standard 1
attestation statement. These The purpose of this Account is
from preventable harm. to illustrate our achievements
key strengths of last year’s
account will be repeated for the 2018/2019 financial year
and the future projects planned
Our Mission in addition to far stronger
for the 2019/2020 financial
consultation strategy for this
Equitable access to safe, high year. This is our retrospective
year’s focus areas.
quality care underpinned by reflection of performance
NSW Health CORE Values: against specific focus areas,
Collaboration, Openness, Stronger Consultation key performance indicators and
Respect and Empowerment. Engagement meetings were most importantly, meeting the
held with clinical and non- expectations of our community.
The Safety and Quality clinical leaders across the
Account 2019/20 was created district to inform this year’s Graeme Loy
in consultation with key account. These meetings Chief Executive
representatives including, were facilitated to collect any Western Sydney Local Health
clinical leaders, executives and information that will capture District
non-clinical staff to ensure how well we communicated to
alignment with the following our consumers and workforce
WSLHD Strategic Plans: about our District and what
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 4
Key achievements in safety and quality
Snapshot of year - end achievements FY2018/19
ChildrenFully Immunised the Executive team with several World Café but ended up
permanent appointments and hosting three events involving
Immunisation in children five new positions including the 350 staff who tackled 16 topics
years and under who were Executive Director Medical drawn from the People Matter
overdue on the Australian Services and Director People
Immunisation Register (AIR)
and JMO surveys feedback.
and Culture to reassure our staff Chief Executive Graeme Loy
has increased as a result of the we are listening and committed
‘Follow-up of Children Overdue was inspired by the level
to improving workplace culture. of interest, enthusiasm and
for Immunisation with Providers’
and ‘Follow-up of Children hope for change. The District
World Café – People Matter
Overdue for Immunisation has now more than 600
without Providers’ projects. WSLHD started a safe culture ideas on how we can make
Ongoing data cleansing is transformation in January 2019 improvements and build
needed to reflect the true with the World Café events. our positive culture. Some
coverage rates in WSLHD. This WSLHD pulled apart our staff initiatives are already underway
will require additional resources and soon expressions of
to maintain the AIR record Experience survey and, interest will be sought for
accuracy. Results from these with help of some actors, involvement in the next steps.
projects instigated a state-wide recreated some of the stories
AIR audit by the NSW MOH. We will continue to work
that the survey responses
provided. While this was quite with our staff and will be
NSW 2018-2019 KPIs: partnering with a consultant
Target: 94%, All Aboriginal
confronting, these reflected
real experiences and staff in culture transformation to
and non-Aboriginal children
needed to hear them. Some assist us in making long-term
(increase from 93% in 2017-2018)
Target: 94%, All Aboriginal and of the topics discussed improvements and build a
non-Aboriginal children at one included: recruitment, career culture that will make WSLHD
year of age (increase from 92% development opportunities, the best possible place to work.
in 2017-2018) senior leader communication,
delegations, manager As a District, we are committed
WSLHD coverage data quarter capabilities and grievance to making the changes that
ending December 2018: handling. are needed to improve the
Aboriginal children at one year experience of our staff.
old 96%; non-Aboriginal children We commenced the year
at one year old 92.7%; Aboriginal intending to hold a single
children at four years old 97.4%;
non-Aboriginal children at four
years old 93.6%.
People and Culture
People Matter Survey
People Matter Survey
In 2019, 41% of WSLHD staff
participated in the People Matter
Survey, an increase of 12% from
2017. Since last
year’s survey, we have engaged
an external consultant in
organisational culture to partner
with the District and have
since made improvements in
recruitment, career development
opportunities, senior leader
communication, established
Committee/working groups
to lead change management,
grievance management and
more. We have some changes in
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 5
Digital Health Program WSLHD is the first District in occurred as a result, including
NSW to develop an electronic time to commence antibiotics,
The Digital Health Program resuscitation plan in the eMR. tests ordered and intensive
continues with further This appears on the banner care (ICU) admission.
implementation of key bar and is active for a period
projects to enhance and In order to increase patient
of up to 3 months as requested
promote benefit realisation of visibility, work is being
by the End of Life (EOL)
the electronic health record undertaken to translate the
Committee.
and digital hospital. This will ED Sepsis Alert report into a
provide clinicians with tools Outpatient eOrders Qlik Sense dashboard with a
to improve safety of clinical planned completion date by
WSLHD is the first District in
practice, improved evidence- end 2019.
NSW to implement electronic
based care practice guidelines ordering of pathology and Clinical Documentation
and support applications. imaging in the outpatient
setting. This will result in With the new eMR system
Electronic Medical Record
significant financial reduction for ED and inpatient units,
(eMR) Enhance
in billing of tests as the costs there have been significant
The eMR Enhance project for tests will be covered by improvements in clinical coding
has had an impact across all Medicare. and increased documentation
disciplines and implemented accuracy for doctors and allied
state and world first Glucose Monitoring MPage health staff.
functionality for WSLHD.
WSLHD has implemented Discharge Summaries
This project will continue to improved prescribing and WSLHD is the first in NSW
optimise the eMR for improved monitoring of glucose levels to develop a district-wide
clinical quality and patient and diabetic medications for discharge summary which
outcomes. patients. will interface with HealtheNet
The eMR Enhance program (a program that connects
features: Emergency Department (ED) disjointed patient information
Sepsis Alert systems) and the My Health
Medication Safety with eMeds/
eFluids The Digital Health team worked Record.
in close consultation with This will enrich clinical
eMEDs is an electronic senior ED doctors to develop
medication management information available in
the Sepsis Alert which was then HealtheNet and improve
system that improves rolled out in late 2018 to all
effectiveness of medication communication with GPs.
District EDs.
management. This application Digital Health have now
supports clinicians as they The reporting component completed the enhancement in
prescribe and dispense the of the Sepsis Alert enables Powernote, which is configured
administration of medications. identification of all patients to send discharge summaries to
placed on the Sepsis Pathway both HealtheNet and GPs.
Resuscitation Status and key aspects of care that
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 6
Integration of ARIA eChemo into Westmead Cancer Services
Digital Health Services have clinical practices associated maintain a library of evidence-
implemented the ARIA eChemo with prescribing, dispensing based protocols approved for
program into Westmead and administering cancer use across the District and limit
Cancer Services. treatments and supporting miscalculations and writing
regimens for outpatients. errors associated with hand
This provides a new District-
written prescribing.
wide governance model The initiative will improve
with electronic capability to patient safety by using the
better monitor and improve ARIA system to build and
Clinical Emergency Response System
In February 2019 the a tool that allows clinicians to breaches, meaning the patient
standardised WSLHD Clinical call for help with regards to is at risk of deterioration and
Emergency Response a patient’s clinical condition requires a medical review.
System for all adult inpatient when it is required. Early data
departments was rolled out indicates a significant increase
across the District. This is in notification of red zone
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 7
WSLHD Aboriginal Elders Olympics
The inaugural Western Sydney
Aboriginal Elders Olympics
was a one-day event held at
The Police and Community
Youth Club (PCYC) in Mount
Druitt. The event provided an
opportunity for Elders to come
together and have their health
checked by the community
health team in a social sports
setting, whilst being recognised
and respected for who they are
and what they represent, as
well as the chance to network.
A group of 65 Elders formed
5 teams and participated in
sports such as flip the loop, an
egg and spoon race, a three-
legged race, tunnel ball and
a throwing station. Awards
were presented to the groups
that showed enthusiasm and
teamwork. Major contributors
included the Emerton Men’s
Shed/Western Sydney
University, PCYC and Active
Van (Parramatta Council).
Elders Olympics events have
been run successfully across
NSW by other Aboriginal
organisations, but never
before in WSLHD. The event
has provided a new way to
work collaboratively with
Aboriginal and non-Aboriginal
organisations to build
capacity of the Aboriginal
community in the District and
promote healthy eating and
exercise. It also reinforced
the WSLHD Integrated
Care Living Well Training
Program, which incorporates
education modules such as
how to self-manage chronic
illness, communicating with
health professionals, reading
food labels and dealing with
emotions.
Participants were asked to fill
out an exit survey at the end of
the day with assistance given
by scribes for feedback to
prepare next year’s event. It will
be continue as an annual event
in the lead up to the NSW Koori
Knock Out.
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 8
Annual Perinatal Cultural and Women from CALD The conference allowed for
Linguistic Conference backgrounds often come sharing of experiences dealing
from non-English speaking with CALD patients and the
More than 300 women
backgrounds (NESB) and find opportunity to develop new
from various nationalities
it challenging to navigate their ideas that can be translated
who work in health and
way around the health system. into future projects.
government agencies gathered
at Westmead Hospital for
the annual culturally and
linguistically diverse (CALD)
Perinatal Conference, which
addresses ways to provide
better care for pregnant
women.
The conference is a
collaboration between
Westmead Women’s &
Newborn Health, the Women’s
Health Clinic, Westmead
Medical Research Foundation
and the Community Migrant
Resource Centre.
Clinical Quality Indicators – wish to use based on the type Kaleidoscope Arts and Culture
Westmead Gynaecological of work they’re doing. Program
Oncology Department
77% of staff reporting that The BMDH expansion project
Westmead Hospital was ABW contributes to a more team have consulted with more
selected as one of the six pilot productive environment than 60 community partners
sites for the development of and 86% report it is more and 500 staff to develop an
the National Gynae- Oncology collaborative than traditional arts and culture program to
Registry (NGOR), a registry workspaces. help improve patient well-being
established to monitor and whilst in hospital. The program
The ABW reflects the evolution
improve the care provided to will continue in 2019/2020
of healthcare delivery, research
women with gynaecological
and education, as well as new with the completion of major
cancers, in turn allowing
ways of working. artworks for the new Acute
for national clinical quality
Services Building.
benchmarking.
Blacktown Hospital
During the pilot phase (Jan
Redevelopment
2018 – Jan 2019) data was
collected for ovarian, tubal and Medical Day Unit Opening
peritoneal (OTP) cancers, with The BMDH expansion project
the ultimate plan to roll this out developed the new Medical
nationally for all gynaecological Day Unit to improve access
cancers. For the 12-month pilot to services for outpatients
period in 2018 there were a who need rapid contact with
total of 103 events recorded for specialists, tests or treatment
63 patients. that can’t be provided in a
community setting. The unit
Activity-based working (ABW) helps reduce unnecessary
Blacktown Hospital is the presentations to the ED, whilst
first hospital in Australia with providing better continuity of
purpose-built, co-designed care for patients with chronic
conditions.
ABWs for clinical staff. Instead
of being restricted to one
space, ABW allows staff to
choose the type of space they
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 9
Project Consumer Consultation Healing Garden at Mount Druitt Hospital
Program
For the design of the new The Healing Garden was Sydney Leadership Dialogue
hospital building, all planning completed in collaboration Boomtown! Awards as part of
groups included a consumer with local Aboriginal Elders, the Community Dialysis Centre
representative where possible winning Health Project of Project.
to ensure that patient, carer the Year in the 2018 Western
and consumer views were
taken into account when
designing the new facilities at
Blacktown Hospital.
New Acute Services Building
The new Acute Services
Building at Blacktown Hospital
will open in mid-2019 and
will provide new, expanded
facilities for the ED, operating
theatres, ICU, maternity and
paediatric services. Blacktown
hospital will grow to become
a major teaching hospital for
Western Sydney. The ‘MOVE’
Program commenced in May
2019 and will deliver training
and readiness sessions for
more than 3,000 hospital staff
to ensure they are prepared
for occupation of the new
building.
Westmead Redevelopment Mental Health Services Access Block (Mental Health
Presentation in ED >24 hours)
The Westmead redevelopment The District mental health
has provided a unique service (MHS) continues to The rate of mental health
opportunity to work in reduce the use of seclusion presentations exceeding the
collaboration with Aboriginal and restraint. High rates of 24 hour benchmark in EDs has
communities to address health trauma (particularly steadily declined.
inequalities experienced by
childhood abuse) are reported Inpatient Absconding
Aboriginal people.
in the history of people with
A continued decline has
The precinct has supported severe mental illness, and
been noted in the number of
community events including because seclusion and restraint
inpatients absconding from
Close the Gap, National is a highly restrictive practice,
Mental Health units. Increased
Apology Day, Harmony Day it can lead to significant re-
staff vigilance on consumer
and Reconciliation Week in traumatisation of vulnerable
observation and engagement,
order to promote and enhance persons.
risk assessments of courtyards
understanding of Aboriginal,
The program in WSLHD MHS and necessary minor capital
Torres Strait Islander and CALD
is based on the Creating works have all contributed to
communities.
Positive Cultures of Care the improved performance.
The overarching Aboriginal Program and the Safe Wards
Legacy Strategy is aligned with Program and includes the
existing Aboriginal and Torres following strategies: leadership,
Strait Islander strategies and workforce development,
plans at Westmead, as well as trauma-informed care,
the National Safety and Quality improving the therapeutic
Health Service Standards for environment, incident review,
Aboriginal and Torres Strait consumer and carer co-design
Islander Health. and the use of data.
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 10Mental Health Consumer Project unWIRED
Co-Design
The unWIRED project aims to
The first model of care
revolutionise the interaction of
workshop to inform the
community mental health staff
redevelopment of the Sub-
with consumers using personal
Acute/Non Acute service was
e-health devices.
held in February 2019. The
workshop included clinical and The project is in the final
non-clinical staff, peer workers stages of a complex ethics
and carer representatives who and governance approval
worked together to plan what process and will soon start
the model of care should look a data collection phase. Key
like to enable optimum care staff have been employed
including consumer and carer and have engaged with the
experience. Prevention Early Intervention
and Recovery Service (PEIRS)
The Mental Health Clinical
team from which patients and
Council continues to
clinicians will come.
engage consumer and carer
representatives to review the Project Air
operations of the service. The
Project Air commenced in
Clinical Council has assisted
January 2019. The strategy
with initial development of the
links to the Living Well
draft models of care. At each
strategic plan for Mental Health
meeting, a broad range of
and has been progressively
issues are considered by the
rolled out across NSW since
Council to support continued
2015.
reform and co-design.
A review of the WSLHD Mental
Project Advantage
Health Service was conducted
WSLHD has initiated and by the Project Air Strategy
led a partnership across and University of Wollongong
local health districts to in 2016 to determine how
bring cognitive remediation effectively the organisation
programs to young people provides care for consumers
with a severe mental illness. in crisis, particularly those
The Advantage Trial is a multi- presenting to hospital with
site Randomised Control Trial a diagnosis of personality
(RCT) investigating the effect disorder.
of combining cognitive and
social cognitive remediation
programs to improve everyday
functioning for young people.
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 11About Western Sydney
Local Health District
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 12Snapshot
A year in the life of our District. In 2018/19 there were:
200,599 178,103 44,728
ED PRESENTATIONS ADMISSIONS SURGERIES
10,658 44,770
BIRTHS VACCINES INJECTIONS
IN HIGH SCHOOLS
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 13WSLHD’s social media achievements 2018/19
FACEBOOK TWITTER
WESTERN SYDNEY @WESTSYDHEALTH
HEALTH
100,000 50,000
WEEKLY REACH TWEET VIEWS PER MONTH
INSTAGRAM LINKEDIN
@HUMANSOFTHEHOSPITAL WESTERN SYDNEY
LOCAL HEALTH DISTRICT
4,600 58,000
POST VIEWS MONTHLY POST VIEWS
WSLHD hosts an annual public meeting. More than 100
people attended the forum in 2018 which included a live
video stream of the event enabling 1,000 people to view
and participate in a Q&A session with our experts.
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 14Priority People
Western Sydney
is a diverse
community with a
complex range of
health needs, but
we’ve prioritised
some groups due
to their significant
health needs. CHILDREN, YOUNG PEOPLE LIVING WITH A
PEOPLE & FAMILIES MENTAL ILLNESS
ABORIGINAL PEOPLE PEOPLE FROM DIVERSE
CULTURAL GROUPS
PEOPLE WITH CHRONIC OLDER PEOPLE
& COMPLEX CONDITIONS
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 15The Health Care Quality and clinical quality systems that others will make the same
Committee (HCQC) is and aims to drive a culture mistakes.
a sub-committee of the of continuous improvement,
WSLHD Board and the peak innovation and excellence. Clinical Governance (CG)
governance committee for provides a learning framework
safety and quality in the District services are supported that aims to support all
District. HCQC is responsible in accordance with the NSW clinicians and managers in
for the governance of the Health Patient Safety and making WSLHD demonstrably
NSW Health Patient Safety Clinical Quality Program better and safer for our
and Clinical Quality Programs (PD2005_608). This Program patients, as well as a rewarding
and provides assurance to the is founded on a culture of workplace for our staff. Our
Board on safety and quality. openness in which errors are specific priorities and focus
The HCQC provides strategic acknowledged and reported, areas are listed below:
oversight of patient safety in order to reduce the chance
Overaching priorities Focus area Enablers
• Patient Safety • Reducing Preventable Harm • Building Capability
and Mortality
• Person Centered Care • Leadership and
• Meeting Consumer Needs Accountability
• Reliability
• Reliable Care Processes • Real Time Information and
• Quality improvement
• Harnessing innovation Measurement
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 16WSLHD Clinical Governance safety, with focus on continual (QIDS) safety reports have
Framework improvement and robust risk been developed to create
mitigation strategies. a comprehensive picture of
Western Sydney Local Health patient outcomes, the provision
The District has seen an
District (WSLHD) is committed of trended information
increasing number of
to providing care to all patients such as hospital-acquired
incidents reported with an
that is safe, reliable and of a complications (HACs), and
accompanying decrease
high quality. to understand system wide
in severity, which can be
quality indicators.
interpreted as improvement
Part of this commitment is
in reporting incidents in order
ensuring that continuous
to reduce patient harm and Safety Walkarounds
improvement occurs across all
optimise clinical care.
levels of the organisation. Safety walkarounds provide
Standardised Patient Safety an opportunity for our patient
The WSLHD Improvement Reports safety and clinical quality team
Framework provides an to demonstrate commitment to
Clinical Governance has worked
overview of improvement building a culture of safety.
to improve the understanding
within the District, including
and reliability of patient safety
the methodologies used to
reports, in addition to building
guide staff.
capacity within the workforce
Proving Incident Reporting to access and understand local
Culture datasets that identify and focus
on areas for improvement.
WSLHD has continued to foster The standardised Quality
a culture change for patient Improvement Data System
Clinical Emergency Response System (CERS) Quiz
CERS – Blacktown Hospital recipients with the A/director of Nursing & Midwifery Rola Tawbe and Director of Medical Services Dr Brett
Gardiner – 7 May 2019
Districtwide implementation of As there is currently no staff on the district-wide CERS
any initiative poses significant formal assessment of staff program that was rolled out
challenges including lack of understanding of the Clinical across the district in February
staff engagement and the Emergency Response Systems, 2019.
ability to assess the degree of theCERS Quiz was developed
success. as an educational initiative for
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 17Safety and Quality Enablers can analyse process failures needed for sustainable patient-
that lead to inefficiencies centered system change.
Key improvement
and/or patient harm, as
methodologies as outlined A central premise of the CLP
well as design solutions to
in the WSLHD improvement is that leadership occurs at all
continuously improve care for
framework are listed below: levels in health care and is not
patients.
dependent on the position to
QI Curriculum
The CEC provides CPI training which a person is appointed.
The Quality Improvement (QI) to frontline clinicians and works WSLHD continues to support
Curriculum is aimed at clinical closely with WSLHD. staff attendance.
and non-clinical staff who wish
Clinical Leadership Program
to develop their QI skills.
(CLP)
CPI Training
The aim of the CLP is to build
Clinical Practice Improvement a cohort of effective clinical
(CPI) training provides a leaders who progressively
framework whereby clinicians become the ‘critical mass’
AIM
Accelerating Implementation
Methodology (AIM) is a
practical guide to effectively
managing change by
overcoming personal and
cultural barriers.
It’s about learning how to
address or remove obstacles
that might prevent you from
delivering projects on time, on
budget and within scope.
It is particularly beneficial for
those: currently implementing
a project, about to implement
a project, involved in an
improvement initiative,
authorising, approving or
managing staff involved in
project implementation.
Practice Development and Quality Improvement Program
Over the last FY2018/2019 • 16 teams are preparing to meetings. The PD labs aim to
submit abstracts for the equip staff to review practice
• 49 teams actively
2019 NM showcase to be & facilitate change. The initial
implemented quality
held in Sept feedback after the initial
improvement initiatives or
sessions has been positive.
projects This year we have increased
the workshop availability and
• 11 participants attended the
have introduced Practice
Practice Development
Development (PD) labs, to
(EOC) workshops
replace the EOC advisory
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 18National Safety and Quality Health Service Standards
National Safety and Quality in Mental Health Services have Preparation continues
HealthCare Standards Version 2 undergone Accreditation. for Westmead Hospital’s
(Blacktown Hospital was assessment against the new
All facilities have undertaken
assessed under version 1) scheme and identifying key
a gap analysis against version
Action plans have been strengths and weaknesses
2 of the National Standards
developed in response to for our performance against
for Safety and Quality in
recommendations generated at the new Standards for
Health Care. Three facilities
survey. accreditation.
– Blacktown, Auburn and
WSLHD Quality Awards
Each year, the District community. Selected projects
Council on Healthcare
recognises our dedicated are supported for submission
Standards Quality Awards.
staff and their contribution to for further recognition at a
improvements in the delivery state and national level as part The next quality awards night
of health care. The benefits of the NSW Health Innovation will be held in September
extend to our patients, Awards, the NSW Premier’s 2019 with eight categories
carers and their families, as Awards and the Australian that mirror the NSW Health
well as to our staff and the Innovation awards categories.
Pictured: WSLHD Director of Clinical Governance Luke Sloane and Quality and Accreditation coordinator Natalie Fester Lloyd with
some of the Clinical Governance team at the 2018 WSLHD
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 19Education for Person-Centred calls across the District from a The video is available on all
Care range of departments. Patient Entertainment Systems
As well as paper brochures, by the bedside and can be
Person-centred care education
R.E.A.C.H information is shown to the patient when
continues to be a key message
now available on all Patient they arrive on the ward and be
delivered to staff at orientation.
Entertainment Systems in accessed anytime during the
Outlined is the importance
English as well as the top ten admission. For patients who
of person-centred care,
languages used in WSLHD. do not speak English, there are
measuring experience and
Ensuring we talk to all of our translated copies available on
including carers in care. In
consumers in a way they the system.
2018-2019 over 2,000 WSLHD
understand and prefer is
nursing staff completed the
central to patient experience
online person-centred care
and safety.
and partnering with carers
education session. The Patient Experience
Manager and Westmead’s
Recognise, Engage, Act, Call, Aboriginal Liaison Officer
Help is on its Way (R.E.A.C.H) are part of the Clinical
Excellence Commission’s
R.E.A.C.H is a system
R.E.A.C.H Aboriginal Advisory
developed by the Clinical
Group, a statewide initiative
Excellence Commission (CEC)
to understand and develop
that helps patients, their
R.E.A.C.H information relevant
family and carer/s escalate
to Aboriginal patients.
their concerns with staff about
worrying changes in a patient’s Patient Safety Video
condition.
The patient safety video ‘What
If there is ongoing concerns matters to you matters to
after the initial response, us’ was created by WSLHD
there is the option to escalate to provide easily understood
concerns by requesting a information to patients about
clinical review which should the hospital experience. The
occur within 30 minutes. In concept is the same as airline
2018 there were 32 R.E.A.C.H flight safety videos.
Patient Experience Symposium 2019
The symposium, held on April
29 and 30, is an annual event
which aims to unite people
who are passionate about
improvements in healthcare
with two days of inspirational
international and local
speakers.
The Patient Experience team
have gathered feedback from
staff who attended about
projects they would like to
develop in their personal
professional practice, in
their teams and ideas they
think the District as a whole
should consider. A WSLHD
community of interest group
has developed from the
symposium.
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 20Patient and Carer Stories Carer Program are based in hospital and
Patient and Carer stories in the community. The
The WSLHD Carer Program is
are continually collected creation of a ‘Carer Retreat
responsible for implementing
and shared across WSLHD. and Resource Centre –
the NSW Carers (Recognition)
From the District Board Because we care’ strategy
Act 2010, the NSW Carers
right down to ward team was developed to promote
Strategy 2014-2019 and
meetings, knowing the patient the need for such space.
support the principles of the
experience, both positive and NSW Carers Charter in the
negative, keeps staff aware District. The Act requires we
of what is important to our treat carers with dignity and
patients, consumers and their respect and their contribution
carers. to society be recognised. The
The Patient and Carer District’s Aboriginal population
Experience team gather and has a higher proportion of
develop patient and carer carers compared to other
stories for various media as priority groups.
well as provide education and On average, Aboriginal
support for all staff to hear and carers are younger than
tell these stories. Stories offer non- Aboriginal carers and
the opportunity to monitor our accept the role to be part of
services and identify where normalfamily and community
quality improvement may be life.
needed.
Key initiatives of the Carer
Patient Report Experience Program include:
Measures
• The ‘Visiting Hours and
A KPI for the District is to Staying Overnight with a
obtain a measure of overall Patient’ policy: created
care received from the client’s to support those visiting
perspective. afterhours and/or staying
Information from people overnight. As a result of
about their experiences can the recent Carer Zone
help improve the way care project having family stay
is provided and ensure that over leads to improved
people get the best outcomes patient experience and
from their care. safety. The development
of Carer Zones in the new
The Agency for Clinical Westmead and Blacktown
Innovation are implementing a buildings means patients
new IT platform called Health who benefit from having
Outcomes Patient Experience someone stay overnight
(HOPE) to capture both will be supported by a
outcomes and the experience designated comfortable
of clients. The HOPE system space for the carer to
will be implemented in WSLHD sleep.
as part of the Integrated Care
strategy and will go live in late • National Disability
2019. Insurance Scheme (NDIS):
Community Youth Health • Carer Retreat and
services have create an ‘emoji’ Resource Centre: The Carer
survey to suit their population Programhas worked with
group. The six question survey the redevelopment team to
has been approved by the submit a Project Initiation
Youth Health Council and will Request (PIR) for a Carer
look to improve the experience Retreat and Resource
of our young adults traveling Centre in Westmead’s new
through our health service. Acute Services Building.
The centre would provide
respite, support and
comfort for our carers that
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 21A Westmead Carer Story
Lorraine Russel has been which medication or feeds may the best decisions for Sarah-
caring for her daughter Sarah- be needed. On top of clinic Jane when she can find some
Jane 24/7 for 22 years. Sarah- visits, if Sarah-Jane needs to be time to get away to a calm
Jane was born with semi-lobar admitted to hospital Lorraine non-clinical environment to
holoprosencephaly and Dandy- will sleep next to her bed every gather her thoughts. Lorraine
Walker malformation. This night and not be able to return highlighted that being able to
requires high levels of constant home until she is discharged. access correct information,
care and means multiple clinic networks, time spent on your
Lorraine describes the caring
visits and hospital stays every own as well as having your own
experience as a constant
year. interests in life are important
high level decision making
for a carer’s mental health
Lorraine will bring Sarah-Jane process by understanding and
and the health of the person
to the hospital at least twice evaluating complex information
they care for. Lorraine believes
a month for clinic visits. Each and its impact on her daughter
providing a Carer Retreat
visit from packing to leave and their family.
and Resource Centre would
home getting to hospital and
This can feel as though a carer support carers in the hospital
then returning home takes an
is breath away from breaking environment.
average of five hours during
point. Lorraine feels she makes
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 22Planned and Realised Actions
2018/2019
Western Sydney is a diverse community with a complex range of needs, but we’ve prioritised some
groups due to their significant health needs.
Improvements achieved in alignment with the WSLHD Quality and Patient Safety Framework, Health
Services Plan to 2026 and the Better West Strategic Priorities for the 2018/19 FY are listed below.
Better West 2019-20
Strategic priorities
Focus
Spending wisely
We have a commitment to our
community to achieve real results
Healthy people Integrated research, for our investment. We will ensure
education & clinical care we are efficient and delivering
We are invested in keeping value from our spending so the
the people of Western Sydney people of Western Sydney get the
We will make research and
healthy - now and in the future. best healthcare. We will build on
education integral to our pursuit
Together with our partners, we our strong foundation in health
of excellence in clinical care. We
are improving children’s health for economics to make Western Sydney
will evaluate and act on the needs
current and future generations. We healthier in the face of limited
of our identified priorities to drive
are addressing Western Sydney’s resources and growing demands.
continuous improvement. Research
diabetes hotspot challenge. We are will be accelerated into effective • We will accurately evaluate and
enhancing the understanding and clinical service models that deliver assign our activities
management of mental health in our positive health outcomes. to attract appropriate funding.
community.
• We will take an integrated whole • We will analyse high quality data PEOPLE LIVING WITH
• We will promote a good start for of hospital approach to ensure and information to maximise A MENTAL ILLNESS
the first five years of life, with care is delivered in the best way, our use of resources, improve
a key priority on reducing child applying best practice, for the our operational efficiencies and
obesity by 5% over 10 years by best value. reduce variations in care.
encouraging activity and healthy
eating. • We will clearly delineate our • We will pursue broader
services, coordinating our opportunities to bring additional
• We will beat diabetes together by surgical and interventional resources to the west.
increasing prevention, screening programs to improve clinical and
and enhancing community and cost outcomes.
hospital management to slow the
progression of diabetes in our • We will reform our mental health Information underpins
community. services so that people with
mental illness are supported to everything we do
• We will increase community live well in the community and
awareness and understanding access treatment as required. We understand that health strategy
of mental health issues and and digital health are now one and ABORIGINAL PEOPLE
breakdown stigmatisation. the same. Exceptional health service
delivery depends on access to high-
Patient experience quality information, when and where
Exceptional people matters it is needed. Information management
and digital technologies will transform
We will improve our communications, the way we work, where and how we
Our people are the heart of our
be transparent and accountable. We provide services, how patients interact
organisation, we want to support,
will deliver safe, quality care whilst with us and how we integrate clinical
nurture and recognise them. We are
retaining dignity and respect. We care with research and education.
committed to supporting our people
to work with confidence. We will will strengthen our systems, our • In collaboration with our partners,
strengthen our education to ensure processes and our care interactions. eHealth NSW, Health Infrastructure
they maintain their ability to deliver We will ensure the voice of the NSW, and our Primary Health
world-class health care of the future. people of Western Sydney is heard Network, we will implement our
We will invest in making it easier for in all aspects of care - health care eHealth strategies and investment
our people to do a good job. policy, planning, design, delivery and plans so we have the information PEOPLE FROM
evaluation. systems and services we need. DIVERSE CULTURAL
• We will invest in our people
systems and structures to attract, • We will learn from the • We will lead the development of GROUPS
retain and develop people of the experiences of our patients, health data sciences capabilities
highest calibre, strengthen our carers and families, with a focus in Australia with our University
recruitment practices and invest on collaborating with people partners, making data sciences a
in optimising the performance of from our community to improve core component of the Westmead
our people. our services. Precinct Innovation Centre.
‘Big data’ will drive continuous
• We will reinforce clinician • We will strengthen our care teams
improvements and innovations.
leadership and invest in working collaboratively with
leadership skill development, roles patients, carers and families to • We will build our health informatics
and responsibilities to promote provide holistic coordinated care. capability by establishing clinical
effective decision making. information leadership roles and
• We will help people to better embedding health informatics
• We will strengthen the behaviours understand their health and in our management training and
for working well together. manage their care. leadership development.
PEOPLE WITH
CHRONIC & COMPLEX
CONDITIONS
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 23This section of the Safety and Through consultation and • Reducing preventable harm
Quality Account provides collaboration between all and mortality
a summary of some of the of WSLHD’s services and
• Meeting consumer needs
initiatives implemented to facilities, the agreed initiatives
drive WSLHD’s safety and and focus areas for the 2018/19 • Reliable care processes
quality priorities. financial year were grouped
• Harnessing innovation
into four key areas:
Healthy People
Aboriginal Art Projects • ‘The River’ will be located Opportunities to develop
in the corridor from the and transition Aboriginal
The Arts and Culture
main entrance atrium and Torres Strait Islander
Committee in consultation
towards the University construction staff
with the Aboriginal and Torres
Clinics in Westmead. It will
Strait Islander Advisory Group The redevelopment team
be infrared photography
have commissioned several have been working in
of Parramatta river,
Aboriginal art projects across partnership with the Westmead
showcasing the importance
the District, including: Connectivity Centre (a
of water to Aboriginal
Multiplex initiative) to identify
• ‘The Night Sky’ is an people
opportunities to develop and
artwork by Darug artists • ‘Tools of Knowledge’ transition Aboriginal and Torres
Leanne Tobin and Leanne is sculptural seating Strait Islander construction
Watson in collaboration representing working staff to long-term employment
with astrophysicist Ray stones used by Aboriginal at Westmead hospital. Recent
Norris, to represent people graduates of the program
Aboriginal knowledge
• The ‘Gathering Place’ obtained the skills they need to
of the sky. It is due to be
garden will be a smoking undertake a formal traineeship
installed in September
pit and yarn circle within within the construction
2019 in the Innovation
the landscaped area next industry. This initiative links in
Centre as part of the new
to the cultural gathering with the Aboriginal strategic
Acute Services Building at
place outside Westmead direction of WSLHD.
Westmead
hospital designed for
• ‘Welcome to Country’ community events, sorry
video wall will be installed business, and celebrations.
in the main entry lobby
exhibition space
The Healthy Mums and Happy Bubs Project
As a result of extended pilot playgroup and the Aboriginal program engaged in smoking
testing, specialist smoking Maternal Infant Health Services cessation and nappy vouchers
cessation support has (AMIHS) antenatal drop-in were given to participants for
commenced at two Aboriginal clinic. quitting or cutting down.
child and maternal health
Results found that 89% of
services: New Directions
women approached about the
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 24Chronic and
Complex
Conditions
Western Sydney Diabetes (WSD)
Diabetes is a critical health
priority for Western Sydney,
and WSD was established
in order to increase the
proportion of the healthy
population, slow the
progression towards people
being at-risk for diabetes, and
reduce the size of the at-risk
population.
Hepatitis testing in the community
The Storr Liver Unit at virus that causes inflammation specialist staff. Testing takes
Westmead Hospital is taking of the liver and is spread just a few minutes, and once
Hepatitis testing out into the through blood-to-blood blood has been collected,
community. The District has contact. The van will offer free patients requiring treatment
launched a mobile van to make blood collection and blood can commence care plans in a
hepatitis C testing much easier spot testing for hepatitis C by matter of weeks.
and faster. Hepatitis C is a
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 25Metabolic Syndrome Screening children aged 3 – 4 in Willmot the Mental Health Therapeutic
and Monitoring Mental Health and Lethbridge Park through Environment Minor Capital
Collaboration early childhood education Works Program (TEMCWP)
centres, with a primary focus to improve the therapeutic
The Blacktown Mental Health
on children living in social environment in mental
Service has collaborated
housing. health units resulting in the
with the WSD team in the
reduction of seclusion and
establishment of monthly joint Middle Years Project (MYP)
restraint in acute mental health
specialist clinics, which have The MYP is a partnership facilities. Working groups
been in place for the last nine project with WSLHD, Sydney including consumers, carers
months. Children’s Hospitals Network and staff were formed for
Weight and Height Stations in (SCHN), FACS, NSW Police, the implementation of each
Community Health Centres Juvenile Justice and WSPHN project.
which provides support for
Child and Family Health are TEMCWP to Reduce Seclusion
vulnerable students in years
implementing weight and and Restraint – Peer Services
five and six transitioning to
height stations in Community Consultations with Consumers
high school with behavioural
Health Centres.
disorders. An important requirement from
Nurses will work with the Ministry of Health was to
The project is currently
population health and have consumer and carer input
working in three schools within
paediatric services to facilitate to inform and help co-design
Western Sydney, but it is hoped
routine growth assessments the process for the Therapeutic
that with successful long term
for all appropriate children Environment Proposal and
outcomes the model can be
presenting for service across to be a part of the sign-off
extended to other schools in
the LHD. process for the application.
the area.
Routine Growth Assessments Over a two week period, peer
Youth Health Services have
of Children and Adolescents workers were able to speak
provided health assessments
with 22 consumers. Out of
WSLHD is improving their for an identified cohort of
these consumers, seven self-
focus on conducting growth children in two public schools,
disclosed they had the personal
assessments of children and and developed and implement
experience of seclusion and/
adolescents, providing brief health management plans
or restraint and agreed to be
interventions and appropriate to support their health and
interviewed further about their
healthy weight messages and development needs to be met.
experience.
referral pathways.
In late 2018, a MYP speech
There were many consumers
Thriving Families NSW pathologist was recruited to
that attended the focus group
work with children at Willmot
Thriving Families NSW who had not experienced
and Noumea Public Schools
commenced accepting referrals seclusion and/or restraint
to undertake communication
in August 2018. It is part of the themselves but had witnessed
screening, provide individual
state-wide Their Futures Matter this as part of being a
and group therapy as required,
reforms for NSW. Thriving consumer on the unit.
provide training for teachers
Families NSW provides clinical
to support young people Themes throughout included:
antenatal and postnatal
transitioning to year seven at
care, case managers, family • Risk to personal safety and
Chifley College.
conferencing and perinatal a feeling of being scared
mental health support to young This is proving to be a on the units
parents. successful project with
• Environment
excellent support from the
The Hive Health Project
schools and families. A Service • Restrictive Practices
This project is in partnership
Level Agreement with the • Boredom
with FACS and will support
Department of Education Communication
the provision of health •
supports the MYP.
assessments and development
and implementation of health Therapeutic Environment
management plans for at risk Minor Capital Works Program The consumers and carers
and vulnerable children in (TEMCWP) in WSLHD were significant
kindergarten at Lethbridge partners in securing funds
WSLHD was successful in to improve the acute unit
Park and Willmot Public
obtaining nearly $1.6m in environment to reduce the
Schools in 2019, and for
funding for six projects under incidents of seclusion and
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 26restraint that occurs in mental meetings and hence came the The majority (84%) of services
health inpatient units. idea of the Clozapine Peer are trained in and have
Group (CPG). Consumers implemented the Munch and
The feedback provided by
reported that they felt relaxed Move program and 69% are
consumers was invaluable to
on the day. They were highly meeting the targeted number
the proposal and was a rich
engaged in discussion, with of key practices.
source of information to the
singing and sensory activities.
Executives and to the mental The SUCCESS App
There are currently over 1000
health service.
consumers receiving mental Researchers from the
These experiences were health services from adult University of Sydney, WSLHD,
further captured in the 2019 mental health teams. Nepean Blue Mountains Local
NSW Patient Experience Health District (NBMLHD),
Mount Druitt Children’s Wards
Symposium, where three Sydney Local Health District
Oral Care
posters presentations on TEP (SLHD) and North Sydney
were accepted. The Oral Health department Local Health District (NSLHD)
provide continued delivery of have developed a model
Clozapine Day
oral care packages and oral of care and app-based
Clozapine is a major care instruction to children intervention to build health
antipsychotic drug that has attending the Mt Druitt literacy capacity and enable
proven efficiency in treatment Children’s Ward. shared decision-making for
resistant chizophrenia. It is chronic kidney disease (CKD)
Munch and Move
associated with major side patients in particular those
effects including myocarditis, Munch & Move is a play-based from CALD backgrounds.
seizures and life threatening program promoting healthy
The app combines a
blood cyscrasias, hence its use eating, physical activity and
standardised patient education
is highly regulated. appropriate screen use in
system using evidence-
children birth to five years
The day was full of based behaviour change
attending family day care or
entertainment, role play and methodologies and health
early childhood service within
educational tips for consumers literacy skills training to
the District. The WSLHD Health
and carers about Clozapine support shared decision-
Promotion team provides
and healthy lifestyle choices; making and self-management
ongoing support, advice and
with very positive feedback for patients with stage five
professional development to
received. On the day, people CKD on dialysis.
442 local services who have
requested regular clozapine
adopted the Munch & Move
program.
Hospital in the Home Rapid Response Team (HITH RRT)
The Hospital in the Home Rapid
Response Team (HITH RRT) is a
collaboration between WSLHD,
Western Sydney Primary Health
Network (WSPHN), NSW
Ambulance and Hospital in the
Home (HITH at Westmead)
enabling rapid access to
medical, nursing and allied care
for people who have urgent
care needs as an alternative to
sending them to the ED.
This service is specifically
targeting patients residing
within a residential aged
care facility (RACF) who
become acutely unwell but are
essentially stable and/or adults
with chronic conditions in the
community
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 27Exceptional This innovative work has been Sydney, Director of Clinical
shown to reduce morbidity, Education WSLHD
people hospital bed days and overall
• Professor Philip John
costs.
O’Connell FAHMS, Director
Work Out West Workforce The studies have become the of Transplantation, Renal
Campaign cornerstone of international Unit, Westmead HospitalDr
The BMDH Expansion guidelines for the treatment of
Saurabh Kumar
Project and the Westmead advanced mucosal neoplasia of
the colon and oesophagus. Dr Saurabh Kumar
Redevelopment team
(cardiologist, Westmead
developed a program to boost WSLHD Researchers
hospital) was the recipient
interest in career opportunities Recognised
of a 2017 Medical Research
in the District through a
The Australian Academy of Future Fund (MRFF) Next
program of events and social
Health and Medical Science has Generation Clinical Researchers
media postings.
elected the following three high Program Career Development
WSLHD Research profile researchers in WSLHD Fellowship (Career
Professor Michael Bourke as Fellows in recognition of Development Fellowship Level
their outstanding contributions 1) to commence in 2018 along
Professor Michael Bourke to the health and medical with a Viertel Foundation
heads the Westmead research landscape in Australia: Clinical Investigator Award.
Endoscopy Unit. Funding has been awarded to
Over the past decade, his Professor Stephen Leeder AO support his research.
internationally recognised team FAHMS, Director, Research and
has developed new methods to Education Network, Western
detect and treat early cancer Sydney Local Health District
of the colon, stomach and • Professor Donald Nutbeam
oesophagus. FAHMS, Professor of
Public Health, University of
NSW Heath Early-Mid Career Research
Associate Professor James In addition, two Westmead meeting. Funding has been
Chong and Dr Saurabh Kumar hospital cardiologists have awarded to support their work.
were both awarded prestigious won young investigator prizes
NSW Heath Early-Mid Career at the 2018 Cardiac Society
Research Fellowships in of Australia and New Zealand
cardiovascular health. (CSANZ) Annual Scientific
Western Sydney Local Health District Safety and Quality Account 2019 – 2020 28You can also read
