2017 WSLHD Quality Awards

Western Sydney Local Health District

2017 Quality Awards finalists

Each year, WSLHD hosts the Quality Awards as an opportunity to harness the creative and innovative ideas of staff, who are committed to making a difference to patient care and health outcomes.

The benefits of the Quality Award projects extend to patients, carers and their families, as well as to staff and the community.

A panel of judges will determine the winners of the 2017 WSLHD Quality Awards. A selection of projects will be submitted for further recognition at a state and national level as part of the NSW Health Innovation Awards and NSW Premier’s Awards.

Category 1. Patients as Partners

Stanford Chronic Disease Self-Management Program

Chronic disease affects every aspect of a person’s life: pain, mobility, fatigue, communication, nutrition, decision making and more. For patients from Aboriginal and Torres islander backgrounds, or who were born overseas, those challenges are magnified by differences in culture, language and health literacy.

From 2014-2017, bilingual workers with the WSLHD chronic disease management team rolled out culturally appropriate self-management programs to 220 chronic disease sufferers – with amazing results.

Health literacy improved, leading to better clinical outcomes. Participants felt more supported and better able to manage their health. Confidence improved.

“…the action plan kept me going to the gym twice a week and doing my exercises at home,” one participant said.

2017 WSLHD Quality Awards finalist team photo - Stanford Chronic Disease Self-Management Program

Transforming Care at the Bedside

You’re in hospital, and nurses are about to change shifts. Imagine if you, and your carers, were part of the handover, providing a firsthand perspective of your experience, concerns and possible improvements.

At Auburn Hospital, that’s exactly what happens after a transformational shift in traditional practices.

The result: fewer trip-ups in care, and greater involvement and empowerment for both patients and carers. After 12 months, more than 65 per cent of patients are regularly asked to join in the handover at the end of each shift.

2017 Quality Awards finalist - Transforming Care at the Bedside

Category 2. Integrated Health Care

Rapid Access to Care and Evaluation (RACE) Program

An estimated cost saving of $400,000 in three months was just the beginning for the RACE program – the impact for geriatric patients presenting to the Westmead Hospital’s emergency department has been even more profound.

Safe, early departures from hospital for elderly patients are at the heart of the program.

A comprehensive assessment identifies suitable patients. They are then discharged for treatment in their home – with a home visit guaranteed within 24 hours. Within five days, a robust individual management plan is put in place.

Average length of stay in hospital has decreased significantly, 90 per cent of patients say they have achieved their goals while on the program, and almost all of them say they’d recommend it to others.

2017 WSLHD Quality Awards finalist team photo - Rapid access to care and evaluation (RACE) program

Community Eye Care in Western Sydney

Partnering with local optometrists, who do standardised exams which are then reviewed remotely by Westmead Hospital ophthalmologists, has reduced the need for hospital appointments by 47 per cent.

This improved access to eyecare means patients get access to opthamologists in the public system quickly, and waiting times have been slashed.

The innovative community program – dubbed C-EYE-C – has also enhanced eyecare in Sydney’s west by building relationships, feedback and learning channels between optometrists and opthamologists.

Of the 241 people who took part in a trial, more than half said they preferred the program, and 85 per cent said they were confident using it.

2017 WSLHD Quality Awards finalist team photo - Community Eye Care in western Sydney

Category 3. Translational Research

Pelvic floor muscle training pre and post radical prostatectomy

Having prostate cancer is bad enough – but suffering incontinence after surgery to deal with it can have long-term impacts on patients’ health and well-being.

In 2016, a Westmead Hospital team began a program of pelvic floor muscle training on 26 patients who had, or were about to have, radical prostatectomies.

The outcome for patients was fantastic - 95 per cent said they were satisfied with the program and nine months after treatment, more than 80 per cent of urologists said it was effective in returning their patients to urinary continence.

The pelvic floor muscle training program was a collaboration between the Westmead physiotherapy department, urologists and nursing staff.

2017 WSLHD Quality Awards finalist team photo - Pelvic floor muscle training pre and post prostatectomy

Category 4. Local Solutions

Westmead After-Hours Nurse Cannulation Team

Cannulation – which places a cannula inside a vein to provide easier access for blood samples, to administer treatment or to supply fluids – is a common procedure in hospital. It’s a job usually done by doctors, but at Westmead Hospital a successful pilot program has revealed an alternative.

Under the program, an after-hours nursing cannulation team was put in place. Using nurses freed up doctors to manage acutely unwell patients.

Sharing the cannulation workload across nursing and medical disciplines has allowed each team to focus their skill sets where they are needed most, improving outcomes for both patients and staff.

2017 WSLHD Quality Awards finalist team photo - Westmead After-Hours Nurse Cannulation Team

Hand Therapy Blitz Shrinks Waiting List!

Patients with acute and subacute trauma to their hands are given priority at Westmead Hospital – but this meant people with chronic hand conditions could wait up to 12 months for an appointment for hand therapy.

Enter the Chronic Blitz Day, where every hand therapist and student at the hospital is made available to assess and treat patients from the chronic waiting list.

At the end of the first Chronic Blitz Day, the waiting list had reduced from 31 to 8 patients. Four subsequent days have been held, sustaining the reduction in waiting times – and resulting in very satisfied patients.

2017 WSLHD Quality Awards finalist team photo - Hand Therapy Blitz Shrinks Waiting List!

Category 5. Preventive Health

Rethink your Drink @ Westmead Hospital

Westmead Hospital cemented its reputation as a trailblazer in preventative health this year when it became the first hospital in Sydney to remove sugar sweetened drinks from food outlets and vending machines.

The project – implemented after a long period of consultation with suppliers – targeted the red-button issue of obesity, and highlighted its link with sugary drinks.

Water was pushed as the drink of choice, leading to a 44 per cent increase in sales. There was also a spike in other healthy drinks as both patients and employees supported the trial.

Rethink Your Drink is now a permanent fixture at Westmead Hospital, and is being emulated across the state.

2017 WSLHD Quality Awards finalist team photo - Rethink your Drink at Westmead Hospital

Reducing Public Health Risks associated with Water Splash Parks

Water parks were identified as an emerging public health risk by the Western Sydney Public Health Unit when it emerged that no health guidelines existed to govern their operations.

The team – working with operators, local government and regulators - became the first public health unit in NSW to do an audit of splash parks, adapting audit tools used for swimming pools. Water splash park guidelines produced by the Western Australia Health Department were also modified and used.

While there was an an outbreak of cryptosporidiosis during the 2016/2017 swimming season in Sydney, there a sharp decrease in cases associated with splash parks.

2017 WSLHD Quality Awards finalist team photo - Reducing Public Health Risks associated with Water Splash Parks

Category 6. Collaborative Team

To Home or Elsewhere - Family Meeting

It’s a frightening situation – being the parent of an unborn baby already identified as being at risk of abuse or neglect.

The ‘To Home or Elsewhere’ project worked with families to break intergenerational cycles of behaviour that make babies and families vulnerable. Lasting change was achieved by taking a multi-pronged approach across multiple agencies.

As a result, there was a 75 per cent reduction in the number of babies taken into care at birth. Family wellbeing and life opportunities were lifted as well.

2017 WSLHD Quality Awards finalist team photo - To Home or Elsewhere - Family Meeting

Partners Make Healthy Normal

Hundreds of staff, volunteers and customers walk through the doors of St Vincent de Paul at Parramatta each year, making it a logical partner for an innovative approach to raising awareness of healthy eating and lifestyles.

More than 40 people signed up for the six-month Make Healthy Normal program – which included a free health coach - as a result of the partnership with Vinnies Parramatta. By the end, they were eating more fruit and vegetables, and drinking more water.

Overall, the increase in awareness driven by the St Vincent de Paul partnership drove a threefold increase to the Get Healthy Service.

2017 WSLHD Quality Awards finalist team photo - Partners Make Healthy Normal

Category 7. Harry Collins Award

Stopping our SABSIs

Staph infections (known in the medical world as SABSIs), however rare, are dangerous. Preventative steps can save lives – as a concerted nine-year hospital-wide effort at Westmead showed.

The aim of the project was to reduce the rate of infections acquired in the 48 hours after admission to Westmead Hospital by improving hand hygiene, aseptic cannulation and central line insertion (which prevents microorganisms being introduced by hands, surfaces or equipment), and looking at surgical prophylaxis guidelines.

In 2008, the rate of infection was more than three per 10,000 occupied bed days.

By 2016, that figure had tumbled to just 0.7 per 10,000 occupied bed days.

From 2013 to 2016, the program prevented 190 episodes and 54 deaths.

2017 WSLHD Quality Awards finalist team photo - Stopping our SABSIs

Spurring on SPAT

Surgical prophylaxis – antibiotics given to patients before surgery - reduces post-operative wound infections and minimises the risk of healthcare-associated infections. In WSLHD in February 2016, 69 per cent of audited antibiotic prescriptions were not given at optimal dosages, a figure the ‘Spurring on SPAT’ program was determined to reduce.

The program implemented the Surgical Prophylaxis Audit Tool (SPAT), which examined dosages, and opened up conversations about how long a patient should be on an antibiotic and how much they should be given.

By September 2016, every audited antibiotic prescription at WSLHD was at optimal dosage. Only 15 per cent of surgical prophylaxis continued beyond the recommended 24 hours, a fall of 31 per cent in eight months.

2017 WSLHD Quality Awards finalist team photo - Spurring on SPAT

Category 8. Arts and Health

Behind Every Favourite Song is an Untold Story: Music and Memory Program in Acute Care

Think about your favourite song. Chances are it brings on a rush of memories: great times, friends, family, experiences.

The music and memory program puts those powerful emotions to work to manage the devastating behavioural and psychological symptoms of dementia.

Individualised iPod playlists are made for each patient. Many now dance and sing, and chat where they previously didn’t. With improved interaction has come reduced agitation and aggression. There is less need treatment with drugs.

One patient - previously aggressive and needing constant supervision – now recognises staff and steps in to calm other patients who are agitated.

2017 WSLHD Quality Awards finalist team photo - Behind Every Favourite Song is an Untold Story - Music & Memory Program in Acute Care

Ten Thousand Paper Petals - a cross-cultural community public art installation

An origami master worked with more than 100 people to create Ten Thousand Paper Petals, a major art installation at Blacktown Hospital.

The project – a floor sculpture of origami flowers five metres in diameter – was designed to build connections and reduce anxiety for the many different communities who use the hospital.

The final work “reduced stress, promoted recovery and created connections” between the hospital and the community, incorporating signs of compassion, optimism and hope.

The project was part of the creative consultation process for the Blacktown and Mount Druitt Hospital Expansion Project Stage 2 Arts and Culture program.

2017 WSLHD Quality Awards finalist team photo - Ten Thousand Paper Petals - a cross-cultural community public art installation

Category 9. Innovation

Not another DVT in the ED

Acute deep vein thrombosis (DVT) is caused by a blood clot in a vein. It restricts blood flow and can have serious health impacts.

This project aimed at assessing and treating 95 per cent of people who presented with acute DVT at Westmead Hospital’s emergency department under global, best practice guidelines by June 2017.

The result was a 60 per cent increase in appropriate investigation, treatment and referral. The time between ED assessment and follow-up in the acute clot clinic fell; 92 per cent of patients were seen in three days or less.

Along with fewer complications and adverse events, patients reported reduced stress and higher rates of satisfaction.

2017 WSLHD Quality Awards finalist team photo - Not another DVT in the ED

Innovative Positional Aids

Patients in WSLHD’s Cardiac Catheter Laboratory have to be positioned carefully to maintain their airways, reduce the risk of injury, improve access to the radial artery and simply be more comfortable during often lengthy procedures.

Two positional aids were developed: the airway support wedge and the forearm support.

Afterward, nurses said airway management was improved. Cardiologists reported greater forearm stability and improved access to the radial artery.

Patients using the aids reported less pain – and in many cases, no pain at all.

2017 WSLHD Quality Awards finalist team photo - Innovative Positional Aids

Category 10. Education and Training

ECAV - Aboriginal Qualification Pathway

Violence in Aboriginal communities is a complex issue: increasing the number of Aboriginal workers skilled in violence prevention can help tackle what is a deep-rooted problem.

The Aboriginal Qualification Pathway starts by training Aboriginal workers in community programs, and – working with the NSW Health Education Centre Against Violence and the University of Sydney - providing education all the way through to Masters level.

More than 270 people have graduated from it, specialising in areas including trauma counselling and social work.

The pathway has created systemic change and empowered communities to develop local strategies to respond and prevent violence and sexual assault. Both perpetrators and victims are willing to disclose more, and as a result future violence has been prevented.

2017 WSLHD Quality Awards finalist team photo - ECAV - Aboriginal Qualification Pathway

Implementation and evaluation of trauma team training

Trauma in patients is unpredictable – and usually demands an urgent response. Training trauma teams to deal with the unknown is a challenge, to say the least.

A program of ‘real-world’ simulations has proved to be the solution at Westmead Hospital.

Patients with major trauma are getting to surgery in less than half the time, and mortality in this urgent operation group has fallen by 25 per cent.

The simulations allow teams from a range of professions to train together without clinical risk, and the flow-on to patients speaks for itself.

2017 WSLHD Quality Awards finalist team photo - Implementation & evaluation of trauma team training

Category 11. Bob Leece

Patient feedback - online, real time, anytime!

My Experience Matters was an Australian first, allowing patients, carers and families to provide real-time feedback on their experience at Westmead and Auburn hospitals through an online survey.

An average patient experience score is now on display on each hospital’s website. Examples of patient-inspired improvements, made as a result of feedback, are also shown – they could be something as easily fixed as a banging door, or suggestions to reduce noise at night.

More than 1300 surveys have been completed to date, and surveys have been rolled out at Blacktown and Mount Druitt hospitals as well. These patient insights are improving services across the district.

2017 WSLHD Quality Awards finalist team photo - Patient feedback - online, real time, anytime!

Now you see it!

Nutrition is a critical component of patient care, and this Blacktown and Mount Druitt Hospitals project makes sure inpatients have all the nourishment they need.

A digital menu enables the collection of data showing what patients order and how much they consume. Then, upskilled dietitian assistants identify patients at risk of malnutrition.

Early intervention means patients are engaged in their nutrition planning and other support strategies. Staff love their enhanced skill set and working more closely with patients.

Up to 40 patients who need nutritional support are now identified each day; previously, they would have gone undetected.

2017 WSLHD Quality Awards finalist team photo - Now you see it!