2017 WSLHD Quality Awards

Western Sydney Local Health District

2018 Quality Awards Winners

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.

Some of the winning projects will now be submitted to the NSW Health Innovation Awards and the NSW Premier's Awards.

Congratulations to all!!

 

Patients as Partners:
IPOP – Interpreter Project in Outpatient clinics

IPOP is the first WSLHD partnership between patients, the Health Care Interpreter Service, University Clinics and Innovation and Redesign.

The aim is to reduce average wait time for booking interpreters by phone by 50 per cent.

Solutions were tailored to address issues affecting CALD patients. They included SMS follow-up phone calls by interpreters for appointment confirmation, and improved check-in including designated interpreter waiting area, a dedicated phone line for on-the-day enquiries and additional block bookings for interpreters.

Delivering integrated care:
GREAT (Geriatric Rapid Evaluation and Treatment) service

The GREAT (Geriatric Rapid Evaluation and Treatment) service is an outreach program provided to local aged care facilities (ACF) during working hours.

It receives referral from ACFs and acute hospitals. Referred patients receive a face-to-face assessment at the ACF. A management plan is developed in collaboration with GPs, ACF staff and the patient’s family.

The GREAT service has established partnerships between local ACFs, the primary care sector and Westmead Hospital to provide timely, safe and effective clinical care for the older person in an ACF. It reduces avoidable hospital admissions and helps prevent potential adverse outcomes associated with hospitalisation. It supports the older person’s choice for treatment in their own home and empowers ACF staff to continue to look after residents in their own environment.

 

Keeping people healthy:
The X-men – exercise classes for prostate cancer

The X-men, an 8-week program of cardiovascular and resistance training, was made available to all males under the care of WSLHD oncologists and was recommended for males who reported deconditioning, weakness or did not participate in regular exercise.

A recognised consumer provided advice pre-implementation while a group of consumers provided advice on the creation and design of program educational resources. Sixty two males have been referred by oncologists with 47 completing the program. Ten are currently in the program or waiting to commence and five participants declined to commence after referral. Participant surveying found 86% had no falls in the past six months, 71% felt steadier and 61% had less fear of falling. Post X-men surveys show positive results with program recommendation (98%), satisfaction (95%), level of education (97%) and educational understanding (97%).

Collaborative teams:
Protecting our Aboriginal kids, now and into the future

An Aboriginal immunisation healthcare worker was employed to engage parents/carers of Aboriginal children in their children’s immunisation journey. A purpose built database assisted the worker to plan and record children’s follow-ups, send letters, text messages and telephone parents/ carers of overdue children. The worker also promoted/distributed resources to community members and trained service providers.

The Australian Immunisation Register (AIR) WSLHD quarterly report - December 2017 showed 95.1% of Aboriginal children fully immunised - 1 year of age (93.3 % non-Aboriginal) and 98.5% of Aboriginal children fully immunised - 4 years of age (93.8 % non-Aboriginal). The Gap is not only closed for Aboriginal children immunisation but coverage has exceeded that of non-Aboriginal children.

Education and Training:
Increasing dysphagia awareness in mental health

The incidence of dysphagia in the mental health population is higher than the general population due to a number of factors including: effects of medication, presence of co-morbidities and behaviour-related eating habits.

A referral pathway, dysphagia strategy flow chart and education guide were developed along with the provision of in-services to staff at Cumberland Hospital.

Three speech pathology staff members provided seven in-services to Cumberland staff across a year on speech pathology and basic dysphagia management in the mental health setting. A total of 97 staff attended the training sessions. Referrals to speech pathology increased over the twelve month period after the staff education program. The project results suggest that increased nursing awareness of dysphagia and speech pathology services resulted in increased number of appropriate speech pathology referrals for mental health patients.

Research and innovation (Tied winner):
6S Success! A Westmead Redevelopment lean storeroom initiative. Building capability and collaboration to ensure a successful transition

The 6S program provides staff with training on Lean methodology combined with practical application thereby supporting the development of shared organisational capability for change and implementation.

The aim is to apply the 6S methodology and transform 36 store rooms by June 2018 to prepare to move into the new Central Acute Services Building at Westmead.

This project resulted in 36 storerooms transformed across 14 services, more than $97,000 worth of stock reallocated and/or disposed of and $230,000 in productivity savings annually.

Research and innovation (Tied winner):
Pharmaceutical supply chain and medicines optimisation

The pharmaceutical supply chain initiative aimed to standardise procurement processes, optimise contract negotiations through supply chain and inventory management, and improve responsiveness to changes in the market. It would secure the supply chain by working with industry to enable better prediction of medicines demand and forecast requirements for WSLHD with patient care and safety in mind.

This project has resulted in significant financial efficiencies across WSLHD, reduced pharmaceutical waste and created a medicines supply chain that has been minimally impacted during a period of extraordinary pharmaceutical shortages across Australia thereby ensuring continuity of patient care.

A safe and healthy workplace:
A state of Biopreparedness

Westmead Hospital recognised gaps in its preparedness to respond to an outbreak similar to the Ebola 2014 outbreak in West Africa. A fragmented system was identified. A survey targeting staff competence and confidence in biologically hazardous infection management was conducted. Semistructured interviews explored staff experiences and perspectives of biopreparedness response. Nine simulation drills assessed readiness and evaluated performance.

Integrating disaster management processes with clinical protocols had a positive impact on the hospital’s biopreparedness response, with all but one staff member understanding their expected role in a post-implementation survey.

Patient safety first :
Fundus photography in the ED: saving lives, eyes and time

Current standards of care in EDs around the world miss up to 13% of patients with clinical signs of life and vision-threatening pathologies because fundoscopy (looking at the back of the eye) in the ED is technically challenging. A portable non-mydriatic camera (NMC) was introduced in ED and the photos taken were uploaded to the eMR and reviewed by the ophthalmology team within 24 hours.

A retrospective audit of clinical practice in the corresponding period last year was conducted. The fundoscopy rate at Westmead Hospital improved from 6.4% to 89.5% during the trial. This was the first portable NMC fundus photography program in Australia and demonstrated the value of collaborative fundus imaging for the safety of patients presenting to ED.



Peak Awards

Chief Executive Award:
Faster screening for stroke

The FASTER screening protocol (Fast, Affordable, Safe and True assessment in the Emergency Room) has been established for stroke presentations using a single DWI MRI sequence and an open access policy. The patient can be sent to MRI with a completed safety checklist to be scanned before the next booked patient, generally completed within 5 minutes.

All potential stroke cases were accepted for DWI MRI and reported urgently. In 996 MR screening cases, 20% (202) were positive for stroke. The impact on patient outcomes has been dramatic. Prior to this project, patients (particularly if young), were often told that stroke was unlikely based on a normal non-contrast CT and were discharged from ED with no firm diagnosis. Now, all stroke episodes are now identified using FASTER and at a higher rate than originally anticipated. On discharge, the GP now has a firm diagnosis of a stroke episode versus “possible migraine” or “query TIA”.

Board Chair Award:
IPOP – Interpreter Project in Outpatients

IPOP is the first WSLHD partnership between patients, the Health Care Interpreter Service, University Clinics and Innovation and Redesign.

The aim is to reduce average wait time for booking interpreters by phone by 50 per cent.

Solutions were tailored to address issues affecting CALD patients. They included SMS follow-up phone calls by interpreters for appointment confirmation, and improved check-in including designated interpreter waiting area, a dedicated phone line for on-the-day enquiries and additional block bookings for interpreters.

WentWest Award: Protecting our Aboriginal kids, now and into the future

An Aboriginal immunisation healthcare worker was employed to engage parents/carers of Aboriginal children in their children’s immunisation journey. A purpose built database assisted the worker to plan and record children’s follow-ups, send letters, text messages and telephone parents/ carers of overdue children. The worker also promoted/distributed resources to community members and trained service providers.

The Australian Immunisation Register (AIR) WSLHD quarterly report - December 2017 showed 95.1% of Aboriginal children fully immunised - 1 year of age (93.3 % non-Aboriginal) and 98.5% of Aboriginal children fully immunised - 4 years of age (93.8 % non-Aboriginal). The Gap is not only closed for Aboriginal children immunisation but coverage has exceeded that of non-Aboriginal children.

NewsLocal People’s Choice Award: Think before you bin it

In October 2017, Auburn General Services noticed a marked increase in the number of plastic items being discarded by the operating suite. Areas were set aside as collection points for reusable plastic items and out of date or no longer required consumables and bins were placed in the best place to collect bottles and cans. Appropriate items were sent to Doctors Assisting in South-Pacific Islands (DAISI) and other charitable organisations.

Building on the successful ‘Cans for Kids’ project, the team began collecting and redirecting reusable items. This reduced the waste management budget from $9,000 to $6,500 within one month. Since November 2017, the staff have recycled: 12,000 plastic bowls, 6,000 kidney dishes and galley pots, 20,000 items of out of date stock, 21,000 pieces of kimguard (non-absorbent material used for wrapping sterile operating packs), 18 large bins of cans and bottles for ‘Cans for Kids’ (NSW Government Recycle Initiative), 20,000 articles of clothing, a delivery suite bed and baby warmer.