Each year, WSLHD hosts the Quality Awards (QA) 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 2016 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
Westmead Women’s & Newborn Health Website
Women often turn to Dr Google for answers to common concerns about their health, pregnancy, birth and newborn care. But, NSW women now have a one-stop shop for healthcare advice, thanks to Westmead Hospital’s new women’s health website. The Westmead Women’s & Newborn Health website, the first of its kind in the state, provides advice, tips and information, along with online booking for childbirth and parenting classes, patient stories and translated information. It also features 360-view virtual tours of the hospital’s neonatal intensive care unit and maternity ward. “Our website provides quality, trustworthy and up-to-date information,” Donna Garland, Westmead Hospital’s operations director of Women’s Health said. There are nearly 6000 births annually at Westmead Hospital, making it the largest maternity unit in the state. NSW Minister for Women Pru Goward officially launched the website in May. Visit the website at: http://www.wslhd.health.nsw.gov.au/WNH/Home/home
Caring for our Carers
Many people with carers feel anxious or stressed during a hospital visit, especially when they have to stay overnight on their own. Western Sydney Local Health District’s Patient Experience team were keen to provide better support and comfort for both patients and carers during hospital stays so they devised an innovative initiative - carer zones. In a NSW-first, the 40 zones, created in Blacktown Hospital’s new Clinical Services Building, allow a family member or carer to stay overnight with a patient. The zones have a single sofa/bed, access to the bathroom and a curtain, which screens the area for carer privacy. Carers have already benefitted from the zones, reporting better access to information and feeling more involved in decisions arising out-of-hours. Levels of anxiety for patients have also decreased while hospital staff feel they can better communicate with carers and have extra support with feeding and care.
Category 2. Integrated Health Care
Child and Family Health, Improving the Universal Home Visiting Offers
New mums often feel overwhelmed after giving birth, particularly in the first few weeks at home with their newborn. Staff from Merrylands Community Health Centre wanted to ensure women were given timely access to home visits from a child/family health nurse so they introduced a new strategy, focused on providing the service within a two-week timeframe. Child and Family Health nursing staff were rostered to contact families and also liaised with mums to offer the service while they were still in hospital. The strategy worked, with more mums accepting at-home visits and staff contacting more new parents. Merrylands Community Health Centre provides a range of services in the Holroyd and Parramatta areas to children, young people and their families. For appointments, contact the Central Referral Service on 1800 600 681.
IPASS – A Partnership: NSW Ambulance/Western Sydney Local Health District
Western Sydney’s emergency departments are busy places, with clinical staff and paramedics often working hard to deliver vital care quickly. A new project, which was a partnership between NSW Ambulance and Western Sydney Local Health District, aimed to improve service delivery for both organisations. A variety of staff undertook a trial to reduce the transport of non-emergency patients to emergency departments (EDs), improving services in the ED and increasing the availability of ambulances. The trial has been a success, reducing turnaround and case times for paramedics and allowing more patients to be seen.
Category 3. Translational research
Feeling the Urge to Push! Programmed Intermittent and Patient-Controlled Epidural Dosing for Women During Labour
Western Sydney Local Health District (WSLHD) has introduced a new technique for administering epidural during labour. The technique, which has been used increasingly worldwide, combines programmed intermittent epidurals, with patient-controlled epidurals. A study was conducted at Blacktown Hospital to compare the technique to traditional methods, which led to the existing WSLHD Obstetric Epidural chart being revised to incorporate prescribing prompts and leg weakness assessment. New epidural pumps were also obtained. Project lead Emily Edmonds said women who received the new epidural used significantly less of the drug ropivacaine, which resulted in a reduction in leg weakness and length of time for second-stage labour. “The redesign of the charts and purchase of new pumps, along with standardising the epidural mode of delivery and education has increased the quality of labour pain management across the district,” she said. “We’ve had positive feedback from patients, with women expressing ‘feeling the urge to push’ without significant pain.”
Kneed to Know – Physiotherapy Classes Before Knee Replacement
Reducing physiotherapy times for patients undergoing a total knee replacement was the driver of a translational research project, delivered by Blacktown Hospital’s physiotherapy team. The staff wanted to reduce physiotherapy times by 50 per cent over six weeks, while maintaining patient satisfaction. They turned to a pre-operative group education program, aimed at encouraging patients to work with their carers and with each other. Project lead Marie March said the program had been successful in not only reducing physiotherapy times but improving the patient experience. “The group delivery has provided peer support and reduced patient anxiety,” she said. “By reducing the strain on the physiotherapist’s time, it has also allowed staff to focus on post-operative care, reducing the risk of complications and extended bed days.” The program also separated the education sessions from the patient’s primary appointment, allowing them to absorb information more effectively.
Category 4. Local solutions
GLAMPing - Group Lessons for Antenatal Musculoskeletal Pain
Many women turn to physiotherapy during their pregnancy to treat muscle pain resulting from changes to the body. Blacktown Hospital’s physiotherapy team partnered with the antenatal clinic to offer GLAMPing – group lessons for antenatal musculoskeletal pain. The sessions were designed to prevent and reduce pain in a group setting, rather than the traditional one-on-one approach. Project lead Rebecca Necevski said the program had been a success, reducing wait times for mums-to-be while improving their overall health. “Accessing early pain management and exercise allows women to stay more active throughout their pregnancy, reducing their risk of gestational diabetes, improving blood pressure and improving post-partum recovery time,” she said. “All the patients involved in the group sessions have expressed high satisfaction with the program, particularly as it has improved their access to treatment.” The project also included a redesign of the referral and booking process, with the physiotherapy team working closely with the antenatal clinic to improve awareness of physiotherapy for mums-to-be.
Blacktown 6S Lean Storerooms: Innovation Through Standardisation
Blacktown Hospital staff have used the LEAN method to reduce waste in storerooms across the facility. The LEAN system, which is commonly used in manufacturing, aims to eliminate waste by identifying each step in a process and then revising or removing steps that don’t create value. The LEAN process was conducted in original storerooms across the hospital and then replicated in the new Clinical Services Building. The cull has standardised stock rooms, reduced excess stock and wastage and made it easier for staff to access equipment. Innovation and redesign officer Emma Clarke said the new system had significantly improved staff’s day-to-day activities. “Reduced time looking for supplies has allowed clinicians to spend more time with patients, improving standards of care,” she said. “Teaching LEAN to staff has also developed skills for ongoing improvement in other areas.”
Category 5. Preventive health
Bstreetsmart – Smarter Safer Driverss
bstreetsmart is an initiative of the trauma service at Westmead Hospital. It was created in 2005 by Westmead Hospital trauma nurses Julie Seggie and Stephanie Wilson. Celebrating its 11th year, bstreetsmart is Australia’s largest educational youth road safety program, with more than 145,000 year 10, 11 and 12 students participating. The students witness a realistic car crash re-enactment and hear stories from young car crash survivors, in a bid to dramatically reduce the injury and death toll among young drivers on our roads. Ms Wilson said the effects of trauma were real, affecting not only the person involved, but their family and often the community. The award-winning event has proven to be so effective, it has been replicated in both Western Australia and South Australia. For further information or to register your school, visit www.bstreetsmart.org.
Battle of the Bulge in Pregnancy
Rates of obesity in pregnant women are growing, prompting Westmead Hospital staff to introduce a program focused on battling the bulge in mums-to-be. Staff in the Women’s Health Clinic worked with nutritionists and dieticians to introduce a program for mums who had gained more than 10kgs in their pregnancy. These women were provided with education about healthy eating and exercise to help them not only lose weight, but reduce the chance of complications during pregnancy and labour. Project lead Bonnie Dorise said the program, which was previously unavailable at the hospital, provided expectant mums with links to dietetic consultations and specialised information, particularly to women from different cultural backgrounds. Although not statistically significant, trends were noted that women who attended the clinic women put on 1.7kg less weight, had a lower risk of antepartum haemorrhage, a reduction in antenatal admissions and were less likely to have a stillbirth. The program has identified some fundamental needs including the appointment of a fulltime dietitian in the Women’s Health Antenatal Clinic.
Category 6. Collaborative team
Medical Morning Report (MMR)
In a busy ward environment, it is important for night medical staff to complete an adequate handover to the clinicians coming onto day shift. Westmead Hospital has created a unique handover system – the Westmead Medical Morning Report (MMR) – to foster a supportive and educative environment for reporting events. Chief medical advisor Associate Professor Ros Crampton said the MMR at Westmead was distinctive for its inclusion of supervision, debriefing and education in a multidisciplinary group. “While each team in the hospital conducts medical rounds and handover, the MMR at Westmead is different … all senior clinicians, both nursing and medical, provide leadership and mentoring to junior medical officers and registrars,” she said. “Having the senior staff more involved in the handover has allowed them to offer real-time advice and suggestions about clinical decision-making processes.” Dr Crampton said the MMR had also furthered relationships between staff and the junior medical officers.
Learning to Control Breathlessness So Breathlessness Doesn’t Control You! A DVD
A new DVD, produced by Westmead Hospital’s Department of Respiratory and Sleep Medicine, has aimed to help people control their breathlessness. The video, which was produced with input from patients, carers and healthcare professionals, was designed to offer self-management strategies for breathlessness. Team leader Mary Roberts said it was important the DVD was applicable to a wide range of viewers. “The DVD was designed for patients to help them explain their condition to family members but it also aimed to assist healthcare workers to understand the symptoms of breathlessness,” she said. The DVD has been a success, with both patients and carers reporting improved understanding of how to manage the condition. “Many patients have reported using the techniques to control their breathlessness, when normally they would call an ambulance,” Ms Roberts said. “Healthcare professionals promoting the strategies have also reported positive outcomes.”
Category 7. Harry Collins Award
Jab on the Job
Auburn Hospital devised an innovative way to increase the number of staff getting the annual flu vaccination. Jab on the Job offered vaccinations in wards during rounds so staff could be immunised without having to leave their busy departments. Nurse Kristina Roberts said staff had responded positively to the initiative. “Staff uptake of the flu vaccination was pretty low and many staff had raised concerns that it was often difficult to access the service while working on the wards,” she said. “Since Jab on the Job, the number of staff immunised is up 100 per cent, which has really helped to minimise the spread of flu among staff, patients and carers.” Annual flu vaccinations are recommended, particularly for people working in healthcare.
Category 8. Arts and Health Award
Being and Belonging – How Art Transformed the New Blacktown Hospital Regional Dialysis Centre
A positive and uplifting environment is particularly important for dialysis patients, who spend many hours each week in treatment. The Blacktown Mount Druitt (BMDH) Expansion Project arts and culture team worked with artists, patients, carers and the community to create a series of works for Blacktown’s Regional Dialysis Centre, which represented the diversity and experience of dialysis patients. A major work by Aboriginal artist Peter Williams welcomes patients and carers to the centre - Bubbles Gallery uses dialysis water and lights to create a kaleidoscope of colour against which a range of objects, created by patients, are displayed. Imagine! is a series of photos and videos recorded by patients about the experience of dialysis. This powerful project provided new insights into the experience of being a dialysis patient, and their sense of belonging in the centre and the community. "Patients reported that creating the artwork reduced tension, alleviated boredom and allowed them to share their experiences about living with dialysis, reducing stigma and promoting quality of life,” Peter Rophail, transition manager, BMDH Project Stage 1 said.
BMDH Arts & Culture Program – Not Just a Work of Art, a Work of Community.
Bringing artwork into the hospital has been a priority for staff at Blacktown and Mount Druitt. The new Clinical Services Building at Blacktown is well-known for its artwork and use of creativity in the design of its new facilities. The Blacktown Mount Druitt Hospital (BMDH) arts & culture program was established to engage with the community to design and create artwork, which reflected Aboriginality and multicultural diversity. BMDH transition manager Peter Rophail said it was crucial to involve the community, patients and staff in creating an environment that felt welcoming, safe and meaningful. “Hospitals are very important civic buildings and should reflect their community. They should reflect the diversity, the aspirations and hopes of that community. I think we’ve been able to achieve that with the arts program,” Peter said.
Category 9. Innovation
iGAP – Improving Gastroenterology Access and Patient Experience
Improving access to timely, quality specialist outpatient services was the aim of the iGaP project – Improving Gastroenterology Access and Patient Experience. Driven by the integrated care model, the project aimed to create a seamless transition for patients from one health setting to another. Staff from the project team worked closely with GPs and community services to create an effective transition – and it worked. Westmead University Clinics’ staffer Julianne Harvey said the project had resulted in reduced delays in medical assessments, improved timeliness of colonoscopy and care, enhanced colorectal cancer screening capacity and an increased number of screening referrals. She said the program had also given staff a chance to develop their communication skills. “It’s been an excellent platform for them to work through challenges and problem solve as a team,” she said. “Staff satisfaction has also strengthened the relationships between clinicians, individual departments and people working in the University Clinics.”
Skin Abscess CPI Project
Staff across several departments at Westmead Hospital collaborated to create a framework to identify patients who present to the emergency department with skin abscesses. Previously, these patients were admitted to hospital, which led to unnecessary bed stays. Now, they are managed as out-patients through the day-only surgical unit. Dr Tony Pang said the new model had benefitted both staff and patients. “We’re definitely using less resources but we’ve also improved the patient experience by reducing waiting times for operations, decreasing fasting times and decreasing overall length of stay,” he said. “We’ve increased the number of patients managed on a ‘day basis’ from 5.6 per cent to 34 per cent so it’s been a success.” Dr Pang said staff from the Department of Surgery, Anaesthetics, the emergency department, the Surgical Outcomes Unit, the Outpatients Department, the day-only ward and Clinical Governance had worked together to implement the framework.
Category 10. Education and Training
We Will Catch You: a Mental Health Falls Prevention Program
Cumberland Hospital’s Willow Cottage developed a new program to help prevent falls among its mental health patients. The program, devised by a newly formed Mental Health Falls Prevention Committee, created a series of “falls champions” dedicated to mentoring staff on how to reduce falls. The champions gave a presentation to other staff, who were then offered resources, support and guidance from the Mental Health Falls Prevention Committee. The program has resulted in a five per cent reduction in falls and a 100 per cent increase of awareness of falls prevention among the workforce. Staffer Alexandra Sepulveda said the program had also led to improvements in leisure activities offered, including tai-chi, line dancing and Otago exercise. Ms Sepulveda said the program had proved a winner with patients and carers, along with nursing, medical and Allied Health staff. “It’s definitely established stronger relationships with patients, both in an inpatient and community environment,” she said.
Don’t Forget About Dementia! Dementia Awareness Month 2015
Blacktown Mount Druitt Hospital’s dementia team delivered an innovative education program as part of Dementia Awareness Month 2015, in the hope of better engaging with patients and carers. The staff created a dementia toolbox, which was delivered to 19 wards and departments, containing educational resources for self-directed learning. Diversional therapy boxes were also created for patient wards, to promote engagement in therapeutic activities. Dementia clinical nurse consultant Katie Conciatore said the program had increased staff knowledge and confidence in working with dementia patients. “We’ve seen the use of non-drug intervention for people with dementia improve significantly across the hospital,” she said. “Therapeutic activities are being carried out by staff and carers and the diversional therapy has really reduced adverse events.” The program involved partnerships with Alzheimer Australia, dementia training and study centres and the Australian Journal of Dementia Care.