Bendigo Health Quality of Care 2013-2014

Bendigo Health

Quality of Care 2013-2014

Welcome

Hello, I'm John Mulder, Chief Executive Officer of Bendigo Health.

I am pleased to introduce to you our Quality of Care Report for 2013/14. This report provides us with the opportunity to showcase various quality improvements implemented and underway across Bendigo Health. This report demonstrates the many ways our staff work to monitor, maintain and improve the quality and safety of the care and treatment they provide. It also demonstrates our commitment to safe, high quality healthcare for all our patients and features consumer stories related to our quality and safety systems.

Our staff are proud of their work, proud of their workplace and passionate about the care they give. It's their skill, dedication and hard work which puts the patient at the centre of everything we do. Our multidisciplinary approach to person-centred care is the essence of our 2013-18 Strategic Plan Healthy Communities and World Class Healthcare. This plan's vision is supported by staff-developed values Caring, Passionate and Trustworthy and defines Bendigo Health's role as one of empowering people and working together to improve our health.

We are proud to be delivering quality of care information to our community in an accessible and easy to understand way. The online report format has been designed to complement the Bendigo Health Strategic Plan (2013-2018). This year we have also produced a series of printable downloads that feature consumer stories, recognising that not everyone wants to read the entire report online. We hope you find this approach accessible and informative. We welcome your feedback via the feedback link so that we can continue to improve presentation and content, making it relevant and accessible to the community that relies on our services.

The report was produced by our Quality Unit after extensive consultation with our Quality Care Council, Community Advisory Committee and our staff at Bendigo Health.

I hope you enjoy reading our stories as much as I enjoy sharing them with you.

John Mulder
Chief Executive Officer

Welcome

Greater Bendigo and

Loddon Mallee Demographics

The Loddon Mallee region encompasses more than a quarter of Victoria, from central Victoria to the Murray River. The population of Loddon Mallee is around 320,400 people. The provincial centre is Bendigo, other major centres being Echuca, Swan Hill and Mildura.

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Population by age

Total population in Greater Bendigo (SA4 area) in 2012: 144,535

  • Females: 73,143
  • Males: 71,392
  • Life expectancy at birth, 2009-2011: Females 84.2 years, Males 79.7 years

Proportion of Aboriginal and Torres Strait Islander Peoples (in 2011): 1.3% of the total population.

The three largest ancestries in the City of Greater Bendigo in 2011 were Australian, English, and Irish.

Unemployment rate in Loddon Mallee in June 2012: 4.99% (Victoria: 5.51%).

Health Statistics by the Bendigo Loddon Primary Care Partnership (BLPCP), as per August 2014:

Adults

Alcohol consumption: Both Greater Bendigo and Loddon had a higher proportion of population that had consumed alcohol at least weekly at risky or high risk levels for health in the short term compared to the Victoria average.

alcohol

Smoking: Compared to Victoria, the BLPCP catchment areas had a slightly higher proportion of population aged 18 years and over who described themselves as current smokers. Males are generally more likely than females to be current smokers. The rate of current smokers in female populations was significantly higher than the average for Victoria females.

smokers

Physical inactivity: Compared to Victoria, in 2008, a lower proportion of all BLPCP catchment adult population had sufficient physical activity time and sessions. The proportion of males and females reporting sufficient time and sessions of physical activity to meet the guidelines decreased slightly between 2005 and 2008 (63.6% to 60.3%).

inactivity

Obesity: Compared to Victoria, a higher proportion of Greater Bendigo and Loddon Shire males and females aged 18 years and over were overweight or obese. Males were more likely to be overweight or obese than females.

Overweight and obese(a) population, population aged 18 years and over (2008):

 

Greater Bendigo

Loddon

Victoria

 

Males

Females

Males

Females

Males

Females

Overweight

46.6

27.1

47.4

24.4

39.9

24.2

Obese

19.6

21.8

15.6

21.6

17.3

16.1

Diabetes: The number and proportion of residents with all forms of diabetes in total more than doubled between 2001 and 2011 for the BLPCP catchment areas. In 2011, Loddon Shire had a substantially higher proportion of population (6.5%) with diabetes than the Victoria average and Greater Bendigo proportion of 4.5%.

diabetes

Cancers: In Greater Bendigo, compared to the Victoria average, the prevalence of different types of cancers among all new cancer cases closely resembled the Victorian average figures, with a 1% higher proportion of cancers of the lung and uterus. The most common new cancer cases (of all cancers) in Greater Bendigo were prostate, followed by bowel and then breast.

Mental health: Within the BLPCP catchment areas, females were more likely than males to have mental and behavioural problems (self-assessed data) and females were more likely to have mental and behavioural problems than the Victoria average.

Estimated number of people with mental and behavioural problems (2007-08):

mentalhealth

Indigenous

Socio-economic status: Generally speaking, the Bendigo catchment's Indigenous population had a much lower income, was significantly less likely to have completed year 12 and was significantly less likely to be employed or participating in the labour force (seeking employment) than the non-indigenous population.

Children

Immunisation: In the December 2012 quarter, compared to the Victorian average, Greater Bendigo had a slightly lower proportion of children aged 24-27 months (91.6%) that were fully immunised while Loddon had a lower percentage of children aged and 24-27 months (90%) that were fully immunised.

immunisation

Mental Health: Compared to Victoria, both the BLPCP catchment area had a slightly higher proportion of Child & Adolescent Mental Health Services clients as a percentage of population.

Young People

Bullying: In 2009, 50.6% of adolescents in Greater Bendigo reported being recently bullied. This was significantly higher than the proportion reported across Victoria (44.6%).

bullying

Teenage pregnancies: In 2011, 2.4% of Greater Bendigo females aged 15-19 years and 3.0% of Loddon females aged 15-19 years had given birth to one or more children. These proportions were much higher than the Victoria average (1.2%).

preganacies

Older Population

 olderpopulation

Socio-economic and health factors: A range of socio-economic and health characteristics that may be linked to or reflect high proportions of ageing population were typical in our region. These included:

  • a high proportion of lone person households (In Greater Bendigo/2011, population aged 65 years and older: 20% males and 38% females),
  • a higher proportion of population (aged 65 yrs plus) earning a low income,
  • decreased labour force participation figures, and
  • certain health conditions appearing to be more prevalent in the Bendigo Loddon PCP catchment.

Residential aged care places: In 2011, compared to the Victoria average, Greater Bendigo had a higher proportion of population aged 70 years and over living in high level residential aged care, while both Greater Bendigo and Loddon had a higher proportion of population aged 70 years and over living in low level residential aged care.

Home and Community Care (HACC) service clients: Compared to Victoria, the BLPCP catchment area had a significantly higher rate per 1000 people aged 70 years and over of population that were receiving HACC services. Additionally, Loddon Shire had more than four times the rate of population under 70 years of age who were HACC clients.

Sources used:

  1. bendigo.vic.gov.au/About_us/About_Greater_Bendigo/Population_and_characteristics (City of Greater Bendigo)
  2. abs.gov.au (Australian Bureau of Statistics)
  3. blpcp.com.au/BLPCP%20community%20profile%20update_6thAugust2014_FINAL.pdf (Bendigo Loddon Primary Care Partnership)
  4. ceh.org.au/resources/demographic (Centre for Culture, Ethnicity & Health)
  5. myregion.gov.au (An Australian Government Initiative)
Greater Bendigo and Loddon Mallee Demographics

Tell Us What You Think

Bendigo Health is passionate about providing safe and high quality care for all our patients and to meet the needs of our diverse communities. We are always seeking ways to improve our services, and the mechanisms described below are just one way of providing us feedback.

Quality of Care Report 2013

Feedback received about the previous year's Quality of Care Report has been taken into account in the development of this report. Readers liked the information on Bendigo Health initiatives and the different areas of the hospital, the online format, and the feature consumer stories that gave the report a more personal and approachable feel. This year, we have also included visual infographics which provide the reader an easy-to-read snapshot of the health service.

Last year's Quality of Care Report was launched as an interactive website. Since its launch in November 2013 to the end of August 2014, a total of 1551 visits to the website have been recorded.

Bendigo Health recognises the positive impact on accessibility the interactive website has had and continues the same format this year. Additionally, printable downloads and brochures can be accessed for use in waiting rooms, wards, clinics, cafeterias and staff rooms across the Bendigo Health sites. Copies will also be shared with our community partners, such as GP practices, community health centres and aged care facilities.

Feedback Survey – Quality of Care Report 2014

We would like to hear what you think of the 2014 report, and welcome feedback from all patients, families, carers and community members. To submit your feedback, please visit our feedback survey.

Compliments and Complaints

Bendigo Health is committed to partnering with our consumers to help improve our services. We view consumer feedback as a method to enhance this partnership and accordingly we encourage all consumers to tell us about their experience with Bendigo Health. Consumer feedback is provided to Bendigo Health through verbal, electronic and paper based methods which include our new feedback brochure. All feedback is treated seriously and confidentially and we make our best effort to respond to any concerns you may have regarding your hospital experience.

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Complaint Types


If you would like to provide feedback, please contact the Patient Relations Officer:

Patient Relations Officer
Bendigo Health
PO Box 126
Bendigo 3552
Ph: 5454 9079

Tell Us What You Think

Positive feedback received from our patients:

"My family and I would like to express our heartfelt thanks for the expertise, care and treatment of yours truly during my recent operation and recovery in the ICU at the hospital. I owe my life and wellbeing to you all. I will be indebted to you forever for all your combined efforts, some over and beyond the call of duty." (Patient at the Intensive Care Unit)

"We've had the privilege to be treated by some wonderful young doctors and nurses. From the front desk on arrival to the time we left. ... We would like to thank Bendigo Hospital for the care and attention given by these young doctors looking after us." (Patient at the Emergency Department)

"I found all the staff, from my specialist surgeon to the nurses, even the people that delivered the meals and the cleaners that came through every day to be extremely helpful. In particular, the medical staff seemed to really care about my well-being and I was very impressed with the quality of care." (Patient at the TBH Acute Campus)

Consumer, Carer and Communtiy Participation

consumer

Supporting the Critically Ill

with Patient Diaries

This story was written in memory of Alicia Hall who died after a long battle, in September 2014. She left behind her loving husband Craig, their three young daughters and their extended family. Alicia's story is published with the permission of her husband Craig for whom Bendigo Health would like to express our sincere gratitude.

Some years ago, Alicia suffered from a work-related back injury requiring two spinal fusions to stop the pain. In 2009, her work at the Police Force brought her to fight the Black Saturday bushfires in Kilmore, which proved so demanding that she was diagnosed with post-traumatic stress disorder. Alicia struggled with both physical and mental recovery, and not being able to get the full support she needed, her health eventually took a dramatic course towards the worse. In 2013, a series of health conditions brought her close to death.

Due to previous health issues, Alicia had suffered from pneumonia over 40 times in the past two years. On one Sunday night she was taken by ambulance to the Bendigo Health Emergency Department, and everyone thought it was just another bout of pneumonia. This time however, Alicia was diagnosed with an acute pneumococcal pneumonia that had severely affected her lungs. Additionally, she had gastroparesis (a form of paralysis of the stomach) and aspiration pneumonia. Alicia was put in a medically induced coma to give her the life-saving treatment that she urgently needed. Husband Craig was called in and told that Alicia had a fifty-fifty chance to survive. Doctors kept watch for minute changes for signs of improvement.

Alicia was fighting to stay alive. Meanwhile, her husband juggled duties at home and school with the children, and the hospital to stay with Alicia. "He was a tower of strength and love to us, and continues to be. He never asks anything in return, he is just amazing", said Alicia as we interviewed her. After a week in a coma, she woke up and had finally turned the corner.

A year after the events, Alicia was able to reflect back on what really happened. "One thing that helped me through is the Patient Diary," she explained and opened her personal diary which was full of hand-written messages from staff who were involved in her treatment and recovery. "The staff in the Intensive Care Unit wrote things during their shifts. Reading through the diary made it clearer to me what I was going through. It was too painful to read for quite some time, so I waited until my health was more settled. It has a feel of a real diary and I will keep it for myself for always."

The Patient Diaries were introduced to the Intensive Care Unit in 2013. "I'd certainly recommend the diary to other patients and families", Alicia continued. "If something critical could possibly happen to you, I would certainly encourage everyone, including your family, to write and add photographs in a diary like this. Thanks to my diary I can see down the track where I am up to each six or twelve months and I will be able to use it with future health practitioners."

Alicia visited the hospital quite a bit in the past year, and her health slowly started to gain steadier ground. "My family and I cannot speak highly enough of the staff at the Intensive Care Unit because they saved my life. We were supported throughout the difficult times and my family was able to stay with me day and night. Staff went beyond their clinical duties and treated us like people: one lady washed and braided my hair when I was asleep. The staff are there every minute when you're in such a critical condition. Thank you to everybody who's been involved at Bendigo Health."

For anyone with a similarly difficult experience, Alicia had a simple message: "Take things slowly but don't dwell on them too much. Take it as a second chance." Undoubtedly this young mother looked at life from a different angle, and the affection with which she spoke about her family showed what her priorities were: "I can't describe with words what my family means to me today, and I am simply grateful for all the extra time and cuddles that we have together. It's been a huge ordeal for us, and more than ever, my girls tell me how much they love me. They just love mummy time now."

Supporting the Critically Ill with Patient Diaries

Bendigo Health Intensive Care Unit introduced Patient Diaries in 2013 to help patients understand more about their illness and to come to terms with their memories, which can be distressing. The diary has shown to reduce stress in patients in the months after their stay at the hospital

Partnering with Consumers

As part of our commitment to actively encourage consumer and community participation, Bendigo Health has in place a range of mechanisms to assist our organisation to be responsive to the needs of our community. Consumers and community members are represented in and operate through the following main groups:

  • Community Advisory Committee
  • Consumer reference groups and other committees with community representation
  • Volunteers and auxiliaries

Community Advisory Committee

The Community Advisory Committee (CAC) is a sub-committee of the Bendigo Health Board of Directors and ensures that the views of the consumers and communities are taken into account at all levels of health service operations, planning and policy development. The CAC supports Bendigo Health in developing links with consumers and the community, and it does this through a range of approaches, including input to strategic planning, the Community Participation Plan, the Quality of Care Report and providing advice and recommendations to the Board of Directors. The CAC is committed to advocate to the Board of Directors on behalf of the community, consumers and carers.

In 2013-14, some of the key activities were:

  • The CAC provided a consumer perspective to the ACHS accreditation against the National Safety and Quality Health Standards, in November 2013. Bendigo Health was proud to receive four 'Met with Merit' ratings for the National Standard 2 – Partnering with Consumers.
  • CAC members played a key role in creating a new Community Participation Plan for 2014-2016.
  • The CAC reviewed progress made on the Cultural Responsiveness Plan and the Improving Care for Aboriginal and Torres Strait Islander Patients Plan (ICAP).
  • The CAC were identified as taking a key advisory role to the Bendigo Hospital Project (BHP), and a workshop was held in October 2013 to define this role and to set the framework for consumer engagement in the BHP.
  • CAC members were invited to provide consumer input to the Electronic Medical Records (EMR) tender process, and specifically to the Patient Portal component of it.

CAC membership 2013/14: Click to Expand

Ms Marg O'Rourke – Board of Directors (Chair)

  • Managing Director, MOR Consulting
  • Bendigo Health, Director
  • Bendigo Kangan Institute, Director
  • Goulburn Murray Water, Director
  • Tasports, Director
  • Aspire Cultural & Charitable Foundation
  • Catholic College Bendigo Advisory Committee

Ms Aileen Berry – Board of Directors

  • Bendigo Health, Director
  • Member, Community Advisory Committee, Quality Council and Medical Advisory Committee, Bendigo Health
  • Media and Communications Advisor

Ms Ruth Harris – Community Member

  • Pharmacist
  • Primary care

Mr Daniel O'Brien – Community Member

  • Employed at Audio Visual installation
  • Member of Vic/Tas Youth Cancer Advisory Council
  • Involved in Peter Mac Cancer Institute

Ms Kathleen Pleasants – Community Member

  • Lecturer, La Trobe University
  • PhD student (Outdoor and Environmental Education)
  • Strategic Planning and Population Health Committee, Bendigo Health
  • Hockey Central Victoria Committee of Management

Ms Robyn Tickner – Community Member

  • Maternal and Child Health Nurse (Maternal and Child Health coordinator Macedon - Ranges Shire council – Retired)
  • President of Bendigo VIEW Club (affiliated with The Smith Family)
  • Member of Bendigo U3A

Mr Ben Lemmens – Community Member

  • Bach. Health Science & Master Podiatric Practice
  • Podiatrist
  • Musician

Ms Sally Fraser – Community Member

  • Community representative in education and the arts
  • Active health consumer
  • Carer
  • Musician

Ms Heather McNeill – Community Member

  • Secondary Teacher and Careers Counsellor (Retired)
  • Chair - BreastScreen Victoria (Bendigo) CAC
  • President of Soroptimist International, Bendigo
  • Member Bendigo Health Intensive Care Auxiliary
  • Active volunteer involvement - Friends of Bendigo Library, Bendigo Art Gallery Guides Bendigo Visitor Centre, Aged Care.

Ms Jodie Rasmussen – Community Member

  • Owned and operated a local spatial consulting business for 7 years
  • Member of Psychiatric Consumer Participation Group
  • Member of Parents and Friends Group at Big Hill Primary School

Mr Jordan Cappy – Community Member

  • Bachelor of Business & Bachelor of Information Technology
  • Major in marketing
  • Programmer

See video: Meet Ben Lemmens, one of the CAC members who volunteers his time to the committee:

As part of its commitment to consumer and community participation, Bendigo Health has also nominated four staff members to support the CAC functions: Ms Liz Hamilton (Executive Director Community and Continuing Care), Ms Yvonne Wrigglesworth (Director Governance, Strategy & Risk), Ms Nina Hakamies (Consumer Participation Support Officer) and Ms Sue Lawrence (Minutes).

Consumer Reference Groups and Committees with Consumer Representation at Bendigo Health

chart1

chart2

chart3

Partnering with Consumers

Community Advisory Committee (from left to right): Liz Hamilton, Ben Lemmens, Robyn Tickner, Yvonne Wrigglesworth, Nina Hakamies, Marg O'Rourke, Daniel O'Brien, Heather McNeill, Aileen Berry, Jodie Rasmussen, Sally Fraser, Kathleen Pleasants, Jordan Cappy and Ruth Harris.

Culturally Sensitive Services

for Diverse Groups

In the past months and years, Bendigo Health has put a lot of effort into ensuring our services are welcoming and accessible to people from the Aboriginal and Torres Strait Islander and other cultural backgrounds. These efforts are increasing with the building of a new world class hospital and expansion of services in 2016.

Aboriginal and Torres Strait Islander Health

  • We welcomed our first Aboriginal volunteer in early 2014.
  • We are strengthening our commitment with our Aboriginal Workforce Plan which aims at increasing employment participation of Aboriginal People.
  • The collaboration agreement with Bendigo and District Aboriginal Cooperative (BDAC) was consolidated.
  • Supports offered by the Aboriginal Hospital Liaison Officer remain in high demand and provide ongoing support to Aboriginal patients.
  • An Aboriginal Space, including Aboriginal gardens, have been designed in the Bendigo Hospital Project.
  • Participation in the 'Closing the Gap Expo', initiated by the Aboriginal Interagency Network. Bendigo Health is monitored and reports yearly to the Department of Health on criteria relating to how we make a difference to Aboriginal Health and how we are closing the gap in our region.

atsipatients

(between November 2013 and June 2014):

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ATSI identified patients

Cultural Responsiveness

  • Cultural responsiveness was demonstrated with the approval and implementation of the Person Centred Care Policy
  • Opportunities for professional development in the area of cultural responsiveness are regularly accessible to staff via iLearn and E-Newsletter (electronic means)
  • Requests by Bendigo Health for interpreter services have grown each year for the past seven years, with the greatest number in the last financial year
  • This year, interpreters for 31 different languages/dialects were requested, with Karen, Dari and Farsi being the top three languages
  • Multicultural groups provide input to the Bendigo Hospital Project, and specifically in regard to the interior, landscaping and way finding
  • Introduction to 'Culturally Inclusive Practice' training was undertaken by psychiatric services staff

No. of interpreter services requested at Bendigo Health:

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Services Requested

Culturally Sensitive Services for Diverse Groups

Pictured: Bruce Forrest (Aboriginal Hospital Liaison Officer) with Nikita Charles at the Bendigo Closing the Gap Day 2014.

Planning for Your

Future Healthcare

What if I become too ill to express my preferences...?

Advance Care Planning (ACP) is a process that helps you to plan for your future health care. It can help you, your loved ones, and those caring for you to discuss what is important to you about the level of healthcare and the quality of life you would want if you became seriously ill and were unable to make your own decisions.

ACP has benefits for both Bendigo Health and for the community we serve. It enables the provision of appropriate care based on the person's beliefs and preferences, particularly regarding end of life medical treatment options. ACP ensures the person's wishes are known and respected, enhancing the quality of their care, and reducing the incidence of inappropriate, invasive and resource intensive medical treatments.

Implementing ACP at Bendigo Health is critical in enacting the organisation's commitment to person centred care and in ensuring that we provide medical treatment appropriate to each consumer's needs.

The ACP program commenced at Bendigo Health in July 2013. Since commencing, 252 people have been introduced to it and assisted to talk to their families and friends about their values and goals in life and their future medical wishes. They have also been assisted to document their wishes if they would like to do so. During this time, four people who had formally documented their end of life wishes have died. Every one of these people had their choices respected.

 

“We have made our decision and we are happy and very comfortable with that, we know our children will be comfortable too because there will be no mixed feelings, there will be no family torn apart through decision-making – it will be our decision.” (Bendigo Health patient)

Planning for Your Future Healthcare

Consumer Register: Become part of our

healthy communities vision

At Bendigo Health we are passionate about providing safe, high quality care for all our patients and committed to ensure that the voice of patients, consumers, carers and community members is reflected in the design of our health services.

The Bendigo Health Consumer Register is a pool of past and present patients, carers and relatives, and consumers of the hospital services, who share their experiences, views and ideas for improvement of our hospital services. The Register is a great asset that supports us in meeting the needs of the community.

Members of the Register can participate in many ways, including contributing to working groups, committees, focus groups, assisting with surveys, providing feedback on information for consumers, participating in interviews, attending community events and forums, etc. Being registered on the Register is entirely voluntary and how members wish to participate is up to them.

Interested?

For further information, please contact the Consumer Participation Support Officer (Quality @ BH) and request an application form: Consumer Participation Support Officer, tel. 5454 9078 or email nhakamies@bendigohealth.org.au

Consumer Register: Become part of our healthy communities vision

Image courtesy of Vlado/FreeDigitalPhotos.net

Bang On A Beanie

Raising awareness about acquired brain injury

Bendigo Health organised a 'BangOnABeanie' barbeque in August 2013, as part of the nationwide campaign to raise awareness about acquired brain injury. BangOnABeanie invites people to purchase and wear a blue beanie to help improve public awareness and in recognition of acquired brain injury.

The BangOnABeanie concept began in Australia in 2011. It supports one of the largest and most disadvantaged groups in Australia and works to transform an "invisible disability" into a very visible one. More than one person in twelve is affected by an acquired brain injury, referring to any damage that happens to the brain from birth onwards. Causes of brain injury include infection, tumour, substance abuse, stroke, trauma, deprivation of adequate oxygen supply, and degenerative neurological diseases such as multiple sclerosis and Parkinson's disease.

BangOnABeanie is sponsored by Bendigo Health's Case Management Services and Carers Support Services. Both teams work closely with people with acquired brain injuries and their families and carers. The BangOnABeanie barbeque was a great success and showed the support these programs have, not only for their own clients, but the 1.6 million people Australia wide estimated to have an acquired brain injury.

Bang On A Beanie

On With The Dance!

Plum Blossom Dance Team visits Bendigo Health Aged Care

The young dancers of the Plum Blossom Dance Team delighted the residents of Bendigo Health Aged Care facilities, as they came to perform the finest modern and historic themes of the Chinese culture. The team, which is part of the Bendigo Chinese Association, received the Victorian Multicultural Commission Grant, which supported a two-day dancing tour to all residential care homes at Bendigo Health.

The plum blossom flower means beauty and longevity. A woman's strength and beauty is sometimes compared to the plum blossom, of which a deeper meaning can be distilled: "Even when a woman is old and tough, they can still bring beauty to the world."

The dancers were very excited to perform to the residents the different styles of dances they had been training for over the months. The graceful moves of the ribbon dance captured everyone's imagination, and it was a wonderful experience filled with joy and colour for all generations.

The initiative was organised in conjunction with the Bendigo Health Foundation, and received very positive feedback from residents and families alike.

On With The Dance!

Bendigo Hospital

Project Milestone

In 2013, an important milestone was reached as the contract was signed for the delivery of the $630 million Bendigo Hospital Project by Exemplar Health. The Bendigo Hospital Project is one of the largest regional healthcare projects in Australia, and Minister for Health David Davis visited the site recently to celebrate the first anniversary of the turning of the first sod for the new hospital. When complete, Bendigo Health will deliver a world class regional hospital which will incorporate the latest design and technology solutions, in a tranquil and caring environment.

The new facilities include 372 inpatient beds, 72 same day beds, 10 new operating theatres, a regional cancer centre, an 80 bed integrated mental health facility, a mother and baby unit, a helipad and parking for 1,350 cars.

A great deal has happened in the past year, including the installation of four cranes, 132,000 tonnes of soil excavated, 15,000m2 of concrete poured and thousands of truck and plant equipment movements in and out of the site. In just a few short months it has gone from a hole in the ground to the beginning of a world class hospital.

This is a very exciting time to be part of the Bendigo Health community. Our staff, patients, consumers and community members have been involved in the project in various ways, including providing input into selecting the preferred proposal and contributing to detailed design. In June 2014, members of the Bendigo Health's 18 consumer committees and groups were invited to attend a presentation and to visit the prototype rooms, and to provide feedback to the project team.

Construction of the new hospital is due for completion by the end of 2016. To find out more, please visit www.bendigohospitalproject.org.au

Bendigo Hospital Project Milestone

Preparing Patients

for Intensive Care

The Bendigo Health Intensive Care Unit (ICU) has designed an innovative model for a pre-admission clinic for patients, and their families, to prepare themselves for complex elective surgical procedures.

Prior to their procedure, the patient meets with an intensive care specialist and an intensive care liaison nurse to evaluate the requirement for intensive care for recovery. The patient is first assessed, based on all available information relevant to their treatment. The process and environment of intensive care are then explained and demystified to the patient and the family. Advice regarding diet, exercise and mental preparation for major surgery is also given. Every patient is told about the concept of Advance Care Planning, regardless of their age or health status, and they are given ample time to discuss any concerns or fears. A tour of ICU is offered to help allay anxiety.

The ICU has received a lot of positive feedback. Patients and families report that the clinic really helped them to prepare for surgery, and that having an introduction to the ICU environment made it a lot less scary than if they just woke up after surgery with medical drips, drains and noisy monitors connected to their body. Quite a few young children of patients have participated in the clinic, which has been very helpful in preparing families to face a very emotionally tough time.

This initiative is unique in that there is little literature available to show that similar ICU specific pre-admission clinics exist elsewhere. A research project is being planned to quantify the benefits to Bendigo Health and its consumers through reduction of cancelled procedures and improved patient flow.

Preparing Patients for Intensive Care
Quality and Safety

quality

Giving Birth Far From Home

Karen refugee mothers tell their stories

Baby babbles fill the room, as a dozen of little po tha's (meaning 'baby' in the Sgaw language) reach for toys and mother's arms. A few older children romp about, while their mothers are busy trying to keep up with their offspring.

These Karen mothers radiate strength and simplicity, although their journey hasn't been an easy one. Having escaped from their home country of Burma, and starting a new life in Bendigo has been a tremendous endeavour. They are proud of their achievements, and not least of these little po tha's who were born at Bendigo Health and are now stealing the show.

Surina's experiences to giving birth to two babies have been very positive ones, although it wasn't always easy. She specifically remembers the language barriers, but fortunately a native Karen interpreter was available. Sometimes hospital staff used medical jargon, and the different Karen dialects spoken by her and the interpreter made communication difficult. "But when words were not enough, body language kicked in", Surina laughs and gestures with her arms.

Ma Cho's own mother, who is a Karen traditional birth attendant, accompanied her in labour when little Sankey boy was born. This support meant to the daughter more than words can tell, giving her the chance to rely on her closest family member and to bring in some cultural birthing practices of the Karen tradition. Ma Cho says that midwives and doctors were fantastic in allowing some of her own customs to be included in the birth. They were respectful and sensitive about her wishes, and helped her to create a comfortable environment, which otherwise might have felt so foreign to the birthing mother.

Paw Mu Nar had a difficult birth with her third child, and the newborn boy had to spend some time at the Special Care Baby Unit. She says the hospital staff were very professional, and the health of the mother and the baby was quickly brought back on track. Despite the challenges, Paw Mu Nar feels she was taken very good care of and she has good memories of the hospital.

Surina and Ma Cho were both clients of the MAMTA program at Bendigo Health (A model of midwifery care that offers continuity of care throughout pregnancy, birth and the postnatal period. The word 'mamta' means mother's love in Sanskrit). A designated midwife followed them throughout the pregnancy and birth, and visited them at home even before the baby was born. This allowed Surina and Ma Cho to create a sense of continuity and a relationship of trust, which subsequently helped minimise any cultural and linguistic obstacles that they faced. "The care we received at MAMTA was wonderful, and we felt safe and supported at all times", the mothers tell.

Jan Porter is a volunteer at the Bendigo Neighbourhood House (a local not-for-profit community organisation) and also well known to the Bendigo Health Maternity Unit. She makes a tremendous effort in supporting the Karen mothers of Bendigo to navigate in the Australian healthcare system. "No wonder I have been given the nickname 'local doula'", she says smilingly. In the past three years, she has witnessed remarkable improvements in regard to cultural sensitivity at Bendigo Health. "A lot of cultural education is still needed in both directions, but we have here an excellent model of care that we should be very proud of. The Bendigo Health Maternity Unit has developed a wonderful empathy and sensitivity to the needs of these women, and they are treated with respect and compassion. It has made the process far less scary for the mothers. This is an outstanding and exemplary service and should be the model for other hospitals", Jan concludes.

Giving Birth Far From Home

Celebrating Person

Centred Care

The month of April is marked as the 'Person Centred Care' month during which Bendigo Health celebrates and raises awareness about all things bringing the patients to the centre of their healthcare.

clipboardThe first annual Person Centred Care Consumer Survey was administered across Bendigo Health in April 2014, which aims at measuring our impact in relation to Bendigo Health's Strategic Goals. By 2018, we aim to have improved our person-centred care practices by 5% each year over the life of the 5-year Strategic Plan.

The survey results suggest that the majority of the respondents felt positive about Bendigo Health's services and the ways in which consumers were involved in their own care:

personcentredcare

  • 90% of the respondents felt that BH always or usually ensures and respects their personal privacy at all times.
  • 86% of the respondents indicated that they always or usually felt comfortable enough to question or to challenge the advice given to them regarding their care.
  • 81% of the respondents indicated that they always or usually felt the staff made an effort to find out what is important to them about their health.
  • Almost 80% of respondents felt that when they first made contact with Bendigo Health that they were able to be directed to the most appropriate service.
  • 67% of respondents felt that their opinions regarding their care were listened to and that their opinions were important.
Celebrating Person Centred Care

Patient as Consumer Survey

clipboardBendigo Health participated in a Benchmarking Study "Beyond Satisfaction: Patient as Consumer", conducted by Best Practice Australia, in 2013. Questions focused on patients' experience during their hospitalisation, and their most pleasant and less pleasant experiences.

patientasconsumer

Key findings of the survey indicate that:

  • 90 % of respondents were satisfied with the overall quality of their most recent stay at Bendigo Health.
  • 87% of respondents felt that Bendigo Health provided significant recovery from their medical condition.
  • 91% of respondents felt that the nurses demonstrated a caring and compassionate attitude.
Patient as Consumer Survey

Pictured: Rosemary Conquit, one of Bendigo Health's over 300 volunteers.

Righteous Pups

Visit Bendigo Health

Animals play an important role in the health and wellbeing of humans. Research suggests that animals can have positive impact on our cardio-vascular and mental health, allergies, asthma and social interactions. Dogs are commonly used to support vision-impaired persons and in occupational therapy and physical rehabilitation, but they are also wonderful companions that improve the quality of our lives.

Bendigo Health's Child and Adolescent Unit recently paired up with Righteous Pups Australia to respond to a request by a paediatric long-term patient who was unable to leave the bedroom let alone the hospital. His family loved dogs and their wish was that the boy could pat and play with a dog while in the hospital.

The social worker of the Child and Adolescent Unit took up the initiative, and Righteous Pups started bringing dogs on a weekly basis to keep company to our young patients. These adorable dogs have brought many smiles and joy to the children, and the visits are greatly anticipated by patients, parents and staff.

 

Righteous Pups Visit Bendigo Health

Pictured: Matilda Garrlick with a labrador from Righteous Pups Australia.

Reducing the Risk of Infections

infectioncontrologoBendigo Health's Infection Prevention and Control Unit's role is to monitor, reduce and control the risk of infection to our patients.

Victorian Cleaning Standards

Every year, Bendigo Health is independently audited on the standard of cleaning in our hospital to ensure we meet the Department of Health cleaning standards. Our latest figure show a high level of achievement, typically well above the benchmark standards:

viccleaningstandards


Hand Hygiene Compliance

The Department of Health has set a target of 70% for hand hygiene compliance across the state. Bendigo Health continues to exceed this target and our compliance remains very high compared with the state aggregate:

Click graph to view in more detail

Hand Hygiene Compliance

Antibiotic Resistance

Worldwide antibiotic resistance happens when bacteria change so antibiotics no longer work in people who need them to treat infections.

The Bendigo Health's antimicrobial stewardship program (AMS) has been in place since 2008 with well-established policy and processes to ensure appropriate prescribing of antimicrobials, to prevent and manage healthcare associated infections and improve safety and quality of care. There are many strategies in place to support the AMS, such as executive leadership and governance arrangements, an AMS team and an antimicrobial approval system (IDEA3s). By reducing inappropriate antibiotic usage, patient outcomes are improved due to patients experiencing less side effects and microbial resistance. As a result of well embedded culture and practice for effective use of antibiotics, Bendigo Health was rated with 'merit' for the antibiotic resistance stewardship system in the 2013 accreditation against the National Safety and Quality Health Service Standards.

The AMS team will address consumer and patient education and continue to grow the program through expansion of existing elements and new initiatives. Join the fight against antibiotic resistance. Ask your health professional or visit www.nps.org.au.

Staff Influenza Vaccinations

This season over 2,300 influenza vaccinations were given to staff. This equates to 65% of staff having had the influenza vaccine this year.

staffinfluenza

Infection Control in the Intensive Care Unit

Public hospitals are required to monitor, and report to the Department of Health via VICNISS (The Victorian Infection Control Nosocomial Infection Surveillance System), infection in patients undergoing complex care who require mechanical assistance with their breathing via a ventilator and also those who require large catheters (Central Venous Catheters) which assist to monitor circulation and provide access to large veins for the delivery of medications. The Intensive Care Unit (ICU) has adopted best practice when managing patients who require a ventilator and a central venous catheter. Staff strictly follow policies which are aimed at reducing infection risk to zero. Staff receive education regarding the measures necessary to prevent infection and are provided with feedback on infection rates and audit results. Zero infection associated with ventilation and central venous catheterisation have been maintained. The insertion of central venous catheters is also monitored over a three month period each year in the ICU to ensure catheters are inserted safely. Compliance with safe insertion practise is achieved consistently. This data is also provided to the Department of Health (VICNISS) where data is compiled, benchmarked against all participating hospitals and provided back to hospitals.

As at the 2nd October 2014, there has not been a case of ventilator associated pneumonia (VAP) for 793 days, nor a case of central line associated blood stream infection (CLABSI) for 1,181 days.

infectioncontrol

Strict compliance with policy and best practice has resulted in these excellent outcomes. The ICU utilise a quality reporting board which displays these and other results at the entrance to the unit. Results are provided transparently to staff and consumers.

Reducing the Risk of Infections

Hepatitis Heroes in the

Infectious Diseases Service

The Infectious Diseases Service at Bendigo Health, since its inception in 2007, has had continuous growth and currently consults over 350 patients per year. With such a substantial increase in patient bookings for our viral hepatitis services, we have required ongoing and continuous involvement with Hepatitis Victoria, using telephone, written and web-based resources when educating staff, patients and their families.

Throughout this work, we have listened to our patients' experiences of stigma and discrimination relating to their illness and were very pleased to be invited to participate in the HepHeroes program. We know that people living in regional areas often have difficulty accessing healthcare and earlier access to screening, diagnosis and treatment can help reduce the incidence of viral hepatitis, providing long term health benefits for our whole community.

Since the HepHeroes program was launched in November 2013, staff of the Infectious Diseases Service has encouraged staff and patients' participation to sign the pledge making a stand against stigma and discrimination.

The 2014 Hepatitis Awareness Week educational events were a great success with a number of enthusiastic and inquisitive attendees signing up to the pledge on the day, after hearing a person with hepatitis C speak about her experiences with discrimination. The HepHeroes program assists our staff to create a healthcare environment that is trustworthy and welcoming for all people, including those who wish to seek treatment and prevent future health complications. Be a passionate supporter of Bendigo Health to raise awareness and stop discrimination and sign up to the pledge at www.hepheroes.com.

Listen to an interview by one of our Hepatitis Heroes, Catina Eyres (ABC 91.1FM).

 Hepatitis Heroes in the Infectious Diseases Service

FAST FACTS:

There are 120,000 Victorians living with viral hepatitis, representing 2% of the state population, with the Loddon Mallee region reporting one of the highest notification rates regionally.

Across Australia, less than 5% of people seek treatment, often fearing judgement by healthcare workers.

The Big Five

– Indicators in Patient Safety

1. Medication Safety

Bendigo Health's clinical staff work in strict compliance with policy and best practice in order to eliminate medication risks to patients. Medical Officers, pharmacists and nursing staff work closely together with the specialised pharmacy advisory committee to ensure that the prescribed medication reaches the patient. It involves three stages – prescribing, dispensing and administration – all of which are carefully checked and monitored.

As part of our continuous improvement, the Pharmacy Department produces a glossy 'Medication Safety' newsletter specifically focussing on supporting staff to have access to best practise information and to remain highly skilled, and hence to promote better health outcomes for our patients.

2. Falls

Bendigo Health's falls steering committees, risk management committees and working groups oversee our objective of reducing the harm that may occur as a consequence of falls.
The following graph shows the number of falls per 1000 bed days (combining all inpatient beds and residential services):

Click graph to view in more detail

Falls per 1000 days

Source: Data collated from VHIMS and Manad

The following graph indicates the number of falls per 1000 bed days in the sub-acute wards. It shows that Bendigo Health is performing better than the Victorian Benchmark:

Click graph to view in more detail

Falls per 1000 days Sub Acute Wards

3. Pressure Injuries

Pressure injuries occur when an area of skin has been damaged due to unrelieved pressure. It usually occurs over the bony areas, especially heels, buttocks and toes.

The following graph shows the total number of pressure injuries per month. The incidents shown record the number of pressure ulcers acquired during care or that were present upon admission and then became worse. They also demonstrate that Bendigo Health ranks very strongly against the Victorian benchmark.

Click graph to view in more detail

Pressure Injuries

Source: Data collated from both VHIMS and Manad (i.e. includes residential services)

4. Oral Health for a Healthy Life

At Bendigo Health we are committed to support patients to look after their oral health, including prevention of pain, infection and tooth loss. Where possible, priority is given to children and young people under 18 years old, Aboriginals and Torres Strait Islanders, refugees and asylum seekers, and homeless people or those at risk of homelessness.

A range of key dental information is systematically reported to Dental Health Services Victoria which in return sends us quarterly clinical indicator data at local, regional and state level.

Trends in the past two years show that Bendigo Health achieved great results across several indicators. These encouraging results are used to inform and focus our quality improvement initiatives to continually improve the delivery and outcomes of our dental service:

individualstreated

Individuals treated for dental care

In 2012/13

In 2013/14

Adults

5567

6636

Under 18 years old

4382

4273

Aboriginals and Torres Strait Islanders

170

257

Refugees and asylum seekers

102

181

Homeless or at risk of homelessness

(none)

5

Significant improvements were achieved in waiting times:

waitingtimes

Waiting time per care type

July 2012 to June 2013

July 2013 to June 2014

Denture care

42 months

3.3 months

Priority groups

2.8 months

0.6 months

timmyThe Community Dental Clinic recently created a designated children's area where the waiting time for our small clients is a more pleasant experience. There are child-sized tables and chairs, and an artistic feature wall that invites children to find Timmy the Tooth hidden in the artwork.

A Dental Services quality improvement project was selected as a finalist in the Bendigo Health Quality Award's program in June 2014.

5. Safe Use of Blood and Blood Products

Bendigo Health's commitment to providing safe blood and blood products remains a high priority. We continue to comply with all state and national blood and blood product sampling, transportation, storage and administration requirements, ensuring that our patients continue to receive the best possible transfusion outcome.

All registered nurses, registered midwives, enrolled nurses, anaesthetic technicians, health service assistants and porters involved in any aspect of the transfusion process must complete annual blood component assessments. This year, the annual assessments for nursing and anaesthetic technicians are available electronically via iLearn, an electronic educational assessment portal.

Blood and blood product related policies and procedures are regularly reviewed and new policies are developed as required.

Bendigo Health remains committed to informing and involving patients in the transfusion process. A new form, a transfusion visual pathway has been developed, which is intended to give patients a general idea of what they can expect before, during and after a blood component transfusion.

blood

The Big Five – Indicators in Patient Safety

"Hear Me"

The simple but powerful "HEAR ME" play was presented to Bendigo Health staff and the general public, in partnership with the Australian Institute of Patient & Family Centre Care, and as part of our commitment to increase training on patient centred care and the engagement of individuals in their care.

Written exclusively for health care professionals, patients and organisations, this play by Alan Hopgood explored the life and death importance of patient centred care. It delved into the consequences of a medication error and failure to recognise the knowledge families hold of their loved ones. The behaviour of senior staff and a climate of fear among junior staff underpinned the story which uncovered the enormous potential for partnering with patients while improving quality and safety.

Seven performances of the play were presented at Bendigo Health in 2013 and in 2014, and over 300 hospital executives, staff and consumers attended the play.

Feedback given about the performances shows that:

  • 95% of attendees felt that the issues raised in the play were very relevant to their health service.
  • 99% of attendees found that the play was very effective in getting key messages across regarding communication, patient safety, quality of care and staff culture issues.

Following the performance the audience had the opportunity to participate in a stimulating discussion forum on clinical incident disclosure, team communication and patient centred care. The forum allowed for hospital staff to debrief, challenge the central premise of the story and discuss practical applications and ideas for change to hospital culture and systems regarding partnering with patients and their carers.

"Hear Me"

Comments about the HEAR ME play:

"Confronting and emotional. A Brilliant way of addressing issues instead of lectures."
"Some of us from the rural areas have come see the play and it has been a really good experience!"
"This play should be performed at every Medical School."
"Great show, great actors, thank you and keep the show going!"

Accreditation and Credentialing

Bendigo Health provides high quality, consumer focused care based on the very best evidence of good practice. The system we use, termed 'clinical governance', is underpinned by our Accreditation system. Bendigo Health is accredited by the Australian Council on Healthcare Standards (ACHS), an independent not-for-profit organisation whose purpose is to ensure we are providing safe, quality care in accordance with widely recognised state and national standards and to identify any areas for improvement. Accreditation is one tool, in a range of strategies, which can be used to improve safety and quality in a hospital. It is a way of verifying that actions are being taken, that system data is being used to inform activity and that improvements are made in safety and quality.

Victorian Clinical Governance Policy Framework

Bendigo Health is committed to improving the quality and safety of our health service by providing care within the domains of quality (as described in the Victorian Clinical Governance Framework – enhancing clinical care, 2009). The framework consists of four domains:

  • Consumer Participation – is the process of involving consumers and community members in decision making about their health care, health service planning, policy development, setting priorities and quality issues in health service delivery;
  • Clinical Effectiveness – is ensuring the right care is provided to the right patient who is informed and involved in their care at the right time by the right clinician with the right skills in the right way;
  • Effective Workforce – Staff must have appropriate skills and knowledge to fulfil their roles and responsibilities within the organisation. Support is required to ensure clinicians and managers have the skills, knowledge and training to perform the tasks that are required of them and that they understand the concept of governance;
  • Risk Management – Clinical risk management is part of the broader organisational risk management system which integrates the management of organisational, financial, occupational health and safety, plan, equipment and patient safety risk.

High – level governance of quality & safety

Bendigo Health's Quality Care Council meets bimonthly (as a sub-committee of the Board) and works to ensure that a consistent endeavour is applied across the organisation to oversee the delivery of optimal care in an environment of minimal risk. The Quality Care Council reviews reports that allow for a systematic, coordinated, and continuous approach to improving performance by focusing on the processes and mechanisms that address these values under the domains of quality.

tickNational Safety and Quality Health Service Standards (NSQHS)

In 2013 we were successfully accredited against all 10 National Standards. The primary aim of the Standards is to protect the public from harm and to improve the quality of health service provision. The ten standards are outlined below:

Click graph to view in more detail

merit

As Bendigo Health offers a diverse range of services to the community, the organisation is involved in numerous additional forms of accreditation which are outlined in the matrix below:

Acreditation Framework

Division

Acreditation Status

Aged Care Standards

Community and Continuing Care

Successfully re-accredited August 2012

Department of Human Services Standards

Community and Continuing Care

Successfully re-accredited April 2014

ISO 9001:2008

Finance

Successfully re-accredited May

National Safety and Quality Health Service Standards (NSQHS)

Organisation Wide

Successfully accredited November 2013

National Standards for Mental Health Services (NSMHS)

Psychiatric Services

Successfully re-accredited in 2010, and all annual self assessments completed since

Community Common Care Standards (CCCS)

Community and Continuing Care

Home and Community Care (HACC) programs re-accredited in November 2013 (concurrently with NSQHS)

In addition, Bendigo Health operates an organisation wide risk management strategy to identify risks and establish appropriate responses and systems to mitigate them.

Bendigo Health's status as a fully accredited health service is of great importance for patients, clients, consumers and families of our service as it indicates that the organisation not only examines its own systems, processes and services, but is also rigorously examined for quality, safety and patient centred care through fully recognised external organisations, allowing clients to be assured that they are coming to an organisation which works hard to provide the best possible care.

Credentialing and Scope of Practice

Credentialing is the formal process used to verify the qualifications, experience, professional standing and other relevant professional attributes of health professionals for the purpose of forming a view about their competence, performance and professional suitability to provide safe, high quality health care services within specific organisational environments.

Bendigo Health uses the Department of Health's "Credentialing and defining the scope of clinical practice for medical practitioners in Victorian health services" guidelines to maintain a credentialing system that oversees the credentialing and scope of practice process for medical staff and specialists. Governance is overseen by the Health Professionals Credentialing Committee (HPCC) which reports to the Quality Care Council (a subcommittee of the Board). The HPCC receive reports from:

  • Senior Medical Staff Credentials Committee
  • Allied Health Credentials Committee
  • Dental Credentials Committee
  • Nursing & Midwifery Credentialing Committee
  • Technologists & Scientists Credentialing Committee

Credentialing processes also apply and are in place to ensure that nursing, allied health and dental professionals are appropriately qualified and registered with their professional body. Processes include annual checks of nursing board registration and initial checks and regular reviews of qualifications for other health professionals as part of performance review programs.

 

Accreditation and Credentialing

Dementia Services Pathways

Dementia is the greatest single contributor to burden of disease due to disability in Australia and is the third leading cause of death in Australia, after heart disease and stroke. The Department of Health and Bendigo Health have a history of collaboration on a range of dementia initiatives that have produced positive outcomes for people with dementia, their families and carers across the Loddon Mallee region.

Most recently, the Department of Health provided funding to Bendigo Health (Collaborative Health Education and Research Centre) to develop regional Dementia Services Pathways. These simple one-page pathways provide a visual step-by-step guide for consumers to recognise possible signs and symptoms of dementia, and provide information on the broad range of services that assist them at the various stages of the dementia journey.

Six regional dementia services pathways and a services user guide were developed. Two of these pathways were developed specifically for consumers and were based on information needs identified by people with dementia and their carers across the Loddon Mallee region. Thirteen consumers and carers participated in focus groups in which participants discussed their own dementia journey and provided valuable input into the information they required in the pathways. A strong theme from consumers was that their information needs are very diverse and based upon individual needs, with no one agency able to provide all the answers or information that they needed.

The pathways are currently undergoing graphic design prior to being uploaded onto the Regional Dementia Management Strategy (RDMS) website. The RDMS was reviewed, and updated service booklets, links, assessment tools, guidelines and other best practice resources are currently being uploaded onto the RDMS website.

Consumers can access the pathways either via the website www.dementiamanagementstrategy.com or through one of the service providers listed on the pathways.

Dementia Services Pathways

Healthy Supermarket Tours

Bendigo Health's Nutrition and Dietetics Department, in conjunction with Diabetes Australia – Victoria, adopted an initiative to support Bendigo Health's healthy communities vision by conducting local supermarket tours.

In the past year, five tours were provided by Bendigo Health Dieticians. Twenty-four community members participated and are now up-skilled on how to read and understand food labels. During the Nutrition Week in October 2013, Bendigo Health staff were provided the opportunity to attend the tour during work hours. The majority of participants were aged between 46-60 years (56%), and 71% of them did not have diabetes or pre-diabetes, despite their affiliation with Diabetes Australia.

The following feedback was provided by the participants on their experience of the tour:

Click graph to view in more detail

supermarkettour1

100% of participants felt their needs were met, the information provided was satisfactory, and their questions answered:

Click graph to view in more detail

supermarkettour2

96% of participants stated they are likely to make dietary and/or shopping changes as a result of the tour. Some stated specific changes as shown in the table below:

Changes participants will make

Look more closely at what foods I purchase

Less fat and more fibre

Choosing “good foods”

More Low GI, less fat etc.

Read labels

The supermarket tours are free for Diabetes Australia – Victoria members and $15 for non-members. Phone Diabetes Victoria on 1300 136 588 to reserve your place.

Healthy Supermarket Tours

Between the Sheets:

Preventing Pressure Injuries

Between-the-SheetsA pressure injury is a type of skin damage that is caused by unrelieved pressure and may occur in anyone with reduced mobility, such as being confined to a bed or chair due to illness or surgery. Pressure injuries can lead to serious complications, but many of them are highly preventable through regular changes of position, good hygiene and skin care, and a healthy diet.

The introduction of an Acute Wound Consultant at Bendigo Health in February 2014 has assisted with providing expert care and advice to patients with complex and chronic wounds. The service is offered to all patients admitted to the acute hospital campus and rehabilitation unit, and 194 new patients have received care since February. In a short period of time, the role has improved confidence in staff to provide a consistent approach to wound care, and to achieve faster and more successful outcomes for patients.

The new service has shown improvement in a range of aspects of skin assessment tools and wound management:

  • Patient and staff compliance with wound care regimes
  • Reduced waiting times and length of hospital stay for patients
  • A reduction in unnecessary surgery and hospital admissions through reducing complications post-surgery
  • enhanced symptom control and improved patient self-management
  • High quality staff education and strong communication pathways between medical staff and patients.

To showcase the hard work and dedication of our very passionate staff to prevent pressure injuries, Bendigo Health participated in two events in 2013: The Australian Wound Management Association (AWMA) State Conference, and a Wound Gala Night which was attended by 84 staff. Participants gave overwhelmingly positive feedback about the events and felt that they were great opportunities to keep up-to-date with best practise in wound care and to promote better health outcomes for our patients.

Between the Sheets: Preventing Pressure Injuries

source: hospitalhealth.com.au

Continuity of Care

Continuity

Say It in a Thousand Words

Tackling Speech Disorders at an Early Age

Evelyn is a four-year-old girl who talks articulately about her favourite things: She loves to play with her baby brother Jeremy and other kids at the playground, she has a pet dog called Lula, and her all-time favourite colour is pink. It is hard to believe she has recently undergone months of speech therapy for stuttering.

At the time of Evelyn's third birthday, mum Laura became aware that there was a pattern in the speaking difficulties that Evelyn presented. The girl first got stuck with one word, then a whole sentence, which then made her stop talking completely. Not being able to say what she intended to made her frustrated and insecure. Laura tried to be as patient as possible, but sometimes people would say to Evelyn: "Just spit it out, girl!" which wasn't easy to hear.

Laura eventually contacted the Child Health Nurse to get Evelyn assessed. A diagnosis for stuttering was confirmed and Evelyn was able to start speech therapy at Bendigo Health's Talking Matters in February 2014. In just four months of regular exercise, including home practice, Evelyn's speech has improved remarkably. Both the frequency and intensity of stuttering have decreased. "If Evelyn now gets stuck on a word, she is able to re-think what she wants to say and to change the direction of her words or simply select different words. It's very rare that we have a big bumpy period. Evelyn still has occasional difficulties, but the bumps are only small and not for whole sentences", says Laura.

"The support we've received from the Bendigo Health Speech Pathology has been fantastic. Especially when Evelyn slipped or regressed, I was concerned that I wasn't on top of the situation. But the therapist was extremely supporting and encouraging", Laura says and continues: "It has been a real advantage to have the same person for her throughout the sessions. Evelyn talked more at each session simply because she was so comfortable and excited to see her therapist again."

Evelyn has come far. Her self-confidence has increased and she doesn't get as frustrated anymore. She also talks freely to anyone, and not just to people she knows. Laura encourages others who struggle with similar issues not to hesitate to get help: "I waited perhaps a bit too long, thinking it was just me who had these doubts. If you have a slightest concert about your child's speaking, just go and ask your health professional. It's for your own peace of mind, and it could affect your child in the long run. The earlier you get on to it the better it is for the child".

Talking Matters Bendigo was announced as the monthly finalist in the Bendigo Health Quality Award's program in October 2013.

Say It in a Thousand Words

FAST FACTS:

Current research indicates that 8.5% of three-year-old children experience stuttering.
Around 1% of the Australian population experiences stuttering at any given time and as many as 5% across a life time.

(Source: Speech Pathology Australia)

Special Care for Special Babies

Our Special Care Baby Unit (SBCU) recently started performing a procedure called 'Bubble CPAP' to assist babies requiring some form of respiratory support using nasal prongs or mask. To date, fourteen babies have been treated by this procedure.

This has meant that babies that would have once been transferred to Melbourne have stayed in their community. The separation from their parents and siblings has been avoided, the bonding process is enhanced and the financial burden to families is reduced (travel, fuel and accommodation expenses).

The SBCU also introduced Kangaroo Care (skin-to-skin contact) for babies and their parents, which promotes parent–infant bonding especially for premature babies. This involves parents in their baby's care, reducing their stress and promoting breastfeeding. It has also been shown to reduce the length of the hospital stay, and to promote a more stable heart beat rate, a more regular breathing, better oxygen saturation levels, longer periods of sleep, more rapid weight gain and brain development, decreased crying, longer periods of alertness, and greater success with breastfeeding.

The SBCU also offers education for new parents to help them continue with safe practises at home for the baby. This includes cardiopulmonary resuscitation (CPR) and safe sleeping guidelines, amongst others. The CPR education is demonstrated using a neonatal mannequin, so that parents gain a good understanding and necessary skills for what to do in an emergency situation at home, should that be required. The safe sleeping guidelines are from the SIDS Foundation and they educate parents on aspects such as safe a sleeping position and place for the baby, uncovering the baby's head, and maintaining a smoke-free environment.

Special Care for Special Babies

Complex Pregnancy Care Program

The Complex Pregnancy Care (CPC) Program at Bendigo Health commenced in October 2007, in response to an identified need at the time of discharge for mothers and babies with complex needs to be specifically supported. It was recognised that opportunities existed throughout the pregnancy to develop strategies for these higher risk clients, to support them with complex social issues associated with pregnancy, child birth and the care of newborn infants, such as mental illness, homelessness, disability, substance abuse, family violence and isolation.

The identification and referral of CPC clients by midwifery and medical staff occur at the Women's Health Centre, and a referral is then made to the CPC Program. The process of identification and referral allows for complex discharge planning occurring prior to the birth of vulnerable infants.

Monthly collaborative meetings take place between maternity support staff, mental health workers and child support workers in the Bendigo area to jointly assess the best possible outcomes and to provide support and safety to CPC families. Where appropriate, collaborative pre-birth and/or discharge case conferences occur with the support and attendance of the families involved.

The CPC program also offers education and support to health care professionals working with families to assist them to identify vulnerable children and respond appropriately.

In 2013, the Bendigo Health CPC Program was awarded the Play Your Part Victorian award, by the National Association for Prevention of Child Abuse and Neglect (NAPCAN), for implementing and sustaining a prevention program where the focus is keeping children safe within their families. The CPC program is in line with the 'Best Interest Principles' of collaborative practice and early intervention under the Child Youth and Family Act (2005). It is an embodiment of the Department of Health's philosophy, 'The safety and wellbeing of vulnerable children is everyone's business'.

Complex Pregnancy Care Program

Improving Balance and

Preventing Falls Together

Bendigo Health's Outpatient Rehabilitation Balance Group is a service for clients experiencing issues with balance and falls. It has been operating successfully for several years, and provided balance retraining for over twenty new clients last year.

The Balance Group recently underwent a significant restructure, including increasing staff's knowledge about risk identification and management of falls. The staff running the groups are now specifically targeting clients who are most likely to have a fall. It also means that those clients most at risk of falling are fast tracked and do not have to wait as long to start in the group. Clients with a lower risk of falling may be directed into other parts of the service, such as the community exercise groups to improve their balance.

The Falls Clinic were announced the overall winner of the prestigious Bendigo Health Quality Awards in 2013. The project 'Balance group: Review of current program structure, criteria and discharge planning' was driven by Allied Health staff.

Comments from the Balance Group participants:

"I'm now able to wear tie-up shoes because I can bend over to tie the laces" (after six 1-hour sessions)

"It is a fantastic group to be part of and all participants ... made significant improvements to their mobility and activities of daily living."

Improving Balance and Preventing Falls Together

Pictured: Estelle Hewston receives her Certificate of Achievement from Julia Birchall, Exercise Physiologist, as part of completing the Balance Group Program.

Preparing Communities

for Disability Care

Bendigo Health's service users assisted us in writing our new Disability Access Plan, which articulates how we aim to make our hospital and healthcare services accessible to all members of the community.
Our commitment at Bendigo Health is to ensure that we provide a healthcare service in which:

  • all people are treated with dignity and respect
  • all people receive quality healthcare, within the resources available
  • all people have access to our buildings
  • all people can find their way around our services
  • information is written in a way that is accessible and easy to read
  • all staff are able to communicate with patients.

The Disability Access Plan Committee meets regularly to ensure that the Plan is implemented. The Committee includes Bendigo Health service users who have disabilities and staff from key Bendigo Health services. In 2013-14, the Committee focused on improved access through improved communications. Specifically, we:

  • created a dedicated Disability Access page on the Bendigo Health website, where our Plan can be accessed.
  • developed braille versions (a writing system used by the visually impaired persons) of the Plan and placed them at Reception. Our consumers are helping to determine other useful locations.
  • adopted Easy English principles to help our staff to create accessible information for our consumers.
  • started work on an Auslan (Australian Sign Language) version of the Plan, which will be ready in December 2014.
  • supported the Food Services Department to develop photographic menus that help people in hospital to make their meal choices.

The Disability Access Plan Committee is dedicated to ensuring that our Bendigo Health services are accessible to all consumers and staff, including those with disabilities. The Committee is currently drafting its 2014-17 work plan, and welcomes consumers' comments and advice (Rose Miles, phone: 5454 7727, email: rmiles@bendigohealth.org.au).

Preparing Communities for Disability Care

'Bendigo Healthy'

 – Staff Health Promotion

A 'Bendigo Healthy' calendar of events is available to our staff featuring opportunities to participate in a variety of health and wellbeing information sessions, exercise groups, national celebrations and "Lunch' n' Learn" sessions.

The Lunch' n' Learns have become increasingly popular among our staff. In 2013, when they were first launched, five sessions were offered through the year on the following topics:

  • information on how to keep motivated keeping new year's resolutions with our in-house dietitians and exercise physiologists offering diet and exercise advice
  • food services chefs offered a cooking class for quick and healthy meals
  • a menopause information session facilitated through the Women's Health Department
  • training, nutrition and remaining injury free for preparation for the Bendigo Bank Fun Run, and
  • taking care of your mental health facilitated by the Psychiatric Services Education staff.

110 staff participated in the Lunch' n' Learns in 2013, with a total of 434 staff participating in other initiatives promoted in the Bendigo Healthy events calendar.

With the launch of the new Bendigo Health Strategic Plan in 2013 and the acknowledgement that the Bendigo Health staff group was an active community in its own right, the strategic goals of the organisation gave a whole new focus on taking care of our own staff. The goal to attain 500 staff participating in health and wellbeing initiatives was set for the 2013/2014 financial year and was successfully achieved with a total of 548 staff taking up opportunities during that period.

During 2014, the Bendigo Healthy calendar has grown in both the range and frequency of health promotion opportunities for staff involvement, including the Lunch' n' Learns expanding into bi-monthly cooking classes conducted by the Food Services Department.

‘Bendigo Healthy’ – Staff Health Promotion

Pictured: Staff attending a healthy cooking class