Shoalhaven News

NSW Health Awards finalists

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Several Illawarra Shoalhaven health initiatives are among the finalists for this year's NSW Health Awards

The NSW Health Awards recognise innovative and sustainable health programs that deliver outcomes that matter to patients and invests in the wellness of the NSW community.

It is more important than ever we take an opportunity to recognise and acknowledge the achievements of our health system.

Allied health working together to avoid unnecessary hospital admission.

In 2019, there was limited access to acute at-home allied health services for elderly patients who presented to ED with a medical episode and at risk of admission to hospital, in the Illawarra Shoalhaven region. This resulted in increased hospital admissions in this patient group. The aim of the project was to develop agreed selection criteria, appropriate for referral to an allied health out-reach team and avoid admission in 80% of accepted patients over six months.

In the second half of 2020, a dedicated Allied health Quick Access Response Team (QuART) was initiated to provide at home allied health services for elderly patients (>65 years) to allow discharge from ED with the aim of avoiding admission.

A novel trans-professional model of allied health care was developed for the six allied health disciplines involved in the team, resulting in collaborative patient-centered care, improved patient satisfaction, reduced average bed/days and cost savings.

206 patients were accepted into the program over the period of the pilot. The initiative resulted in 92% discharged safely with some requiring referral for follow-up allied health services.

Most referrals (60%) related to admission avoidance (patients referred to the program from ED), 27% to facilitation of early discharge, and 13% to other referrals, including from community services.

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Safer, better emergency nursing care.

To reduce patient deterioration related to ED care by implementing our new, validated emergency nursing framework HIRAID.

HIRAID was developed with experts, tested, then implemented in ISLHD EDs (302 nurses) using a multi-pronged behaviour change strategy. Causal factors to all 920 deterioration events within 72-hours of ED departure were analysed. Cost savings were calculated via OLS regression.

Results showed that ED related deterioration halved (27% to 13%) as did treatment delays (28% to 15%) and failure to escalate when abnormal vital signs were identified (20.2% to 6.9%). Documentation significantly improved. Savings were $1,914,252 with a payback period of 75 days.

The NSW goal Providing World-Class Clinical Care is clearly achieved through immediate, measurable improved emergency nursing care for 150,000+ ISLHD emergency patients each year.

This multi-disciplinary collaboration changed policy and practice. The ACSQHC, NSW ACI, NHMRC and the NSW and Commonwealth Chief Nurses have partnered with us to upscale HIRAID in another 32 EDs (1500+ nurses) across Australia.

This multi-centre study provides the reliable and necessary evidence and pathway for system-wide change.

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“SEED” an innovative and sustainable staff well-being program.

In January 2020, following the Australian bushfire crisis, the Illawarra Shoalhaven Local Health District Chief Executive assigned a Senior Social Worker to provide immediate crisis support to staff at Milton Ulladulla Hospital (MUH). This action reflected NSW Strategy of supporting our workforce to provide right care, in the right place, at the right time, for staff to continue to do the same for patients despite personal challenges.

During the fires and their aftermath, staff at MUH played a critical role in supporting their vulnerable community despite physical and emotional exhaustion.

Using a Participatory Action Methodology, co-designed with staff, has resulted in the development of the wellness program called ‘SEED’, encompassing five staff led initiatives, promoted healing, wellness, belonging and connection.

The SEED Program has since spread to other sites and services within the District and has more recently been recognised nationally and internationally. SEED has successfully received an NHMRC grant and several other grants, with the aim of shaping the change preparedness model for the Patient Reported Measures program.

The SEED Program continues to harness research in collaboration with the University of Wollongong and Agency of Clinical Innovation.

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Enhanced care anywhere.

Virtually enhanced Community Care (VeCC) improves care for chronic disease patients through comprehensive remote monitoring of patients symptoms and wellbeing. Aim: Utilising an easy to use virtual modality, VeCC aims to improve patient experience with patient-centred care, planning, support and individualised health coaching to improve selfmanagement skills, and reduce unnecessary hospital admissions and length of stay.

Patients admitted to VeCC have their symptoms and clinical observations remotely monitored alongside virtual consultations via an ISLHD provided Phillips tablet and equipment.

Since commencement in November 2020, more than 120 patients have been admitted to VeCC with improved patient outcomes and reduction in length of stay noted.

The implementation of VeCC for chronic disease patients aligns with NSW Health Strategic Priorities 3 (enabling eHealth) and 4 (designing and building future focused infrastructure) as well as National Safety and Quality Health Standards (NSQHS) 5 and 8, and Strategy 3: Integrate systems for truly connected care. VeCC provides a mechanism for ISLHD to deliver NSW Health Integrated Care Strategy Planned Care for Better Health (PCBH).

VeCC strengthens care provided for ISLHD patients with chronic disease, reducing risk of hospitalisation, improve patient experience and outcomes, keeping them healthier over the long-term.

Images: NSW Health 

 

 

Tags: NSW Health, Illawarra Shoalhaven Health