All Initiatives

1 Deadly Step

Aim: The 1 Deadly Step program promotes screening, early detection and follow up of chronic disease in Aboriginal communities in NSW. The unique component of 1 Deadly Step is the involvement of sport and its ability to engage Aboriginal people that would not normally be screened for chronic disease. Piloting the program across selected communities in NSW will enable NSW to refine the delivery model before a statewide implementation is developed.

Benefits: The 1 Deadly Step project is an initiative of the Chronic Care for Aboriginal People Program (CCAP). This project demonstrates how the CCAP Model of Care can be used as a framework for designing chronic disease programs targeting Aboriginal people and communities.1 Deadly Step provides an ideal platform on which to establish committed partnerships between local major health service providers such as the Local Health District, Aboriginal Medical Service and Medicare Locals, to improve health outcomes for Aboriginal people and...

ACI Ready to Implement Added: 7 February 2014|Last updated: 4 January 2016

12 Key Learnings from the Diagnostic Report to Inform the Model for Palliative and End of Life Care Service Provision

Aim: To present the 12 Key Learnings from the Diagnostic process that will directly inform the Model for Palliative and End of Life Care (PEoLC) Service Provision in a one-page summary.

Benefits: The key learnings of the Diagnostic Report provide the ACI with the basis on which to develop solutions and a Model of Care that directly address the core problems that have been identified.

ACI Ready to Implement Added: 21 July 2014|Last updated: 5 August 2014

48 Hour Follow Up Evaluation

Aim: To determine what proportion of eligible patients receive follow up; and whether the provision of enhancement funding has had any impact on rates of follow up. The program also aims to determine whether: Socio-demographic, disease and health service factors predict whether someone receives 48 Hour Follow Up; Compared to Aboriginal people who do not receive 48 Hour Follow Up, whether Aboriginal people who receive follow up have lower rates of 28 day adverse events; Rates of readmission among Aboriginal people...

Benefits: The 48 Hour Follow Up program was conceived as a result of the NSW Walgan Tilly Redesign project, which aimed to address gaps in health care and to improve access for Aboriginal people to chronic care services. The 48 Hour Follow Up program involves following up, within 2 working days of discharge, Aboriginal people aged 15 years and older who are admitted to an acute care facility with a chronic disease.Follow up is mostly carried out by telephone by a...

ACI Ready to Implement Added: 7 February 2014|Last updated: 5 January 2016

5x5 Antimicrobial Audit

Aim: The 5x5 Antimicrobial Audit is an initiative of the Clinical Excellence Commission that aims to improve communication and selection of empirical antimicrobial therapy among clinical teams.

Benefits: The 5x5 Antimicrobial Audit provides a platform for introducing regular, frequent and directed measurement and reporting of antimicrobial prescribing indicators in NSW local health districts and networks. The auditing process encourages clinically appropriate interventions where indications are unclear and/or empiric antimicrobial prescribing is found to be non-concordant with local guidelines. The 5x5 Antimicrobial Audit also facilitates rapid feedback of ward or unit-level antimicrobial prescribing indicators by providing tools and support to enable simple reports to be generated and discussed with...

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 November 2015

A Clinician’s Guide: Caring for people with gastrostomy tubes and devices

Aim: The Guidelines are a practical resource for clinicians to assist them in providing standardised care for children and adults who have a gastrostomy tube or device.

Benefits: The Guidelines provide a practical, evidence-based approach to the care of patients with gastrostomy tubes and devices in NSW.

ACI Ready to Implement Added: 8 November 2013|Last updated: 13 July 2015

Accelerating Implementation Methodology (AIM)

Aim: To increase Implementation capability across NSW Health; To embed AIM principles in large-scale program and model of care implementation; To apply AIM principles in Local Health District project implementation.

Benefits: Given the scale and pace of change-initiatives there is an ongoing demand for increased capability in applying AIM principles across the NSW Health system. The AIM strategy moves beyond training, to build capability through application of the principles in practice.

ACI Ready to Implement Added: 8 November 2013|Last updated: 17 January 2014

Access to Health Services for People with Intellectual Disability: The Patient Story

Aim: To inform people with intellectual disability, and their carers, about how the health system works to address their needs; To give health professionals insights on how the people they care for interact with the health system.

Benefits: Adapting the health service needs of people with intellectual disability according to their identified needs.

ACI Pre-implementation Added: 8 November 2013|Last updated: 4 December 2013

ACI Building Co-design Capability Strategy

Aim: The Strategy aims to build capability in patient experience and co-design thinking, methods and practices within the ACI and across NSW Health by employing a learn, do, teach, share approach.

Benefits: Delivering more person-centred and sustained health care improvement as a result of working in partnership with consumers, carers and health care workers.Stronger relationships and enhanced communication between consumers, carers and health care workers.Improved health literacy.

ACI Ready to Implement Added: 8 December 2016|Last updated: 8 December 2016

ACI Guidelines for Home Enteral Nutrition (HEN) Services (2nd edition)

Aim: To provide a generic best-practice framework for the care of people needing HEN.

Benefits: The ACI Guidelines for HEN services promote a coordinated, multidisciplinary and patient-centred approach for people requiring HEN.

ACI Ready to Implement Added: 6 November 2013|Last updated: 13 April 2015

ACI Innovation Awards

Aim: ACI Innovation Awards were introduced at the seven rural Local Health District Quality Awards 2014, and at the HETI Statewide Rural Health and Research Congress to recognise and reward innovation and capture models of care which have potential for broader implementation across other health sectors. Selection Criteria include:Improved patient outcome and experience for hard to reach population groupsResourcefulness and creativity utilising existing resourcesInclusive partnerships which increase access to servicesTransferability or system-wide potential

Benefits: Winning projects are loaded onto the new ACI Innovation Exchange, replacing Australian Resource Centre for Healthcare Innovation (ARCHI) as a one-stop-shop for health service providers to share lessons learned and resources.

ACI Ready to Implement Added: 23 September 2014|Last updated: 10 October 2014

ACI Research Framework

Aim: To guide all research the ACI undertakes, commissions or partners in, to ensure this research meets the highest ethical, scientific, regulatory and professional standards.

Benefits: This framework ensures that ACI research meets the highest ethical, scientific, regulatory and professional standards.

ACI Ready to Implement Added: 8 November 2013|Last updated: 15 October 2014

Acute Myeloid Leukaemia (AML) Model of Care

Aim: To optimise the quality of care for patients with AML and enable a consistent approach to the provision of care. It provides a set of principles and outlines the key requirements at each stage of the patient’s journey based on evidence of best practice. It incorporates guidelines related to various components of the model.

Benefits: Key points included in this model are:Mechanisms to ensure early identification and referral to an AML treatment centreA multidisciplinary team (MDT) approach to treatment planning and the provision of care in an appropriate settingThe use of ambulatory care services to enable early discharge programs in a safe and efficient wayEffective follow-up and supportive care for all patients with AML

ACI Pre-implementation Added: 5 November 2013|Last updated: 10 July 2015

AMBER Care Bundle

Aim: The AMBER care bundle provides clinical teams a framework to develop a management plan that may include end of life decisions in collaboration with the patient and family for patients whose recovery is uncertain while continuing with treatment in the hope of a recovery.

Benefits: Early identification of people who may have end of life care needs is the foundation of excellent end of life care. If early identification does not occur then appropriate planning, transfer, interventions and communication with the person and their family cannot take place The AMBER care bundle: Provides a tool to help clinicians identify people for whom recovery is uncertain and who may have end of life care needs Simplifies key interventions to support best practice Supports staff to start...

CEC Ready to Implement Added: 25 June 2013|Last updated: 9 November 2015

Assistants to the Anaesthetist

Aim: During an episode of anaesthesia, the anaesthetist must be assisted by another appropriately trained person, in order to ensure the safety and quality of care for patients. Therefore, the Network established a working group to identify the skills that are necessary for an assistant to the anaesthetist.

Benefits: Standardising education and training requirements for the anaesthetic assistant; Ensuring safe and efficient anaesthesia; Ensuring anaesthetic assistants are provided with the appropriate skills and training.

ACI Future Initiative Added: 27 March 2014|Last updated: 21 August 2015

Between the Flags

Aim: The aim of Between the Flags is to improve early recognition and response to clinical deterioration.

Benefits: The Between the Flags system is designed to protect patients from deteriorating unnoticed and to ensure they receive appropriate care. It is a ‘safety net’ for patients who are cared for in NSW public hospitals and health care facilities.

CEC Ready to Implement Added: 30 October 2013|Last updated: 9 November 2015

Blood and Marrow Transplant Environmental Cleaning (BMTEC) Project

Aim: To measure level of cleanliness provided in NSW BMT program. Establish baseline level of environmental cleanliness informed by three external environmental cleaning audits per facility. To ascertain the methods by which units are cleaned (e.g. frequency and process), resourcing, training, and education of environmental service personnel and clinical governance; To pilot and validate the CEC NSW environmental cleaning audit tool against an established standard; To inform quality improvements in environmental cleaning standards in BMT/Haematology units (an extreme-risk functional area). Monitor...

Benefits: With the support of the BMT Network Council and ACI, the BMTEC project provides the following benefits: (i) Enhanced compliance with the Environmental Cleaning Policy NSW (PD2012_061, Nov 2012). Authored by the Clinical Excellence Commission (CEC), this policy was released as a policy directive by the NSW Ministry of Health in November 2012 (1). The categorisation of risk in the Policy provides a basis for recommendations of frequency and minimum cleaning standards for each functional area.Additionally, the policy outlines measures...

ACI Ready to Implement Added: 8 November 2013|Last updated: 5 August 2016

Blood and Marrow Transplantation Long Term Follow Up (LTFU) Project

Aim: The primary goal of this project is to develop clinical guidelines for management of patients following allogeneic blood and marrow transplant. The guidelines apply to adult patients and patients transitioning between paediatric and adult services, across metropolitan, regional, and rural areas.

Benefits: LTFU assists early recognition of complications, survival and quality-of-life issues for patients post-BMT transplant. These benefits have been supported by recently published guidelines including the Joint Recommendations of the European Group for BMT, the Centre for International BMT Research, and the American Society of BMT (1).

ACI Future Initiative Added: 8 November 2013|Last updated: 5 August 2016

Building on Aboriginal Programs – Improving the Uptake of Aboriginal People into Chronic Disease Rehabilitation

Aim: To identify a number of Local Health District sites with Aboriginal programs that have elements of a chronic disease rehabilitation program, then work with Local Health Districts to apply a gap analysis that has been developed from the NSW Rehabilitation Model of Care to determine and implement the resources required to be recognised as a rehabilitation program.

Benefits: The Chronic Care for Aboriginal People (CCAP) team are investigating innovative ways of improving enrolment and completion of rehabilitation rates for Aboriginal people by building on existing programs that are targeted for Aboriginal people. An example of one such program which already delivers many of the components of a rehabilitation program is the Aunty Jean’s Program. This program was developed to build on community’s capacity to work together for better health outcomes, with leadership provided by local Aboriginal Elders. The...

ACI Ready to Implement Added: 7 February 2014|Last updated: 7 February 2014

Care of Adult Patients in Acute Care Facilities with a Tracheostomy

Aim: To improve the safety and quality of care provided to adult patients with a tracheostomy in NSW hospitals.

Benefits: Reduce number of, and severity of adverse events in adults with tracheostomy Improve patient experience and outcomes Improve staff experience in caring for patients with a tracheostomy Reduce length of stay

ACI Ready to Implement Added: 28 October 2013|Last updated: 26 June 2015

Care of Confused Hospitalised Persons (CHOPs) program

Aim: Provide simple strategies to improve the care outcomes of older patients with confusion in NSW hospitals, through:increased staff knowledge and skills to identify, treat and care for older people presenting to their hospitals with confusioninvolvement of carers and families.Achievements, innovation and knowledge will be shared and systems embedded into practice to sustain and spread improvements in care.

Benefits: Increased screening, improved risk assessment and more appropriate treatment and management of confusion.Increased awareness, knowledge and skills of staff to better care for older patients with dementia/delirium.Minimisation of harm during care and safer and more supportive hospital environments.Improved patient outcomes, including:prevention of functional declinereduced morbidity and adverse eventsreduced length of stayreduced readmissionsreduced rate of admission to a residential aged care facility upon discharge.Greater accuracy of coding for delirium DRGs.Reduced per capita cost.

ACI Ready to Implement Added: 13 August 2015|Last updated: 14 August 2015

Catalogue of Research on Intellectual Disability (NSW)

Aim: Identify current research and research gaps concerned with intellectual disabilities.

Benefits: Awareness of what research is current in the field of intellectual disability in NSW, including gaps, funding sources, and identification of suggestions for minimal data set.

ACI Pre-implementation Added: 8 November 2013|Last updated: 4 December 2013

Centre for Healthcare Redesign (CHR) Graduate Certificate Program

Aim: The Centre for Healthcare Redesign (CHR) Program aims to: Increase capability within the Health System to deliver, redesign and service improvement activities; Promote a patient-experience based approach to service improvement; Create a learning culture to support professional development and networking opportunities for healthcare workers; Implement recommendations from external review of the CHR Graduate Certificate Program.

Benefits: The CHR Graduate Certificate Program builds capability in Project Management, Change Management and Redesign through a combination of eLearning, face-to-face training, and workplace coaching applied in real-time to a workplace project.

ACI Ready to Implement Added: 8 November 2013|Last updated: 11 August 2016

Chronic Pain and Spinal Cord Injury Project

Aim: The aim of this initiative was to provide web-based resources for consumers who live with spinal cord injury and chronic pain in addition to a clinical navigation tool to assist clinicians to develop a pain management plan for SCI-related pain for their patients. The project also resulted in the development of a service model providing assessment and management of people with SCI and chronic pain which incorporates use of telehealth technology.

Benefits: The project has developed extensive resources and a service model that are now accessible to consumers and clinicians.

ACI Ready to Implement Added: 12 February 2015|Last updated: 12 February 2015

Chronic Pain Telehealth Model

Aim: The aim of this project was to pilot a telehealth platform and chronic pain toolkit to facilitate the ‘business as usual’ use of videoconferencing between specialist pain services and general practice and primary care.

Benefits: The pilot project delivered benefits to the patient, the clinicians in the service and in primary care, and the system as a whole. These benefits were realised in the following ways: reduced travel time for the patient reduction in cancellation of appointments increased efficiency for clinical staff ready access to expertise for the GPs. Referring clinicians were more likely to refer a second patient following a successful telehealth intervention. Compliance with the essential documentation and process aspects of telehealth were...

ACI Ready to Implement Added: 25 February 2016|Last updated: 25 February 2016

Clinical Analytics Initiative

Aim: To extract data from the electronic medical record and work with clinicians in using information to deliver quality and efficiency initiatives, and research the future needs for clinical analytics.

Benefits: Enable clinician led improved quality, safety and efficiency initiatives using data from the electronic medical record; Increase clinician engagement with information from the electronic medical record.

CEC Pre-implementation Added: 2 June 2014|Last updated: 2 June 2014

Clinical Innovation Program – Spread of Innovation

Aim: The aim of the ACI Clinical Innovation Program is to:Accelerate implementation of ACI Models of Care and Guidelines; Assist in the sharing and spread of local innovations.

Benefits: Improved implementation and system uptake of models, with demonstrated patient and health system benefit; Reduction in time and effort for LHDs to replicate contemporary evidence based models; Opportunities for LHDs to receive funding to implement the model.

ACI Ready to Implement Added: 4 August 2014|Last updated: 7 August 2014

Clinical Leadership Program

Aim: The ultimate aim of the program is to build a cohort of clinical leaders with the skills and commitment to shape a sustainable culture of patient safety, professionalism and positivity within the NSW health system.It aims to enhance:the understanding of clinicians about the workings of NSW Health; knowledge of contemporary approaches to patient safety and clinical quality systems; the skills of clinicians in relation to communication, conflict resolution and team leadership within an environment of health care resource limitation; the...

Benefits: The Clinical Excellence Commission (CEC) believes that the power of clinical leadership is an essential component of the CEC’s commitment to improving patient safety and clinical quality in our healthcare system. Clinical leaders play a pivotal role in the patient safety and clinical quality environment and need to have their full potential harnessed to ensure the health system works better and more safely for staff, patients and their families. In this, the program supports clinicians to develop extraordinary leadership practice....

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 November 2015

Clinical Practice Improvement (CPI) Advisors Group

Aim: The CPI advisors group aims to bring quality managers together to share their knowledge and experiences with each other as well as working together to develop resources for use across the NSW public health system. This group communicates by monthly teleconference and meets face to face annually for a professional development workshop. Members have also been involved in a collaborative workshop with Clinical Redesign leads.

Benefits: The program enables quality managers to meet up with peers in a similar position, who can assist with directing or sharing policies or procedures. CPI advisors share how their organisation has responded to changes within the system around accreditation and national standards and how they are implementing or supporting CPI initiatives in their Local Health District (LHD) / Specialty Health Network (SHN). The group has a shared HSnet site where articles of interest or resources can be uploaded to share....

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Clinical Practice Improvement (CPI) Training Program

Aim: The CPI training program provides clinicians with training in a methodology to address a problem or issue they have identified as adversely affecting patients. They then undertake a project to address the problem, with the ultimate aim being to improve patient outcomes / care or patient experiences.

Benefits: The methodology, once learned, can be applied to a variety of clinical settings and enhance patient care and clinical quality. There can be savings both monetary and in decreased length of stay. Some projects successfully manage to reduce variation in what they do and therefore improve processes and standardise care. Teams are interdisciplinary and can work more closely together towards a common goal. The training helps created a pool of staff skilled in quality improvement. Participants can use being on...

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Clinical Practice Improvement Program for Advanced Trainees and Recent Fellows

Aim: The purpose for Clinical Practice Improvement (CPI) is to build capacity in front line staff to improve healthcare processes and to achieve efficiency, reduce harm and improve satisfaction of the patient experience; A one-year program aims for Advanced Trainees to gain skills in patient safety and improvement methodology and to undertake a project to improve patient outcomes; A unique program which will help the RACP Advanced Trainees to recognise areas where improvements in the health system are needed, and to...

Benefits: The CPI Program provides an opportunity for RACP Advanced Trainees and recent FRACP graduates to focus on developing their non-technical skills as well as their medical expertise. Quality and safety is central to all aspects of patient care. This program provides the Advanced Trainees with the skills required to recognise and respond to improvement opportunities. It also gives participants some of the skills required to be future leaders in health system. The program aligns with several domains of the RACP...

CEC Ready to Implement Added: 25 February 2015|Last updated: 9 April 2015

Clinical Variation in 30 Day Mortality for Acute Myocardial Infarction

Aim: To examine clinical variation in 30 Day mortality for patients presenting with Acute Myocardial Infarction to hospitals throughout NSW.

Benefits: Increased understanding of the factors that contribute to unwarranted clinical variation (UCV) in 30 day mortality for Acute Myocardial Infarction. If UCV is confirmed there may be opportunities to improve the quality of patient care and decrease length of stay, resulting in reduced costs.

ACI Pre-implementation Added: 6 November 2013|Last updated: 6 November 2013

Collaborating Hospitals’ Audit of Surgical Mortality (CHASM)

Aim: To improve the quality and safety of surgical care in NSW hospitals. To reduce the number of preventable surgical deaths in NSW hospitals.

Benefits: All surgeons who are in operative practice are required to report the clinical management of their patients who die while under their care to CHASM for peer review. CHASM provides feedback on the peer review findings to surgeons to facilitate reflective learning and improvement in surgical care.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

Community Acquired Pneumonia Clinical Variation

Aim: To assist clinicians and managers within NSW hospitals to investigate and address clinical, process and systems factors that may contribute to unwarranted variation in outcomes for adults admitted with community acquired pneumonia (CAP).

Benefits: Improve patient outcomesReduce unwarranted variation in outcomes following admission for CAP

ACI Ready to Implement Added: 26 June 2015|Last updated: 26 June 2015

Community Update on Patient Safety and Quality

Aim: The Community Update is designed to provide consumers with information on the progress of NSW public hospitals across key areas including: handover, hand hygiene, medication safety, falls, healthcare associated infections, sepsis and incident management. A template of the Community Update is available for Local Health Districts who would like to report on their safety and quality data locally.

Benefits: By engaging the community and partnering with patients, family and carers as team members we can improve quality in health care. The Community Update supports the Australian Commission for Safety and Quality in Health Care National Safety and Quality Health Service Standard 2.7.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

Cystic Fibrosis Model of Care

Aim: Maintain or improve the health and wellbeing of people with CF Provide consumers with greater choice for how and where care can be safely and effectively provided Improve care and support provided to for people with CF, with additional focus on young people 15-24 and those with severe disease.

Benefits: Better meet the health care needs of people with CF in NSW now and into the future Build capacity within the health system to provide timely and effective care

ACI Ready to Implement Added: 8 November 2013|Last updated: 15 January 2016

Develop and Implement an ACI Knowledge Management (KM) Approach

Aim: To partner with Health Services to develop and implement an approach that supports collaboration, learning capability and sharing knowledge about innovation and improvement projects in health services.

Benefits: A robust KM approach will serve NSW Health by ensuring: Both small and large-scale innovations and improvements generated across health services are recognised and shared to benefit the broader health system The work of the ACI is shared across the NSW Health system to encourage effective partnerships and assist in delivering better health outcomes, improved patient experience and efficient service delivery.

ACI Ready to Implement Added: 8 November 2013|Last updated: 30 May 2014

Diagnostic Report to Inform the Model for Palliative and End of Life Care Service Provision

Aim: The Diagnostic Report aims to define the problems associated with the provision of palliative and end of life care and to better understand the root causes of those problems with a view to developing longer-term, evidence-based solutions.

Benefits: This Diagnostic phase has identified key challenges in the provision of care to people approaching and reaching the end of life. By identifying and refining the ways in which we describe these – in light of the breadth of evidence gathered – the Model of Care development process then looks towards describing the ways in which end of life journeys can be improved. The findings of this Diagnostic Report provide the ACI with the basis on which to develop solutions...

ACI Ready to Implement Added: 21 July 2014|Last updated: 5 August 2014

Diet Specifications for Adult Inpatients

Aim: To provide detailed specifications for a range of therapeutic diets for adults in NSW public hospitals.

Benefits: The specifications provide an evidence-based guide on food and nutrition for adult inpatients in hospital.

ACI Ready to Implement Added: 4 November 2013|Last updated: 13 April 2015

eChartbook

Aim: The Clinical Excellence Commission (CEC)’s eChartbook is an interactive web-based tool providing a curated, accurate and timely view with expert commentary providing an overview of the state of knowledge in relation to quality and safety of health services in NSW. It aims to be a key resource for driving change within the NSW health system. It focuses particularly on CEC’s on Projects and Programs.

Benefits: The eChartbook is designed for use by clinicians, local health district (LHD) health professionals and other interest groups. It also provides information for the public about safety and quality issues and is written in a publicly-accessible style. The eCharbook presents more timely data through the use of dynamic charts, updated in real time

CEC Ready to Implement Added: 18 February 2015|Last updated: 23 March 2015

Electronic Persistent Pain Outcome Collaboration - routine patient outcomes reporting of pain management intervention

Aim: The NSW pain plan provided funding and an outline of a system of collecting and analyzing data from NSW pain clinics which quantified patient outcomes.

Benefits: The routine collection and analysis of data regarding patient outcomes is an important aspect of service delivery and improvement. The data enables benchmarking across NSW services as well as nationally enabling us to build on the service aspects that deliver the best outcomes.

ACI Ready to Implement Added: 25 February 2015|Last updated: 25 February 2015

Emergency Surgery Redesign

Aim: To provide a reference tool for Local Health Districts when initiating the redesign of emergency surgery practices.

Benefits: There are multiple benefits, including:Improved patient outcomesEnhanced patient and surgical team satisfactionIncreased trainee supervision in emergency surgeryHigher rates of emergency operating-theatre utilisationReduced patient cancellationsReduction in after-hours costs.

ACI Ready to Implement Added: 5 November 2013|Last updated: 30 May 2014

Endoscopy Information System (EIS)

Aim: To develop a high-quality endoscopy reporting system to ensure that an accurate assessment of NSW endoscopy services can be undertaken against accepted patient safety, quality and utility benchmarks.

Benefits: The implementation of a standard EIS across NSW Health will:Provide accurate statewide information on endoscopic procedures carried out in NSW public hospitals; Inform on issues of productivity, activity, costs, and access to services; Facilitate the comparison of services against critical safety and quality benchmarks; Facilitate electronic reporting to the National Bowel Cancer Screening Program’s Register; Enhance the efficiency and accuracy of clinician procedure-reporting through electronic image capture and customisable reporting templates; Allow endoscopic reports to be electronically stored and accessed...

ACI Ready to Implement Added: 5 November 2013|Last updated: 23 September 2014

Eye Emergency Manual - Smart Phone App

Aim: To provide a quick and simple guide to recognizing important signs and symptoms and management of common eye emergencies for medical and nursing staff in Emergency Departments (EDs)

Benefits: This initiative has provided easy access to highly graphical overview of signs, symptoms and management of common eye emergencies.

ACI Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Factsheet on Food and Nutrition in NSW Hospitals

Aim: To provide introductory information for patients and their carers about food and nutrition care in NSW hospitals.

Benefits: Benefits include clear information for consumers on food and nutrition care provided in hospital.

ACI Ready to Implement Added: 5 November 2013|Last updated: 13 April 2015

Fascia Iliaca Blocks for older people with hip fracture

Aim: To develop a toolkit of resources facilitating Fascia Ilaica Block (FIB) as a method of pain management in hip fracture.

Benefits: To assist in the practical application of effective pain management as referred to in the Minimum Standards for Hip Fracture; To reduce the harm arising from overuse of opiate medications; To provide a method of implementing application of the procedure.

ACI Ready to Implement Added: 9 November 2015|Last updated: 9 November 2015

Framework for the Statewide Model for Palliative and End-of-Life Care Service Provision

Aim: To inform the development of a comprehensive model of care for equitable palliative and end-of-life care service provision in NSW.

Benefits: The Framework is the foundation for advancing work towards the Network’s vision that all NSW residents have access to quality care based on assessed need as each approaches and reaches the end of their life.

ACI Ready to Implement Added: 11 November 2013|Last updated: 20 January 2014

Framework for Urinary Continence in Children and Young People

Aim: This initiative aims to provide leadership, support and advice on development of a framework for paediatric urinary continence that includes evidenced based guidelines, education, development of resources and brings in the voices of children, young people and their families.

Benefits: The potential benefits include: development of state wide evidenced based guidelines for clinicians that aim to improve patient care development of an education app targeted at GPs links to information about continence issues in children and young people on the relevant ACI websites information on the experiences of children and young people that brings in the voices of consumers trial of pop up clinics that aim to improve access for rural and regional patients.

ACI Future Initiative Added: 13 July 2015|Last updated: 4 January 2016

Guidelines for Research in the Area of Intellectual Disability

Aim: To guide people interested in conducting research in the field of intellectual disability, including how to include people with intellectual disability themselves and suggestions for easy-read formats.

Benefits: Research guidelines are often not tailored to inclusive research for people with intellectual disability. This paper suggests different models of how this may occur.

ACI Pre-implementation Added: 11 November 2013|Last updated: 12 November 2013

Guidelines for the use of Telehealth for Clinical and non-Clinical Settings in NSW

Aim: The Agency for Clinical Innovation (ACI) Rural Telehealth Working Group has developed state-wide Guidelines for those using telehealth across NSW. The aim of these guidelines is to provide a framework which will support improved use and continuity of telehealth consultations. It provides a focus on the communication and reporting of telehealth consultations for clinical handover and how these consultations should be managed and funded.

Benefits: Ability to reduce wait times; Focus on patient centred care closer to home; Additional way of providing broader care options; Implementation of best practice continuity of care; Reduced costs and increased safety for patients and health organisations.

ACI Pre-implementation Added: 23 September 2014|Last updated: 3 March 2016

Hand Hygiene

Aim: Through sustained improvement in hand hygiene by healthcare staff reduce the risk of healthcare associated infections.

Benefits: Improved health outcomes for patients (reduced morbidity and mortality); Reduced risk transmission of pathogenic organisms to patients, visitors and staff.

CEC Ready to Implement Added: 2 June 2014|Last updated: 2 June 2014

Health Pathways Implementation and Evaluation

Aim: The ACI is supporting three sites to implement and four sites to evaluate Health Pathways. Local services review and clarify their patient pathways between primary and specialist care and share the information on a reference website for health professionals. This process is aimed at improving patient management, assessment and referral through streamlined links between primary and secondary care clinicians and providing clear information for referrers. The Local Health District/Medicare Local sites that the ACI are supporting are the Central Coast,...

Benefits: Creates clear referral pathways between services Provides comprehensive service information for referring clinicians Links clinicians to the appropriate best practice information Increases the appropriateness, quality and timeliness of referrals to specialist services Highlights opportunities for service improvement and redesign Creates links between primary and secondary care clinicians

ACI Ready to Implement Added: 4 December 2013|Last updated: 5 December 2013

Healthcare Associated Infections (HAI)

Aim: Healthcare Associated Infections (HAIs) are infections acquired in healthcare facilities and infections that occur as a result of healthcare interventions and which may manifest after people leave the healthcare facility. Prevention of HAIs and the transmission of multi-resistant organisms (MROs) are key patient safety and clinical quality initiatives for NSW Health. The HAI program at the CEC aims to reduce the risk of acquiring a HAI during care delivery in NSW health facilities. The program enables NSW Local Health Districts...

Benefits: Improved health outcomes for patients (reduced morbidity and mortality); Reduced risk of HAI transmission to patients, visitors and staff; Standardised approach to HAI prevention and control.

CEC Ready to Implement Added: 2 June 2014|Last updated: 9 April 2015

Hepatitis C: A guide to current treatment and care

Aim: To provide health care managers and staff with information to help design and implement services for the best care for patients with hepatitis C in their own environments.

Benefits: Improvements in clinical practice and patient care.

ACI Pre-implementation Added: 8 November 2013|Last updated: 9 December 2014

High Volume Short Stay Surgical Units (HVSSS)

Aim: The HVSSS Unit Model emerged as a model of care from the Surgery Futures – A Plan for Greater Sydney project (released January 2011). This toolkit provides Local Health Districts with information about the key features of the model, processes for service delivery, staff roles, diagnosis-related groups suitable for HVSSS, key success factors, benefits, and steps for implementation of this model.

Benefits: Improved access to planned surgical services; Improved service efficiency, regarding both operating theatre and bed utilisation; Extended range of procedures suitable for the short-stay environment; Release of additional clinical capacity (including beds, staff and other resources) within tertiary/quaternary surgery centres; Reinvestment of this additional capacity into emergency and complex service needs.

ACI Ready to Implement Added: 7 November 2013|Last updated: 30 May 2014

Home Enteral Nutrition (HEN) Cards

Aim: To improve HEN care and communication between health professionals, via practical reference cards.

Benefits: Improved support for consumers accessing HEN services.

ACI Ready to Implement Added: 6 November 2013|Last updated: 13 April 2015

Home Enteral Nutrition (HEN) Factsheets and Brochures

Aim: To provide information about HEN for consumers and health professionals. Practical information for health professionals about HEN in NSW.

Benefits: Improved support for consumers accessing HEN services.

ACI Ready to Implement Added: 6 November 2013|Last updated: 13 April 2015

How to Develop and Implement a Model of Care

Aim: Providing a methodology for ACI networks to use when creating a model of care (MoC), and to assist networks to implement models that they have developed.

Benefits: Brings together change-management techniques to create five key phases when developing a model of care: Project Initiation; Diagnostic; Solution Design; Implementation; Sustainability.

ACI Ready to Implement Added: 8 November 2013|Last updated: 18 November 2013

Implementation of the Statewide Pain Plan

Aim: To document and implement a statewide pain strategy to reduce the burden of chronic pain in the community.

Benefits: Following the implementation of the NSW Pain Plan, there will be greater access to expert services, and improved support for primary care, for people living in regional NSW.

ACI Ready to Implement Added: 8 November 2013|Last updated: 20 January 2014

Improving Patient Outcomes from Cataract Surgery Study

Aim: The primary aim of the research is to explore patient-centred outcomes of cataract surgery in Australia and the effectiveness of currently available tools to assist Australian Ophthalmologists to appropriately plan surgery for people with cataract.

Benefits: While there is a large body of knowledge describing visual improvement following cataract surgery, we currently know little about the expectations that Australian cataract patients have of their impending surgery, or their satisfaction with post-surgical outcomes. This research will provide important information on which to shape patient-focused criteria for cataract surgery referral, including measures of driving confidence and quality of life.Up to 500 bilateral cataract patients in NSW will be assessed for vision function and quality of life prior to...

ACI Pre-implementation Added: 8 December 2014|Last updated: 8 December 2014

Improving the Medical Inpatient Journey with Criteria Led Discharge

Aim: To reduce delays when a patient is medically ready to return home from hospital.

Benefits: A formalised criteria-led discharge process has the potential to: Improve patient experience: patients are able to get home sooner; Enhance patient safety: criteria led transfers of care through a checklist; Reduce unnecessary length of stay: not being in hospital when patients can actually return home; Reduce bed days: elimination of unnecessary days in hospital; Minimise waste: reduction of costs as a result of eliminating unnecessary lengths of stay in hospital; Improve staff satisfaction: staff are not pressured to transfer patients...

ACI Ready to Implement Added: 8 November 2013|Last updated: 30 May 2014

In Safe Hands Program

Aim: The In Safe Hands program aims to build and sustain effective health care teams. It is intended to give these teams the structure and tools to redesign their units into strong, interdisciplinary teams, working together to deliver highly reliable, planned care to all patients.

Benefits: Teams that have implemented In Safe Hands have identified the following benefits: Reduced patient length of stay; Reduced unexpected deaths; Reduced adverse events; More satisfied staff; Improved patient experience; Improved safety culture.

CEC Ready to Implement Added: 6 November 2013|Last updated: 12 January 2015

Inclusion in Mainstream Health Services: Using Visuals for people with intellectual disability

Aim: This project aims to improve communication between people with disabilities and health professionals in busy mainstream healthcare environments by developing and evaluating the use of visuals.

Benefits: Using visual aids for people with intellectual disability in busy healthcare environments can assist with communication and allay fear and confusion for the person undergoing routine procedures such as dental examination, having bloods taken and a physical examination. Simple visual aids which can be readily accessed by consumers, carers and staff and adapted to the individual situation will enhance the interaction with health services and benefit health outcomes for people with intellectual disability.

ACI Ready to Implement Added: 10 July 2015|Last updated: 10 July 2015

Investigating Clinical Variation in Acute Care

Aim: The aims of the ACI Investigating Clinical Variation in Acute Care project are to identify clinical variation in the inpatient management of COPD, CAP and CHF and then assess if this variation may be unwarranted. This is achieved by:audit tools that empower individual sites to assess their clinical practice and identify areas for improvement in partnership with the ACIcapacity building and access to clinical expertise to support the identification and prioritization of opportunities for improvementsupport for networking across sites to...

Benefits: Unwarranted clinical variation (UCV) is an ongoing barrier to providing safe and effective care for patients. Recognising and addressing UCV has been identified as a shared priority across the NSW Health system.

ACI Pre-implementation Added: 13 March 2017|Last updated: 13 March 2017

Mapping of Services within NSW Health for People with an Intellectual Disability

Aim: Develop a web based service directory of available NSW Health service and resources for people with an Intellectual Disability. Identify existing specialist service and gaps in service for future planning.

Benefits: Information collected will be developed into a web based service directory for use by clinicians/health professionals, consumers and their families/carers. The information collected will also be used to support local and state-wide service delivery and to identify gaps in service for future planning.

ACI Pre-implementation Added: 30 May 2014|Last updated: 2 June 2014

Medical Imaging District Services (MIDS) Implementation Toolkit (business model)

Aim: To assist Local Health Districts implement a more business-like approach to the delivery of Medical Imaging clinical services for sustainability and better patient care.

Benefits: Timely access to services and reporting to enable better patient care Appropriate referrals, optimal use of imaging Economies of scale across the LHD reducing costs for all sites

ACI Ready to Implement Added: 27 August 2014|Last updated: 25 February 2015

Medication Safety and Quality Unit

Aim: To support the safe and quality use of medicines by identifying and addressing emerging medication safety risks.

Benefits: The CEC Medication Safety and Quality unit oversees four programs, Continuity of Medication Management, High-Risk Medicines, Medication Safety Self Assessment and VTE Prevention. The Continuity of Medication Management program provides tools and resources to support medication reconciliation; the process of ensuring that patients receive all intended medicines and that accurate, current and comprehensive medicine information follows them at all transfers of care. The High-Risk Medicines program heightens awareness of the harm that can be caused and assists in improvements to...

CEC Ready to Implement Added: 8 December 2014|Last updated: 9 November 2015

Minimum Standards for Safe Procedural Sedation

Aim: To support the safe provision of procedural sedation (in non-operating-theatre settings) across NSW public hospitals, ensuring all clinicians who provide sedation have the necessary skills, and access to appropriate training/resources.

Benefits: A consistent approach for procedural sedation across NSW, Local Health Districts (LHDs) and hospitals; Appropriate skills and training for all clinicians who provide or support sedation; Adequate support and resources for all sedation sites; Address unwarranted clinical variation to prevent adverse events and poor patient-outcomes; Improved experience for patients through effective sedation use.

ACI Ready to Implement Added: 11 November 2013|Last updated: 21 August 2015

Minimum Standards for the Management of Hip Fracture in the Older Person

Aim: To improve the outcomes of patients with fractured hips requiring surgery and management in NSW.

Benefits: Reduced medical complications, reduced hospital stays and improved patient outcomes.

ACI Ready to Implement Added: 5 November 2013|Last updated: 7 April 2015

Model of Care for Prevention and Integrated Management of Pressure Injuries in People with Spinal Cord Injury and Spina Bifida

Aim: To promote a model of care which focusses on supporting self-management and education strategies for the person with Spinal Cord Injury (SCI) / Spina Bifida (SB) to take ownership over their skin integrity status in the first instance, but also to promote access to essential services and equipment in a timely and equitable manner and to strengthen processes for an integrated approach to care.

Benefits: There are an estimated 6,500 individuals living in NSW with spinal cord injury (SCI) and spina bifida (SB), who have an overall lifetime incidence of pressure injury (PI) of more than 85%. The social and economic impact of PI on the individual, family and community is immense and can have long term physical and psychological consequences. The Model of Care promotes a prevention and early intervention integrated management approach which aims to identify and manage risk, and establish prevention and...

ACI Future Initiative Added: 3 July 2014|Last updated: 7 June 2016

Music & Memory

Aim: To improve the experiences of consumers in NSW Health services through Music & Memory.

Benefits: International evaluations have shown that Music & Memory:reduces depression, anxiety and painhelps awaken the mind and restore identityparticipants are happier, calmer and more socialreconnects participants with caregivers, family and friendsreduces the need for psychotropic medicationsincreases awareness, engagement and cognition.

ACI Ready to Implement Added: 5 July 2016|Last updated: 4 August 2016

Non-Invasive Ventilation (NIV) Guidelines for Adult Patients with Acute Respiratory Failure

Aim: Provide clinicians in critical care areas and specialist respiratory care units with best practice guidance regarding the provision of NIV for appropriately selected patients detailing clinical assessment, NIV therapy management and patient care. Ensure safe and effective NIV is provided to patients and they are managed in the appropriate clinical settings in NSW hospitals.

Benefits: Improve patient experience and outcomes Reduced need for invasive ventilation, prolonged mechanical ventilation and tracheostomy Reduce length of stay

ACI Pre-implementation Added: 8 November 2013|Last updated: 26 June 2015

NSW Chronic Pain Clinics Information Flyer

Aim: To provide information to consumers and primary care clinicians on the purpose and approach of various pain management services, alongside relevant contact details.

Benefits: Benefits include improved information for consumers on available pain-management services in NSW. The flyer outlines each of the publicly-funded pain management services in NSW and supplies contact details.

ACI Ready to Implement Added: 7 November 2013|Last updated: 22 January 2014

NSW Falls Prevention Program

Aim: To reduce the incidence and severity of falls among older people. To reduce the social, psychological and economic impact of falls among older people on individuals, families and the community.

Benefits: The goal is to prevent falls and harm form falls for older people living in the community, NSW Health residential aged care services and when admitted to hospital.

CEC Ready to Implement Added: 6 November 2013|Last updated: 20 January 2014

NSW Health Coaching Panel (pilot phase)

Aim: Establish a coaching panel to provide high quality, easy to procure coaches for the health services to:build capability for improvement, implementation and leadership; develop the capability of LHD local managers to sustain change and innovation.

Benefits: High quality coaches will be pre-assessed and appointed to the coaching panel.LHD / SHN Senior Project Leads and Managers will increase capability for change management and sustainability, growing capacity in local health services.

ACI Ready to Implement Added: 4 August 2014|Last updated: 7 August 2014

NSW Pain Clinic Referral Form and Process

Aim: To provide a consistent method when making a referral from primary care to a tertiary pain service, irrespective of where the service is located.

Benefits: All services will have the same triage criteria and process for accepting patients from primary care.

ACI Ready to Implement Added: 7 November 2013|Last updated: 17 November 2014

NSW Rehabilitation Model of Care

Aim: To implement a consistent model of care for rehabilitation services which supports equity of access, appropriateness of care, and the provision of care in the least restrictive setting available.

Benefits: Through the provision of early, intensive rehabilitation, patients will benefit from: Shorter lengths of stay in hospital due to more intensive therapy services; Greater choice and flexibility in how and where they receive their rehabilitation services; A quicker return to their previous level of functioning; More active involvement in deciding their rehabilitation goals; Care closer to home. By targeting specific patient cohorts, it will also be possible to prevent the rising incidence of physical deconditioning by reducing patient wait times...

ACI Ready to Implement Added: 5 November 2013|Last updated: 20 January 2014

NSW Standardised Pain Charts (adult)

Aim: Development and implementation of statewide charts to be used at the bedside when delivering Patient Controlled Analgesia (PCA), ketamine infusions and neuraxial opioid administration. To standardise practice and reduce error relating to documentation, monitoring and prescription across NSW.

Benefits: Benefits include improved safety and quality of care for patients.

ACI Ready to Implement Added: 7 November 2013|Last updated: 15 December 2014

NSW Stroke Reperfusion Project (SRPP)

Aim: To improve early access to thrombolysis for ischaemic stroke patients.To improve pre-hospital assessment by paramedics for identification of stroke through a validated standardised assessment tool. To improve in-hospital reception, assessment and management of stroke patients to achieve early access to safe reperfusion. To improve mechanisms across the whole patient journey to deliver effective rehabilitation.

Benefits: There are multiple benefits involved in this project:To train paramedics in the application of the ‘FAST’ (Face, Arm, Speech and Time) stroke assessment tool, which is both internationally recognised and validatedTo define, locate and govern permanently operating stroke-unit hospitals that offer thrombolytic therapyTo provide road-based transport for stroke patients to arrive at stroke-unit hospitals within 4.5 hours of symptom onsetTo maintain strong networks between facilities, so patients are returned appropriately for ongoing acute and rehabilitative care, close to their point...

ACI Ready to Implement Added: 8 November 2013|Last updated: 25 June 2015

NSW Subcutaneous Insulin Prescribing Chart

Aim: To standardise an adult subcutaneous insulin chart and minimise risks in insulin prescription, administration and documentation.

Benefits: The chart combines prescription and administration with blood glucose, ketone monitoring and glycaemic management. It links all the necessary information for glycaemic management in one document.The chart is designed to minimise delays in management decisions and provide clinicians with clear guidelines for:Insulin prescription and administrationGlycaemic managementSafe supplemental insulin use.The chart includes:Regular, supplemental, once only, and telephone ordersMonitoring for blood glucose levels (BGLs) and ketonesGlycaemic management guidelines to support clinicians that may not have access to local guidelines, policies or specialist...

ACI Ready to Implement Added: 8 November 2013|Last updated: 16 July 2015

Nurse Delegated Emergency Care (NDEC) Project

Aim: To provide timely, quality care for patients presenting to EDs in rural and remote areas with low risk, low acuity conditions, and to empower Registered Nurses to manage entire episodes of care through a delegated care model which promotes a more sustainable clinical workload for rural doctors.

Benefits: For patients - access to timely and quality care for less-urgent conditionsFor nurses - a validated and authorised framework to work within their scope of practice to manage entire episodes of careFor doctors - a robust model under which care can be delegated, leading to more sustainable clinical workload and work-life balanceFor rural health services - a collaborative framework for delivering quality patient care in small rural EDsFor rural communities – mitigation of some of the barriers to recruitment and...

ACI Ready to Implement Added: 7 November 2013|Last updated: 17 August 2016

Nutrition Standards for Adult Inpatients in NSW Hospitals

Aim: To define the types and amounts of foods that must be offered to patients on standard hospital menus in NSW.

Benefits: To provide an evidence-based guide on food and nutrition in hospitals.

ACI Ready to Implement Added: 23 October 2013|Last updated: 13 April 2015

Nutrition Standards for Consumers of Inpatient Mental Health Services in NSW

Aim: To define the types and amounts of foods that must be offered on the menu for people admitted to inpatient mental health facilities in NSW .

Benefits: Implementing the standards will:Support recovery; Help people achieve good physical and mental health; Meet the needs and expectations of consumers.

ACI Ready to Implement Added: 7 November 2013|Last updated: 13 April 2015

Nutrition Standards for Paediatric Inpatients in NSW Hospitals

Aim: To define the types and amounts of foods that must be offered to paediatric patients on standard hospital menus.

Benefits: An evidence-based guide on food and nutrition for paediatric patients in hospital.

ACI Ready to Implement Added: 7 November 2013|Last updated: 20 June 2014

Open Disclosure

Aim: The Open Disclosure project aims to enhance the care and support provided to patients and/or their support people and health care staff involved in a patient safety incident, through outlining a clear process for open disclosure communications and the roles and responsibilities of health services and their staff.

Benefits: Effective open disclosure can [1]: improve patient safety through an improved understanding of how things go wrong increase trust between patients who have been harmed by a patient safety incident and health care providers when information is exchanged and an apology is received assist patients to become more active partners in their care. [1] Australian Commission on Safety and Quality in Health Care (ACSQHC) Australian Open Disclosure Framework, Sydney, 2013

CEC Ready to Implement Added: 2 June 2014|Last updated: 17 November 2014

Operating Theatre Efficiency Strategies

Aim: Following the Auditor-General’s report, Performance Audit: Managing operating theatre efficiency for elective surgery, the ACI will work with the Ministry of Health (MoH) to support Local Health Districts (LHDs) in meeting three of seven recommendations outlined in the report and assigned to ACI.

Benefits: Increased collaboration and support for operating theatre efficiencies.

ACI Pre-implementation Added: 7 November 2013|Last updated: 20 January 2014

Osteoarthritis Chronic Care Program (OACCP) Model of Care

Aim: The OACCP aims to provide interventions that support people with osteoarthritis of the hip and/or knee to: Self-manage their condition and co-morbidities; Reduce pain, increase function, and improve their quality of life; The OACCP considers and supports management of physical and psychosocial health care needs.

Benefits: The OACCP model of care has been implemented and evaluated in eight LHDs in NSW. Most of the participants have been on the NSW public hospital wait list for elective hip or knee joint replacement surgery. There have been a number of clinical gains, including: 11% of participants with knee arthritis who have been waiting for knee joint replacement surgery have agreed they do not need surgery at this time About 4% of those with hip arthritis have been supported...

ACI Ready to Implement Added: 7 November 2013|Last updated: 9 February 2015

Osteoporosis Refracture Prevention Model of Care

Aim: To ensure people who sustain a minimal trauma fracture have access to early identification, diagnosis, treatment, and follow-up for osteoporosis.

Benefits: Benefits include improved patient outcomes, better utilisation of hospital services, and reductions in health system costs for at risk people.

ACI Ready to Implement Added: 7 November 2013|Last updated: 9 February 2015

Paediatric Clinical Practice Guidelines Audit Project

Aim: To assess compliance with the guidelines and assist local health districts to further improve the care of children in emergency departments.

Benefits: Empower generalist NSW hospitals, which see the majority of children presenting to an emergency department, with tools and resources to deliver the highest quality care, regardless of location.

CEC Future Initiative Added: 6 November 2013|Last updated: 9 April 2015

Pain Management Network Website

Aim: Provide freely accessible, evidence based information to consumers with chronic pain; Provide evidence based tools and resources for clinicians to assist them to better manage people with chronic pain.

Benefits: A major objective of the NSW pain plan is to support the management of chronic pain in the primary care setting. The development of an evidenced based website with information for clinicians and consumers was considered an effective way of achieving this. It has the intention of enabling consumers to adopt and practice a range of self- management strategies which will assist them to manage their pain

ACI Ready to Implement Added: 20 June 2014|Last updated: 20 June 2014

Palliative and End of Life Care: A Blueprint for Improvement

Aim: The Blueprint aims to guide services and Local Health Districts in constructing their own localised models of care.

Benefits: The Blueprint emphasises the need for an integrated approach to care whereby relationships between specialist palliative care providers and care providers across all settings of care are fostered. It seeks to enhance networks of support, to build skills and competence in providing care to those approaching and reaching the end of their lives and seeks to better support patients, families and carers along the way.

ACI Ready to Implement Added: 9 November 2015|Last updated: 22 February 2016

Parenteral Nutrition Factsheet

Aim: To provide introductory information about parenteral nutrition for patients and their carers. Parenteral nutrition is a specialised nutrition solution delivered directly into the bloodstream.

Benefits: Improved information for consumers accessing parenteral nutrition.

ACI Ready to Implement Added: 6 November 2013|Last updated: 20 June 2014

Patient Experience and Consumer Engagement (PEACE) Methodology

Aim: The Patient Experience and Consumer Engagement (PEACE) methodology supports the ACI’s ongoing commitment to promote meaningful engagement and consumer-led redesign of healthcare.

Benefits: The PEACE methodology captures consumer input and harnesses direct patient and carer experience to inform ACI activities.

ACI Ready to Implement Added: 23 September 2014|Last updated: 23 February 2015

Pleural Drains in Adults - Consensus Guidelines

Aim: Improve the standard of clinical practice in the insertion, management, trouble shooting and removal of pleural drains in adults within NSW hospitals.

Benefits: Improve patient experience and outcomes. Increase awareness of ‘good’ practice in relation to pleural drains. Support managers and clinicians to implement processes that will reduce the risks associated with pleural drains.

ACI Ready to Implement Added: 8 November 2013|Last updated: 15 January 2016

Pre Procedure Preparation / Perioperative Toolkit

Aim: To review the NSW Health Guideline: Pre-Procedure Preparation Toolkit.

Benefits: To review the existing toolkit to ensure it supports best practice for pre procedure care for patients undergoing surgery or a procedure.The existing toolkit was developed in 2007 by a working group of the Surgical Services Taskforce. The Anaesthesia Perioperative Care Network, in collaboration with the Surgical Services Taskforce, is currently reviewing the document. As part of the review process, work has also being undertaken to include information specific to Aboriginal/Torres Strait Islander people in the toolkit.

ACI Pre-implementation Added: 11 November 2013|Last updated: 11 August 2015

Pressure Injury Prevention Project

Aim: To foster best practice in the prevention and management of pressure injuries within NSW health facilities.

Benefits: Enhance patient safety by promoting pressure injury prevention and management among health care professionals and patients, in line with the Pan Pacific Clinical Practice Guidelines for the Prevention and Management of Pressure Injury 2012 as evidence based practice.Support local health districts (LHDs) and Networks to meet the Australian Commission on Safety and Quality in Health Care, National Safety and Quality Health Service Standards - Standard 8, Preventing and Managing Pressure Injury.

CEC Pre-implementation Added: 7 November 2013|Last updated: 2 June 2014

Quality Systems Assessment (QSA)

Aim: The Quality Systems Assessment (QSA) is a clinical risk management program designed to provide clinicians and managers at all levels with information relevant to their local systems for clinical quality and patient safety.

Benefits: The QSA is one vehicle that contributes to resilience in our health system. Working directly with local teams and local priorities, the QSA supports continuous learning and improvement to prevent and reduce patient harm. Through the multi-level self-assessment, reporting and site visits the QSA is able to identify risks and support improvements: Locally – through detailed local data returned directly to local teams Systemically – through aggregation of local data to identify high priority themes for action All effort that...

CEC Ready to Implement Added: 24 January 2014|Last updated: 14 October 2014

Quality Use of Antimicrobials in Healthcare (QUAH) Program

Aim: To optimise antimicrobial use in NSW public health facilities by raising awareness of antimicrobial stewardship (AMS) principles and providing guidance in the implementation of structures and processes to support quality use of antimicrobials.

Benefits: By supporting AMS activities, the QUAH Program contributes to a range of proven benefits associated with optimised use of antimicrobials, including: A reduction in inappropriate use of antimicrobials and more considered selection of antimicrobial therapy when appropriate; Improved patient care outcomes both in the individual patient and in the prevention and control of healthcare associated infections; Reduced risk of adverse consequences associated with inappropriate antimicrobial use such as antimicrobial resistance, adverse events and unnecessary costs.

CEC Pre-implementation Added: 6 November 2013|Last updated: 9 November 2015

REACH (Patient and Family Activated Escalation)

Aim: REACH empowers patients and families to escalate care if they are concerned about the condition of the patient by first encouraging engagement with the treating clinicians at the bedside.

Benefits: Evidence suggests there is improved patient and family experience, decreased mortality and improved operational outcomes. The REACH process aligns with the Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standards, Standard 9.9: Enabling patients, families and carers to initiate an escalation of care response.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

Reducing Catheter Associated Urinary Tract Infections

Aim: To improve clinical practices associated with urinary catheter insertion, maintenance and removal in acute care settings.

Benefits: Improved practice will:Ensure that urinary catheterisations are undertaken only when appropriately indicated; Reduce the risk of insertion site and drainage device contamination; Reduce the dwell time of catheterisation; and Reduce the risk of acquiring a urinary tract infection due to catheterisation.It is anticipated that reducing the incidence of catheter-associated urinary tract infections will reduce the risk of acquiring an infection caused by a multi-resistant organism and reduces the likelihood of needing complex antimicrobial therapy and prolonged hospitalisation.Other benefits anticipated from...

CEC Ready to Implement Added: 3 September 2014|Last updated: 15 March 2016

Reducing Unwarranted Clinical Variation (UCV) Taskforce

Aim: To oversee the development and implementation of a system-wide approachto identify, address and reduce Unwarranted Clinical Variation (UCV).

Benefits: To refine care processes and implement evidence-based models of care tosupport improved patient outcomes.

ACI Ready to Implement Added: 8 November 2013|Last updated: 17 November 2013

Regional Aged Care Hospital Avoidance Compendium Report 2014

Aim: To provide a snapshot of current established Regional Aged Care Hospital Avoidance Models of Care as a ‘one-stop-shop’ for service providers to view the diversity of programs across NSW when considering options which might meet local need.

Benefits: The Compendium will provide a synthesis and analysis of options; programs, the resources and partnerships required for implementation and sustainability, key stakeholder contacts and websites for further information.

ACI Ready to Implement Added: 23 September 2014|Last updated: 10 October 2014

Rehabilitation Implementation Toolkit

Aim: To facilitate the implementation of the Rehabilitation Model of Care.

Benefits: The Toolkit assists Rehabilitation Implementation leads and other key LHD stakeholders to understand the value delivered in current care settings, while identifying the gaps in service delivery. It can also be used to develop and implement additional rehabilitation settings to meet current and projected demand.

ACI Ready to Implement Added: 28 October 2013|Last updated: 16 January 2014

Rural Health Network

Aim: To provide a co-ordinated approach to the implementation of models of care and innovation for rural communities, including the use of technology; To develop, share and showcase innovative rural ‘working’ models of care; To work collaboratively with Local Health Districts (LHDs) and the Ministerial Advisory Committee in improving rural health-service delivery.

Benefits: To support rural and remote clinicians and provide co-ordination between ACI, health service providers and consumers in rural areas to inform and drive improved access and quality of health services in rural areas.

ACI Ready to Implement Added: 8 November 2013|Last updated: 20 January 2014

Rural Innovations Changing Healthcare (RICH) Forum

Aim: To offer a conference without the travel where projects can be presented from the nearest participating venue. RICH is an annual ‘virtual’ forum, linking 17 sites around NSW by Videoconference, for a day of showcasing innovative projects which demonstrate: An innovative approach to an existing local issue That change had been embedded and is sustainable The ability to be taken up by other health sectors

Benefits: Using a combination of face to face, videoconference and social media, the one day forum links 17 satellite hubs across rural NSW bringing together a mix of cross sector disciplines at each site for a day of interdisciplinary networking between Local Health Districts (LHDs), NSW Ambulance, Residential Aged Care Facilities, Medicare Locals, General Practice and Consumers.

ACI Ready to Implement Added: 23 September 2014|Last updated: 10 October 2014

SEPSIS KILLS Program

Aim: To improve the recognition and treatment of sepsis and septic shock in NSW healthcare facilities and to reduce their impact, mortality and financial costs.

Benefits: Successful implementation of the SEPSIS KILLS program is providing significant benefits at both clinical and system levels, including: more timely, standardised and effective detection and management of sepsis; reduced mortality, morbidity and bed-stays from sepsis-related conditions; enhanced clinician skills in sepsis recognition and management; enhanced networking opportunities across the system for clinicians and service teams; improved quality and safety of care; a better and safer patient experience.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 February 2015

Service Quality and Communication in Emergency Department Waiting Rooms

Aim: The Clinical Excellence Commission (CEC) funded research into service quality and communication in emergency department waiting rooms. The research team was comprised of staff from Southern Cross University with applied skills and knowledge in organisational communication, culture, history, structures and operations.

Benefits: The CEC and Southern Cross University are collaborating on developing educational materials to further progress this area in NSW. Sites interested in being pilot sites for this work are encouraged to email the Directorate of Patient Based Care and express interest.

CEC Pre-implementation Added: 6 November 2013|Last updated: 5 March 2015

Special Committee Investigating Deaths Under Anaesthesia

Aim: To improve the quality and safety of anaesthetic administration in NSW. To reduce anaesthesia-related mortality in NSW.

Benefits: SCIDUA looks for errors of management in the administration of anaesthesia and/or sedation. The committee also monitors anaesthetic outcomes and identify emerging trends that are associated with changes in anaesthetic, surgical and medical interventions over time. Lessons are identified and shared to facilitate improvements.

CEC Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014

Specialist Outpatient Services Improvement Project

Aim: This collaboration is designed to support the achievement of providing equitable access to timely, quality care, efficiently and sustainably, in the outpatient setting.

Benefits: It is intended that this initiative will provide the system leadership and direction required to achieve the following service outcomes:Services that are responsive to community need, appropriate, effective and sustainableThe provision of outpatient services enhances the system as a whole to better integrate services across the continuumPatient care pathways are underpinned by evidenced-based standards of care that are contemporary, efficient and offer a consistently high quality of carePerformance targets are transparent, continually monitored and informed by timely and reliable information...

ACI Future Initiative Added: 17 September 2014|Last updated: 10 October 2014

Standards for High Risk Foot Services (HRFS) in NSW

Aim: “The Standards” will be used to:Provide a consistent definition for HRFSReduce clinical variation, aligning existing services tostate, national and international guidelinesGuide the implementation of new HRFSIdentify services with the capacity to provide Telehealth services to support areas without a comprehensive high risk foot clinic

Benefits: Facilitate equity of access to an appropriate level of foot care for all patients in NSW by supporting a basis for standardising the clinical servicesImprove care co-ordination and strengthen the multi-disciplinary approach to management of the high risk foot

ACI Ready to Implement Added: 18 June 2015|Last updated: 18 June 2015

State Cardiac Reperfusion Strategy (SCRS)

Aim: To improve care for all patients in NSW with a suspected Acute Coronary Syndrome (ACS) and reduce the time from symptom onset to reperfusion for patients with ST Elevation Myocardial Infarction (STEMI).

Benefits: Care is tailored to specific settings so that all patients, regardless of their geographical location or presentation pathway can benefit from early access to specialist medical advice and appropriate treatment. Timely reperfusion rapidly restores blood flow to the heart, which means patients with STEMI may have better outcomes and fewer days in hospital.

ACI Ready to Implement Added: 11 July 2013|Last updated: 21 May 2015

Statewide Burn Injury Service (SBIS) Telehealth Project

Aim: To establish a Telehealth model of care for the Statewide Burn Injury Service.

Benefits: There is significant potential for Telehealth to focus on patient centred care and improve the quality of care for:Patients by providing services that will allow patients to receive their care and treatment closer to home that will save time and money for the patientBurn Units by reducing the demand on tertiary burn units and save on bed days and ambulatory care clinic attendancesRural/non-burn unit clinicians by increasing their experience and knowledge in the treatment of burn care and provide a...

ACI Pre-implementation Added: 27 March 2015|Last updated: 16 April 2015

Stroke and Vision Defects Study: Phase 1 Validation of a Vision Screening Tool

Aim: To validate the effectiveness of the Tool developed for use by stroke clinicians, in detecting the presence of vision defects in patients diagnosed with stroke.

Benefits: The Vision Screening Tool will facilitate rehabilitation and recovery for patients with stroke by detecting both acquired and long standing vision defects.

ACI Pre-implementation Added: 2 July 2014|Last updated: 3 July 2014

Stroke Clinical Variation Statewide Strategy (SCVSS) & Stroke Clinical Audit Process (SCAP) V2

Aim: The SCVSS will ensure the delivery of best quality care through a process which regularly assesses clinical variation , determining and correcting its causes through a quality improvement process on a site by site basis.The SCAP V2 will provide data analysis and support to LHDs to improve service delivery through the development of quality improvement action plans and forums for shared improvement strategies and learning across NSW.

Benefits: Reduction in mortality and functional outcomes for stroke (ischaemic and haemorrhagic) patients admitted to NSW public hospitals.

ACI Ready to Implement Added: 30 June 2015|Last updated: 14 July 2015

Supervision for Safety

Aim: It is proposed that the Supervision for Safety project address NSW Health system deficiencies related to supervision at the point of clinical care. Specifically related to ensuring patient care plans are appropriate and deterioration in patient condition is escalated to the most appropriate level.

Benefits: The Supervision project aims to ensure the appropriate support is provided to less experienced clinicians.The expected project outcomes include:Supervision of the clinical workforce is built into core work practices; Supervision is structured to allow clinicians to be trained without compromising patient care; Supervision provided by clinicians at the point of care is appropriate for the level of expertise of the clinicians involved; Practices are in place to establish the level of expertise of less experienced staff; Supervision is treated as...

CEC Pre-implementation Added: 2 June 2014|Last updated: 2 June 2014

Support Network for the Local Health District Redesign and Innovation Leaders Group

Aim: To enable, support and challenge group members to achieve their mission of driving healthcare quality and efficiency through shared knowledge, collaborative communication and professional peer support.

Benefits: This network can generate significant momentum for local and system change by optimising relationships within and across clinical and geographical boundary lines.

ACI Ready to Implement Added: 25 October 2013|Last updated: 5 August 2016

Surgery Redesign School

Aim: The School is aimed at project leaders who are responsible for implementation of surgical models of care, or improving operating theatre efficiency.

Benefits: Increased awareness and skills in project management, change management and Accelerated Implementation Methodology (AIM).

ACI Ready to Implement Added: 6 November 2013|Last updated: 30 May 2014

Telehealth Pilot for Pain Management

Aim: To implement the telehealth toolkit and test and modify its application in the real setting of a pain clinic.

Benefits: Telehealth is a modality that can be utilized to improve access for people to specialized healthcare who live in rural and remote regions.It also provides support to clinicians working in distant locations and facilitates a multidisciplinary approach.It provides support to GPs who may be under resourced to provide appropriate pain management support.

ACI Ready to Implement Added: 31 March 2015|Last updated: 16 July 2015

Telehealth Resource Package

Aim: To assist in the implementation of Telehealth as a service delivery method.

Benefits: Telehealth is a tool that can improve the delivery of health care programs to patients and provide equity of access, especially for people who may be disadvantaged or living in isolated rural communities. Telehealth has great potential to facilitate better health outcomes within NSW Health.

ACI Ready to Implement Added: 23 October 2013|Last updated: 3 March 2016

The Health Literacy Guide

Aim: The Health Literacy Guide has been developed to assist health services by providing practical strategies to address health literacy barriers for patients. The Guide also assists health services to meet new performance goals and the Australian Commission for Safety and Quality in Health Care (ACSQHC) National Safety and Quality Health Service Standards.

Benefits: By considering approaches to health literacy, health care organisations can benefit by improving safety and quality in health care. Consumers can benefit by accessing health information that is meaningful and relevant to their individual medical needs and navigating the system more easily.

CEC Pre-implementation Added: 6 November 2013|Last updated: 15 July 2014

The Musculoskeletal Primary Health Care Initiative

Aim: The Musculoskeletal Primary Health Care Initiative aims to plan, implement and evaluate a ‘one-stop’ program of care within primary care settings for people who meet the criteria for the need of either the model of care for osteoporotic refracture prevention, osteoarthritis chronic care program, or the draft model of care for acute low back pain.

Benefits: The Musculoskeletal Primary Health Care Initiative proposes the benefits will be that validated musculoskeletal models of care can be provided in primary health care settings with equal or superior outcomes compared to current methods of providing coordinated musculoskeletal health care in hospital based settings.

ACI Ready to Implement Added: 15 July 2014|Last updated: 9 February 2015

The Nutrition and Mental Health Toolkit

Aim: The purpose of the toolkit is to provide guidance, tools and resources to support the:Implementation of the Nutrition Standards for Consumers of Inpatient Mental Health Services in NSW, andDevelopment of governance structures and leadership for implementing the NSW Health Nutrition Care Policy (PD2011_78).

Benefits: The toolkit will assist LHDs / Networks and/or facilities in both developing and implementing an action plan to meet the requirements of the Nutrition Standards and Nutrition Care Policy. It may assist in developing food service partnership level agreements.

ACI Ready to Implement Added: 13 April 2015|Last updated: 13 April 2015

The Patient Based Care Challenge and Associated Guide

Aim: The Patient Based Care Challenge and associated provides practical strategies for transforming hospitals and health services for a patient based care focus.

Benefits: Local Health Districts sign up to The Challenge as a long term strategic commitment. The Guide provides practical advice on strategies within The Patient Based Care Challenge. Improving patient care experience is linked to improved clinical and business outcomes, including cost savings.

CEC Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015

Toolkit for Adolescents and young people with chronic pain: Supporting transition or direct entry to adult services

Aim: To develop a statewide toolkit of resources to assist pain clinics managing adolescents and young people aged 14-25 years with chronic and complex pain. The toolkit will supplement what already exists in the Transition Network with tailored resources specific to pain management and issues for young people and their families.

Benefits: The experience of young people entering adult services will be assisted by having age appropriate treatments, approaches and resources available. The transition process will be enhanced through the availability of checklists and other resources relevant to young people.

ACI Ready to Implement Added: 26 April 2016|Last updated: 26 April 2016

TOP 5

Aim: The TOP 5 program acknowledges the value of carer information for people living with dementia and other types of cognitive impairment to improve patient outcomes and carer and staff experience.

Benefits: Benefits to individuals with dementia and carers include increased compliance, more effective treatment, less distress and shorter lengths of stay.

CEC Ready to Implement Added: 6 November 2013|Last updated: 7 April 2015

Training in Patient Based Care

Aim: The Directorate of Patient Based Care facilitates training and education in Patient Based Care to: Board, Executive, Leaders, Senior Managers and Clinicians; Junior Clinicians; and the workforce (through Train-the-Trainer).

Benefits: Through training the Directorate assists services to provide patient based care and meet new performance goals and the Australian Commission on Safety and Quality in Health Care National Safety and Quality Health Service Standards (Standard 2.6 Implementing training for clinical leaders, senior management and the workforce on the value of and ways to facilitate consumer engagement and how to create and sustain partnerships).

CEC Ready to Implement Added: 7 November 2013|Last updated: 5 March 2015

Transition Care Principles

Aim: The principles document for the transition of young people with chronic conditions from paediatric to adult care has been developed by the Agency for Clinical Innovation (ACI) Transition Executive Committee and Trapeze, a service of The Sydney Children’s Hospitals Network (SCHN), for use in the NSW Health system. The principles are evidenced based and aim to promote best practice for health professionals involved in caring for young people during transition. It is hoped that this document will assist LHDs and...

Benefits: Despite agreement about the importance of effective transitional care, there is little evidence to inform best practice about both the process of and what constitutes effective transition.1 The ACI Transition Care Network and Trapeze believe that the implementation of, and adherence to, evidence-based principles will considerably improve the care and management of young people with chronic conditions transitioning from paediatric to adult health care including: better functional outcomes including increased adherence, improved self-management and knowledge of condition, and improved wellbeing;...

ACI Pre-implementation Added: 15 September 2014|Last updated: 20 October 2014

Understanding Program Evaluation: An ACI framework

Aim: To provide a framework for undertaking evaluations of programs and projects. Programs include projects, models of care, clinical pathways and guidelines, and other innovations and interventions aimed at improving health outcomes.The frameworkis divided into three sections, covering:Purpose and principles of evaluation; Types of program evaluation and the key steps in undertaking an evaluation; An overview of the suggested governance process for undertaking evaluations in ACI.

Benefits: High-quality evaluation supports accountability and provides a rigorous evidence base toinform health-service development and program design.Program evaluation will provide the information needed to guide better resource allocationand improved services.

ACI Ready to Implement Added: 8 November 2013|Last updated: 18 November 2013

Understanding the Role of Health Economics at ACI

Aim: Improved decision-making to support the delivery of sustainable, system-wide change proposals.

Benefits: Describes how health economics will be integrated into the work of the ACI; Articulates the objectives and principles of the ACI economics function and team; Demonstrates how health economics supports the development and implementation of ACI models of care; Provides high-level explanations of key economic techniques and documents.

ACI Ready to Implement Added: 8 November 2013|Last updated: 20 January 2014

WentWest Child Development Care (CDC) Coordination Project Evaluation

Aim: To improve the health, growth and development of children through awareness of developmental concerns and service supports.

Benefits: Early identification of need and awareness of services to support patients and families and professionals.

ACI Ready to Implement Added: 10 July 2015|Last updated: 16 July 2015

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