Initiatives by Local Health District / Specialty Network
Initiatives have been piloted, implemented or key activities/milestones have taken place or are planned in sites relating to this Local Health District / Specialty Network.
Hunter New England Local Health District
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.
Ready to Implement Added: 6 November 2013|Last updated: 5 February 2015
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...
Ready to Implement Added: 5 November 2013|Last updated: 23 September 2014
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.
Ready to Implement Added: 6 November 2013|Last updated: 5 March 2015
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...
Ready to Implement Added: 7 November 2013|Last updated: 17 August 2016
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.
Ready to Implement Added: 28 October 2013|Last updated: 16 January 2014
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.
Ready to Implement Added: 7 November 2013|Last updated: 9 February 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.
Ready to Implement Added: 25 February 2015|Last updated: 25 February 2015
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.
Ready to Implement Added: 13 August 2015|Last updated: 14 August 2015
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...
Ready to Implement Added: 8 November 2013|Last updated: 5 August 2016
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...
Pre-implementation Added: 27 March 2015|Last updated: 16 April 2015
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.
Ready to Implement Added: 11 July 2013|Last updated: 21 May 2015
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).
Ready to Implement Added: 6 November 2013|Last updated: 30 May 2014
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...
Ready to Implement Added: 5 November 2013|Last updated: 20 January 2014
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.
Ready to Implement Added: 7 November 2013|Last updated: 15 December 2014
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.
Ready to Implement Added: 30 October 2013|Last updated: 30 May 2014
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...
Ready to Implement Added: 8 November 2013|Last updated: 25 June 2015
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.
Ready to Implement Added: 7 November 2013|Last updated: 22 January 2014
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.
Ready to Implement Added: 8 November 2013|Last updated: 17 January 2014
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...
Ready to Implement Added: 7 November 2013|Last updated: 9 February 2015
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.
Ready to Implement Added: 7 November 2013|Last updated: 17 November 2014
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
Ready to Implement Added: 18 June 2015|Last updated: 18 June 2015
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.
Ready to Implement Added: 6 November 2013|Last updated: 12 January 2015
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.
Ready to Implement Added: 5 November 2013|Last updated: 30 May 2014
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...
Future Initiative Added: 3 July 2014|Last updated: 7 June 2016
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...
Ready to Implement Added: 8 November 2013|Last updated: 30 May 2014
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.
Ready to Implement Added: 23 September 2014|Last updated: 10 October 2014