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.

Northern NSW Local Health District

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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 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

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

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