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 Sydney 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

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

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

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

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

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

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

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

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

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 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

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

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 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 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

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

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

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

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

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

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

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

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

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

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

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

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