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.

Western 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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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