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 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

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

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

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

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

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

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 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 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

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

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

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

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

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

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

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

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

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

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

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