Alexandra District Health 145th ANNUAL REPORT 2015-2016Hospital Profile 4 Organisational Structure 4...

ANNUAL REPORT

Alexandra District Health145th ANNUAL REPORT

2015-2016

Alexandra District HealthA

nnual Report 2015-16

In late 1866, the mining boom hit Redgate, (as Alexandra was then known) and with the consequential population explosion, the need for medical and hospital care became an issue.

In 1870, the Local Council purchased two buildings for two pounds. They went on to spend a further 50 pounds, converting part of an old hotel into a courthouse and the other section into a hospital. From these humble beginnings sprang the Alexandra District Hospital.

The Grand Opening Ball of the Hospital on the hilltop site was Friday, September 20, 1871. Its official incorporation and registration as a Public Hospital was on Saturday, December 11, 1871, the official opening date.

The then new Hospital had a bed capacity of five and the first matron was Mrs Margaret Milroy. In 1888, the size of the Hospital was doubled

to ten beds with the reconstruction from wood to brick and the addition of the Jubilee Wing.

In 1957 a disastrous fire destroyed the major part of the Hospital but also all the archive records prior to that point, making the development of this institution very difficult to recount. Suffice to say, a total reconstruction was undertaken.

Between 1969 and 1977, further development increased the services to a total of 30 beds including the only nursing home beds in the area.

The mid 1980s to the present day saw the most rapid expansion in services and development of the Hospital. The Hospital now provides specialist medical services in eleven clinical disciplines, as well as a local doctor service of five general practitioners, supporting radiology, pathology, physiotherapy, district nursing and many other services.

In 2011 Alexandra District Hospital was moved from a nineteenth

century building on the corner of Myrtle Street and Cooper Street to a state-of-the-art fully integrated health facility at 12 Cooper Street. The new facility is capable of serving the community well into the future.

On the 18th June 2015 Alexandra District Hospital’s name was formally changed to Alexandra District Health.

It is however, more than worthy of repeating an excerpt from The Alexandra and Yea Standard at the turn of the century-

“During the first two decades of this century, the Hospital was greatly supported by the people of the surrounding area. Donations of goods were greatly appreciated and acknowledged in monthly Hospital reports which were published in the local paper.”

The unstinting support from this community is what will always ensure the vitality and perpetuity of this Hospital.

Foreword In late 1866, the mining boom hit Redgate, (as Alexandra was then known) and with the consequential population explosion, the need for medical and hospital care became an issue.

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Mission Statement02

Our Mission:

Provision of quality integrated health services that meet the needs of our community.

Philosophy:

The Alexandra District Health Service philosophy is based on an abiding concern for all patients and their families, but primarily the patient, and that concern revolves around:

1. Prompt attention.

2. Communicating explanations of treatment, delays, changes, re-locations and environment.

3. Comfort – mental, physical and spiritual.

4. Identifying each patient as an individual with individual needs, and help to reduce apprehension.

5. Finally, for staff to appreciate and

possess a capacity to see the hospital and its services from the patient’s point of view and convey the need for review through proper channels.

Strategic Plan Objectives:

Our Vision and Strategic Intent:

“To be recognised as a leader in rural health service provision, workforce development and consumer engagement.”

Corporate Objectives:

• Sustain our General Practitioner workforce.

• Achieve accreditation as a “health promoting hospital”.

• Improve (two way) communication with our customers.

• Maintain accreditation (includes all operational requirements of

Australian Council of Healthcare Standards).

Key Initiatives and Projects:

The key initiatives and projects of Alexandra District Health for 2015-16 were:

• Continued development of landscaping

• Completion of the solar panel installation

• Achieving all accreditation requirements

• Ongoing up-skilling of nursing staff to provide radiology and limited delivery of medications to urgent care patients

• Further development of “telehealth” project linking ADH with the Emergency Department in Wangaratta.

Table of ContentsForeword to the 145th Annual Report 1

Mission Statement, Philosophy, Objectives, Key Initiatives and Projects 2

Disclosure Index 3

Hospital Profile 4

Organisational Structure 4

Board Chair and Chief Executive Officer / Director of Nursing Report 5

Attestations and Declarations 7

Senior Staff Positions and Roles 7

Finance Report 8

Financial Performance Summary 8

Committee Structure 8

Corporate Governance 9

Board of Management 10

Statutory Reporting 11

Environment and Sustainability 13

Statement of Priorities 14

Key Financial and Service Performance 19

Life Governors 20

Our Services 20

Medical Staff 20



Legislation Requirement Page reference

Legislation Requirement Page reference

Disclosure IndexThe annual report of Alexandra District Health is prepared in accordance with all relevant Victorian legislation. This index has been prepared to facilitate identification of the Department’s compliance with statutory disclosure requirements.

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Ministerial DirectionsReport of Operations

Charter and purpose FRD 22G Manner of establishment and the relevant Ministers 4

FRD 22G Purpose, functions, powers and duties 2

FRD 22G Initiatives and key achievements 2

FRD 22G Nature and range of services provided 20

Management and structureFRD 22G Organisational structure 4

Financial and other informationFRD10 Disclosure index 3

FRD 11A Disclosure of ex-gratia expenses N/A

FRD 21B Responsible person and executive officer disclosures 7

FRD 22G Application and operation of Protected Disclosure Act 2012 11

FRD 22G Application and operation of Carers Recognition Act 2012 11

FRD 22G Application and operation of Freedom of Information Act 1982 11

FRD 22G Compliance with building and maintenance provision of Building Act 1993 11

FRD 22G Details of consultancies under $10,000 12

FRD 22G Details of consultancies over $10,000 12

FRD 22G Employment and conduct principles 4

FRD 22G Major changes or factors affecting performance F

FRD 22G Occupational health and safety 11

FRD 22G Operational and budgetary objectives and performance against Objectives 8

FRD 24C Reporting of office-based environmental impacts 13

FRD 22G Significant changes in financial position during the year 13

FRD 22G Statement of National Competition Policy 11

FRD 22G Subsequent events NA

FRD 22G Summary of the financial results of the year F

FRD 22G Workforce Data Disclosures including a statement on the application of employment and conduct principles 4

FRD 25B Victorian Industry Participation Policy disclosures 11

FRD 29A Workforce Data Disclosures 4

SD 4.2(g) Specific information requirements F

SD 4.2(j) Sign-off requirements 7

SD 3.4.13 Attestation of data integrity 7

SD 4.5.5 Attestation on compliance with the Ministerial Standing Direction 4.5.5 Risk Management and Framework 7

Financial Statements

Financial statements required under Part 7 of the FMA

SD 4.2(a) Statement of changes in equity F

SD 4.2(b) Comprehensive operating statement F

SD 4.2(b) Balance sheet F

SD 4.2(b) Cash flow statement F

Other requirements under Standing Directions 4.2

SD 4.2(a) Compliance with Australian accounting standards and other authoritative pronouncements F

SD 4.2(c) Accountable officer’s declaration F

SD 4.2(c) Compliance with Ministerial Directions F

SD 4.2(d) Rounding of amounts F

LegislationFreedom of Information Act 1982 11

Protected Disclosure Act 2012 11

Carers Recognition Act 2012 11

Victorian Industry Participation Policy Act 2003 11

Building Act 1993 11

Financial Management Act 1994 F

(F): Financial Report attached inside back cover of report.



Hospital Profile

JUNE JUNE Current Month Year To Date FTE FTELabour Category 2015 2016 2015 2016

Nursing 19.90 19.66 19.43 20.09

Administration and Clerical 13.24 12.61 11.97 11.14

Medical Support 10.59 8.99 10.79 9.85

Hotel and Allied Services 10.31 11.22 9.53 10.75

Medical Officers 0.20 0.25 0.24 0.38

Ancillary Staff 0.64 0.62 0.63 0.5904

Organisational Structure

Chair:Ms Carole Staley

Chief Executive Officer/Director of Nursing:Mrs Heather Byrne (to 30/10/15) Mr Mark Ashcroft (Acting from 2/11/15 to 23/05/16)Mrs Mara Richards (from 23/05/16)

Relevant Ministers: The Hon. Jill Hennessy, MP Minister for Health,

Minister for Ambulance The Hon. Martin Foley, MP Minister for Housing, Disability

and Ageing, Minister for Mental Health

Originally Established:Incorporated December 11th, 1871 – Hospital and Charities Act (6274)

Accreditation Status:Fully Accredited to 9th March 2017

Workforce Data:

All employees are correctly classified in workforce data collections and are required to comply with the Alexandra District Health Code of Conduct under their respective employment agreements. Alexandra District Health is committed to applying the Public Sector employment principles and upholds the key principles of merit and equity in all aspects of the employment relationship. To this end we have policies and practices in place to ensure all employment related decisions including recruitment, training and retention are based on merit.

Approved Beds:25 acute 6 day procedure

Office Bearers:Chair: Ms Carole Staley Deputy Chair: Mrs Jennifer CumminsTreasurer: Ms Cheryl Nickels-Beattie Board Members: Mr Geoff Hyland Ms Kristin Michaels (resigned 25/09/15)

Ms Margaret Rae Mr Ray Twitchett Mrs Lorna Gelbert Auditor: Auditor GeneralAppointed Agent: Richmond, Sinnott & DelahuntyBankers: NAB/ANZSolicitors: Phillips Fox / Health Legal

C:\Users\anne\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\C6AHS46R\0216 Organisational Chart.docx Revised February 2016

BOARD OF MANAGEMENT

CHIEF EXECUTIVE OFFICER / DIRECTOR OF NURSING

Director Medical Services

Visiting Medical Officers Group

Infection Control Practitioner

Ward Charge Nurse

Theatre Charge Nurse

Human Resources

Coordinator

Professional Contracted Services

- Finance - Health

Information Management

Ward Nursing

Staff Pharmacy

Theatre Staff

Administration - Payroll - Finance

Primary Health Staff - Allied Health - District Nursing

Volunteers

CH Manager

Catering Cleaning

Catering and

Domestic Services Manager

OHS Co-Ordinator

Reception

Facilities Manager / Executive Assistant

Building and

grounds

Quality Manager



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The Board embarked this year with a Strategic Planning, Community and Stakeholder Engagement Workshop, seeking input and guidance from participants to shape the current and future health services. Representatives from ADH Board and staff, the Community Advisory Group, relevant State and Local Government agencies, primary health providers, health related businesses and the local community contributed to robust discussions, with key themes evolving around partnerships, community engagement, operational excellence, workforce and future needs. These themes form the platform for future planning and development of ADH services and support our vision to be recognized as a leader in rural health service provision, workforce development, and consumer engagement.

Service provision has, at its core, the requirement for skilled staff such as General Practitioners, Specialist Medical Officers, Nursing and Allied Health staff. ADH remains committed to the training and recruitment of staff that are capable and confident to provide the diverse portfolio of services currently offered and anticipated in the future. This commitment is demonstrated by the appointments of Cassandra Fraser to the Nurse Unit Manager role

Board Chair and Chief Executive Officer/Director of Nursing ReportIt is with great pleasure that we submit this report as a collaborative venture between the new Board Chair and the new Chief Executive Officer / Director of Nursing of Alexandra District Health (ADH). The health service has seen many changes in leadership over the past 12 months and a new era has begun with a newly appointed Chief Executive Officer to lead the organisation on behalf of the Board of Management. The Board would like to acknowledge the long partnership that Heather Byrne had with ADH and wish her well for her future. The Board would also like to recognise the leadership that both Mark Ashcroft and Margaret Baker provided to ADH during the recruitment process.

overseeing the acute clinical area and Claire Palmer to manage the Quality and Risk portfolio, they have both been appointed from within the health service. Under Cassandra’s leadership we continue to develop nursing skills with a commitment to the Remote and Isolated Practice Endorsed Registered Nurses (RIPERN) program and formal training in undertaking x-rays. These nurses are the frontline clinicians who are able to assess and manage patients who require non-urgent attention and treatment, saving patients from travelling to other hospitals for x-rays for minor injuries. For urgent medical conditions, we continue to have a General Practitioner on-call roster supported by the Alexandra and Yea medical workforce and we are grateful for their support.

Our elective surgical program continues to provide a broad range of specialist services to the community of Alexandra and surrounds and was supported through the purchase of new equipment to ensure theatre facilities remain state of the art. Under the leadership of Margaret Baker our nursing and technical team provide a first class service and ably support the visiting surgeons and anaesthetists. The theatre team have achieved commendations

in infection control and sterilising standards within the Hume region and are recognised leaders in rural Victoria.

The community health program maintains an effective service, providing both health promotion focussed events and a range of nursing and allied health services to individuals. The Community Health Manager, Jane Judd, and her team are exploring opportunities to optimise access to a range of community based services with a focus on keeping our community healthy and well at home.

There has been an increase in activity across all clinical areas of the health service this year and this has been achieved within budget, ending the year in a strong financial position. The increase in activity has occurred concurrently with changes to staff and their roles. The staff can be commended for staying focused on providing quality care amidst all the changes, as demonstrated by excellent patient satisfaction results.

Underpinning the provision of clinical services is our quality and risk management framework and we acknowledge and thank Jane Judd for establishing a firm foundation in preparation for the “organisation wide survey” by the accreditation body, the Australian Council on



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Healthcare Standards (ACHS) in October 2016. We have an evolving culture of continuous improvement across the organisation and quality and risk are performed as part of everyone’s duties at all times whilst on duty. There is much work that happens in the background as we formally document everything that we do in preparation for accreditation. All staff contribute in some way to this and it is now overseen by our quality navigator, Claire Palmer, and her team of “champions”, staff that lead the way and educate staff on individual standards. A big responsibility for all involved, however, an effective way to embed the knowledge throughout the organisation.

Although the health service building is no longer “new” we are still settling in and addressing a number of minor issues common to all building projects. The solar project has been completed and we are already seeing the benefits in lower energy costs. The health service has, as one of its primary environmental objectives, a keen desire to explore any opportunity to reduce its carbon footprint and become more energy wise and environmentally responsible. Our staff have contributed to a great range of initiatives that help us realise that goal, including a focus on recycling, particularly in the

area of clinical waste of which, the disposal of, is a very expensive area. Another initiative led by the staff, is a desire to improve the front public entrance to our main building. While the patient rooms overlook maturing and attractive gardens other areas have not developed as well. We have commenced an environmental project in redeveloping the gardens at the front of the building with a focus on softening the look of the garden and making the entrance more welcoming to our visitors.

Our health service would not be able to function if it was not for the staff that make it happen in the background. The support staff do not always appear front and centre however, the staff at the Reception desk that welcome you to our health service, the administration staff that work in the back offices keeping the bureaucratic wheels in motion, the staff that prepare and serve the magnificent meals in our kitchen, the staff that maintain the cleanliness of the health service environment, the maintenance team that keep the building ship shape, to our volunteers and to the Community Advisory Committee and Fundraising Committee, a very sincere thank you from the Board and Chief Executive Officer / Director of Nursing on behalf of the community you serve.

We would also like to acknowledge the dedication of our Board, who give freely of their time to provide oversight and strategic direction to the health service. We would like to thank outgoing board member, Kristen Michaels, who served on the board for five years; and also Christine Bell who served as the independent chair of the Audit and Risk Committee. We are most grateful for their contributions. We look forward to welcoming Sally Percy as a new Board Member this year, who will add strength to the clinical governance of this health service.

Alexandra District Health will continue to seek opportunities to improve our health service in every department, we will make you feel welcome and streamline access to our services and we will provide the best possible care we can, this is our commitment to you, our community.

Carole Staley, Board Chair

Mara Richards, Chief Executive Officer/Director of Nursing30 June 2016



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Senior Staff Positions and RolesChief Executive Officer/Director or Nursing:Mrs Mara Richards This role encompasses the overall management of the Hospital and requires a detailed knowledge and understanding of all facets of health service operation from clinical services to administration. Strategic planning to ensure the organisation meets the short and long term requirements of our community is a major responsibility.

Community Health Manager:Jane JuddThis part time position is responsible for the management of Community Health services. This includes the management of primary health staff in a range of disciplines and is responsible for the provision of services against defined targets.

Nurse Unit Manager (Ward):Cassandra Fraser This full time position is responsible for patient care delivery in the ward and urgent care area. This position requires a high degree of clinical skill as well as a broad range of management expertise.

Nurse Unit Manager (Operating Theatre) Margaret BakerThis part time position is responsible for the clinical care and management of the theatre suite. This role also includes running the pre-admission clinic for elective surgery.

Accountant: AASB Accounting and Audit Solutions Andrew Arundell This is a contracted position with Andrew Arundell attending the hospital one day per month. The timely preparation of monthly reports for Board members and Department of Health, as well as Year End Financial Reports is the major responsibilities for this position.

Responsible Bodies Declaration In accordance with the Financial Management Act 1994, I am pleased to present the Report of Operations for Alexandra District Health for the year ending 30 June 2016.

Carole Staley Chair Board of ManagementAlexandra On the 30th June 2016

Attestation of Data Integrity

1, Mara Richards certify that Alexandra District Health has put in place all appropriate internal controls and processes to ensure that reported data reasonably reflects actual performance. Alexandra District Health has critically reviewed these controls and processes during the year.

Mrs Mara Richards Chief Executive Officer/ Director of NursingAlexandra On the 30th June 2016

Risk Management Framework and Process AttestationI, Mara Richards certify that Alexandra District Health has complied with the Ministerial Direction 4.5.5 – Risk Management Framework and Processes. Alexandra District Health’s Audit Committee has verified this.

Mrs Mara Richards Chief Executive Officer/ Director of NursingAlexandra On the 30th June 2016

Heather Byrne received a Life Governor Award at the 2015 Annual General Meeting for her exceptional service to Alexandra District Health.



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Performance

Finance Report

Committee StructureBoard of

Management

Policy and Procedure

Review

Visiting Medical Officers

Finance and Physical

Resources

Fundraising Group

Audit Ethics Safe Practice and Environment

Continuum of Care

Drugsand

Therapeutics

Continuous Quality

Improvement

Medical Credentialing and Defining

Scope of Clinical Practice

Medical Appointments

Advisory

This is the operational result of the health service and reflects the growth funding received in acute and primary services whilst keeping total operating expenditure in check.

The overall result after capital and specific items has improved with a large bequest received as well as

insurance recoveries associated with medical equipment and old hospital repairs and a reduction in the depreciation of the old hospital as per the Valuer General’s assessment.Cash reserves have increased with the bequest mentioned above, improved results and a call upon the

Department of Health and Human Services Long Service Leave Debtor – see reduction in receivables.

The new liability reported in 2015/16 are lease liabilities associated with the Hume Rural Health Alliance.

Andrew Arundell Contract Accountant

The financial results for 2015/16 have continued to improve in comparison to the previous two years when assessing the result prior to capital and specific items.

Five Year Financial Comparison Summary:

2016 2015 2014 2013 2012

Total Revenue 7,656,794 7,134,199 7,037,653 7,014,411 7,699,936

Total Expenses 8,551,853 8,707,796 8,291,351 9,007,563 7,578,114

Net Result for the Year (including Capital and Specific items) (895,059) (1,549,269) (1,253,698) (1,993,152) 121,822

Retained Surplus/ (Accumulated Deficit) 14,901,660 15,768,795 17,318,064 18,571,762 20,564,914

Total Assets 27,732,716 28,515,494 30,059,698 25,898,409 27,933,349

Total Liabilities 1,729,981 1,645,624 1,640,559 1,534,386 1,576,174

Net Assets 26,002,735 26,869,870 28,419,139 24,364,023 26,357,175

Total Equity 26,002,735 26,869,870 28,419,139 24,364,023 26,357,175



Corporate GovernanceAlexandra District Health (ADH) Annual Report has been compiled to meet the requirements of the Public Administration Act, Financial Management Act and other requirements.

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Performance

Information required by legislation – but not recorded elsewhere in this annual report is summarised below.

The organisation is governed by the Board of Management. The Board is appointed by the Governor-in-Council upon the recommendation of the Minister of Health, the Hon Jill Hennessy MP.

The functions of the Board as determined by the Health Services Act 1988 are:

• To oversee and manage the Organisation;

• To ensure the services provided by the Organisation comply with the requirements of the Act and the aims of the organisation.

Board Committees

Committee membership is governed by the Alexandra District Health Rules.

Audit Committee

The committee receives and makes recommendations relating to internal and external audit reports and ensures compliance with any matters raised by the Auditor-General’s office. The committee meets four times annually. The committee chair and at least one other member meet the requirements for independence.

Audit Committee Members

Christine Bell (Independent Chair resigned 13/5/16)Geoffrey HylandIan McKaskillJennifer CumminsCarole StaleyCheryl Nickels-Beattie

Finance and Physical Resources Committee

The committee examines monthly reports and ensures that they are prepared in accordance with the appropriate accounting requirements and sound accounting principles and standards. The committee meets monthly.

Medical Appointments Advisory Committee

The committee meet as necessary and advises the Board regarding the appointment, suspension and removal from office of medical practitioners as required.

Medical Credentials and Defining the Scope of Clinical Practice Committee

The committee meets as necessary to consult and provide advise on the range of clinical services, procedures or other interventions that can be provided safely in the organisation.

The committee also review and verifies the minimum credentials necessary for a medical practitioner to fulfil the duties of a specific position or scope of clinical practice.

Continuous Quality Improvement

The committee is responsible for coordinating quality assurance activities and risk management both clinical and non-clinical. The committee meets monthly.

Continuum of Care

The committee reports to the Board of the overall quality, effectiveness, appropriateness and use of services rendered to patients of the hospital. The committee works to review and establish the specific areas of care. The committee meets monthly.

Visiting Medical Officers

The committee provides a forum for discussion and determination of clinical matters relating to medical/clinical practices within the hospital. The Committee meets four times per year.

Ethics Committee

The committee deliberates and gives advise on the resolution of significant ethical issues and confronts issues relating to moral choices and rules of conduct. The committee meets as required.

Policy and Procedure Review

The committee is responsible for reporting the overall quality, effectiveness and appropriateness and compliance with policies, procedures and guidelines. The committee meets monthly (excluding January).

Five Year Financial Comparison Summary:

2016 2015 2014 2013 2012

Total Revenue 7,656,794 7,134,199 7,037,653 7,014,411 7,699,936

Total Expenses 8,551,853 8,707,796 8,291,351 9,007,563 7,578,114

Net Result for the Year (including Capital and Specific items) (895,059) (1,549,269) (1,253,698) (1,993,152) 121,822

Retained Surplus/ (Accumulated Deficit) 14,901,660 15,768,795 17,318,064 18,571,762 20,564,914

Total Assets 27,732,716 28,515,494 30,059,698 25,898,409 27,933,349

Total Liabilities 1,729,981 1,645,624 1,640,559 1,534,386 1,576,174

Net Assets 26,002,735 26,869,870 28,419,139 24,364,023 26,357,175

Total Equity 26,002,735 26,869,870 28,419,139 24,364,023 26,357,175



Mr Geoff Hyland

Geoff has a background in finance and accounting having graduated with a Bachelor of Commerce degree and worked with a Melbourne

accounting firm for seven years before being self employed as an on course bookmaker – a profession he has enjoyed for 35 years. Geoff has been involved in traders and tourism bodies in Marysville and Alexandra at committee level.

Ms Kristin Michaels (resigned 25/12/2015)

Kristin is the Chief Executive Officer of the Society of Hospital Pharmacists of Australia. Kristin has worked in a range of Health Management positions across

Commonwealth, State and private organisations. She holds qualifications in arts, education, organisational leadership and governance, and has held Director positions in a number of primary, acute and community care organisations. Kristin was a finalist in the Telstra Australian Business Women’s Awards in 2008.

Mr Ray Twitchett

Ray has worked in the Construction and Water Industry for some 47 years, having gained considerable experience in both the public and

private sectors both as a contract plumber and in project management/supervisory positions. Ray holds a Diploma in Project Management and is well versed in OH&S requirements. He has also held various positions at Board level with sporting bodies in both Euroa and Shepparton as well as being actively involved in the organisations.

Chair: Ms Carole Staley

Carole is Registered Nurse and holds qualifications in health service management. She has 30 years’ experience within the health care

sector including senior management roles. She has extensive experience in implementing new models of care and improvement initiatives, particularly at the interface between the acute hospital and community care area. She currently operates her own healthcare consultancy business.

Deputy Chair: Mrs Jennifer Cummins

Jenny is a qualified Physiotherapist who has held senior management positions in public hospitals. Jenny has experience in quality assurance, occupational health

and safety management and has held directorships in a number of private companies.

Treasurer: Mrs Cheryl Nickels-Beattie

Cheryl is the Finance and Information Services Manager at Mansfield Shire Council. Her qualifications include a Bachelor of Business -

Accounting. She has experience in local government and health service senior management. Cheryl has worked in Financial Management, Information Management, and Risk Management.

Mrs Lorna Gelbert

Lorna is a currently practicing Lawyer and is an Accredited Property Law Specialist. Until 2013, Lorna was a partner with a medium sized law

firm in Melbourne CBD but moved permanently to Buxton and set up

Board of Management

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her own small practice in partnership with her partner Colin. Lorna has previously been a Board Member of Places Victoria, Women’s Legal Service Victoria and Family Law Legal Service. She is currently Chair of the Law Institute’s Specialisation Board’s Property and Commercial Tenancy Committee. Aside from her legal practice, Lorna and her son Michael own and operate Buxton Ridge vineyard and winery.

Mr Ian McKaskill

Ian McKaskill is a mechanical engineer with over 35 years’ experience. He has expertise in the project management and delivery of large capital works

projects in the process industries. Earlier in his career, he worked in the areas of design of large capital equipment. He has specific skills in the delivery of large Engineering, Procurement and Construction projects including the areas of project and management, contracts formulation and risk management. Ian is Executive Manager of the Upper Goulburn Landcare Network, President of the Murrindindi East Chapter of U3A, Director of Yea and District Community Bank, Independent Chairman of the Murrindindi Shire Council Audit Advisory Committee.

Ms Margaret Rae

Margaret has a background in both the public and private sectors and a professional career in academic management. Margaret has extensive

experience on a range of boards and committees, including the Goulburn Valley Water Authority Board, Lake Mountain Alpine Resort Management Board and Buxton CFA, together with active involvement in local tourism and community organisations. Also a graduate from the Australian Institute of Company Directors, Margaret brings a range of skills to bear on the complex issues managed by the Board in conducting its core business and in future planning and development initiatives.



Statutory Reporting

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Information required by legislation but not recorded elsewhere in this annual report is summarised below.

Pecuniary Interests The Board of Management members are required to notify the Chair of the Board of any pecuniary interests. All members have completed a statement of pecuniary interests.

Health Services Act, 1988Alexandra District Health does not administer any Acts. The Health Services Act of 1988 is the vehicle by which Health Services are incorporated and prescribes the manner in which they are regulated.

Complaints System A complaints register is maintained and quarterly reports are made to the Health Services Commissioner.

Complaints are assessed promptly and the Board of Management is kept informed of the nature of complaints.

Complaints are used as a means to achieve continuous quality improvement in all facets of health care business.

Freedom of Information Act, 1982The Freedom of Information Officer is the Chief Executive Officer (CEO). Persons wishing to access information under the Freedom of Information Act 1982 should apply in writing to the CEO.

During 2015/2016 there were 27 Freedom of Information requests.

Alexandra District Health’s Annual Report has been compiled to meet the requirements of the public Administration Act, Financial Management Act and other requirements.

Protected Disclosure Act, 2012 Alexandra District Health complied with the Protected Disclosure Act 2012 for the year 2015/2016.

Carers Recognition Act 2012 Alexandra District Health complied with the Carers Recognition ACT 2012 for the year 2015/2016.

Victorian Industry Participation Act, 2003 Alexandra District Health complied with the Victorian Industry Participation Policy ACT 2003 for the year 2015/16.

Employment and Conduct PrinciplesAlexandra District Health complied with the Victorian Industry Participation Policy Act 2003 for the year 2015/16.

Fees and Charges Alexandra District Health charges fees in accordance with the Department of Health Fee Schedule.

Occupational Health and Safety Alexandra District Health has an Occupational Health and Safety (OH&S) Committee which meets regularly. Staff report incidents, accidents and near misses which are then assessed at monthly meetings and appropriate action is taken.

During 2015/16 Alexandra District Health has:

• Updated the online manual handling and occupational violence training for all staff.

• Provided staff with training for OH&S managers and supervisors and refresher training for OH&S representatives.

• Provided staff with annual fire extinguisher and hose reel training.

Competitive Neutrality Alexandra District Health has a policy in place for the implementation of the Victorian Government’s policy on Competitive Neutrality.

Industrial Disputes Time lost through industrial disputes: Nil.

Overseas Travel Nil.

Building Standards Alexandra District Health complies with Regulation 1209 and 1215 of the Building Act 1993. The Alexandra District Health engages an independent contractor to perform an assessment of all buildings in accordance with Section 22E of the Act. A current Annual Safety Measures Report is on display at the Urgent Care entry.

Outsourcing of services• AASB Accounting and Audit

Solutions – Accounting

• Clinical Labs – Pathology

• North East Health Wangaratta / Mansfield Radiographic Service – Radiology

• Sound Imaging – Ultrasound



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Details of Consultancies Engaged In 2015-16, there was one consultancy where the total fees payable to the consultant was $10,000 or greater. The total expenditure incurred during 2015-16 in relation to this consultancy was $12,500 (excl. GST).

In 2015-16, there was one consultancy where the total fee payable to the consultant was less than $10,000. The total expenditure incurred during 2015-16 in relation to this consultancy was $12,416 (excl. GST).

PublicationsThe following publications dealing with the functions, powers, duties and activities of the hospital were produced in 2014/2015 and may be viewed at the health service upon request:

• Alexandra District Health 145TH Annual Report

Information and Communication Technology (ICT) ExpenditureThe total ICT Expenditure of ADH is outlined below.

Occupational ViolenceAlexandra District Health publicly reports and monitors incidents of occupational violence. The below table outlines these instances.

Definitions:For the purposes of the above statistics the following definitions apply.

Occupational violence – any incident where an employee is abused, threatened or assaulted in circumstances arising out of, or in the course of their employment.

Occupational Violence Statistics 2015-16

1. Workcover accepted claims with an occupational violence cause per 100 FTE Nil

2. Number of accepted Workcover claims with lost time injury with an occupational violence cause per 1,000,000 hours worked Nil

3. Number of occupational violence incidents reported 2

4. Number of occupational violence incidents reported per 100 FTE 2%

5. Percentage of occupational violence incidents resulting in a staff injury, illness or conditional Nil

Total ICT Costs 2015/16 (Ex GST)

Business As usual (BAU) ICT Expenditure (Total Ex GST) $164,063Non-Business As Usual (Non-BAU) ICT expenditure (total operational and capital expenditure ex GST) $257,355Operational expenditure (excluding GST) $202,853Capital Expenditure (excluding GST) $54,502

Expend- iture Consultant Purpose of Start End 2015-16 consultancy date date (ex GST)

Kristin Michaels GP Workforce Services Nov 15 Feb 16 $4,891 Workshops A&S Whitmore Bank Tender 10/12/15 01/01/16 $3,000Health Recruitment CEO Recruitment Dec 2015 April 2016 $12,500Specialist

Regional Strategic Planning March 16 April 16 $3,025Development ForumCompany

Building Services Condensation Feb 16 July 16 $1,500Group Investigation Report

Incident – occupational health and safety incidents reported in the health service incident reporting system. Code Grey reporting is not included.

Accepted Workcover claims – Accepted Workcover claims that were lodged in 2015-16.

Lost time – is defined as greater than one day.



Environment and Sustainability

13

Alexandra District Health (ADH) recognises its role in a more sustainable state for future directions.

Over the past twelve months Alexandra District Health has undertaken a number of environmental performance improvement activities including:

• The installation of solar panels to supplement our power usage. We expect that the system will decrease our overall electricity use and in turn decrease our carbon footprint.

• A review of our clinical waste has been provided by an external provider and has identified a number of ways that we can decrease our overall clinical waste volume.

• Our theatre department is now participating in a sterile wrap recycling project that means this product no longer ends up in landfill.

• We are currently working on a replacement program to replace our halogen lighting with LED replacements throughout the hospital site.

• Review of landscaping designs to incorporate water wise plants and low maintenance garden areas. Reducing the water requirements over summer months.

• In 2015/16 ADH used a total of 625 reams of paper on which 50% is made of recycled materials.

• ADH prints publications on demand. The printing of our annual report is limited to 120 copies with documents available on the Hospitals website. Patient information brochures are printed in house on demand and are not printed by commercial printers on mass.

Our Goals:

• Reduce clinical waste in total volume and containers through education of the correct separation of clinical and general waste.

• Reduce our overall carbon footprint by 50 tonnes by 30 June 2017 by reducing our electricity, water and gas usage through various environmental projects.

• Overall fuel consumption target reduction of 5% by the end of 2016/17 by reducing non-essential travel and increased use of video and tele-conferencing.

Energy Consumption Kilowatt Hours (kWh)

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50000

100000

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Energy Consumption Kilowatt Hours (kWh)

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Water Consumption Total KL/ML

Water Consumption TotalKL/ML

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WaterConsumption TotalKL/ML


Waste - Clinical Kilograms (Kgs)

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Waste ‐ Clinical Kilograms (Kgs)

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Clinical ‐Waste (Containers)

Waste Clinical Waste(containers)

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Waste - General Kilograms (Kgs)

8000

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2013/14 2014/15 2015/16

Waste ‐ General Kilograms (Kgs)

Waste General (Kgs)

700720740760780800820840860880900

2013/14 2014/15 2015/16

Total Greenhouse Gas Emissions

Tonnes CO2e

8000

8500

9000

9500

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Waste ‐ General Kilograms (Kgs)

Waste General (Kgs)

700720740760780800820840860880900

2013/14 2014/15 2015/16


Tonnes CO2e




Statement of Priorities

Priority Action Deliverable Outcome

Developing a system that is responsive to people’s needs

14

Statement of Priorities Part A – Strategic Priorities for 2015/16

The Victorian Government’s priorities and policy directions are outlined in the Victorian Health Priorities Framework 2012–2022. In 2015/16 Alexandra District Health (ADH) will contribute to the achievement of these priorities by:

• Drive improved health outcomes through a strong focus on patient-centred care in the planning, delivery and evaluation of services, and the development of new models for putting patients first.

• Strengthen the response of health services to family violence, this includes implementing interventions, processes and systems to prevent identify and respond appropriately to family violence at an individual and community level.

• Participate in the development and delivery of the subregional surgical plan.

• Work with the Consumer Advisory Committee to implement consumer recommendations for service delivery.

• Identify and communicate to all staff the appropriate referral pathways when identifying and responding to family violence at an individual and community level.

• Develop and strengthen partnerships with other regional/subregional services to support a collaborative approach to developing and implementing appropriate support and prevention strategies for victims of family violence.

• Review and implement a training program that ensures all staff are adequately trained and respond to incidences of family violence.

Achieved. • Equipped appropriate staff with the

skills to engage in consultation and discussion with consumers.

• Key staff completed formal consumer engagement for health professionals post graduate training.

• Created social media space to and engage the community and advertise services and events.

• Placed articles / interviews of interest / information in local newspapers and on radio and more recently social media.

• Men’ Health Expo used to connect men to services successfully such as physio and mental health supports.

• “Engaging with Consumers” framework completed and implemented.

In progress. • Agreed a collaborative strategy

approach with Lower Hume PCP to respond to family violence and for the victims of domestic violence.

• Revised the Alexandra District Health (ADH) Vulnerable Babies, Children and Young People at Risk of Harm Policy incorporating Child Safe Standards (2015).




15

Developing a system that is responsive to people’s needs

• Identify service users who are marginalised or vulnerable to poor health and develop interventions that improve their outcomes relative to other groups, for example, women, Aboriginal people, people affected by mental illness, people at risk of elder abuse, people with a disability, homeless people, refugees or asylum seekers, people whose alcohol and other drug use is damaging their health or impacting on their recovery.

• Select priority key marginalised groups in the community and build strategies to improve health outcomes through standardised multi-disciplinary care pathways, particularly in:

- Mental health; and - Alcohol and other drugs.

Achieved. • Local Aboriginal Elder actively

participates in the Consumer Advisory Committee and is committed to the “Welcome to Country” protocol at key events like the AGM.

• ADH monitors use of all services by Aboriginal and Torres Strait Islander(ATSI) community members and reports these in the HACC Diversity Plan.

• Opened a discussion with Murray Primary Health Network to explore opportunities for service development for locally based mental health service demands.

• Completed a pilot run and evaluation of a ‘Better Mood and Motivation’ program for local people with depression.

• Clarified and strengthened local referral pathways for people suffering from alcohol and other drug related illnesses.

• Celebrated ‘Closing the Gap’ and NAIDOC week to connect to ATSI community and ATSI workers.

• Training for ADH staff is now available in relation to cultural responsiveness and its uptake is being monitored by the Community Health Manager.

• Demonstrate an organisational commitment to Occupational Health and Safety, including mental health and wellbeing in the workplace. Ensure accessible and affordable support services are available for employees experiencing mental ill health. Work collaboratively with the Department of Health and professional bodies to identify and address systematic issues of mental ill health amongst the medical professions.

• Review, update and communicate to all employees our Occupational Health and Safety Policy that: - States Alexandra District

Health Occupational Health and Safety Objectives; and

- Demonstrates a commitment from the Board and Management to improving performance including mental health and wellbeing.

• Identify strategies to encourage employees to have a work, life balance and provide information to staff around mental health related support services as part of an employee assistance package.

Achieved. • ADH has developed a formal

Employee Assistance Program Policy with a view now to extending this to incorporate a strategy for positive work attendance.

• ADH offers flexible work options for staff including part time and reduced hours where possible to encourage work, life balance.

Governance, Leadership and culture



16


Safety and quality

• Monitor and publically report incidents of occupational violence. Work collaboratively with the Department of Health and Human Services to develop support systems to prevent the occurrence of occupational violence.

• Promote positive workplace culture and implement strategies to prevent bullying and harassment in the workplace.

Monitor trends of complaints of bullying and identify and address organisational units exhibiting poor workplace culture and morale.

• Undertake and annual board assessment to identify and develop board capability to ensure all board members are well equipped to effectively discharge their responsibilities.

• Create strategies to monitor and promote an aggression free and workplace in the facility and support staff in reporting all inappropriate behaviours on Victorian Health Incident Management System (VHIMS).

• Develop and implement an anti-violence and aggression management training program to all staff including managers and board members.

• Revise policies to include strategies to prevent the occurrence of occupational violence in the workplace.

• Create a positive culture of teamwork and support and provide training about the qualities of effective and respectful communication.

• Encourage reporting of complaints of bullying and harassment.

• Utilise a recognised Board

evaluation process which addresses the principles of effective governance.

In progress. • Code Grey Policy revised and E3

learning availability in place for staff on the topics of occupational violence and bullying in the workplace. VHIMS Riskman system in place to provide a framework to support the formalisation of incidents associated with occupational violence.

In progress. • Implemented a Leadership Group

that meets fortnightly to create a positive united management approach.

• E3 learning mandatory module to be completed every two years.

Achieved. • Board education plan and an

associated budget line completed with log of education completed by Board members.

• Board evaluation process in place and annual Board Work plan revised in January of each year.

• Ensure management plans are in place to prevent, detect and contain Carbapenem Resistant Enterobacteriaceae as outlined in Hospital Circular 02/15 (issued 16 June 2015).

• Implement effective antimicrobial stewardship practices and increase awareness of antimicrobial resistance, its implications and actions to combat it, through effective communication, education and training.

• Develop and implement management plans and prevent detect and contain Carbapenem Resistant Enterobacteriaceae as outlined in Hospital Circular 02/15.

• Establish a local antimicrobial plan and implementation strategy that increases workforce awareness of antimicrobial resistance, its implications and actions to combat it.

Achieved.• Carbapenem Resistant

Enterobacteriaceae (CRE)• Policy document defined which sets

the standards for CRE prevention, detection and containment.

Achieved.• Regular antimicrobial use

auditing with improving results• Participate in the Hume Region

Infection Prevention and Control Compliance and AS4187 Audits with favourable results.

Governance, Leadership and culture



17


Safety and quality

• Provide information and support about prevention, risk factors and early detection and management of diseases by employing a prevention detection approach similar to the ‘Supporting patients to be smoke free: an ABCD approach in Victorian health services’ model.

• Implement early identification and early intervention health promotion management strategies for key risk factors (e.g. Diabetes).

Achieved. • The 2014 Quality of Care report

was presented in 2015 calendar format, with a clear focus on health promotion and the promotion of ADH values with respect to quality and effectiveness of care.

• A number of program plans have been completed in alignment with sub-regional and regional objectives and including ‘Healthy Eating’ and ‘Alcohol Harm Minimization’ programs.

• Heart Health walking groups and Cardiac and pulmonary rehabilitation groups align with Heart Health Strategy.

• Established diabetes education, diabetes self-management groups (August 2015) Healthy Living with Diabetes multi-disciplinary monthly diabetes education sessions.

Financial Sustainability

• Improve cash management processes to ensure that financial obligations are met as they are due.

• Undertake cost benchmarking and develop partnerships with peers to improve operating efficiency.

• Implement integrated care approaches across health and community support services to improve access and responses for disadvantaged Victorians.

• Review all cash management processes as part of the existing internal audit program.

• Progress and establish a formal partnership via Hume Chief Executive Officer forum to deliver efficiencies in corporate services.

• Participate in regional projects to develop new models of care for commonwealth Home Support Programs.

Achieved. • Established an action plan

for the implementation of all recommendations received against a recent external Accountant services review.

• Financial Review undertaken in response to deficit; FMIP and Action Plan developed and implemented with favourable results.

• Commenced revision of the ADH Audit Committee charter, schedule and agenda.

• ADH Finance and CQI Committees driving the development of enhanced management reports inclusive of risk, activity and human resource data.

Achieved. • Attendance and participation in

Hume Region CEO forum.• Annual benchmarking comparison

by external accountant with up to 20 other rural health services.

Achieved. • Developed a shared support model

with local Government focused on providing support for community based carers who provide home support for people with dementia. Launch of program scheduled for 10th Feb 2016.

Access



18


Access • Progress partnerships with other health services to ensure patients can access treatments as close to where they live when it is safe and effective to do so, making the most efficient use of available resources across the system.

• Optimise system capacity in line with 2015-16 growth funding.

• Progress and establish a formal partnership via Hume Chief Executive Officer Forum to deliver local clinical services in elective surgery.

Achieved. • Continuing discussions with GVH in

relation to ENT surgical list delivery at ADH.

• Increased availability of Urologist and Nephrologist, albeit with modest uptake.

• Respiratory Physician consulting services commenced.

• Gastroenterology service maintained with recruitment of Gastroenterologist.

• Antenatal Outreach clinic commenced in April 2015 provided by Mansfield District Health at Alexandra District Health.

• Revised level of surgical services to manage waiting lists resulting decrease in wait times to procedures.

• Video Conferencing unit now situated in Urgent Care linked to North East Health Emergency department as part of pilot project to provide medical consultation as necessary. Completed on-site training sessions.

In progress.• Discussions commenced with other

health services about the potential for such arrangement.

• Facilitate access to Alexandra District Health operating room capacity to other health services that are unable to meet demands within current operating room capacity.

• Optimise system capacity in line with 2015-16 growth funding.



Key Financial and Service Performance

19

Part B: Performance priorities

SAFETY AND QUALITY PERFORMANCE

Key performance indicator Target 2015-16 actualCompliance with NSQHS Standards Accreditation Full compliance Full compliance

Cleaning Standards Full compliance Full compliance

Compliance with Hand Hygiene Australian program 80% 87.4%

Percentage of healthcare workers immunised for influenza 75% 91%

Submission of infection surveillance data to VICNISS Full compliance Full compliance

Patient Experience and outcomes performance Target 2015-16 Actual Key performance indicator

Victorian Healthcare Experience Survey – data submission Full compliance Achieved

Victorian Healthcare Experience Survey – patient experience Quarter 1 95% positive 100 % Achieved experience



Governance, leadership and culture performance

Key performance indicator

People Matter Survey – percentage of staff with a positive response to safety culture questions 80% 85%

FINANCIAL SUSTAINABILITY PERFORMANCE

Key performance indicator Target 2015-16 actualFinance

Operating result ($m) 0.10 0.18

Trade Creditors <60 days 40.46

Debtors <60 days 48.19

Asset Management Target 2015-16 actualAsset Management Plan Full compliance Full compliance

Adjusted current asset ratio 0.7 1.97

Days of available cash 14 days 45 days



20

Our Services• Access Worker• Asthma Education• Audiology (private service)• Bounce Back with Babes• Childbirth Education• Cardiac Rehabilitation• Heart Health Program• Continence Management• Diabetes Education• Dietetics• Dindi Early Intervention Program for

children• District Nursing Service• Echocardiography (private service)• Exercise Programs:• Gymnasium• Stall the fall• Gentle exercise

• Strength training• Fit for birth• Hearing Clinic (private service)• Improving Quality of Life Program –

Living with a chronic disease• Lung Function Testing (private

service)• Meals on Wheels• Specialist Outpatient Consultations: (General Surgeon, Gynaecologist,

Ear, Nose and Throat Surgeon, Orthopaedic Surgeon, Paediatrician, Gastroenterologist, Eye Surgeon, Urologist, Cardiologist, Kidney Specialist, Respiratory Physician)

• Occupational Therapy• Palliative Care Support

• Papscreening for women• Pathology (private service)• Physiotherapy• Psychologist• Podiatry (private and HACC

eligible)• Pulmonary Rehabilitation Program• Peer-led Support Groups• Radiology (private service)• Speech Therapy• Strength Training Program• Surgery including: General,

Gynaecology, Ear, Nose and Throat, Orthopaedic, Endoscopy, Urology, Eye Surgery)

• Ultrasound (private provider)• Wound Management Clinic

Adie, Mr Andrews, Miss HBamford, Mr WBond, F RBradbury, A KBunn, Dr PByrne, Ms HCrooke, Dr CCumming, G FDe La Pierre, KDobson, Ms ADobson, Mrs B

Dobson, Mr GGale, Mrs MGale, Mr WGriffiths, A LIser, Dr JJohnston, Mrs DJolley, Mr T and Mrs BLayton, Mr ALester, Mr JMacdonald, Mrs AMatthews, Mr GMcNair, Mrs I

Nihei, MNoye, T JParsons, Mrs BPask, Mrs EPritchett, Mrs MProctor, Mrs WRadford, M KReddrop Mr M & Mrs TRobinson, Mrs HSartori, Mr PScott, Miss MScott, Mr R

Shands, Mrs E BSims, Mrs DSloan, Mr RSmith, Ms JTaylor, Mrs MTate, R HThain, Mrs AWebster, Mrs E SWeeks, A JWelch, Mrs JWhittaker, J WWilliams, Mrs

Life governors

Medical StaffDirector of Medical Services:Dr Peter Sloan MBBS

Visiting Medical Staff:Dr T Chuah, MBBSDr J. Findlow, MB,Ch.B, DCH, MRCPDr L Fraser, MBBSDr M Lowe, MBBSDr E. Zadneprovskaya, MBBSDr M Ashti-Baghaei, MBBSDr M Moghadas, MBBS

Visiting Specialists:Visiting General SurgeonMr R Masters MBBS, FRACSVisiting Obstetrician / GynaecologistDr A Lawrence, B.Sc. (Hons), MBBS (Hons), FRACOG, MRCOG

Visiting GastroenterologistDr P Mahindra MBBS, FRACGP

Visiting Specialist AnaesthetistsDr R Barnes, MBBS, FRANZCADr P Brown, MBBS, B Sc (Hons), FRANZCADr M Coghlan MBBS, FRANZCADr N Gattuso, MBBS, FRANZCADr A Gurr, MD, FRANZCADr M Keane, MBBS, FRANZCADr S Kondogiannis, MBchB, FRANZCADr J Marxsen, MBBS, FRANZCADr J Monagle, MBBS, FRANZCADr C Noonan, MBBS, FRANZCADr A O’Leary MB,c.h.B, FRANZCADr B Slon, MBBS, FRANZCADr R Vittalraj, MBBS, FRANZCA

Visiting Orthopaedic SurgeonsMr N Hartnett, MBchB, FRACSMr J Harvey, MBBS, FRACS orth

Mr C Kondogiannis, MBBS, FRACS

Visiting Specialist Ear, Nose, ThroatMr A Guiney, FRACS

Visiting OphthalmologistDr C Chesney MBBS, FRANZCO, Cataract Surgeon and General Ophthalmology

Visiting Urologist Dr P Ruljancich MBBS, FRACS

Visiting CardiologistDr E Kotschet MBBS (Hons) FRACP

Visiting Paediatrician Dr D Cutting MBBS, FRACP

Visiting Nephrologist Dr P Branley MBBS, BPharm

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