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THE OFFICIAL MAGAZINE OF THE

AUSTRALIAN PRIVATE HOSPITALS

ASSOCIATIONDecember 2012

AS I SEE ITQUALITY IN

FOCUS LEGAL MATTERS

PHARMACYFOCUS

surgical innovationSydney Adventist’s state-of-the-art operating theatre

Mri-safe paceMakersAn Asia-Pacific first for Hollywood

faMily planningAddressing overpopulation on Kiriwina Island

private hospitals helping in the community

001_PH1212_Cover_R2.indd 1 29/11/12 1:51 PM

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Material in Private Hospital is protected under the Commonwealth Copyright Act 1968. No material may be

reproduced in part or in whole without the written consent from the copyright holders (APHA).

Private Hospital welcomes submissions and a diversity of opinion on hospital-related issues and will publish views

that are not necessarily the policy of the APHA. All material must be relevant, cogent, submitted to APHA

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arising from the information contained in Private Hospital.

Private Hospital is published six times a year (February, April, June, August, October and December)

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THE OFFICIAL MAGAZINE OF THE

AUSTRALIAN PRIVATE HOSPITALS

ASSOCIATIONDecember 2012

AS I SEE ITQUALITY IN

FOCUS LEGAL MATTERS

PHARMACYFOCUS

SURGICAL INNOVATIONSydney Adventist’s state-of-the-art operating theatre

MRI-SAFE PACEMAKERSAn Asia-Pacific first for Hollywood

FAMILY PLANNINGAddressing overpopulation on Kiriwina Island

Private hospitals helping in the community

Platinum Associate MembersOrion Health

Gold Associate Members3M HealthcareActive Partners in Health SolutionsAvant Insurance LimitedB. Braun Australia Pty LtdBMDi TUTA Healthcare Pty LtdCcentric Group Coregas Pty LtdGlobal-Mark Pty LtdHealth Industry PlanHolman Webb LawyersHPS PharmaciesJohnson & Johnson MedicalKnight Frank AustraliaLeighton Contractors Pty LtdMedline International Two Australia Pty LtdMedtronic Australasia Pty LtdNexa Group Pty LtdUnique Care Pty LtdVirginia Rigoni Consulting Pty Ltd

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Diamond Sponsor:

Major Sponsors:

Australian Private Hospitals AssociationChief Executive Officer: Michael RoffDirector, Policy & Research: Lucy Cheetham Director, Communications & Marketing & Editor: Lisa RamshawCommunications Officer: Lyndal Bailey

APHA National Council 2012-2014Steve Atkins Healthe Care Australia Henry Barclay Cura Day Hospitals GroupMichael Coglin Healthscope Robert Cooke HealthscopeAlan Cooper Friendly Society Private HospitalAnne Crouch Eye-Tech Day SurgeriesAndrew Currie Healthscope Philip Currie Sydney Adventist HospitalRobert Cusack St Vincent’s Private HospitalRay Fairweather St Andrew’s Toowoomba HospitalChristine Gee Toowong Private HospitalAlan Kinkade Epworth HealthCareBronwyn Mace Epworth HealthCareCraig McNally Ramsay Health CareMoira Munro Perth ClinicKathy Nagle Western HospitalAmanda Quealy Hobart ClinicChris Rex Ramsay Health CareRichard Royle UnitingCare HealthGeoff Sam Healthe Care AustraliaDaniel Sims Ramsay Health CareDenise Thomas Metropolitan Rehabilitation HospitalNick Warden Burnside War Memorial Hospital Inc

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Bowel Preparations

Bowel Kits

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16 Just what the doctor ordered: TLC

Epworth’s Transitional Living Centre

19 Fancy pants to muddy pants

Volunteering for New Hope Cambodia

22 Inspiring future healthcare staff

The Wesley’s new school internship program

24 Operation Open Heart in Fiji

Westmead Private’s staff provide care in Fiji

26 Raising awareness of stroke

Hunter Valley Private is sharing its knowledge

28 Family planning on Kiriwina Island

Norwest Private’s mission to Papua New Guinea

30 Help for country patients Support from Epworth

Medical Foundation

32 Developing orthopaedics in Fiji

Prince of Wales Private nurse helping in Labasa

34 Improved cardiac care Peninsula Private’s first open heart surgery

36 Cardiac care in PNG San staff are helping local doctors develop their skills

38 The healing power of art The new art collection at St Andrew’s War Memorial

06 Editor’s Letter With Lisa Ramshaw

08 President’s Report With Chris Rex

10 As I See It With Michael Roff

12 News From APHA and beyond

56 Policy Patter With Lucy Cheetham

58 Quality in Focus With Christine Gee

60 Pharmacy Focus With Michael Ryan

62 Legal Matters With Alison Choy Flannigan

64 Since the Last Issue

66 Valuing Private Hospitals

70 On The Ground With Maree White

24

16December 2012

40 Surgical innovation John Flynn Private’s new

operating theatre

42 Help to navigate cancer Sydney Adventist’s

Integrated Cancer Centre

44 Improving drug and alcohol nursing

Brisbane Private nurse shares her knowledge

45 Sharing expertise in palliative care

Bethesda links up to online palliative care resources

46 Grafiti A makeover for Westmead

Private’s paediatric recovery bays

49 Improving patient blood management

The National Patient Blood Management Program

50 Robotoc helping hands State-of-the-art surgery

introduced at Sydney Adventist Hospital

51 MRI-safe pacemakers Hollywood Private

implants Asia-Pacific’s first

52 Help for the hard of hearing

St Andrew’s hearing services receive a boost

54 Measuring safety and quality

APHA’s National Collection and Reporting of Safety and Quality Indicators

Also in this issue

In focus: Community involvement Regulars

Contents

36

50

42

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6 December 2012

Editor’s Letter

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ReCently I haD the opportunity to spend a bit of time in the chemotherapy unit at one of our member hospitals. luckily for me, I was not there

for treatment but rather to help the hospital with our campaign around the Government’s removal of the price subsidy on Docetaxel (more on that on page 64). as I spent the day at St andrew’s hospital in toowoomba, I was impressed by the staff – the nurses, the doctor, the pharmacist, even the tea lady who all worked in unison to ensure the 70 patients seen that day all felt looked after and cared for. I was astounded by the staff’s energy, their passion for their jobs and how they made each patient feel important.

I felt fortunate to have spent this day with them and as I started home, I thought about all of the thousands of private hospital staff members around the country who work tirelessly for our patients – helping them in so many ways, ensuring they get the best possible care.

It is these staff members that we celebrate in this issue of Private Hospital. We focus on programs where staff go the extra distance for their patients, like at epworth

Rehabilitation with their transitional living Centre or hunter Valley Private hospital where they work tirelessly to raise awareness of the importance of responding to strokes quickly. there are also stories of nurses giving up their time to volunteer overseas to assist with life-saving surgeries in Fiji and Papua new Guinea or to run a free health clinic in a slum in Cambodia.

More than 50,000 people work in private hospitals across australia and they are all committed to providing the best possible care to our patients. you can see that every day at St andrew’s in toowoomba and in any of our other 300 member facilities. So to all of these amazing staff members, I would like to say thank you for your efforts.

as this is our last edition of Private Hospital for 2012, I’d also like to wish all our readers a happy, safe and fun filled holiday season. I hope you get a break and come back to work in 2013 refreshed and ready to take on a new year!

Lisa [email protected]: @priv8hospitals

Editor’s Letter

Great time of year to value hospital staff

It is good to stop from time-to-time to recognise staff efforts

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8 December 2012

President’s Report with Chris Rex

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The Government has announced further changes to the way private health insurance rebates are calculated

Changes to the way the government will calculate private health insurance rebates were announced by the government in the Mid-year

economic and Fiscal outlook (MYeFo) released last month.

as we suspected all along, the legislation to means test the private health insurance rebate, which passed through parliament earlier this year, was not the end of the attack on the rebate. the latest changes, which propose to strip the rebate from the Lifetime health Cover surcharge and, from 2014, index overall rebate increases in line with the consumer price index (CPI) rather than higher premium rises, will further erode the value of the rebate.

Past trends indicate that premium rises generally outpace inflation with premiums increasing by 80 per cent since 2002 compared to the CPI which has risen by just 28 per cent. It is generally acknowledged that healthcare costs rise at about two and a half times the rate of the CPI, which means that the value of the rebate will continually erode in real terms.

these new measures will affect all 10.6 million australians with private health insurance regardless of their income. and, in addition to the means testing legislation, there is likely to be a cumulative impact in terms of membership drop outs and downgrades.

the government has pinned its reasoning for these measures on economic “savings” but these measures do not make healthcare costs disappear. In reality they just shift the cost from one bucket to another. If private care becomes unaffordable, healthcare costs transfer back to the public system and it is instead paid for by the taxpayers.

over the next two decades we are going to face an ageing population that is unprecedented at any time in our history. any government that does not encourage people to contribute to the cost of their healthcare is sending the wrong message about the ability of the government to adequately do so.

the aPha has argued this point and the regressive nature of the latest PhI changes announced in the MYeFo to key federal MPs in Canberra recently. We had several

receptive meetings and were encouraged by the feedback. the proposed changes must be ratified by Parliament and the government will need the votes of the Independents. We will continue to work on these MPs to fight against these proposed changes.

In the meantime, the silence on these changes from the health insurance industry is baffling. We have an excellent system of balanced public and private health care in australia which should be maintained and one would expect that health insurers would prefer their current membership levels than those in countries like UK where PhI membership is below 10 per cent of the population. the rebate remains a crucial plank in maintaining these levels of participation and represents a great investment from governments to reduce its exposure to the cost of healthcare in the public sector.

the attacks

continue

008_PH1212_President_R2.indd 8 29/11/12 1:56 PM

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As I See It with Michael Roff

10 December 2012

The future of private health

insurance

RecenTly, Two very interesting reports into health insurance were released. The first is a discussion paper on competition in the Australian Private Health

Insurance Market, published by the Private Health Insurance Administration council’s new Premiums and competition Unit (PAcU).

The PAcU was established earlier this year to support an improved understanding of a range of issues surrounding the Australian private health insurance industry and the publication of this discussion paper is the first step in that process. The paper includes a useful discussion of exclusionary products, which it states can be the source of significant customer dissatisfaction. It says these policies are largely considered to be in the interest of insurers, not consumers.

The paper goes on to say: “exclusions are viewed by some industry stakeholders as counter-productive to community rating as they allow the healthy to strip back their insurance, leaving a greater proportion of high cost claimants in the pool for high cost services. Further, the increased use of exclusions may also lead to privately insured consumers choosing public hospital treatment, a result that may work against the

policy objective of private health insurance in easing the burden on public hospitals.”

This begs the question, why would health funds promote products that undermine the policy objective underpinning government support for the private health sector?

The second paper is quite different. It was prepared for Medibank by Deloitte Access economics and is titled The Future of Private Health Insurance Premium Setting: Seeking Integrative Solutions. This is a fairly thinly veiled exercise in self-interest promoting regulatory changes that would expedite consolidation in the health insurance market. I wonder which fund in particular might benefit from such a move?

There are, however, some very interesting statements in this paper, for example:• “consumers don’t understand the

implications of exclusions, which reduces consumer welfare”

• “consumers are unclear about the effect of exclusions”

• “Health funds confuse consumers through product proliferation, intentionally muddying the waters”

• “Health funds game the system by pricing premiums increases higher than in necessary.”

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Do exclusionary products serve only the interests of insurers?

Amazingly, none of this behaviour is the fault of the funds, it is the premium setting regulations and 2nd tier default benefits that are to blame!

In his column, chris Rex discusses the latest attack on private health insurance rebates. word around the traps is that several health funds were actually advocating the kind of changes announced as part of the MyeFo. In return for changes to indexation of the rebate, they wanted the Government to ease the regulatory controls that currently apply to premium setting. coincidentally, this is also the principal recommendation contained in the Medibank paper!

of course, what we may end up with (depending on what happens in the Parliament) is an erosion of the value of the rebate and no change in the regulatory framework.

It’s a good thing that companies like Medibank only enter the public debate to advocate in the public interest. Imagine what would happen if they only looked after themselves!

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APHA News

12 December 2012

A pArtnership between BCnA and Berlei, the My Care Kit is designed especially for women who have recently had breast surgery. the kit contains a specially designed Berlei bra and soft form/s. the bra features seams and lining that avoid pressure, extra hooks and eyes in the back to allow for any swelling, and soft form inserts that can be modified to size, in a style that caters for support and comfort. it is designed to cover the post-surgery period of up to 12 weeks and can be worn during radiation treatment.

since December 2011 the kit has also contained strengthen Your recovery, a post-surgery pilates DVD produced by BCnA and estee Lauder. the DVD features easy-to-follow, gentle pilates exercises and instructions to help regain strength and ease discomfort in the affected arm and chest area after recently having breast cancer surgery.

the kit also comes with a copy of the latest edition of BCnA’s magazine the Beacon and information on BCnA’s My Journey Kit, a free information resource for women newly diagnosed with breast cancer.

the My Care Kit is available free of charge to women in Australia who undergo surgery for breast cancer via health professionals enrolled in the My Care Kit program. Once enrolled, health professionals can order this bra for women in their care.

For more information or to order a My Care Kit please contact BCnA on [email protected] or 1800 500 258.

My Care Kit

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prOFessOr Allan Fels, Chair of the national Mental health Commission, has said that Australia can improve the lives of millions of Australians if the prime Minister, premiers and Chief Ministers – through COAG – reaffirm their commitment to mental health and have the courage to respond tenaciously to the first national report card into mental health and suicide prevention.

A Contributing Life: the 2012 National Report Card on Mental Health and Suicide Prevention is the independent Commission’s inaugural annual report card and is a world first of its kind. Built on the personal stories of people who are not often heard – people with a lived experience of mental health difficulty, their families and supporters – the report card views mental health as an issue affecting every aspect of the life of a person; a “whole-of-life approach”. its theme, ‘A Contributing Life’, recognises that people with mental health difficulties need the same things as everyone else – a stable home, a decent education, a job, family, friends and healthy relationships, good treatment and access to services and rights.

According to the report card, Australia leads the world in progressive mental health policy, but it falls down in delivery. the report card paints a big reform picture, makes ten specific recommendations, and calls for change in a range of areas where the

Commission believes action can and must start now. For example:• reducing the early death of Australians

with severe mental illness and improving their physical health

• Minimising the use of seclusion and restraint

• increasing access to mental health services from the current six to eight per cent to 12 per cent of Australia’s population

• Making the mental health of Aboriginal and torres strait islander peoples a higher priority

• stopping people from being discharged from mental health services into homelessness or unstable homes

• increasing the employment rates of people with mental illness and paying greater attention to supporting them at work

• increasing access to home based visiting to support families and children

• providing effective, local interventions to prevent suicide.

A full copy of the report can be downloaded from www.mentalhealthcommission.gov.au. A series of short videos telling the real stories of real people has also been developed to help engage Australians in the theme of each chapter and bring mental health into the public spotlight as well. Go to: www.mentalhealthcommission.gov.au.

World’s first national report card into mental health and suicide prevention

012_PH1212_News_R1.indd 12 29/11/12 1:56 PM

December 2012 13

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A neW iphone app, created by the Australian institute of health and Welfare (AihW) will allow users better access to health information. the app, Ozhealth, presents the latest facts and figures on the health and wellbeing of Australians and can be downloaded from the Apple itunes store.

‘information is presented in a ‘fact sheet’ format, with each page exploring a different topic in simple, easy to understand language,’ said AihW spokesperson Alison Verhoeven. ‘topics include: diseases and conditions (such as cancer and asthma), injury, risk factors, health spending, the use of illicit drugs, alcohol and tobacco, as well as an overview of the health of particular population groups, such as children, indigenous Australians, and people with low incomes.’

Users can ‘favourite’ particular pages, enabling easy access to topics of interest. Ozhealth also includes a detailed glossary, explaining some of the more complex health-related terms used within the app. it also features an interactive quiz, allowing users to test their knowledge about Australia’s health and health system. ➤

Ozhealth – new app for health information

012_PH1212_News_R1.indd 13 29/11/12 1:56 PM

APHA News

14 December 2012

ACHS President and office bearers re-elected the Australian Council on healthcare

standards (AChs) has re-elected its president, Adjunct Associate professor Karen Linegar for another year. Based in tasmania, professor Linegar is the representative of the Australian College of nursing on the Council. she has been

a member of the AChs Board since 2004, and was elected as Vice president in 2008. professor Linegar has been the executive Director of nursing, Midwifery and Care redesign and Acting Manager primary health – tasmanian health organisation - north West since 2009, and has been

an AChs surveyor since 2005. the AChs Vice-president, Mr John

smith, psM and the treasurer, Mr stephen Walker were also re-elected to their respective positions at the Annual General Meeting, held in sydney.

sUrViVAL rates for breast cancer nationally are improving, however, 37 Australian women are diagnosed with breast cancer each day, according to a report released recently by the Australian institute of health and Welfare (AihW) and Cancer Australia.

the report, Breast cancer in Australia: an overview, shows the number of new breast cancer cases more than doubled from

around 5,300 to 13,600 cases between 1982 and 2008.

‘there was a sharp increase in the incidence rate of breast cancer between 1990 and 1995, after which the rate has been stable ’, said AihW spokesperson Anne Bech. ‘the sharp increase in the incidence rate in the early 1990’s was most likely due to the introduction of the national breast cancer screening program in 1991.

Breast cancer is the most common cancer in Australian women and the majority of cases (69%) are diagnosed in women aged 40–69. ‘the number of women diagnosed with breast cancer is expected to rise in the future due to the ageing population. Our projections indicate that in 2020 about 17,200 new breast cancers will be diagnosed in Australia. this would equate to 47 women being diagnosed every day,’ Ms Bech said.

Breast cancer survival improving,

but 37 women still diagnosed each day

012_PH1212_News_R1.indd 14 29/11/12 1:57 PM

December 2012 15

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COnGrAtULAtiOns to AphA member, st Vincent’s private hospital in sydney which took out one of the three Australian Council on healthcare standards 15th Quality improvement Awards this year.

the Campus Food and nutrition services team won the award in the healthcare Measurement category for their “Making food and nutrition care a priority” project.

the aim of their project was to provide optimal nutritional care and professional hospitality, as a critical component of the patient’s total clinical care package; engendering a collaborative and coordinated approach to patient care.

ACHS Award Winner

the royal College of pathologists of Australasia (rCpA) has launched a fun and light-hearted social media campaign to encourage viewers to imagine a “World Without pathologists”. the campaign, which is the first of its kind in the pathology arena, aims to harness the power of social media to generate discussion and raise awareness of the critical role that pathology plays in everyone’s lives. the online videos and interactive games show a doctor trying to help patients in a world where pathologists do not exist.

professor Yee Khong, president of the rCpA, explains that although these videos are light-hearted and fun, the underlying message is serious.

“this is the first time that the rCpA, and perhaps any pathology group, has utilised social media with a creative campaign to drive its message. We’ve taken a new angle to highlight the crucial role of pathology and pathologists. pathology largely takes place ‘behind the scenes’, so it’s still relatively unknown and its importance is not widely understood by the public. this is a real concern as there is serious message behind our campaign. there is currently a critical shortage of pathologists across Australia, a trend which if left unchecked could jeopardise the profession’s high standards,” says professor Khong.

Visit the website to find out more: worldwithoutpathology.rcpa.edu.au.

pathologists launch social media campaign

012_PH1212_News_R1.indd 15 29/11/12 1:57 PM

In focus: Community involvement

16 December 2012

Epworth’s Transitional Living Centre is helping accident victims get their life back on track

Manager of TLC Helen Harrington walks to the shops with a resident

TLCJust what the doctor ordered:

It is one year since David Jones, 28, was hit by a train while crossing the tracks at north Williamstown. He doesn’t remember being trapped under the train for an hour before

being flown to the Alfred hospital. He only remembers thunder and torrential rain on his way home from work and then waking a month later with a shoulder injury, fractured skull and an acquired brain injury (ABi).

these days he is rapt to be back working as a carpenter on a huge building site in

Prahran, even though his stamina levels have not caught up with his pre-accident ones.

“My boss is a great person. i had only been working with him for about a week before the accident, but he kept a place for me. He has let me come back three half-days a week for now and is mindful of safety, so does not try to push me beyond my endurance levels.”

David spent three months in epworth Rehabilitation, firstly in the hospital unit trying to remember how to co-ordinate his balance, walk, talk and eat. then at the

016_PH1212_EpworthTLC_R2.indd 16 29/11/12 1:57 PM

December 2012 17

The aim is To provide The besT of Care To enabLe

brain injured paTienTs To Live in The CommuniTy

‘‘‘‘thornbury and provides a unique residential

rehabilitation program that helps people with brain injury regain the skills to enable them to return to live in the community. the centre consists of a house and four units and is staffed by a skilled specialist team comprising occupational therapists, social workers, psychologists and allied health assistants.

Manager Helen Harrington said that in the 23 years since the centre was established, everyday heroes make it a very special place. she includes neighbours, staff and families, as well as the patients themselves, who often return as volunteers to continue the great work of the centre by working with new residents.

“the majority of residents come to the tLC courtesy of the tAC (transport Accident Commission) – insurance paid in vehicle registration to cover anyone injured in road accidents in Victoria. these two anagrams are important – the aim is to provide the best of care to enable brain injured patients to live in the community with a lifestyle that maximises their functional ability as well as their quality of life,” she says.

epworth Rehabilitation Director Professor John olver says the idea of a community residence had humble beginnings. “the Keilor Rotary Club understood the need to create something different from a hospital setting for ABi patients. their generous grant saw the program begin – much to the delight of doctors and the salvation Army who were witnessing the frustrations of patients and families.”

David counts himself as fortunate in so many ways – for the fantastic care and ongoing support he receives from epworth and his family; that his physical injuries weren’t worse; that his boss stan is so kind and encouraging; and that all his treatment is covered by tAC.

“Being hit by a train is not lucky, but i am blessed with having the support of my wonderful girlfriend, my mum and dad and family and friends. While i am disappointed there are things i probably can never do again, like playing footy, the real pain for me is when i see how the accident has affected the people who love me. that’s the really hard part.”

transitional Living Centre (tLC), he had to learn how to care for himself all over again and manage emotions and expectations before he could return home to his girlfriend Ash so they could start adjusting to a different life together.

epworth Rehabilitation is one of the largest private sector rehabilitation services in Victoria with more than 225 rehabilitation beds across three sites at Richmond, Camberwell and Brighton. the transitional Living Centre (tLC), also managed by epworth Rehabilitation, is located in

David Jones – back at work one year after his accident

016_PH1212_EpworthTLC_R2.indd 17 29/11/12 1:57 PM

In focus: Making a difference

national recognition?Has your hospital implemented

an innovative initiative worthy of

Call for abstractsPHAQ extends an invitation to all private hospitals and day hospitals to consider submitting an abstract for the 2013

Innovative Practice in the Private Sector Conference and Awards.

PHAQ in partnership with HESTA Super Fund will be hosting the popular Innovative Practice in the Private Sector Conference and Awards at the

Brisbane Convention and Exhibition Centre on 17 June 2013. The conference provides a platform to showcase and reward innovation in the private hospital sector from across the nation.

The 2013 Awards will attract a category award prize of $1,000 to the winning hospital, in addition to each of the category winners being eligible for an overall prize of a further $4,000. Abstracts are now being sought in four categories:• Clinical Innovations • Non-Clinical/Operational Innovations• Innovations in Education and HR

Management• Innovations in Marketing and/or

Community Awareness.

Closing date for submission of abstracts – Monday 18 February 2013

The conference program will be structured around the 16 selected abstracts which will be finalists for the 2013 Innovative Practice in the Private Sector Awards.

Innovative practice need not necessarily involve major projects - practical solutions to common problems will also be considered for presentation however there will be a focus on demonstrated outcomes. Small hospitals and day hospitals are also encouraged to submit.

Guidelines for the submission of abstracts, together with an abstract submission template may be obtained by contacting:

Lucy FisherExecutive Director - Private Hospitals Association of QldTel: (07) 3279 7600 Fax: (07) 3279 7601Email: [email protected] Website: www.phaq.org

018_PH1212_PHAQ_R1.indd 18 29/11/12 1:57 PM

December 2012 19


➤

Thirteen years into my nursing career and, at least on paper, things are looking ok. some might even say great. i’m a nurse unit manager of a

surgical ward in one of Brisbane’s premier private hospitals. i have incredible staff and a director of nursing and general manager who are more demanding and supportive than any i’ve ever worked for.

My work is challenging. i manage budgets and activities as well as encourage my staff to grow and develop their professionalism. all that, plus managing the day-to-day demands of patients and doctors and trying to find the place in it all that keeps all parties relatively happy.

But after three years in this role, i started to think that i needed to be doing something else or something more.

Jody Bonar, Nursing Unit Manager at Brisbane Private Hospital explains the joys and challenges

of volunteering for New Hope Cambodia

muddy pantsFancy pants to

019_PH1212_Cambodia_R2.indd 19 29/11/12 1:58 PM


20 December 2012

Last year i began to investigate avenues outside of health care that would allow me to continue my current role but would fulfil my desire to do more. i researched working for the rsPCa and other volunteer organisations around Brisbane and i looked into further study at university. it wasn’t until i attended a fundraising event for an organisation called new hope Cambodia (nhC), that i eventually found something that sparked my interest.

i attended the fundraiser with my best friend, not because we thought new hope Cambodia was a brilliant organisation but because we celebrated the chance to get frocked up and head out together for the evening. neither of us had heard of nhC and i had never really given too much thought to the people of south east asia. But everything changed on that night.

During the course of the evening there was much propaganda presented to us in various forms and apparently a great deal of money was raised for nhC. i can’t remember if the money was being raised for a particular project but i do remember that i was struck by the fact that they ran a free health clinic in the middle of a slum. through this introduction to the organisation, i began my affiliation with nhC and the helen Bonner health Centre in Mondul 3 village, siem reap in august 2011.

i volunteered for four weeks but when i got home i knew i had to go back and do more

and for a longer period of time. sustainable changes aren’t made over a one or two month period. i applied for and was granted 12 months’ leave without pay from my position at Brisbane Private. i packed my belongings into storage and rented out my unit and headed off for the sequel to my short-term working adventure.

ten months into this adventure and the challenges are still coming through the doors every day. Burns, fungus like bark on people’s feet, some of the worst ear infections i have ever seen with a smell that could be used as a chemical weapon and things i had only ever

Ten monThs inTo This advenTure and The challenges

are sTill coming every day‘‘ ‘‘


December 2012 21

heard of but had never seen in my, evidently, sheltered nursing career.

i have been seeing a lady who is in her late 50s and has been breastfeeding her grandson since his mother left him with her and went to thailand to find some work. When she initially came into the clinic with the scrawny baby boy, i thought that my interpreters were letting me down when they were explaining that he was her grandson but the more i asked about their story, the more i understood that they had it right and my ignorant western mind had it wrong. yes, this woman was the mother to a daughter who was in her mid 20s and had left her baby boy with his grandmother who, like african woman i had read about, started to lactate and feed the baby. i’m still not sure whether or not i would have believed it to be true had she not been feeding him in front of me. this kind of thing doesn’t happen at Brisbane Private.

although the baby was small, he was healthy. But his grandmother was struggling. she wasn’t making enough milk to satisfy his growing hunger and she asked if we could help. We added them to the formula program that nhC runs, gave grandma some extra rice and multivitamins and the health of both of them has improved.

the milk program is a slightly controversial program, with some volunteers to the clinic suggesting that all mothers should be breastfeeding and that nhC has a duty of care to be enforcing this for the betterment of the child. this is a wonderful theory that works well in the west but for the people of Mondul 3, it is a little fanciful.

Unfortunately due to the poverty, people are very undernourished and struggle to eat at all some days. the problem for many women is simply that they cannot produce milk for their babies and for some women the diagnosis of hiV prevents them from breastfeeding. it is the children of these women who we help with the formula program, as their only other option is rice noodles in water.

there are so many other experiences here that seem surreal upon reflection, but the stand out experience every day is that of the gratitude and unbelievable resilience of our patients. the people of Mondul 3 village and the surrounding areas are unlike any group of people i have ever met, let alone cared for. the ailments and complaints that they put up with

and work with everyday are things that would have some of us in the west demanding a private room in a hospital and hours of sympathy from our nearest and dearest.

Obviously all things are relative and in the west we are blessed with excellent health care, which allows us to be demanding and needy of our doctors. But it also allows us to seek treatment and potential cures in a timely manner. in Mondul 3 this didn’t, and still largely doesn’t, exist. What we do have is a clinic, which offers free care including medication and treatments and has begun to see encouraging outcomes for patients. i am so proud to be the coordinator of this clinic and to see how much it continues to improve

the lives of the people in Mondul 3. i have only a few months left on my

contract as coordinator and i am expected back at Brisbane Private in January, but who knows what the future will hold? From the immaculate surrounds of a private hospital to one of the poorest, filthiest slums in south east asia -- life takes some interesting turns when you let it and thankfully nursing allowed that to happen for me. By Jody Bonar

New Hope Cambodia is a not for profit, non-government organisation in Mondul 3 village Siem Reap. For more information visit www.newhopecambodia.com



staff of the futureInspiring healthcare The Wesley’s new school internship program is introducing students to the hospital setting

The Wesley hospital in Brisbane has launched a comprehensive school internship program, which aims to inspire school students

considering a career in the healthcare sector.Pastoral Care Manager and school

Internship Program Manager at The Wesley, Reverend Murray Fysh, said it was the first dedicated intensive hospital school internship program to be held in Queensland.

“We believe the program will be a valuable educational experience and excellent launching pad for the healthcare workforce of the future,” Rev Fysh said.

The tailor-made program aims to provide students from the community with a practical and theoretical insight into working and learning within a hospital setting.

“While the Wesley hospital provides exceptional patient care and a comprehensive

range of clinical services across 35 specialty areas, it also runs a very strong clinical education school and the school Internship Program is now an important element of this,” Rev Fysh said.

“Annually, at a tertiary level, The Wesley Clinical school offers more than 1000 undergraduate clinical placements across all health disciplines and takes its responsibility of teaching very seriously to ensure a positive experience for the student as they journey to become a professional.”

The Wesley Clinical school currently has formal partnerships with The University of Queensland, Bond University, Griffith University, Queensland University of Technology, James Cook University, Australian Catholic University and Careers Australia College of healthcare.

The first Wesley school Internship Program will comprise of 25 year 11 students

from 11 Brisbane schools to spend one week at the hospital from 3 to 7 December. During the week they will be involved in presentations by and discussions with healthcare leaders; tours of departments including theatre, wards and kitchen areas; education sessions including learning new skills in simulation labs; practical work placements with practitioners and daily debriefing sessions.

Rev Fysh said the initial response to the program has been overwhelming with nearly 400 students having submitted applications for the 25 places. The program aims to include a range of students with interests in all healthcare fields including nursing, allied health, medicine and support services.

“Ultimately, we hope to inspire our school interns to pursue a career in the healthcare sector and come back to the Wesley for their undergraduate placements and eventually to work once they graduate,” he said.


22 December 2012

Pastoral Care Manager and School Internship Program Manager, Reverend Murray Fysh and Director of Clinical Education, Wendy Zernike at the launch of the Wesley School Internship Program

022_PH1212_Wesley_R2.indd 22 29/11/12 1:58 PM

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24 December 2012

WestmeaD Private Hospital’s Julie Hulston (Nurse Unit manager and Cardiac Clinical Coordinator), Dr ian

Nicholson (Cardiothoric surgeon) and Dr ajay Kumar (Perfusionist) have recently returned from Fiji after volunteering for two weeks at Colonial War memorial Hospital

where they helped save the lives of 34 Fijians.Julie, ian and ajay were part of a team of

volunteers for the program Operation Open Heart, which has been providing life-changing surgery to patients suffering from congenital and rheumatic heart disease for the past 25 years. in Fiji they have no other access to cardiac surgery. For patients suffering with cardiac disease, this means

in FijiOperation Open Heart

Westmead Private Hospital staff give their time to support those in need in Fiji

Julie Hulston and Dr Ian Nicholson during surgery

024_PH1212_Fiji_R3.indd 24 29/11/12 1:59 PM

December 2012 25

OperatiOn Open Heart is tHeir Only cHance OF receiving tHe critical treatment tHey

desperately need‘‘

‘‘

that Operation Open Heart is their only chance of receiving the critical treatment they desperately need.

tim Daniel, chief executive officer of Westmead Private Hospital, said he was extremely proud of the team.

“We sometimes take for granted the complex clinical expertise we have at Westmead Private Hospital,’ he said. “it is nice for our staff to give back to those who are less fortunate than us.”

For Julie, this was her ninth Operation Open Heart trip and her sixth trip to Fiji. Julie explains that it is the local Fijians’ attitude that keeps her going back.

“the people are so grateful and appreciative of us and our help. even when we are unable to operate on everyone either due to the fact that they are too sick or high risk, or because we physically cannot do an unlimited number of cases in the two weeks we are there.

“the hardest part is sitting through the case presentations a couple of weeks before we operate and reducing the list to what is physically possible by the team. We also have to have a few patients on ‘reserve’ as sometimes patients or their parents change their mind or cannot make it to the main island in time. Having to send people home without a scheduled operation is always heart breaking. Fortunately we have only had a few unplanned and sad outcomes which can be very emotional for the team.”

another challenge the team must deal with is working with limited resources. For each trip the team needs to ship approximately three tonnes of equipment from australia to Fiji in order to be self-sufficient. the team then has to manage their instruments and mitral valve replacements throughout the

Julie with patient Nancy

two weeks. Julie briefly describes the daily procedure that the team has in place to manage the equipment.

“We usually have two full teams on duty and each has to get the theatres set up for their first case (some days are harder than others when the locals ‘borrow’ the equipment overnight). We then use the local sterilising department, however due to the limited number of trays and equipment, we have to keep a close eye on the turnaround time so that it will not impact on the scheduled cases and that we get all of the equipment back in time.

“in the paediatric theatres, we make sure we schedule varying weights of children so we don’t use all the same sized instruments all at once and we usually bring another theatre team member in mid-morning so they can help with the washing and drying up of equipment.

“We also do a large number of mitral valve replacements so we need to keep a close eye on what size valve we are putting in so we don’t run out of valves. Just about every trip, no matter how hard we try, we end up phoning australia for an urgent delivery of heart valves.”

Julie’s biggest highlight from her nine trips is operating on paediatric patients. most of the patients at Westmead are adults, so it is different to her usual day-to-day operations. Julie finds it extremely interesting and challenging with the smallest baby operated on weighing 2.1 kilograms. another highlight for Julie is the perioperative environment with the other international nurses and interstate volunteers.

“We learn a lot from each other and it’s amazing the similarities we have in our work and also some obvious differences,” says Julie.

024_PH1212_Fiji_R3.indd 25 29/11/12 1:59 PM


26 December 2012

Hunter Valley Private Hospital is raising awareness of the importance of responding quickly to stroke and the important

role private hospitals play in helping stroke survivors recover by sharing the story of patient Bryan lynch.

Friday 13 July was a black day for Bryan, 80, who was working in his son’s garage when the stroke struck. a love of embroidery has been a strong motivation for the retired electrician to successfully recover.

Mr lynch started his ongoing rehabilitation at Hunter Valley Private Hospital’s specialist rehabilitation service during Stroke Week. twice a week for half a day, staff such as occupational therapist Bridget Bynon have been giving him exercises

to help correct his speech, eating difficulties and improve the use of his arm and hand. the exercises include simple things such as picking up shirt buttons and pins to get Mr lynch’s fine motor skills back to normal as well as puckering his lips and cheek smiles to strengthen facial muscles.

Ms Bynon said having the goal of getting back to his embroidery has been an important factor in Mr lynch’s great recovery. She said he is making excellent progress in regaining the use of his arm and fingers, in his speech and eating.

Mr lynch took up embroidery seven years ago after he tore tendons in his shoulder, which stopped him from playing bowls. He is famous among family and friends for embroidering Disney and other cartoon characters on shirts, bags and towels. His

favourite characters include Sylvester the cat, Foghorn leghorn and tramp.

Hunter Valley Private Hospital CeO lance Wheeldon said that people underestimate the impact a stroke can have on their lives, not just physically, but in terms of confidence and re-learning living skills. Hunter Valley Private Hospital specialises in rehabilitation, including from stroke. It has a 20-bed rehabilitation unit, dedicated team of nurses and allied health professionals, a gym, hydrotherapy pool, an independent living centre and outdoor rehabilitation area.

Mr Wheeldon said the provision of day rehabilitation programs was expanding because they allow people to be at home, where they want to and need to be, while still accessing care.

strokeRaising awareness of

L-R: HVPH occupational therapist Bridget Bynon, Brian Lynch, HVPH speech therapist Emma Paisley

Hunter Valley Private Hospital is sharing its knowledge to help stroke victims survive and recover

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28 December 2012

Kiriwina IslandFamily planning on

Back (L-R) Anna Smith, Dr Greg Jenkins, Dr Don Butler, Patricia Butler, Barbara Hough.Front (L-R) Wendy Stein (team leader), Marian Piper and Dr Gee

028_PH1212_Norwest_R2.indd 28 29/11/12 1:59 PM

December 2012 29

Norwest Private Hospital’s medical mission to Papua New Guinea

There Is much To be done buT The journey of a Thousand mIles sTarTs wITh one sTep‘‘ ‘‘

Ateam from Norwest Private Hospital’s maternity unit recently visited a remote island off Papua New Guinea (PNG) to help address the

problem of overpopulation.Nurse unit manager marian Piper,

obstetrician Dr Greg Jenkins, paediatrician Dr Don Butler and midwives Patricia Butler, Barbara Hough and anna Smith travelled to Kiriwina Island located off the eastern coast of Papua Guinea. the island has a mostly indigenous population of subsistence farmers.

the team from Healthscope’s Norwest Private Hospital journeyed to Kiriwina Island as part of rotary’s Save the Kula Babies project. the team’s mission was to initiate family planning options and initiatives for the women and families in the island’s capital Louisa.

Island women asked for family planning to address the increasing birth rate and subsequent overpopulation. With no contraception available, birth rates are high and most women on Kiriwina Island have seven or more children.

“Until 12 months ago, there had not been a doctor on this island for 27 years,” said marian Piper. “the island’s infant and maternal mortality is one of the highest in the world.”

Sexual health issues, typhoid, malaria, pneumonia and water pollution are typical

on Kiriwina Island. average life expectancy is only 54 years.

“Due to the remoteness, overpopulation, regular food shortages, violence and conflict over land, the people of the islands often face economic, health and financial hardships,” said marian.

Kiriwina Island’s only health centre has minimal running water, basic facilities and limited medical supplies. electricity is only available between 6am and 10pm when the diesel generator is running. a small but dedicated nursing team is supported by Dr Giyodobu tosiyeru, known as Dr Gee.

the Norwest Private Hospital team successfully overcame language barriers to introduce family planning. over a week, 384 women benefited from the mission.

“this was the first time a medical team from outside PNG has visited the island and the response was overwhelming,” said marian.

“Women came on foot from villages and canoes from surrounding islands,” she said.

Local nurses were trained to continue the family planning initiatives. a follow up mission in october 2012 allowed a few members of the team to evaluate outcomes of the earlier trip, as well as provide education and outreach to the Kiriwina Island community.

“there is much to be done but the journey of a thousand miles starts with one step,” said marian.

028_PH1212_Norwest_R2.indd 29 29/11/12 1:59 PM


country patientsHelp for Rural and regional cancer patients are receiving accommodation support from the Epworth Medical Foundation

Cancer patients living in country Victoria often need to travel long distances or arrange to stay in the nearest city centre to

complete a six-week course in radiation therapy as part of their recommended cancer treatment. During 2012, thanks to a specified donation, the epworth Medical Foundation (eMF) established a program to provide accommodation support grants to rural patients coming to Melbourne for their treatment.

recently, patricia Jones completed six weeks of daily treatment at epworth Freemasons radiation Oncology. With husband ray, they often took a stroll in the treasury Gardens before going ‘home’ to their apartment at tribeca – right opposite

the hospital in east Melbourne. Both retired, they normally enjoy living

in the wide-open space of regional Victoria. shepparton is where patricia grew up and where she and ray were married more than 50 years ago. When patricia’s last breast screen identified a lump, she had the surgery locally and was referred to the nearest radiation clinic in Bendigo for the next step in her cancer treatment. the distance between the towns is more than 120 kilometres, so driving there and back for a 10-minute appointment every day for six weeks was not a practical option.

“Being pensioners, we are not in a position to pay for an extended, expensive stay in a hotel or apartment,” patricia said. “i was pleased to be considered so quickly for the epworth accommodation support. it meant

i could proceed with the next lot of therapy six weeks after the lump was removed.“

the Department of Health provides a daily accommodation subsidy for rural and regional cancer patients needing to stay near a city centre. eMF negotiated with tribeca apartments to allow its patients to stay for the reduced Monday-thursday night rate every night, which is covered by combining the government rebate with a top-up from eMF.

so far, at no extra cost to themselves, several country patients have completed their course of radiation treatment in Melbourne earlier than they could have had they travelled to their nearest regional city centre.


30 December 2012

Patricia Jones talks about her treatment at Epworth Radiation Oncology

Preparing for radiation

therapy

phot

os b

y M

ark

che

w

030_PH1212_EpworthCancer_R1.indd 30 29/11/12 2:00 PM

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32 December 2012

A Prince of Wales Private Hospital nurse takes her theatre knowledge to a Fijian hospital

FijiDeveloping orthopaedics in

SyDney-baseD registered nurse angela Grein assisted orthopaedic surgeon Dr andreas Loefler on a charity trip to Fiji earlier this year. angela took

time away from her role as operating theatre manager at Prince of Wales Private Hospital for the trip.

It was the sixth time angela has volunteered her time and skills with Orthopaedic Outreach, a charity established by the australian Orthopaedic association

that provides surgical training and services in underdeveloped Pacific countries.

“The tenet of the charity is for australian orthopaedic surgeons and nurses to form ties with a Pacific hospital and its staff,” explained angela.

angela and Dr Loefler spent a week at Labasa Hospital in Labasa, the main town of Vanua Levu, the second largest island in Fiji, and home to approximately 28,000 people. Labasa Hospital also services neighbouring islands and rural towns. The hospital relies

032_PH1212_Labasa_R2.indd 32 29/11/12 2:00 PM

December 2012 33

Our rOle is tO teach and train lOcal staFF and this can be a challenge given

their limited resOurces‘‘

‘‘feet,” said Dr Loefler. “There is presently no prosthetic service for amputees.

“Our role is to teach and train local staff and this can be a challenge given their limited resources,” said angela. “staffing of the surgical department has improved with Dr alipate, who successfully completed the Master of surgery in Fiji.”

Dr alipate plans to undertake further orthopaedic training in australia or new Zealand.

“There is presently no registrar at Labasa Hospital, but there are three keen residents who all wish to enter the surgical training program,” said angela.

During the trip, angela assisted in the orthopaedic clinic, spending much of her time organising the operating theatre lists.

“We did twenty surgeries including knee arthroscopies, hip hemi-arthroplasty, spinal decompression, ankle fracture and a supra condylar fracture of the humerus,” said angela.

“Due to a paucity of equipment we had to balance the theatre lists to leave sufficient time to sterilise the sets.”

angela carefully inspected donated arthroscopy equipment to ensure it was in good working order.

“The C-arm was not in good condition and it was a challenge to get an x-ray cassette positioned under an anaesthetised patient undergoing a spinal decompression,” she said.

surgical cases included a lacerated tendon caused by a cane knife, a common injury in Fiji where sugar cane is harvested by hand. The team also assisted a fisherman whose lower leg was lacerated by a barracuda, severing his peroneal tendons.

“Rugby is a national obsession in Fiji and we saw the usual assortment of related injuries – most seriously, three young men with cervical fracture dislocations in traction,” she said.

between procedures the volunteers treated bone and joint infections including chronic osteomyelitis, and gave lectures to hospital staff.

“I feel the visits are worthwhile and I appreciate the support readily given by management at Prince of Wales Private Hospital and Healthscope,” said angela.

on donated medical supplies including instruments, plates and screws.

With no specialist orthopaedic surgeon in the region, hospital staff and patients rely on Dr Loefler’s bi-annual visits. Dr Loefler said the purpose of visiting Labasa Hospital is to teach resident medical and nursing staff the principles of orthopaedics.

“The orthopaedic workload includes much trauma which presents late, acute and chronic infection, post-traumatic arthritis and many patients with diabetic ulcers of the

Angela Grein (centre) with Labasa Hospital staff

032_PH1212_Labasa_R2.indd 33 29/11/12 2:00 PM


34 December 2012

Peninsula Private Hospital has performed the first open heart surgery on the Mornington Peninsula

Improved

on the Peninsulacardiac care

The first open heart surgery at the newly redeveloped and upgraded Peninsula Private hospital in frankston was successfully completed recently.

former Mayor of the Mornington shire, 74-year-old Mr Brian stahl received a new heart valve and a coronary artery bypass in the first open heart procedure performed since the hospital’s recent expansion.

Private patients in frankston and the Mornington Peninsula are already reaping the benefits of major redevelopments at both

Peninsula Private hospital and Beleura hospital, which include expansion of surgical and mental health services, additional beds and new critical care facilities.

the development projects, costing $19.2 million and completed in August, were jointly funded by ramsay health Care and Australian Unity investments, which owns both hospitals through its healthcare Property trust.

CeO of the two hospitals, Mr Greg hall said: “the new developments will assist our hospitals to meet the growing demand for

034_PH1212_Beleura_R2.indd 34 29/11/12 2:00 PM

December 2012 35

private hospital services in frankston and on the Mornington Peninsula due to the growing and ageing population in the region.

“As part of these redevelopments we have expanded our operating theatres and bed capacity at both hospitals; increased the number of beds at Beleura for mental health and have established an intensive care unit at Peninsula to permit more complex operations including open heart surgery to be undertaken at this hospital.

“Peninsula and Beleura hospitals are held in high regard by patients and health practitioners having served the local and broader communities well over many years. We are delighted to be able to offer these new facilities to the community.

“these developments will provide a major boost not only to health services on the Peninsula but also to the local economy in terms of job opportunities for nurses and other hospital support staff.

The InTensIve Care unIT and open hearT surgery servICe provIde an alTernaTIve for

paTIenTs Closer To home‘‘

‘‘

on the Peninsulacardiac care

“in particular we are recruiting for the new intensive care unit which has opened at Peninsula Private. this is the only private intensive Care Unit on the Mornington Peninsula and there are ample opportunities for highly skilled critical care nurses to apply their skills locally and not have to travel up the city hospitals.”

Major redevelopments began in August 2011. New state-of-the-art operating theatres have now been completed at both facilities; a new 13-bed extension has been opened at Peninsula Private and a new 25-bed ward was recently opened at Beleura Private. the highly anticipated seven-bed intensive Care Unit is now open and admitted its first patients at the end of August 2012.

it is only through this investment that it was possible for Mr stahl to have his surgery close to home. even though he lives in hastings, the short journey to frankston is significantly quicker and easier than travelling

to a city hospital for complex surgery.Dr Gregory szto, Cardiologist at Peninsula

Private hospital referred Mr stahl to Mr Adrian Pick for surgery, who performed the first heart surgery at Peninsula Private hospital. the procedure took a little under three hours to perform. Mr stahl spent several days in the intensive Care Unit and subsequently transferred to the cardiac unit for ongoing care. Both cardiologist and cardiac surgeon were very pleased with the procedure and the very good outcome.

About 250 Victorians with private health insurance who live in frankston and the Mornington Peninsula undergo cardiac surgery every year and up until now they have had to travel off the Peninsula to have their operations. the intensive Care unit and open heart surgery service provide an alternative solution for these patients closer to home. By David Calladine

Brian Stahl in recovery after

his surgery

034_PH1212_Beleura_R2.indd 35 29/11/12 2:01 PM


36 December 2012

Papua New Guinea

Cardiac care in

San Radiology Nursing Unit manager Richard Todd with a patient

36 December 2012

036_PH1212_PNG_R2.indd 36 29/11/12 2:01 PM

December 2012 37

SaviNG liveS aNd makiNG medical aNd NurSiNG Staff

Self-SufficieNt iN heart SurGery waS the aim

‘‘‘‘

SyDney ADventist Hospital (the san) staff were among an Australian contingent who used their expertise to change the lives of 27 children and eight adults

during a recent six-day surgical operation in Port Moresby.

saving lives and making medical and nursing staff in Papua new Guinea self-sufficient in heart surgery was the aim of Operation Open Heart, the san’s humanitarian aid overseas cardiac program.

san volunteers were joined by staff from other public and private facilities around Australia to make a 64-strong team which operated on children as young as six months old with potentially fatal heart failure and congenital (birth) defects including holes in the heart. the Australian team worked side by side with Papua new Guinean doctors and nursing staff, helping develop and increase the local teams’ skills to make them self-sufficient.

the san’s Radiology nursing Unit manager Richard todd has been donating his time and expertise – taking annual leave and contributing towards trip expenses – for several years.

“so much has changed since i was last here seven years ago. the local surgeons are now operating independently and nursing staff are much more confident. Clearly, the work we

are doing is making a real difference.” Working alongside san staff, sydney

Children’s Hospital’s anaesthetist Dr Matthew Crawford was another member of the contingent who played a critical role in training the local medical staff. Dr Crawford instructed in general intensive care, cardiac care and anaesthesia. He has been volunteering for the program since 1993 and is also working with the University of Papua new Guinea to create a formal training program for the local staff.

“We are providing the training and education at a post-graduate degree level, similar to what they would receive in Australia,” he said.

“there will be clinical based learning followed by a final exam. these local medical teams will be enormously powerful in creating the future by taking over the work we have been doing. We must have people who can lead after us.”

Operation Open Heart has been travelling to Papua new Guinea annually for the last 19 years and has performed 783 free life-changing surgeries. Operation Open Heart is part of the hospital’s HealthCare Outreach Program that began in 1986 when then san nurse Russell Lee, who has gone on to become a driving force of the program, was appalled that residents in tonga were

dying from conditions that were readily and easily treated here.

the team from around Australia included two cardiologists, three surgeons, seven anaesthetists, four perfusionists, three engineers, 39 nurses, three intensivists, a physiotherapist, a pathologist and a pharmacist. they all donated their time, skills, expertise and contributed financially towards their trip expenses as they are motivated to ensure patients in Papua new Guinea have access to same medical treatment readily available in Australia.

Anaesthetist Dr Matthew

Crawford

Sydney Adventist Hospital staff are helping others develop the skills to help themselves

A patient in Papua New Guinea

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38 December 2012

ARTThe healing power of

Dr Phil Hall and Tony Anderton, coordinator for Art from the Margins

St Andrew’s War Memorial Hospital’s new art collection

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December 2012 39

Gynaecologist Dr Philip Hall is a visiting medical officer (VMO) at St Andrew’s, a passionate private art collector and the volunteer curator driving the hospital’s burgeoning art collection.

“Art is important in hospitals – beautiful works of art have a healing presence. Many major events in people’s lives take place in hospitals: births, deaths and treatment for serious illness or injury, and its important our hospitals are places that help healing,” Dr Hall said.

“The best hospitals are centres of care, not sterile institutions, and art has been found to contribute to patient recovery. I have been very pleased to volunteer for this important project and I really value the support of St Andrew’s management and the UnitingCare Health group,” Dr Hall said.

In October, St Andrew’s launched a new donor program to encourage philanthropic support for the project.

“We have already had some encouraging support as we grow our art collection and at the same time support Indigenous artists, Art From The Margins, young artists finishing their degrees and other people active in the art world.”

Dr Hall said his interest in art went back decades. “I have been a collector for 30 years, I have been to art school as an adult and have some understanding of art theory. I thought St Andrew’s, with its positioning statement, ‘First-class treatment, world-class results’, needed an art initiative to match.”

Dr Hall’s interest in launching an art collection at St Andrew’s began after a highly successful hospital redevelopment was completed three years ago.

“When the hospital was rebuilt, there was a budget for rented artworks, but most of the art was not very remarkable. So we have revamped the rental budget into a small kitty to buy art and we hope this will be expanded by philanthropic support.”

Some recent initiatives include:• Supplying a collection of artwork created

by Northern Territory Indigenous artists• Procuring a notable national collection of

prints, entitled “Divine Geometry”• Sponsoring the final year art prize for

Griffith University Fine Arts honours students (PhD visual arts student Alija Bezer won the 2012 award for her “Etude Series” now displayed in the hospital); and

• Working with the Wesley Mission Brisbane’s creative initiatives Art From The Margins project to display artworks created by disadvantaged artists in the hospital.

Dr Hall said the Art From The Margins work included some exceptional pieces, which are being displayed in a new gallery space.

“When St Andrew’s new hospital was built

it included an extensive linking corridor. This area and an adjoining room is the perfect location for an art space,” Dr Hall explained. “Recently we had one of Australia’s foremost contemporary artists, Imants Tillers, visit to support our project – we hope to acquire one of his works which fits with our values.”

Dr Hall said he was particularly proud that St Andrew’s was supporting Indigenous artists. “UnitingCare Queensland has a strong commitment to reconciliation and displaying this beautiful art is part of our support for this community.”

Other initiatives include providing a scholarship for an Indigenous artist from the Art From The Margins group. Future plans include an artist-in-residence program and offering art therapy as part of rehabilitation.

Dr Ian England, general manager at St Andrew’s, said the hospital was proud to support the new art initiatives.

“We hope our patients, visitors and staff enjoy the unique art from so many talented artists - this will become a valuable asset to the hospital and also represents important cultural change.”

ART IN hospitals is not rare but it may seem surprising for a hospital to launch a new art collection when it has been successfully providing

patient care for more than 50 years. But that is precisely what St Andrew’s War Memorial Hospital in Spring Hill, Brisbane is doing because of the recognition of the healing power of art.

We hope ouR pATienTs, visiToRs And sTAff enjoy The unique ART fRom so mAny TAlenTed ARTisTs‘‘ ‘‘

038_PH1212_StAndrews_R2.indd 39 29/11/12 2:01 PM


SurgicalinnovationJohn Flynn Private Hospital opens its EndoAlpha Operating Theatre

On 10 September 2012, John Flynn private Hospital on the Gold Coast officially launched their new endoAlpha Operating

theatre. this state-of-the-art theatre is the first fully integrated, glass modular operating theatre in Australia and the first theatre in the world that incorporates the latest theatre technology developed by Olympus.

Launched by mr michael Siddle, Deputy Chairman, ramsay Health Care, this multimillion dollar theatre was built in collaboration with Olympus Australia and

Draeger medical Australia and features the latest endoscopy, digital image management and glass-panel technology that is expected to transform operating theatres. equipped with video streaming and conferencing capabilities, the new theatre will enable surgeons to perform operations while transmitting live high definition procedural video to surgeons and students throughout the world, for teaching and training purposes.

From a functionality and aesthetic standpoint, this stunning theatre contains design and functionality geared towards facilitating a successful and modern

operating environment the likes of which have yet to grace Australian shores.

enclosed in spectacular blue glass walls aimed at improving disinfection of the operating environment while substantially decreasing wear and tear of the room as well as creating a working environment that delights staff, this room contains an undeniable ‘instant wow-factor’ upon first impression.

the room also contains automated blue glass doors with rubber kickers for access to the room without requiring an un-natural entrance method which is typically

Improving care

40 December 2012

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December 2012 41

Inspecting the new theatre

important for sterilization purposes. this, as well as automated blinds, are small examples of the design detail that has taken place within this theatre which truly sets a benchmark in design.

Surgeons can utilise the high definition video conferencing and recording capability, choosing from a variety of image sources, including a high definition in-light camera, to broadcast consultation and education sessions or live cases, internally throughout the hospital or worldwide. this will enable John Flynn Hospital surgeons to extend their support network beyond their in-house colleagues as well as potentially extending the Australian educational footprint in their respective fields of specialty.

Dr ray randle, Gold Coast Orthopaedic Surgeon, was involved in the development of the endoAlpha theatre and his first patient in the theatre had a total knee replacement performed in early August.

“the most important feature of this theatre is that we can use it for teaching in a way that we have never previously been able. the operation will be transmitted live, through encrypted channels, directly to surgeons, registrars in training, nurses and students who can watch operations and learn in a way not previously possible,” Dr randle said.

“Without the need to travel, surgeons and students can watch repeated operations of the same theme and ask questions live. this reinforcement in teaching will be quite superior to the current one-off observation.”

the theatre also contains technology specifically aimed at streamlining workflow and efficiency including the ability to control all medical and non-medical equipment devices – as well as full Apple ipod integration – via a centralised touch screen and the ability to pre-program ‘scenes’ to configure the theatre’s equipment via a single touch of a button. It is anticipated that this centralised control concept will lead to massive efficiency gains allowing the hospital to ultimately treat more patients.

In terms of surgical equipment, the theatre is the first in the world to showcase the entire range of the latest Imaging platform from Olympus. the latest in surgical visualisation technology will give surgeons the crispest high definition imaging available when conducting surgery while the theatre is also equipped with the world’s only platform that integrates Ultrasonic and Advanced bipolar energies delivered through a single multi-functional instrument, allowing a surgeon to simultaneously seal and cut vessels. this device will allow for the treatment of more patients due to substantially decreasing procedural time while also greatly improving patient recovery times.

John Flynn private Hospital anticipates that with the technology in place, the theatre is in a position to capitalise on the coming internet-enabled health revolution that will see modern infrastructure projects such as the nbn provide hospitals with opportunities for telemedicine and remote consulting.

“With the development of this new theatre, John Flynn will enter a new phase placing the hospital at the forefront as a private surgical teaching facility on the Gold Coast,” said mr Greg Jenke, John Flynn CeO.

Dr randle has already been approached by surgeons in new Zealand, Germany and India wanting to view partial knee and hip replacement surgery and revisions.

This will allow for The TreaTmenT of more paTienTs

while also greaTly improving paTienT recovery Times

‘‘‘‘

040_PH1212_JohnFlynn_R2.indd 41 29/11/12 2:02 PM

42 December 2012

Improving care

The importance of good treatmentYoung chef and mother of two girls, Sole Astudillo, is one of the cancer sufferers who understand how important good cancer treatment is.

“I thought there’s no way I could ever get cancer. I was only 30, isn’t that too young? All I could think was, how do I tell my girls and where do I go now?

“Then I came to the San. I feel safe here and I know that I’m in the best care possible and everyone is there to look after me. I feel special and well looked after at the San.”

Help to navigatecancerImproving care

42 December 2012

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December 2012 43

Sydney Adventist Hospital is to build an Integrated Cancer Centre

RecognISIng ThAT cancer can be a complex and distressing disease with its management requiring multiple tests, consultations, treatments

and recovery, Sydney Adventist hospital (the San) in Wahroonga is building a state-of-the-art Integrated cancer centre of excellence.

Part of the current $200 million redevelopment of the hospital due to be completed by mid-2014, the new centre will build on the San’s existing comprehensive range of cancer services. The Integrated cancer centre will allow better management of patients by:• catering for the expected 40 per cent

increase in cancer• Providing cancer patient navigators• Providing easy access to a wide range of

diagnostic, consulting, treatment and recovery services

• Being designed according to architectural principles promoting healing and wellbeing

• encouraging review of a patient’s diagnosis and treatment plan by multiple specialists

• Improve the quality of and extend lives.

cancer surgeon Associate Professor Michael hughes says the centre will provide a new model of care.

“The best treatment we can offer is access to an Integrated cancer centre where it’s filled with highly-skilled people who all have specialist training, who all understand the role of each other and who can communicate with all other team members. Then a patients’ management plan will run smoothly.”

The San’s existing San cancer Support centre provides free resources and services for cancer patients and their carers. Facilitator of the general cancer Support group Dr Yvonne McMaster says integration of services to provide a complete circle of care in one place and to minimise the stress to patients who are already emotionally vulnerable and compromised by their treatment is long overdue.

“You can’t imagine how hideous it is for patients to have to go from one cancer centre to another… a cancer specialist in one hospital, a radiotherapist at another hospital and another doctor at another. It’s just

craziness. What we need is a place where people can be together, where there is coordination between the specialists, where the staff are warm and sympathetic and helpful and where people can feel at home. We need the San Integrated cancer centre.”

An important example of the benefits the new centre will deliver to cancer patients is the availability of the centre’s cancer patient navigators. cancer patient navigators will act as advocates to mentor and guide patients through the often confusing and vast range of processes they deal with during their cancer journey. Planning for them has been welcomed by other facilitators including Prue Fairlie.

“cancer can be an absolute maze. People are saying ‘where do I go?’ ‘how do I know what’s best for me?’. They really want someone they can trust who is going to help them work out which way to turn and how to navigate the system. our counsellors try to teach them and empower them. Patient navigators at the new Integrated centre will make such a difference.”

Cancer Centre Campaign launchA fundraising campaign to raise $20 million of the money needed to build the Integrated cancer centre has been officially launched. campaign co-chairmen David Murray Ao (formerly of the Future Fund and the commonwealth Bank) and Dick Warburton Ao (chairman of Westfield Retail Trust) have contributed to the cause.

“The San Integrated cancer centre is the vision of people at the coalface of the delivery of cancer services; the doctors, nurses and other health professionals who understand, recognise and are determined to meet the future challenges of cancer. It will be a proud legacy,” said Mr David Murray Ao and Mr Dick Warburton Ao, joint chairmen of the San Integrated cancer centre Fundraising campaign.

The campaign has been widely endorsed. “I admire the San and its commitment to the principle of christianity in Action. They

do great work and have great people,” said former Prime Minister John howard.

“I and many of my family were born at the San hospital,” said author and former broadcaster Peter FitzSimons who spoke at the launch. “Tonight is about people and an institution that can save

generations from here on in.”“This is a good cause which we should all

support,” said journalist and television host Ray Martin who volunteered as Master of ceremonies at the event.

Queries about support for the centre can be made to Barbara Ward on 1300 034 357.

L-R: David Murray, Drs Gavin Marx, Barry Oliver, Michael Hughes, Paul Fletcher MP, Barbara Ward, Dr Leon Clark, Peter FitzSimons and Ray Martin

042_PH1212_SanCancer_R2.indd 43 29/11/12 2:02 PM


Brisbane Private Hospital nurse Colleen Blums is sharing her specialised drug and alcohol nursing knowledge

Clinical nurse colleen Blums from Brisbane Private Hospital has recently been elected President of Drug and alcohol nurses of australasia

(Dana). colleen has been with Damascus Health services at Brisbane Private Hospital since 2003. Damascus Health services assists patients that are dependent on alcohol,

prescribed and over-the-counter drugs.Dana is the peak organisation for nurses

and midwives with a professional interest in alcohol, tobacco and other drugs. as Dana’s new President, colleen will share her vast knowledge and experience of working with patients dependent on substances.

Members of Dana include specialty drug and alcohol nurses, nurse practitioners, as well as nurses working in a variety of other clinical settings. Dana members also work in a variety of professional settings including teaching, research, policy-making, prisons and court liaison.

“nurses working in mental health, maternal health, accident and emergency departments, medical and surgical settings often take the lead in assisting patients who misuse substances,” said colleen.

colleen added that substance misuse and dependence is encountered by nurses working in a variety of clinical settings.

“every nurse needs to be aware of issues around substance misuse, regardless of where they work. it is widespread in our community and may complicate the outcome of other medical treatment,” she said.

colleen said Dana members often work with patients affected by chronic pain, Hepatitis c, blood borne viruses, and those with complications resulting from ongoing substance dependence.

Dana provides professional development, education and mentoring for members. The

organisation also facilitates networking and professional development meetings for members across australia and new Zealand, including those in remote communities.

“One of the ways our members learn is by sharing ideas and developing relationships with colleagues who work in different clinical areas,” said colleen.

recently, Dana members collaborated to develop a framework of standards and competencies relevant to drug and alcohol nursing in any professional setting.

“This framework will form the basis of our next major project which will see Dana develop a process of professional validation or credentialing,” said colleen. “This project will help us better articulate the skills we have to offer organisations and this complex range of patients.”

Through a series of meetings and forums, Dana is consulting with drug and alcohol nurses and other specialist nursing groups across australia and new Zealand.

“Drug and alcohol nursing provides some very interesting career paths, so it’s important we have a clear understanding of the set of skills required by nurses to undertake this work,” said colleen. “We aim to determine firstly if a credentialing scheme would meet this need and then how it could be structured and implemented,” she said.

For more information visit www.danaonline.org or follow Dana on Twitter @Dananews1.

Specialist nursing

44 December 2012

Clinical nurse Colleen Blums from

Damascus Health Services at Brisbane

Private Hospital

improvingdrug & alcohol

nursing

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December 2012 45

Bethesda Hospital links up to online palliative care resources

BethesDa hospital is excited to announce that they have become a founding collaborator with e-hospice, which was launched globally on

2 october 2012 and is managed in australia by palliative Care australia (pCa). the Claremont-based hospital is the only private hospital in Wa to be a member of e-hospice.

ehospice is the first globally-managed news app and website that will deliver international news and intelligence on hospice, palliative and end of life care. Readers online or using their iphone and ipad will have access to current news, best practice, jobs and events from around the globe.

Dr Yvonne luxford, pCa Chief executive officer said: “ehospice will bring together the expertise and experience of the global hospice and palliative care community in one place for the first time”.

Bethesda hospital has an outstanding reputation in the provision of palliative care, through their 24-bed in-patient palliative Care Unit (pCU) and their palliative ambulatory service North (pasN) – a mobile consultancy service based at the hospital and funded by the Wa health Department.

Bethesda has also just become partners in a collaborative palliative care learning project with the University of Notre Dame (australia) and the University of Western australia. this project provides nursing and

medical students with the opportunity to learn about the provision of palliative care, either at the hospital or in the community, supported by Bethesda hospital staff, a nursing scholar and palliative care physician.

“Bethesda hospital is committed and passionate about palliative care service provision, and being part of ehospice is a fantastic way to share our valuable resources and expertise with others, as well as provide easy to access information for patients”, said Ms Yasmin Naglazas, Bethesda hospital’s Chief executive officer.

Specialist nursing

sharing expertise inpalliative care

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Makeover magic

46 December 2012

Graffiti

The recovery team with the finished mural

Westmead Private Hospital’s paediatric recovery bays have received a makeover

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December 2012 47

THe recovery team of Westmead Private Hospital looked at ways to improve the paediatric recovery bays in theatre to make the area

more child friendly, welcoming and an environment which would put the children and their parents coming in for surgery more at ease. Staff discussed the idea of a wall mural and Jason, an IcU Porter at the hospital, was put forward as a possible artist. Jason is a very talented graffiti artist and in

his spare time has painted pieces all over the world, including in the USA and Thailand. He kindly agreed to spray his magic for a good cause.

The money for the paint ($700) was donated by the volunteers of Westmead Private Hospital from funds raised through their ‘lolly trolley’.

The colourful mural is of cartoon spacemen floating in space and has brightened up the area. It is a real talking piece with staff, doctors, patients and their parents.

The colourful mural has brighTened up The area and

is a real Talking piece‘‘ ‘‘

Jason with the finished artwork

046_PH1212_Graffiti_R1.indd 47 29/11/12 2:03 PM

Creating value with a da Vinci Surgery Program

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December 2011 49

Developing world-leaders in blood management

More than 60 healthcare practitioners from across Perth attended a recent symposium held at the University of Western

australia that discussed the development and implementation of the national Patient Blood Management Program (nPBMP). the program aims to improve clinical outcomes by avoiding unnecessary exposure to blood components and focuses on the optimisation of blood volume and red cell mass; minimisation of blood loss and the patient’s tolerance to anaemia.

Chair of the symposium, upper gastrointestinal and bariatric surgeon at hollywood Private hospital, Winthrop Professor Jeff hamdorf, said the conference was a great opportunity for healthcare professionals to meet and openly discuss how

to use a multi-disciplinary approach in the management of haematological disorders.

“this meeting outlined the optimal use of donor blood and systems to reduce transfusion associated risk for patients,” he said

Clinical haematolgist at hollywood Private hospital Dr Steve Ward’s presentation entitled Iron therapy for optimisation of Patients Pre-operatively discussed the problem of iron deficiency and how healthcare professionals can help manage this prior to a patient undergoing surgery.

“Low iron is an extremely common problem among pre-operative patients and can cause serious implications if not identified and addressed prior to surgery,” said Dr Ward.

“research has shown that correcting low iron levels pre-operatively benefits patients by increasing haemoglobin and decreasing

the risk of infection. Previously undiagnosed iron deficiency in surgical patients increases the likelihood of blood transfusions which in turn is associated with increased mortality and hospital length of stay.”

other speakers at the event included former Chief Medical officer and executive Sponsor of the Wa Patient Blood Management Program a/Professor Simon towler, who discussed the development and system changes required for the implementation of the nPBMP; Mr Shannon Farmer from the Blood Patient Management team at the Wa Department of health, whose presentation outlined the nPBM guidelines; and general and liver Surgeon at Joondalup health Campus Professor Paul Moroz, who outlined the importance of meticulous surgical haemostasis in the PBMP.

Improving care

Improvingpatient blood management

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State-of-the-art surgery introduced at Sydney Adventist Hospital

Healthcare delivery is being transformed at Sydney adventist hospital (the San) with the help of medical science’s robotic surgical

systems. Named after the italian inventor for its combination of technical artistry and science, the new multi-million dollar da vinci Surgical System will be used by San doctors to assist with complex and delicate procedures for both men and women.

Similar to a laparoscopy machine but more refined with even better movement, precision and images, its arrival at the San has been welcomed by the San’s urologists; obstetricians and gynaecologists; colorectal; ear, nose and throat and cardio-thoracic surgeons.

“this machine enables the benefits of laparoscopic surgery – small wounds, decreased blood loss, rapid convalescence,” says dr Phil Bergersen, chairman of the section of Urology at the San. “it allows surgeons to do more things laparoscopically – procedures that are more precise and secure than ever before. it puts laparoscopic surgery safely and rapidly within the reach of more surgeons.”

commonly called the da vinci robot, the machine will increasingly be used for the

thousands of patients that undergo prostatectomies each year to ensure fewer complications, less post-surgical pain, a shorter hospital stay and a faster recovery.

“the machine has a greater range of hand movement and visual acuity than a human hand,” San Urologist associate Professor henry Woo says. “the high definition 3d images provide the surgeon with unprecedented vision that enables surgical precision around vital structures.”

Patients, too, have embraced the arrival of the da vinci at the San. Prostate cancer patient William Wright underwent a prostatectomy in July.

“i don’t feel like i’ve even had surgery, i’ve had no post-surgical pain and haven’t had a pain killer since i came out of surgery,” he said.

Patient Gordon dean underwent a prostatectomy one week after being diagnosed with prostate cancer and chose the San’s da vinci robot over traditional surgery to avoid the large incisions.

“a relative of mine had a prostatectomy some years ago and was in immense pain for quite a while. With the da vinci they operated on me through six very small holes and i’ve had hardly any pain. it was a couple of days in hospital and that was that,” he said.

50 december 2012

Improving care

helping handsRobotic

Dr Philip Bergersen, Dr Phillip Katelaris and Associate Professor

Henry Woo with the da Vinci Robot

traditional surgery for prostate cancer involves making large incisions to access pelvic organs, which can cause significant post-surgical pain, lengthy recovery times and unpredictable impact on continence and sexual function.

the da vinci robot enables physicians with traditional expertise to perform the same surgical procedure through tiny incisions and with greater accuracy by manipulating, scaling and translating their hand movements to the robotic arms operating on the patient. the robot is designed so that the surgeon sits alongside the patient and operates remotely viewing 3d images that result in surgical precision and better preservation of important nerves and blood vessels surrounding the prostate.

”robotic surgery offers a new tool to us as laparoscopic surgeons” said San urologist dr Phillip Katelaris.

“Our existing extensive range of treatments are complemented by this state-of-the-art new generation of technology. it is another measure which reaffirms the San’s position as a centre of excellence for urological treatment on the North Shore.”

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December 2012 51

Hollywood Private Hospital implants the first MRI-safe pacemaker in the Asia-Pacific region

HollywooD Private Hospital is once again at the forefront of medical and technological innovation as one of the hospital’s

cardiologists implanted asia-Pacific’s first ‘Mri conditional’ cardiac resynchronisation (biventricular) pacemaker.

the 71-year-old man who received the revolutionary pacemaker was complaining of worsening shortness of breath and swollen ankles due to fluid accumulation. He was diagnosed with heart failure due to dilated cardiomyopathy (where the heart becomes weakened and enlarged and cannot pump blood efficiently).

His heart failure was difficult to treat despite maximal medications. He had suffered a recent stroke in March 2012 thus necessitating the need for a device that could be implanted to help improve his heart function and still be safe for future possible cranial Mri scans.

Many patients with pacemakers are restricted from undergoing Mri procedures as it interferes with the pacemaker’s functions and leads.

However, the new BiotroNiK evia ProMri® HF-t device has widened the scope of medical treatment that has previously been restricted for people fitted with cardiac resychronisation pacemakers. this is an important consideration as a significant number of patients with pacemakers may be affected by other conditions that often require Mri scanning.

Cardiac resynchronisation pacemakers are designed to help treat patients with heart failure. it sends small, undetectable electrical impulses to both lower chambers of the heart to help them beat together in a

more synchronised pattern. this improves the heart’s ability to pump blood and oxygen to the body in addition to medical therapy. the device itself is actually a miniaturised computer and a battery, contained in a small titanium metal case that is about the size of a pocket watch.

Consultant Cardiac electrophysiologist Dr Shakeeb razak, who performed the revolutionary procedure, said several thousand people in australia get a pacemaker implanted every year and many among them may need an Mri scan during their lifetime.

“in the past patients would be barred from undergoing any Mri scanning as exposure to magnetic radiation could cause complications. But this new Mri conditional cardiac resynchronisation pacemaker is a game changer for patients as it ensures

they can safely receive future diagnostic imaging as well as advanced features such as comprehensive heart failure diagnostics, the unique patented Closed loop Stimulation (ClS) technology and the BiotroNiK Home Monitoring remote monitoring service that allows for early detection of any potential problems,” said Dr razak.

recently appointed Director of Cardiology at Joondalup Health Campus, Dr Jenny Deague said the cardiology team at both Hollywood Private Hospital and Joondalup Health Campus who are part of the ramsay Healthcare Group, were delighted to lead the way in this medical advancement.

“this is truly revolutionary and demonstrates how we can improve the scope of our care and treatment to more of our patients.”

New technology

Mri-safepacemakers

Dr Razak with Rosanna and Robert Hindmarsh

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52 December 2012

Improving care

hard of hearing

Help for the

Improving careImproving care

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December 2012 53

generally patients are able to hear speech clearly enough to once again enjoy a chat‘‘ ‘‘

The world-class hearing service at St Andrew’s Toowoomba Hospital receives a boost

Long waiting periods to see a doctor for adults and children requiring ear, nose and throat surgery will be relieved by the recent commencement of two

ear, nose and throat (Ent) surgeons at St andrew’s toowoomba Hospital.

Dr Suresh Mahendran and Dr Ranit De join local toowoomba Ent surgeons Dr garrett Fitzgerald, Dr Roger grigg and Dr Ross Harrington in providing a comprehensive ear, nose and throat, head and neck cancer service for both public and private patients in toowoomba and the Darling Downs region.

“we have made significant investment in state-of-the-art theatre equipment and expanding medical services. Patients deserve the best care available in a timely manner,” said Mr Ray Fairweather, Chief Executive officer, St andrew’s toowoomba Hospital.

“our doctors treat patients of all ages. Children aged from one year having tonsils and adenoids removed are cared for by our dedicated nursing staff in a safe child friendly environment.”

Prior to moving to australia from the UK, Dr Mahendran was an Ent surgeon and department lead for head and neck/thyroid surgery at ninewells Hospital and University Medical School, Dundee, Scotland, one of the largest teaching hospitals in Europe. He has extensive experience in a broad range of Ent conditions and a specialty interest in head and neck cancer, thyroid disease and managing voice problems.

Dr De was working at the University Hospital Birmingham nHS Foundation trust, Birmingham, one of the world’s largest tertiary referral centres for Cochelar implantation.

For the first time, toowoomba patients with profound hearing loss can benefit from Cochlear implantation surgery.

toowoomba local, Mr Michael Luce was the recipient of the first cochlear implant in toowoomba at St andrew’s toowoomba Hospital, in June this year. He had experienced progressive hearing loss in both

ears and hearing aids offered limited benefit. Social situations were difficult and it was impacting on the quality of his life.

Dr De identified him as an ideal candidate for an implant and it was smiles all round when his device was turned on for the first time by the audiology team. He had an astounding 92 per cent speech identification result at the first test and the audiology team said results will continue to improve over time.

Dr De said the implant is a simple procedure, which can easily be provided in toowoomba, rather than patients having to travel to Brisbane.

“People with hearing loss experience isolation and are unable to hear well enough to take part in conversations. the benefits of the implant are that generally patients are able to hear speech clearly enough to

once again enjoy a chat with their friends and family,” explained Dr De.

“age is not a limiting factor, some patients in their 90s are being implanted.”

Dr De hopes to also perform middle ear implants and Bone anchored Hearing aid (BaHa) procedures as indicated for patients in toowoomba. the hospital also has plans to establish a Hearing and Balance Clinic as part of the expansion of hearing service at St andrew’s toowoomba Hospital.

“we are pleased to be able to offer patients a comprehensive Ent service in the one location. it is wonderful to have Dr Mahendran and Dr De join St andrew’s to support the excellent service provided by our dedicated local Ent surgeons,” said Mr Fairweather. By Louise Cuskelly

Dr Suresh Mahendran (centre) and Dr Ranit De attending to Kathleen McMenamin at St Andrew’s Toowoomba Hospital

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54 December 2012

Improving care

Get involved in APHA’s independent national data collection, analysis and reporting

In early 2009, aPHa established the national Collection and reporting of Safety and Quality Indicators by Private Hospitals project. The collection has established itself as

an independent national data collection, analysis and reporting facility that provides feedback to contributing hospitals on twelve indicators which can be compared with a selection of peers.

The collection has grown from 30 participants to a current list of 116 private hospitals from a range of facility types: 80 are medical surgical facilities, 19 are psychiatric facilities, nine are rehabilitation facilities and eight are stand-alone day procedure centres.

What the program offersOnline submission of data and report access means that facilities can access the edgebox indicator collection to submit data and obtain instantly updated reports.

The program collects data on twelve indicators and currently provides up to two full years of trend data. Participants are able to access trend data for their own facilities and also benchmark against data for their peer group and participants as a whole at national and state level.

What participants sayParticipants use this program in various ways. Some indicators lend themselves to trend analysis and benchmarking while others can trigger critical incident analysis or system review.

“A clear and consistent set of indicators that can be used for both internal and external validation of where a hospital sits in relation to key safety and quality issues.”anne Crouch, CeO, eye-Tech Day Surgeries

“A valuable collection and great initiative by APHA for its members. As a standalone hospital, the benchmarking against other facilities is a most useful value added analysis. Benchmarking is also of value in meeting external quality reporting requirements.”Christine Gee, CeO, Toowong Private Hospital

“Great evidence based and outcome based quality indicators enabling the identification of outliers and improved practices to be put in place. This resulted in a strong and positive accreditation experience.”Bernadette lyons, national risk and Quality Manager, Healthe Care australia

Interesting trendsThe three charts on the next page show examples of the reports that are available to participants.

Hospital readmission (Fig.1): There is a small band of variance in performance since 2010 around a mean of 0.6 per cent. The acute peer group closely matches the aggregate performance of all facilities and rehabilitation facilities have greater variance but generally lower mean rates.

Infection control (Fig. 2): 2010 saw the overall rate jump initially then trend down below the mean. The majority of cases were in the acute peer group. Most peer groups by bed numbers had a mean around 0.03-0.04 per cent. Facilities with 76-150 beds had the least variance in their peer group overall.

Patient falls (Fig. 3): The overall rate remained stable during 2010-2011 with all care types remaining close to the mean. nSW was the best performing state but experienced a high number of cases early in 2010.

Future directionsThe systems underpinning the collection are provided by edgebox Pty ltd under a contract with aPHa and in conjunction with George neale and associates ltd, but the collection has always been participant led through the Indicator Working Group.

Going forward, 2013 will be a transitional year for the collection as aPHa considers the implications for the private sector of the national Health reform Performance and accountability Framework and how aPHa might best advocate for effective indicator reporting and sound interpretation.

For more information contact George neale on [email protected]

Improving careAPHA indicator collection update

safety Measuring

quality &

054_PH1212_CollectionUpdate_R2.indd 54 29/11/12 2:05 PM

Fig. 1: Hospital ReadmissionPeer Group: allnumerator: Total number of unplanned and unexpected readmissions within 28 days of separationDenominator: number of separations (excluding deaths, including same-day)

Fig. 2: Infection Control Peer Group: all numerator: number of patients with blood cultures positive for Staphylococcus aureusDenominator: number of overnight separations

Fig. 3: Patient FallsPeer Group: allnumerator: Total number of patient falls requiring interventionDenominator: Total number of occupied bed days

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054_PH1212_CollectionUpdate_R2.indd 55 29/11/12 2:05 PM

56 December 2012

Policy Patter with Barbara CarneyPolicy Patter with Lucy Cheetham

Understanding private

hospitalsAn outline of the geography of

private health services in Australia

One of the many frustrations private hospitals and day surgeries often share is getting anyone from outside the

sector to understand not only its depth, breadth and complexity but also the range of communities served. It is often assumed that private hospitals are confined to metropolitan centres.

People in rural and remote regions access private hospital services less frequently than do people in major cities.1 nevertheless, private hospitals often play a vital role in regional communities. Whether it is the provision of dialysis in Alice Springs, chemotherapy in Toowoomba, ophthalmological day surgery in north-west Tasmania or a psychiatric ward in regional new South Wales, the private sector is often integral to the provision of essential services.

Sometimes the private sector provides the lion’s share of services. nationally, 60 per cent of day chemotherapy services are provided by the private sector. In some states, reliance on the private chemotherapy is even greater: in QLD it is 68 per cent, nSW 92 per cent and in SA almost 100 per cent.2

The private sector has been agile in responding to expanding demand for services in population growth hotspots such as greater Perth and coastal Queensland and new South Wales.3 Local communities have often invested tremendous energy over many years to establish and maintain private hospital services. federal Government funding through the Health and Hospitals fund has assisted private hospitals to expand services across regional communities including Toowoomba, Griffith, Lismore, Port Macquarie, orange, Bundaberg, Hervey Bay, Mackay, Rockhampton and Townsville.4

There is comparatively little published data on the geography of private health services in Australia.5 APHA is working to fill this gap and raise awareness of the size, distribution and complexity of Australia’s private hospital and day surgery sector. The figures presented summarise the distribution of licensed beds provided by APHA member hospitals.6 While 57 per cent of these beds were in inner metropolitan areas, 17 percent were in outer metropolitan areas and 26 per cent were located in regional areas.

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References1 The Australian Institute of Health and Welfare, Australian health expenditure by remoteness: a comparison of remote, regional and city health expenditure, 2011.2 AIHW, Same day Separations for Chemotherapy, Australian Hospital Statistics 2010-11.3 ABS, Regional Population Growth, Australia, 2011, Cat 3218.0. 4 The Australian Governments Health and Hospitals fund, Regional Priority Rounds 2010 and 2011, Regional Cancer Projects november 2011.5 national Rural Health Alliance, Australia’s Health System needs re-balancing, January 2011.6 This analysis is based on licensed hospital beds reported to APHA by full members as at november 2012. Beds used to provide public services have not been excluded.

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Distribution of APHA member hospital beds

NSW/ACTInner metro – 53%Outer metro – 13%Regional – 34%

QLDInner metro – 44%Outer metro – 8%Regional (SEQ) – 43%Regional – 5%

VICInner metro – 63%Outer metro – 26%Regional – 11%

WAInner metro – 64%Outer metro – 36%

SAInner metro – 78%Outer metro – 17%Regional – 5%

TASMetro – 75%Regional – 25%

NTMetro – 100%

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58 December 2012

Quality in Focus with Christine Gee

Many of you may be like me and be wondering where 2012 went, or at least how it passed so quickly. What a busy year. I would like to

take this opportunity to wish you all a very happy, healthy and safe Christmas and new year season – I look forward to bringing you more Quality in focus news throughout 2013. It will certainly be yet another very busy year particularly as it is the first year of implementation of the new model of accreditation with the introduction of the 10 national Safety and Quality Health Service Standards (nSQHS).

NSQHS Standards and ResourcesHealth services should be in receipt of the australian Commission on Safety and Quality in Health Care (aCSQHC) nSQHS Standards Documentation Box Set. These were distributed by the Commission in late october, early november and include: • The nSQHS Standards• Safety and Quality Improvement Guides

for each of the 10 nSQHS Standards • accreditation Workbooks for use by

hospitals and/or day procedure services• USB device loaded with a copy of each of

these documents.

The Safety and Quality Improvement Guides have been developed by the Commission to assist health services align their quality improvement programs using the framework of the nSQHS Standards. The guides detail the requirements to achieve the criteria of the nSQHS Standards and include tables describing suggested tasks, implementation strategies and examples of the outputs of improvement processes.

The accreditation Workbooks have been developed by the Commission to assist health services in the coordination of accreditation processes. The workbooks outline the key steps in the safety and quality accreditation process and provide examples of evidence that could be used to demonstrate the nSQHS Standards have been met.

These documents, along with a wealth of other detailed evidence-based resources relating to the nSQHS Standards, are available on the Commission’s website at www.safetyandquality.gov.au.

Advice CentreThe Commission established an advice centre which commenced operation on 24 September 2012. The advice centre has been provided to assist and take enquiries from health service organisations, surveyors and accrediting agencies. The advice centre can be accessed by calling 1800 304 056 (normal business hours australian Eastern Standard Time) or via email [email protected]).

The advice centre will provide advice and support during the transition to the national Safety and Quality Health Service Standards to ensure health services have a consistent and shared understanding of the nSQHS Standards.

Additional supportThe Commission is committed to providing additional support to health service organisations undertaking accreditation during 2013, including: • Establishing networks of similar health

service organisations to provide regular telephone contact, resources, support and expert information as they prepare for accreditation.

• Providing access to experts, and onsite visits where necessary.

Introducing the new

standardsIn 2013, the Comission’s focus will be

on assisting health services implement the new National Safety and Quality

Health Service Standards

Quality in Focus with Christine Gee

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august 2012 59

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• Developing strategies to support small rural health services undertaking accreditation.

• Mediation: The Commission will take calls that are made jointly from surveyors and health service organisations during ‘on site’ visits.

Second tier default benefit arrangements Both the aPHa and the Commission have been working with the Department of Health and ageing (DoHa) on amendments to the administrative arrangements of the Second Tier Default Benefits to incorporate the changes to accreditation resulting from the implementation of the nSQHS.

at the time of writing, DoHa was finalising new Second Tier Default Benefit arrangements with a commencement date of 1 January 2013 that should see the ‘Core Standards’ replaced by the 10 nSQHS Standards. It is understood that DoHa will be working with the Commission on transition arrangements.

Thank youI would like to take his opportunity to say ‘Thank you’ to a number of people. first and foremost, thank you to Michael Roff and the team at aPHa. year after year, they are tireless in the outstanding work that they do in ensuring communication flows and in supporting efforts and endeavours dedicated to the area of safety and quality. Stephen Walker, who sadly stepped down from his position on the aPHa Board in october, again led the members of the aPHa Quality and Safety Taskforce through 2012 on what has been a very busy year of consultation, advice and feedback of priority areas for private hospitals.

I would like to acknowledge the commitment and dedication of Bill Beerworth, Chairman and Deb Picone, Chief Executive officer and indeed all members and staff of the Commission as well as the contributions of the members of the Commission’s Private Hospital Sector Committee (PHSC): Dr Leon Clark, Dr Michael Coglin, Ms anne Crouch, Mr Kim

Knoblauch, Dr Shaun Larkin, Mr Rohan Mead, Dr annette Pantle, Ms Glenna Parker, Mr Stephen Walker and Dr Peter Woodruff. as I have said before, it is both an honour and a pleasure to be a member of the Commission and to Chair the PHSC.

It is also important to acknowledge and thank Lucy Cheetham, aPHa, Patrick Tobin, CHa and Lucy fisher, PHaQ for their much appreciated efforts in the distribution of information and materials from the Commission and the PHSC across their memberships.

finally, thank you to you… all management and staff across the private hospital sector who not only support but who embrace safety and quality in health care. It is on the ground at the coal face of patient care that all of the efforts in safety and quality count most.

I welcome your feedback on this column and on any matters relating to quality and safety and the australian Commission on Safety and Quality in Health Care. I can be contacted via the aPHa Secretariat – [email protected]

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60 December 2012

Pharmacy Focus with Michael Ryan

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No one likeS unbudgeted costs. And increasingly, high cost, unsubsidised medicines are making up a sizeable portion of this expense

category. Whether it’s expensive antibiotics and anti-fungal agents, activated factor Vii, new immunotherapy agents, or botulin toxin for non-s100 indications – the list goes on – the impact and effect on the bottom line is the same.

A recent study from Peter MacCallum Cancer Centre (PMCC) in Melbourne presented findings that are particularly worrying for private hospitals, where numbers of admissions for chemotherapy administration continue to grow. The study results, published in internal Medicine Journal earlier this year, show that in 43 per cent of treatment regimens used at PMCC (containing 82 different drugs, across 15 tumour groups), a drug or combination of drugs to treat a particular cancer were

not listed the Pharmaceutical Benefits Scheme (PBS).

The use of non-PBS medicines or PBS medicines for non-PBS indications are two of a number of reasons for the increasing expenditure on unsubsidised medicines in private hospitals. other reasons include:• The lag time between TGA registration

of a medicine (ie when a medicine can be prescribed by any registered medical practitioner) and its listing on the PBS is getting progressively longer, due to both process and political reasons

• More ‘cutting edge’ medical specialists being given admitting rights to private hospitals – a double-edged sword that results in more patients being admitted, but which may also bring the specialist’s desire to prescribe newly-approved medicines with which they have become familiar through participation in clinical drug trials in public hospitals; and

• An increasing number of pharmaceutical

companies questioning the value of applying for PBS listing for medicines that are principally used in hospitals. The ‘private market’ is often seen as a quicker and easier path to achieving revenue targets, compared to the expensive and time-consuming task of applying for PBS approval.

Hospital strategiesSo how do public hospitals, which have responsibility for patient care as well as research and teaching, manage expenditure of high cost medicines? And does this approach provide guidance for private hospitals in this challenging area?

Public hospitals use a number of tools and processes to manage high cost medicine use. These include:

Hospital formulary: this is the most common (and successful) mechanism used to manage use of new, high-cost medicines. The formulary, which is simply a list of medicines permitted to be prescribed by accredited medical practitioners (with or without restrictions), is usually managed by a multi-disciplinary drug and therapeutics committee (DTC).

Managing high-cost medicines

As uncertainty grows in regard to doctors prescribing expensive, unsubsidised new

medicines, so too does the need for a rigorous and effective medicine approval process

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December 2012 61

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The DTC has the responsibility of assessing applications (accepted only from doctors), for formulary listing. The formulary application requires doctors to provide:• evidence of the benefits of the medicine for

which approval is sought (using data from trials published in major peer-reviewed journals)

• A comparison of the advantages and disadvantages of the new medicine with currently used treatment(s); and

• An estimate of the number of patients and annual cost (including additional costs or savings in monitoring) of the new medicine compared with the existing therapy.

Individual Patient Use (IPU) applications: if an urgently required, high-cost medicine is not on the formulary, or the indication for which it is to be used is not approved, doctors in public hospitals can apply directly to a delegate of the drug and therapeutics committee for approval to prescribe, by completing an iPU application. Most DTCs require details and outcomes of iPU approvals to be tabled at subsequent DTC meetings.

The emergence of state-wide committees in SA, WA, Tasmania and the long-established Queensland Health Medicines Advisory Committee to manage high cost medicines is a response to the increasingly difficult task faced by individual teaching hospitals in properly assessing the value for money of a large numbers of new medicines. Many believe that nSW and Victoria will follow the lead of the other states as activity-based funding, performance and throughput targets becomes consistent throughout Australia.

Options for private hospitalsThe question is, can these successful public hospital strategies be applied to a private environment given the sensitive dynamics of the relationship between private hospitals and specialist medical practitioners?

The answer is yes, but consultation with key prescribers is critical to achieving a rigorous, reliable and effective medicine approval process. options include:1. individual hospitals establishing drug

and therapeutics committees with the same range of expertise and authority as teaching hospitals;

2. individual hospitals adopting the formulary of a major teaching hospital or

state health department (and leaving the assessment of evidence of ‘value’ of new medicines to the public hospital entity);

3. Groups of private hospitals establishing a single drug and therapeutics committee with the appropriate expertise and understanding of the dynamics of the private hospital system, to assess and provide advice to hospitals in regard to new medicines; and

4. A national private hospital drug and therapeutics committee assessing and providing advice to all private hospitals using agreed criteria for new non-PBS medicines.

Michael Ryan, Director, PharmConsult PharmConsult is Australasia’s leading hospital pharmacy consultancy advising hospitals on the operational, financial, professional, service, risk and legislative issues associated with hospital pharmacy services. www.pharmconsult.com.au

060_PH1212_Pharmacy_R2.indd 61 29/11/12 2:06 PM

62 December 2012

Legal Matters with Alison Choy Flannigan

I n AustrAliA there is state and territory legislation which provides limited protection for volunteer members of community organisations.1 While based upon the

same model, there are differences between the jurisdictions. this article focuses on the position in new south Wales.

under Part 9 of the Civil Liability Act 2002 (NSW) (Civil liability Act) four broad criteria are required to be met before a volunteer may take advantage of the protection. A ‘volunteer’ must:• Be working on a ‘voluntary basis’;• Be performing ‘community work’ that is

‘organised’ by a ‘community organisation’;• Come within an area of liability protected

by the Act; and• not fall within a stated exception.

‘Community organisation’ means any body corporate (such as an incorporated association or company), church or other religious organisation, or authority of the state, that organises the doing of community work by volunteers and that is capable of being sued for damages in civil proceedings.

‘Community work’ means work that is not for private financial gain and that is done for

a charitable, benevolent, philanthropic, sporting, educational or cultural purpose, but does not include work declared by the regulations not to be community work.2

A ‘volunteer’ means a person who does community work on a voluntary basis.

‘Work’ includes any activity. However, community work done by a person under an order of a court is not to be regarded as work done on a voluntary basis. Community work for which a person receives remuneration by way of reimbursement of the person’s reasonable expenses in doing the work, or within limits prescribed by the regulations, is to be regarded as work done on a voluntary basis.

A volunteer does not incur any personal civil liability in respect of any act or omission done or made by the volunteer in good faith when doing community work which is organised by a community organisation or as an office holder of a community organisation.

there are various limitations on the protection. the immunity only applies where the volunteer is acting within the scope of activities authorised by the organisation and is following relevant instructions.3 Protection from liability is also excluded where the volunteer was engaged in conduct that

liability for volunteers and

Good samaritansA look at legislation providing protection

for volunteer members of community organisations and Good Samaritans

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constitutes a criminal offence,4 the volunteer was intoxicated5 or engaged in activities where insurance was is required by law6. liability is also excluded for motor accidents in which the volunteer is engaged, that would have been covered by a third-party insurance policy or would have been recoverable from the nominal defendant.7

the Civil liability Act is exceptional in protecting the community organisation or other body that utilises volunteers from vicarious liability for the actions of its volunteers.8 Other Australian jurisdictions have enacted provisions that transfer to the organisation the liability that would have been incurred by the volunteer.9 However, the new south Wales legislation should be read in conjunction with the Law Reform (Vicarious Liability) Act 1983 (NSW).10

Further, there may be some Commonwealth laws which may take priority to the extent of any inconsistency between the Commonwealth and state laws, for example liabilities under the Corporations Act 2001 (Cth).

062_PH1212_Legal.indd 62 29/11/12 2:06 PM

advice

Good Samaritanssection 57 of the Civil liability Act also provides some protection for ‘Good samaritans’ in respect of any act or omission done or made by the good samaritan in an emergency when assisting a person who is apparently injured or at risk of being injured. A Good samaritan is a person who, in good faith and without expectation of payment or other reward, comes to the assistance of a person who is apparently injured or at risk of being injured. the section does not affect the vicarious liability of any other person for the acts or omissions of the good samaritans.

the protection from personal liability does not apply if it is the good samaritan’s intentional or negligent act or omission that caused the injury or risk of injury in respect of which the good samaritan first comes to the assistance of the person.

Further, the protection from personal liability does not apply if:

(a) the ability of the good samaritan to exercise reasonable care and skill was significantly impaired by reason of the good samaritan being under the influence of alcohol or a drug voluntarily consumed (whether or not it was consumed for medication); and

(b) the good samaritan failed to exercise reasonable care and skill in connection with the act or omission;11

(c) a person is impersonating a health care or emergency services worker or a police officer or is otherwise falsely representing that the person has skills or experience in connection with the rendering of emergency assistance.12

CommentaryAll health care facilities and community organisations should procure and maintain appropriate insurance, including directors and officers, professional indemnity, public liability and workers compensation insurance to cover their officers, employees and agents (including volunteers). However, it is useful to be aware of these limited protections.

References1 see new south Wales (Civil Liability Act 2002), Victoria (Wrongs Act 1958, ss 37-41), Queensland (Civil Liability Act 2003, ss 38-44), Western Australia (Volunteers and Food and Other Donors (Protection from Liability) Act 2002), south Australia (Volunteers Protection Act 2001), ACt (Civil Law (Wrongs) Act 2002), northern territory

(Personal Injuries (Liabilities and Damages) Act 2003), tasmania (Civil Liability Act 2002).2 ibid s 60 (1).3 ibid s 64.4 ibid s 62.5 ibid s 63.6 ibid s 65.7 ibid s 66.8 Civil Liability Act 2002 (NSW), s 3C.9 see for example ACt (Civil Law (Wrongs) Act 2002) s 9, Victoria (Wrongs Act 1958) s 6110 Law Reform (Vicarious Liability) Act 1983 (NSW) s 10.11 Civil Liability Act 2002 (NSW), s 5812 ibid.

Alison Choy Flannigan Partner, Health, aged care & life sciences Holman Webb, Lawyerswww.holmanwebb.com.au [email protected]

This article is provided for general information purposes only and should not be relied upon as legal advice.

December 2012 63

Does your insurance cover your volunteers?

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64 December 2012

Since the Last Issue

Results of the APHA Board Election 2012

At tHE mEEting of the APHA Council on monday 30 October in Sydney, elections were held for the APHA Board for 2012-2014

with results as follows:• President: Chris Rex• Vice President: Richard Royle • Chair of Council: geoff Sam • treasurer: Philip Currie • Policy and Advocacy taskforce:

Richard Royle • Safety and Quality taskforce Chair:

Christine gee• Communications and marketing

taskforce Chair: Anne Crouch• Workforce taskforce Chair: Danny Sims• Alan Cooper • Robert Cooke

in addition, it was noted that Christine gee will continue to chair the APHA Psychiatric Committee while Bronwyn mace will chair the APHA Rehabilitation Committee.

new members of the Council, nick Warden and Bronwyn mace were welcomed and a vote of thanks was recorded for outgoing Board member and Councillor Stephen Walker and outgoing Councillors mark Stephens and george toemoe.

Chemotherapy UpdateAs we go to press, APHA continues to work to reach a sensible compromise over the Federal government’s plans to reduce Pharmaceutical Benefits Scheme (PBS) benefits on several chemotherapy drugs from 1 December 2012, which will have a significant impact on many of our member hospitals and their patients. APHA has been working with concerned stakeholders (patients, patient advocacy support groups, specialist doctors, private hospitals, community and hospital pharmacists, cancer clinics, wholesalers and third party compounders) involved in the delivery of chemotherapy services to patients to come to a solution.

there has been considerable public activity around this issue in the past few weeks and APHA has also had meetings with the minister for Health and Ageing, tanya Plibersek, as well as many other members of Parliament.

We hope a solution can be found in the next few days and will update members as information comes to hand.

Submission sent to IHPAAPHA has responded to the independent Hospital Pricing Authority’s Consultation Paper for the Pricing Framework for Australian Public Hospital Services 2013-14 (31 August 2012). http://ihpa.gov.au/internet/ihpa/publishing.nsf Key issues raised include:• Private patients in public hospitals• Funding for teaching, training and

research activities• Application of ABF to mental health, and• Pricing for safety and quality.

Proposed Changes to PHI Rebate Indexationin the mid Year Economic and Financial Outlook, the government announced changes to the indexation of private health insurance rebates that would erode the value of the rebate over time.

APHA President, Chris Rex and CEO, michael Roff have lobbied key federal mPs in Canberra in relation to these measures. they explained that these changes were regressive as they affect every health fund member regardless of income, but the impact will be felt most acutely by the 3.4 million Australians with health insurance who have an annual household income of less than $35,000. in addition, coming on top of means-testing of the rebates, there is likely to be a cumulative impact in terms of membership drop outs and downgrades.

The APHA Board for 2012-2014 has been elected

What you need to know about the potential rise in costs for Chemotherapy TreatmentOn 1 December 2012 the Australian Government is planning to cut PBS

subsidies for chemotherapy and as a result this may have an impact on

both the patients that require chemotherapy, as well as the hospitals that

provide these treatments. FACT Private hospitals deliver 60% of all lifesaving chemotherapy services in Australia. Private hospitals understand the importance of not cutting corners and delivering quality service. Private hospitals have been fighting for a more

sustainable funding model for chemotherapy treatment since 2009. Chemotherapy drugs are only affordable due to the Federal Government subsidies currently provided. The Government is planning to reduce the subsidy

on Docetaxel (one of the most commonly prescribed drugs which cross-subsidises many others) by 76.2% on 1 December. Without that subsidy, the supply of many chemotherapy drugs will not be financially viable.

A DROP IN SUBSIDY WILL MEAN Pharmacies and hospitals will not be able to supply treatment at the same low costs Some private health insurance providers may not cover the extra costs

Some private hospitals may be forced to ask patients for increased contributions to the costs Some private hospitals may be forced to shut down their chemotherapy services

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66 December 2012

Valuing Private Hospitals

Valuing Australia’sPrivate Hospitals

Mental HealtH Week 2012 tested the nation’s knowledge of some of the most prevalent mental disorders that are treated

in the private sector, including depression, anxiety, substance abuse and eating disorders.

the week, from 7-13 October, saw nearly 200 private hospitals around australia, set up displays featuring our campaign material asking the question: ‘What do you know…

about mental illness?’. Hospitals also hosted staff events such as lunches and exercise classes as well as community talks.

the aim of Mental Health Week 2012 was to better educate australians on the lesser known symptoms of these mental disorders, to dispel negative stereotypes and common misconceptions and to get the australian public more actively involved with the facts. aPHa also wanted to promote the innovative programmes that are available to treat mental

disorders and for all australians to check their private health insurance to ensure they are covered for mental disorders.

aPHa would like to thank everyone who participated in Mental Health Week 2012 because without your support our campaign message would have been lost.

Below is a snapshot of some of the fantastic photos that were sent to us during Mental Health Week 2012 by hospitals across australia.

Celebrating Mental Health Week 2012

Toowong Private Hospital

Brisbane Private Hospital

Belmont Private Hospital’s poster

Friendly Society Private Hospital

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august 2012 67

Voice your support! Visit the aPHa website www.apha.org.au/media-centre/mental-health-week-2012 to find out more about the Mental Health Week 2012 campaign and how hospitals got involved.

You can also check out our Facebook page at www.facebook.com/valuingprivatehospitals and take the quiz to find out what you know about mental illness, or join the conversation on twitter at @priv8hospitals.

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL No. 235249 Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Consider a Product Disclosure Statement before making a decision about HESTA products, call 1800 813 327 or visit our website for copies.

More people in health and community services choose HESTA than any other fundYour super fund can make a lifetime of difference

3 Run only to benefit members

3 No commissions

3 Low fees

hesta.com.au

954.HESTA Generic Group_210x148.5.indd 1 28/06/12 4:44 PM

Toowong Private Hospital’s positive affirmation tree

Albury Wodonga Private Hospital’s reception

St Andrew’s Private Hospital

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68 December 2012

News from our advertisers

Industry updateNews from the healthcare and hospital industry

Be assured of quality with Austco Austco is a wholly owned subsidiary of Azure Healthcare, an international provider of healthcare communication and clinical workflow management solutions. The company is headquartered in Australia, has subsidiaries in six countries and supports 6,000 healthcare facilities through our global reseller network.

As the largest manufacturer of call systems in the southern hemisphere, your healthcare facility can be assured of the highest standard of product quality and performance. Every system installed is designed to suit the individual requirements of the healthcare facility, focussing on maximizing operational efficiency. Tacera is an advanced IP based nurse call solution for healthcare facilities that provides “plug-and-play” functionality. This minimizes the cost of installation and commissioning, as well as making ongoing maintenance more cost effective – reducing the total cost of ownership of the system.

Calls may be displayed on pagers, DECT and VoIP based wireless telephones, quickly alerting staff that a call has been activated. Tacera’s VoIP interface enables crystal clear voice communications between nursing staff and the patient, without the need for third party middleware.

Additionally, all your clinical alarm systems, such as Patient Monitoring, Ventilators, IV Pumps and Stat Lab results may be integrated into Tacera allowing “one click” staff allocation for all mission critical alerts.

For more information cll 08 9244 4499 or visit www.austco.com

The European market leader in customised procedure packs, Mölnlycke Health Care, is proud to announce the delivery of its 20-millionth ProcedurePak pack. The pack, produced at Mölnlycke Health Care’s plant in the Czech Republic, was presented to the Clinique Saint-Luc in Bouge (Namur), Belgium by Eric De Kesel, President Surgical Division of Mölnlycke Health Care.

Mölnlycke Health Care has produced procedure packs in the Czech Republic for the past 10 years. “We have grown from an annual production of 73,000 trays 10 years ago to 3.5 million trays in 2011,” says Mr De Kesel.

“Besides this volume growth, the market has also become more complex. In our Karvina plant, we have the expertise and knowledge to process 12,000 different configurations with 5,000 unique components. Every month, 100 new customised configurations enrich our portfolio. Our 20-millionth pack in 10 years’ time is an important event for us and for our loyal customers, who have grown with us in this market. Every six seconds, a surgeon in an operating theatre somewhere in Europe uses

one of our customised procedure packs.”By switching from the traditional

preparation of operating theatre supplies to ProcedurePak® customised procedure packs, hospitals cut preparation time for surgical procedures by up to 50 percent. This way they can free up time to focus on patient care, staff training and coaching, or for additional procedures.

Mölnlycke Health Care’s ProcedurePak pack is a sterile pack containing all single-use material required for a particular surgical intervention, customised to meet surgeons’ individual needs. For more information, please contact 1800 005 231 or email [email protected]

Twenty million ProcedurePaks®

ACSS has been a leader in the Australian healthcare industry since 1992, pioneering electronic claiming to Medicare and providing solutions to over 1000 clients throughout Australia such as Westmead, Prince of Wales and St Vincent’s hospitals.

SimDay® is the choice of software for private hospitals and day surgeries.

SimDay® is well known for being an easy to use system, saving facilities time and money. Now with ECLIPSE (online claiming) integration, SimDay® makes your day even easier, eliminating paper work, speeding up payments from health funds and DVA, and giving you the ability to perform health fund eligibility checks and online patient verifications.

With the ability to import all your patient, episode and billing history from your old system into SimDay®, you won’t need to refer back to your old system ever again.

The SimDay® team is dedicated to providing a high level of technical support and has the flexibility to customise SimDay® to your hospitals needs. For more information, please contact the SimDay® Team on 1300 788 005.

Streamlined electronic systems

068_PH1212_IndustryUpdate.indd 68 29/11/12 2:07 PM

December 2012 69

HESTA serving the communitySince 1987, HESTA has been serving those

in the health and community services sector. For 25 years we’ve been working to inform you about your options — so

you can grow a better retirement savings balance.

With HESTA’s solid history of strong long-term returns, a focus on super

education and access to limited financial advice, we help you take an active role in building a healthy nest-egg. We talk to you in plain language, using real-life examples that are

relevant to your life and experiences.

As an industry super fund, HESTA has low fees and exist only to benefit you, so we pay no commissions to financial advisers. And, with client relationship managers, superannuation advisers and member education managers in every state and territory, HESTA has a truly national focus.

For more information visit hesta.com.au or free call 1800 813 327.

Issued by H.E.S.T. Australia Ltd ABN 66 006 818 695 AFSL 235249, Trustee of Health Employees Superannuation Trust Australia (HESTA) ABN 64 971 749 321. Investments may go up or down. Past performance is not a reliable indicator of future performance. For more information about HESTA, free call 1800 813 327 or visit hesta.com.au for a copy of a Product Disclosure Statement which should be considered when making a decision about HESTA.

Herman Miller Procedure Carts Herman Miller healthcare carts are designed to meet the demands of today and the changes of tomorrow. A wide variety of bodies and parts make it easy to create the cart you need: procedure, supply, utility, medical/surgical, linen and document storage.

Lightweight and ergonomically designed, Herman Miller carts are easy to move even

when fully loaded. They are made from highly durable, impact-resistant plastic, are GREENGUARD certified as low-emitting products and are up to 98% recyclable. Herman Miller carts are backed by a 10-year, three-shift warranty.

Middlemore Hospital in Auckland, New Zealand, chose Herman Miller carts when

standardising their resuscitation trolleys in 2008. Tracey Cooper, Team Leader, Resuscitation Educational Facilitator said that the Herman Miller carts were considered alongside the previous brands used by the hospital. She said Herman Miller carts were: “more mobile, more robust, fully cleanable and much more appropriate from an infection control perspective, customisable and cost effective”.

“They have proved over the last four years to be worth the investment. They require little to no maintenance and we have had no mechanical or structural issues reported out of the entire fleet purchased for both onsite at the main hospital and the community hospital units.”

Ergonomic, durable and flexible products make Herman Miller a long term partner for your healthcare needs.

For more details or to view our entire range of procedure carts, please visit www.hermanmiller.com.au or email [email protected].

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70 December 2012

On The Ground

Maree Where do you work, what is your role and how long have you been there?I am a registered nurse working at John Fawkner Private Hospital as a Discharge Coordinator with a clinical role.

In 2010 I took leave and applied to the Remote Area Health Corp (RAHC), a Federal Government organisation that supplies remote area health nurses to Indigenous communities in the Northern Territory. My first five-week placement was in an Aboriginal Health Centre (Congress) in Alice Springs where I gained the confidence to take up a remote position the following year.

I had two placements at Kalkarinji, a remote Aboriginal community 500 kilometres south-west of Katherine with a population of approximately 700. The community has a health centre staffed by registered nurses working full time and providing 24-hour on-call service. A doctor visits weekly. We follow the Carpa manual, a guide to prescribing and delivering care and treatment for patients. We refer to the

District Medical Officer (DMO) in Darwin for clarification of treatment.

Can you describe one of your shifts? I remember one particular long night on call. I first received a call from a distressed girl stating she had been bitten by a snake. It is ‘white man’s law’ to evacuate all snake bites to Darwin, so a Care Flight was scheduled to arrive at 1am. Her care involved half hourly blood clotting and keeping her immobile – challenging when she wanted to go outside to smoke.

I omitted to alert the on-call person to turn on the airstrip lights, which created a minor hiccup. The plane then had to abort the next landing attempt to avoid a donkey on the runway.

As the plane took off, Greg (the local policeman) called, requesting I attend a man who had been run over at ‘the grid’, a place where community folk went to drink. I made my way there feeling anxious and unsure. The man was deceased and I needed

to pronounce him dead, which was very traumatic for the distressed people present.

What challenges did you face by being so far away from resources?The distance and heat. The non-functioning morgue and undertakers four to five hours away. Arranging for the deceased to be respectfully cared for until the undertakers arrived.

When working with the traditional community did you have to make changes to your clinical practice? My clinical practice in Kalkarinji was very different to hospital work – I was a sole practitioner. Mostly I diagnosed and treated patients independently, referring to either Carpa or the DMO in Darwin.

I was presented with many conditions including childhood anaemia and failure to thrive. Rheumatic heart disease is also prevalent in Indigenous communities, as is diabetes, chronic heart disease, renal disease, skin disorders, STIs, plastering and suturing related to domestic violence.

What was the highlight from your clinical placement experiences?Working with Indigenous people and being a part of the community, delivering primary healthcare and contributing to improving health. I loved being in the outback and it was a privilege to have the opportunity. I look forward to continuing this work.

How do you think the experience has made you a better nurse?The experience brought a balance to my life. I have certainly learnt a great deal. I feel the clinical expertise needed for this role is practicality. There were many times when I was presented with a difficult case and had to run with it. Fortunately I managed most challenges and built on my knowledge.

Discharge Coordinator at John Fawkner Private Hospital

...with White

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18–23

REGISTRATION NOW OPEN

Equity and Access to Health Care

Australian College of Nursing

Australian member of ICNLeading nursing expertise and care through access, learning and advocacyRCNA TCoN&

AUSTRALIAN COLLEGE OF NURSING

18–23

REGISTRATION NOW OPEN FOR THE 2013 ICN CONGRESSThe International Council of Nurses 25th Quadrennial Congress – the largest international nursing event is coming to Australia in May 2013.

For further information about the Congress or to register please visit www.icn2013.ch

The Early registration deadline is 14 February 2013. All fees are in AUD and inc. GST.

REGISTRATION CATEGORY First DEADLINE Up to 14 February 2013

Second DEADLINE As of 15 February 2013

ON-SITE DEADLINE As of 02 May 2013

ICN Member 799 999 1249

ICN Non-member 999 1249 1559

Day Card 399 399 399

Student 399 499 625

Student Day Card 199 199 199

Accompanying person 75 75 75

ACN members eligible for ICN member category

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