JULY AUGUST SEPTEMBER 20 Board Chair praises outstanding work of Warwick Hospital operational services team Toowoomba Community Care Unit celebrates its first birthday Bumper crowds enjoy NAIDOC week celebrations New BreastScreen Queensland Toowoomba premises opened by Chief Health Officer Toowoomba Hospital Guiding Stars celebrate 10 years Construction commences on the new Toowoomba Hospital kitchen This year’s milestones 30 DDHHS Annual Report 2016-2017 | Our performance
Transcript
JULY AUGUST SEPTEMBER OCTOBER2016Board Chair praises outstanding work
of Warwick Hospital operational
services team
Toowoomba Community Care Unit celebrates its first birthday
Bumper crowds enjoy NAIDOC week celebrations
New BreastScreen Queensland Toowoomba
premises opened by Chief Health Officer
Toowoomba Hospital Guiding Stars celebrate
10 years
Construction commences on the new Toowoomba Hospital kitchen
Nursing Home awarded first prize in the Inter-Nursing Home Challenge at
Toowoomba Royal Show
Renal services boosted at
Toowoomba Hospital with new
inpatient renal beds
Congratulation Dr Lennox –
recipient of the AMA Excellence in Healthcare Award
Launch of DDHHS Staff
Wellness Program
$3.14 million expansion of
Toowoomba Hospital Central Sterilising
Department underway
DDHHS Length of Service
Awards
New palliative care room at Cherbourg Hospital officially
opened
DDHHS Community Information Expo held
Patient able to attend funeral thanks to use of telehealth services
at Toowoomba Hospital
Toowoomba Hospital MRI
service sees its first patient
33Our performance | DDHHS Annual Report 2016-2017
DDHHS Annual Report 2016-201734
Our performance
This financial year the DDHHS continued its high performance against a range of targets and key performance indicators set by the Department of Health. Across the DDHHS there was an overall increase in activity, although a few areas including birthing experienced a decrease in the number of services when compared to the previous financial year.
Performance highlights 2016-17
Specialist outpatient waiting list – almost 100% of all patients seen within clinically
recommended timeframes,
maintained now for the past two years.
Elective surgery waiting list – 100%
of all patients treated within clinically recommended
timeframes, maintained now for the past three and a
half years.
Oral health waiting list – third consecutive
year that 100% of all patient’s waiting had waited less than two years for treatment.
Gastrointestinal endoscopies – almost
100% of patients treated in time.
People admitted to
hospital8% increase
Breastscreens7% increase
People presenting to
emergency departments
3% increase
Babies born5%
decrease
Outpatient occasions of
service6% increase
Telehealth consultations
36% increase
Endoscopies3% increase
Emergency surgery
Toowoomba Hospital
5% increase
82,054 admissions, 5,957 more
than 2015-161
19,037 screens,
1,272 more than 2015-16
159,723 presentations,
4,598 more than 2015-16
2,949 babies born, 162 fewer than
2015-16
261,712 attendances, 15,274 more than 2015-16
7,090 consults,
1,962 more than 2015-16
5,720 procedures,
160 more procedures
than 2015-16
3,618 surgeries, 185 more surgeries
than 2015-16
DDHHS Annual Report 2016-2017 35
Our service standardsThe DDHHS is responsible for providing public hospital and healthcare services which includes a range of medical, surgical, emergency, obstetrics, paediatrics, specialist outpatient clinics, mental health, critical care and clinical support services for people within the Darling Downs region. The DDHHS delivered these services in line with the 2016-17 Service Delivery Statements (SDS) and Service Agreement with the Department of Health. Some of the DDHHS’s key priorities for 2016-17 published in the SDS were:
Key priority area: Status as at 30 June 2017
Progressing works towards the establishment of a state-of-the-art MRI service and second CT (Computerised Tomography) Scanner at Toowoomba Hospital
Installation completed and services operational
Construction of a seventh operating theatre at the Toowoomba Hospital
Project commenced in late 2016-17 with completion expected in 2017-18
Expansion of the Emergency Department at the Toowoomba Hospital Completed and services operational
Continuing to implement the Government’s policies for nursing, focusing on safety, quality and patient centred care.
Roll out of four year nurse navigator program commenced in 2015-16, with additional positions recruited to in 2016-17. Final recruitment to program to occur in early 2017-18.
The Service Agreement between DDHHS and the Department of Health identifies the health services the DDHHS provides, funding arrangements for those services, and defined performance indicators and targets to ensure outputs and outcomes are achieved. The DDHHS reports against national targets as set in the National Partnership Agreement on Improving Public Hospital Services and documented in the SDS and Service Agreement.
Toowoomba Hospital installed a state-of-the-art MRI, with the first patient
Our achievements this year against standardsEmergency department access
Service standards Notes 2016-17 Target 2016-17 Actual Performance
Emergency Length of StayPercentage of emergency department attendees who depart within 4 hours of their arrival in the emergency department
2 >80% 86%
Percentage of patients attending emergency departments seen within recommended timeframes:
Category 1 (within 2 minutes) 2 100% 95%
Category 2 (within 10 minutes) 2 80% 83%
Category 3 (within 30 minutes) 2 75% 68%
Category 4 (within 60 minutes) 2 70% 79%
Category 5 (within 120 minutes) 2 70% 94%
Median wait time for treatment in emergency departments (minutes) 2 20 14
Patient Off Stretcher Time (POST) Percentage of patients transferred from Queensland Ambulance Service (QAS) into the Emergency Department in 30 minutes
2,3 90% 89%
Emergency Department (ED) presentations increased by three percent in 2016-17 compared to last year4. This increase in demand placed pressure on our EDs particularly in locations where there is limited physical capacity to treat patients. Despite the increase in the number of presentations, facilities across the service achieved the target, or a result close to the target for the majority of ED performance indicators. Specific areas for improvement are outlined below, however performance against these measures was close to target or comparable with State averages:• 95 percent of Category 1 patients were seen in time, this was lower than both the State average of 99
percent and the SDS target of 100 percent• 68 percent of Category 3 patients were seen in time. This was better than the State average for this
category at 62 percent although below the SDS target of 75 percent • 89 percent of patients were transferred from a QAS ambulance to the ED treatment area in less than thirty
minutes (POST) almost reaching the State and SDS target of 90 percent.
ED presentations
Increasing ED presentations trend: 3% increase in 2016-17 over 2015-16
200000
175000
150000
125000
1000002013-14 2014-15 2015-16 2016-17
37Our performance | DDHHS Annual Report 2016-2017
Specialist outpatient appointments presentations
6% increase in specialist outpatient attendances in 2016-17 over the previous year 2015-16.
Total patients waiting for specialist outpatients appointments
34% increase in patients requiring specialist outpatient appointments
2015-16 2016-17
8000
6000
4000
2000
0
To improve timely access to ED care, the DDHHS has completed or is currently undertaking significant refurbishments or extensions at three facilities to increase capacity to meet demand. When completed the improvements will provide improved patient care facilities and assist in meeting ED targets. These include:• A $3 million refurbishment of the Toowoomba Hospital ED which was completed in June 2017. This
refurbishment increased the total number of treatment spaces from 21 to 30 to substantially improve capacity • A $3 million redevelopment of the Warwick Hospital ED is planned to commence in mid-November 2017
and will be completed by mid 2018. The new layout will include two additional treatment bays, a paediatric resuscitation bay, isolation room with ensuite and a mental health assessment room. Five existing examination rooms will be replaced with four assessment bays, one triage bay, one triage or QAS bay and a triage room
• Nearly $1 million of improvements to the Kingaroy Hospital ED are planned to be completed in 2017-18 to improve patient flow and safety, as well as provide additional space for consultations and two extra examination bays. The improvements will ensure that Kingaroy Hospital ED continues to maintain a high standard of care whilst the hospital redevelopment is completed.
Specialist outpatient appointments provided in time
Service standards Notes 2016-17 Target 2016-17 Actual Performance
Percentage of specialist outpatients waiting within clinically recommended times:
Category 1 (30 days) 2,5 98% 100%
Category 2 (90 days) 2,5 95% 99%
Category 3 (365 days) 2,5 95% 100%
The DDHHS maintained this achievement throughout 2016-17 to ensure that patients referred for specialist treatment were seen within clinically appropriate timeframes. Activity also increased with a six percent increase in attendances over the previous year. With 100 percent of category 1 and 3 patients and 99 percent of category 2 patients seen in time, the DDHHS has for two consecutive years ensured that almost all patients are seen in time. The DDHHS performed well above target for this measure and continued to outperform all other health services in the State.As at 30 June 2017, 6,441 patients were on the specialist outpatient waiting list, an increase of 1,631 from 30 June 2016. A total of 261,712 patients attended a specialist outpatient clinic in 2016-17, an increase of six percent over the previous year.
Service standards Notes 2016-17 Target 2016-17 Actual Performance
Percentage of elective surgery patients treated within clinically recommended times:
Category 1 (30 days) 2 98% 100%
Category 2 (90 days) 2 95% 100%
Category 3 (365 days) 2 95% 100%
Median wait time for elective surgery (days) 6 25 48
Elective surgery provided in time Statewide targets measure the percentage of elective surgery patients who receive their treatment within the clinically recommended timeframe for their urgency category. The DDHHS has maintained an excellent result by consistently exceeding targets since December 2013. This result was maintained in 2016-17 with 100 percent of patients treated in time. Achieving this result in conjunction with similar excellent results for surgical specialist outpatient wait times means that patients in the DDHHS are seen by a specialist and receive surgery (if they require surgery) in a clinically appropriate time. The median wait time for surgery in the DDHHS was 48 days, above the target of 25 days. This is as a result of a significant proportion of the people waiting for elective surgery being category 2 and 3 patients that require treatment within 90 or 365 days respectively. The DDHHS treated 6,428 patients for elective surgery in 2016-17. This is an eight percent decrease from the previous year as a significant amount of after-hours elective surgery was undertaken in 2015-16 to reduce the number of patients waiting for surgery. This additional activity was not required in 2016-17 to achieve the targets for elective surgery waiting times and the DDHHS’s focus is now on sustaining elective surgery provided within clinically recommended times.
Gastrointestinal endoscopies
Service standards Notes 2016-17 Target 2016-17 Actual Performance
Percentage treated within the clinically recommended time for their category:
Upper and lower gastrointestinal endoscopies treated in time 2 90% 100%
This was the first year that the DDHHS reported on performance against treatment time for gastrointestinal endoscopies as part of the Service Agreement. In 2016-17, 5,720 patients had an endoscopy, which is an increase of three percent over last year, with 100 percent of these patients receiving their procedure within clinically recommended timeframes. This is another outstanding achievement for the DDHHS, once again exceeding Statewide targets and achieving a high standard in healthcare delivery.
Endoscopy patients treated
3% increase in the number of gastrointestinal endoscopies in 2016-17 compared to 2015-16
Case
s
6000
5000
4000
3000
2000
1000
02015-16 2016-17
DDHHS exceeded 2016-17 activity targets in almost all categories
39Our performance | DDHHS Annual Report 2016-2017
Safety and qualityThe DDHHS is dedicated to working towards reducing hospital acquired infection rates. The acceptable rate for healthcare associated Staphylococcus aureus bacteraemia infection is no more than 2 per 10,000 occupied bed days. The DDHHS performed well below this rate at 0.3 per 10,000 occupied bed days for 2016-172.
Value for moneyUnder the activity-based funding model, Weighted Activity Units (WAU) provide a common unit of comparison for all clinical activities so that hospital activity can be measured and costed consistently. In 2016-17 the DDHHS delivered 20 percent above the activity target which equated to $27.1 million in Commonwealth additional growth funding above base funding, based on National WAU (NWAU) targets and actuals.The DDHHS’s activity results are as follows:
Darling Downs Hospital and Health Service Notes 2016-17 Target 2016-17 Actual Performance
Total weighted activity units: 7
Acute Inpatient 47,136 52,010
Outpatients 11,901 10,504
Sub-acute 4,638 6,381
Emergency Department 15,482 17,392
Mental Health 8,680 27,868
Prevention and Primary Care 3,170 3,479
Efficiency measureAverage cost per weighted activity unit (WAU) for Activity Based Funding facilities
Other key performance indicatorsThe following table documents performance against the other key service standards defined in the SDS and Service Agreement with the Department of Health.
Service standards Notes 2016-17 Target 2016-17 Actual Performance
SDS standards:
Mental Health
Rate of community follow-up within 1-7 days following discharge from an acute mental health inpatient facility 9 >65% 72.8%
Proportion of readmissions to an acute mental health inpatient unit within 28 days of discharge 9 <12% 12.9%
Ambulatory mental health service contact duration (hours) 9 >72,612 92,454
Minimum Obligatory Human Resource Information (MOHRI) 2 4,011 4,215
Service Agreement standards:
Access to oral health services – percentage of patients waiting less than two years 2 100% 100%
Discharged Against Medical Advice (DAMA) 10,11 < 0.8% 1.2%
Percentage of complaints resolved in 35 days 12 80% 96.7%
Telehealth – number of non-admitted telehealth service events 2 6,247 7,090
Relative Stay Index (average length of stay) 2 1.00 1.02
Highlights or strategies the DDHHS is implementing to improve performance on indicators from the above table include:• Oral Health
» As at 30 June 2017, 100 percent of patients were waiting less than two years for dental treatment. This was the third consecutive year that this result was achieved demonstrating the DDHHS’s continuing commitment to delivering improved oral healthcare for residents in the region
» In 2016-17 the DDHHS exceeded the oral health weighted occasions of service (WOOS) target by three percent. This was still a reduction of 17 percent from 2015-16 activity levels due to significant additional work being undertaken to reduce the number of patients waiting for dental treatment not required in 2016-17 to achieve the target
» Oral health waitlist numbers increased in 2016-17 from 4,036 to 7,917 due to the very high numbers of patients being added to the list each month this year. Despite the increase in waiting list numbers, the forecast for 2017-18 is to maintain zero long waits. This will be achieved by monitoring the waiting list closely and ensuring that all patients are treated within two years.
Oral health adult patients treated Patients on oral health waiting list
60000
50000
40000
30000
20000
10000
02013-14 2014-15 2015-16 2016-17
8000
6000
4000
2000
02014-15 2015-16 2016-17
41Our performance | DDHHS Annual Report 2016-2017
• Telehealth achieved a 36 percent increase over and above the number of telehealth services delivered in 2015-16. Further detail on this achievement is provided in the following section under Strategic Objective 1
• In 2016-17 the DDHHS exceeded its activity target by 20 percent (based on NWAU); increased staffing to deliver this additional activity is the primary reason for exceeding the MOHRI full-time equivalent (FTE) target by 172 FTE. The opening of an additional ward at Toowoomba Hospital as a winter demand management strategy also contributed to the FTE increase. Despite being over the MOHRI target, the DDHHS delivered a balanced budget at year-end as the additional FTE is funded through growth funding revenue associated with the additional activity.
• The DDHHS is undertaking intensive work to reduce Discharge Against Medical Advice (DAMA), particularly for Indigenous DAMA that has a target of 1 percent (the Indigenous DAMA rate in the DDHHS was 3.2 percent as at 31 March 2017). In May 2017, Toowoomba, Cherbourg and Warwick hospitals launched the Discharge With Medical Support strategy to support and monitor patients who discharge without meeting required criteria. This work is being undertaken in conjunction with Making Tracks project activities to reduce DAMA (see following section - Strategic Objective 1 for a complete list of Making Tracks projects)
• A key performance indicator for measuring efficiency is the comparison of the average length of stay for identified procedures with the State average results. Overall the DDHHS Relative Stay Index was 1.02 compared to a target of 1.00 in 2016-17. While the DDHHS Relative Stay Index was slightly higher than the State average, the DDHHS achieved significantly lower average length of stays for specific surgical procedures while maintaining high-quality patient care. Length of stay results for laparoscopic cholecystectomy, and hip and knee replacements were 17 to 19 percent shorter than the State average. Focused efforts to improve clinical discharge process for procedure groups with above average length of stay are currently underway for implementation in 2017-18.
Continuing increase in demandThe number of admissions to DDHHS facilities continues to grow at a rate much higher than the rate of population growth. In 2016-17 there was an eight percent increase in admissions compared to the previous year. Additionally, there was also a five percent increase in emergency surgeries this financial year. Research has found that poor health status is linked to socioeconomic position. A large proportion (30.6 percent) of our population is considered socioeconomically disadvantaged. Our ageing population, high incidences of chronic disease, along with decreasing rates in private health insurance contribute to a much higher growth in demand for health services over and above population increases alone. To ensure a sustainable service the DDHHS is implementing a number of innovations in keeping with our vision - To deliver excellence in rural and regional healthcare.
Admissions
Eight % increase in admissions in 2016-17 when compared with the previous year 2015-16
Emergency surgeries
Emergency surgery increased 5% in 2016-17 over the previous year 2015-16
Explanatory notes:The 2016-17 targets are as published in the 2017-18 SDS. Percentage results are rounded to the nearest whole percentage point.1. Source: HBCIS/TALONS, excludes outsourced activity and counted as separations2. Source: System Performance Report (SPR) Darling Downs HHS Performance Report Month 12 as at end of
June 20173. Service Agreement key performance indicator4. Source: EDIS and manual count from non EDIS sites. ED presentations include all admitted and non-
admitted triage categories, did not wait, transfer presentations, died in ED, admitted and non-admitted return visit all triage categories
5. Statewide target for specialist outpatient appointments within clinically recommended time Category 1 = 98%, Category 2 = 95%, Category 3 = 95% (clinically recommended times are Category 1 = 30 days, Category 2 = 90 days and Category 3 = 365 days)
6. Source: Activity Costing and Evaluation Service (ACES) report developed from SATR 7. SDS breakdown reported in Queensland WAU (QWAU). Actual performance sourced from DSS ABF (New)
10/08/2017 for full year 2016-17. ‘Prevention and Primary Care’ is comprised of BreastScreen and Dental WAUs. 2016-17 Mental Health estimated actuals are higher than the 2016-17 actuals due to the statistical discharge of all long stay patients
8. Reflects 1 July to 31 December 2016 activity based costs and actual activity based funded activity. Total 2016-17 patient level costing not available until 30 September 2017
9. Source: CIMHA – POS Contact Delivery Mode Profile, HBCIS APP2, and Activity and Costing and Evaluation Service (ACES) report developed from Talons
10. DAMA target for Aboriginal and Torres Strait Islander patients is less than or equal to 1 percent and less than or equal to 0.8% for non-Aboriginal and Torres Strait Islander patients
11. Results as at 31 March 2017 from SPR. 30 June 2017 results not available at the time of publishing12. Source: Prime CI and RiskMan.
More than 2940 babies were born in the DDHHS in 2016-17
Our performance indicatorsThe DDHHS’s Strategic Plan 2016-2020 describes how the health service will provide quality care for the community, and includes our aspirations, strategies and measures of success. The DDHHS carefully monitors its achievements against these targets.
Strategic objectivesOn 1 July 2016, the DDHHS’s new strategic plan came into effect with six new key objectives to replace the four objectives in the previous plan. The new objectives align with the five core directions of Queensland Health’s 10-year strategy for Queensland - My health, Queensland’s future: Advancing health 2026, which was released in May 2016.The strategic objectives are:
1. Deliver quality evidence-based healthcare for our patients and clients
2. Engage, communicate and collaborate with our partners and communities to ensure we provide integrated, patient-centred care
3. Demonstrate a commitment to learning, research, innovation and education in rural and regional healthcare
4. Ensure sustainable resources through attentive financial and asset administration
5. Plan and maintain clear and focused processes to facilitate effective corporate and clinical governance
6. Value, develop and engage our workforce to promote professional and personal wellbeing, and to ensure dedicated delivery of services
The following sections demonstrate our progress in 2016-17 against each of these objectives.
43Our performance | DDHHS Annual Report 2016-2017
Strategic objective 1Deliver quality evidence-based healthcare for our patients and clientsThe DDHHS has for the fifth consecutive year delivered more healthcare than contracted under the service agreement with the Department of Health. In 2016-17 we provided 20 percent more activity than contracted to improve access to health services in the region. This included meeting or exceeding targets for elective surgery, specialist outpatients, oral health, telehealth and endoscopy services. The strategic objective to deliver quality evidence-based healthcare incorporates these healthcare priorities together with improvements in other program areas including mental health, breast screening and Closing the Gap. During 2016-17 there were a number of measures for these programs to assess the DDHHS’s overall performance against this strategic objective.
Accreditation affirms safe and quality care.The DDHHS underwent several accreditation assessments in 2016-17. This included a periodic review against the National Safety and Quality Health Service Standards (NSQHS), assessment against the National Mental Health Standards and a surveillance audit against the Australian Standard/New Zealand Standard International Standards Organisation (ISO) 9001:2008. The DDHHS achieved ongoing certification, receiving a “met with merit” status against NSQHS Standard 2.1.1 “Consumers and/or carers are involved in the governance of the health service organisation”. The Institute of Healthy Communities Australia conducted the assessments over a two week period in April 2017 against all facilities within the DDHHS.The Australian Aged Care Quality Agency (AACQA) undertook several audits against the residential aged care facilities within the DDHHS. Two facilities underwent full re-accreditation assessments of the four standards and 44 outcomes and both were successful in gaining accreditation for a further 3 year period.
The AACQA also conducted unannounced assessment contact visits at all residential aged care facilities and all met the standards assessed on the day.
Systematic Approach Facilitates Excellence (SAFE) Audit ProgramThe SAFE audit program has been in place throughout the DDHHS since July 2014 and remains one of the highpoints of the DDHHS clinical audit program. The program engages management and front line clinicians in assessing compliance against the NSQHS in Healthcare, the National Standards for Mental Health Services and Aged Care. SAFE audits are conducted monthly and consist of six theme-based modules which are complemented by a mini audit. Results are reviewed by all levels of management and action plans put in place to address any areas falling below the agreed benchmark of 80 percent. The SAFE program constantly evolves to assist in meeting and measuring new strategies.
Prestigious partnership commences with Cognitive Institute
In early 2017 the DDHHS entered into a long-term partnership agreement with The Cognitive Institute to become a Safety and Reliability Improvement Partner. The Cognitive Institute is an international provider of healthcare education that is renowned for delivering targeted training focused on improving patient safety and driving culture change. Partnership with The Cognitive Institute is prestigious with only seven other Safety and Reliability Improvement Partners selected to join its exclusive group of partner healthcare organisations.
BreastScreen Toowoomba celebrate the 350,000th screen since the service commenced in July 1992.
The Safety and Reliability Partnership will drive a quantum leap in the delivery of safe and reliable healthcare across the DDHHS through its focus on organisational culture, leadership, reliability science and high-performance work practices. Commencing in 2017 the Safety and Reliability Improvement Programme will be delivered over four phases:1. Needs analysis2. Leadership development3. Improvement projects4. Accountability.
Prevention – Breast cancer screeningThe BreastScreen Queensland Toowoomba Service (BreastScreen Toowoomba) provides breast cancer screening services to women in Toowoomba and the surrounding regions. On 23rd January 2017, the service celebrated its 350,000th screen since the service opened in July 1992.BreastScreen Toowoomba successfully relocated from the Toowoomba Hospital campus to a new facility in the Toowoomba Central Business District, which was officially opened in August 2016. The new location has been well received by clients with its modern spacious fit-out and free and ample car parking for clients and staff. A mobile service is also available and provides screening to women in rural centres of the DDHHS, as well as women outside the DDHHS (Windorah within the Central West Hospital and Health Service, major centres in South West Hospital and Health Service and Gatton in the West Moreton Hospital and Health Service). The service introduced an online booking system in December 2016 as an innovative tool to improve access to services. Since the introduction of this innovation, 12% of BreastScreen Toowoomba clients have booked their screening appointment online.Digital breast tomosynthesis is the latest advancement in mammography. It creates a three dimensional picture of the breast using x-rays allowing enhanced assessment and diagnostic work-up. In 2016-17 there were a number of technological and equipment improvements made to the BreastScreen Toowoomba equipment including the addition of tomosynthesis capability:• Upgrade of the Siemens mammography machine to tomosynthesis capability at a cost of $75,000 with the
funds generously donated by the Toowoomba Hospital Foundation• Installation of new Hologic tomosynthesis mammography machine• 2 new ultrasound machines.
The breast screening target for total number of annual screens was exceeded in 2016-17 and represented the highest number of women ever screened since the service commenced 25 years ago. This achievement together with other highlights are summarised in the table below:
Key performance indicator Notes 2016-17 Target 2016-17 Actual Performance
Total number of breast screens performed: 19,000 19,037
Service highlights:• 10,188 mobile screens • 8,849 Toowoomba static site• 563 indigenous women screened (highest annual achievement
since the service began 25 years ago)• 89% women screened have been screened by the service
previously and the remaining 11% are new patients to the service • 1,721 out of hours screens (outside Monday to Friday, 8.00am to
5.00pm) conducted by BreastScreen Toowoomba, significantly exceeding the target of 906 out of hours screens
• 1,058 of the women screened had further investigations and approximately 123 women were referred for definitive treatment.
45Our performance | DDHHS Annual Report 2016-2017
Aged Care Cluster highlights
Aged Care Assessment Team exceeds national key performance benchmarksThe Aged Care Assessment Team (ACAT) undertakes assessment and provides information and support to older people and their carers to obtain a range of Commonwealth funded services. The team provides:• Assessment and care coordination for individuals and carers to enable clients to remain living at home or to
enter an aged care residential home• Individual, carers and group education to enhance knowledge and skills for management of people with dementia• Analysis of service needs and gaps to contribute to the development of local and regional aged care
community services.
Key performance indicator Notes 2016-17 Target 2016-17 Actual Performance
National ACAT Key Performance Indicator 1
Referrals issued to action (including self-referrals for comprehensive aged care assessments) are actioned (accepted or rejected) within 3 calendar days of issue
90% of referrals 98.8%
National ACAT Key Performance Indicator 2
First clinical intervention of clients for high priority ACAT referrals (within 2 calendar days) 90% of referrals 96.4 %
First clinical intervention of clients for medium priority ACAT referrals (within 14 calendar days) 90% of referrals 96.9%
First clinical intervention of clients for low priority ACAT referrals (within 36 calendar days) 90% of referrals 99.5%
Community Care and Transition Care ProgramsThe DDHHS cares for nearly 300 people a day in our residential aged care facilities (RACFs) or multipurpose health services (MPHSs). 2016-17 brought about changes to Aged Care and Community Care services with our under 65 clients and Disability Services Queensland clients moving to the National Disability Insurance Scheme (NDIS) at the end of May 2017. Home Care Packages also became mobile at the end of February 2017 enabling clients to choose their own provider.
Other highlights • The Transition Care Program celebrated 10 years of
service in 2016-17. They also received a total of 91 compliments in the year
• Residents, families and staff greatly appreciated the garden improvements at The Oaks RACF in Warwick. The garden improvements provide a friendly and welcoming environment for residents and staff and are all part of the DDHHS’s efforts to ensure continued accreditation of our services
• The Oakey Hospital and Dr EAF McDonald Nursing Home won the open garden for a rural hospital or nursing home division as part of the Toowoomba Regional Council’s Carnival of Flowers in September 2016. The gardens also became the venue for the wedding of two longstanding hospital staff members, with all residents delighted to be able to celebrate the event
• Mt Lofty Heights Nursing Home’s therapy dog, Sammy featured on national television demonstrating the benefits to resident care that a pet therapy dog can provide. Unfortunately Sammy died in May 2017 and a memorial service was held to celebrate the valuable role Sammy had as a therapy pet
• Mt Lofty Heights Nursing Home, Dr EAF McDonald Nursing Home (Oakey), Millmerran MPHS and Milton House RACF (Miles) collectively won the Better Practice Award 2016 from the Australia Government Aged Care Quality Agency for their entry on Maintaining Mature Mouths using Teledentistry. Maintaining Mature Mouths using Teledentistry is an innovative model of care enabling DDHHS RACF residents to have oral checks and dental reviews via a live streaming videoconference appointment with a dentist. The integrated approach between DDHHS’ Oral Health Clinic, Telehealth team, four RACF’s, as well as residents and their families, allows residents to receive optimal dental care while remaining in their own surroundings, eliminating the need for frail residents to be transported to the oral health clinic via ambulance with a nurse escort.
Mental Health Alcohol and Other Drugs Division highlights
Tackling Regional Adversity through Integrated Care (TRAIC) Mental Health Alcohol and Other DrugsThe DDHHS has successfully received $296,937 of ongoing annual funding for the TRAIC program. With this funding, the DDHHS has appointed a Regional Adversity Integrated Care Clinician (RAICC) in April 2016 who has taken the lead role across the DDHHS to coordinate improved support for frontline emergency department staff working with people experiencing suicidal behaviour and feelings. The Suicide Risk Assessment and Management in Emergency Departments (SRAM-ED) is a Statewide developed and locally run program that aims to provide improved care for people at risk of suicide. The appointment of the RAIIC has ensured that the DDHHS TRAIC program has delivered on all performance requirements in 2016-17.
Independent Patient Rights Advisers for mental health clientsThe DDHHS recruited two Independent Patient Rights Advisers in 2017 to support people in the DDHHS and South West Hospital and Health Service (SWHHS) using mental health services. The appointments were made in accordance with the Mental Health Act 2016 and relevant Queensland Health policies with dedicated State funding provided for these positions.
Acute Mental Health Unit goes tobacco free2017 saw the Acute Mental Health Unit go tobacco free with a no handling of tobacco products policy. Extensive consumer education and the use of evidenced-based approaches to nicotine replacement therapy are used to support people to stop smoking. This approach was recently showcased as a leading example of enhancing patient care at the Department of Health’s Clinical Excellence Division Innovation Showcase in May 2017.
Closing the GapOne of the DDHHS’s strategies is to deliver Aboriginal and Torres Strait Islander health and support services in line with Closing the Gap to improve the health outcomes of Aboriginal and Torres Strait Islander people. This commitment aligns with the Queensland Government Making Tracks towards closing the gap in health outcomes for Indigenous Queenslanders by 2033: Policy and accountability framework (2010).
47Our performance | DDHHS Annual Report 2016-2017
The DDHHS was successful in obtaining $1.79 million under the Making Tracks investment strategy 2015-18 for nine projects to implement evidence-based initiatives that will address the health gap. Achievements in 2016-17 for each of the projects include:Queensland Health Aboriginal and Torres Strait Islander Cultural Capability Framework • The DDHHS Cultural Capability Action Plan 2017-20
was developed in June 2017 for implementation over the period July 2018 to June 2020. The plan consolidates existing cultural capability activities within DDHHS, as well as introducing a number of innovative projects focused on building Aboriginal and Torres Strait Islander workforce and leadership. The DDHHS will expand on current models of care and improve cultural competence of the health workforce, including recruitment and retention of Aboriginal and Torres Strait Islander people
• Ward signs were erected in June 2017 at Toowoomba Hospital incorporating Aboriginal designs to demonstrate cultural recognition and build rapport with Aboriginal and Torres Strait Islander people visiting the Toowoomba Hospital. It is a visual way of indicating that Aboriginal and Torres Strait Islander people are welcomed by the health service and this is a safe place for them to be
• The DDHHS held the National Close the Gap Day expo in Toowoomba on 16 March 2017 to improve understanding of Indigenous Health with staff. The expo provided an opportunity for DDHHS staff to learn about holistic health care and programs addressing the social determinants of health. One of the aims is to improve the rate of Discharge Against Medical Advice (DAMA). High rates of DAMA show that Aboriginal and Torres Strait Islander people do not feel culturally safe in our facilities. By breaking down barriers, myths about bad experiences, and the stigma attached to hospitals with Aboriginal and Torres Strait Islander community members, it will enable DDHHS to improve DAMA statistics
• A cultural audit of 406 DDHHS staff and 121 community members was completed in 2016-17. Results demonstrate that: » 88% of staff had completed the cultural
awareness survey » 54% of staff implement welcome to country
and acknowledgement of country at meetings and forums
» 68% of community members are able to understand the health information given by staff
» 69% of community members feel comfortable when they have to come to the hospital for appointments
• The DDHHS Aboriginal and Torres Strait Islander Health Forum is held quarterly to give Aboriginal and Torres Strait Islander Health staff an opportunity to highlight their successes, gain knowledge of other programs and projects within the DDHHS and community organisations, to network with their peers and community-based staff from services outside of the DDHHS and Aboriginal and Torres Strait Islander community members
• National Aboriginal and Islander Day Observance Committee (NAIDOC) observance activities were held in the first week of July 2016. 23 DDHHS facilities hosted a NAIDOC event to assist in breaking down barriers for Aboriginal and Torres Strait Islander people accessing DDHHS facilities and celebrating the history, culture and achievements of Aboriginal and Torres Strait Islander people.
Indigenous Multi-disciplinary Care Team – Toowoomba Hospital• The team delivered culturally and clinically
effective dietetics, pharmacy and podiatry services to Aboriginal and Torres Strait Islander people to improve the early detection, treatment and management of chronic diseases, and reduce the rate of potentially preventable hospitalisations and readmissions for chronic disease-related conditions. This service is provided to Aboriginal and Torres Strait Islander people presenting to Toowoomba Hospital with a chronic disease or at risk of chronic disease. Achievements in 2016-17 include: » Pharmacy - 360 occasions of service including
37 medication reviews and 83 smoking cessation interventions
» Podiatry - 372 occasions of service including 50 new foot protection program plans
» Dietician - 204 appointments including 33 weight reduction and 32 type 2 diabetes mellitus weight reduction plans.
South Burnett Indigenous Hospital Liaison Service• In 2016-17 the rate of Indigenous admissions
was 22 percent at Kingaroy Hospital. To ensure culturally-appropriate services are provided, two Indigenous Liaison Officers see every patient on admission and are involved in their inpatient stay and follow up care. This service improves the patient journey and continuity of care by implementing comprehensive gender specific culturally-safe and coordinated case management and referral pathways across all entry and exit points into and out of the Kingaroy Hospital, including liaison with Cherbourg Hospital and community health services.
Indigenous Alcohol, Tobacco and Other Drugs (ATODS) Youth Program (Cherbourg)• In 2016-17 the Youth ATODS Program in Cherbourg
provided practical support to young Aboriginal and Torres Strait Islander people at risk of harm from drug and alcohol use. The program delivers alcohol, tobacco and substance misuse harm prevention, early intervention and treatment services to reduce the uptake and rates of harm caused by alcohol consumption, smoking and the use of illicit substances and inhalants by Aboriginal and Torres Strait Islander young people. Achievements in 2016-17 include: » Volatile substance program – 1,077 recorded
occasions of service » Breakfast program – 2,081 occasions of service » Health Promotion 62 occasions of service » Counselling 165 occasions of service.
South Burnett Renal Services Expansion• The objective of the expansion is to increase
access to specialist renal services and delay the onset of end stage renal disease by increasing the number of dialysis chairs available at Kingaroy and Cherbourg Hospitals and implementing a nurse practitioner model of care to improve the early detection, treatment and management of Aboriginal and Torres Strait Islander people with chronic kidney disease.
• Achievements in 2016-17 include: » Monthly chronic kidney disease clinics with
renal nurse practitioner and Indigenous health care workers
» Telehealth chronic kidney disease and haemodialysis clinics and reviews
» Plan for commencement of services from two renal chairs at Cherbourg Hospital
» Increased capacity for self-dialysis at Kingaroy Hospital from 12 to 18 clients.
Cherbourg Young Parent Support Service• The service delivered comprehensive culturally-
appropriate and responsive community based antenatal, intrapartum, postnatal and early parenting care to Aboriginal and Torres Strait Islander young women to improve infant and child health outcomes. Achievements include: » Services provided to 129 clients for antenatal
and postnatal services » From 1 January 2017 to 30 June 2017, 92 percent
of babies born to mothers attending the service were above the standard 2500g at birth – this is an increase on the previous 6 month’s achievement (77 percent).
Outreach Maternal and Infant Health Service (Boomagam Caring)• Provides comprehensive, culturally-appropriate,
and responsive community-based antenatal, postnatal and infant care services to pregnant Aboriginal and Torres Strait Islander women to reduce mortality in Aboriginal and Torres Strait Islander infants aged 0 to 6 weeks. The service is located in Toowoomba and surrounding areas within a thirty minute radius and provided to pregnant and parenting Aboriginal and Torres Strait Islander women, with a particular emphasis towards those under 20 years old. Approximately 10.4 percent of births (equivalent to 200 births) in Toowoomba Hospital are to Aboriginal and Torres Strait Islander mothers). Achievements in 2016-17 include: » 2,269 occasions of service » 100% Boomagam Caring Outreach Midwifery
Service clients receiving five or more health checks over the reporting period
» 96 clients provided with midwifery care plans for both antenatal and postnatal periods.
49Our performance | DDHHS Annual Report 2016-2017
Maternal Child and Youth Health Workforce Development Program• The program delivers high-quality workforce
training to Maternal, Child and Youth health staff to improve service delivery for young people’s transition to adulthood and reduce mortality in Aboriginal and Torres Strait Islander children aged 0 to 4 years. Workforce development programs have been implemented across a range of areas. The Cunningham Centre Workforce Division oversees the governance of the Queensland Aboriginal and Torres Strait Islander Maternal, Child and Youth Health Workforce Development Program in collaboration with key stakeholders.
Acute Mental Health Indigenous Health Liaison• In 2016-17, 571 occasions of service were provided
by this service including a range of mental health hospital liaisons, case coordination assistance to Aboriginal and Torres Strait Islander patients with mental illness accessing Toowoomba Hospital and related services (including their families and carers). The aim of the service is to: » Improve the patient journey and continuity of
care by implementing comprehensive, culturally safe and coordinated case management and referral pathways across the continuum of care and all entry and exit points into and out of DDHHS hospitals
» Implement strategies to reduce the rate of Discharge Against Medical Advice for Aboriginal and Torres Strait Islander patients accessing the Toowoomba Hospital.
Telehealth highlightsIn 2016-17 the DDHHS delivered 36 percent more telehealth services against a target of 20 percent more service events than provided in the previous year. Highlights of this year’s achievements include:• Telestress testing commenced in April 2017 with
Toowoomba Clinical Measurements as a recipient site and the Royal Brisbane and Women’s Hospital (RBWH) cardiac scientist and cardiac registrar as the service provider. Since commencement of the service 128 patients have received a stress test under the guidance of the team at the RBWH resulting in patients being able to receive the necessary testing that they require closer to home
• A 3 month trial of a telepharmacy service commenced in April 2017. The trial involved a pharmacist receiving referrals from those rural facilities without a pharmacist and the provision of inpatient and outpatient medication consultations. A total of 72 patients were seen as part of the trial which has improved access to medication reviews and assessment in rural areas demonstrating that telehealth is a viable mode of delivery for enhancing access to pharmacy services in rural areas. The trial is currently being evaluated and considered for full implementation.
• The Telehealth Emergency Support Unit (TEMSU) nursing model was introduced in December 2016. This model provides emergency nursing support via telehealth for DDHHS rural and regional facilities 24 hours a day, 7 days a week. There were 53 telehealth consultations in total in 2016-17. Development of a medical model is currently in progress with plans to commence implementation of this model in late 2017
• A Pastoral Care Telehealth Outreach service has been provided to DDHHS rural hospitals. This has included the coordination of a video conference for a Buddhist palliative care patient with a Buddhist Nun providing in-service advice to nursing staff and individualised support to the patient. The recipients of this session expressed their gratitude for both the support and advice provided. A patient who was unable to leave Toowoomba Hospital was also able to ‘attend’ her father’s funeral in Windorah (700kms away) through live streaming of the funeral to an electronic tablet device at her bedside. These are significant examples of how our staff care for and support our patients to receive a holistic patient care experience.
Telehealth presentations patients treated
36% increase in telehealth presentations 2016-17 over the previous year 2015-16
New tele-chemotherapy service commences at Dalby Hospital Dalby Hospital was selected as a pilot site for a new tele-infusion and supportive therapies service to provide chemotherapy services closer to where patients live, reduce patient travel time, and minimise disruption to their family and work routines. The service commenced in November 2016 with patients receiving stage 1 chemotherapy and supportive therapy at Dalby Hospital with assistance from an Oncologist and nurse from Toowoomba Regional Cancer Centre using videoconferencing facilities. Staff at Dalby Hospital were trained at the Toowoomba Regional Cancer Centre prior to the trial commencing. Patient feedback on this new service has been overwhelmingly positive and as a result the service delivery model will be extended to other sites in the DDHHS in the 2017-18 financial year.
Nurse Navigator ProgramThe nurse navigator initiative is a four year government commitment to increase nursing resources between 2016 and 2019 by funding dedicated nurse navigator positions across the State’s Hospital and Health Services. In 2016-17, the DDHHS appointed nine nurse navigators with a further ten scheduled to be appointed by late 2017. Nurse navigators support and work across system boundaries in close partnership with multiple health specialists and stakeholders to ensure patients receive appropriate and timely care. Nurse navigators are highly experienced and have an in-depth understanding of the health system to assist patients with complex health conditions. The core functions of the DDHHS Nurse Navigators are shown in the diagram below.
Nurs
e Navigators
Patient
Access logistics
Education/health literacy
Care path transitions
Monitoring and evaluation
of care outcomes
Self Management
Support Strategy
AdvocacyReferral
Patient at Dalby Hospital uses videoconferencing to speak with his oncologist.
Hospital in the Nursing Home and Acute Geriatric ServiceIn July 2016-17 the pilot of the nurse navigator aged care model (Hospital in the Nursing Home) commenced with the appointment of a nurse navigator to the Acute Geriatric Service Toowoomba Hospital. Services provided by the Hospital in the Nursing Home include:• ‘Virtual admission’ of RACF residents allowing
acute care to be provided under a Geriatrician within their nursing home supported by the nursing practitioner
• A telephone triage service providing advice to RACFs prior to a potential hospital admission, in consultation with the patient’s GP
• Organisation of an acute response team to attend the RACF if required following a referral from a GP or RACF
• Education and support to RACFs and communication and partnerships with GPs.
As a result of the pilot there have been decreased presentations to EDs and a reduction in preventable hospital admissions by improved early management of a deteriorating patient. There has also been a significant reduction in length of stay for readmissions of this patient group. In 2017-18 the service will be expanded to include four nurse navigator positions providing services to all aged care facilities in the DDHHS region.
51Our performance | DDHHS Annual Report 2016-2017
DDHH Board Chair Mr Mike Horan AM speaking at the inaugural DDHHS Community Information Expo.
Birthing ServicesThere were five percent fewer babies born in the DDHHS in 2016-17 compared to 2015-16. The decrease was relatively evenly distributed across the health service with most hospital locations reporting fewer births.
Babies born in the DDHHS 2016-17
Hospital Location Births
Toowoomba 2,013
Kingaroy 333
Warwick 163
Dalby 173
Stanthorpe 110
Goondiwindi 97
Chinchilla 51
Cherbourg, Miles, Millmerran 9
Total 2,949
Total births since 2014-15
5% reduction in births in 2016-17 compared to 2015-16
Maternity and Birthing Advisory GroupThe recommendation to form a Maternity and Birthing Advisory Group was a key outcome from the Maternity Services Forum held on 21 June 2016. The DDHHS Executive Management Committee endorsed the establishment of the Maternity and Birthing Advisory Group in July 2016.
The function of the Maternity and Birthing Advisory Group is to develop a health service wide Maternity and Birthing Services Plan for 2016-2020. The Plan will develop a consumer focused model of care promoting consistency of safe practice using a collaborative approach. The plan will address the challenges of providing safe maternity and birthing services for a population with an increasing risk profile due to health issues. Remoteness, culturally appropriate services, workforce, access and infrastructure were issues identified at the forum to be included in the development of the plan.
New renal dialysis service opens at Dalby HospitalPrior to 2017, Dalby Hospital provided intermittent and limited renal services with one dialysis machine for self-caring haemodialysis patients. Few patients requiring dialysis met the required criteria for this service and most patients in the Western Downs requiring haemodialysis needed to travel to Toowoomba three times a week to receive their treatment. In January 2017 the DDHHS commenced a new renal dialysis service at Dalby Hospital by training nursing staff to deliver haemodialysis to relatively stable patients three days a week (Monday, Wednesday and Friday). Up to four patients a day can be treated using both the morning and afternoon sessions. Three new dialysis machines were purchased to support the service. The Toowoomba Hospital Renal Unit provided initial training for Dalby Hospital nursing staff working in the unit and continues to provide valuable support and education to the Dalby Hospital Renal Unit and regular Telehealth consultations. The Toowoomba Hospital Renal Educator makes routine visits to Dalby Hospital to support nursing staff. Patients who previously spent time travelling for their dialysis treatment are now able to spend that time on daily living activities in their local community.
Strategic objective 2Engage, communicate and collaborate with our partners and communities to ensure we provide integrated, patient-centred care The DDHHS completed a number of actions in 2016-17 to support this strategic objective. The measures of success listed in the DDHHS Strategic Plan 2016-20 include:• We will establish and facilitate an engaged and effective consumer advisory council• We will coordinate meetings and jointly plan with the Darling Downs West Moreton Primary Health
Network (DDWM PHN) and community-controlled Aboriginal and Torres Strait Islander health services• We will hold meetings between community groups and the Board at least monthly• We will disseminate information and communicate updates about our activities to inform the community
and our partners
Included in the Our governance section of this report is an extensive list of community meetings that DDHHS Board members attended in 2016-17, demonstrating the Board’s commitment to this strategic objective. In addition to the Board activities, staff throughout the DDHHS proactively engage with community and consumers on a regular basis. The information below provides a summary of how these actions demonstrate support for this strategic objective this year.
Gail Capewell, Kayleen Wallace and Anne Doyle at the Toowoomba Hospital Closing
the Gap Day Health Expo
53Our performance | DDHHS Annual Report 2016-2017
Consumer and community engagement
Consumers engaged
The DDHHS has 39 consumer representatives involved in 21 committees across the DDHHS.Consumers have been engaged through various committees and advisory groups:• DDHHS Consumer Council• Toowoomba Hospital Management Committee• Toowoomba Hospital Patient Safety and Quality Committee• Reducing Harm Committee• Toowoomba Hospital Consumer Advisory Committee• Consumer Communication Committee• Consumer Publication Review Group• Maternity and Birthing Advisory Group• Floresco Advisory Group• Domestic and Family Violence Working Group• Human Research and Ethics Committee• Diabetes Model of Care Project Group• NDIS Reference Group• Nurse Navigator working groups• Rural Division Management Committee• Goondiwindi Hospital Indigenous Advisory Working Party • Cherbourg Health Action Group• Stanthorpe Community Consultative Committee• Texas Community Advisory Network• Millmerran MPHS Community Advisory Network• Tara Health Community Consultative Committee Issue-specific consumer engagement has occurred in various models of care, including:• Diabetes model of care• Aged care model of care• Stroke model of care.
Consumer engagement activities
• DDHHS & DDWMPHN hosted a collaborative Community Information Expo in Toowoomba in June 2017 with 51 exhibitors
• Pittsworth Bi-annual Health and Wellness Expo held in April 2017 in collaboration with DDHHS and Toowoomba Regional Council
• Closing the Gap – Indigenous Health Expo held in March 2017• Mental Health consumer and carer advisory forums held in Stanthorpe, Kingaroy and Dalby• A carer volunteer program was established at the acute mental health unit to assist families to
connect with relevant support services• Regular communication through the media about our services and how consumers can access
these services• Patient information brochures updated• Increased partnerships with DDWM PHN and local governments• Patient discharge surveys conducted by volunteers via an iPad• This year saw the establishment of a Consumer and Community Engagement Officer role in
April 2017• Mental Health staff members invite consumers to participate, in the Statewide Your Experience
of Service (YES) survey instrument.
Good governance • Health service governance processes and structures have been developed and implemented, including a consumer and community engagement strategy, consumer engagement policy, consumer feedback procedure, consumer publication management procedure, staff tools and resources
• These resources guide how we engage and collaborate with our consumers to provide enhanced healthcare services.
Patient experience • A variety of patient experience feedback mechanisms have been implemented and made available to all patients throughout the health service in 2016-17. These mechanisms enable patients, their family and carers to provide feedback on their experience across the health service
• Numerous patient experience surveys have been undertaken by units across all areas of the health service
• Survey data has been analysed to drive quality improvement.
Education and Training
• Staff and consumer representatives have participated in Health Consumers Qld (HCQ) training• Staff and consumer representatives attended the HCQ Annual Forum to build awareness and
knowledge of engagement activities and programs across the State• Consumer representatives are provided orientation to assist in the function and purpose of
their roles.
Patient feedback • 3,560 compliments • 1,651 complaints• Ratio of 2:1 of compliments to complaints• 98.4% of complaints acknowledged in 5 calendar days and 96.7% resolved within the state-
wide benchmark of 35 days.
DDHHS action in response to complaints The DDHHS takes seriously any complaint about our service including staff conduct. In 2016-17 the majority of complaints were resolved with an acknowledgement of concern or an apology. Some complaints required further action such as a policy or procedure change, staff training or provision of a service such as a second clinical opinion. Of the 1,651 total complaints received, 115 required further action over and above an acknowledgement of concern, or an apology.
DDHHS volunteer Margaret Goodman and consumer
representative Dr Jim Madden at the Consumer Engagement morning tea
28 February 2017.
55Our performance | DDHHS Annual Report 2016-2017
Toowoomba Hospital speech pathologist Madeline Dawson, pictured with patient Mrs Lorna Rickert, won the statewide ‘Leaders in Speech Pathology – new graduate quality improvement award’ for the development of an easy-to-read version of the Australian Charter of Healthcare Rights
Allied Health innovation – Australian Charter of Healthcare RightsThe Australian Charter of Healthcare Rights describes the rights of patients, consumers and other people using the healthcare system and was developed by The Healthcare Commission on Safety and Quality in Healthcare in 2008. The Charter is provided to all consumers on admission or entry into a hospital or health service. In January 2017 one of the DDHHS’s Speech Pathologists, Madeline Dawson, developed an alternative version of the Australian Charter of Healthcare Rights as the way the current Charter is written is hard for people with age-related or acquired communication and/or cognitive difficulties to read. The new version of the Charter presents the information for all consumers in an easily understandable format, whilst reflecting the same key patient rights. Patient feedback on the alternate version has been overwhelmingly positive.
“I definitely think the new version is the
better of the two”
“The writing is a lot bigger, you can see everything
much more clearly and it’s far easier to read.”
(102 year old inpatient, name withheld)
The alternate version of the Charter has been rolled out for use across all DDHHS facilities, community services and outreach facilities and is provided on admission to the health service, in consumer information packs, displayed in waiting rooms and at each bedside for patients to read. Madeline presented this project at the DDHHS’s Allied Health Showcase in March 2017. This project was also showcased on local radio and television media and Madeline was awarded the Statewide “Leaders in Speech Pathology – new graduate quality improvement award”. This new Charter has also been adopted by Logan Hospital, Mackay Hospital and Lady Cilento Children’s Hospital.
Aged Care – Community engagement highlightsWondai Hospital and Forest View RACF staff actively engage with their local community to build close relationships. Activities in 2016-17 included:• Wondai annual fete run by the hospital auxiliary
with all members of the community invited to attend. The fete this year was opened by the South Burnett Regional Council Mayor and Councillors, DDHHS Board Member (Cheryl Dalton) and the Director of Nursing of Wondai
• Mutual exchange of invitations with the local childcare centre to shared functions
• Providing opportunities for school students and TAFE students to have work experience including ‘a project’ to complete
• Inviting the local Kingaroy bike club to visit twice to have morning tea with the residents.
Mental Health Alcohol and Other Drugs Division achievementsThe Division continues to support engagement and collaboration with consumers, carers and the community including:• Participating in the Queensland Mental Health
Commission’s recent regional consultation days regarding the review of the Queensland Mental Health, Drug and Alcohol Strategic Plan 2014-2019. This included both a general community workshop and a specific lived experience workshop
• Supporting strong family and carer engagement through the introduction of a volunteer carer support service in the Adult Acute Inpatient Unit. As part of this service experienced carers are on hand most afternoons during visiting hours to provide information and support
• The Alcohol and Other Drugs Service ran several community family drug support workshops in 2017 to help staff better understand supports required by families and carers of people who use drugs. Family Drug Support education included a carers evening session
• Continuing to facilitate and support a number of mental health Consumer and Carer Reference Groups throughout the region
• Engaging an Indigenous Liaison Officer in the Adult Acute Mental Health Unit to support consumer and family engagement through the Making Tracks Program
• Introducing a revised Police Ambulance Intervention Plan (PAIP) to improve interagency coordination and support to people experiencing complex mental health problems in the community.
Planning for the future – Toowoomba Hospital redevelopment consultation In August and September of 2016, the DDHHS invited both staff and the community for their input regarding future planning and redevelopment options being considered for Toowoomba Hospital to meet the growing healthcare needs of the population. The options being considered include:1. A staged redevelopment of Toowoomba Hospital2. A new “greenfield” hospital built at Baillie
Henderson Hospital3. A hybrid model which would see acute services
provided at Baillie Henderson and subacute service at the Toowoomba Hospital campus.
Community and staff information sessions were held over two months culminating in a survey on the three proposals and the feedback received being included in a preliminary business case that was submitted to the Queensland Government. The DDHHS has received $3 million in the 2017-18 financial year to develop a more detailed business case on the options to enable the government to make a final decision on the best option for Toowoomba and the Darling Downs region.
A volunteer carer support service was
introduced in the Adult Acute Inpatient Unit at Toowoomba Hospital
57Our performance | DDHHS Annual Report 2016-2017
Strategic objective 3Demonstrate a commitment to learning, research, innovation and education in rural and regional healthcareA range of educational and training activities occurs throughout the DDHHS. Our leading education centre, the Cunningham Centre, delivers a wide range of high quality programs throughout Queensland in areas such as allied health, medicine and nursing with experienced and accredited trainers. Since its establishment, the Centre has been involved in high-quality training, education, research and support of health personnel in Queensland.
Cunningham Centre rural and remote support and education highlights
Allied health rural generalist pathwayThe allied health rural generalist pathway is a key strategy to progress the sustainability and value derived from Queensland’s rural and remote allied health workforce. This initiative provides funded supernumerary graduate positions for rural or remote allied health teams. It aims to support early career rural and remote workforce development and to assist teams to implement rural generalist service redesign and development. A key component of the allied health rural generalist pathway is a structured education program which supports capability development for rural allied health practice. In 2016-17, an education provider was sought to develop and implement a two-level program. James Cook University and the Queensland University of Technology were successful in this regard, and the Rural Generalist Program (Level 1 program) opened for enrolments in May 2017. Allied Health Rural Generalist Training Positions in Queensland Health, as well as other states, will be participating in this program during 2017-18. It is anticipated that the Graduate Diploma in Rural Practice (Level 2 program) will be offered from early 2018. Ten allied health rural generalist training positions were implemented in rural and remote locations in 2016, and outcomes of these positions were presented at an implementation showcase in May 2017.
In 2016, the selection process for 2017-18 host sites was conducted and 11 host sites were selected. Positions for 2017-18 are located across eight HHSs, and include one or more positions from the professions of dietetics, medical imaging, occupational therapy, pharmacy, physiotherapy, podiatry and social work.
Allied Health HP3 to HP4 Rural Development PathwayThe Allied Health, Health Practitioner’s (HP)3 to HP4 Rural Development Pathway is a human resource and workforce development strategy jointly coordinated by the Cunningham Centre and the Allied Health Profession’s Office of Queensland (AHPOQ). The pathway provides a recruitment strategy for health services and an intensive development plan for practitioners that are tailored to rural and remote practice requirements.The second participant to successfully complete the pathway finished in September 2016, and two further participants are mid-way through the pathway, having successfully completed their annual external evaluations in April 2017. A major component of the pathway is a suite of learning resources. Stage 1 and 2 support modules are available online with some stage 3 and 4 also available online. Although tailored to rural and remote services, these online resources are valuable for allied health practitioners in regional or metropolitan settings.
Telehealth educationAn online training program was developed and launched by the Cunningham Centre in March 2017. The program is designed in three sections: service redesign, clinical examples and telehealth resources. Since the launch, 77 Queensland Health staff have accessed the training program. Administration of the Telehealth Network and presentation series transitioned to the Cunningham Centre in late 2016. The network currently has 165 members. There have been four presentations in 2017 with a total of 50 videoconference sites registered. Topics have included presentations on occupational therapy hand therapy, teleradiography, pharmacy and multidisciplinary persistent pain management.
X-ray operator training and supportIn 2016, there were approximately 330 Queensland Health staff in rural and remote facilities who were also licenced X-ray operators. A range of training and support activities for X-ray operators were provided by the Cunningham Centre in collaboration with the Toowoomba Hospital Department of Medical Imaging during 2016-17. These included:• Seven training and assessment workshops which
provided professional development opportunities as well as components of the X-ray operator annual competency assessment. 82 participants from seven HHSs attended
• A videoconference in-service series for X-ray operators. Twelve in-services were well attended and featured guest speakers covering a range of topics relevant to X-ray operator skill development
• Facilitation of the Radiographic Advisor Reference Group which met quarterly to discuss topics relevant to X-ray operator support.
A number of new activities were introduced during 2016-17 in an effort to meet increasing demand for X-ray operator training and support from across Queensland. These new activities were:• An advanced training and assessment
workshop providing professional development opportunities and annual competency assessment requirements in a condensed format, to more efficiently meet the needs of experienced X-ray operators
• A videoconference assessment workshop option for X-ray operators who were able to source training from their local Radiographic Advisor, and needed to access annual competency assessment components only
• An initial training course for new X-ray operators, which meets the needs of the Queensland Health Education and Training Framework for X-ray Operators, and is endorsed by Radiation Health. This course is delivered in a blended learning format, with online, videoconference and face-to-face practical workshops forming part of the course. The first cohort of this pilot course concluded in April 2017, and the second pilot cohort commenced in May 2017. Evaluation of these two initial cohorts will be used to determine the future delivery strategy for this course.
Allied Health Professional Enhancement ProgramThe Allied Health Professional Enhancement Program (AHPEP) provides regional, rural and remote allied health professionals and assistants with access to individually tailored placement opportunities which focus on improving services and health outcomes for their clients. Placements focus on service improvement themes including clinical or evidence-based practice, skill development, succession planning, and investigation of a new service delivery model or clinical education. In 2016-17 a total of 99 placements were completed, including 93 individual, five team and one expert clinician visit. A total of 406 placement days were also completed. 66 percent of participants were from regional areas. Immediately after their placement 99 percent of participants who completed the post placement survey reported that they intended to make changes or improvements in their workplace or clinical practice. When surveyed 3 months after their placement, 96 percent of participants who completed the survey reported they had implemented changes to their practice or service as a result of their placement.
Clinical Education and Teaching Access in Rural Areas (CETAR)The Clinical Education and Teaching Access in Rural Areas (CETAR) initiative has been developed to promote allied health pre-entry clinical education capability in rural and remote Queensland. The purpose of this initiative is to build the number of student supervisors in rural and remote Queensland.The target for this initiative is allied health professionals in increment positions of HP3.2 and above and in HP4 positions that have not been a primary student placement supervisor previously. CETAR links into existing Cunningham Centre programs such as the AHPEP and Supervision training. CETAR includes the following phases: learning stage, AHPEP placement with an experienced student supervisor, student supervision, reciprocal AHPEP placement with the experienced supervisor and critical reflection stage. This initiative is currently supporting three identified rural and remote practitioners in the development of supervision-active to gaining experience as a primary supervisor for a pre-entry student. Furthermore, CETAR is being evaluated to inform the way forward and the evaluation results will be available in late 2017.
59Our performance | DDHHS Annual Report 2016-2017
Allied Health Division highlights
Allied Health ShowcaseThe DDHHS Allied Health 2017 Showcase this year saw innovations in clinical excellence recognised.DDHHS Senior Physiotherapist, Ciaran Fitzgerald presented on the “implementation of day-zero mobilisation for total joint replacements at Toowoomba Hospital” and was awarded best presentation at the showcase. Ciaran presented a study comparing two groups of patients undergoing major joint surgery. Patients who mobilised on the day of surgery experienced an 11 percent reduction in length of stay, without any adverse outcomes. The results provide support for further investigation into this innovative physiotherapy model of care and strategies to be implemented to mobilise more patients on the day of their surgery.Two other awards were presented at the showcase including the best poster award to Ben Kalinowski for an evaluation of a four-week preadmission clinic pharmacist trial, and the innovation award to Amanda Williamson from Transition Care presenting on the neoRehab service delivery model using telehealth to provide services to people’s homes.
Embedding evidence-based research into practice The Research Support Team encourages and facilitates active research collaboration and engagement by providing flexible, targeted research assistance, support and education for DDHHS staff. Team members provide one-on-one consultation with staff members to review drafts or to provide assistance with study design, protocol development, ethical matters, or anything research related. This support is also available to staff undertaking non-research service evaluations, audits and service improvement projects. Achievements in 2016-17 include:• Introduction of on-demand group training and
DDHHS online research education• New fortnightly Research Drop-In sessions held
in the Toowoomba Hospital library• The inaugural 2016 DDHHS Research Awards,
which included awards for Novice and Advanced Researchers
• A central, searchable Research Repository for research output from the DDHHS, including publications and conference presentations linked to the Library homepage. This resource is a valuable, concrete record of successful research activity in the region
• Creation of secure, central stores for paper-based and electronic research records to assist researchers in meeting national guidelines for the retention and disposal of research materials
• Development of useful resources, including guidelines for the completion of the Human Research and Ethics Committee preferred research protocol, and guidelines to assist with completing local assessment of governance processes for all research projects. These documents have been well used by DDHHS staff since their release, and the protocol guidelines are now being adapted by the Mackay Institute of Research and Innovation for their own use
• Development of the Research Publication Submission Procedure in December 2016. This procedure describes the processes required for DDHHS staff submitting a research manuscript for publication where the manuscript is based on research either utilising DDHHS data or conducted by staff whilst engaged in their DDHHS role
• Ongoing reviews of all DDHHS studies listed as active and following up with researchers who are overdue in submitting research reports and assistance offered by the Research Support Team.
Publications and research projects led by DDHHS or as a collaborator• A total of 37 research projects were published in
2016-17 where at least one of the researchers was from the DDHHS
• 13 research projects were led by DDHHS staff members this financial year. This includes all projects where a DDHHS staff member has been listed as a primary or chief investigator. Research leads are responsible for conducting the research, obtaining funding if required and leading research dissemination
• A total of 32 research projects were commenced within the DDHHS where DDHHS staff member/s were listed as a research team member collaborating on the project.
DDHHS successfully secures Integrated Care Innovation Funds for two innovative projects
Diabetes Model of Care ProjectThe DDHHS was successful in receiving funding from the Department of Health’s Integrated Care Innovation Fund (ICIF) for the two year Diabetes Model of Care project commencing in 2016-17. The ICIF contributed approximately $1.69 million and the DDHHS committed a further $150,000 over two years. The project has four key components:• Aboriginal and Torres Strait Islander Care
Coordination Virtual Team• GP led diabetes care• Queensland Ambulance Services (QAS) referral
pathway• Home monitoring.
Referred clients have access to appropriate evidence-based clinical care as close as possible to their own community. Through the project, clients improve their health literacy and self-management to better control diabetes and achieve improved health outcomes. The project has the following goals: • Services should enable people to take more
responsibility for their own health and wellbeing• People should stay well in their own homes and
communities• When people need complex care it should be
timely and appropriate.
The Diabetes Model of Care Project in partnership with QAS and GPs commenced patient referrals in February 2017. By end of June 2017 after five months in operation, there were 158 patients referred and 26 patients discharged from the project. The DDHHS achieved 101 percent of the 2016-17 target referrals required. The project has received excellent consumer and clinician feedback to date.In June 2017, the DDHHS entered into an agreement for home monitoring to provide a telehealth solution to 50 patients within the program with complex and high-needs diabetes. These patients will be provided with home monitoring equipment tailored to their needs. The equipment will monitor daily vital signs and provide telephone support, with alerts and step-up care protocols in place. Patients can take their own vital signs readings and answer questions, which are communicated to a monitoring station for a clinician to review and follow up if necessary.
Floresco ToowoombaThe DDHHS was also successful in receiving funding from ICIF for the Floresco Toowoomba Initiative to provide an innovative mental health service for adults experiencing a moderate or severe mental illness who require integrated care. ICIF have provided $1.5 million in funding for the project. This model is based on the already established Floresco Centre in Ipswich, the first of its kind in Australia, and provides holistic, person-centred, integrated and cost-effective clinical care and psychosocial support.In April 2017, DDHHS signed a service agreement with Aftercare as the key partner in the Floresco Toowoomba project. The DDHHS Mental Health Alcohol and Other Drugs Division will work in partnership with Aftercare to develop an integrated community mental health support service. The service will commence in the 2017-18 financial year.
Mental Health Alcohol and Other Drugs Division
SMS for DadsThe division is currently participating in an innovative research project in conjunction with the Queensland Centre for Perinatal and Infant Mental Health and the University of Newcastle. The project provides regular information and support updates to fathers about growth and development to help them understand and support their partners and new family member.
Rural and Remote Medical Support Division
Educative framework for Junior Doctors Queensland Country Practice (QCP), in collaboration with the Australian College of Rural and Remote Medicine (ACRRM), commenced the development of an educative framework for junior doctors undertaking a prevocational rural generalist medical placement. Curriculum will be based on the Australian Curriculum Framework for Junior Doctors (ACFJD) with three key learning areas in clinical management, professionalism and community.
61Our performance | DDHHS Annual Report 2016-2017
The Queensland Rural Generalist Leader ProgramIn collaboration with the Royal Australasian College of Medical Administrators (RACMA), a customised Leadership for Clinicians Training Program contextualised to the needs of the rural medical workforce in Queensland has been developed. The inaugural cohort commenced in March 2017 with the aim to increase the supply of suitably qualified medical leaders working in rural and remote Queensland.
Rural Generalist Pathway Jurisdictional Forum QCP established a national Rural Generalist Pathway Jurisdictional Forum with the aim of sharing information on State, Territory and Commonwealth rural generalist endeavours and progressing training, practice and research in rural generalist medicine for the benefit of Australian rural communities. Membership comprises representatives from each Australian State and Territory and the Commonwealth Department of Health.
Rural Junior Doctor Training Innovation FundQCP has partnered with universities, other HHSs and colleges submitting a bid to secure funding to develop rural intern training terms in a primary care setting. In doing so, QCP will broaden its scope and join up medical education from university right though to vocational practice.
Relief servicesStatewide relieving services have provided a total of 2,269 weeks of health professional staffing relief to rural and remote communities across the following disciplines:• Medical – Junior – 1,428 • Medical – Senior – 274• Allied Health – 293• BreastScreen – 274
This equates to 43.6 Full Time Equivalent (FTE) staff providing support for rural and remote communities by enabling better access to essential health services.
Specialist pathwaysQCP’s specialist training pathways have worked with hospital and health services and medical education units to deliver significant training opportunities for the specialist medical workforce across Queensland, incorporating centralised recruitment, selection and education. Achievements in 2016-17 include:1. Coordinating the Statewide centralised recruitment,
selection and allocation for the following specialist vocational training pathways/networks: » Basic Physician Training Adult Medicine – 133
new trainees and 168 current trainees, a total of 301 trainees
» Basic Physician Training Paediatric – 50 new trainees and 84 current trainees, a total of 134 trainees
» Intensive Care Medicine – 54 new trainees and 91 current trainees, a total of 145 trainees
» Advanced Training General Medicine – 36 new trainees and 36 current trainees, a total of 72 trainees
» Advanced Training General Paediatric –7 new trainees
2. QCP delivered the following educational programs for specialist vocational trainees: » Queensland Internal Medicine Education Program
(QIMEP) is a registrar-led fortnightly evening lecture series for 72 advanced trainees in general medicine
» Clinical examination preparation program - 1 weekend course and 7 evening lectures with 196 registrants
» Intensive Care Unit (ICU) Supervisor of Training workshop with 20 registrants
» Basic Assessment and Support in Intensive Care (BASIC) were held at Gold Coast and Nambour Hospitals with 24 attendees per course.
3. The inaugural Paediatric Clinical Examination Preparation Program (PCEPP) was held in April 2017. PCEPP is designed as an adjunct to hospital-based clinical exam preparation and provides paediatric trainees with practical advice from topic experts for long and short case preparation with some summaries of issues, pitfalls, strategies, and important cases to master
4. The Royal Darwin Hospital was included as an accredited paediatric training facility in the Queensland Basic Paediatric Training Network.
Queensland Rural Generalist ProgramThe DDHHS’s Queensland Rural Generalist Program (QRGP) was awarded the Premier’s Award for Excellence in the Leadership category in December 2016. The team is responsible for the strategic direction and operational implementation of rural generalist training in Queensland and celebrates 10 years of operation in 2017. A rural generalist is a medical practitioner who provides primary and secondary care to rural communities across hospital and general practice settings, including advanced skills in one or more disciplines. In addition to service and workforce design, the team is responsible for the recruitment, education, placement and support of junior medical officers aspiring to a rural medical career. In 2017, more than 300 trainees are completing Rural Generalist Training and more than 100 Fellows have completed their training.
Executive Director Rural and Remote Medical Support retiresAfter a career spanning 40 years, Dr Denis Lennox retired as the Executive Director Rural and Remote Medical Support on 30 June 2017. Dr Lennox was instrumental in establishing the QRGP and was passionate about ensuring that rural Queenslanders had access to quality healthcare. Dr Lennox was bestowed a number of prestigious awards by the medical fraternity in the lead up to his retirement in recognition of his outstanding achievements during his career with Queensland Health.
DDHHS Director Rural Generalist Training Dr James Telfer (right)
instructs Rural Generalist Pathway (RGP) trainees Dr Marika
Goodman and Dr James Boland during the RGP Anaesthetic
Introductory Program
63Our performance | DDHHS Annual Report 2016-2017
Strategic objective 4Ensure sustainable resources through attentive financial and asset administrationThe DDHHS achieved a balanced budget for the 2016-17 financial year. This result was achieved against a background of increased activity over the previous 12 months and sustained high performance in providing safe and efficient care to patients requiring elective surgery, outpatient appointments, oral health services and gastrointestinal endoscopies.
Revenue and expenses – FY ending 30 June 17
$ (000)
Revenue 726,099
Expenses
Labour and employment 497,217
Non-labour 207,899
Depreciation, impairment and revaluation
20,945
Total 726,061
Net surplus from operations 38
How we are fundedDDHHS’s total income for the 2016-17 financial year was $726 million. This comprises $428.1 from the State, $192.3 from Commonwealth, Special Purpose Grants worth $32.2 million and other revenue (including self-generated) was $73.4 million.
Income $ (000)
State contribution $428,142
Commonwealth contribution $192,338
Special Purpose Grants $32,200
Other revenue (including self-generated
$73,419
How the funding was distributedThe DDHHS operates a complex group of healthcare services across a broad and diverse geographical area. The table below shows the proportion of the budget spent on operational and support services within the DDHHS. Total expenses for 2016-17 were $726 million averaging $1.98 million dollars a day.
Budget allocated
Toowoomba 37%
Rural 30%
Mental Health 11%
Other professional and support 19%
Depreciation 3%
How the funding is spentJust over two thirds of expenditure is against labour costs, this amounts to 68.48 percent of expenditure across clinical and non-clinical support staff. Non-labour expenses such as clinical and non-clinical supplies, other clinical services (such as pathology, radiology, prosthetics), catering, maintenance and utilities accounted for 27.6 percent of expenditure.
Expenses $ (000)
Employee expenses $497,217 68.48%
Supplies and Services $200,409 27.60%
Grants and subsidies $2,992 0.41%
Other expenses $4,498 0.63%
Depreciation and expenses $20,945 2.88%
Labour costs as a proportion of total expenditure increased from 67.83 percent in 2015-16 to 68.48 percent in 2016-17, while supplies and services decreased from 28.32 percent to 27.6 percent for the same period. In terms of absolute dollar value, supplies and services increased by four percent over the previous year as a result of increased activity rates.
Financial outlook In the 2017-18 financial year the service will provide public healthcare in line with the Service Agreement with the Department of Health. The DDHHS will have a total operating budget of $761.74 million, an increase of 4.9 percent or $35.64 million from 2016-17. Next financial year the DDHHS will continue to focus on delivering a balanced budget. This will be a challenge in an environment where demand continues to increase due to rising chronic disease and an ageing population. The health service will continue to work collaboratively with the Department to ensure that we can deliver quality public healthcare to all patients within our region as efficiently as possible.
Strengthen and enhance ICT capacity and capabilityThe DDHHS is committed to strengthening and enhancing our information and communications technology (ICT) capacity and capability. Projects completed in 2016-17 to improve our ICT services include:
Dalby Telecommunication Infrastructure Replacement (TIR) projectAt a cost of nearly $420,000, the project involved the construction of communications rooms in four buildings on the hospital campus (Mental Health, Myall, Acute Ward and Nurses Quarters) and was completed in June 2017. The project was jointly funded from DDHHS accrued surplus and eHealth Queensland funds.
Increased technology use within Aged Care Assessment Team (ACAT)This project has seen all Toowoomba ACAT clinicians begin using mobile devices and the Myassessor offline app to complete comprehensive assessments on the National Screening and Assessment Form (NSAF). These assessments are uploaded to the live My Aged Care Portal and completed. The use of mobile devices has halved the time it takes to complete a comprehensive assessment, which has greatly assisted the ACAT team to deliver efficient services to their clients.
Investment in asset optimisation, asset maintenance and asset replacement or expansion
Health Technology Equipment Replacement (HTER) The Health Technology Replacement (HTER) program is a Statewide rolling two year program to replace aged and obsolete health technology. The HTER program budget for the 2016-18 program was $6,387,825 with an allocation of $1,950,100 in 2016-17. Major items replaced as part of the program in 2016-17 included:• Ultrasound unit Toowoomba Hospital $103,000• Mammography unit BreastScreen Toowoomba
$229,252• Colonoscope, light source and processor Miles
Hospital $80,249.
Backlog Maintenance Remediation Program (BMRP)The DDHHS achieved an excellent result for the Backlog Maintenance Remediation Program (BMRP) by reducing $50.6 million of backlog maintenance in four years and completing 474 projects in total. The DDHHS BMRP was the third largest program in the state, after Metro North and Metro South Hospital and Health Services. The main achievements of the BMRP were to provide major plant replacement and building repairs to ensure DDHHS asset capability is maintained for patients and staff into the future. While BMRP was a four year project, 2016-17 was an exceptionally busy year. Projects with a total value of approximately $20 million were completed in 2016-17 including the following major projects:• Replacement of main campus and Medical Block
switchboards Toowoomba Hospital • Replacement chillers Emma Webb Building and
installation of new chillers for main campus buildings Toowoomba Hospital
• Refurbishment of Warwick Hospital kitchen• Installation of fire compartments to Medical
Block Toowoomba Hospital
65Our performance | DDHHS Annual Report 2016-2017
Director of Medical Imaging Aiden Cook, MRI team leader Alastair Collett and DDHH Board Deputy Chair Dr Dennis Campbell at the official opening of the Toowoomba Hospital MRI service.
• Replacement of the main switchboard at Dalby Hospital
• Replacement of the electrical submains at Baillie Henderson Hospital
• Installation of air-conditioning to Stanthorpe Hospital
• Installation of fire compartments to Stanthorpe Hospital
• Installation of air-conditioning at Dalby Hospital• Demolition or removal of empty buildings
no longer cost effective to maintain or repair throughout the DDHHS (including Residence 5 and Gowrie Hall at Baillie Henderson Hospital, Farr Home Kingaroy Hospital, Community Health building Murgon and Community Health buildings Nanango Hospital)
• Repair and refurbishment of heritage-listed buildings at Baillie Henderson Hospital
• Repair of Kingaroy Hospital roads• Refurbishment of Fountain House 2 on the
Toowoomba Hospital campus• Refurbishment of 8 bathroom ensuites at Kingaroy
Hospital• Internal painting of Kingaroy Hospital.
Capital worksThe DDHHS invests its annual $3.5M minor capital allocation provided through the State Budget on equipment and infrastructure prioritised to support the continuous delivery of clinical services. Key clinical equipment purchases in 2016-17 included a new theatre table, theatre pendants, telemetry equipment and scopes. Minor infrastructure projects completed in 2016-17 included: • Tara Hospital ambulance bay and ramp -
completed in April 2017 at a cost of $205,000 to provide a covered ramp to the hospital with the appropriate gradient and safety railings
• Baillie Henderson Hospital Laundry upgrade including batch washer and ironer purchased and installed in 2016-17 at a total cost of $1.2 million
• Refurbishment of main staff station area in Goondiwindi Hospital to provide improved patient privacy, staff safety and administration facilities at an approximate cost of $170,000 and completed in April 2017.
• Upgrade of the Acute Mental Health Unit Toowoomba Hospital courtyard security at a cost of approximately $240,000 completed in June 2017. The refurbishment included replacement of existing fencing and roofing in the courtyard areas to improve patient safety and amenity. The new fencing is less institutional in appearance while still ensuring patient safety.
The DDHHS has continued to reinvest accrued surplus funding this year to provide vital clinical infrastructure and equipment. Projects completed in 2016-17 include:• Cherbourg Hospital – An area was refurbished within
the hospital to create a new palliative care room at a cost of $150,000 to deliver more comfortable facilities for patients and families at difficult time when loved ones are receiving end-of-life care. The new room was officially opened on 30 June 2017
• Miles Hospital – » Primary health hub completed in February
2017: An existing building on the Miles Hospital campus was extensively refurbished to accommodate primary health hub services including a general practice
» Staff accommodation completed in March 2017: new purpose built facility including eight modern self-contained units, communal areas and car parking
» The combined value of both projects was $2.6 million. The completed projects have provided Miles Hospital with infrastructure that will make it easier to attract clinical staff to this rural location.
New switchboard for the third electricity feed at Toowoomba Hospital
• A second CT Scanner was installed at Toowoomba Hospital in September 2016. The $2.75 million project included replacement of the existing CT Scanner nearing the end of its functional life with a new machine and installation of a second machine to provide additional capacity for medical imaging services. The scanning capacity of the new scanners is 500 slices a rotation providing a significant improvement on the existing machine installed in 2006 that only had 64 slice capacity
• The commissioning of new sterilisers at Toowoomba Hospital Central Sterilising Department (CSD) neared completion at the end of the financial year with final completion of this stage expected in August 2017. The next stage of the project will follow in 2017-18 with the refurbishment of CSD to provide a dedicated reverse osmosis plant to meet the requirements of a new Australian Standard (AS4187), as well as improve throughput for future increased theatre capacity. Total cost of both Stage 1 and Stage 2 CSD works is estimated to be $3,410,000
• The first stage of a three stage $4 million expansion of renal services at Toowoomba Hospital was completed in April 2017. At a cost of approximately $750,000, stage 1 consisted of refurbishing an existing ward area to provide a five bed haemodialysis facility in the Toowoomba Hospital’s Medical Unit Two (MU2).
The five bed facility enables seriously ill patients who need dialysis to have their treatment on the ward, rather than being transported through the hospital to the Renal Unit which is set up for ambulatory patients. Stages 2 and 3 of the project will involve refurbishment of the Renal Unit to improve patient and staff flow and increase capacity, and refurbishment of a small building co-located next to the Hospital for an outpatient renal self-care and training centre.
State funded infrastructure projectsMedical imaging services for all patients within the DDHHS region were enhanced with the installation of the first magnetic resonance imaging (MRI) service at Toowoomba Hospital. The medical imaging department welcomed their first MRI patient in May 2017. The $9.55 million State Government funded project included $1.85 million to relocate the BreastScreen Toowoomba service to a new purpose-built offsite premises which enabled the new MRI service to be installed adjacent to the existing medical imaging department. The BreastScreen relocation was completed in July 2016. The new MRI service increases access to public hospital services for patients in the region with this service previously only available at private facilities in Toowoomba.
67Our performance | DDHHS Annual Report 2016-2017
The new service means that inpatients at Toowoomba Hospital no longer need to travel offsite for an MRI and provides medical imaging staff at Toowoomba Hospital with valuable clinical experience using the latest technology.The $3 million expansion of the Toowoomba Emergency Department (ED) was completed June 2017. The refurbishment involved the extension of the ED area to provide additional patient treatment areas, clinical storage and staff support spaces. The expansion has increased the number of treatment spaces from 21 to 30 to help facilitate an increase in patient throughput and assist in alleviating some of the capacity issues being experienced by the ED due to increasing demand. The scope of the project included building an extension to create additional storage and staff amenity facilities, internal refurbishment (including reconfiguration of ED), and a dedicated paediatric treatment room. The new kitchen project for Toowoomba Hospital at a cost of $9,760,000 commenced on 30 August 2016. The project will provide a new kitchen to serve the Toowoomba Hospital campus for the preparation of patient meals. Key areas of design in the new kitchen include preparation areas, cool rooms and freezers, dishwashing and plating areas, and office and staff amenities. The project is expected to be complete by late 2017.In June 2017 the Minister for Health and Ambulance Services announced the Kingaroy Hospital redevelopment with a total value of $62 million. The redevelopment will increase the range of services and improve the hospital’s role as a hub for trauma, paediatric, obstetric, rehabilitation and mental health services. It will also enable the delivery of contemporary and future models of care for the entire community into the future. Planning for the development will commence in 2017-18.
Our generous supportersOur local hospitals are an important part of each community and we are big-heartedly supported by the Toowoomba Hospital Foundation, local auxiliaries, service clubs, other groups and individuals through fundraising efforts and other generous donations.
The list below is a summary of the valued support provided to the DDHHS by our partners in 2016-17:• The Toowoomba Hospital Foundation supported
Toowoomba Hospital and our staff by providing funding projects and equipment with a total value if $668,410. Major items included construction of a carpark for day visitors and staff, mammography equipment, urology equipment, an ICU ventilator, support for Patient Flow Manager software, disinfection unit and blood testing equipment
• The Miles Hospital Auxiliary provided $116,781 in donations for equipment and furnishings for Miles Hospital including patient monitors, installation costs for information technology improvements, tables, chairs and blinds for consultation and conference rooms
• The Kingaroy Hospital Auxiliary donated a monitor for endoscopy procedures at a total cost of $30, 184
• The Lions Club Nanango donated a $3,600 patient monitor (pulse oximeter) to Kingaroy Hospital
• Murgon Hospital Auxiliary provided $18,169 to upgrade blinds in palliative care and to provide privacy frosting to the palliative care room. The funds also provided for items to improve the Emergency Department storage capacity
• Tara Hospital Auxiliary donated $9,840 for improvements to the staff quarters and patient equipment including a tympanometer
• Incapacitated Service Men and Women provided Oaks Nursing Home in Warwick with a donation of $5,000
• The Goondiwindi Hospital Auxiliary donated $3,710 for over-bed tables
• The Millmerran Hospital Auxiliary and Lions Club donated a monitor valued at $2,903, The Millmerran Hospital Auxiliary and Hot Rods Inc donated a sofa bed valued at $2,110, and the Millmerran Hospital Auxiliary donated a trailer and sprayer at a cost of $650
• The Dalby Hospital Auxiliary donated $5,425 for a telehealth-chemotherapy trolley, two palliative care mattresses and two televisions with headsets for the renal unit
• The Jandowae Lions Club donated to Jandowae Hospital a mobility aid at a cost of $1,995
• Individual donations were also made to Stanthorpe Hospital, Dr EAF McDonald Nursing Home, Oaks Nursing Home and Miles Hospital with a total value of $18,713.
Strategic objective 5Plan and maintain clear and focused processes to facilitate effective corporate and clinical governanceA number of initiatives were undertaken in 2016-17 to support this strategic objective including implementation of improved reporting systems, implementation of a sustainable energy project and actions to support legislative and policy changes and requirements.
Establishment of dedicated Strategy and Planning Team set to boost health service planning and service redesign A key strategic objective for the DDHHS is to establish redesign and innovation capability, and support staff with the implementation of service and clinical redesign initiatives across the organisation. The DDHHS Strategy and Planning team was established in April 2017 to help fulfil this goal. Strategy and Planning is a small, diverse team of project and service planning officers led locally by a Director. Under the governance of the Health Service Chief Executive and Executive Management Committee (EMC), the Strategy and Planning team evaluates the feasibility of projects and engages the broader workforce in developing and implementing innovative ideas. The team also leads larger health service wide, strategic projects and supports the organisation through the management of corporate performance planning and reporting.The Strategy and Planning team will undertake comprehensive health service planning activities in 2017-18, which will enable the DDHHS to proactively respond to emerging health needs and issues, ensure our future service developments are in line with health data evidence, and include engagement with our staff and community in the health service planning process.
Public Health - Water Risk Management Plans to Control Legionella On 1 February 2017, amendments to the Public Health Act 2005 commenced which required public sector hospitals and aged care facilities to develop and implement water risk management plans to control Legionella in their water distribution systems.
The Darling Downs Public Health Unit has continued to develop and refine these plans for each of the DDHHS facilities. In line with the plans, water samples are taken quarterly from each facility and Legionella detections notified to the Department of Health. A report about the results of testing is also submitted to the Department each quarter.If Legionella is detected a range of remedial actions are implemented to minimise the risk to staff and patients as determined by the facility’s water risk management team. Remedial actions may include, but are not limited to, replacing fittings, flushing water lines to improve chlorine levels, pasteurising hot water systems, plumbing upgrades and minimising the exposure of at risk patients. All DDHHS facilities have been working to eliminate dead legs in plumbing systems and improve hot/warm water systems to reduce the risk from Legionella.Portable chlorinators have been purchased to assist with Legionella remediation and prevention programs in areas where facilities have low chlorine levels in incoming water. The implementation of the water risk management plan ensures quality and consistency in our processes through compliance with appropriate standards and with legislative and regulatory requirements.
New Health Service Directive for Emergency ManagementThe DDHHS is committed to implementing the principles of the Queensland Health Disaster and Emergency Incident Training Framework published in June 2016. The Framework is an overarching guide to the requirements and considerations of capability development; through training, exercises and lessons management, and is supported by Health Service Directive 003:2017 Disasters and Emergency Incidents which came into effect January 2017. The Health Service Directive mandates such things as:• the establishment of an emergency management
committee• ensuring the DDHHS is represented on district and
local disaster management groups• record keeping for appointments• roles and responsibilities are understood• collaboration with external entities.
The DDHHS has developed a training program to meet the requirements of the new training framework and is progressively training all relevant staff that manage and are involved in emergency incident management.
69Our performance | DDHHS Annual Report 2016-2017
The DDHHS Board inspects solar panels at Murgon Hospital with Murgon Hospital staff and community members
Patient Travel Subsidy Scheme (PTSS) improvement initiatives implementedThe DDHHS completed a Patient Travel Subsidy Scheme Service Improvement report in March 2016 identifying 16 key recommendations to improve PTSS processes including centralisation, governance of appeals and approvals, completion of forms and identification of telehealth and information technology options. A significant amount of work has been done to complete 10 of the report’s recommendations and work continues on completing the remaining six of the 16 recommendations. As a result of the review the District Travel Officer position has now taken on a DDHHS-wide focus and acts as the central point of accountability for all PTSS-related queries. This change has greatly increased the efficiency and effectiveness of PTSS processing and the overall service within the DDHHS. A key initiative identified to improve management of PTSS is the purchase of a software solution for the management, processing and reporting of patient travel claims, which will enhance efficiency and improve PTSS services to our patients. Implementation of this system will occur in the 2016-17 financial year.In 2016-17 the DDHHS spent $7.7 million on PTSS (not including aeronautical retrieval services).
PTSS Annual Expenditure
There was a 4 percent increase in PTSS in 2016-17 over 2015-16
Murgon Hospital goes solarErgon Energy supplied and installed one hundred and eight 280-watt solar panels on the Murgon Hospital roof in October 2016. Murgon Hospital is now running partly on solar power as part of an Ergon Energy initiative. Ergon will maintain and monitor the panels to assess the feasibility of implementing similar systems at other hospitals in the DDHHS with comparable energy usage. The solar panels are estimated to reduce the hospital’s monthly energy bill by approximately 23 percent, a saving of around $10,000 per year. The panels generate more power than what the hospital alone can use enabling the extra power to contribute to the grid system.
Allied Health Division takes on operational and professional focus The Division of Allied Health was realigned in 2016-17 to include operational management of allied health services. In October 2016 the Division established the Allied Health Workforce Development Officer – Data and Informatics position to use data and informatics to promote greater flexibility and allocation of resources which has resulted in:• An 88% reduction in long waits for Allied Health
outpatient services• Increases in all outpatient occasions of service
including a 70% increase for telehealth consults and a 6% increase in face to face consults.
• An 8 % increase in inpatient events
Implementation of the Mental Health Act 2016The new Mental Health Act 2016 came into effect on the 5 March 2017. The DDHHS undertook extensive consultation, education and administrative preparation for this change. This included outreach support to general EDs regarding new responsibilities under the Public Health Act 2005.
Risk managementIn 2016, DDHHS was one of three hospital and health services selected to participate as a pilot site for the Queensland Integrated Safety Information Program (QISIP) to replace the aged clinical incident, consumer feedback and staff incident management systems (PRIME CI, PRIME CF and IMS.net) with RiskMan. The software solution also replaces the Risk Management system (QHRisk).On 13 February 2017, DDHHS became the first hospital and health service in Queensland to commence using the RiskMan software. DDHHS staff expertise in trouble-shooting and problem-solving significantly enhanced the implementation process making it easier for other hospital and health services to follow.With the implementation of the software, there has been a need to review internal processes. The most significant change is the recording of workplace health and safety events and their management directly into the software system rather than through a paper-based system. The new system also has the capability to accept staff feedback in the form of compliments and suggestions for managers to review.
Compliance management frameworkA Compliance Management Framework comprising of a policy, procedure and guide to Compliance Management System was implemented in November 2016. The primary objective of the Compliance Management System is to support and guide the behaviour of all those working for or on behalf of the DDHHS to ensure compliance with relevant legislative and regulatory obligations, government policies, directives, and standards.
Rollout of Qlikview dashboards – improving timely access to dataQlikview is a web based graphical reporting system providing clinical and administrative managers with current information on performance in areas such as ED and elective surgery. The first dashboards became available in February 2017 and development is set to continue to produce more reports in consultation with users. Qlikview is consistent with our strategy to support timely access to accurate data to facilitate and support decision making.
DDHHS was the first HHS in the state to start using
RiskMan software
71Our performance | DDHHS Annual Report 2016-2017
The DDHHS Staff Wellness Program was officially launched by HSCE Dr Peter Gillies on 24 May 2017
Strategic objective 6Value, develop and engage our workforce to promote professional and personal wellbeing, and to ensure dedicated delivery of services
Management Development ProgramThe Workforce Division commenced the Management Development Program in February 2017 using existing staffing resources within the DHHHS to develop, facilitate and present. The objectives of the program are to provide managers with training that is focussed on building their confidence and competence to perform organisational functions in line with DDHHS expectations. As at 30 June there were: • 12 graduates• 26 enrolled in the program• 38 service improvement projects including one
initiative to be implemented as a DDHHS strategic project (Review of Community Health services)
A survey undertaken to measure the success of the program demonstrates that 100% of participants and mentors would recommend the program to their peers and staff reporting to them. The average rating given by participants on the quality of the presentations is 8.8 out of 10.
Sterilisation Services – The Main GameThe Cunningham Centre commenced delivery of the updated version of the nationally recognised Certificate III in Sterilisation Services course under the Australian Qualification Training Framework in February 2017. The qualification contributes to the development of knowledge and skills required to comply with the Australia/New Zealand Standards (4187:2014 and 4815:2006). The goal of the training, known as ‘The Main Game’ is to encourage sterilisation workers to focus on each stage, in every phase of reprocessing, to ensure that the sterilised device legitimately meets the release criteria 100% of the time. This improves patient safety by decreasing the risk of complication from a hospital acquired infection. 37 students enrolled in the pilot cohort in 2016-17, and as at 30 June 2017, total enrolments had raised $74,200 in revenue. Participants provided very positive feedback from the pilot cohort about the quality of the online training component and the impact it has on their learning. Students reported that the course really helped them to apply their learning in the workplace.
University Department of Rural Health (UDRH), Southern Queensland Rural HealthIn April 2017 the DDHHS, led by the Executive Directors for Allied Health, Rural and Remote Medical Support and Nursing and Midwifery, in collaboration with South West Hospital and Health Service, University of Queensland and University of Southern Queensland were successful in a bid for Commonwealth funding to establish a University Department of Rural Health (UDRH) in Southern Queensland. Known as ‘Southern Queensland Rural Health’, the department will host students from the professions of allied health (Exercise Physiology, Nutrition and Dietetics, Occupational Therapy, Pharmacy, Physiotherapy, Social Work and Speech Pathology), nursing and midwifery. Work continues on the establishment of the centre in 2017-18.
Allied Health InitiativesClinical education placements across a range of professions including Nutrition and Dietetics, Occupational Therapy, Physiotherapy, Podiatry, Psychology, Social Work and Speech Pathology were provided during 2016-17. Allied Health Clinical Education Support Officers, Clinical Educators and Clinical Supervisors supported these placements to achieve: • 6,445 clinical placement days• 11,935 hours of student clinical activity
(represented approximately 7% of overall allied health service delivery )
• high levels of student satisfaction with quality of clinical education and level of professional preparedness (as per clinical placement evaluations)
An audit of the compliance of the Division of Allied Health with the Allied Health Professions Office of Queensland (AHPOQ) Allied Health Assistant Framework was undertaken from January to June 2017. Recommendations from this audit regarding various changes to DDHHS processes will be implemented in 2017-18.
DDHHS Staff Wellness Program Launched May 2017
Healthcare facilities play an important role in promoting the health and wellbeing of patients, staff and visitors. The DDHHS was successful in obtaining funding under the Queensland Health ‘healthier drinks at healthcare facilities’ initiative for the DDHHS Staff Wellness Program. The DDHHS Staff Wellness Program supports staff members to incorporate healthy choices into daily living as well as identifying opportunities for regular movement and exercise.
The program takes a holistic view of health with focus on mental health, physical health, emotional health and financial health. The program is coordinated through the Work Health and Safety Unit and was launched in May 2017 at health services across the region. Staff are kept informed through the DDHHS intranet page, screensavers, Staff Connect, Facebook group and their local Wellness Champions.
The program will be implemented over a three year period and had an initial allocation of $185,000 for 2016-17. Actions to date include:• Majority of high sugar content drinks removed
from vending machines across the DDHHS (the Toowoomba Hospital Foundation kindly participated in making these change at Toowoomba and Baillie Henderson hospitals as well as Directors of Nursing at locations where vending machines were located).
• Morning and afternoon teas and lunches provided at launches have a healthy focus
Embed a values–based cultureIn early February 2017, the DDHHS engaged Best Practice Australia, an organisation that specialises in improving culture in the health sector, to deliver a comprehensive workplace culture survey. All staff had access to the survey in an electronic or paper based format. Of the 5,229 surveys distributed, 52% or 2,738 DDHHS staff responded.The survey results included very detailed benchmarking data comparing the DDHHS with public and private healthcare organisations across Australia and New Zealand. Overall the DDHHS performed slightly above the average for public hospitals but there are many opportunities for us to improve our organisational culture, recognising the broader Queensland Public Service values. The DDHHS Executive team are all highly motivated to improve the culture across the organisation and, assisted by the Workforce Capability, Culture and Engagement Team, are ensuring that all work units develop action plans to improve the workplace culture in their areas and have access to relevant training and support to achieve this goal. The results of the survey also guided the DDHHS Board and Executive in the development of a new set of values to be launched in 2017-18. A repeat survey will be undertaken in February 2019 to measure any change in the DDHHS’s culture response.
73Our performance | DDHHS Annual Report 2016-2017
Planning for and retaining a skilled workforceIn 2016-17 DDHHS had a retention rate of 88 percent for permanent staff with a separation rate of 7.35 percent or 307 resignations. These figures remain comparable with the previous two years, indicating a stable workforce ratio. The DDHHS welcomed 140 new permanent employees to the service in 2016-17. All new staff completed an orientation and induction training package via the DDHHS’s online training platform Darling Downs Learning Online (DD-LOL). The training package provides a comprehensive overview of the DDHHS, our values and performance expectations and development opportunities for our staff. The DDHHS paid $57,000 to two employees in termination benefits in 2016-17. No early retirement or retrenchment packages were paid during this period.
The DDHHS’s Strategic Workforce Plan 2016-2020 is a key tool that helps the DDHHS to identify the key risks, objectives and goals that affect our workforce and was updated for 2017. Key to this plan is the DDHHS values and embedding a workforce culture that commits to these values and the highest standards of ethical behaviour. With an increasing demand on aged care services in our region, pressure on health expenditure, as well as State and Federal healthcare reforms, the DDHHS work environment will continue to change. The workforce plan develops an understanding of these changes and the adaptation that will need to be undertaken by the DDHHS to continue to improve performance, productivity and healthcare delivery.
Educating and training our workforceThe DD-LOL team deliver training courses for staff induction, work health and safety, cultural practice, ethics, patient centred care and other role specific training to support our workforce. In 2016-17 the DD-LOL contributed to:• workplace culture initiatives by producing the
“Introduction to Performance Appraisal and Development” and “Workplace Bullying and Harassment” packages online.
• the effort to reduce medication errors by providing access to the Intellilearn resources for Medication Safety and assisting with reporting
• the reduction in financial penalties incurred through poor management of pressure injuries by facilitating the development of the “Pressure Injury Prevention and Management package”.
• Learning initiatives with the creation of 46 courses
Ethics trainingThe DDHHS is committed to ensuring the highest level of ethical behaviour through all areas of the health service. As a public service agency, the Code of Conduct for the Queensland Public Service is applicable to all employees of the DDHHS. All employees are expected to uphold the Code by committing to and demonstrating the intent and spirit of its principles and values. We strongly support and encourage the reporting of Public Interest Disclosures. All employees have a responsibility to disclose suspected wrongdoing and to ensure any disclosure is in accordance with DDHHS ethical culture.
To support our staff in complying with their obligations under the Public Sector Ethics Act 1994 staff are required to complete an ethics and fraud awareness training package annually through the DD-LOL platform.
Division of Nursing and Midwifery highlightsThe Division of Nursing and Midwifery had an exceptionally busy year rolling out a number of initiatives in 2016-17. Highlights included:• The workforce and workload management system
TrendCare and patient management system Patient Flow Manager were installed across all DDHHS facilities to support effective capacity demand management in the delivery of patient centred care
• International Nurses Day held in May 2017 was refreshed with a Health Hub concept held at Toowoomba Hospital in liaison with Queensland Nurses and Midwives Union. Across the rural divisions, the day was celebrated with many local events including barbecues, morning and afternoon teas. This special day’s events were very well received by all staff
• Two preceptor awards were implemented this year – one for rural and one for Toowoomba Hospital and Mental Health. Award recipients were Jessica Boyes and Rosie Beutel
• The application of the Business Planning Framework (BPF) is now embedded in all facilities across the DDHHS. Ratio compliance of 99 percent has been achieved across legislated units within DDHHS. Statewide BPF General and Midwifery audits across selected units were undertaken with confidence and presented to a Statewide Health Round Table.
75Our performance | DDHHS Annual Report 2016-2017
Registered nurse Jessica Boyes (centre), Toowoomba Hospital, receives her Preceptor of the Year award. Also pictured are (l to r) Helen Towler, EDNMS Karen Abbott, Karen Gordon and Megan Minasi
Registered nurse Rosie Beutel (centre), pictured with Mt Lofty Heights Nursing Home Director of Nursing Cindy Pitt, and EDNMS Karen Abbott, also received a Preceptor of the Year award
Finalists in the DDHHS Employee Awards Caring category Vicki Stenhouse, Lee Jenson, Katrina Mackenzie, Corey Keable (winner), and Tania Hydes
• From July 2016, 85 graduate nurses and midwives were recruited to the Nursing and Midwifery Graduate Program across Toowoomba Hospital, Mental Health and the Rural Division facilities including three aged care facilities. These graduates have undertaken a revitalised theoretical and critical skills and judgement supported practice program. This new program model has been presented at a state level and received very positive feedback from the applicants, unit and facilities and from Statewide peers
• On 11 May 2017 the DDHHS held a workshop for all DDHHS community and primary care providers to review current practice models and identify strategies to inform future practice models to promote alignment with the DDHHS vision and strategic objectives. The initial planning outcomes from this workshop will be developed in 2017-18 for future implementation
• The Office of the Chief Nursing and Midwifery Officer (OCNMO) facilitated a workshop to coordinate a Professional Practice Model with direct care nursing and midwifery staff from across the DDHHS. The outcome of the workshop will progress the development of a DDHHS Nursing and Midwifery Services Professional Practice Model
• The quarterly DDHHS Nursing and Midwifery Senior Nursing Forums continued in 2016-17 to provide professional development of senior nursing and midwifery staff and sharing of innovative quality activities and models of care. The OCNMO have attended these meetings on a regular basis to provide updates on statewide and national issues
• Miles Hospital participated in an innovative telehealth mentoring program for child health nurses in rural and remote locations. Mentoring is well-known as a valuable support tool and involves an experienced clinician partnering with an inexperienced clinician to assist them in their professional development. Traditionally, participants meet face to face but developments in technology have prompted the introduction of tele-mentoring.
Work health and safetyThe DDHHS is committed to providing a healthy and safe work environment through the implementation of a robust governance framework and continued improvements to our safety management system. Our major focus areas include safety management, injury management, safety training and staff wellness with a priority on meeting legislative and policy requirements to create a safe workplace for all staff. In 2016-17 the DDHHS continued to perform well against key work health and safety indicators as outlined below.
Key performance indicators:
State target
(%)
DDHHS Result
(%)
Current hours lost (WorkCover hours) vs occupied FTE
0.33 0.27
Average return to work 21.37 16.08
New work health and safety initiatives underway this year include:• A task analysis project being undertaken
to include inherent job requirements such as physical/sensory/psychosocial and environmental demands within all DDHHS role descriptions
• Modification of Occupational Violence training to include a component for management in aged care residences
• Planning for the introduction of body worn cameras by DDHHS security officers
2016 Annual DDHHS Employee Awards The 2016 Annual DDHHS Employee Awards were held in January as a celebration of individuals and teams who “go the extra mile” in their work. There were 127 nominations received in 11 categories, including new categories to recognise researchers and volunteers. The employee awards program recognises employees for excellence in demonstrating our values, delivering our purpose, and striving towards our vision. The 2016 awards saw two new categories:• Senior and Junior Researcher awards to
encourage the development of a research culture across the DDHHS and recognise the important contribution our staff make to contemporary evidence
• Volunteers of the Year Awards, supported by the Toowoomba Hospital Foundation to recognise the wonderful efforts of volunteers right across the hospital and health service.
The winners in each of the categories were:• Caring: Corey Keable, Assistant Business
Manager for the Southern Cluster, Rural and Aged Care Division
• Doing the right thing: Wendy Friend, Human Research Ethics Committee Coordinator, Medical Services Division
• Openness to learning and change: Damien Teakle, Clinical Nurse at the Community Care Unit in Toowoomba, Mental Health Division
• Being Safe, Effective and Efficient: Lynn Boundy, Nursing Director Clinical Governance for Rural and Aged Care, Medical Services Division
• Being open and transparent: Hayley Farry, Senior Learning Consultant with the DD-LOL team, Workforce Division
• DDHHS Purpose: Dr James Beit, Director of Anaesthetics, Toowoomba Hospital
• DDHHS Vision: Cecil Brown, Senior Health Worker for Healthy Hearing, Cherbourg Health Service, Rural Health and Aged Care Division
Inaugural Volunteer Awards (supported by the Toowoomba Hospital Foundation) • Quiet Achiever Award: David Wait, volunteer with
Health Information Services at Toowoomba Hospital• Commitment Award: The Texas Hospital Auxiliary
Inaugural Research Awards• Novice Researcher: Margot Tannock, Clinical
Pharmacist and CHARM Team Leader, Toowoomba Hospital
• Advanced Researcher: Peter Gilbar, Pharmacist Consultant, Toowoomba Hospital
Length-of-service awards The DDHHS acknowledged 83 of our longest serving staff members whose service totals more than 2,866 years between them at a special awards presentation in June 2017. One staff member had achieved an incredible 60 years of service and three had five decades of service recognised. Staff who had also achieved milestones of 45, 40, 35 and 30 years of service were also honoured at the awards ceremony.
Queensland Health Workforce Diversity and Inclusiveness Strategy initiatives – DDHHS implementation planThe DDHHS is committed to diversity in the work place and is proud that 63 percent of our senior management positions are occupied by women. In late 2016-17 the Queensland Health Workforce Diversity and Inclusion Strategy 2017-22 was circulated to hospital and health services in preparation for its implementation at the local level in the 2017-18 financial year. The DDHHS’s implementation plan includes setting up a group of colleagues, practitioners and sources of knowledge (also known as a ‘community of practice’) to share knowledge and develop learning content. This group will work together with Workforce Planning to formulate the DDHHS’s local Diversity and Inclusion Action Plan. The Queensland Public Service has identified Aboriginal and Torres Strait Islander peoples, people with a disability, non-English speaking backgrounds and gender equity as areas in need of critical attention.
