Saturday, September 24, 2011

Elective Surgery Report Card released

ACT Chief Minister Katy Gallagher has released a new ACT Surgery Report Card as part of her ongoing commitment to open government and increased transparency. The report card is attached for your information and reference.
The ACT Government has made significant progress on elective surgery, with more people than ever having operations, reduced waiting times and fewer people on the waiting list. The volume of surgery has increased and there has been a reduction in the number of people waiting for surgery longer than clinically recommended time period. There was a 16% increase above last financial year's performance which means 11,336 people from the ACT and NSW had their operations in 2010-11. They also outsourced about 150 surgeries to the private sector in an attempt to improve access for consumers.
The Government deserves to be commended for this work. 
The health care is a complex system and it is not as simple as completing more surgery.  Surgery is one part of the health system and capacity for surgery is dependent on operating theatre access, surgeons, nurses, anaesthetists. Surgery is also dependent on having wards for recovery and rehabilitation programs.  For example, someone having primary joint replacement (ie, knee or hip) requires a place in rehabilitation program to recover and regain full movement.  If there are not places available in the rehab programs then surgery cannot be done.  From the consumer perspective we want to have a coordinated approach to surgical admissions so that we have the best opportunity to have treatment and recover.
Kerry Burton is working with HCCA on the National Access Program.  Kerry is interested in collecting consumer stories on elective surgery.  Kerry can be contacted at the HCCA office Monday to Thursday.

Friday, September 23, 2011

Patient Journey Boards Improving Patient Flows

I visited Calvary Public Hospital on Tuesday to learn more about their Patient Journey Board and the Patient Flow Unit.  This is to have a more coordinated approach to the way in which patients move through the hospital.  It is a large magnetic whiteboard that is near the nurses’ station.  It contains de-identified information about the patients and it means that the commonly asked questions are answered at a glance: When is the patient going home? Has the patient been referred to Allied Health? What is the status of the referral? It means that not only the treating team can see this information but so can the patient and their family. 

The manual whiteboard is a common method for tracking patients and their care planning is a manual whiteboard within the clinical space.  This approach has been used for some time on other hospitals and Calvary have adapted it to their facility.  Flinders Medical Centre in Adelaide is using this approach also.  A poster of their work is available online.

Sir Charlies Gardiner Hospital in WA has also undertaken this work.  A slideshow of their approach is available online and will give you an idea of what they have done to improve patient flow through the hospital.

The Department of Health and Human Services in Tasmania, as part of their broader eHealth strategy, was interested in identifying ways to improve the quality of patient care while also increasing organisational efficiency in their hospitals.  One way they did this was by replacing the manual magnetic whiteboard which tracked patients’ admission and care during their stay in hospital with an electronic clinical portal.  There is a short video online that provides an overview of this.

The Access Improvement Service unit within Queensland Health, in conjunction with the University of Southern Queensland (USQ), is conducting an evaluation project to measure the benefits of the electronic patient journey board (EPJB) across a range of clinical settings. The study will be conducted across 12 hospitals and their 32 medical, surgical, and maternity wards. The key areas for evaluation centre on how the EPJB can:

•           make the in-hospital patient journey visible to the whole multidisciplinary team

•           improve communication between multidisciplinary team members

•           facilitate making investigation and care plans more visible, to streamline the patient journey

•           improve the coordination of discharge planning.

More information is available in the newsletter (pp. 5-6) 

Patient flow is an issue of great importance to consumers and we will continue to look at ways this is improving in the ACT health system.

Darlene Cox
Executive Director

Monday, September 19, 2011

Food and Culture: The Impact on Health and Ageing

On 8 September  HCCA staff attended the workshop Food and Culture: The Impact on Health and Ageing at the Theo Notaras Multicultural Centre. This event was hosted by the Canberra Multicultural Community Forum.  The purpose of this workshop was to explore the issues and challenges in providing a range of food from different cultures in hospitals, nursing homes and aged care services.

The Minister for Multicultural Affairs, Ms Joy Burch MLA, opened the session and welcomed the diversity of cultures and food in the ACT. Following her presentation, a variety of speakers from different fields gave their insight about food and its significance in people’s cultures and the impact on their health.  The keynote speaker was Jane Kellet, a Lecturer in Nutrition and Dietetics at University of Canberra. She talked about current research on malnutrition in elderly people in hospitals and residential care.  Garry Wright, the Food Services Manager and Kim Crawley, The Nutrition Manager from The Canberra Hospital talked about the changes they are making in their everyday menu planning to cater the diversity of patients admitted every day. Penny Jackson, the Manager for Nutrition Services from Red Cross also gave a good insight about Meals on Wheels services and the changes they are going through.  Terry Swarner, a consumer rperesetnative with HCCA, explained Food as a Clinical Issue, the history of clinical food, the standards of nutrition and to close the session he left us with a good prescription providing a healthy hint to have an apple everyday to keep the doctor away; Terry provided an apple to all attendees. Different individuals from Canberra multicultural communities spoke about what food means in their culture and their personal experiences in hospital, Meals on Wheels and aged care homes, suggesting what changes can be made.

The forum closed with an interesting panel discussion where questions were answered. All agreed that communication was an important factor to get the message across to the right people for changes to happen.

Yelin Hung
HCCA Office Manager

Friday, September 2, 2011

President's speech reflecting on consumer representation in the last year.

On 1 September 2011 the ACT Minister for Health hosted a reception at the Legislative Assembly to thank consumer representatives for their contribution to the development of health services.  Adele Stevens,  HCCA President, gave the following speech at the event.

2011 marks my third year as a President of the Health Care Consumers’ Association (HCCA)  of the ACT, and I am proud to say that the third year of my tenure has been just as productive as the first two.  Integral to the important work of HCCA are the committed and hardworking consumer representatives, who tirelessly devote their time and energy to providing consumer input on a range of significant health matters.  It is great to see that their contribution is being honoured today.

This year, HCCA has supported 34 consumer representatives on 67 health committees across the Territory and all divisions of ACT Health.  In addition to this representation on committees, we have trained 22 new consumer representatives in March and May/June and are expecting a further 15 participants for our September training.  As we have 34 consumer reps on 67 committees, this means that on average each rep is on about 2 – 3 committees.  My experience as a rep demonstrates this. 

I am a consumer rep on 3 committees - I have been one of the consumer representatives on the Clinical Audit Committee for a number of years now.  This is a very important committee as it examines when things go wrong in the ACT Health service and looks at ways to prevent these mistakes happening again. 

Secondly, following this, I joined the Respecting Patient Choices committee as their only consumer rep.  This is an area of health care which I am passionate about.  I am one of the growing number of older people who are worried about being kept alive with no quality of life by a health system which has gone mad with technology to prolong life.  The Respecting Patient Choices program provides a way for us to register our end of life wishes and for these instructions to be available to health care professional should I arrive at hospital and am not able to make my wishes known.  I am pleased to say that that ACT Health has doubled the funding to this program in the last year.  The cost of the program is minuscule compared to the money we waste in intensive care keeping old people alive who have made clear that they do not want to keep living without a good prospect of a decent quality of life.

Third, in the last year, I have joined a committee, under the Capital Asset Development Program, overseeing the redevelopment of the Community Health Centres in the ACT.  This is an exciting project with a new model of patient centred care for the community service.  This means integrating all the different patient records into a single patient record, which means merging our e-health records that are in separate services – eg dental, mental health, continuing care in community – into one record per patient - a challenging task to achieve by the time the new centres are due to open next year.

Health Care Consumers is an organisation which is committed to supporting the improvement of our health record with e-health technology, and the joint work of both of us, HCCA and ACT Health on the e-health consumer reference group is an good example of an innovative way both HCCA and ACT Health are working together to advance electronic health care services to improve health care.

But let us move on from the consumers representation program, to some of the other work we do. In addition to their role as consumer representatives on specific committees, members regularly attend events organised by HCCA which aim to deliver consumer input on a variety of health issues.  This year HCCA Consumer Representatives have attended a myriad of events, including the regular e-Health Consumer Reference and Health Issues Groups and Capital Asset Development Program Representatives meetings.

The growth in acceptance of the place of consumers at the table continues and this year we continue to experience high numbers of requests for consumer representation.  We know our colleagues at the Mental Health Consumers’ Network share our experience. 

We are receiving an increasing number of phone calls from the public seeking guidance and support on how to navigate the system.  We are working hard to ensure that consumer participation is not limited to consumer representation on committees.  We are committed to working with ACT Health staff to convene round tables and consultative fora on health service plans, medication safety, workforce development, e-health and the development and implementation of the national health reform agenda.

The e-health consumer reference group has developed over this year. We are the only jurisdiction in Australia to have a dedicated reference group of this type. We would like to acknowledge the support of the ACT Health Directorate for their continuing involvement in this committee. I would also like to thank Russell McGowan for his energy and vision in chairing this group.

The Consumer Representatives Program is truly the cornerstone of HCCA. I am proud to note that this program goes from strength to strength as evidenced by the commitment and dedication of our representatives.

Adele Stevens