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Health and Wellbeing Precinct: The new frontiers of health and wellbeing

Professor Mitchell K Byrnembyrne@uow.edu.au

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John’s story

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HolisticPerson-centred

Inter-professionalCollaborative Care

Holistic Perspective

• Physical, Mental and Social health are inextricably connected

• Poor health in one domain almost always leads to poor health in the others and a loss of wellbeing

• Both intervention and prevention need to address all aspects of the ‘person’

• The Health and Wellbeing initiative has this as a core principle

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Redefining “Health”

• WHO – “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity”

• Hits the three intersecting domains BUT…

• Complete?

• According to WHO, if you have a chronic illness you are definitively ill

– Defines you through the systems of care and places limits on how you might achieve a sense of personal wellbeing

• A more “allostatic” viewpoint: perceived wellbeing and adequate functionality in the face of changing physical, social, psychological and economic circumstances

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A new way of viewing health

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Resiliency

Capacity to cope and to maintain, or restore, a sense of wellbeing.

Health defined as “the ability to adapt and self-manage”

Wellbeing and the Individual

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Wellbeing: how one feels about oneself and one’s life

PersonCentred

Care

Health: the ability to adapt & self-manage

• Physical

– Allostasis: Maintaining physiological homeostasis through changing circumstances

• Adapting to changing functionality

• Not assessing current self against past self

• Mental

– Capacity to comprehend, manage and draw meaning from challenging situations

• Social

– Ability to manage our lives with some degree of autonomy, despite a medical condition, such that you participate in social activities

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Summary

• The definition of health needs to change in a world of longer lives and changing physical, social and psychological circumstances.

• Wellbeing will only be achieved by adaptation to these changes and self-management of personal circumstances.

• The role of the health practitioner is to understand what wellbeing means for each individual and to work with them in partnership to achieve that sense of wellbeing

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UOW HEALTH AND WELLBEING STRATEGIC INITATIVES

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UOW “IntoHealth” a PCHINNOVATION CAMPUS

UOW clinician-led ‘one-stop diagnostic shop’ delivered by academic & regional clinicians, focussing on physical & mental health & wellbeing as well as applying research in clinical practice.

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AGED LIVINGINNOVATION CAMPUS

A stimulating living environment appropriate to the health & wellbeing needs of the Illawarra’s older community, including research to improve quality of life.

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CENTRE FOR MOLECULAR & LIFE SCIENCESWOLLONGONG CAMPUS

New research facility to provide scientists with high-end technologies to deliver research outcomes that recognise the future intertwining of molecular biology & chemistry to deliver personalised medicine.

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MIND the GaPSHOALHAVEN CAMPUS

Mental Illness in the Nowra District: Goals & Prevention – will deliver improved mental wellbeing for the Shoalhaven with particular emphasis on the adolescent population & suicide prevention.

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PRIMARY HEALTH NETWORKSILLAWARRA & STATEWIDE

Includes UOW Rural & Regional Training Hub program to improve the quality of care given to patients in country hospitals and rural practices by addressing the misdistribution of rural medical workforce Australia.

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NURSINGEDUCATION WESTERN SYDNEY AND BEGA

Includes establishment of a UOW Nursing Education Facility in Western Sydney and a Nurse Training Hub in Bega.

HEALTH AND WELLBEING PRECINCT

https://www.uow.edu.au/about/health-and-wellbeing-strategy/index.html

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Social Justice

Wellness defined beyond physicality

Inter-professional collaborative care & education

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Driven by Values

Vertical integration of teaching, research and service provision

Embracing TechnologyCollaboration with industry

Person-centred holistic care

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Health & WellbeingPrecinct

Agreement between UOW & Lendlease Retirement Living

• Develop 7.5 hectare Precinct over 5 years

• Southern third of the Innovation Campus

Components include

• Primary and Community Health Clinic - intoHealth

• 120+ bed Residential Aged Care

• Approx 200 Independent Seniors Living Apartments

• 80+ place Early Childhood Education and Care

• Green heart, creating a hub for connection and interaction

• Community facilities

• Some retail and ancillary support facilities

• Parking & community gardens

Health & WellbeingPrecinct

Health & WellbeingPrecinctProposed Masterplan – Stage 1

Future Development Area –Later Stages

Health & WellbeingPrecinct: intoHealthUOW Primary and Community Health Clinic

o One- stop shop model of careo Focused on patients and families (Person-centred)o Complement existing health/allied health

services in the region, non- surgicalo An intergenerational & vibrant health communityo Innovative & dementia friendly environmento Students & researchers from a multitude of

disciplines learn & contribute

Services at intoHealth

• Described in terms of “clinics”, the professionals working at intoHealth will move across clinics to provide a bespoke program of care articulated in collaboration with the patient.

• Services will be provided by ‘clinical academics’ where the discipline is taught at the UOW, and where it is not taught at UOW, by contracted health professionals on the basis of a ‘collaboration agreement’ to ensure operational and philosophic consistency.

• All clinicians will integrate clinical services with teaching and research, in accordance with usual ethical guidelines.

Services at intoHealth• The entire precinct, and especially the clinical services,

will be technology enabled, to maximise patient outcomes and research potential. This will include machine learning, AI and IoT across diagnostics, treatment planning and treatment implementation.

• Services will be offered within the intoHealth facility, but also through outreach and ‘telehealth’

• Services are to either fill gaps or provide complementarity with extant health services

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Proposed Clinics• Primary Health Care• GP clinics (including phase 3 interns)• Men’s and women’s health promotion• Nurse-led clinics (such as vaccinations, health screening)• Allied health (psychology, social work, dietetics, exercise medicine, OT, Physio)

• Metabolic Medicine• Endocrinology• Nephrology• Vascular• Cardiology• Dietetics (dietician & diabetic nurse)• Podiatry• Exercise medicine

Proposed Clinics• Muscular-skeletal• Podiatry• Exercise medicine• Orthotics/prosthetics• Physiology• Physiotherapy• Occupational therapy• Rheumatology• Stroke rehabilitation

• Mental Health & Wellbeing• Psychology• Psychiatry• Social work• Toxicology• Exercise medicine• Dietetics• Mental health nursing

Proposed Clinics• Aged Care• Nursing• Geriatrician• Occupational therapy• Rehabilitation specialist (various possible disciplines)• Psychology• Social Work• Dietician

• Pharmacy

• Pathology

• Diagnostic Imaging (CMRP)*****

• Community services hub

• Centre for Remote Care Services (“telehealth”)

intoHealth will be a place of interdisciplinary

Teaching and Research

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The precinct will be a complex digital ecosystem

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Bench to bedside research

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‘That’s funny…’

Alexander Fleming

Antibiotics: one of medicine’s greatest triumphs

Estimated 100 million lives saved since WW II

Antibiotic resistance: When life-saving drugs stop saving lives…

The review on antimicrobial resistance(‘the O’Neill report’):

By 2050: 10 million deaths per yearand a total of 100 trillion USD in lost productivity

The full O’Neill report:https://amr-review.org

Molecular Horizons @ UOW

- An $80 million investment in molecular life sciences

- bringing chemists, biologists and physicists together

- using advanced microscopy to visualise the processes of life

- Working with HWP to find solutions

Health & WellbeingPrecinct Opportunities for Regional Campuses

• Telehealth, including VR technologies• Online educational programs, including micro-credentials• Clinical placements• Collaborative research programs (intoHealth & MIND the GaP)

• Future information:– Clinical: Professor Tracey Moroney (tmoroney@uom.edu.au)– Research: Professor Paul Stapley (pstapley@uow.edu.au)

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