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RICH Forum
Rural Innovations
Changing Healthcare
A one day ‘virtual’ forum linking 16
satellite hubs across rural NSW
Friday 14 March 2014
8.30am – 4.30pm
Aim To showcase and share rural models of care which:
show a resourceful and innovative approach to an existing issue
have potential to be taken up by other rural health settings
demonstrate sustainability in embedding the change
Audience The forum is aimed at the rural multidisciplinary workforce including those who work in non government organisations (Local Health Districts, Aboriginal Medical Services, Medicare Locals, Residential Aged Care Providers, NSW Ambulance, Royal Flying Doctor, University Departments of Rural Health and Royal Far West Kids)
Cost The forum is free – but please advise if you register and are then unable to attend. Registrations are invited on-line by Monday 10
th March 2014 at www.aci.health.nsw.gov.au/networks/rural-health-network/rural-innovations-changing-healthcare-forum
Satellite Hubs LHD Site Venue Local Contact HNE Tamworth HACC and Disabilities, 1
st Floor Meeting
Room [email protected]
Inverell North Wing Meeting Room [email protected]
Webstream http://hnestream.hnehealth.nsw.gov.au [email protected]
NNSW Tweed Mental Health VC Room [email protected]
Lismore Crawford House Ground Floor Meeting Room
MNC Coffs Harbour
CHHC, Education Room 25 [email protected] [email protected]
Port Macquarie
Community Health, Morton St [email protected] [email protected]
Macksville Kath Bowman’s Executive Office [email protected]
WNSW Orange VC Lecture Theatre [email protected]
Dubbo Hawthorn St, Large Conference Room [email protected]
Murrumbidgee Wagga Wagga
Rural Clinical School Main Lecture Theatre
Griffith Nurses Training School [email protected]
SNSW Queanbeyan Peppertree Lodge, Snow Drop Room [email protected]
Bega The Blue Meeting Room [email protected] [email protected]
Cooma Room 10, Community Health Centre [email protected]
FW Broken Hill Kincumber Board Room [email protected]
Balranald Meeting Room 3 [email protected]
ACI Chatswood Yandhai Room, Level 7 [email protected]
About the ACI The Agency for Clinical Innovation (ACI) is the lead Agency in NSW for promoting innovation, engaging clinicians and designing and implementing models of care. Our clinical networks, Taskforces and Institutes provide a forum for doctors, nurses, allied health professionals, managers and consumers to collaborate across the NSW health system.
The NSW ACI Rural Health Network works collaboratively with rural Local Health Districts, health service providers and consumers to identify and showcase innovative models of care and to provide critique for models of care being developed to ensure compatibility for implementation in rural communities. To join an ACI Clinical Network, go to www.aci.health.nsw.gov.au/join-a-network
Further Information Contact Jenny Preece, ACI Rural Health Manager Dorrigo MPS Ph 02 66927716 Mob 0427568249 Email [email protected]
RICH Program Friday 14 March 2014
8.30am Arrival / Registration Site
9.00am Introduction, Acknowledgement to Country and Housekeeping – Jenny Preece, ACI Rural Health Manager
ACI
9.15am Official Opening – Dr Nigel Lyons Chief Executive, ACI ACI
9.20am Necessity is the mother of invention: how need drove the development of two rural memory assessment services. Keynote Speaker: Prof. Sue Kurrle, Geriatrician Hornsby and Batemans Bay hospitals
ACI
10.00am Three way collaboration for dental treatment for children 0 – 18yrs; Jenny Conquest SNSW LHD
Wagga Wagga
10.30am 10 Minute Trauma Topics – Structured Trauma Education in the Emergency Department; Vicki Conyers WNSW LHD
Orange
11.00am Morning Tea
11.15am Co-ordinated discharge package to reduce re-admissions in the Medical Assessment Unit (MAU); Dr Keegan Lee MNC LHD
ACI
11.45am Speech Pathology Teletherapy: Working with schools and preschools to create health solutions for rural children; Dr Robyn Ramsden, Donna Parkes; Royal Far West
ACI
12.15pm Lunch
1.00pm Crossing Over: Seconding Nurses from the hospital to private General Practice – a partnership for nurse retention; Dr Hamish Meldrum, Ochre Health; Judy Caswell, WNSWLHD
Dubbo
1.30pm Nurse-led Peripherally Inserted Central Catheter (PICC) Service in a rural hospital setting; Andrew Patterson WNSW LHD
Dubbo
2.00pm ACE Program – Co-operation can keep Aged Care residents well and out of hospital; Catherine Turner, Hunter Medicare Local
Port Macquarie
2.30pm Afternoon tea
2.45pm A rural Public / Private partnership for New Graduate Physiotherapists Recruitment and Education; David Schmidt, Chris Cheung; SNSW LHD, Naomi White; Sapphire Coast Physiotherapy
Bega
3.15pm Frequent User Management; Kevin McLaughlin, NSW Ambulance ACI
3.45pm What a difference a little lytics makes- Paramedic initiated thrombolysis in rural NSW; Dean Pennell, NSW Ambulance
ACI
4.15pm Evaluations and Close ACI
Professor Susan Kurrle is a geriatrician at Hornsby Ku-ring-gai Hospital in northern Sydney and Batemans Bay Hospital in Southern NSW, and she holds the Curran Chair in Health Care of Older People in the Faculty of Medicine at the University of Sydney. She has had a long interest and involvement in practice and research in dementia, and she runs memory clinics in Sydney, Batemans Bay and Armidale. She is also involved in clinical drug trials for dementia. In 2012 she was appointed to lead the new NHMRC National Partnership Centre on Dealing with Cognitive Decline. Rural and regional areas are very poor in the supply of geriatricians, in contrast with the rich supply of
geriatricians in urban areas. Eurobodalla is a popular retirement region in coastal southern NSW with a very high proportion of older people. Armidale is a university town and rural service centre also with a high proportion of older people. Neither have access to regular geriatrician services. This presentation looks at how this problem was addressed in two different ways, and how the services have improved access to specialist input, particularly for people with dementia.
Presentations Local Solutions Category Nurse Led Peripherally Inserted Central Catheter (PICC) Service in a rural hospital setting Andrew Patterson, Leigh Hobden, Geoff Hardacre, WNSW LHD Historically patients requiring PICC were placed on the ‘Emergency’ waiting list having the PICC inserted in the Operating Theatre with significant delays and complications. The PICC Service team consist of 2 credentialed RNs and one medical officer, with the nurses inserting the majority of PICC lines by the next business day after referral; saving $2,900 each PICC insertion based on Operating Theatre times, wages and bed days saved. 10 minute Trauma Topics – Structured Trauma Education in the Emergency Department Vicki Conyers, WNSW LHD Emergency Departments are unpredictable environments and dedicated professional development time is challenging. The structured trauma education program has seen 83, 10 minute topics presented over 12 months across the multidisciplinary team – Nursing, Medical, Allied Health, Ambulance; average attendance 14 at each session. Co-Ordinated Discharge Package to reduce readmissions in the Medical Assessment Unit (MAU) Dr Keegan Lee, MNC LHD Key performance indicators were being breached for re-admission rates, so the MAU team developed a co-ordinated discharge package (CPD) where the JMO has routinely implemented a discharge consultation followed by a 48 hour call back. CPD has seen a reduction in re-admissions of almost 50% since March 2013 and has become permanent methodology at Coffs Harbour MAU. Building Partnerships Category ACE Program – Co-operation can keep Aged Care residents well and out of hospital Catherine Turner, Hunter Medicare Local HNE LHD and Hunter Medicare Local are co-operating on broader implementation of the ACE program (Aged Care Emergency) utilising online clinical guidelines, and a Clinical Nurse Consultant and two Clinical Nurse Specialists funded by the Medicare Local to embed practices in RACF’s and with NSW Ambulance. Early results demonstrate significant reduction in admission rates of RACF residents. Three way collaboration for dental treatment for children 0 – 18 years Jenny Conquest, SNSW LHD This partnership is collaboration between MLHD, CSU and the Centre for Oral Health Strategy NSW. In 2011, there were 349 children on waiting list at Wagga Wagga. Payment for a set of prescribed services has enabled students to provide treatments for 1,357 children since 2011. The program was extended to WNSW LHD in 2013. Speech Pathology Teletherapy: Working with schools and preschools to create health solutions for rural children Dr Robyn Ramsden, Donna Parkes, Royal Far West Kids Royal Far West has developed a speech and communication therapy program; Come N’ See which was delivered to 152 children across 23 rural and remote preschools and primary schools in 2013. Six fortnightly therapy sessions are delivered via technology. Families, school principals, teachers and local agencies have become critical partners in delivering speech therapy services to schools. A Rural Public / Private Partnership for New Graduate Physiotherapists Recruitment and Education David Schmidt, Adam Woolacott, Naomi White, Megan Kurtz, Chris Cheung, Duane Kelly, Jeremy Fernanda, Neil Dmytryk A public / private partnership between SNSW LHD and Sapphire Coast Physiotherapy was formed to attract new graduate physiotherapists to Bega to work part time in both sectors. Education, management and support are shared between both sectors; offering a range of clinical experiences, a large pool of mentors and creating a certainty around staffing. The strategy plans to extend to student undergraduate placements. Crossing Over: seconding nurses from the hospital to general private practice. A partnership for nurse retention and better health outcomes Dr Hamish Meldrum, Heather Finlayson, Michelle McMullen, Ochre Health / WNSW LHD Brewarrina Health Service and Ochre Health have collaborated to create a Full Time Equivalent (FTE) position in which the FTE spends 24 hours per week in private practice to deliver Chronic Disease Management services and the balance in the LHD. The Nurse’s salary is fully recovered from Medicare item numbers, is additional to the LHD budget and sustainable with governance provided by WNSW LHD.
Patients as Partners Category Frequent User Management Kevin McLaughlin, NSW Ambulance As a demand management strategy, data was extracted to identify most frequent callers to 000. Interagency planning meetings with the patient have established and implemented care plans which have seen a significant decrease in the number of calls to 000 and transport to EDs, with associated cost savings to Ambulance and flow on savings to LHDs. Integrated Healthcare Category What a difference a little lytics makes – Paramedic initiated thrombolysis in rural NSW Mr Dean Pennell, NSW Ambulance As part of the cardiac reperfusion strategy, 2000 paramedics have been trained to provide paramedic initiated accelerated reperfusion via two pathways: Pre-hospital assessment of Primary Angioplasty (PAPA) or Pre Hospital Thrombolysis (PHT). 3,000 patients have been enrolled in the primary angioplasty pathway and 200 patients have received paramedic administered thrombolysis in rural areas since 2011.