QUALITY

Welcome to TMHS

Our Towns

By Mark JohnsonChief exeCutive offiCer

The 2012 Quality of Care report is a report to our

community, our consumers and our partners in health care delivery of the measures we have taken over the past year to ensure that we maintain and enhance the high standards of safe, quality care and services that we provide.

The report has been developed with significant assistance from the members of our Community Advisory Committee who have

T erang is a small rural town of 3,734 residents (includes

surrounding district) with an estimated median age of 42 years. A total of 90.1% of the population was born in Australia and 95.5% of residents speak English as their first language.

The town is located 216 km west of Melbourne and 50 kilometres north east of Warrnambool on the Princes Highway and rail line between Warrnambool and Melbourne. Terang serves farming, dairying and pastoral industries and the surrounding towns of Noorat, Glenormiston and Panmure.

Educational needs in Terang are served by three schools – the Terang College (P -12) for years prep to 12, Hampden Special School and St Thomas’, a Catholic school for primary students. Other smaller primary schools are situated in Noorat and Panmure. The junior secondary campus of a regional Catholic school is also situated at Noorat.

Other services include May Noonan Hostel providing low level residential care for the aged and Cooinda Terang Inc. a disability service providing residential and day care for intellectually disabled adults.

Mortlake is 24km north of Terang on the Hamilton Highway. The population including the surrounding area is 3,575. Mortlake sits on the base of Mount Shadwell, one of numerous scoria volcanoes found in the western district. Mortlake has two schools, Mortlake College (P-12) and St Coleman’s Catholic primary school.

Abbeyfield House is located in Mortlake and provides residential accommodation including self-contained units and high and low level aged care beds.

Terang & Mortlake Health Service was established on 1st November 1994, following the amalgamation of the Terang & District (Norah Cosgrave) Hospital and the Mortlake District Hospital.

chosen the format in which the report has been published, have written the stories throughout the report and provided the

accompanying photographs.

The report provides you with information about the services we provide, the important events

that have taken place at Terang & Mortlake Health Service throughout the year and the ways in which we have worked to improve the safety and quality of care and services that we take pride in providing to our community.

I would like to thank the members of the Consumer Advisory Committee, the members of staff and members of the community who have participated in the development of the report and hope that you enjoy reading about your health

service and the people involved with it.

We are committed to providing the best possible health care to our community with the resources we have at our disposal. Your feedback to us is important and helps us to continue to improve on the services we provide. Please take time to complete the short questionnaire accompanying the report and return it to the Health Service. All returned surveys will be placed in a draw with an opportunity to win a Christmas hamper.

OFCARE

T e r a n g & M o rT l a k e H e a lT H S e rv i c e

t u e s D aY , O c tO B e r 3 0 , 2 01 2S I N c e 1 9 9 4

REPORT

We are committed to providing the best possible health care to our community

PaGe 2 PaGe 5

terang & Mortlake Health Service – terang.

Our Health Service

Cultural Responsiveness

T he Terang & Mortlake Health

Service (TMHS) is a multi

campus health service. The Terang

campus comprises 27 acute beds

and 15 high-care residential beds.

TMHS also offers community care

and primary care at the Terang

and Mortlake Community Health

Centre’s.

The Terang & Tweddle Early

Parenting Centre gives assistance

to families with babies and

children up to 36 months old

C urrent census data indicates

that the vast majority of

the people residing in the Terang

& Mortlake Health Service

catchment areas were born

in Australia and that of those

members of our community

who were born overseas most

come from English speaking

countries. Only 1.1-1.6% of

respondents indicated that they

speak a language other than

English at home. In recognition

that people with varying levels

of proficiency in the English

language may require care at

our facilities Terang & Mortlake

Health Service staff are able

to access an interpreter service

via the National Translation

and Interpreting Service and

also download up to date health

information that can be printed in

other languages using the Health

Translation Directory.

Our Diversity Plan

acknowledges the issues that

culture and diversity play in

providing education and help to

manage parenting issues including

feeding difficulties, unsettled/

irritable infants, infant/toddler

sleeping problems, uncertainty

with parenting issues, challenging

toddler behaviour, maternal

exhaustion, and postnatal anxiety

and depression.

Consumers are encouraged to

be involved in decision making

regarding their care, treatment,

and the health and wellbeing of

creating barriers to service access.

The plan has been developed in

line with Home and Community

Care (HACC) principles of equity

and person centred care. It has

been recognised that culture

and diversity are not solely due

to a person’s country of birth

or religion but may stem from

identification with or belonging to

a community or group who have

different needs and expectations.

The TMHS diversity plan also

recognises that culture is self-

ascribed and defines who we are,

how we think and what we value.

The continued use of “Life Stories”

within the Planned Activity Group

themselves and the community.

Participation means having your

say about how we can improve your

care and how we can improve our

service delivery to the community.

Research tells us that your

involvement in decisions regarding

your treatment will decrease the

number of days you spend in

hospital especially with clients who

have a chronic illness. (Bauman,

Farley & Harris 2003. (ref).

and the redevelopment of intake

and assessment forms within

HACC funded services focussed

on client identified needs has

improved awareness by staff of our

clients’ values and expectations

and allowed tailoring of care and

programs to acknowledge culture

and diversity.

The TMHS Diversity plan aims

to improve access to services

by our diverse population by

broadening the knowledge of

staff and volunteers regarding

diversity issues through a three

year education plan, for all staff

and volunteers, which involves

collaboration with outside agencies

including local cultural resources.

Diversity and the resultant issues

around access are being added

as standing agenda items to all

relevant meetings, including the

Community Advisory Committee,

and will be considered in all

policy development and review.

An audit of the Health Service

built environment and service

practices and a Sexual Diversity

Health Services audit will be

undertaken to determine progress

toward identifying gaps in and

the associated barriers to service

provision.

Leadership for cultural respon-

siveness is demonstrated by the

development of the three year

training program for all staff and

volunteers.

Policies ensure that accredited

interpreters are provided to patients/

consumers who require one. In the

year in review interpreter services

were not required to be accessed.

Appropriate signage is displayed

facility wide and we have easy

access to online translator services

if required.

Inclusive practice and care

planning recognises and responds

to dietary; spiritual; family;

attitudinal and other cultural

practices. Our organisation

policies and procedures support

consumer choice regarding

appropriate nutritional needs.

Results from the Victorian Patient

Satisfaction Monitor indicate that

our consumers/patients at Terang

& Mortlake Health Services are

very satisfied with the manner in

which their cultural and religious

needs were met.

Staff throughout the health

service are provided with

professional development

opportunities to enhance their

understanding of and response to

diversity. In the past 12 months

staff members have attended

cultural awareness training

and implemented policy and

practices that support cultural

responsiveness.

Our HealtH Service ......................................... 2cultural reSpOnSiveneSS ............................. 2cOnSumer adviSOry cOmmittee ........................................................ 3accreditatiOn .................................................. 3Quality imprOvementcOmmittee ........................................................ 3tHe live life Well prOgram ............................ 3mOrtlake cOmmunity HealtH centre ........... 4diabetic educatOr .......................................... 4lOcal life Saver .............................................. 4WOrking at tmHS ............................................. 5SmOking ceSSatiOn prOgramme facilitatOr ....................................................... 5terang & tWeddle early parenting centre . 5infectiOn cOntrOl .......................................... 6Hand Hygiene ................................................... 6cOmplaintS/cOmplimentS management ..... 6OH&S repOrt .................................................... 6catering department ..................................... 7envirOnmental ServiceS ................................ 7maintenance .................................................... 7

planned activity grOup .................................. 7clinical gOvernance frameWOrk ................ 8credentialing and defining tHe ScOpe Of practice ...................................................... 8diStrict nurSing Service ............................... 8patient SatiSfactiOn reSultS ......................... 8acute care ....................................................... 9Operating Suite ............................................... 9imprOving care fOr cardiac patientS .......... 9midWifery repOrt ........................................... 9urgent care department ............................. 10mOunt vieW aged care .................................. 10gOOd buddieS ................................................ 11medicatiOn management ............................. 11antibiOtic uSage ............................................ 11incident repOrting ....................................... 11fallS – reducing tHe riSk ............................ 11Safe uSe Of blOOd prOductS ....................... 11preSSure injurieS ......................................... 11meet tHe bOard .............................................. 12vOlunteer cOOrdinatOr............................... 12Quality Of care repOrt feedback ............... 12

2 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce

OTHER NEWS

QUALITY OF

CARE REPORTLoCaL Life saverPaul Dunn – As an Ambulance community Officer he attends training once a month, and this training stood him in good stead when he went to a football game in June at etihad Stadium.

PaGe 4

WorkinG at tMhsFind out what it is like to work at the Mortlake community Health centre from someone who knows best, Administration Officer Genevieve rounds.

PaGe 5

Mount vieW aGeD CareMount View residents continue to celebrate culturally important days including ANZAc day, the AFL grand final, Christmas and Easter.

PaGe 10 terang & Mortlake Health Service – Mortlake.

results from the Victorian Patient Satisfaction Monitor indicate that our consumers/patients at terang & Mortlake Health Services are very satisfied with the manner which their cultural and religious needs were met

Accreditation

Quality Improvement Committee

Consumer Advisory Committee

The Live Life Well Program

A ll Victorian Public Hospitals are required to maintain a

form of accreditation with a focus on continuous quality improvement. We choose the Australian Council on Healthcare Standards to monitor our continuous improvement program against their Evaluation and Quality Improvement Program (EQuIP) standards .

In June 2012 we participated in a Periodic Review of the standards which aims:• to verify that levels of consumer

/patient care remain satisfactory;• to maintain momentum for

continuous quality improvement; • to assess progress against any

recommendations from the previous survey, and;.

The Live Life Well Program (LLWP) is a chronic condi-

tion self-management program offered to the Terang & Mortlake Communities. The target popula-tion for the LLWP are frequent hospital attendees who are most likely to benefit from integrated care and have the potential to reduce avoidable hospital admis-sions. This includes people with heart disease, respiratory disease and diabetes.

Once participating in the LLWP clients are assessed and care planned using the Flinders Pro-gram. The Flinders Program in-volves holistic chronic condition management: it provides a gener-

A ll staff have a role in contributing to the delivery

of safe, quality care and services whether or not they are directly involved in the provision of care to our consumers. The Quality Improvement Committee is responsible for monitoring and evaluating standards of care and service delivery and membership of the committee includes broad representation of staff groups, members of the Board of Management and the Chair of the Consumer Advisory Committee.

During the year committee members have been involved in the development of a new Strategic Quality Improvement Plan. The initial workshop was held in the Terang Civic Hall and facilitated by Dr Cathy Balding, a renowned quality improvement consultant and Director of Quality Works. Following the workshop Dr Balding assisted the Executive staff and Quality Managers to develop a process and methodology to develop a Strategic Quality Improvement Plan. Development of the plan has progressed throughout the year and over 100 people have participated in the consultation process including members of staff, the Board of Management, members of the Consumer Advisory Committee and consumers themselves. A draft of the plan is

• to adjust accreditation status if necessary.

Following this successful review our accreditation status has been confirmed until 2014.

Commencing in 2013 the National and State Health Ministers have agreed to and will introduce a new set of health standards at a National level known as ‘National Safety and Quality Health Services Standards (NSQHS). It will be compulsory for all health services to ensure compliance with these standards as a requirement

ic clinical process for assessment and planning for disease specific management. It uses a semi-struc-tured framework which could be applied to any chronic disease or condition and co-morbid condi-tions in the same person, that is patient centred and holistic i.e., incorporates the disease and psy-chosocial aspects of a person into a plan, and is motivational.

Why self-management? Chronic conditions accounted for 70% of Australia’s overall disease burden in 2005, which is expected to rise to 80% by 2030, and demand on health carers has increased. Evidence suggests self-management programs can

due to be presented to the Quality Improvement Committee at their November meeting and outlines the strategies we will implement to embed a patient centred approach to

care throughout the organisation.

“Patient Centred Care: Improving quality and safety through partnerships with patients and consumers” published by the Australian Council on safety and Quality in Healthcare states that ‘The Patient Centred Care approach to health care treats each person respectfully, as an individual human being and not as a condition to be treated. It involves not just the patient, but families, carers and other supporters. It is concerned about the patients comfort and surroundings as well as their beliefs and values’.

We firmly believe that embedding patient or client centred care throughout the organisation will assist us to achieve our vision of enabling and supporting our community to optimise their health and wellbeing.

of accreditation. The Australian Council Healthcare (ACHS) has developed a program which combines all of the 10 compulsory National Standards with a number of additional standards under the program title ACHS EQUIP / National.

Our aged care facility is also required to maintain accreditation status under a different set of standards namely ‘Aged Care Standards’ and in 2011 were assessed and met all the requirements of the 44 standards and were accredited until 2014.

assist people by equipping them with knowledge, skills, and the confidence to manage chronic health conditions.

Positive Outcomes for 2012 – As at July 2012 no participants of the LLWP have had admissions to hospital relating to their chronic health condition, 10 new people have been referred to the program, 5 have agreed to participate in self- management education. 11 people have been discharged from the program – 64% were discharged due to successfully self- managing their chronic health condition while participating in the LLWP.

A s in the previous year this year’s Quality of Care

report has been developed with the assistance of our Community Advisory Committee. Members of the Committee, Eve Black and Susan Keane have taken a lead role in the publication conducting the interviews with consumers, Board members and staff and have taken a number of the photographs to accompany the stories.

Committee members have continued throughout the year to assist with the development and review of information developed for consumers and have reviewed drafts of this report and during its development to ensure that the language used is understandable and that the report is not filled with the acronyms and hospital

jargon prevalent in our internal documentation.

During the year committee members attended a presentation along with Board members and staff provided by Dr Cathy Balding, Director of Qualityworks Pty Ltd. regarding the development of strategic Quality Improvement Plans.

They participated in a focus group assisting the Executive staff and Quality and Risk Managers to identify opportunities for improvement to be included in our own strategic Quality plan.

Mrs Eve Black, Chair of the Consumer Advisory Committee agreed to join the Quality Improvement Committee and brings a consumer perspective to the safety and quality matters discussed by the committee.

Quality of Care report tUeSDAY, Oc tober 30 , 2012 – 3terang Mor t lake Hea l th Ser v i ce

Terang community members benefiting from integrated care in the Live Life Well Program.

Following this successful review our accreditation status has been confirmed until 2014

Patient Centred Care: Improving quality and safety through partnerships with patients and consumers

Mortlake Community Health CentreCoMMunitY transPort

D uring the year a survey was conducted with the

Community Transport Volunteer drivers to assess their knowledge and satisfaction with the current systems in place; and to provide them with an opportunity to tell us their ideas that might improve the service and systems in place.

Over half of the drivers have been active in the program since its commencement over 10 years ago and so have a great deal of experience on which to draw. All drivers indicated they understood and feel comfortable with the manual handling requirements of the role. Manual handling education had been attended by 88% of drivers, presented by a physiotherapist at an afternoon tea and gathering hosted at the Mortlake Community Health Centre.

The survey results indicated that a small number of drivers were unsure of the emergency response protocol. This prompted a review and simplification of the emergency procedures and revision of the induction process, which had been identified as being inconsistently presented on occasion. A range of checks has been implemented, designed to ensure that the vehicle is in a satisfactory condition and that drivers and passengers are well prepared for their trip.

The introduction of the Volunteer

Manual and the appointment of a Volunteer Coordinator has also done much to address the issues outlined above. Our volunteer recruitment and induction system has been reviewed and revised, new policies and procedures have been developed and a trial is currently being undertaken with new recruits to ensure the systems meet the needs of our volunteers.

The Mortlake Community Transport Team was nominated for the 2012 Minister for Health Volunteer Awards, three drivers attended this day in Melbourne on the 17th May with the Mortlake Community Health Centre Coordinator.

A Community Transport Volunteer Drivers general information session was held on the 29th May where Occupational health and safety issues were presented by Gaye Sanderson, and provided an opportunity for drivers to share experiences with one another and share ideas for improvement.

outPatients feeDbaCk surveY anD aCtivities

W ith funds generously donated by the Mortlake

Murray to Moyne team “Blood Sweat & Gears” the Mortlake Community Health Centre has been able to purchase and install a new vaccine fridge, for the safe storage of valuable vaccines. This together with the installation of new roll top benches, and a new hand washing sink with a sensor tap has greatly contributed to high standards of infection control in the primary care department. A client satisfaction survey carried out in the middle of 2011 demonstrated that clients are highly satisfied with the services offered, but that

satisfaction with the waiting areas received a mixed response.

Development of a separate waiting area for allied health has been welcomed by clients. Improvements have been made to the waiting area for the primary

care department with the purchase of comfortable, height appropriate chairs.

Comments by survey respondents were very positive, and included:

“Very important service as we don’t have a hospital”

“All care and attention is of a very high standard”

“Outstanding staff who go out of their way to provide a service quality that I have never experienced before, a credit to your organisation.”

Mortlake Health Service nurse Jenny Grice checks the blood pressure of patient Vi Whittaker.

4 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce

the Mortlake community transport team was nominated for the 2012 Minister for Health Volunteer Awards

All care and attention is of a very high standard

Diabetic EducatorM ichelle Symons has been

nursing for fourteen years and has been a Diabetic Nurse for ten of those years. When a new client is referred to her, Michelle’s first question is “What does he/she want to do about the disease?”

With Moyne Shire having one of the highest diabetes rates in Victoria, her work load is fairly full. Michelle does not advise clients on diet, that is left to the dietician; her focus is on giving extra support, helping set goals

for clients and guiding lifestyle changes to benefit their overall health.

On the morning of our interview, Michelle’s client was Mortlake’s Don Aitchson. Don was diagnosed with diabetes sixteen years ago when, after experiencing excessive thirst and dizziness amongst other symptoms, he went to his GP and was surprised to learn that he had the disease. Seeing Michelle each fortnight for a thirty minute consultation has been of great benefit to Don; Michelle keeps an eye on his exercise programme, eating habits and weight.

So keen is Michelle on getting

her clients moving, that she will often take them on a “walking consultation” where most of the half-hour is spent gently walking around the streets of Mortlake. As I write this, Michelle, who lives in Terang, is preparing for the birth of her second child; she finds time to garden when not at work.

Like most diseases, diabetes is non-selective and Michelle’s clients range in age from 38 to 93. Michelle encourages potential clients to visit their GP or come to TMHS. As Don summed up so very well, if only one person is helped, the programme will have been more than worthwhile.

Don Atkinson with Diabetes educator Michell Symons.

So keen is Michelle on getting her clients moving, that she will often take them on a “walking consultation” where most of the half-hour is spent gently walking

Local Life Saver

P aul Dunn is a life-long local resident who has

worked for the Health Service for the past seven years.

Paul works as a maintenance officer and handyman at all four campuses, including the Day Centre and the Parenting Centre. Paul says the staff are great to work with and he also enjoys spending time with the clients, who have valuable input into gardening and general improvements.

Paul enjoys seeing the progress made as a result of his efforts. He has worked as a volunteer with Ambulance Victoria for 4 years. As an Ambulance Community Officer he attends training once a month, and this training stood him in good stead when he went to a football game in June at Etihad Stadium. On his way to his seat he noticed a man who had collapsed with what turned out to be a massive heart attack. Finding no sign of life Paul immediately began CPR. The man got a pulse but then arrested again twice with Paul continuing CPR for 15 minutes until the first-aiders arrived. He continued to work with them and finally the 67 year old man was able to speak to them. Needless to say Paul didn’t get to see his Bombers beat the Bulldogs that night.

After four weeks in hospital the man was able to go home to a very grateful family and Paul has made some life-long friends.

Paul Dunn.

Quality of Care report tUeSDAY, Oc tober 30 , 2012 – 5terang Mor t lake Hea l th Ser v i ce

Working at TMHSM rs Eve Cumming-

Black, Chair of the Consumer Advisory Committee interviewed Administration Officer Genevieve Rounds to find out what it is like to work at the Mortlake Community Health Centre.

How long have you been working at TMHS?I commenced working at the Mortlake Community Health Centre in July 2011.

Have you worked in the health sector before?I worked at Warrnambool Base Hospital in the early 80’s as an internal courier, moving into the role of administration switchboard operator and then payroll officer. I moved to Cairns in the late 80’s and worked at Cairns Base hospital as a ward clerk for 2 wards, the short term surgical and thoracic wards.

What attracted you to this job?

The definite attraction was the hours and being able to work in close vicinity to home. And the security of working within the health sector is a big plus.

What is the best part of your job? And are there any downsides?I enjoy the direct contact with the public, my personality is very much true to the Aquarian nature of being a ‘people person’.

Downsides - trying to keep up with technology is always a challenge. The frustration of keeping the printer/copier in working mode - always a challenge! Ahh, the joys of full time work!

As the “front of house” person at Mortlake, what do you consider to be the most important aspect of your work? And the most rewarding?Organisational skills are hugely important. Also being able to meet and greet with a positive outlook, good listening skills, and being part of the ‘team’.

The most important aspects of my work are co-ordination, promoting and advertising

Mortlake Administration Officer Genevieve Rounds.

L-r Kerri Nicholson, Mortlake community Health centre coordinator during her interview by eve cumming-Black, chair of the consumer Advisory committee.

programs within the Mortlake Community Health Centre. The role also includes receipting, recording and banking, raising invoices for services provided, ordering and receipt of supplies for the Health Centre, co-ordination of meetings and preparation of agendas and minutes etc., preparing and lodging claims for the provision of District Nursing service visits and consumables with the Department of Veterans’ Affairs and compiling statistical reports. There is always something to do.

Does being a “local” make the job any easier?Being a ‘local’, people know you, it is often reassuring for the public to see someone who will be helpful, pleasant etc!

Can you tell me a little about your involvement with the volunteer driver service; how does this service work and your role.This is a wonderfully rewarding experience for a generous soul to lessen the hardship of some people enduring an often stressful and not so pleasant journey. Happy is the hand that stretches out to others… and happier is the hand that takes a hold, for the journey is then often shared. Our volunteer drivers are a terrific group of very kind individuals, for which I am grateful to be able to help co-ordinate client appointments, the driver and the vehicle. My role is to take client bookings for the vehicle, organise a volunteer driver to take client to the appointment, receipt, record and bank all monies taken associated with the trip and compile statistical reports for the community transport service.

Becoming a volunteer driver is

certainly something to consider for myself ‘down the track’!

Tell me about some of your interests away from work.I have always been a social butterfly and love a ‘get together’ to share a meal and a glass of wine. I love to cook, but I especially love to cook for people who ‘love to eat’! The last dinner party I held catered to 18 guests, for a 6 course, sit down dinner. My opening phrase to begin the meal “Welcome to my home (one of the beautiful historic Mill Cottages of Mortlake), enjoy the company of friends, eat well, drink well and be oh so very merry! Enjoy.

I am definitely a passionate ‘horse nut’. Horses have been very much a large part of my life from age 6 until now. “Heaven will be a disappointing place if there are no ponies!”

Are you a morning person or a night-owl?In my younger years I was definitely a ‘night owl’. At 20-30 years old my days started around 5am and was often in bed by 10pm. At 40 years - Ah life begins! Now a single parent with 3 beautiful children ages 5, 6, and 8 years. Enrolled full time in a university course at Glenormiston College my day commenced at 4.30am for the next 2 years. I learnt to sleep fast!!! At 40-50 years: I certainly ‘own my own shoes’. 50 + years - life is great for me now.

One piece of advice your mother gave you?Life is all about ‘putting memories in the memory bank’. Life is all about, giving it a go. Life is all about, opening a door for someone. Life is all about, lying in bed straight every night.

Life is never about, putting a trailer behind the horse!

Have you done much travelling, either within Australia or overseas?Not so much overseas yet - that’s still to come! Lots in Australia, I have lived in some remote places - Weipa, the Alice, Cairns and Perth.

What makes Mortlake a good place in which to live and raise a family?The people make this community a great place, the services, such as TMHS, the local schools, the community groups. It is a very caring community.

It is affordable and people are community minded. Offers a mindset of community volunteer involvement, people are conscious that they can make a difference. TMHS offers services that keep the community going, it fulfils the needs of the population. It is mindful of the wellbeing of those that live in the community.

Smoking Cessation Programme FacilitatorKerri NicholsonBy eve CuMMinG-bLaCkChair of the ConsuMer aDvisorY CoMMittee

I f you are trying to give up smoking in ten easy lessons

(or five hard ones), think again. But if you are seriously looking for help the Smoking Cessation Programme offered at TMHS may well be for you.

The programme has been running for the past four years, initially, shared between Kerri Nicholson and Jill O’Brien. It is now solely run by Kerri.

Clients may be referred by a GP or they can refer themselves. In 2011 fifteen clients were assisted to “Quit” and so far in 2012, five clients. Their ages range from 19 to 70 plus years.

Kerri Nicholson conducts consultations without judgment and sees tobacco addiction as a disease. An initial assessment conducted over one hour is made. The client will be asked why he/she smokes, a history is taken and clinical checks such as blood pressure and weight are recorded.

Treatment may include nicotine replacement in the form of gum and lozenges, helping clients to the realization that the addiction is actually a disease, and

simply having a sympathetic and understanding ear.

On the afternoon I interviewed Kerri, the Plain Packaging legislation had been passed and she was very excited about this forward step to help stop non-smokers from taking up the habit.

Kerri spends time speaking to school students, emphasizing that weight gain need not necessarily be an outcome of giving up smoking, but that saving money certainly is a positive gained by not smoking.

When she is not gently, but firmly easing programme participants away from tobacco, Kerri loves to spend time with her family; she keeps herself fit and active by walking and gardening and she likes to read. Live theatre, dining out and wine appreciation are also some of Kerri’s out of hours interests.

Kerri and her husband are looking forward to a trip to India to explore some family history.

If you are seriously looking for help the Smoking cessation Programme offered at tMHS may well be for you

I enjoy the direct contact with the public, my personality is very much true to the Aquarian nature of being a ‘people person’.

Terang & Tweddle Early Parenting CentreT he Terang & Tweddle Early

Parenting day stay program began catering for the parenting needs of the South West in April 2001.

The Terang Early Parenting Centre is operated in partnership with Tweddle Child and Family Health Services. The parenting centre provides a Day Program for families with babies and

children up to 36 months old: education and help to manage parenting issues including feeding difficulties, unsettled/irritable infants, infant/toddler sleeping problems, uncertainty with parenting issues, challenging toddler behaviour, maternal exhaustion, and postnatal anxiety and depression.

Infection Control

Hand Hygiene

Each year all staff are offered a free influenza immunisation. Firstly to avoid contracting the virus themselves and secondly to guard against the virus being passed on to others including patients who may be at higher risk should they contract the virus.

In 2012 117 staff members were offered the vaccine and it

was accepted by 82% of all staff members. This compares to a State wide acceptance rate of 51% and is something our staff can be proud of. There have been almost 30,000 confirmed cases of influenza nationally and in Victoria almost 3500 cases. Hence annual immunisation against influenza is imperative for all staff and members of the community.

6 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce

the department has overseen one of the highest hand hygiene scores in the state during October 2011 with a score of 91.2%

138

81

57

117

77

40

108

65

39

96

63

333416 18 21 14 7

020406080

100120140160

Accepted

Declined

Nursing/

Medica

l

Nursing/

Medica

l

H and hygiene is a funda-mental control in infection

prevention. The health industry worldwide has adopted a protocol for hand washing known as the “five moments of hand hygiene”. These being:

– Before touching a patient,– Before a procedure,– After a procedure or body

fluid exposure risk,– After touching a patient and,– After touching patients

surroundings.

Hands must also be washed after using the bathroom, after blowing nose, sneezing or coughing,

before eating or handling food, after handling uncooked meat, after handling waste, handling money, touching animals and staff are advised to avoid touching their mouth, eyes, nose or ears when hands are unwashed.

Audit of public hospitals compliance with hand washing began in 2010 and results are required to be submitted to the Department of Health quarterly. The graph below records the results of our compliance audit for the April to June quarter 2012 and indicates a high level of compliance.

D uring the 2011-2012 financial year the infection

control department was the first in the region to introduce the Clinismart C64 infectious waste containers. The containers provide an innovative way to manage infectious waste. They do not utilise disposable plastic inserts common in most other systems, and so generate less waste than others. They are pedal operated, reducing the need to touch the opening and so reducing the risk of infection transfer, they are easy to manoeuvre and significantly more aesthetically appealing than similar systems. The eco-friendly wash process “Washsmart” uses a fully automated wash system that uses

recycled water and further reduces the environmental impact.

The department has overseen one of the highest hand hygiene scores in the state during October 2011 with a score of 91.2% this was later highlighted in the Herald Sun in April this year. Hand hygiene is considered to be the number one link in not only reducing but, containing any types of infections. TMHS is committed to hand hygiene education and monitoring of not only staff but all visitors. During April to June 2012 the hand hygiene compliance rate was recorded as 84.3% this is an excellent result. The required compliance rate is currently 70% for all health care workers nationally.

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

Hand hygiene compliance rate Apr-June 2012

Before

a

proce

dure

Complaints/Compliments Management

Occupational Health and Safety Report

T erang and Mortlake Health Service recognise the

value of feedback, both positive and negative and all comments are seen as an opportunity for improvement. We encourage

T he Board of Management, Executive Committee and

staff members amalgamate to demonstrate a commitment to maintaining, promoting and sustaining a health and safety program of impeccable standards throughout the organisation, this was acknowledged during the Aged Care Accreditation Process held in May by the Assessors.

traininGThe Occupational Health and Safety component of Mandatory training has taken on a new dimension during the past 12 months, covering a multitude of areas that enhance “Best & Safe Practice” including Defining Bullying in the Workplace, Fire & Emergencies, Effective Communication, The Code of Conduct, Dressing to Impress, Emergency Colour Codes and their meanings and Staff Incident & Hazard reporting. Feedback from participants who have attended the training sessions has been overwhelmingly positive.

fire anD eMerGenCY PrePareDness

To ensure that all staff have appropriate skills and knowledge in the event of a fire we have continued to hold fire drills and desk top scenarios. Senior staff participate in

all patients and consumers to discuss any concerns they may have about care they receive, the level of customer service and treatment from staff and the facility. All complaints/

fire panel and emergency warning intercommunication system management on a monthly basis.

All staff are required to complete fire safety training annually utilising a computer based education program that assesses the users competency and provides a certificate of attainment on successful completion of the course. This method of training enables staff to complete the training at their own pace whilst ensuring competency.

The Critical Hospital Operating Contingencies Plan (CHOC Plan) records responses and actions to be undertaken in response to a broad range of internal and external events including loss of power, water, gas etc. To enhance our contingency emergency planning we developed a “Heat map” that indicates where staff live. This proved very useful during the floods of 2010, enabling us to plan alternative travel routes to and from work for staff who had to negotiate road closures.

Work CoverOur return to work program for

employees who become injured at work is supported by a “No Blame” approach to Work Cover Management. We aim to assist any injured employee to return to work as soon as their treating doctor

compliments are treated with the strictest confidentiality, entered into our electronic incident data recording mechanism and reviewed by our Quality Improvement Committee.

advises us that they have a capacity to work, either on transitional duties or modified times. Injured employees that have participated in a Return to Work Plan have been asked to complete a questionnaire to evaluate the extent to which their plan was successful, and to identify any areas that we may improve in. Evaluations to date have been very positive towards our program.

revieW of oh&s ManaGeMent sYsteMs

We have reviewed our Occupational Health and Safety Systems against the National Standards AS/NZS 4801-2001 to ensure compliance is met in all areas. A diagnostic breakdown of Safety Management Systems has been completed and provides evidence that we meet “Best Practice” criteria in relation to Occupational Health & Safety Management.

“Safety Snippets” our OH&S newsletter is published quarterly and has proven an effective way of informing staff of relevant issues discussed at Occupational Health & Safety meetings and providing tips to stay safe in the workplace.

Quality of Care report tUeSDAY, Oc tober 30 , 2012 – 7terang Mor t lake Hea l th Ser v i ce

Catering Department

Environmental Services

MaintenanceO ur catering department

continues to provide high quality home style meals to our patients, residents and community clients and provided in excess of 50,000 meals in the current year. The catering department utilises a 28 day rotating menu to ensure variety and caters to special needs such as diabetic and gluten intolerant people.

In November 2011 we were awarded the contract to provide Meals on Wheels to Terang recipients and have seen the numbers grow from an average of under 400 per month in the first

O ur dedicated team of cleaning staff ensure that

our facilities are kept clean and support our infection control policies and processes. Both internal and external cleaning audit scores indicate a high standard of cleaning in all areas and our results remain well above the 85 point Accepted Quality Level set by the Victorian Cleaning Standards.

The graph below records our cleaning scores for the financial year, the highlight being the near perfect score of 99% recorded in October and assessed by an External Auditor.

I n the 2011-2012 year there have been 1133 requisitions

for the maintenance department lodged, with 995 of these completed and 404 completed

in one day or less. These tasks include maintenance of essential service and regular monitoring to ensure that fire and safety systems are well maintained.

The following graph indicates the numbers of tasks carried out over the last two years at our four campuses.

two months to well over 550 per month currently. The service relies on a dedicated group of volunteers who deliver meals seven days per week including public holidays. If you are interested in helping to deliver Meals on Wheels please contact Kate Justin our Volunteer Coordinator.

During December 2011 the Mt View laundry was reallocated to the acute level, following the refurbishment of the acute outside laundry. The purchase of a new industrial washing machine and drier has enabled staff to perform their allocated duties more efficiently and effectively.

Our catering department... provided in excess of 50,000 meals in the current year

the purchase of a new industrial washing machine and drier has enabled staff to perform their allocated duties more efficiently and effectively.

Planned Activity GroupA ctive Service Model principles

are now well embedded in the practices of staff at the Community Health Centre. The client centred approach enables staff to plan activities and programs that suit a diverse range of needs, abilities and goals.

The programs have evolved over time and promote active participation by clients. A monthly calendar of programs and activities is provided to clients, carers, case managers and referring agencies to promote the range of activities available and a monthly newsletter is circulated highlighting client participation and activities planned for the upcoming month. There are currently 61 clients participating in Planned Activity Group programs.

The Planned Activity Group runs five days per week, offering a range of cognitive, creative and physical activities. Outings occur three times per week utilising our wheel chair accessible bus.

Clients actively participate in the decision making process regarding activity programs they wish to participate in, furnishings and equipment purchases for use within the facility, destinations for their outings and their food options.

The Men’s Mobility Mapping program has developed into the Men’s Travelling Lunches group who have an outing each week for lunch and a visit to a site of interest. This program targets

socially isolated men who have not previously attended the Planned Activity Group. There are currently 22 registered participants for this activity. These outings provide a social connection, friendship group and supportive environment and are regularly booked out.

Documentation used is designed to capture information about our clients’ interests, their life journey and current health and wellbeing goals. This data has enabled staff to tailor programs to suit a wide range of interests and needs.

The majority of programs which initially commenced under Well 4 Life funding have continued i.e. strength training, gardening and community kitchen and continue to be a tangible connection for Home & Community Care (HACC) eligible community members to the Community Health Centre.

Volunteer roles within the Planned Activity Group have been maintained. The volunteers remain a very valuable part of the Planned Activity Group team, bringing with them new skills, ideas and knowledge to benefit staff and clients.

Outings’ planning has been reviewed and a template introduced to assist staff when planning outings. The template prompts staff to consider such things as venue access, mobile phone coverage, weather forecasts and client capabilities in the planning of any outing.

In line with HACC requirements a Diversity Plan for the next three years has been developed which aims to address service accessibility and suitability for people with diverse needs such as those who have dementia and their carers. Staff education needs regarding cultural diversity will be addressed and a whole of service audit assessing Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) friendliness of the service will also be conducted.

PhYsiCaL environMent anD resourCes

The Planned Activity Group space continues to undergo refurbishment including repainting, new window furnishings and the purchase of two three seater sofas. Funding for the sofas was provided by the clients from the proceeds of two street stalls.

The sofas have become a popular spot for clients to gather informally to chat and rest. The continued creation of smaller spaces within the larger framework of the Activity room has led to improved utilisation of the space and the opportunity for greater diversity in the programs offered.

The Community Health Centre garden, coordinated and designed by a volunteer is nearing completion. A mix of raised garden beds, retaining walls, shaded seating areas and level areas for walking will provide further opportunity for clients to increase their physical activity with a combination of structured activities and informal garden walks or visits.

The Planned Activity Group runs five days per week, offering a range of cognitive, creative and physical activities

Clinical Governance FrameworkC linical governance is the term used to describe the approach taken by

the Board of Management, clinicians and staff toward ensuring that the services we provide are both safe and of the highest quality. A Clinical Governance Framework published by the Department of Health in 2009 has been adopted and provides guidelines and principals for health services to ensure accountability for providing safe care and is fundamental to continuing to improve patient safety within Victorian health care system. The four domains of quality and safety identified within the framework are described below.

C redentialing and defining the scope of practice is

the method utilised to ensure all of our staff are appropriately qualified to undertake their roles and sets parameters for the level of complexity of care that individuals are able to engage in.

aLL of our DoCtors are CreDentiaLeD aCCorDinG to best PraCtiCe GuiDeLines

aLL of our DoCtors are reGistereD With the MeDiCaL boarD of austraLia

aLL of our nurses are reGistereD With the austraLian heaLth PraCtiCe reGuLation aGenCY

aLL staff anD voLunteers have unDerGone nationaL PoLiCe CheCks

QuaLitY DoMain What the fraMeWork saYs We shouLD Do What We Do

ConsuMer PartiCiPation

Consumers participate in health service governance, priority setting, and strategic and business and quality planning.

Consumers participate in safety and quality initiatives.

The Chair of the Community Advisory Committee is a member of the Quality Improvement Committee and is involved in the review of quality improvement activities.

Members of the Community Advisory Committee and consumers participated in the development of our Strategic Quality Improvement Plan.

CLiniCaL effeCtiveness

Safety and quality indicators are defined, monitored, reported and managed.

Clinicians are involved and provide leadership in safety and quality governance and management.

We benchmark our services and care with other providers to identify and implement opportunities for improvement.

Our clinicians, Medical Officers and Nursing staff meet quarterly to review our policies and processes.

effeCtive WorkforCe

Provide comprehensive education and training for all staff in safety and quality skills and methods.

The organisation culture values staff and consumer input.

Our computer based training systems and annual in-service training program for all staff focuses on safety and quality.

Over 100 people including members of staff, the Consumer Advisory Committee and consumers contributed toward the development of our Quality Improvement Plan.

risk ManaGeMent

Clinical and corporate risks are seen as equally important.A complaints and complements management system is in place.

Our comprehensive risk register reflects and responds to both clinical and corporate risk.

Complaints management and complements are reviewed by the Quality Improvement Committee.

8 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce

District Nursing Service

Patient Satisfaction Results

O ver the 2011/2012 financial year the District Nurses

at both Terang and Mortlake campuses have visited a total of 168 individual clients. Of these, 127 were Home and Community Care (HACC) eligible (received visits at a subsidised cost), 13 were privately funded, 23 were Dept. of Veterans Affairs (DVA), 3 work cover (WC) and 2 Transport Accident Cover (TAC).

There have been 103 client admissions and 88 client discharges from the District Nursing Service.

During the year we developed a new documentation package to assist staff to focus on client needs when assessing clients and putting their care plan into place. It also assists the client to consider what their individual needs are so that they can actively

participate in the development of their care plan.

Our district nursing service continues to liaise with the South West Sub-Regional District Nursing Group, the HACC Coordinators/Discharge Planners Committee and the Transition Care Program by attending the meetings of each of these groups.

Over this past year, both Terang and Mortlake campuses have hosted nursing students from South West TAFE and Deakin University. In their Community placement the students focus on the services available and the specific needs of people receiving care in their homes. We are pleased to assist this next generation of nurses to consolidate their theoretical knowledge and develop their practical skills.

ensuring that the services we provide are both safe and of the highest quality

Credentialing and defining the scope of practice

overaLLCare

aCCess anD aDMission

GeneraL Patient

inforMation

treatMent anD reLateD inforMation

aLL hosPitaLs 80 78 84 80

CateGorY D hosPitaLs 86 84 89 85

tMhs 88 87 89 87

CoMPLaints ManaGeMent

PhYsiCaL environMent

DisCharGe / foLLoW uP

ConsuMer PartiCiPation

aLL hosPitaLs 82 77 79 81

CateGorY D hosPitaLs 87 85 83 86

tMhs 88 88 86 88

A ll of our patients are provided with an opportunity

to participate in a State-wide survey titled the Victorian Patient Satisfaction Monitor (VPSM) conducted on behalf of the Department of Health. Survey results are compiled half yearly and provided back to the participating hospitals enabling them to review the results and identify areas for improvement. The report provides a

comparison is between all hospitals in the State and between hospitals of similar size or grouping. TMHS is a Group D hospital. The results the period July 2011 to June 2012 are summarised below.

The results indicate that TMHS scored higher than both the All Hospitals and Category D Hospitals Mean Index in all 8 indices.

A copy of the full report is available on request.

VPSM results July 2011 to June 2012.

District Nursing Service Unit Manager– rosemarie Barby.

Acute CareQuality of Care report tUeSDAY, Oc tober 30 , 2012 – 9terang Mor t lake Hea l th Ser v i ce

Midwifery Report

Operating Suite

T he Terang Campus has continued to support

the Shared Care Program, involving the GP Obstetrician and midwives, allowing greater continuity of care of mothers and babies. During the year health service staff participated in 222 share care visits, the number in the previous year was 191.

The programs follows a framework developed by the South West Maternity Strategy in conjunction with the Regional Obstetricians, ensuring a risk screening approach for women birthing in rural facilities.

This year we have welcomed the arrival of 34 babies, 2 of which were solely Midwife deliveries.

this year we have welcomed the arrival of 34 babies, 2 of which were solely Midwife deliveries.

T he Terang Campus of the Health Service continues to

deliver a range of acute services including:

– General Medical

– General Surgery

– Endoscopy procedures

– Gynaecology procedures

– Obstetrics

– Haemodialysis

Recruitment and retention of nursing staff is a challenging issue across Australia. The Terang & Mortlake Health Service encourages nursing staff to pursue on-going professional development and education. During the year twelve members of the Enrolled Nursing staff completed their Medication Endorsement course at South West TAFE and are now qualified to give medications to our patients and residents.

Four members of the Enrolled Nursing staff have commenced and are at differing stages of completion of a Bachelor of Nursing degree being studied through Deakin University. These nurses are granted leave by the Health Service to complete their clinical placements at health services throughout the region.

keY initiativesKey initiatives for ongoing professional development include:

During the year we reviewed and revised our approach toward the provision of our Mandatory Training program which now is comprised by two distinct processes.

The first of these is our face-to-face training program. All employees are required to attend one of the face-to-face sessions once in every two years. Topics presented at these sessions include Occupational Health & Safety, Infection Control, Quality Improvement, Environmental Resource Management, and an introduction to chronic disease management.

The second component, SOLLE (SWARH On Line Learning & Education) was implemented in 2011. SOLLE is utilised to manage on-line computer based training. All staff members are required to complete competency assessed modules related to Fire safety, Manual handling, hand hygiene, incident reporting and open disclosure. In addition, members of the nursing staff are required to complete additional modules related to medication management, basic life support, and safe administration of blood and blood products.

All staff participate in an annual performance review during which they are asked to identify any other areas of training and education they would like to participate in. In response to requests from nursing staff education was provided on Advanced Life Support, Triage in urgent care, Obstetric updates for midwifery staff, identification of and response to the deteriorating patient, wound care, caring for clients with dementia, and Preceptor training for staff who work as mentors for students and recent graduates.

E quipment purchased this year included a new anaesthetic

machine used for the delivery of anaesthetic agents and the monitoring of patients during a procedure. Funds raised by the

All staff participate in an annual performance review during which they are asked to identify any other areas of training and education they would like to participate in

Improving care for cardiac patientsThe Victorian Cardiac Clinical

Network (VCCN) was established in February 2009 and aims to improve quality, access, equity, cost effectiveness and sustainability of cardiac services in Victoria through the facilitation of a co-ordinated approach to care using evidence based guidelines for the care and management of both adults and children with cardiac conditions and; working across organisational boundaries to develop effective health system responses to enhance cardiac service provision and improve cardiac health outcomes across the state.

In 2010 the VCCN organised a cardiac services survey to be conducted across all services in regional/rural Victoria.

The survey identified a range of opportunities to improve cardiac care and made the following recommendations:

– That a framework for the management of acute coronary syndrome in rural state-wide health services be developed which takes into account the limited access to support services such as radiology and pathology.

– That access to a Cardiologist (could be phone only) be made

accessible to all rural health services 24/7.

– That the development of a consistent policy for point of care testing be developed for all rural health services and that the policy includes a competency tool.

In response, the Victorian Cardiac Clinical Network decided to undertake a pilot during 2011-12, of Point-of-care Troponin (POCT) assays to assist in the triage of patients presenting with chest pain in the Emergency Department/Urgent Care Service in Small Rural Health Services. The pilot took place in the South West region at seven health services of which the Terang hospital was one.

The project aimed to introduce an Acute Coronary Syndrome Pathway to the seven health services involved in the pilot and evaluate the impact of improved access to evidence-based acute and follow up cardiac care.

During the pilot the following strategies were implemented and evaluated.

– In order to support timely risk stratification and decision making regardless of geographic location, bed side POCT testing for cardiac Troponin was

introduced where turnaround time for Troponin assays by the pathology provider normally exceeded 60 minutes.

– Improved accessibility to specialist cardiology advice regarding Electro cardiograph (ECG) interpretation, other diagnostic test interpretation, triage and treatment decisions. This aim was to develop processes enabling clinical staff to provide prompt advice 24 hours per day, 7 days per week, with an average response time of less than 10 minutes.

– Provision of comprehensive cardiac continuing medical education for the medical and nursing workforce servicing these areas.

– Develop agreed Clinical Pathways for Chest Pain/Acute Coronary Syndrome.

Following successful conclusion of the pilot it was agreed that Point-of-care testing and the Cardiac Clinical Pathway developed and trialled during the project be retained by the participating Health Services, and that the Cardiac advice line established at Barwon Health with the support from Barwon Cardiologists also be retained.

Murray to Moyne Cycle Relay team were utilised to purchase an instrument dryer for the Sterile Supply department.

The number of procedures completed in the operating suite:

ProCeDure 2010-11 2011-12

GastrosCoPies/CoLonosCoPies 204 221

GeneraL surGiCaL 41 42

GYnaeCoLoGY/obstetriCs 19 20 Welcomed into the world at the terang Hospital. clara Kenna, pictured with her mother Naomi.

T here have many changes during 2011-12 in Mount

View including staffing, refurbishment, commencement of continuous improvement working parties, to name a few.

The Social Inclusion project continues with the Grade 5 and 6

students from St Thomas Primary School, forming wonderful relationships with the residents and families. The meaning to all is immeasurable in monetary terms. The intergenerational program encourages the development of ongoing buddy relationships

between the students and our residents and provides opportunities to share special events including farm days, sporting competition and concerts. The program is invaluable to all involved.

10 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce

Mount View Aged Care

Urgent Care DepartmentA ll people presenting to the

Urgent Care Department will be met by a nurse and triaged according to the Australian Triage Scale Target Time to Medical Review.

Triage comes from the French word “trier” meaning to sort or choose. Triage is a process of rapidly classifying patients on the basis of the urgency

of treatment that is required. The level of urgency is based on the nature and severity of the illness or complaint; the patient’s medical history; vital signs and symptoms; general appearance and a brief physical assessment. After assessment, patients are allocated a triage category based on the Australian triage Scale;CateGorY 1 (Resuscitation) ImmediateCateGorY 2 (Emergency) Within 10 minutesCateGorY 3 (Urgent) Within 30 minutesCateGorY 4 (Semi-urgent) 1 hourCateGorY 5 (Non urgent) 2 hours

During the year we received very generous donations from the Ryan family and the Terang Hospital Ladies Auxiliary enabling the purchase of 8 new dining room chairs with wheels. Working parties continue to review areas of improvement relating to how documentation is completed and ways in which to approach these changes.

The volunteer program has been extended in Mount View to see newspaper reading to our residents on a regular basis. This opportunity is greatly appreciated by all.

Education Programs attended by staff members during the year included dementia training, wound care, comprehensive assessment

of the elderly, pain management, person centred care and privacy.

To further enhance the activities program in Mount View, two members of the Environmental Services staff have completed a Certificate IV in Lifestyle and Leisure and assist our Activities Coordinator in providing the activity program. These staff members have now commenced Diploma of Health and Leisure.

Mount View residents continue to celebrate culturally important days including ANZAC day, the AFL grand final, Christmas and Easter. Other ongoing planned activities included cooking, barbeques, music therapy, crafts and bus trips which the resident’s thoroughly enjoy.

Long standing Mount View resident Betty Logan.

the graph above represents the percentage of patients seen within the triage guidelines.

triage is a process of rapidly classifying patients on the basis of the urgency of treatment that is required

Good Buddies Medication Management

Pressure Injuries

Safe use of Blood Products

A ge is no barrier between the students of St Thomas’s

school and the residents of Mount View when it comes to being buddies.

The buddy system began in 2010 when, as a result of a Commonwealth Government initiative a grant of $25,000 became available. This grant was used to get the system off the ground, but after the first 12 months it has continued on a voluntary basis. School Principal Terry Harney says that all grade 5 and 6 students are involved in the scheme.

The students are assigned a buddy, often working in pairs. They visit Mount View a couple of times a term, when they chat

T erang and Mortlake Health Service promotes

safe, effective and appropriate medication use and promotes organizational accountability and responsibility in the safe administration of medications.

The majority of medication administration errors recorded

A pressure ulcer is an area of skin that

has been damaged due to unrelieved and prolonged pressure.

Pressure ulcers are usually found on bony parts of the body, but can occur almost anywhere on an area to which pressure is applied for a prolonged period of time.

All patients and residents are risk screened to determine the risk of developing a pressure ulcer area during their stay. Nursing staff use a range of specialised equipment to help reduce the pressure ulcer risk including pressure relieving mattresses, heel wedges, and the encouragement of patients and residents to be as active as possible.

T erang & Mortlake Health Service monitors

compliance with best practice processes when managing blood and blood products. All Registered Nurses must complete the Blood Safe e-learning program annually, developed by clinical experts in the area of transfusion. Data collection and monitoring ensures policy is adhered to. There have been no adverse events relating to blood transfusions.

to their buddies, play games and entertain them with musical items.

Once a term there is also a major activity. For example, the residents visit the school for a day of games, liturgy and other activities. Another special day is a farm day, when again the residents visit the school and get to experience farm animals and equipment.

Eleven year old Sarah Pekin has been involved with the scheme for two years. She says she enjoys the opportunity to spend time with older people. She enjoys chatting to her buddies, playing games and entertaining them.. She believes the residents also get a lot of pleasure from the experience.

relate to;

Signature omissions – the medication was given but not signed for.

Omitted dose - medication missed or not administered at the due time.

Most signature omissions are due to distractions while completing medication rounds. Interruptions

such as answering the telephone, responding to general enquires, or when being called to assist with patient/resident needs during the medication round are all potentially distracting and increase the risk of error. It is comforting to note that there has been no error that resulted in harm to the patient or resident.

Antibiotic UsageA ntibiotics are an integral

part of health care, however on occasion antibiotics are not always appropriately managed. Sometimes antibiotics are given as a prophylaxis in particular in nursing homes, as an intervention to prevent urinary tract infections. This practice is no longer encouraged, medical and nursing staff members are now encouraged to have infections confirmed via appropriate pathology prior to the prescription and administration of antibiotics. This is more likely to result in prescribing of the most suitable antibiotic.

In order to reduce unnecessary pathology interventions, clinicians are required to use the

Quality Performance Systems (QPS) assessment as a first line management tool. The QPS assessment is utilised to verify a variety of infections including wound infection, conjunctivitis, urinary tract infections and gastroenteritis. If the appropriate level of criteria is met a pathology request is initiated by the individuals medical officer.

Following implementation of the QPS assessment, residents in Mount View are no longer administered antibiotics as a prophylaxis. This, together with the successful introduction of cranberry tablets to avoid urinary tract infections, has reduced the volume of antibiotics being used for unconfirmed infections.

Quality of Care report tUeSDAY, Oc tober 30 , 2012 – 11terang Mor t lake Hea l th Ser v i ce

Incident ReportingT he following graph reports

our results for the four

major incident categories recorded

and reported throughout the past

three years. We encourage staff to report all incidents and near misses to enable us to analyze causes and make improvements

to our systems and processes to minimize harm.

T he World Health Organisation defines a “fall” as “An event,

which results in a person coming to rest inadvertently on the ground or other lower level.”

Falls in the elderly patient and resident are not uncommon, Terang & Mortlake Health Service is committed to the prevention of harm from falls through the minimization and management of falls. Research evidence indicates that interventions to minimize falls risk can reduce both the risk of falling and falls related injuries. On admission to the hospital and nursing home a comprehensive falls risk assessment is completed and additional re-assessment is undertaken if a change in the persons condition indicates a change in the risk of falling.

It is important to note that a number of events can be classified as a fall, for example, a patient/resident rolling on to the floor when the bed is in the floor line position is classified as a fall.

The strategies we have implemented has reduced the level of harm from falls, the most common harm being skin tears.

FALLS – REDUCINg THE RISk

Winners of the 2012 Good Buddies Sports Day, Mary Maguire with buddies Mac and Scotty carlin.

A word from our Volunteer Coordinator

Meet the Board

It is hard to believe that a year has gone by since we commenced the delivery of Meals on Wheels and the introduction to my position as Volunteer Co-Ordinator.

During this time Terang & Mortlake Health Service has introduced a Volunteer program which includes the recruitment of new volunteers as well as maintaining our current volunteers and the processes that we now have to have in place for OH&S, Infection Control, Training and Police Check requirements etc.

TMHS currently have approximately 90 volunteers who volunteer their time at various sections through the organisation which include, visiting Mt View, gardening, community transport, Meals on Wheels, music, and assisting at the Community Health Centre.

On May 15th in Terang and May 29th in Mortlake we conducted a morning tea for our volunteers to celebrate Volunteer’s Week, which is celebrated from the Monday after Mother’s Day in May each year. This year’s theme for the week was “Volunteers – Every One Counts”.

During the morning tea, Gaye Sanderson conducted a talk on Occupational Health and Safety and how it affects us during our everyday routines. It also gave Terang & Mortlake Health

voLunteer is More than Just a WorD, it’s a WorLD fiLLeD With PeoPLe DeDiCateD to servinG others, voLunteers Lift uP the hearts of others, anD Most iMPortantLY, voLunteers restore hoPe.

The Health Services Board was fortunate to recently gain two new members, both with a wealth of community service behind them. One of these is Helen Kenna. Helen is a long-time local resident, having lived in the district for 39 years, for the past 20 of which she has worked at Mercy Regional College as Student Welfare Counsellor.

Helen is no stranger to voluntary work, having been involved with many community groups. These include school boards of St Thomas’s School and Mercy Regional College, the Noorat and District Tennis Association, and Kolora Football Club. She has been a member of Nexus for many years, is immediate past president and has recently joined St Vincent de Paul Society.

Recently the hospital Board

Service the opportunity to express our gratitude by giving out a little caring kit and volunteer verse that contained the following:sunfLoWer seeDsVolunteers plant seeds of kindnessMint LoLLY As you are worth a ‘mint’ to usPen You have made a lasting and permanent impressiontea baG To remind you to relax daily and count your blessingsbath saLts To take you away, you deserve a quiet break.

We are hoping to hold another tea party latter in the year giving our Volunteers the opportunity to catch up for a chat.

I would like to take this opportunity to thank all the people who volunteer their time, as without your hard work and dedication a lot of activities would not be possible.

PLease reMeMber

kate Justin

introduced an apprenticeship system to encourage new members and the President invited Helen to join. This enabled her to attend several meetings as an observer. As part of this program she went with Barry Philp to Melbourne where they attended a conference hosted by the Victorian Healthcare Association. After this Helen made the commitment to join the Board.

Helen believes it is important for Community Members to make a contribution – she is certainly doing her bit.

The second new Board Member is former Kiwi Barry Philp. In 1996 Barry moved with his family from a dairy farm in TeAroha, New Zealand to a property in Garvoc.

Barry soon became involved in his new community. He joined the CFA where he served a term as

President. He served for a time on the Garvoc Hall Committee and has been a member of Terang and District Lions Club for many years, taking on the roles of President and Treasurer.

Barry says he has now reached a point in his life where he has time to put still more into the community. He believes the health system is very important and that caring for the health of both young and old constantly offers new challenges. Barry wants to offer what help he can in this field. He says he is learning as he goes, and joined the apprenticeship system along with Helen. They have been full Members of the Board from July this year. Our Board is indeed fortunate to have two such dedicated and community minded new members.

Volunteers aren’t paid, not because they are worthless, but because they are priceless

Helen Kenna. Barry Philip.

Quality of Care Report FeedbackI n 2011 we circulated over 1500

Quality of Care Reports to households throughout the Terang and Mortlake districts. Included with the report was a survey seeking reader’s comments on the quality of the report and usefulness of the information provided. We received feedback from 26 people and their responses to the survey questions are recorded in the graph.

Comments included:

– The personal stories were interesting.

– Thank you to those of you that looked after us, plenty of great

care, the meals were extremely good, if for any reason I have to be hospitalised I hope its Terang.

– You all do a fantastic job, fantastic caring staff in a small community.

Once again we seek your feedback on the report and have enclosed a questionnaire for you to complete and return to the Health Service together with your name address and phone number. All respondents will be placed in a draw to take place on 1 December 2012 and eligible to win a Christmas Hamper valued at $100.

12 – tUeSDAY, Oc tober 30 , 2012 Quality of Care report terang Mor t lake Hea l th Ser v i ce