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Issue 30 Summer 2016
Women’s and Children’s Health Network
HEALTHYFOCUS
Smart machines helping kids get back on track
Robotic Rehab
HEALTHY FOCUS2
In September, we were very proud to launch our Person and Family Centred Care Charter, which was co-designed with consumers and community. Why a charter, you might ask? A charter illustrates focus and direction, and also serves to educate others about your commitment to act. It is our promise.
By doing this, we are declaring our promise to deliver on the things our consumers and community told us matter to them.
These are now enshrined as the foundation pillars of our charter:
• Treat consumers and their families with dignity and respect
• Communicate clearly and openly with consumers
• Actively involve consumers in decision making, and
• Be positive and kind.
This edition of Healthy Focus is again a celebration of great partnerships and the spirit of inquiry, excellence and innovation that abounds in the Women’s and Children’s Health Network (WCHN).
Our new guide service exemplifies these principles beautifully. Staffed entirely through the goodwill of our volunteers, it is making a wonderful impact on how people and families experience their arrival in our hospital.
Likewise, the enthusiastic members of our Youth Advisory Group are contributing their energy and ideas to transform the experience of young people who access our care through initiatives such as the Youth Guide to Places and Spaces.
More than ever before, we are creating opportunities for our consumers to provide us with feedback. We recognise that many of our consumers are digital natives who increasingly expect us to adopt different ways of connecting with them.
Gone are the days of the annual patient survey. We now have a 24/7 electronic suggestion box, an e-kiosk in the Kermode Street foyer Women’s and Children’s Hospital and listening posts. Other creative strategies inspired by our consumers include poetry feedback, the Consumer Coffee Club and fairy face painting for our very young consumers.
We have also introduced an online crowdsourcing platform, Basecamp, to provide a secure, virtual community hub for consumers to interact and provide feedback about a range of WCHN projects.
Effectively engaging consumers in decision-making is another of our goals and with the advent of our Citizen Jury we are inviting our consumers to consider
changes in practice and advise us on what they think needs to happen to improve our services. They have contributed to critical decision-making in the past 12 months on topics as diverse as family involvement in medication, resource allocation principles and how we can support our families.
In this edition we celebrate Jackie Ah Kit, our Director, Aboriginal Health, who was honoured at this year’s Gladys Elphick Awards. We are very proud of Jackie’s strong and positive leadership in closing the gap in health inequality for our Aboriginal babies, children and women.
The wonderful work by our Renal team to effectively transition young people with chronic kidney disease, as they become adults, and the collaboration with our colleagues in adult services is a great example of person and family centred care. We know the anxiety these young people and their families experience, when faced with leaving the safe and familiar environment of our care for the unknown and somewhat daunting world of adult health services. Getting this transition right is an important priority for us.
As always, we are very grateful for the support that we receive to provide quality, evidence based care to our consumers, whether it’s the gift of humour from our Clown Doctors or the generous philanthropic support of the Little Heroes Foundation which was instrumental in the establishment of our Australian-first Centre for Robotics and Innovation.
Our commitment to contributing to research to improve health outcomes for babies, children and women is showcased in three excellent case studies – the benefit of physical activity in children with type 1 diabetes, the work being done to break intergenerational cycles of obesity and chronic disease in Aboriginal mothers and babies, and our success in infant reunification, where there has been significant maltreatment or neglect.
Finally, as the leading provider of health care to the women and children of South Australia, we have made a public stand, through seeking White Ribbon accreditation, to act to prevent and act against the violence which is perpetrated against women, and the associated trauma and life-long adversity this creates for children. We want all women to live in safety, free from all forms of men’s violence, and to ensure our workplace is safe, equitable and respectful in which men and women alike can achieve their goals.
Naomi Dwyer Chief Executive Officer
From the Chief Executive Officer
2 HEALTHY FOCUS
From the Chief Executive O�cer
In September, we launched the Women’s and Children’s Health Network (WCHN) Consumer and Community Engagement and Responsiveness Strategy.
It marked a key point in the evolution of our Health Network, and we publicly made a commitment to improve our relationships with our consumers and the community at large.
What we are saying to the South Australian community is that not only are we committed to delivering safe, quality health services, but that this process is not a one-way street. Our strategy is about building and enhancing partnerships, which recognise that our consumers and the community are central to what we do and how we do it.
By investing considerable time and resources in creating this strategy, the WCHN is looking to engage with our core stakeholders in a meaningful, respectful and purposeful way.
In developing the strategy we want to embed and strengthen effective engagement into our culture so we can meet the needs of our consumers and the community, and also achieve the National Safety and Quality Health Service Standards.
The principles, strategic goals and strategic actions it contains are based on an extensive consultation, a literature review to capture the best evidence to support our way forward, an analysis of other strategy documents, taking the learnings from high-performing health services in Australia and hosting a consensus conference to capture critical input from consumers and staff involved in the Consumer and Community Engagement Project Advisory Group.
Through this we make a very serious pledge to allow for our decisions to be authentically informed by the needs and aspirations of the people we serve.
You might ask how can we improve on what is already a very good service?
My answer is that if you stop seeking to improve, you will eventually find yourself going backwards.
And the best way of improving is through listening and genuinely caring about what people have to say, caring about their lived experience, and tailoring our professional knowledge and skills to ensuring we can deliver what our community wants and expects.
Theodore Roosevelt, the 26th President of the United States said: “People don’t care how much you know until they know how much you care.”
And that is what true engagement is about, caring about what your communities of interest think.
This goal is clearly captured in one of the key principles for engagement we have identified – namely empathy – or walking in another’s shoes.
This strategy will guide us over the next three years, but there has already been a flurry of activity, which is helping to set the foundation for the successful implementation of the strategy, including the establishment of a Consumer Register, which now boasts more than 100 members and is constantly growing.
Work has also begun on the consumer governance structure for the strategy; including an innovative youth advisory group and a patient feedback and improvement citizen jury, which I will chair.
I would like to thank everyone who provided input into, or were involved in the development of the strategy and implementation plan.
Our Manager, Consumer and Community Engagement Allan Ball often says that to do things differently, we need to think differently. This strategy and implementation plan marks a real paradigm shift in our approach to engaging with our consumers and the wider community and it’s a journey I’m really looking forward to.
To read the Consumer and Community Engagement and Responsiveness Strategy go to www.wch.sa.gov.au/support/consumer
Naomi Dwyer Chief Executive Officer
Women’s and Children’s Health Network
HEALTHY
FOCUS
Healthy Focus is the official newsletter of the Women’s and Children’s Health Network and is produced by the Media and Communications unit. 72 King William Road, NORTH ADELAIDE 5006
Editor: Tim Boord [email protected] Contributors: Charmaine Newton, Sheryl Klingner Photography: Tim Boord Design: Paul Barrow Graphic Design
© Department for Health and Ageing, Government of South Australia. All rights reserved.
Our strategic goals are to:
> Provide quality health care to our patients, clients, and communities.
> Provide effective systems and processes to support delivery of our health services.
> Manage resources and infrastructure to best meet health needs.
> Build and support our people, culture and capability.
www.ausgol.gov.au/creative-commons
“If you stop seeking to improve, you will eventually find yourself
going backwards.”
Our Cover: 7-year-old Adelaide boy Gary Wanganeen became the first child in Australia to undergo an auto islet transplantation operation, which was conducted at the Women’s and Children’s Hospital. Read his story on pages 10-12.
HF
Our strategic goals are to:
> Provide quality health care to our patients, clients, and communities.
> Provide effective systems and processes to support delivery of our health services.
> Manage resources and infrastructure to best meet health needs.
> Build and support our people, culture and capability.
Healthy Focus is the official newsletter of the Women’s and Children’s Health Network and is produced by the Media and Communications unit. 72 King William Road, NORTH ADELAIDE 5006
Editor: Tim Boord [email protected]: Jane Clayton and Charmaine NewtonPhotography: Tim Boord, Design: Studio Alumni© Department for Health and Ageing, Government of South Australia. All rights reserved.
Our cover: 7-year-old Tanna Saunders is watched by mum Kim and dad Darren as she tries out the new robotic gym equipment at the WCH. Picture: Tim Boord
www.ausgol.gov.au/creative-commons
Women’s and Children’s Health Network
Issue 30 Summer 2016
Women’s and Children’s Health Network
HEALTHYFOCUS
Smart machines helping kids get back on track
Robotic Rehab
FOCUSHEALTHY
An innovative program which works with vulnerable families to create safe and caring environments so infants can be returned to their care has received a major Australasian mental health award.
The Infant Therapeutic Reunification Service, a partnership program between the Child and Adolescent Mental Health Service (CAMHS) and Families SA, won the ‘Assessment and Treatment’ category at the 2016 TheMHS Awards held in Auckland, New Zealand in August.
Based in the Department of Psychological Medicine at the Women’s and Children’s Hospital, the Infant Therapeutic Reunification Service provides early assessment and therapy for infants under three years and their parents, where significant maltreatment and neglect has occurred, or is at risk of occurring.
The service is an equal collaboration between child protection and health services, aimed at addressing the health and safety of vulnerable infants and their families. It operates on a “case conferencing” model, in which services such as drug and alcohol and domestic violence counselling, financial support, accommodation and reunification teams work together as a care team for a family.
Dr Prue McEvoy, a child and adolescent psychiatrist and Clinical Director for the Child and Adolescent Mental Health Service (CAMHS) said the program determined whether reunification between an infant and parent was viable and in the best interests of the child.
“Where indicated, parent/infant therapy is undertaken to reduce the impact of trauma and facilitate positive relationships, leading to a safer caring environment for the infant,” Dr McEvoy said.
“Where reunification is not possible, timely long-term decisions that meet the infant’s developmental needs are made.”
In 2015, there were 2,690 children and young people living in out-of-home care under the Guardianship of the Minister through care and protection court orders. Of these, 20% were aged 0-4 years, with 6% under 12 months of age.
Aboriginal or Torres Strait Islanders represented 29% of these children and were seven times more likely to be involved in the child protection system.
In an effort to address this situation, clinicians in Adelaide looked to international best practice and evidence-based supports for a suitable model of care.
“Our approach is based on the Tulane Intervention developed by Tulane University in New Orleans, which is a systemic model for maltreated infants that addresses the child-parent relationships and the many interacting contexts which bear upon them,” Dr McEvoy said.
“By placing the infant’s needs at the centre of our processes, our service is seeking to ameliorate the devastating long-term mental health impacts of early abuse and trauma and, where possible, interrupt patterns of intergenerational trauma and abuse.”
Through a suite of interventions and supports, around 40% of infants who come through the program have been reunited with their families. This represents a 10% improvement on outcomes achieved by alternative programs.
The program has three distinct tiers, which clearly set out roles and responsibilities relating to assessment, court processes and therapy.
“The service seeks to enhance the care-giving environment by building supportive and reflective relationships at every level of service delivery,” Dr McEvoy said.
Achieving change in a difficult environment … Infant
Therapeutic Reunification Service team members from left Dr
Georgie Swift, Patricia O’Rourke, Dr Prue McEvoy, Ali Knight and
Heather Warne with their award. (Absent: Professor Jon Jureidini,
Sally Watson and Kiara Price.)
The service is an equal
collaboration between child protection and
health services.
3 HEALTHY FOCUS
Award-winning program reunites families
NEWS
HEALTHY FOCUS4
Robotic technology will be used to aid the rehabilitation of children with serious neurological disorders and injuries thanks to a $1.5 million purpose-built gym at the Women’s and Children’s Hospital (WCH).
The Little Heroes Foundation Centre for Robotics and Innovation, which is the first facility of its kind in Australia, was launched in August, with equipment that provides tailored therapies to aid in walking, arm movement and coordination.
The centre is part of the WCH Paediatric Rehabilitation Department and has been made possible through the generous support of Little Heroes Foundation, a charity that has been supporting the WCH for the past 20 years.
Little Heroes Foundation Chairman Chris McDermott was joined by young patients Andre and Cameron to officially cut the ribbon to the new centre and the Hon. Leesa Vlahos MP, Minister for Disabilities and Minister for Mental Health and Substance Abuse was among the special guests at the opening.
The project emanated out of a conversation about two years ago between Associate Professor Ray Russo, Head of Research with the Rehabilitation Department, and Little Heroes Foundation Chairman Chris McDermott, in which Assoc. Prof. Russo was encouraged to “think big” about what assistance his department needed to enhance the care it offered to young patients.
“I thought I might as well pitch them the concept of assessing robotics and innovation as a focus for helping children with rehabilitation needs, and they just loved the idea,” Assoc. Prof. Russo said.
According to Assoc. Prof. Russo, who will oversee the gym’s operations, the more therapy a child with neurological dysfunction can access, the greater the benefits are likely to be.
“To improve neurological disability, you need a high quantum of therapy,” he said.
“Robotic technology is a way of giving children a larger quantum of therapy without necessarily involving a lot more cost in terms of therapist time.”
Assoc. Prof. Russo said that to provide this type of therapy for children with a high level of need for walking would normally require two to three therapists during a rehabilitation session to support the child in taking steps.
Robotic rehab
COVER STORY
Lokomat’s looking good for John … John Bishop has benefited from using the Lokomat machine similar to the one in the new Centre for Robotics and Innovation.
Story and pictures: Tim Boord
5 HEALTHY FOCUS
“Now you can do this with one trained assistant, after the child has been positioned within the robotic device by the robotics physiotherapist,” he said.
Each therapy session on the robotic machines is an interactive experience, using avatars on a screen controlled by the child.
“This allows the child to be fully immersed in the therapy, which is critical in assisting neuroplasticity and brain reorganisation to allow for improvement in function,” Assoc. Prof. Russo said.
Young people who are current inpatients or day patients of the Paediatric Rehabilitation program will be able to access the technology.
Initially, two robotic machines have been installed in the gym – a Lokomat designed to improve walking pattern and function – and an Armeo, which assists with developing muscle strength, power and range of movement in the arm. In addition, Dynavision, a tool for assisting with visual awareness and eye-hand coordination, is also used in the gym.
Little Heroes Foundation Chairman Chris McDermott said the Centre for Robotics and Innovation had been a passion of the charity for some time.
“There is a whole new field out there in rehabilitative medicine, and the more we researched, the more excited we became about the possibility of bringing this robotic equipment to South Australia to give seriously ill children the best chance to resume a normal life,” Mr McDermott said.
“Recent advances have been significant, and we wanted to ensure the doctors and the rehabilitation team had access to this cutting edge technology.
“After beginning our relationship with the WCH in 1996, it gives us a great feeling to still be here two decades later creating a ‘world class’ facility.”
Seven-year-old John Bishop is one child who knows first-hand the benefits of using robotic technology as part of his rehabilitation therapy.
His biggest challenge in life has been to walk – something his parents were told may not happen after his cerebral palsy was diagnosed in 2009, when he was just one year old.
Today, he has gone from needing a wheelchair, and then a walker, for mobility to walking completely unaided.
To correct his uneven gait, doctors recommended regular use of the Lokomat, which he has accessed at another local facility.
“The changes we’ve seen in him in the last two years have been phenomenal,” John’s mother Kate said.
“We’ve thrown away the chair and the walker.
“When you put a child in the Lokomat, everything is tailored to that particular child – it teaches the correct gait patterns for walking and corrects if a child might favour one leg or the other.”
Women’s and Children’s Health Network Chief Executive Officer Naomi Dwyer said the addition of the gym to the services provided for paediatric rehabilitation patients was a wonderful merger of health care and technology.
“This is an exciting development in the treatment we can provide to children with neurological disorders or injuries,” she said.
“The Centre for Robotics and Innovation is a wonderful outcome from our partnership with Little Heroes Foundation, and I know that many of our young patients will benefit from it.”
Associate Professor Ray Russo and physiotherapist Felicity Baker with
some of the new robotic gym equipment.
“This is an exciting development in
the treatment we can provide to children with
neurological disorders or
injuries.”
Naomi Dwyer, WCHN Chief Executive Officer
HEALTHY FOCUS6
Researchers at the Women’s and Children’s Hospital (WCH) have discovered that children who have type 1 diabetes can significantly improve their cardiovascular health by simply taking an extra 1,000 steps a day.
Led by Dr Alexia Peña, a paediatric endocrinologist at the WCH and senior lecturer at the University of Adelaide, the research team monitored the physical activity of 90 children in the pre-teen to early teenage age group with type 1 diabetes.
Each child was fitted with a multi-sensor armband for a minimum of five consecutive days to record their activity levels.
“In that short time, we were able to identify a clear correlation between artery thickness and the average number of steps per day,” said Dr Peña. “With an increase of 1,000 steps each day, we saw a measurable decrease in arterial thickness, body weight, blood pressure and triglycerides. We also saw an increase in good cholesterol (HDL cholesterol) with a subsequent decrease in cardiovascular risk.”
The evidence to date has shown that children with type 1 diabetes often undertake less physical activity than their non-diabetic peers and tend to show early signs of atherosclerosis, which is a build-up of plaque in the arteries.
“We have demonstrated for the first time that the daily number of steps a child with type 1 diabetes takes has a direct impact on their cardiovascular health,” said Dr Peña. “The clear message from our research findings is that even a small increase in activity will improve a child’s blood vessel structure and lower their risk of heart disease.”
Dr Peña hopes that the findings of her research will emphasise the importance of education around physical exercise for children with type 1 diabetes. “The more steps they do, the better,” she said.
This work has been supported by the Women’s and Children’s Hospital Foundation, Diabetes Australia Research Trust, and grants from Australasian Paediatric Endocrine Care.
The results of Alexia’s research have been published in Diabetes Care, volume 39, August 2016.
Staying one step ahead
“We were able to identify a clear correlation between artery thickness and the average number of steps per day.”
Dr Alexia Peña
RESEARCH
Story: Jane Clayton
Thanks to a near $1 million grant, the Women’s and Children’s Health Network (WCHN) has commenced a five-year research project to improve the nutritional health of Aboriginal mothers and babies during and after pregnancy.
The research will involve distributing “mother and baby bundles” to families enrolled in the Aboriginal Family Birthing Program at the Women’s and Children’s Hospital (WCH) and at Child and Family Health Service (CaFHS) centres throughout South Australia.
The bundles will include fruit and vegetable packs, baby care items, hand breast pumps and vouchers for healthy food. They will be given to women at key milestones during pregnancy, such as their first antenatal visit, as well as during the first year of their baby’s life.
“Healthy eating is extremely important as excessive gestational weight gain and retention of weight after giving birth can have profound consequences for a woman’s health in pregnancy and later life, including caesarean section, macrosomia and stillbirth, diabetes, and hypertension,” said Associate Professor Philippa Middleton, who is leading the research. “There are also health risks for the child that can span from conception through to adulthood.”
Associate Professor Philippa Middleton, who is based at the WCH but who is also a principal research fellow at the South Australian Health and Medical Research Institute (SAHMRI), is working alongside co-investigators Deanna Stuart-Butler, Manager of the Aboriginal Maternal and Infant Care (AMIC) Program, and Jackie Ah Kit, Director of Aboriginal Health at the WCHN. Additional collaborators from SAHMRI, WCHN, the University of Adelaide and the Murdoch Childrens Research Institute are playing significant roles.
“We have seen how good nutrition during pregnancy can prevent short and long-term health problems for women and their children, and contribute to breaking intergenerational cycles of obesity and chronic disease,” said Philippa. “In
addition to the bundles, we will be distributing a variety of information and tools to assist mothers with breastfeeding and healthy eating in the antenatal and postnatal periods.”
Philippa and her team are consulting widely with Aboriginal Maternal and Infant Care workers and Aboriginal families to determine how best the project should be run and how to best meet the nutritional needs of women during gestation and beyond.
“We want our research to enhance the Aboriginal Family Birthing Program by making nutrition a top priority,” said Philippa.
The first “mother and baby bundle” is due to be distributed next year. It is hoped that at the end of the project, Philippa and her team will have collected comprehensive data about gestational weight gain and dietary status among Aboriginal women that can be used to further improve the services currently offered to them.
If the research collaboration is successful in achieving its aims, Philippa expects the results will likely have a significant and long-lasting impact on policy and practice in the field of Aboriginal health.
The project is being funded by a National Health and Medical Research Council grant of $975,882.
7 HEALTHY FOCUS
Bundles of goodness for Aboriginal families
RESEARCH
Staying one step ahead
“This research project represents a rare opportunity
to fill crucial knowledge gaps in the nutritional
status and needs of Aboriginal
women.”
Associate Professor Philippa Middleton
Story: Jane Clayton
WCHN Chief Executive Officer Naomi Dwyer signs the White Ribbon Statement of Commitment, flanked by Phil Robinson, WCHN Executive Sponsor for White Ribbon Accreditation (left) and Liam Dooley, White Ribbon Australia Manager, Community Engagement (right).
HEALTHY FOCUS8
The Women’s and Children’s Health Network (WCHN) has made a clear commitment to the people of South Australia that it will do all it can to stamp out violence against women and children.
Horrifying statistics, including one woman being killed every week in Australia as a result of domestic violence, have led the Health Network to embrace the White Ribbon campaign as part of its effort to bring the scourge of domestic violence out from the shadows and make it everyone’s business.
In Australia, one in three women will experience physical or sexual violence in their lifetime. The violence perpetrated against women most often occurs in their home and is most often perpetrated by their intimate partner. Violence crosses all cultural, age and socio-economic boundaries.
Violence against women is a global health and clinical epidemic and is a significant determinant of morbidity and mortality. It also has a huge economic impact, with intimate partner violence costing the Australian health sector an estimated $207 million per year.
In 2014, the South Australian Government launched the “Taking a Stand: Responding to Domestic and Aboriginal Family Violence” initiative.
The WCHN has a leading role in supporting SA Health’s response through the Women’s Safety Strategy and WCHN’s Multi-Agency Protection Service team.
White Ribbon is Australia’s national campaign to end men’s violence against women and girls, promote gender equality, healthy relationships and a new vision of masculinity.
Our commitment
PARTNERS
Story and pictures: Tim Boord
On 25 November 2015, coinciding with International Day for the Elimination of Violence against Women, WCHN announced its decision to work towards becoming an accredited White Ribbon workplace.
“We are committed to zero tolerance of violence and dedicated to the vision of the White Ribbon campaign that ‘all women live in safety free from all forms of men’s violence’,” said WCHN’s White Ribbon Executive Sponsor, Phil Robinson.
“The care and protection of women and children is integral to what we do as a statewide health service. Our staff work on the frontline of this epidemic and can be part of the solution by acting early and quickly to identify and seek to prevent further violence.”
Mr Robinson said accreditation would involve WCHN adapting organisational culture, practices and procedures to promote respectful relationships and safe workplaces for women.
As part of the process, WCHN staff were encouraged to complete a survey to determine their current knowledge of domestic and family violence.
In May, WCHN Chief Executive Officer Naomi Dwyer signed a White Ribbon Statement of Commitment.
“This statement is our pledge to encourage greater understanding, knowledge and action around violence prevention within our Health Network. It means that we recognise violence against women as a human rights issue that must be addressed in the workplace,” Ms Dwyer said.
In August, WCHN staff had the opportunity to hear first-hand about the devastating impact of
domestic violence on a woman’s life, both at home and in the workplace.
“We hosted a special Grand Round presentation at which domestic violence survivor Stacey Nelan gave a harrowing account of her experience of violence at the hands of her male partner, describing how it impacted on her work and home life and resulted in a diagnosis of post-traumatic stress disorder after leaving the relationship,” Mr Robinson said.
As part of their mandatory training, WCHN staff are required to undertake online training modules to further their understanding of the White Ribbon campaign, the causes and incidence of domestic violence and the role they can play in preventing violence.
“We are embedding the White Ribbon message into the culture of our organisation so that everyone knows that we are serious about making a difference,” Mr Robinson said.
“Violence against women at home or in the workplace has flow-on effects that impact the safety of women at work, their wellbeing and productivity.
“By seeking accreditation as a White Ribbon Workplace, WCHN is taking a stand to make our workplace a safe, equitable and respectful environment in which men and women alike can flourish and achieve.”
If you or someone you know is experiencing violence and needs help or support, please call 1800RESPECT (1800 737 732).
For more information about White Ribbon visit www.whiteribbon.org.au
WCHN staff show their support for White Ribbon on 2015 International Day for the Elimination of Violence against Women.
9 HEALTHY FOCUS
HEALTHY FOCUS10
PARTNERS
Story: Jane Clayton Picture: Tim Boord
A renal transition program pioneered by the Women’s and Children’s Hospital (WCH) and the Royal Adelaide Hospital (RAH) has had a 100% success rate in preventing kidney failure among teenagers.
The program uses a shared-care model whereby children with kidney disease aged between 13 and 18 see a children’s nephrologist at the WCH in addition to seeing a transplant physician for adults from the RAH, who comes to the WCH once a month.
The model gives children the chance to form strong relationships with their primary physician as well as the specialist who will ultimately care for them in adulthood.
Paediatric nephrologist at the WCH, Dr Sam Crafter, says the transition program is the first one of its kind in Australia.
“Before we started the program in 2012, we would see at least one kidney failure per year due to medication non-compliance. Our teenage patients found it hard to transition from the paediatric care they had received at the WCH to the adult care they then received at the RAH when they turned 18. As a result, not all of our patients were sticking to their medication plan,” said Dr Crafter.
“As a result of the program, teenagers are now able to transition more successfully from the care they have received since they were youngsters at the WCH to the care they will receive as adults at the RAH.
“They are also more supported to self-manage their medication regime, which ensures that their body doesn’t reject their transplanted kidney.”
Instrumental to the program is an external renal clinic for young adults aged between 18-25 years, which helps build on the groundwork established by the WCH and the RAH and keeps young adults engaged in self-care.
“Over the last 20 years in South Australia, one third of transplanted kidneys have been lost due to non-compliance with medication,” said Dr Robert Carroll, who spearheads the transition program and who is a transplant physician at the RAH.
“Every time a child undergoes a re-graft, the body finds it harder and harder to accept the new organ. It is not uncommon for re-graft patients to spend a year on dialysis before receiving their new kidney, which increases their risk of mortality.
“In addition to the physical and emotional toll this process takes, re-grafts are also hugely expensive. With appropriate support and education, children can expect to get 15-20 years out of their first kidney transplant, and that is the chief goal of the renal transition program.”
Twenty-one-year-old Stephanee Hermsen has been a part of the renal transition program for the past four years. When she was 17 she was diagnosed with chronic kidney disease and this year underwent a kidney transplant.
“The transition program helped me feel more comfortable at the RAH and allowed me to form a relationship with my transplant physician there,” said Stephanee.
“I attend the young adult clinic whenever I can and this gives me the opportunity to talk to other people my age who have had a similar experience to me and understand how I feel.”
Inspired by world-class renal clinics in Oxford and Boulder, Colorado, the program represents a significant collaboration between health networks to achieve the best possible outcomes for patients.
Saving kidneys through collaboration
“The transition program helped me feel more comfortable at the RAH.”
Kidney transplant recipient Stephanee Hermsen
Stephanee Hermsen with Dr Robert Carroll (left) and Dr Sam
Crafter (right).
11 HEALTHY FOCUS
Saving kidneys through collaboration
HEALTHY FOCUS12
years of fun“The Clown Doctors cleverly and creatively distract children and families from their fear and anxiety.”
Naomi Dwyer, WCHN Chief Executive Officer
CHILDREN’S ENTERTAINMENT
Story: Charmaine Newton Pictures: Tim Boord
For 15 years, a special kind of medicine has been delivered to sick and injured children at the Women’s and Children’s Hospital (WCH) courtesy of performers known as Clown Doctors, who spread fun and laughter to those who need it most.
The Clown Doctors are an initiative of The Humour Foundation, a national charity dedicated to promoting and delivering the health benefits of humour to the Australian community.
Clown Doctors visit the WCH each week, and through humour, music, magic, mime and puppetry, they distract children from painful procedures and help ease fear and anxiety.
They parody the hospital routine to help children adapt to hospital life and visit all wards, including burns, oncology, emergency and intensive care, as well as corridors, lifts and foyers.
Women’s and Children’s Health Network (WCHN) Chief Executive Officer Naomi Dwyer, thanked the Clown Doctors and The Humour Foundation for their contribution to the children and families of the WCH over the past 15 years.
“Having a sick or injured child is distressing for families. The Clown Doctors cleverly and creatively distract children and families from their fear and anxiety, helping them to smile and laugh despite their discomfort,” Ms Dwyer said.
“This supports the care we are able to provide to our children and families and we thank them for their contribution to improving children’s health, and their service to the hospital, over the past 15 years.”
Alan Holy (AKA Dr Blot), one of the original Clown Doctors who began at the hospital in 2001, said the Clown Doctors aimed to make a difference
13 HEALTHY FOCUS
to a patient’s time at the hospital by “connecting with the person and not with their particular illness”.
“Every patient or family is different,” he said.
“(Our work) is supported by lots of scientific studies on the significance of humour and human connection in the healing process.”
Although they are paid professional performers, funded by The Humour Foundation whose services are provided at no cost to hospitals, delivering a regular dose of laughter to the WCH patients is more than just another job for the Clown Doctors.
“We feel we make a contribution to the health of kids and their families,” Alan said.
“We are guided by what the patient wants and provide that via comedy, storytelling and improvisation, music, bubbles, magic and parody of medical procedure.”
“We also provide a distraction for a number of medical procedures and reduce anxiety in patients and their families.”
The Humour Foundation Chief Executive Officer Melinda Farrell said the national charity was pleased to be delivering the health benefits of
humour to the South Australian community through their Clown Doctors program.
“The Humour Foundation currently has over 58 professional Clown Doctors around Australia who make a difference to children, families and hospital staff, over 185,000 times every year,” Ms Farrell said.
Main picture; Dr Primrose and Dr Heebie entertain Tamika
at the WCH
Left: Alan Holy (AKA Dr Blot)
HEALTHY FOCUS14
Jackie’s hope
“My inspiration to work in this area comes from my life experiences as an Aboriginal woman.”
Jackie Ah Kit, Director Aboriginal Health
OUR PEOPLE
Jackie Ah Kit admits she hasn’t always felt optimistic about the plight of Aboriginal people.
Having dedicated her professional life to trying to improve the health outcomes of her people, she knows that things can move slowly and gains can be small.
But she says times are changing and she is now more hopeful than ever that the historical disadvantages faced by Aboriginal people can be redressed.
“Today, I think it’s different – different in the sense that people are committed to improving relationships and participating in the conversations,” Jackie, who is Director, Aboriginal Health with the Women’s and Children’s Health Network, said.
“There is a commitment to not only do the right thing, but to do things right.”
Part of that process is to help educate people about the difference between equality and equity.
“There are those who believe that all Australians should be treated equally, and special treatment should not be given to minority groups such as Aboriginal and Torres Strait Islanders,” she said.
“To treat Aboriginal people as equal (with non-Aboriginal people) ignores situations of inequity and therefore perpetuates that inequality. As Aristotle explains: ‘There is nothing so unequal as the equal treatment of unequals’.”
Jackie has headed up the Aboriginal Health Division since early 2012, having previously held senior positions with Northern Territory Health and Country Health SA, as well as being former Chief Executive Officer of Port Lincoln Aboriginal Health Service.
An integral part of the WCHN’s Executive team, Jackie’s current role is to provide strategic leadership and policy advice for Aboriginal health across the Health Network, and she has oversight of Aboriginal workforce development and the development and support of strategic partnerships.
“It’s about developing the capacity of the WCHN to integrate and sustain services and programs that improve access to health services for Aboriginal people,” she said.
“If we do this well, we will achieve improved health outcomes for Aboriginal women, young people, children and their families.”
It’s for this commitment to building an Aboriginal workforce and services that meet the needs of Aboriginal and Torres Strait Islander consumers and their families that Jackie received a prestigious Gladys Elphick Award in August.
The annual awards are named after Kaurna-Narungga Elder Gladys Elphick MBE, a community leader and the first President of the Council of Aboriginal Women of South Australia. They acknowledge the significant contribution of Aboriginal women in all areas of the SA community.
Jackie received the inaugural Shirley Peisley Award, which acknowledges the contribution by an Aboriginal woman to influencing positive change for Aboriginal people in the workforce. The award honours honours Shirley Peisley AM, a leading South Australian campaigner for Aboriginal welfare and cultural and legal rights since the 1960s.
“At first I was a little embarrassed to hear that I had been nominated for this award because there are so many strong black women out there that do so much for our people and our communities with very little recognition for what they do,” she said.
“But nonetheless, I feel very honoured. I am committed to developing systems that encourage and enable Aboriginal and Torres Strait Islander staff to project and protect their culture and heritage in the workplace, and to improving the cultural competence of services across the WCHN.”
For Jackie, who is a proud descendant of the Waanyi people (from the southern Gulf of Carpentaria region) and the Warumungu people from near Tennant Creek, the decision to pursue a career in Aboriginal health was very personal.
Story and picture: Tim Boord
Jackie Ah Kit
15 HEALTHY FOCUS
Jackie’s hope
“My inspiration to work in this area comes from my life experiences as an Aboriginal woman,” she said.
“At 18, I had my first child, and my eyes were opened to a life in which I left behind the simple pleasures of childhood.
“They were opened to the many instances of unfairness and inequality that were part of society in those days and it awoke in me for the first time, a sense of responsibility to my people, and a sense of purpose in attempting to achieve justice for my people.”
Jackie cites enhanced governance arrangements around Aboriginal health at WCHN as being the key to the positive change.
“Through the effective leadership of Chief Executive Officer Naomi Dwyer, we are ensuring continuous safety and quality improvements and accountability for Aboriginal Health across the whole of the WCHN,” she said.
Two of the key priorities of South Australia’s Strategic Plan are to improve Aboriginal health and wellbeing, and increase Aboriginal leadership opportunities.
Jackie said the renewal of WCHN’s Aboriginal Health Improvement Plan, which expires in December 2016, the development of a WCHN Aboriginal Workforce Plan, the renewal of the WCHN Reconciliation Action Plan and the development of the Cultural Competence Framework are priorities for action over coming months.
“The renewed Aboriginal Health Plan will reaffirm the commitment to work together to achieve improved health outcomes for Aboriginal women, young people, children and their families,” she said.
HEALTHY FOCUS16
A new volunteer guide service for the Women’s and Children’s Hospital (WCH) was launched during National Volunteer Week in May.
Based at the WCH’s Kermode Street entrance information kiosk, the guides are available to assist patients, their families and visitors to find their way around the hospital and more easily access services.
They are easily recognisable by their teal-coloured shirts and purple volunteer lanyards.
“The guide team volunteers have been especially recruited for this service with the aim of not only transforming the experience for our consumers, but expanding the opportunities of our volunteers to make a positive difference,” said Lis Brittan,
Manager, Women’s and Children’s Health Network (WCHN) Volunteers.
Providing effective way finding around the hospital is a direct response to consumer needs and a core part of the WCHN’s approach to person and family centred care.
“Most of us will have entered a hospital, worried about a loved one, anxious about where to go, overwhelmed by the complex mazes of corridors and signage,” Lis said.
“Our consumers told us that we could make things easier for them by demystifying the experience and making our hospital easier to navigate. We listened to them and set about introducing the guide service.”
Currently 35 volunteers have been trained as hospital guides.
Between May and September, about 10,000 people have been assisted by the volunteer guides, with these interactions also providing invaluable feedback about the Health Network’s facilities and services.
WCHN Chief Executive Officer Naomi Dwyer described the volunteer guides as “our directors of first impressions”.
“They are the smiling face, the kind word, the knowledgeable guide and the helpful resource,” she said.
The volunteer guide service operates Monday to Friday from 8am to 4pm.
If you are interested in becoming a volunteer guide or in other volunteering opportunities with WCHN, please call 8161 6437 or check out the website www.wch.sa.gov.au/volunteers.
The Women’s and Children’s Health Network (WCHN) has launched a new guide to the Women’s and Children’s Hospital, created entirely by young consumers.
The Youth Guide to Places and Spaces, which was developed by the Network’s Youth Advisory Group (YAG), is specifically for children and teens, with the aim of demystifying the hospital environment.
YAG was established in late 2015 following a recommendation from the Consumer and Community Engagement Strategy and Responsiveness Plan 2015-2018.
It has around 20 members and is supported by Hospital Education Services and the Arts in Health program coordinated by TeamKids.
To create the guide, the members of YAG did a thorough audit of the hospital’s clinical facilities
and other services to develop a comprehensive resource for young people and their families.
WCHN Chief Executive Officer Naomi Dwyer said the greater involvement of consumers and the community at all levels and ages had been one of the wonderful advances for WCHN in the past 18 months.
“One of the most exciting initiatives to emerge is our Youth Advisory Group, which has been a vibrant presence within the Network, giving us young peoples’ perspectives on how a modern health service should look.”
The new guide is one of the many quality improvements being developed by YAG based on feedback from young people aged 12-18, who access WCHN services.
Download the guide from the WCH website www.wch.sa.gov.au/support/consumer/consumer_library.html
WCH guides are go
Youth Guide to Places and Spaces
CONSUMER ENGAGEMENT
Wei and Pam were among the first volunteer guides when the service was launched in May.
