QUALITY

Welcome to TMHS

Our Towns

By Mark JohnsonChief exeCutive offiCer

The 2013 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 were 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 24 km north of Terang on the Hamilton Highway. The population including the surrounding area is 3,575. Mortlake sits at 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 Colman’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 and Mortlake Health Service was established on the 1st November 1994, following the amalgamation of the Terang and 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

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

REPORT

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

PaGe 7 PaGe 9

terang & Mortlake Health Service – terang.

Our Health Service

Cultural Responsiveness

T he Terang and Mortlake

Health Service (TMHS) is

a multi-campus health service.

The Terang Hospital campus

comprises 27 acute beds and 15

high care residential beds. TMHS

also offers community care and

primary care services at our

Terang and Mortlake Community

Health Centres.

The Terang and Tweddle

Early Parenting Centre gives

assistance to families with babies

C urrent census data indicates

that the vast majority of

the people residing in the Terang

and 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% to 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 and

Mortlake Health Service staff can

provide access to 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

and children up to 36 months old

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,

culture and diversity play in

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 Terang and Mortlake

Health Service 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

and the health and wellbeing of

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 (Reference:

Bauman, Farley & Harris 2003).

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 Terang and Mortlake Health

Service 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

responsiveness 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 is recognised and

responds to dietary; spiritual;

family; attitudinal and other

cultural practices. Our organisation

policies and procedures support

consumer choice for regarding

appropriate nutritional needs.

Results from the Victorian Patient

Satisfaction Monitor indicate that

our consumers / patients at Terang

and Mortlake Health Services are

very satisfied with the manner in

which their cultural and religious

needs were met.

All staff throughout the

health service are provided

with professional development

opportunities to enhance their

understanding of 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 imprOvement cOmmittee ........................ 3tHe live life Well prOgram .................................. 4mOrtlake cOmmunity HealtH centre ................. 4Jenny grice and tHe mOrtlake Walking grOup ...................................................... 4tmHS ripern Jill O’brien ....................................... 5tmHS cOntinence nurSe lyn turner ................... 5cOmplaintS/cOmplimentS management ........... 5infectiOn cOntrOl................................................. 6Hand Hygiene ......................................................... 6OH&S repOrt .......................................................... 6catering department ........................................... 7maintenance .......................................................... 7envirOnmental ServiceS ...................................... 7clinical gOvernance frameWOrk ...................... 8credentialing and defining tHe ScOpe Of practice ............................................................ 8diStrict nurSing Service rOSemarie barby ...... 8patient SatiSfactiOn reSultS ............................... 9reSOurce Smart.................................................... 9planned activity grOup ........................................ 9imprOving care fOr cardiac patientS .............. 10clinical bedSide HandOver ............................... 10

SOutH WeSt HealtHy kidS tracey egan .............. 10acute care ........................................................... 11Heart Of cOrangamite........................................ 11terang & tWeddle early parenting centre ..... 11midWifery repOrt ............................................... 12urgent care department ................................... 12Operating Suite ................................................... 12mOunt vieW aged care ........................................ 13riSk management and patient Safety ............... 13medicatiOn management ................................... 14antibiOtic uSage .................................................. 14incident repOrting ............................................. 14Quality indicatOrS .............................................. 14fallS – reducing tHe riSk .................................. 14Safe uSe Of blOOd prOductS ............................. 14preSSure inJurieS ............................................... 14incidence Of reSidentS uSing nine medicatiOnS Or mOre ......................................... 15perSOn centred: a reStraint free apprOacH .. 15unplanned WeigHt lOSS ..................................... 15vOlunteer cOOrdinatOr kate JuStin ................. 15primary HealtH care cOOrdinatOr meliSSa mitcHell ................................................ 15meet tHe bOard .................................................... 16imprOving Our clientS eXperience ................... 16Quality Of care repOrt feedback ..................... 16

2 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report terang Mor t lake Hea l th Ser v i ce

OTHER NEWS

QUALITY OF

CARE REPORTtMhs riPern – Jill o’BrienJill O’Brien has been nursing since 2001, having commenced her training as a mature-age student.

PaGe 5

volunteer CoorDinator – kate JustinOne interesting program instigated by Kate involves a local man, Gerard Overweter, who brings his dog once a week to interact with clients at Mount View and the Acute care Ward.

PaGe 15

Meet our BoarD – aDaM BoxOur hospital is fortunate in having outstanding local people willing to serve as Board Members. One of our new members is Adam Box, Principal of terang college, who brings with him a wealth of experience in community service.

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terang and Mortlake Health Service – Mortlake

Leadership for cultural responsiveness is demonstrated by the development of the three year training program for all staff and volunteers.

Accreditation

Consumer Advisory Committee

The Accreditation process for health services across

Australia has undergone significant change. The Australian Commission for Safety and Quality in Health Care developed new accreditation standards following extensive public and stakeholder consultation. The Standards are a critical component of the Australian Health Service Safety and Quality Accreditation Scheme endorsed by The Australian Health Ministers in November 2010.

The Standards provide a nationally consistent and uniform set of measures of safety and quality for application across a wide variety of health care services.

In January 2013 The National Safety and Quality Health Service Standards became mandatory for all public health services.

Terang and Mortlake Health Service has chosen to be accredited by the Australian Council on Healthcare Standards (ACHS) under the EQUiP (Evaluation and Quality Improvement Program) National Standards of which there are 15. Standards 1 to 10 are the mandated National Standards. Standards 11 to 15 are additional standards unique to EQuIP.

National Standards and are designed to ensure that Standards assessed under the EQuIP program are maintained, including the performance of service delivery process, provision of care and non-clinical systems. It is a continuous improvement process by which the achievement of standards must be demonstrated by means of an independent external peer assessment.

The EQUiP National Standards are titled:1. Governance for Safety and Quality in Health Service Organisations;2. Partnering with Consumers;3. Preventing and Controlling Healthcare Associated Infections;4. Medication Safety;5. Patient Identification and Procedure matching;6. Clinical Handover;7. Blood and Blood Products;8. Preventing and Managing Pressure Injuries;9. Recognising and Responding

to Clinical Deterioration in Acute Health Care;10. Preventing Falls and Harm from Falls;11. Service Delivery;12. Provision of Care;13. Workforce Planning Management;14. Information Management;15. Corporate Systems and Safety.

Terang and Mortlake Health Service recognised that in order to have a collaborative approach from all health workers we needed to appoint The National Standards as Portfolios to staff members. Being a Portfolio champion has empowered our staff to review our polices, audit our current practices, educate colleagues and consumers about the standard and recommend improvements to ensure that we deliver safe, high quality health care to our patients/clients and residents.

T he establishment of the Consumer Advisory

Committee has enabled Terang and Mortlake Health Service to increase consumer, carer and community participation and provides a central focus for all strategies relating to consumer involvement. The responsibilities of the committee are to provide direction and leadership in relation to the integration of consumer, carer and community views into all levels of health services.

Consumers; be they patients, carers or clients or other health care providers, offer a unique insight into their experiences, expectations and needs of the Health Service.

As 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 this publication by conducting the interviews with consumers, Board members and staff and taking the photographs that accompany the stories. The committee members have developed a check list to assist with reviews of information developed by the organisation for consumers. When reviewing publications they have taken into consideration that the language used is understandable and the report is not filled with the

acronyms and hospital jargon often prevalent in our internal documentation.

During the year, committee members adopted the Consumer Participation Policy which is

intended to provide guidance to staff on the importance of involving consumers in the planning and delivery of care and services.

Mrs Eve Black, Chair of the

Consumer Advisory Committee is also a member of the Quality Improvement Committee and brings a consumer perspective to the safety and quality matters discussed by the committee.

Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 3terang Mor t lake Hea l th Ser v i ce

community Advisory committee Members L-r: Jane Fitzgibbon, Meilssa Mitchell, Dorothy Selman, eve Black and ceO Mark Johson.

terang and Mortlake Health Service recognised that in order to have a collaborative approach from all health workers we needed to appoint the National Standards as Portfolios to staff members.

Quality Improvement CommitteeA ll of our staff play

an important 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.

The committee members have been involved in the development of a new Strategic Quality Improvement Plan. This strategic quality improvement plan challenges everyone at Terang and Mortlake Health Service to seek to continuously improve the quality and safety of care and services we provide to our consumers.

For the purposes of our plan Quality is described as ‘striving for and reaching excellent standards of care’ whilst Safety is described as ‘the degree to which potential risk and unintended results are avoided or minimised’.

The goals and objectives contained in the plan were arrived at following an extensive consultation process in which we asked over 100 people including members of the Board of Management, members of

staff, members of the Consumer Advisory Committee and consumers to tell us what they want from their Health Service in the way of safe, quality care.

The responses were unanimous and focus on the four widely accepted dimensions of quality care;

• People want safe care,• They want person centred care,• Appropriate and effective care,

and • Continuous, accessible,

integrated, efficient care.

There is wide-spread agreement that a person centred approach to care makes care safer and of higher quality

The Australian Council on Safety and Quality in Healthcare describes person centred care as ‘healthcare that is respectful of, and responds to, the preferences, needs and values of patients and consumers. The widely accepted dimensions of person centred care are respect, emotional support, physical comfort, information and communication, continuity and transition, care coordination, involvement of family and carers and access to care’.

To help meet the challenge of continuously improving the level of care and services we provide to our consumers everyone is invited to share the ideas and initiatives they may currently hold and continue to ask “what can I do next”.

TYPE OF ACCREDITATION OUTCOMEAustralian Council on Healthcare Standards

Periodic Review June 2012 with excellent results, with ongoing accreditation achieved.Next Survey, Organisation Wide Survey – May 2014.

Community Common Care Standards (CCCS)

Accreditation successfully maintained.Next Survey – May 2014.

Aged Care Accreditation Mount View

Accreditation successfully maintained – one unannounced visit within past 12 months. Service commended on care to residents Next Aged Care Site Visit – May 2014.

terang Mor t lake Hea l th Ser v i ce

Mortlake Community Health CentreT he Mortlake Leisure Group

meet fortnightly to watch a movie at the health service. This has been an ongoing success since its introduction in January 2013. Many attending do not have any other social activity and other attendees have provided social support to some members by offering to pick them up or take them home. This social inclusion & connectedness has been a beneficial spinoff to a simple program offered initially over summer when health promotion was in recess. In total 14 movies have been viewed by 138 attendees.

The safety of children attending the day Centre for Play Group has been enhanced with the installation of a mirror above the driveway, signage denoting that children are present & the placement of coloured flags when the children are attending this activity. These raise awareness when drivers are entering the car park.

The garden project at the Mortlake

Community Health Centre saw the overgrown agapanthus in the central roundabout removed with replanting of young agapanthus. This was considered a snake hazard as well as being detrimental to the existing garden edging. Five trees

have been planted in this lawn area. All car parking has been clearly delineated around the exterior of the health centre. The shed adjacent to the garage has had metal gates installed allowing all bins to be stored safely and securely.

Mortlake Health Service Nurse Jenny Grice attending to a patient.

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

Jenny Grice and the Mortlake Walking Groupmonths. We have walked the Timboon Rail Trail, Terang Dry Lake walk, the return beach walk from the Breakwater to Thunderpoint in Warrnambool and the Terang to Noorat walk. We often enjoy a cup of tea or coffee at a nearby café before heading off to a park for a picnic lunch. We aim to be back in Mortlake at about 2pm.

You have recently completed a Nordic Walking course. What is Nordic Walking and how does it differ from “just plain walking”?

Nordic Walking, simply defined, is fitness walking with specially designed poles to create a low-stress, total body work-out.

The benefits of Nordic Walking include:

• 90% of body muscles are activated

• 20-25% greater cardiac fitness effect than regular walking

• burns up to 46% more calories compared to regular walking

How long have you been leading the Walking Group? I have been involved with the group for over ten years.

How many walkers do you have in the group? The numbers range from four to six walkers each week; more on “special” walking trips.

It would seem that the socialising may be every bit as important and beneficial as the actual walk. What are your thoughts?

Yes, I would agree with this; a lot of the clients walk on their own as well as making sure that they attend the Health Service walk for the social chit-chat along the way. Even on a grey and rainy morning our enthusiastic walkers turn up. It is terrific that they are prepared to walk in most weather conditions.

Do you walk further afield or are you restricted to Mortlake?

We have “special” walks, approximately every three

without poles• decreases the weight load and

impact on the joints of the lower body

• strengthens as well as tones the upper back and shoulders

Would you like to see more Mortlake residents join the walkers? How do they join your group?

I would really like to see more clients join the group; just register with the Health Service and present at the Mortlake Campus at 8.45 every Wednesday morning.How does this group fit with your general nursing duties?

The Walking Group, Strength-training class and Better Health Self Help group are all part of the Health Promotion Programme and Community Health nursing at Mortlake. Social interaction is a very important part of these groups.

When you are not nursing, how do you like to relax?

My hobbies include

bushwalking, gardening and reading.

What is the best thing about being a nurse in a small country town?

The wide variety of experiences in nursing; being able to run community health programmes and knowing the clients and their

families.

Any advice for someone contemplating a career in nursing?

Gaining work or voluntary experience in nursing prior to commencing a university or TAFE course is very important.

The Live Life Well ProgramThe Live Life Well Program

(LLWP) is Terang and Mortlake Health Service’s chronic condition self-management program. Self-management is what the client does to better manage their condition(s). Self-management describes the strategies that individuals use to manage the disease process itself, any emotional impacts of living with the condition, and the changes that occur to everyday living as a result of the condition. This involves finding information, making decisions and taking action. Self-management does not mean that an individual must manage their own health without any medical or healthcare treatments or support (DoH, 2011).

LLWP clients are assessed using the Flinders Program. The Flinders ProgramTM provides a semi-structured method of ensuring that patients are fully engaged in the delivery of their own care. The client is assisted in making goals and care plans, which are formulated in partnership with the care coordinator. The client is then supported through weekly, fortnightly or monthly consults with the care coordinator. As at July 2013 there are 21 individuals participating in the LLWP; 11 at Terang Campus and 10 at the Mortlake Campus.

The goals of the LLWP are; to reduce avoidable admissions to hospital and urgent care presentations and reduce length of stays in hospital, through planned client centred care.

Since the program was established 6 years ago the health service has seen a reduction in hospital admissions and reduced length of stays for people who have the target chronic health conditions.

To quote one of the program’s very successful self-managers “The program saved me…I was in a deep hole and didn’t know how to get out. You need a plan and a purpose in life…To start with my plan was simple; get out of bed each day and do something. Now I walk each morning and go to the gym twice a week…I have a step by step plan of what to do if my asthma flares up”.

Participants of the LLWP all have a hand held management plan which contains; a list of current medications, an action plan (specific to each chronic condition) this is used in times of acute exacerbations of the chronic health condition, and a care plan that lists all the persons involved in the client’s care. For further information, or to join the “Live Life Well” program, contact our Terang Community Health Centre or Mortlake Community Health Centre.

enthusiastic members of the Mortlake Walking Group.

4 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

terang Mor t lake Hea l th Ser v i ce

TMHS Continence Nurse Lyn Turner

TMHS RIPERN Jill O’Brien

J ill O’Brien has been nursing since 2001, having

commenced her training as a mature-age student. She has spent ten years with the Health Service with five of those years spent at the Mortlake Campus. Jill completed extra studies in Infection Control and Dialysis and is now our qualified RIPERN nurse.

What is RIPERN? This acronym stands for: Rural Isolated Practice Endorsed Registered Nurse.

The RIPERN qualification allows Jill to perform some treatment of clients previously only done by a medical practitioner.

RIPERN nurses can supply limited medication, including some antibiotics; perform limited suturing of wounds; order limited pathology; have increased clinical practice (compared to non-RIPERN nurses) and undertake comprehensive health assessments for clients.

The main task of the RIPERN nurse is to provide appropriate care when there is no doctor available. Jill cannot write

tMHS ripern Nurse Jill O’Brien.

tMHS continence Nurse Lyn turner.

prescriptions or provide medical certificates, but she can forward a follow-up letter for a client to his/her doctor.

If a client is on regular medication, prescribed by a General Practitioner, the RIPERN nurse is not able to supply this medication to the client.

Having Jill in this role at Terang & Mortlake Health Service provides our community with a number of benefits. Clients have improved access to health care without having to travel; this could be of great benefit in an accident or other emergency. With permission from the client, the RIPERN nurse will contact the General Practitioner about the client’s condition. During busy times when no GP is available, the RIPERN nurse can support and lighten the doctor’s load. Clients still have the right to refuse treatment from a nurse and can ask to be seen by or sent to a doctor.

This is certainly a challenging position for Jill, and one which not all nurses would wish to undertake. Hopefully, in the future, Terang & Mortlake Health Service might have some more RIPERN nurses to assist Jill in her role.

Jill, who has lived in Mortlake for twenty years, has grandchildren who take up some of her out-of work time. She also enjoys sewing and quilting and is a member of the Mortlake Spinners’ and Weavers’ Group. A dog lover, Jill also has two spoilt canines to look after.

L yn has been Continence Nurse for the Health

Service for the past sixteen years and continues to find her work challenging and rewarding.

Continence problems are incorrectly regarded as belonging solely to the elderly, but Lyn assured me that this is certainly not so. Incontinence can strike at any age and males can suffer just as much as females. This being said, Lyn has only had one child amongst her many clients over the years.

Most of Lyn’s clients are women; it seems that men are much more reluctant to seek help. Often men who have had surgery and treatment for prostate disease find themselves incontinent as a result. Lyn stressed that more could be done by other medical professionals to explain, educate and inform their patients of the possibility of a continence problem and what help is available.

Lyn sees clients in their own homes and at the Health Service in Terang and Mortlake. Clients can be referred to her by their own doctor, district nurses (most commonly) or themselves; anyone with a problem can come to the Health Service and ask for help.

Once Lyn takes on a client she told me that the continence problem is usually a life-long one. However, some women can

experience short-term problems after childbirth and at menopause. Again, education is the key to management.

Apart from her work as Terang & Mortlake Health Service Continence Nurse, Lyn is Activities Co-ordinator at the

Day Centre and regularly nurses at Mount View. She has worked at Terang and Mortlake Health Service for twenty-eight years and obviously loves her work.

When Lyn is away from the Health Service she enjoys spending time with family (two sons and a daughter), walking, gardening, swimming and craft work.

At Terang & Mortlake Health Service we are indeed fortunate to have such a dedicated member of staff to help deal with what can be an embarrassing problem which could afflict any one of us.

continence problems are incorrectly regarded as belonging solely to the elderly,

What is rIPerN? this acronym stands for: rural Isolated Practice endorsed registered Nurse.

Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 5

Complaints/Compliments ManagementT erang and Mortlake Health

Service recognise the value of feedback, both positive and negative. All comments are seen as an opportunity for improvement

Terang & Mortlake Health Service is committed to ensuring high quality patient and client care. The complaints mechanism is in place to ensure

that any complaint made by a patient, resident, client or other stakeholder is dealt with and resolved swiftly and efficiently.

Terang & Mortlake Health Service affirms its commitment to the “Charter of Patients’ Rights” and “Charter of Resident’s Rights and Responsibilities” as displayed in the facility. In respect of complaints and consistent with

the above, the Health Service maintains that:

Patients and/or their representatives should feel comfortable about voicing their concerns without fear of retribution in any form.

All complaints are addressed without prejudice and will be dealt with promptly.

CoMPliMents & ConCerns reCeiveD JulY 1st 2012 - June 30th 2013

GraphSupplied

Infection Control

Hand Hygiene

antiMiCroBial / antiBiotiC steWarDshiP

As part of the national standards,

hospitals are required to have an

antibiotic stewardship program.

This is an opportunity for Terang

& Mortlake Health Service to

monitor and to question antibiotic

usage. A brief discussion with

the nurses and the doctors

when possible can promote a

conversation about antibiotic

appropriateness. Antibiotics are

a vital part of the health care

process but, they need to be used

correctly. This means taking

a complete course prescribed

by the doctor, this means that

there must be an infection to

treat or if deemed necessary

prophylactically. However

antibiotics will only work in the

case of bacterial infections and

not viruses. As most common

colds or flu are caused by viruses

antibiotics will be of no benefit.

In fact taking smarties would

be a more enjoyable process.

With the overuse of antibiotics

comes resistance and this creates

additional problems. With

over 22 million prescriptions

written every year, Australia is

one of the largest consumers of

antibiotics. In addition The World

Health Organisation considers

inappropriate use of antibiotics

to be a major concern worldwide.

In October 2012, it was reported

that for the Barwon Region up

to 53% of antibiotics prescribed

were inappropriate, 41% were

prescribed with no clinical

indication and 6% were the

wrong dose.

Hence, hospitals must now

be more accountable, Terang &

Mortlake Health Service monitors

the use of antibiotics on a weekly

basis, and this then promotes

awareness and an opportunity

to improve. In order to alert

staff to antibiotic usage a Care

poster has been developed and

placed in selected areas within

the organisation. CARE is an

acronym per the following, C for

communicates, A, for appropriate

to the patient or resident’s needs,

R for the five rights, being right

route, right dose, right person,

right medication, and right time

and finally E for evaluate the

care provided. To conclude, it is

perfectly acceptable to question

antibiotic appropriateness as a

staff member and as a patient.

terang Mor t lake Hea l th Ser v i ce

H and hygiene compliance rates have continued to be

consistently recorded in the high eighties percentile; in this regard, all Terang & Mortlake Health Service staff members are to be commended. Although not 100% it is still a very high compliance rate when compared to other hos-pitals results recorded on the “My Hospital” website.

The minimum standard

compliance rate is 70%. Hand hygiene is considered to be the number one link in not only reducing, but containing many types of infections. Terang & Mortlake Health is also committed to hand hygiene education and monitoring of not only staff but all visitors to our facilities.

Hand Hygiene available data for 1st July 2012 to 14th June 2013 are as follows:

T he infection control department has recorded

the influenza uptake for 2013, to be 81% of all staff. This is certainly something to be proud of considering that the Victorian Health Care Associated Infection

Surveillance Program, aims for 65% of all health care workers to be immunised annually against influenza. This is slightly down from 2012 when 82% of staff members were vaccinated.

Occupational Health and Safety Report The 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.

traininGThe Occupational Health and Safety component of Mandatory training has taken on a new dimension during the past 24 months, covering a multitude of areas that enhance “Best & Safe Practice”. We found the “face to face” and the “hands on” approach to be very beneficial to the participants. Participants have had the chance to explain to me what their understanding of safety in the workplace is.

We have also stressed the importance of reporting all incidents at the time of the incident, even the ones considered as minor as they enable us the opportunity to fix them in the minor/ insignificant stage rather than

in the stage when the likelihood and consequences of the incident could have a greater impact on the human aspect and the organisation.

Feedback from participants who have attended the training sessions has been overwhelmingly positive.

During 2012 we introduced the 4 Steps For Life program for non-nursing staff to learn CPR (Cardio Pulmonary Resuscitation) the key to survival.

You can make a difference- “Witnessing a cardiac arrest can be one of the most stressful experiences someone will ever encounter. It is important to remember that the first few minutes is when a bystander can really make a difference”

Safety awareness information has also been provided to the volunteer groups during the past 12 months, how to safely carry objects , load your car safely , driving in inclement weather conditions and being prepared for emergencies including how to report incidents.

fire anD eMerGenCY PrePareDness

To ensure all staff members possess appropriate skills and knowledge in the event of a fire we have continued to hold regular fire drills and desk top scenarios. Senior staff members participate in a competency based Emergency Warning Intercommunication System (EWIS) training program to ensure all are competent and have appropriate skills and knowledge to take on the in-charge roll.

All staff members are required to complete fire safety training annually utilising a computer based education program (SOLLE) that assesses the user’s competency and provides a certificate of attainment on the 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, telecommunications etc. To enhance our contingency emergency planning we have developed a “heat map” to indicate where our staff members reside.

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 advises that they have a capacity to work, either on transitional duties or modified times. Injured employees who 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 was 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.

6 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

overall CoMPlianCe rate 1/7/2012 – 31/10/2012

Correct Hand Hygiene Actions

Total Moments

Compliance Rate

Confidence Interval

Lower 95% Upper 95% 94 107 87.9% 80.3% 92.8%

overall CoMPlianCe rate 1/11/2012 - 30/3/2013

Correct Hand Hygiene Actions

Total Moments

Compliance Rate

Confidence Interval

Lower 95% Upper 95% 93 103 90.3% 83% 94.6%

overall CoMPlianCe rate 1/4/2013- 14/6/2013

Correct Hand Hygiene Actions

Total Moments

Compliance Rate

Confidence Interval

Lower 95% Upper 95% 89 101 88.1 80.4% 93.1%

OH&S coordinator Gaye Sanderson demonstrates the correct use of a fire extinguisher.

terang Mor t lake Hea l th Ser v i ce

Catering Department

Environmental Services

MaintenanceT he Catering Department

has provided almost 49,000 meals for the year and has been providing Meals on Wheels to the Corangamite Shire residents. We have also been providing meals within the Moyne Shire.

This has been a great service to the community and has relied on volunteers from the Terang area to assist with the delivery to homes.

The meals supplied to all our consumers within the health service have been provided from a 28 day rotating menu. This gives a variety of meals. Special dietary requirements are catered for at all times. Regular meetings have been held with staff and the dietician, to review Nutrition and hydration standards

The Health Service’s kitchen was inspected by the Environmental Health officer from the Corangamite Shire in January and June. Swab samples were taken and tested to ensure we meet required standards.

The food safety plan was audited on May 31, 2013 by Carolyn Humphrey from Food Hygiene Australia. This is conducted annually, to ensure compliance. The Food Service Department also has audits completed by the Infection Prevention Team. In September we received a score of 99%.

New equipment purchased included a dishwasher for Mount View in February 2013; we have also sourced quotes to replace the electric combi oven.

All catering staff members are to be congratulated on their commitment to providing a safe food service. the first 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.

R esults of Terang and Mortlake Health Service

cleaning audits remain well above the accepted quality level set by the Victorian Cleaning Standards (VCS).

In April 2013, several cleaning

I n the 2012-2013 financial year there were 1026 requisitions

lodged with the maintenance department. Of these, 1020 were completed and 407 completed within 24 hours.

Maintenance staff members are responsible for completing all essential service checks (fire and safety) which are audited by Stokes

Perna (an external Contractor). Annual compliance sign off was completed in August 2013.

With maintenance jobs coming from all four health service campuses, as well as maintaining grounds and gardens it has again been a very busy year for our maintenance staff.

staff attended a seminar demonstrating micro fibre and steam cleaning.

Future plans include the introduction of micro fibre mopping pads to mop all wet areas; this would replace the

current out dated mop head / mop bucket style of floor cleaning.

The introduction of micro fibre mopping pads will significantly reduce the volume of water and detergent used. This modified practice will also alleviate strain

on the body compared with cleaning undertaken with a mop and bucket.

There will also be lesser risk of cross contamination as a clean pad will be used for each area mopped.

Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 7

Noela Davey –environmental Services.

Part of our dedicated team. L-r: Michael, Michelle, Kerryn and Sue.

Maintenance Manager Ian Barrand.

Meals ProviDeD BY the CaterinG DePartMent

tMhs 3 Year CoMParison MaintenanCe reQuisitions

funCtions CatereD for 2012–2013 Meals

2012–2013 CleaninG auDit sCores

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 principles for health services to ensure accountability for providing

safe care and is fundamental to continuing to improve patient safety within the 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 this sets parameters for the level of complexity of care that individuals are able to engage in.

all of our DoCtors are QualifieD 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 PoliCe CheCks

QualitY DoMain

What the fraMeWork saYs We

shoulD DoWhat 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 & 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 focus 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 compliments management system is in place.

Our comprehensive risk register reflects and responds to both clinical and corporate risk.Complaints management and compliments are reviewed by the Quality Improvement Committee.

Credentialing and defining the scope of practice

O ur district nursing team

of registered nurses and

medication endorsed enrolled

nurses provide care to clients

from Panmure to Dundonnell and

Glenormiston North to Caramut.

A broad range of care is provided

from: single visits to assess needs,

with referral to other services if

required; short term assistance

following acute illness, injury

or hospital admission; wound

management; or ongoing long

term visits enabling the client

to remain living at home, when

they would otherwise require

residential care.

The nurses not only provide

care to the client but also support

the client’s family and carers

in their role. The district nurses

work in coordination with the

Corangamite and Moyne Shires,

clients and General Practitioners

and other allied health providers,

and local and regional hospitals

to assist the client’s, and their

support networks, to plan what is

the best care strategy for them.

All district nursing staff

members actively update their

knowledge so that best practice

care can be given. In the past year

staff members have completed:

Diploma of Community Service

Coordination (2), Diploma

of Wound Management (1),

and attended short courses in;

Health assessment of the older

person, wound management,

pain management, management

of central lines and diabetes

management.

Over the 2012/2013 financial

year the district nurses have visited

a total of 208 individual clients (an

increase of 40 in comparison to

the previous 12 months) with 131

client admissions and 101 client

discharges.

District Nursing Service Unit Manager rosemarie Barby checks the blood pressure of client Joyce Lucas.

District Nursing ServiceRosemarie Barby

All district nursing staff members actively update their knowledge so that best practice care can be given.

terang Mor t lake Hea l th Ser v i ce8 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

Patient Satisfaction Results

overallCare

aCCess anD aDMission

General Patient

inforMation

treatMent anD relateD inforMation

all hosPitals 80 78 84 81 CateGorY D hosPitals 87 85 90 87

tMhs 88 89 89 88

CoMPlaints ManaGeMent

PhYsiCal environMent

DisCharGe / folloW uP

ConsuMer PartiCiPation

all hosPitals 82 77 78 81

CateGorY D hosPitals 88 86 84 88

tMhs 87 88 87 87

T he Victorian Patient Satisfaction Monitor

(VPSM) has been developed by the Department of Health to assist hospitals improve services and patient experience. The survey requests the patient to provide feedback about their hospital stay.

Results from the VPSM survey are used by the hospital to identify ways that they can improve services. A standardised questionnaire is sent to Terang and Mortlake Health Service patients if they have agreed to participate. The information is then compiled by Ultra feedback, the company contracted by the Department

of Health to collect, analyse and report the data. The information that we receive back from VPSM responses is useful to assist with monitoring the quality of care and services that we provide at Terang and Mortlake Health Service. The reports received provide details that allow us to prioritise areas for further work, also to acknowledge that we are doing well and to pass this information onto our staff.

Thinking about all aspects of your hospital stay, how satisfied were you? The latest half-yearly results from Wave 24: January 2013 to June 2013 of the Victorian Patient Satisfaction Monitor are summarised below.

vPsM results JulY 2011 to June 2012.Planned Activity Group members enjoying our new community garden area.

Planned Activity Group

Resource Smart

O ver the past financial year we have had 77 clients

registered with the Planned

Activity Group (PAG) and

we currently have 59 clients

participating in a variety of

programs. Client centred care

remains the priority for staff at

the Terang Community Health

Centre. This is reflected in the

activities that occur within the

Planned Activity Group. Our staff

members discuss with clients their

interests, both past and present,

then plan activities that relate to

those interests. This occurs on an

individual and group level.

Programs and activities are

offered Monday to Friday.

These programs are designed to

stimulate physical and cognitive

functioning but with a major

focus on providing a friendly,

social environment.

Staff members have participated

in various educational updates

including Easy Moves for

Active Ageing, Comprehensive

Assessment of the Older Person

and Health and Lifestyle

programs.

Men’s Travelling Lunches

continue to run each Monday with

24 registered clients. These bus

outings are designed specifically

for older men in the community,

giving them the opportunity to

The Resource Smart Healthcare initiative is a program

developed jointly by the Department of Health and Sustainability Victoria as part of the Victorian State Government’s commitment to reduce the adverse environmental impact of its funded agencies.

As the largest portfolio within Government, Health Care is responsible for about half of the Victorian Government’s energy use, 40% of its greenhouse gas emissions (from stationary energy) and about half of its total water use.

Each year, public hospitals consume enough energy to power over 60,000 households; enough water to fill over 1,700 Olympic sized swimming pools and generate approximately 14 billion black balloons (or 180,000 cars) of greenhouse gas emissions from stationary energy.

As healthcare providers, Terang & Mortlake Health Service know that the environment is a key determinant of health, and that the healthcare sector has an obligation to minimize its own environmental and carbon footprint.

Victorian Government policy committed all public agencies (including health services) to develop environmental management plans by the end of 2011

Our organization is committed to implementing sound environmental

practices in all areas of our operations and we recognize it is essential that all energy/water users and producers of waste manage these aspects to minimize the negative impact on the environment, as well as the financial cost.

It is an expectation that all members of the TMHS team play their part to minimize unnecessary energy waste and actively participate in recycling initiatives.

aChieveMents to Date • Establishment and circulation of

an end of day checklist to reduce energy wastage to include:

• Shut down of laptop computers and turning off standalone printers; microwaves, phone chargers and televisions at the power point;

• Ensuring split system heating & cooling appliances have been turned off;

• Closing of blinds/curtains in winter to reduce heat loss at night;

• Turn off taps tightly to ensure they are not dripping

• Checking that refrigerator and freezer doors are closed properly

• Save water by operating dishwashers only when they are full or close to capacity;

• Review (based on trial data analysis) whether we need to operate separate dishwashing facilities in the Kitchen and

Mount View – can this be centralised to reduce energy consumption and costs;

• Encourage staff to print documents double-sided and reuse non-confidential waste as scrap paper for notes and messages;

• Utilise available teleconferencing or videoconferencing facilities to reduce the need to travel for meetings.

• Keep the message fresh – provide regular feedback to staff on initiative results and focus on a quarterly energy saving idea

ConClusion

Since 2006, we have implemented a number of very effective energy saving and waste reduction strategies through our active involvement in Sustainability Victoria’s Waste Wise and, more recently the Resource Smart programs.

Although it is early days and measurable data is limited, the eradication of diesel fuel, conversion of the Terang Hospital’s hydronic heating to LPG, installation of split system heating/ cooling systems and

the installation of a solar powered pre-heating system have combined to reduce the adverse impact of our operations on the environment – not to mention the positive financial impact.

Moving forward, our primary focus will be on a continued awareness program for staff, to educate all team members on the small actions they can take, both at work and in their own home that collectively can make a big difference.

socialise in a range of settings that are of interest to them.

The Community Garden, which was established last year, is now productive with clients and staff able to have fresh seasonal fruits and vegetables they have grown themselves. The garden has also contributed to the fresh ingredients used within the Community Kitchen, providing healthy options and ideas for using these ingredients for participants.

A review of the goal setting documentation used in the PAG has been undertaken. The review has indicated that they are not well used and staff and clients find it a difficult process. It has been determined that to maintain the client centred focus there is a need for simplified documents which enable staff and clients to have a conversation about what is important to the clients. More appropriate documents have been sourced and are currently being trialled.

Two Year 10 students from Mercy Regional College have been attending the PAG each Wednesday afternoon as part of their outreach program. The clients have enjoyed the intergenerational contact and actively engaged with the students in both physical and cognitive activities such as Soccer

and Charades.

Clients from the PAG now

attend the Terang Croquet Club

on a monthly basis. This has

provided an opportunity for

socialising with other groups at

the same time as providing an

opportunity for gentle physical

activity. One client commented

that “it is exciting to be playing

sport again”.

Friends and family afternoon

teas are held on a bimonthly basis

with clients able to invite someone

to spend the afternoon with them.

This provides an opportunity.

PhYsiCal environMent anD resourCes

The Planned Activity Group

space is in the process of having

the floor coverings replaced as the

original vinyl was beginning to

deteriorate. An automatic sliding

door is to be installed at the rear

of the Community Health Centre

allowing easier access for clients,

especially those who use walking

frames or other mobility aids.

Three iPads were purchased for

the PAG clients to provide another

source of access to cognitive

activities/games with a view to

encouraging use of information

technology to maintain contact

with family and friends, virtual

travel and ongoing learning.

terang Mor t lake Hea l th Ser v i ce Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 9

Clinical Bedside HandoverImproving care for cardiac patientsProJeCt 1Point of Care troPonin BaCkGrounD

The Victorian Cardiac Clinical Network (VCCN) commenced in February 2009 and aims to improve quality, access, equity, cost effectiveness and sustainability of cardiac services in Victoria through:-

Facilitating a coordinated approach, based on evidence based guidelines for the care and management of both adults and children with cardiac conditions.

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 following recommendations resulted as outcomes of the survey:

1. That a framework for the management of acute coronary syndrome in rural state-wide health services should be developed, which takes into account the limited access to support services such as Radiology and Pathology.

2. Access to a Cardiologist (could be phone only) being made accessible to all rural health services 24/7.

3. Development of a consistent policy for point of care testing for all rural health services and that this policy includes a competency tool

As part of a range of activities for 2011-12 the Victorian Cardiac Clinical Network decided to undertake a pilot of point-of-care troponin (POCT) essays to assist in the triage of patients presenting with chest pain in the Emergency Department /Urgent Care Service centres in small rural health services. It has been decided to undertake this pilot in the seven health services in the South West Region.

The troponin blood test measures the levels of certain proteins called troponin T and troponin I in the blood. These proteins are released when the heart muscle has been damaged, such as a heart attack. The more damage there is to the heart, the greater the amount of troponin T and I there will be in the blood.

PurPoseThe overall aim is to introduce an

Acute Coronary Syndrome Pathway to South West Victoria and evaluate its impact by improving access to evidence-based acute and follow-up cardiac care through the provision of the following resources and implementation strategies.

Around twelve months ago Terang and Mortlake Health

Service introduced the clinical handover at the bedside in the acute ward between shift changes from the am to pm shift to engage the consumer in their care and further improve communication with the consumer and staff. This is a one-to-one nurse handover in the presence of the patient, usually at their bedside. Our Clinical handover has been reviewed and improvements made including;

• Commencement of bedside handover between nurses and patients at the morning – evening shift change over.

• Posters for patient’s room explaining the process

• Auditing of nurses and patient experiences

• Redesign of handover sheets.• Education for nursing staff

& prompts available using a standardized approach to handover of the ISBAR (I-Identify, B-Background, A-Assessment, R-

oBJeCtivesIntroduce a pilot project on bed side

POCT testing for cardiac troponin in centres that cannot otherwise ensure a turnaround time for troponin assays of <60 minutes (24/7) to support timely risk stratification and decision-making regardless of geographic location.

Improved accessibility to specialist cardiology advice regarding ECG (electro cardiogram) interpretation, other diagnostic test interpretation, triage and treatment decisions. This service would aim to provide prompt advice 24hours/ 7 days a week utilising an escalating paging service, 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

With due consideration of cardiac clinical guidelines

Develop agreed Clinical Pathways for Chest Pain / Acute Coronary Syndrome (ACS)

This project examined selected emergency departments in rural hospitals in the South West region of Victoria.

The South Western Region is defined, in this project as the shires of Moyne, Warrnambool, Corangamite and the southern section of Glenelg shire. This corresponds to the catchment of the subregional Hospital at Warrnambool. Seven hospital sites have been identified for inclusion: Warrnambool, Portland, Timboon, Camperdown, Port Fairy, Heywood, and Terang.

reCoMMenDations froM Patients

1. Point of care testing of troponin should be available in all Victorian rural hospitals without a 24hour on site pathology service

TMHS Action – this is available in the urgent care department.

2. All Victorian rural hospitals should own and use ECG machines with automated ECG interpretation

TMHS Action – ECG machines at TMHS have this function available.

3. All rural nurses assessing emergency patients should be trained to recognise patients with possible acute coronary syndrome

TMHS Action – ongoing education for nursing staff.

4. Cardiac advice lines should focus on providing risk stratification of possible acute coronary syndrome patients with high risk features

Recommendations)The benefits include:• Improved time effectiveness

and efficiency• Comprehensive, accurate

information being relayed• Improved safety, including

decreased staff omissions and errors

• Improved continuity of care• Increased patient / carer

involvement, compliance and satisfaction in their plan of care therefore achieving best possible outcomes

• Improved relationships and increased rapport with patients and their carers/families

• Improved staff knowledge and skills

• Opportunities to educate and support junior staff

• Effective clinical handover can reduce communication errors between health professionals and improve patient safety and care.

TMHS Action – Continue to access cardiac advice line

5. Cardiac advice line to remain 24/7 from Barwon Cardiologists

ProJeCt 2reCoGnisinG & resPonDinG to CliniCal Deterioration in aCute health Care

The South West Barwon Region was successful in receiving funding to implement the Compass Program across the region. The program relies on a three pronged approach. The goal of this system is to identify early any clinical signs of deterioration of a patient, and appropriate actions.

The idea behind the ‘Compass’ name is to point you in the right direction, with the aim of improving the early recognition and timely management of deteriorating patients. The Compass program was designed by the Australian Capital Territory Health Australia.

• A track and trigger system and supporting policy- Modified Early Warning system (MEWS)

• A colour coded observation chart incorporating the scores

• Nursing staff attending training sessions at South West Health Care Warrnambool to facilitate a “train the trainer” implementation of the COMPASS program at Terang & Mortlake Health Service

clinical Bedside Handover involving the patient and nursing staff at change of shift.

What is it?

South West Healthy Kids (SWHK) is a community based,

health development initiative promoting physical activity and healthy eating in children (aged 3-12 years) and their families. It is a collaborative partnership of local government, community and health agencies including: Moyne Health Services, Terang and Mortlake Health Services, Moyne Shire Council, South West Healthcare – Macarthur Community Health and South West Sport.

CoMPleteD WorkIn 2012 a community needs

assessment project was completed in the communities of Port Fairy, Koroit, Macarthur, Hawkesdale, Mortlake and West Warrnambool to:

Identify current healthy eating and physical activity policy and practice in early childhood

education and care services and schools

Identify factors which help or hinder physical activity and healthy eating in children and understand the different concerns in each community.

Identify opportunities to consolidate and strengthen local childhood obesity prevention efforts.

next stePsIn 2013, SWHKs has been

successful in grant funding through the Medibank Community Fund and Great South Medicare Local to support the delivery of a ‘Lunchbox Blitz’ program across nine schools in the region.

The program aims to improve the quality of food brought to school in the children’s lunchboxes. In particular the 2012 lunchbox audit illustrated the number of lunchboxes without an identifiable

main meal (13%), without fruit (28%), vegetables (95%) or dairy (81%); and the number of lunchboxes with energy dense nutrient poor (EDNP) packaged snacks (50% had at least one packaged snack and 21% had two or more) and confectionery (19%) was concerning.

Mortlake P12 will be the first school to deliver the program in term 4 2013. The program strategies will include:

• Developing a menu-planner with 2-6 sessions food skills program (e.g. education on healthy eating, cooking demonstrations, tips for budgeting etc.)

• Families trial menu-planner which will be published as a resource for all parents within the school.

• Professional development for teachers and school personnel

• Introduction of at least one new healthy eating policy within the school

South West Healthy Kids Tracey Egan

terang Mor t lake Hea l th Ser v i ce10 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

The Terang Campus of the Health Service continues to deliver a

range of acute services including:

The 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 have

encouraged nursing staff to pursue on-

going professional development. Two

of our Unit Managers have completed

the extra training in management.

Rosemarie Barby – The Unit

Manager District Nursing completed

the Diploma of Community Services

and Lynda Hubbard – Aged Care

Manager completed Certificate IV

in Frontline Management. There

are currently four Enrolled Nurses

at different stages completing their

Bachelor of Nursing at Deakin

University. The nurses are granted

leave by the Health Service to

complete their clinical placements.

Key Initiatives for ongoing professional development include:

• 5 Mandatory study days for staff

to attend bi-annually, topics

included Occupational Health

& Safety, Infection Control,

Quality Improvement, Resource

Management, Live Life Well

Program;

• We commenced SOLLE (SWARH

On Line Learning & Education)

initiative In July including

Open Disclosure, Medication

Management, Manual Handling,

Basic life Support, Blood Safe,

Infection Control, Fire Training

are mandatory for staff to

complete yearly;

• Maternity Services Education

Program (MSEP) ……

• The purpose of this training and

development day was to discuss

current maternity model of care,

and explore options to provide

sustainable maternity care to local

women;

• Cohesive group decision regarding

midwifery led care when GP

unavailable In Terang;

• Refresh knowledge of Victorian

Department of Health – Capability

Framework for Maternity and

Newborn Services, aligned to

TMHS / SWAMI document &

flow chart;

• Refresh knowledge of National

Midwifery Guidelines for

Consultation & Referral.

Other Training:• Advanced Life Support Training

• Triage Education

• Obstetric Education

• Deteriorating Patient Education

• Wound Care

• Dementia training

• Preceptor training

In February 2013 Tracey Harris,

Julie Plummer and Heather Hicks

attended a “simulated patient”

workshop run by the Greater Green

Triangle group. Simulated patients

are people who are trained to act out

medical scenarios.

Greater Green trianGleDuring the year several scenarios

were run involving staff and nursing

students. Some of the topics covered

also included emergency treatment of patients presenting with severe asthma, chest pain or “ICE” overdose.

The scenarios were most beneficial to all staff members attending. Our close relationship with the Greater Green Triangle resulted in THMS attaining moulage supplies and an intravenous (IV) blood practice dummy arm.

Deakin Medical School Simulation Workshop. the intent of attending the workshop simulations was the anticipation of improving skills in patient care management

Terang & Tweddle Early Parenting CentreThe Terang and Tweddle

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

The Terang Early Parenting Centre, based at 46 Thomson Street Terang is operated in

partnership with Tweddle Child and Family Health Services.

The early parenting centre provides a Day Program for families with babies and children up to 36 months old. The facilitators provide education and practical techniques to

help manage parenting issues including feeding difficulties; unsettled/irritable infants; infant/toddler sleeping problems; uncertainty with parenting; challenging toddler behaviour; maternal exhaustion and postnatal anxiety and depression.

Acute Care

What is it?

The Heart of Corangamite Network was established in

2005 in response to the Greater Green Triangle University Department of Rural Health, Flinders and Deakin University research project, which identified a high occurrence of risk factors for cardiovascular disease (CVD) in the Corangamite Shire.

The Network decided to focus on the key risk factors of physical activity and nutrition. The Network aims to be recognised as a leader for sustained and integrated health promotion and be known as a best practice model for its coordinated effective partnership approach to reducing CVD at a population level.

CoMPleteD WorkIn 2013, the network published

a Quick Guide to Corangamite Shire’s Walking Tracks which includes a total of 23 walking tracks across the 12 major towns. The tracks are graded according to their safety, comfort, connectivity and accessibility for an overall “walkability” ranking. The walks are graded as leisurely, moderate or energetic and vary from 800 metres to eight kilometres.

Terang walkers can take on the 4.5 km around Terang’s dry lake bed or the 2.5km walk around the township. The walking booklet aims to increase the quantity and frequency of walking across the shire as well as increase awareness of the existing walking tracks in the Shire. Terang’s Easy Walkers walking group assisted in mapping

and auditing both of Terang’s walking tracks.

Heart of Corangamite is also currently completing a needs assessment across seven schools in the shire. The project is currently spending time in the community, taking stock of what is currently happening and gathering information about issues or factors that may be making it hard for kids and families to eat well and be active as they go about their daily lives.

The same data has already been completed by South West Healthy Kids. The data collection methods include parent surveys, principal survey, student engagement sessions, parent focus groups and lunchbox audits.

The findings will be used to make decisions about local action to take to make it easier for children and families to eat more nutritious food and be more active. There are many benefits to promoting health in schools, the simplest being that healthy children learn better. The school environment can influence children’s health and wellbeing, which has an impact on learning and development.

next stePs A workshop facilitated by the

Collaboration of community based Obesity Prevention Sites (CO-OPS) will be completed from the needs assessment data to determine which areas need to be prioritised to improve nutrition and physical activity in children and their families across the Corangamite Shire.

Heart of Corangamite

terang Mor t lake Hea l th Ser v i ce Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 11

terang Mor t lake Hea l th Ser v i ce

Urgent Care Department

Midwifery Report

A 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.

The Terang Campus has continued to sustain

the Shared Care Program, involving the GP Obstetrician and midwives, allowing greater continuity of care of mothers and babies. The health service has recorded 222 share care visits during 2012/13, up from 191 for the previous year. The programs

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. The following table of information sets out the triage time, patients classified in that category and the number of patients in the category seen within the classified time frame in the past six months.

follows the 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 42 babies, 2 of which were solely Midwife deliveries.

After assessment, patients are allocated a triage category based on the Australian triage Scale.

12 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

Margaret O’Sullivan, one of our dedicated team of midwives.

Surgeon Dr. Barry Morphett, theatre Nurse elizabeth Mioduchowski and Anaesthetist Dr. tim Fitzpatrick.

CateGorY tYPe tiMe fraMe nuMBer PresenteD

nuMBer seen BY a DoCtor

1 Resuscitation Immediate 1 1

2 Emergency Within 10 minutes 4 4

3 Urgent Within 30 minutes 40 37

4 Semi Urgent 1 hour 224 214

5 Non Urgent 2 hours 1164 1164

Operating SuiteThe number of procedures completed in the operating suite:

ProCeDure 2011-12 2012-13

GastrosCoPies/ColonosCoPies 221 189

General surGiCal 42 25

GYnaeColoGY/oBstetriCs 20 27

shareD visit Births

Risk Management and Patient Safety

In October 2012 we celebrated the opening of the balcony. The

official opening was well attended by residents, families and staff, with the ribbon being cut by Betty Logan on behalf of herself and Cattie Glennan, our two longest residing residents.

The new balcony enables us to facilitate a variety of activities, including a barbeque area, quiet seating arrangements and potted flowers and plants for the garden enthusiasts also an outdoor dining area.

The residents have used the area during the warmer months for activities and our monthly barbeques are cooked out here.

The Person Centred Aged Care Project (PCAC) commenced late 2012 with 5 staff attending 6 months of training. This project is to ensure that all continuous improvement has the resident as the focus.

Some of the trials that the group participated in included orange citrus face wash trial to see if it enhanced appetite; time line of resident’s care, based on the Maslow’s triangle of needs; staff warm up exercises and; a visual board has been put in the dining room for all to see the improvements in place.

The way forward with PCAC is to enhance the dining room experience and to make the lounge room more appealing and less institutionalized by incorporating the view and making little “nooks” within the big lounge room.

Equipment purchased included 2 new air mattresses, an ophthalmoscope, a bladder scanner and two falls mats.

We are in the process of purchasing two new extra-long

floor level beds to accommodate residents who are tall in stature.

There have been many changes during 2011-12 in Mount View, including staffing, refurbishment, commencement of working parties, to name a few.

The Social Inclusion Project continues with Grade 5 & 6 students from St Thomas’ Primary School, forming wonderful relationships with the residents and their families. The benefits for all participants in this project, both young and old, are immeasurable.

The intergenerational program has allowed for ongoing buddy relationship with the residents and opportunities to share special days, including farm, sporting and concerts.

During the year we were fortunate to purchase 8 new dining room chairs with wheels. This was funded from the family of a previous resident, the Ryan family, and The Ladies Auxiliary.

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 for staff have included opportunities to attend:-

• Dementia training

• Wound Care

• Comprehensive Assessment of the elderly

• Pain Management

• Person Centred Care

• Privacy

To further enhance the current activity program in Mount View, two environmental staff members have completed the Certificate IV in Lifestyle and Leisure. These staff members will assist our Activities

Co-Coordinator in broadening the activity program and have now commenced the Diploma of Health and Leisure.

Mount View residents continue to celebrate culturally important days, including ANZAC Day, AFL Grand Final Day, Christmas and Easter. Other ongoing planned activities included cooking, barbeques, music therapy, crafts and bus trips, which the residents thoroughly enjoy.

terang Mor t lake Hea l th Ser v i ce

Mount View Aged CareQuality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 13

Long time resident Betty Logan cuts the ribbon for the official opening of the new verandah.

Nurse Barbara Wilson with Mount View resident tony Kenna.

T erang & Mortlake Health Service (TMHS) takes

safety very seriously. As part of ensuring high quality care for our community, we have a strong risk management system in place. We aim to identify and fix problems before an incident occurs.

The Department of health

(DoH) is committed to improving the quality and safety of Victorian Health Services. We use a standardised framework for the collection and management of clinical incidents known as Victorian Health Incident Management System (VHIMS) using Riskman data base system.

inCiDents BY severitY ratinG 1st JulY 2012 – 30th June 2013

Pressure Injuries

Safe use of Blood Products

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 virtually anywhere on the body where pressure is applied for a period of time.

All patients and residents are risk screened to determine the risk of developing a pressure area during their stay. Nursing staff use a range of special of equipment and strategies to help reduce the pressure ulcer risk. These include the use of pressure relieving mattresses, heel wedges, and encouraging 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.

The World Health Organisation definition

of a fall is “An event, which results in a person coming to rest inadvertently on the ground or other lower level”

Terang & Mortlake Health Service remains committed to the prevention, harm minimization and management of falls. Research evidence indicates that interventions to minimize falls risk can reduce the risk of falling and falling related injuries in people assessed as having a high risk of falling. A comprehensive falls risk assessment is completed on admission and followed up as required for all patients & residents.

It is important to note that a number of things are classified as a fall; for instance a patient/resident rolling on to the floor when the bed is in the floor line position is classified as a fall. We have been able to maintain a low level of injuries resulting from falls, the most common being skin tears. There were only two falls resulting

in fractures during the 2012/13 financial year - one occurred on the acute ward and one in our Mount View nursing home.

FALLS – REdUCING THE RISK

In October 2012 we celebrated the opening of the balcony. The

official opening was well attended by residents, families and staff, with the ribbon being cut by Betty Logan on behalf of herself and Cattie Glennan, our two longest residing residents.

The Victorian Public Sector Residential Aged Care Service (PSRACS), evidence based quality indicators were introduced in 2006; and are aimed at assisting facilities to monitor and improve the quality

of care provided to residents.

Terang & Mortlake Health Service, Aged Care Facility, Mount View continues to collect data, for five quality indicators, these are submitted to the Department of Health (DoH) on a quarterly basis.

These include:• Prevalence of pressure ulcers• Prevalence of falls and fall

related fractures• Incidence of use of physical

restraints• Incidence of residents using nine

or more different medications• Prevalence of unplanned weight

loss

The data is submitted to the Department of Health (DoH) and then benchmarked against other Victorian public sector aged care facilities. Each facility uses its own data as a focus for improvement, in particular where results vary from the State average.

Quality Indicators

Incident ReportingT he following graph reports

our results for the four major incident categories recorded & reported throughout the past

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

to our systems and processes to minimize harm.

Antibiotic Usage

Medication Management

Antibiotics 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; however this

practice is no longer encouraged.

Hence medical and nursing staff

members are now encouraged

to have queried infections

confirmed via appropriate

pathology.

This in turn will recommend

the most suitable antibiotic. In

order to reduce unnecessary

pathology interventions,

clinicians are required to use the

Quality Performance Systems

(QPS) reporting tool as a first

line management.

The tool provides a clear

understanding of the criteria for

a variety of infections including

wounds, conjunctivitis,

urinary tract infections and

gastroenteritis. If the tool criteria

Terang and Mortlake

Health Service promotes

safe, effective and appropriate

medication use and promotes

organisational accountability

and responsibility in the safe

administration of medications.

Majority of medication

administration related errors at

TMHS are:-

• Signature omissions – the

medication was given but not

signed for.

• Omitted dose - medication

missed or not administered at the

due time.

• Outcome - nil errors have

resulted in patient harm.

Most signature omissions

are due to distractions while

completing medication rounds.

Interruptions and potential

distraction may remove staff

is obtained then pathology should

be requested from the medical

officer.

Since becoming more aware

and with ongoing discussion

with medical staff, residents

in Mount View are no longer

administered antibiotics as a

prophylaxis. This has reduced the

amount of antibiotics being used

for unconfirmed infections, in

particular urinary tract infections.

In addition the use of cranberry

tablets has been implemented

for some residents with positive

results.

Furthermore nursing, catering

and environmental staff should

all be commended on the very

high level of care shown to

all residents. In a health care

environment, it can often be very

difficult to avoid cross infections

when caring for residents

with complex care needs. The

fundamentals of hand hygiene

practice would have contributed

significantly to this positive

outcome

attention from the job at hand,

such as answering the telephone

or general enquiries, or when

being call to assist with patient/

resident needs during the round.

We have introduced several

new measures to assist in reducing

the number of medication errors.

These include wearing a red apron

to avoid disruptions - this signals

to other staff that the nurses are

busy administering medications

and not to be disturbed.

The nurses now take the

medication trolley with them

to patient’s bedside and once

commenced, the medication

round must be fully completed

before any other tasks are

undertaken. Further education is

being provided to staff at shift

hand-overs.

terang Mor t lake Hea l th Ser v i ce14 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

inCiDent BY ClassifiCation

Person Centred: a restraint free approach

Terang and Mortlake Health Service Aged Care Facility

Mount View has embraced the person-centred care approach, using a restraint free approach where practicable.

This way of thinking aims to preserve the human rights of any person. All our residents are entitled to respect and protection of their basic rights and freedom of choice.

By adopting a restraint free approach where practicable, the use of any restraint is always the last resort after exhausting all reasonable alternative management options to ensure the safety and wellbeing of our residents.

Nutrition plays an important role in maintaining health

and an even more important role in the presence of illness or injury. Nutritional requirements increase dramatically in the presence of infection or injury and hence weight loss is a common negative outcome. Maintaining good nutritional intake during times of illness can be hard.

Other factors that also affect the nutritional state of patients residents and clients include, food accessibility , ability to cook and shop, poor dental care, lack of access and/or storage, increased calorie needs and some diseases.

Risk screening occurs in all areas of our services, identifying risk factors that may contribute

to weight loss/gain or nutritional deficiency.

Once identified there are pathways to allow staff to implement an individualised care plan to encourage and support a healthy and nutritious diet which may or may not include supplementation.

Mt View participates in The Public Residential Aged Care Performance Indicators on Weight Loss Management. Data from these indicators demonstrates that Terang and Mortlake Health Service is successful in enhancing resident’s nutritional status.

A nutritional working party has been created to ensure we meet the “Best Practice” guidelines with nutritional management.

Incidence of residents using nine medications or moreMany residents in

our facilities have diverse medical issues that require complex medication management and as a result some of our residents are prescribed nine or more medications.

Management of this indicator has been centred on ensuring timely medication review, which involves input from the resident’s doctor, an external pharmacist review, nursing staff and resident and relative input.

Kate is a Terang girl born and bred and now

lives with husband Wayne, a self-employed electrician, and children Thomas 12 and Elizabeth 8.

Before working for Terang Mortlake Health Service, Kate worked in real estate and administrative positions. She has been working for TMHS for four years, the last two years as Volunteer Co-ordinator.

She organises 110 volunteers over all three campuses.

The volunteers under Kate work in many different capacities. These include helping with arts and crafts at Mount View, music sessions at Mount View and the Community Health Centre, various other activities at the Community Health Centre and delivery of Meals on Wheels, which involves about 60 volunteers, to name just a few of Kate’s involvements.

She says people seem to spark up when the dog arrives and the clients enjoy its company.

Kate finds her job really rewarding. She enjoys introducing people to volunteering and likes to see the personal reward the volunteers themselves get from their efforts.

One interesting program instigated by Kate involves a local man, Gerard Overweter, who brings his dog once a week to interact with clients at Mount View and the Acute Care Ward. Gerard has trained with guide dogs, so is well versed in the way dogs can interact with people. Kate developed this idea after learning how well a similar program worked in Warrnambool.

Volunteer Coordinator Kate Justin

Melissa, who lives in Warrnambool with husband

Dale, a psychiatric nurse, and children Hugh 17 and Nell 16, has been working for TMHS since 1990.

She began as a District Nurse, working alongside Pam McConnell and taking over as Unit Manager of District Nursing on Pam’s retirement. During this time she unified the Terang and Mortlake

services into one organisation and says this has worked really well.

In 2011 when the role of Primary Health Care Co-ordinator became available, Melissa was ready for a new challenge so took on this position. She finds this very rewarding and she especially likes the personal contacts involved. Being in the main street there is easy access for clients and Melissa can help people to be aware of and

to access the services available to them.

She says interaction with Day Centre clients is fantastic; they are all interesting people with incredible stories to tell. Melissa says older people can sometimes be ignored, but she really values the wisdom of these people. She says both she and her staff have learned a lot from the people they come into contact with. Melissa says she has remained in this job because the work atmosphere is supportive and the staff are great to work with.

Last year Melissa had the opportunity to participate in the Great South Coast Leadership Program. This involved attending meetings to look at opportunities for development in the region and also problems faced. The idea was for people to be aware of the important roles they could have in their communities, such as setting up volunteer projects. She believes strongly in the importance of social equity, of ensuring that disadvantaged people have the same opportunities as others to participate in education and sport, and to be valued community members.

Melissa finds Terang a very welcoming and inclusive community, and although living in Warrnambool she says she feels more a part of the Terang Community, because of all the local people she has been fortunate to meet.

Primary Health Care CoordinatorMelissa Mitchell

Kate Justin

Melissa Mitchell

Mount View resident Joe Noonan enjoying a visit from friend Shirley.

Unplanned Weight Loss

Quality of Care report WeDNeSDAY, Oc tober 30 , 2013 – 15terang Mor t lake Hea l th Ser v i ce

Meet the Board

Our hospital is fortunate in having outstanding

local people willing to serve as Board Members. One of our new members is Adam Box, Principal of Terang College, who brings with him a wealth of experience in community service.

Adam first moved to Terang in 1997, and has been in his current position for over 7 years. He is married to Mel, and they have three children, Gemma 10, Charlie 8 and Joseph 4.

Adam enjoys being part of the Terang Community. He believes the community is very inclusive, a person’s background doesn’t matter and people look after each other.

He is currently a Board Member of South West Local Learning and Employment Network. He has had extensive experience with different football clubs, as a player, committee member and coach. He is secretary of Noorat Cricket Club and a committee member of Terang Mortlake Football Club, and has won numerous awards for his service to both football and cricket, including Best Club Person awards at several clubs. He also received the honour of being named Corangamite Shire Australia Day Citizen of the Year in 2001.

Adam is passionate about hospitals and joined the Health Services Board because he believes that having a hospital is incredibly important for our community. He would also like to see health and education work more closely together, and sees a great opportunity for Terang College to work in with the Health Service, for instance in the field of speech pathology, where ideally the hospital would collaborate

Adam Box craig coates

Quality of Care Report FeedbackTerang and Mortlake Health

Service recognise the value of feedback, both positive and negative and treat all comments as opportunities to reflect on our performance and identify potential improvements. We encourage all consumers to raise any concerns they may have about care and or services they receive. The

CoMMents inCluDeD: • We feel lucky to have such

a great health service in our community. We have needed the emergency service several times for sick children/asthma.

• Tabloid format makes for easy reading. I was particularly impressed with profiles of Board Members and others involved in

feedback we receive is treated with the strictest confidentiality, entered into our electronic data recording systems and reviewed by our Quality Improvement Committee.

In 2012 TMHS circulated approximately 1,500 Quality of Care Reports to households throughout the Terang and Mortlake districts. To assist the

organisation to reach our goal to provide great care every time we encouraged feedback from readers also giving them a chance to win a Christmas hamper. The winner of the Christmas hamper was Mrs Anne Blacker from Mortlake.

Twenty two questionaries were returned. Feedback results are as follows:

the smooth running of this vital community asset.

• It is good to see locals we know with good photos and reports. We have always been treated well and with care at the Mortlake Health Service. We are lucky to have it.

• Great to read, full of information. Nice to see locals in the photo. Very well presented,

thank you.

• I found the report most informative and interesting in that so many locals are either employed or are volunteers. When my late husband needed hospital or doctor care in Melbourne some years ago we were very grateful to the volunteer drivers here in Mortlake.

terang Mor t lake Hea l th Ser v i ce16 – WeDNeSDAY, Oc tober 30 , 2013 Quality of Care report

with the school to procure the joint appointment of a speech pathologist. This allied health professional could then work on a regular basis with students requiring this service as well as servicing the needs of the broader community.

Craig Coates and his wife Pip have been Noorat residents for

four years. Between them they have six children and ten grandchildren, and moved to Noorat to be near to family in Camperdown. Before that Craig had lived in Cairns for 10 years, running a business involved with agriproducts. He settled in Noorat because he felt it was a welcoming place with a good atmosphere. Also, having lived on a dairy farm in Exton, Tasmania, the idea of a 5 acre block appealed to him.

Craig has had a lot of community involvement in the past. He was on the local council in Deloraine, where his main areas of involvement were parks, recreation and finance. He was a member of Rural Youth, serving as President and Secretary. He was a member of Deloraine Apex Club for 15 years and has also belonged to Lions and Rotary Clubs. His main sporting interest was squash, which he enjoyed playing for several years.

When asked if he was interested in joining the Health Services Board the idea appealed to Craig for several reasons. Having lived in Deloraine, a country community, he is aware of the necessity for people to be able to remain in a familiar environment when they get older. Services need to be available and this can only happen with the involvement of others. He also feels that he has had a good life himself, and this is a way of

giving something back to the community. He believes that his business experience together with the management courses he has done; mean that he has something to offer as a board member.

Improving our clients experienceBy 2015 we will provide consistently great care and services by asking ourselves and our clients, what can I do next?

Our challenge is to align the building blocks that

will lead to SUCCESS

PERSON CENTRED

CARE

EFFECTIVE APPROPRIATE

CARE

ACCESSIBLE, CONTINUOUS,

EFFICIENT CARE

SAFE CARE

PERSON CENTRED

CARE

EFFECTIVE APPROPRIATE

CARE

ACCESSIBLE, CONTINUOUS,

EFFICIENT CARE

SAFE CARE

feeDBaCk froM the 2012 QualitY of Care rePort