Protecting and growing our people

YEAR IN REVIEW 2019/2020

Front cover, from top left: NICU nurse Masieray Bangura, ICU orderly Bill Zammit, SRMO ophthalmologist Dr Andrew Kam, ICU Nurse educator Nitisha Kumar, Nursing and Midwifery graduate Jima Mokri. Inside cover: WSLHD Aboriginal workforce coordinator Caspa Tyson embraces her past at this scarred tree in Parramatta Park.

Copyright of Western Sydney Local Health District

ISBN 174 080 1733

2019/20 WSLHD YEAR IN REVIEWCONTENTS

WHAT WE DO 14

Our Health 15

Financial Sustainability 17

OUR SPECIALTY SERVICES 28

Mental Health (Cumberland Hospital) 29

Oral Health 30

Drug Health 30

Allied Health 31

Aboriginal Health 32

Integrated and Community Health 33

Population Health Key Activities 35 2019/20

COVID-19 6

COVID Care and Community 6

WSLHD acknowledges the Australian Aboriginal and Torres Strait Islander peoples of this nation. We acknowledge the traditional custodians of the lands on which our organisation is located and where we conduct our business. We pay our respects to ancestors and Elders, past and present.

WSLHD is committed to honouring Australian Aboriginal and Torres Strait Islander peoples’ unique cultural and spiritual relationships to the land, waters and seas and their rich contribution to society.

OUR PEOPLE 8

Our Patients and Community 9

Our Board 10

Our Executive 11

Our Staff 12

Staff Numbers 2019/20 13

OUR HOSPITALS 18

Westmead Hospital 19

Westmead Hospital Key Activities 21 2019/20

Auburn Hospital 22

Auburn Hospital Key Activities 2019/20 23

Blacktown and Mount Druitt Hospitals 24

Blacktown Hospital Key Activities 26 2019/20

Mount Druitt Hospital Key Activities 27 2019/20

APPENDIX 42

Glossary and References 42

INNOVATION AND QUALITY 36

Digital Health and Patient Safety 37

Research and Education Network 38

WSLHD Quality Awards 40

Above: Artwork by Leanne Tobin. Leanne’s artwork reflects the vibrancy and transitional motions of the dragonflies as they move through their journey of life.

4

Above: Multiplex project manager Jane Curran hands over the key to the Central Acute Services Building to WSLHD chief executive Graeme Loy,

supported by executive director, Health Infrastructure, Bruno Zinghini, and chief executive, Health Infrastructure, Rebecca Wark.

In the midst of a global pandemic Western Sydney Local Health District (WSLHD) staff demonstrated their incredible resilience, adaptability and above all, commitment to patients and each other.

There are many things that have made this year memorable – it’s been a time marked by infrastructure growth, impactful research, a renewed focus on staff wellbeing and crucial progress towards improving the health of our community.

The District introduced some significant projects and innovations throughout the year, including Western Sydney’s first home birth service, the launch of a new osteoarthritis clinic at Auburn Hospital, the delivery of 100,000 diabetes screening tests in our emergency departments, reaccreditation of Westmead Hospital Intensive Care Unit, the implementation of our primary school mobile dental program, and the introduction of the Horizons Group that is building stronger than ever relationships with clinicians and planning for a post-COVID-19 health system for WSLHD.

Our focus on Aboriginal health included increased support for Aboriginal women

and children, and the creation of an Aboriginal Health Advisory Committee. Our Aboriginal Health Strategy director Braiden Abala set the aim of improving our Aboriginal workforce representation from 0.9 to 2.5 per cent and purchased Darug artist Leanne Tobin’s piece Dance of the Dragonflies to brand all Aboriginal and Torres Strait Islander work across the District. A permanent tribute to the Stolen Generations was installed at Mount Druitt Community Health Centre.

The District remains a centre of research excellence, with highlights including a $1 million grant from Google for AI-boosted heart research led by Professor Clara Chow. The latest round of National Health and Medical Research Council (NHMRC) Investigator Grants saw more than $9 million awarded to our highest-performing researchers, in addition to millions of dollars in other NHMRC grants for specific projects. Research heavyweight Professor Jacob George has also received international recognition for his lifetime of work in hepatology.

The evolution of Blacktown Hospital continued with the opening of Blacktown Hospital’s Acute Services Building, as part of the $700 million

Blacktown and Mount Druitt Hospitals expansion project. The community now has access to a state-of-the-art facility with new services for emergency, birthing, newborn care, women’s health and intensive care.

The keys to Westmead Hospital’s Central Acute Services Building were handed over in May 2020, bringing world-class infrastructure to the Westmead Health Precinct. The 14-level building is the centrepiece of the Westmead Redevelopment project and includes two emergency departments and more than 300 patient rooms. Over an 8-week period we fast-tracked planning in case we needed to shift gears and open the new build as a COVID-19 hospital. This plan is fortunately not required but we stand ready to provide the care our communities need. Work was also completed on The Gathering Place, a safe and welcoming healing space for Aboriginal staff, patients, families and visitors. The building is set to open to patients in early 2021.

As the designated home of the NSW Infectious Diseases Unit, Westmead Hospital was the first in NSW to provide care for a COVID-19 patient in January 2020. Our expert staff

WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019FOREWORD WSLHD YEAR IN REVIEW

Commitment to our community

5

Above, from top: Auburn Hospital celebrates International Nurses Day.

Westmead nursing staff have upskilled clinical practice to be able to work

in ICU. WSLHD Interpreter Services and Blacktown Midwifery.

Professor Jeremy Chapman AC Board deputy chair

Graeme Loy Chief Executive

Richard Alcock AO Board chair

also travelled interstate and overseas to care for patients from the very beginning of the pandemic. Our COVID-19 clinics have tested more than 200,000 people in the District, and we embraced telehealth and video conferencing care models to keep services running without face-to-face contact. We provided home care for patients with COVID-19 and mobile screening for our vulnerable and high-risk populations. The District also provided nearly 10,000 interpreting sessions for returned travellers spending 14 days in hotel quarantine, and we were the first in the state to embrace video as the new standard for interpreter services.

Staff are the cornerstone of everything we do, and this year, WSLHD established a collective vision to create a workplace that celebrates diversity and success, and a place where all our staff feel safe, respected and supported. We continued building a workplace culture of listening to each other, with hundreds of staff sharing ideas at the district’s first Safety Symposium. We focused on staff wellbeing during COVID-19, with more than 5100 interactions via drop-in centres, coaching and ward visits, giving our staff a safe space to talk. The Wellness team thought outside the box to deliver innovative programs including staff meditation and mindfulness sessions.

In 2019/20, our mental health staff proudly supported regional communities during the bushfire crisis, with deployments to affected areas, and again rose to the occasion during the pandemic. Working with the State Health Emergency Operations Centre, they established a 24-hour service to provide rapid mental health assessments for people experiencing severe issues while in mandatory hotel quarantine, and we continue to provide this vital service to all returning residents and travellers in hotel quarantine.

The District also launched a revolutionary program for young people with severe mental health issues, supporting them with proactive follow-up care in the transition from hospital admission to the community, and established a helpline specifically for young people experiencing stress and anxiety related to COVID-19.

We look back on 2019/20 as one characterised by significant milestones and an incredible response to a global pandemic that has impacted on all of our lives. We are enormously proud of our staff for their tireless work and commitment to our community and look forward to a bright 2020/21.

WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019CHAIR, DEPUTY CHAIR AND CHIEF EXECUTIVE

“We look back on 2019/20 as one characterised by significant

milestones and an incredible response to a global pandemic that has impacted on all of our lives.”

COVID CAREAND COMMUNITY

Health gatekeepers12,000 people were screened daily by our “health gatekeepers” at the hospital entrances. Health screening stations were introduced on 7 April across the district to help protect everyone from the spread of COVID-19. Staff have been deployed from different departments including ambulatory surgery, oral health, geriatric units, COVID-19 wards and the casual pool.

First patient at WestmeadWestmead Hospital was the first in NSW to provide care for a COVID-19 patient in January 2020.

4024 elective surgery cases were performed onsite at WSLHD facilities from March through to June, and 1107 procedures were performed offsite at local private facilities (a total of 5131 cases performed over this time period).

This represents 29% of total combined (onsite + offsite) elective surgery activity for the 2019/2020 financial year. Given that there was a total service suspension and staged resumption during this time, this underlines the extraordinary effort to manage elective surgery output across WSLHD throughout COVID-19.

Elective surgery Since it became mandatory for travellers to spend two weeks in isolation upon arrival in Australia, the medical teams attending to thousands of people have had 24/7 access to WSLHD Health Care Interpreter Service and Mental Health Services.

24/7 access to services

107,801* COVID-19 tests involving WSLHD residents were reported up to 30 June 2020.

*Numbers limited to one test per person per day. The data for one person can be included multiple times across multiple days. Excludes tests carried out on confirmed cases after the date that they became confirmed as a case.

COVID-19 testing

Above, from left: Westmead JMO and COVID-19 clinic lead Brandon Verdonk. Clinical Nurse Specialist Nicola Cherry at Jeffery House COVID-19 testing clinic. WSLHD Rouse Hill COVID-19 pop up testing clinic. Swabbing technicians Eva Liu and Aarti Nair at WSLHD Western Sydney University COVID-19 pop up testing clinic. Right: Nakita Cosgrove wearing PPE preparing to test staff.

We have identified 201 residents as Aboriginal at Mount Druitt test clinics, giving an overall participation rate of 7.4%.

Aboriginal residents

We have conducted 2713 tests at Mount Druitt Hospital test clinics from opening on 8 April 2020 up until 30 June 2020.

Tests conducted

Our expert staff travelled interstate and overseas to care for patients from the very beginning of the pandemic.

Expert staff care

We have opened 18 COVID-19 screening clinics since March 2020, including several in response to local outbreaks originating from schools and churches.

Opened clinics

OUR PEOPLEOur Patients and Community 9

Our Board 10

Our Executive 11

Our Staff 12

Staff Numbers 2019/20 13

1

Right: Nurse Narelle Batley and security officer Thomas Pantelis at Mount Druitt Hospital.

9

One big familyWe are a tight-knit group of people from a range of countries and different backgrounds. Here is a snapshot of our hospital staff, patients, volunteers and community events. We are one big, colourful family, full of character and with big hearts.

Humans of the HospitalIf you’ve ever been to Auburn Hospital, then chances are you were greeted by the enthusiastic smile of Maged “Mags” Nessim.

Maged was an architect in Cairo, Egypt before immigrating to New Zealand in 1996 and Australia in late 2000.

He started working as a patient transport bus driver at Auburn Hospital in 2001, and in 2010 moved to the information desk where he spends his day guiding visitors, transporting files, sorting mail and generally bringing joy everywhere he goes.

Maged always tries to smile, because in his opinion smiling is the best way to make people happy. Seeing him

smile makes even nervous and anxious patients feel at ease. It creates a change in them straight away. Maged just loves helping people, it’s in his DNA.

He goes above and beyond for our patients and makes sure that everyone who meets him, leaves feeling appreciated.

His work has made him more patient and has given him a different perspective on life. It makes him happy and that shows in everything he does. Maged is the epitome of a beautiful human being.

His motto is that love is everything in life. That if we all tried to love everyone as much as we can, there would be no problems in this world.

Pocket RocketRosie the miniature schnauzer has to be our favourite little volunteer.

But don’t be fooled by her size, as the impact this Delta Therapy Dog has on our community outweighs her physical appearance by far. Rosie visits Westmead Hospital every second Tuesday, bringing cuddles and joy to our staff and patients.

Above, from left: WSLHD Integrated and Community Health Nursing and Clinical Governance director executive assistant Zuka Alber. Westmead patient Mamoud El Massiny with registered nurse Aileen Dalay. Eight-year-old Piya Sharma donating her own paintings to Blacktown Hospital.

Left: Nurse Kelani Finau, Julie McMaster from Delta Therapy Dogs, nurse Reesa Lim and Dr Laxmi Vasireddi with Rosie.

Auburn Hospital administration officer Maged Nessim.

“ His motto is that love is everything in life”.

OUR PATIENTS AND COMMUNITY OUR PEOPLE WSLHD YEAR IN REVIEW 1

10

Ex Officio

The following ex-officio Board members participate in agenda items relating to their areas of expertise:

WSLHD chief executive Graeme Loy

WSLHD executive director Operations Adjunct Associate Professor Robynne Cooke

WSLHD director finance Barry Mitrevski

Chair, Westmead Medical Staff Council Dr Mark Priestley

Chair, Blacktown and Mount Druitt Medical Staff Council Professor Mark McLean

WSLHD executive director Medical Services Dr Emma McCahon

WSLHD director Nursing & Midwifery, Clinical Governance, Adjunct Associate Professor Ms Caroline Farmer

Our BoardThe members of our Board are appointed by the NSW Minister for Health for a term of up to four years.

Mr Richard Alcock AO (Board chair)

Professor Jeremy Chapman AC (Board deputy chair)

Mr Andrew BernardMs Narelle Bell

Professor Donald NutbeamProfessor Michael Edye Professor Diana O’Halloran AO

Mr Adam Stuart

Adjunct Professor Debra Thoms

Ms Loretta Di MentoDr Keith Hartman AMAdjunct Professor Michael (Mick) Reid AM

10

OUR BOARDOUR PEOPLE WSLHD YEAR IN REVIEW1

Our ExecutiveThe members of the Executive Leadership Team support the chief executive to lead, direct and coordinate the operations and performance of WSLHD.

WSLHD chief executive Graeme Loy

WSLHD director Office of the Chief Executive

Tiffany Sly

WSLHD director finance Barry

Mitrevski

WSLHD director Nursing & Midwifery, and Clinical

Governance Caroline Farmer

WSLHD executive director Mental Health

Services Professor Vlasios (Bill) Brakoulias

WSLHD director Aboriginal Health

Strategy Braiden Abala

WSLHD director Corporate Communications

Sia Anthopoulos

WSLHD director People and Culture

Luci Caswell

WSLHD director Redevelopment

and Infrastructure Matt Sydenham

OUR EXECUTIVE OUR PEOPLE WSLHD YEAR IN REVIEW 1

Responsibilities of our Board and chief executive include:

• Improving local patient and population health outcomes and responding to issues;

• Delivering services and monitoring the performance of WSLHD against measures in the local health district service agreement including an agreed budget based on annual strategic and operating plans;

• Ensuring services are provided efficiently and responsibly;

• Production of annual reports that are subject to state financial accountability and audit frameworks;

• Maintaining effective communication with local and state public health stakeholders.

WSLHD director Allied Health

Jacqueline Dominish

WSLHD executive director Medical Services

Dr Emma McCahon

Westmead and Auburn Hospitals general manager

Rebecca Tyson

Blacktown and Mount Druitt Hospitals acting general

manager Ned Katrib

11

12

OUR STAFFOUR PEOPLE WSLHD YEAR IN REVIEW1

Our focus continues to be nurturing a positive and supportive workplace culture, supported through program offerings including building resilience, emotional intelligence, coaching community practice, proactive management of workforce issues and positively resolving workplace conflict.

The WSLHD People and Culture team has supported over 6000 staff through the COVID-19 pandemic, responding to required workforce changes. Workplace Wellness centres and information points across the District were established to support our workforce physically, psychologically and emotionally. The team provided information, facilitated team wellness sessions, offered coaching for managers, mindfulness meditation sessions, and drop-in visits to wards and units. Over 1000 staff were visited by a Workplace Wellness team member dressed in purple vests. More than 2000 staff accessed the wellbeing information points, over 500 mindfulness sessions were attended, and more than 500 manager-connect sessions were provided.

Our workforce To assist with workforce management, we created a new district-wide and multidisciplinary casual workforce pool, streamlined the recruitment and onboarding processes, and integrated with existing casual workforce pools and recruitment agency Randstad. The team implemented risk management of vulnerable health care workers and supported them with means including temporary staff accommodation, work-from-home arrangements and development, and implementation of new assessment and approval tools. To be able to respond to rapid change and reduce disputation, we also developed a streamlined Union Specific Consultative Committee (USCC) process and industrial consultation. Due to COVID-19 we saw temporary closure of some services and

we supplied HR support for the rapid redeployment of staff.

Leadership We launched the Manager Capability Framework to build organisational performance through leadership and management, this included the development capability pathways at foundational, intermediate and adept levels to support managers in leading quality improvements and change.

WSLHD is a registered training organisation for NSW Health and this year we supported the District with 70 graduates from the three nationally recognised qualifications on offer in Leadership and Management, and Health Administration.

Staff development We also achieved staff development outcomes with 70 staff being trained in Mental Health First Aid; more than 1000 staff completed the three Creating a Safe Workplace programs; and more than 380 staff completed the Building Resilience program.

WSLHD launched its Board-approved Culture Change Strategy and established the Culture Steering Committee, chaired by the CE, to drive progress against eight cultural priorities (each with an executive sponsor): wellbeing, bullying and harassment; keeping people informed and celebrating success; job satisfaction; strategic planning; recruitment confidence; high performance; diversity and inclusion; and staffing numbers, workload and overtime. WSLHD has engaged an external culture partner who together with a Culture Reference Group comprising staff representatives, will support Culture Change Management.

Our workforce still growing through 2019/20

10%Total growth of staff

4%Growth in staff aged under 35

3%Growth in staff aged 35-55

3%Growth in staff aged 55 and over

Above, from left: Westmead Hospital registered nurses Kate Maguire and Jessica Stracciari. Blacktown Hospital registered nurse Alisha Douglas. Auburn Hospital general services assistant Walid Assoum.

Our people matterOur exceptional staff have been the backbone of WSLHD and shown us their resilience and commitment during a challenging year.

STAFF NUMBERS 2019/20 OUR PEOPLE WSLHD YEAR IN REVIEW 1

1106ALLIED HEALTH STAFF

272ORAL HEALTH

PRACTITIONERS AND SUPPORT WORKERS

11,096TOTAL

1628MEDICAL STAFF

3

4

2

1

1883CORPORATE SERVICES

AND HOSPITAL SUPPORT

399SCIENTIFIC AND

TECHNICAL SUPPORT STAFF6

7

5

1047REMAINING STAFF

4761NURSING STAFF

1 Blacktown Hospital registered nurses Morgan Cansdale, Carl Torres, Jasmeen Jhundh and Jessica Dobson. 2 Mount Druitt Security team members Thomas Pantelis and Malek Taouk. 3 WSLHD Director of Nursing and Midwifery, Carol Farmer, attending a multidisciplinary meeting in the ward at Blacktown Hospital. 4 Westmead Hospital intensive care unit staff, Christine, Sherrie and Tracey-Lee, show their support for R U OK? Day. 5 Westmead Hospital Aboriginal liaison officer, Narelle Holden, and Cumberland liaison officer, Shai Grigg. 6 Linen service orderly Charlie Mercieca has worked at Blacktown for 30 years. 7 Westmead and Auburn hospitals librarians and technicians with cardiology fellow and PhD student Dr Siddharth Trivedi. Full time equivalent (FTE) data (including overtime) as at 30 June 2020 by Treasury Code. SOURCE: Statewide Management Reporting System.

2

Right: Westmead patient Ashleigh Powell (right) thanking staff after spending 4 months in hospital.

Our Health 15

Financial Sustainability 17

WHAT WE DO

15

About our residentsThe following insights provided by WSLHD Epidemiology and Health Analytics give us a historic insight into the health status of residents of WSLHD. We noticed a significant decrease in the rate of mortality caused by influenza and pneumonia as well as cardiovascular disease in the District.

Cancer Across all years of 2007 to 2016, the average incidence of cancer in males was 7.9% lower in WSLHD (548.1 cases per 100,000 population) than in the NSW males (591.3 per 100,000).1 The average incidence of cancer in females was 5.4% lower in WSLHD (399.8 per 100,000) than in NSW females (421.3 per 100,000).

From 2007 to 2016 the incidence rate of cancer in males in WSLHD and NSW dropped by 13.2% and 6.9%, respectively.1 However, females experienced an increase, by 14.3% and 8.7% in WSLHD and NSW, respectively.

From 2009 to 2018, mortality rates from malignant cancer decreased in both WSLHD and NSW, with a greater degree among males.2 In males, malignant cancer deaths decreased by 16.6% in WSLHD population (from 200 to 166.8 deaths per 100,000 population) and by 13.3% in the NSW population (from 217 to 188.1 deaths per 100,000). In females, malignant cancer deaths decreased by 14.4% in WSLHD (from 130.3 to 111.6 deaths per 100,000) and by 9.9% in the NSW population (from 137 to 123.4 deaths per 100,000).

CardiovascularCompared with the rest of NSW, the cardiovascular hospitalisation rate for WSLHD males was significantly higher and females of WSLHD was significantly lower, during the period of 2014-15 to 2018-19.2 From 2009 to 2018, in WSLHD

and its Local Government Areas (LGAs) as well as NSW, cardiovascular disease mortality rates showed a declining trend.

Mortality rates for heart failure are similar in WSLHD and NSW. During the period 2009 to 2018, the male and female mortality rates for both WSLHD and NSW showed slight declines.2 During the five years (2014 to 2018), WSLHD mortality rates for heart failure in males were comparable to the rest of NSW. In contrast, WSLHD mortality rates for heart failure in females were significantly lower than the rest of NSW.

RespiratoryThe rate of hospitalisations for respiratory disease among residents of WSLHD from 2009-10 to 2018-19 was similar to NSW showing an increasing trend.2

From 2009 to 2018, mortality rates for all respiratory diseases showed fluctuations in the female population and decreased in the male population.2 Deaths from respiratory disease occur at a higher rate in males. In WSLHD in 2018, the respiratory disease mortality rate in males (44.7 deaths per 100,000) was 19.7% higher compared to that in females (35.9 deaths per 100,000).

DiabetesThe rate of hospitalisations for diabetes as a principal diagnosis among residents

OUR HEALTH WHAT WE DO WSLHD YEAR IN REVIEW 2

Above: Westmead patient, Paul Molly, who fell from a ladder, and his wife, Betty Molly.

2019/20WSLHDKEY ACTIVITIES

Births in hospital

10,725

Hospital non-admitted patient services

(occasions of service)

2,947,370

Number of vaccine injections given in high schools

39,151

Ambulance presentations

54,983

References on page 43.

16

of WSLHD from 2009-10 to 2018-19 was similar to NSW showing a decreasing trend.2

In WSLHD population in 2018-19, the female hospitalisation rate for diabetes as a comorbidity was 3,979.7 per 100,000 population compared to 3,397.6 per 100,000 population for the NSW. In comparison, the male hospitalisation rate for diabetes as a comorbidity in WSLHD as of 2018-19 was 4,297.9 per 100,000 population compared to 3,974.2 per 100,000 population for NSW. Both NSW and WSLHD experienced increasing hospitalisation trends for diabetes as a comorbidity.

From 2009-10 to 2018-19:

• In most years, both male and female residents of WSLHD had significantly higher hospital separation rates of diabetes as a comorbidity than their NSW counterparts.

• In all years, hospitalisation rates for type 1 diabetes were lower in WSLHD residents compared to NSW.

From 2001-02 to 2017-18, trends of rates of diabetes-related deaths for both NSW and WSLHD were gradually decreasing.3

Age, Aboriginality and ethnic background In 2018-19, 35.6% of all hospitalisations in WSLHD were aged 65 years and over.

In 2016-17, the rates of hospitalisations for all causes were 37,104.6 per 100,000 population for WSLHD residents born in Australia and 20,429.2 per 100,000 population for those born overseas.4

From 2017-18 and 2018-19, 43.4% and 56.6% of hospitalisations for all causes were for residents born overseas and in Australia, respectively. Among WSLHD Culturally And Linguistically Diverse (CALD) residents, those born in India had the highest proportion (8.5%) of hospitalisations, followed by those born in Lebanon (7.4%), China (7.1%), United Kingdom (6.9%) and The Philippines (5.5%).

From 2018 to 2019, the proportions of WSLHD residents having their first antenatal visit before 14 weeks have increased from 58.2% and 72.4% in Aboriginal and non-Aboriginal women to 70.9% to 81.2%, respectively.5

OUR HEALTHWHAT WE DO WSLHD YEAR IN REVIEW2

Above: Westmead patient Melvin Beyers, with interns Hayden Andrerson, James Grogin and Vlad Danaila.

Other interesting statistics in 2018-19:2

• The rates of hospital separations caused by motor vehicle accidents is lower in WSLHD residents than NSW (181.2 per 100,000 vs 207.7 per 100,000 population);

• The rate of respiratory disease hospital separations between WSLHD residents and NSW residents is comparable (1,668.0 per 100,000 vs 1,691 per 100,00 population);

• The rate of potentially preventable hospitalisations (PPH) for vaccine-preventable conditions is higher in WSLHD residents (260 per 100,000 population) than NSW (189.7 per 100,000 population);

• The rate of hospital separations for all malignant cancers is lower in WSLHD residents (1,031.8 per 100,000 population) than NSW (1,264.9 per 100,000 population).

IN THE PERIOD OF ONE YEAR6

decreased considerably from 11.3 per 100,000 to 6.4 per 100,000 population compared to NSW (12.5 to 8.2 per 100,000 population), from 2017 to 2018.

The rate of mortality caused by influenza and pneumonia

decreased in females from 951.1 per 100,000 population to 933.6 per 100,000 population, from 2017-18 to 2018-19.

In WSLHD, the rate of PPH for chronic diseases in females

decreased from 145.1 per 100,000 population to 136.0 per 100,000 population which was notable compared to the decreased rate in NSW from 154.0 per 100,000 population to 152.0 per 100,000 population.

From 2017 to 2018, in WSLHD, malignant cancer mortality rate

References on page 42.

17

FINANCIAL SUSTAINABILITY

Doing the numbersAmidst the impact of the pandemic we continued the trend from last year of achieving commendable savings through better management of employee-related costs, and improved savings in purchasing supplies and services.

The total of WSLHD’s expenditure for 2019/20 was $2.14 billion. Employee-related expenses made up for 66.8% of that total. Replacing agency staff by permanent staff (especially in nursing areas) and reducing the use of contractors by 27 FTE assisted in better management of employee-related costs.

This financial year, we achieved a total of more than $5 million in additional savings in purchasing clinical and medical supplies as well as sourcing of corporate services. This represents a continuing trend from our previous year.

These results were achieved in light of a 5% increase in non-admitted patient services (occasions of service) and a 1% rise in births in hospitals. Dealing with the COVID-19 pandemic added additional pressure on staff and services across the District. The impact was managed through good planning and great teamwork.

Own-source revenue contributed $203 million towards funding health services. This is a reduction to the previous year of 1.5%, primarily due to COVID-19 as revenue from patient fees, car parking and commercial returns was severely impacted.

WSLHD cost per NWAU vs state In terms of Activity Based Funding (ABF) efficiency, the District is working with NSW Ministry of Health in analysing and understanding impact that COVID-19 has had on service delivery. Many services were curtailed even though staff remained on duty to deal with actual and preventative COVID-19 issues. This process is ongoing across all Local Health Districts.

Revenue

WHAT WE DO WSLHD YEAR IN REVIEW 2

Savings achieved in purchasing clinical and medical supplies and

in the sourcing of corporate services

$5m+

WSLHD expenditure

$2.014b

Own-source revenue that contributed to

funding health services

$203m

2019/20FINANCE STATISTICS

66.8%Employee Related

Expenses

Other Operating Expenses

26.6%

Depreciation and Amortisation

3.8%

VMOs2.3%

Grants and Affiliated Health Organisations

0.5%

72.5%Sales of Goods and Services

Other Revenue27.5%

Top five highlights

*Emergency Departments for WSLHD and Sydney Children’s Hospital - Westmead, hybrid and digital operating theatres, day surgery, inpatient beds and National Infectious Diseases Unit (NIDU). Overall footprint includes University of Sydney and Innovation Centre areas.

**Head count of 194 additional nurses were permanently recruited to fill vacancies across WSLHD. For financial year: 140.52FTE additional nurses were recruited to fill vacancies across WSLHD. This in turn decreased the need to use Agency nurses.

Completion of $1b Westmead Hospital Redevelopment including delivery of a brand new 14 floor Central Acute Services Building (CASB)*.

The CASB was made available by the contractor to WSLHD for early use as a COVID-19 facility on 4 May 2020, which was not required. This 83,500m2 building will be the centrepiece of the Westmead Health Precinct.

1

2

More efficient and affordable bed base which will aid in future budget management.

More than $5m in additional savings in procurement of clinical and medical supplies.

Replacement of agency staff by permanent staff, especially in nursing areas**.

4

5

3

Expenditure

3

Right: Westmead surgeon Dr Jay Chandra retired this year from clinical practice after being involved in ophthalmology since 1972 at Westmead Hospital.

OUR HOSPITALSWestmead Hospital 19

Westmead Hospital Key Activities 2019/20 21

Auburn Hospital 22

Auburn Hospital Key Activities 2019/20 23

Blacktown and Mount Druitt Hospitals 24

Blacktown Hospital Key Activities 2019/20 26

Mount Druitt Hospital Key Activities 2019/20 27

19

We are aiming highOnly the sky was the limit for the Westmead Redevelopment project with the early handover of the key to the tallest health building in Australia, the Central Acute Services Building (CASB).

WESTMEAD HOSPITAL OUR HOSPITALS WSLHD YEAR IN REVIEW 3

Above, from left: WSLHD chief executive Graeme Loy and NSW Health Minister Brad Hazzard walk through the new building. Partners in the CASB join the minister.

Another major milestone was celebrated in the Westmead Redevelopment project this year. NSW Premier Gladys Berejiklian confirmed major construction on the 14-level hospital had finished three months ahead of schedule. The Central Acute Services Building was made available by the contractor to WSLHD for early use as a COVID-19 facility on 4 May 2020, which was not required.

The new state-of-the-art hospital building is the centrepiece of the $1 billion-plus Westmead Redevelopment and is just one part of a once-in-a-century plan for a world-class multi-disciplinary campus to improve the lives of the people of Western Sydney and beyond.

It is the biggest health infrastructure project in the state and includes the Westmead Hospital redevelopments and stage 1 of The Children’s Hospital at Westmead. Construction works to the 14-storey Central Acute Services Building (83,500m2 including Innovation Centre of 8,400m2) has been ongoing and in accordance with the schedule program.

Completion and delivery of several departments as part of refurbishment works to the existing hospital included the Adolescent Young Adult unit on 5 March 2020, Transition Unit on

23 April 2020 and Gastroenterology on 10 June 2020.

Once fully operational, the CASB will feature:

• Two new emergency departments — one for adults and one for children;

• Digital operating theatres;

• Expanded imaging, pharmacy and logistics;

• More than 300 patient rooms (a high proportion of single rooms with dedicated carer zones);

• Education, training and research facilities on every floor;

• 1.5 floors for the University of Sydney to enable greater integration of education, research and health services delivery.

The CASB is a collaboration between Westmead Hospital, The Children’s Hospital at Westmead, the University of Sydney and Health Infrastructure.

“...major construction on

the 14-level hospital had finished three

months ahead of schedule.”

Above: Central Acute Services Building at Westmead.

20

Westmead’s flexible and versatile approach to COVID-19In early 2019, a series of Westmead Hospital ‘biopreparedness’ workshops helped staff plan the management of patients with an infectious disease, public health outbreaks and even biological terrorism. This knowledge was applied in January 2020, when the hospital received the first two cases in NSW of COVID-19 in the Intensive Care Unit.

In rapid succession the COVID ward as well as a COVID clinic attached to the ward were opened. Initially the infection control staff worked in the COVID ward to support staff and implement infection control processes. In March 2020, the need for a larger clinic was evident and two wards were established: one for confirmed cases and one for suspect cases. An area in the Emergency Department – the ‘hot-zone’ was created for patients suspected of COVID. Patients would be assessed and channelled straight to the hot-zone and transferred to the COVID wards. A lot of structural enhancements were made to maintain good infection control precautions.

Education is keyCOVID highlighted the need for additional training in precautionary processes such as hand hygiene, cleaning and use of appropriate Personal Protective Equipment (PPE).

We have provided a lot of reminder-education to staff and have developed a set of standard precautions, systems and processes that keep staff and patients safe.

The Infection Control Unit, NSW Bio-Containment team and nurse educators from REN provided education

on PPE and viral swabbing for the management of COVID. Multiple scenarios for management of COVID have been explored, such as working in high risk areas such as ICU and operating theatres and high-risk situations where close-up contact between staff and patients was required and in which we managed to keep everyone safe and on the same page.

Westmead Hospital was the first hospital in Australia to successfully culture the COVID-19 virus. Because of Westmead Hospital’s association with the ICPMR lab it was the first hospital initiating all the COVID tests.

GatekeepersIn April 2020, health screening stations at the entrance to all Western Sydney Local Health District (WSLHD) facilities were introduced to help protect employees, patients and visitors from the spread of COVID-19.

The screening staff - the “health gatekeepers” - have been deployed from different departments including ambulatory surgery, oral health, geriatric units, COVID-19 wards and the casual pool. All recruited staff receive ongoing training in customer service as well as training in containing COVID-19 spread. The screening process is not just about containing the virus. All arriving patients are being triaged and sent in the right direction via one of the eight screening stations.

On average 12,000 visitors, patients and staff were being screened and triaged daily for signs of the virus this year.

WSLHD has put lots of processes in place to make sure people are being screened in the fastest possible way and with the utmost respect and empathy towards each individual case. The screening stations have become part of everyday life at the hospital.

Daily a team of screening staff greets and screens the community and staff at the hospital entrances. The team provides customer services to each individual when being assessed for COVID-19 symptoms, ensuring the safety for each individual is being met through the efficiency of adhering to social distancing and providing surgical masks for their protection on arrival.

Since March of this year, Westmead Hospital Multicultural Health Services’ (WHMHS) dedicated staff have helped Culturally And Linguistically Diverse (CALD) communities understand countless COVID-19 messages and restrictions, with resources available in more than 22 languages. From the beginning of the COVID pandemic, Westmead Hospital Multicultural Health translation services worked long hours to ensure translated messages were available to our patients, consumers and communities.

OUR HOSPITALS WSLHD YEAR IN REVIEW3

Above, from left: Westmead clinicans Richard Halliwell, Rebecca Halliwell (CNE), Emma Halliwell (JMO). Andrew Moore ID screening at Westmead Hospital’s main entrance.

WESTMEAD HOSPITAL

For a full list of services, visit www.wslhd.health.nsw.gov.au/ Westmead-Hospital/Our-Services

Daily average number of patients seen by Westmead Hospital’s

COVID-clinic at the pandemic peak.

70 - 300

Total number of COVID-19 case admissions to Westmead Hospital since January 2020 including the

first and second wave.

80

WESTMEAD HOSPITAL KEY ACTIVITIES 2019/20 OUR HOSPITALS WSLHD YEAR IN REVIEW 3

1 Patient, Marjike Ryan, with nurses Rebecca Dadion (left), Joanne Cucio, and nurse educator Maridy Morrison (right). 2 Couple Ingrid and Karl welcome baby girl Arkadia in Westmead Hospital’s first home birth with the help of midwives Janice and Olivia. 3 Westmead Hospital food services staff remind people to stay at home during COVID. 4 Westmead Hospital’s newest physiotherapists. 5 Westmead Hospital radiation therapy deputy director Allana Mackertich. 6 Westmead Hospital ICU acting NUM Kazuyo Okuyama, Blacktown Hospital NUM Rossana van Meeuwen and WSLHD specialist dentist, Dr Avanti Karve. 7 Westmead Hospital midwifery unit manager, Florence Ong, with her celebratory flowers and thank you card. 8 Senior lecturer Dr Audrey P. Wang, ED director Rebecca Nogajski, PhD student Jake Rhodes, director Redevelopment and Infrastructure Matt Sydenham, clinical nurse Pamela Bold, ED director Dr Mathew Vukasovic and cardiology NUM Robbie Cruceanu celebrate the Westmead Redevelopment.

5261BIRTHS IN HOSPITAL

4

3

6

8

1

72,743EMERGENCY DEPARTMENT

PRESENTATIONS

20,157SURGERIES

89,945CENTRE FOR ORAL

HEALTH PATIENT VISITS

24,600AMBULANCE

PRESENTATIONS

2

5

7

22

Amazing improvements for AuburnWe saw ED waiting times reduced, were awarded full accreditation and received a huge response to the My Experience Matters survey.

Auburn Hospital was awarded full accreditation against the National Safety and Quality Health Service Standards in July 2019, with a range of quality improvements implemented to meet the standards. These improvements focused on ensuring patients, carers and consumers were engaged and involved in decision-making for the hospital, culminating in the establishment of the Auburn Hospital Community Council. Engagement with the local Aboriginal community was also central to these improvements, with the community invited into the hospital to review the welcoming environment and provide suggestions for improvement.

Training and education focused on ensuring staff could respond appropriately to deteriorating patients, with specific workshops held such as the Newborn Education and Skills Training workshop, in addition to regular mandatory and targeted training. We also focused on our patient experience through training for administrative staff in improved customer service and ‘asking the question’ to better identify Aboriginal and Torres Strait Islander patients.

We saw improvements in safety and quality with the trial of Treatment after Triage in the Emergency Department, resulting in improved access to care metrics and patient experience. The average length of stay in the ED reduced from 3h 06m to 2h 47m as earlier senior decision-making was executed. The implementation of a centralised model for antenatal assessments also saw an improvement in safety and quality, with the Auburn Maternity Assessment Clinic opening in November 2019. This not only improved the patient journey, but also more accurately documented patient care, resulting in a significant increase in revenue for the service.

Baby StepsFurther improvements in maternity services are underway with the Baby Steps program which began in 2019. Partnering with WSLHD’s Innovation & Redesign Team, the Baby Steps project commenced in August 2019 as part of the Agency for Clinical Innovation’s Centre for Healthcare Redesign Graduate Certificate Program. The aims of the project were to provide timely

access to specialised antenatal care and improve the patient experience at Auburn Hospital.

The preliminary outcomes of the project include:

• 15% of women commenced care at <14 weeks gestation;

• An increase of 8% in the number of women commencing antenatal care by 14-18 weeks’ gestation (from 39% to 47%);

• An increase in accurate referrals recorded in the iPM systems (94%);

• Greater than 3% increase in appointments.

My Experience Matters There has been a huge response from patients and carers this year, with 660 patients and carers providing feedback through the My Experience Matters survey during 2019/20, compared to 386 the previous year. There has been an improvement in all core questions from the previous year, with an average monthly score of 94 for ‘likely to recommend’ and 88 for ‘kindness and respect’. The overall patient experience score has increased from 84 to 88, which reflects the improvements made across the hospital.

AUBURN HOSPITAL

For a full list of services, visit www.wslhd.health.nsw.gov.au/Auburn-Hospital/Our-Services

Above, from left: Dr Kanan Shah VMO Anaesthetist at Auburn Hospital. Graduate midwives Thao-Vi Van, Danya El-baf, Sanjani Sharma and Tracey Brown Auburn CNE at Auburn Hospital.

OUR HOSPITALS WSLHD YEAR IN REVIEW3

“The overall patient experience score has increased from 84 to 88 which reflects the improvements

made across the hospital.”

AUBURN HOSPITAL KEY ACTIVITIES 2019/20 OUR HOSPITALS WSLHD YEAR IN REVIEW 3

3

5484AMBULANCE

PRESENTATIONS

6496SURGERIES

1395BIRTHS IN HOSPITAL

4

28,787EMERGENCY DEPARTMENT

PRESENTATIONS

21

6

5

7

1 Auburn Hospital midwives celebrate the launch of the new clinic. 2 Project manager Kelly Shadid rolls out the RIS system at the first site in NSW, Auburn Hospital. 3 Auburn Hospital ED resident Dr Anthony Ooi opens his new tablet. 4 Auburn Hospital midwives. 5 Auburn Hospital midwife Jawaher Masri. 6 Auburn Hospital director of nursing Kate Murphy, Auburn Clinical School head Prof Hadia Haikal-Mukhtar and Auburn Hospital director of medical services Chun Yee Tan. 7 Cumberland City Council Deputy Mayor Eddy Sarkis (left) and Mayor Steve Christou (centre) with Cumberland City Community Pride Award winners Kristina Roberts, Roseanne Smith, Barbara Chapman, Helen Sal and Alex Roberts from Auburn Hospital.

24

BLACKTOWN AND MOUNT DRUITT HOSPITALSOUR HOSPITALS WSLHD YEAR IN REVIEW3

Blossoming BlacktownWe moved into the new Acute Services Building, dealt with the threat of a global pandemic by adjusting our models of care and saw our staff adapt and collaborate and achieve remarkable things.

In August 2019, the completion and delivery of the newly designed and developed Stage 2 Acute Services Building took place as part of the $700 million Blacktown and Mount Druitt Hospitals Expansion Project. Transition into the newly developed Acute Services Building commenced in a staggered approach between 7 August 2019 and 29 August 2019. This saw the changeover into purpose-built spaces for the following departments: Emergency Department, reception area and atrium, Centralising Sterilising Services, Peri Operative Services (incl. theatres), Maternity and Women’s Health Services, Newborn Care and Birthing Unit.

Another remarkable achievement this year was the flexibility, adaptability and singularity of purpose all staff showed to ensure we were prepared to manage the pandemic threat. The rapid turnaround in which models of care were adapted, telehealth was increased and new ways of delivering care were adopted, was a significant feat. A clear sense of true engagement and collaboration by our staff was evident and helped achieve remarkable things.

BMDH launched a Behaviour Ultimate Management Plan (BUMP) project – to reduce the incidents of aggression, enhancement of the safety of patients, visitors and staff while addressing current behavioural management strategies including medications, use of specials (increased supervision), code black

responses, staff leave and management of incidents. BUMP project is in response to the increase in aggressive incidents involving patients who have identified with cognitive impairments.

COVID ResponseBMDH worked to develop a cohesive response plan to the COVID-19 pandemic. Each department facilitated its response which was collated into a robust plan and worked in conjunction with WSLHD response plans. BMDH successfully implemented a COVID-19 Clinic – seeing on average 220 patients a day. During the peak of the first wave, a COVID-19 (AMBER) Ward was implemented with availability to surge as required.

BMDH successfully adjusted the theatre footprint activity during the COVID-19 pandemic period and is now running above 100% to alleviate pressures of waitlists across the District. In doing so, partnerships with the private facilities have strengthened to maintain timely access to surgery and to continue waitlist reduction. BMDH performed a high number of endoscopy procedures at Mount Druitt operating theatres to address the Gastroenterology/FOBT growing waitlist demand.

UpskillingNurses benefitted from upskilled critical care techniques during COVID-19 and beyond. More than 210 nurses in Western Sydney have had Intensive Care Unit (ICU) refresher training to combat COVID-19 and help patients recover from the virus. The training focused on ventilation, chest x-rays, pneumonia, different medications and using different lines and pumps for treating people with COVID-19. This training is part of a $3 million investment by the NSW Government where more than 1,500 nurses across the state have been upskilled in ICU education and training.

Go-live for the purpose-built ICU was brought forward by two months during the COVID-19 pandemic to assure availability of ICU surge capacity and high-level care should it be required as the pandemic developed.

BMDH commenced Safety Huddles in the Emergency Department and Maternity Services with senior executive staff presence. This resulted in an increased awareness and focus on patient safety and provided consistency with Ministry of Health’s WH&S Better Practice Procedures.

In June 2020, ward 2A Mount Druitt Hospital was refurbished to accommodate the Paediatric Outpatient Clinics and allergy testing and became operational in July 2020. NSW State Budget allocated $100,000 to undertake the upgrades.

Above, from left: Clinical nurse educator Ellen Patiag at The Transition to Professional Practice Program graduation. Patient Maryam Shahrestani adds her thumbprint to the fingerprinting tree on her final day of cancer treatment with radiation therapist Madelyn Wuth.

“...we were prepared to manage the

pandemic threat”

25

SmartIn March 2020, a new smartphone app, BMDH Junior Medical Officer (JMO), was launched. It allows ease of access to procedural documents, moodle education, issues and scenarios for unexpected events and has an automatic dial pad to Switchboard. It gives JMOs the opportunity to study and continue learning during downtime on the ward.

MRIIn October 2019, Dr Raymond Damadian, inventor of the MRI, visited Blacktown Hospital.

During this recent tour, Dr Damadian officially launched the WSU and BMDH partnership which has created a University degree (masters in advanced MRI) which is only run through Blacktown Hospital.

Get Healthy in Pregnancy (GHiP)The GHiP Program is a collaborative partnership between Women’s Health Clinic and Health Promotion, which has resulted in delivery of high-quality health care during pregnancy. The aim of the intervention is to support women to have healthier pregnancies and increase the number of referrals to meet the Key Performance Indicator (KPI) goal. In WSLHD, 42.4% of women are overweight or obese during pregnancy which increases the risk of complications (HealthStats NSW, 2019).

GHiP is a free telephone coaching service that supports women in NSW to manage their weight and choose a healthier lifestyle during pregnancy. As of April 2020, Blacktown Hospital referred 402 women to GHiP, exceeding the target KPI of 324 referrals.

2019/20BMDHSTATISTICS

Women referred to GHiP by Blacktown Hospital

as of April 2020

402

BMDH patients who quit smoking in the

first half of pregnancy

28%

Nurses in Western Sydney who have had

Intensive Care Unit refresher training

210+

Above, from left: Mount Druitt security officer Malek Taouk with general service staff Christine King . Mount Druitt palliative care patient Debbie Pearson with volunteers Anne Goncalves and Ilgun Huseyin.

For a full list of services, visit www.wslhd.health.nsw.gov.au/ Blacktown-Mount-Druitt-Hospital/ Our-Services

BLACKTOWN AND MOUNT DRUITT HOSPITALS OUR HOSPITALS WSLHD YEAR IN REVIEW 3

Quit Smoking in PregnancyThe BMDH Women’s Health team continues to provide advice and support to pregnant women to quit smoking. In 2019/20, 32% of women quit smoking during their pregnancy, with 28% quitting in the first half of pregnancy. This is a significant improvement from last year and higher than the NSW state average of 19% of women quitting smoking in the first half of pregnancy (NSW Mothers and Babies 2018).

Quitting smoking in pregnancy is one of the 5 evidence-based practices of the Safer Baby Program, which aims to reduce the rate of stillbirth after 28 weeks’ gestation by 20% by 2023. WSLHD is involved in the research arm of the Safer Baby Program and among the first services in NSW to deliver the program.

WatchListIn February 2020, a digital initiative ‘The WatchList’ was successfully implemented at Blacktown Hospital. The innovative new system makes paper prescriptions a thing of the past, with patients’ discharge medications sent directly to pharmacists. This will result in patients being discharged from hospital sooner, with processing time decreased from 105 minutes to 76 minutes compared to the same period during 2017/2019.

Audits at Blacktown Hospital during 2018/19 highlighted an average discharge medication processing time of 105 minutes, with primary causes of delay:

1 No notification of prescription being generated (29.5% of scripts).

2 Manual transportation of prescription from place of printing to Pharmacy taking 38 minutes.

Watchlist is a nationally first-of-its-kind in a public hospital solution to improve the discharge medication process and was piloted by Western Sydney Local Health District (WSLHD).

4069BIRTHS IN HOSPITAL

9741SURGERIES

13,675DENTAL CLINIC PATIENT VISITS

1

5

8

55,829EMERGENCY DEPARTMENT

PRESENTATIONS

18,706AMBULANCE

PRESENTATIONS

1 Wanderers stars crash Blacktown Hospital Christmas party and pose for a photo with registered nurse Jessica Wyld. 2 Blacktown Hospital aged care ward nurses Monique Perry and Logan Muddle. 3 Blacktown Hospital’s clinical nurse educator Nitisha Kumar (left), registered nurses Samjhana Kunwar and Vinaychandra Tevani (right). 4 Blacktown Hospital medical officer Dr Usama Munir is first recipient of the Santosh Rampersad Memorial Award. 5 Blacktown Hospital general manager Ned Katrib, Medical Imaging operations director Dr James Nol, radiologist Andrew Jones and physiotherapy head Ian Starkey. 6 Tabbetha Senior was the first patient treated in Blacktown Hospital’s new ED in August 2019.

2

3

6

4

BLACKTOWN HOSPITAL KEY ACTIVITIES 2019/20OUR HOSPITALS WSLHD YEAR IN REVIEW3

MOUNT DRUITT HOSPITAL KEY ACTIVITIES 2019/20 OUR HOSPITALS WSLHD YEAR IN REVIEW 3

35,906EMERGENCY DEPARTMENT

PRESENTATIONS

5

6193AMBULANCE

PRESENTATIONS

4157SURGERIES

3

6

1

4

2

1 Mount Druitt palliative care patient Debbie Pearson (left) with volunteer Anne Goncalves and RN Anne May. 2 WSLHD Aboriginal Health Strategy director Braiden Abala, Aboriginal elder Aunty Zona Wilkinson and Aboriginal Health Services manager Belinda Cashman unveil the remembrance stone at the Mount Druitt Aboriginal Health Hub. 3 Staff at Mount Druitt Hospital during RU OK? Day. 4 Rita Wright planting trees at Mt Druitt Aboriginal Health Hub Sorry Day ceremony event to pay tribute. 5 Mount Druitt security officer Thomas Pantelis. 6 Two Mount Druitt-based teams from Burbaga Burawa at the Aboriginal Health Knockout Challenge presentation ceremony.

4

OUR SPECIALTY SERVICESMental Health (Cumberland Hospital) 29

Oral Health 30

Drug Health 30

Allied Health 31

Aboriginal Health 32

Integrated and Community Health 33

Population Health Key Activities 2019/20 35

Right: Mental health registered nurse Rhiannon Lance holding a WSLHD Healing Heart sticker.

29

MENTAL HEALTH (CUMBERLAND HOSPITAL) OUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW 4

Mental HealthWSLHD-MHS provided COVID-19 rapid response mental health support for quarantined travellers in Sydney hotels. People returning from overseas are required to be quarantined within hotel rooms and are not allowed out of their room for 14 days. WSLHD-MHS developed its own model and guidelines and has worked closely with HCA and the SHEOC to provide a 24-hour service and to ensure that returned travellers remain safe and have access to expert mental health care when required.

Since April 2020, over 40,000 people have been quarantined. Our specialised mental health team has provided rapid mental health support to people experiencing severe mental health issues such as stress, anxiety, depression, suicidal thoughts, self-harm behaviour, homicidal thoughts and relapse of pre-existing psychiatric disorders. The MHS has provided over 502 hours of clinical care, 217 hours of face-to-face assessment, counselling and support, and 42 hours of psychiatric consultation to the clients and HCA clinicians. In that past six months 58 males and 53 females benefitted from our Rapid Mental Health Support; completed the hotel quarantine and returned to their families and community safely.

WSLHD has launched a free mental health phone service, called COVID-19 Let’s Talk. It provides advice and help for children, teenagers, carers and adults who require counselling and support to deal with stresses and lifestyle changes caused by the COVID-19 pandemic. The pandemic has led to changes to our normal practices including self-isolation, physical distancing, remote learning and job changes, which may cause distress. ENABLE was funded by a $663,000 NSW Health grant to enhance community provision of mental health services. It is part of the $166.8 million WSLHD budget allocated to mental health

treatment in the 2019/20 budget.

A new mental health program called

Engaging Assertively and Building Links

to Empower (ENABLE) was rolled out by

WSLHD. It is designed for young people

with severe mental health issues including

self-harm, acute suicidal ideation, mood

disorders and psychosis. This program aims

to tackle the barriers to leaving hospital by

providing patients with up to 10 weeks of

assertive, daily follow-up care while they

transition out of hospital back into their

regular lives. This revolutionary approach

supports young people with tailored

mental health care in their own homes.

Mental health is a top concern for new Australians. In a quest to improve

communication with people from different

backgrounds we need to think outside

the box and consider different options

such as images, interpreters and bilingual

healthcare workers. The MHS has worked

collaboratively with the TMHC seeking

regular clinical cultural consultations

for consumers, carers and families from

migrant and refugee backgrounds who are

connected with community mental health

teams and inpatient facilities. The TMHC

works with a broad range of WSLHD

mental health teams from perinatal mental

health services right through to older

persons’ mental health services to get

the best outcomes.

A ‘welcome’ poster has been developed

and implemented to engage migrant and

refugee communities who enter mental

health services. TMHC’s multilingual

multimedia resources (available online

and in hardcopy) provide additional

in-language information to consumers,

carers and families and information on

their website and webinars support and

assists local services with their ‘COVID-19

Pandemic Mental Health Response &

Planning for Culturally Diverse Settings’.

Above, from left: People & Culture team in purple vests provide support to staff who may be feeling overwhelmed by COVID-19 and workplace changes. Organisational development consultant and Workplace Wellness team co-leader Shari Hendricks. Workforce training coordinator David Johnson.

2019/20MENTAL HEALTH KEY ACTIVITIES

Service events

168,176

Admissions

4587

Hours of face-to-face assessments, counselling

and support

217

30

Oral HealthThe Oral Health team responded to the COVID-19 pandemic service restrictions by adapting the service and introducing a remote model of care. During the height of restrictions on dental practice, patients were able to speak to a dentist over the phone for advice, prescription of antibiotics or pain relief, and options for emergency care, with clinics averaging 1500 individual phone consultations per month. As the restrictions eased, the Oral Health Service continued to incorporate telehealth options into the service, including provision of vouchers to access care with a private practitioner, for those requiring less complex care.

The ‘My Virtual Care’ system has been introduced to add video capabilities to this telehealth service, initially as a collaboration with the Healthcare Interpreter Service. A total of 4,297 telehealth consultations were performed up to 30 June 2020, with a total number of individual telehealth consultations of 7,756 at the end of September 2020.

Meanwhile, a project to expand and improve the function of the dental laboratory has been completed. Digitisation and use of in-house milling systems has simplified laboratory procedures and enhanced patient care. Multiple workstations are now available for the planning, printing, milling and processing of a range of dental products, with the new equipment expected to provide a reduction in ongoing laboratory expenses.

Drug HealthThe Drug Health Service in WSLHD continues to grow and evolve. 2020 has seen the go-ahead for two important initiatives funded by NSW Health: the Assertive Case Management and Substance Use in Pregnancy Services. These new teams will work across the service and LHD to provide better care to patients with complex needs and those who are pregnant or have young children respectively.

Our research program continues apace with important clinical implications. The successful trial of subcutaneous buprenorphine for opioid dependency has been followed by the wider rollout of this new form of an established medication. It has led to significant improvement for many of our patients in employment and stability in treatment. It also is a more efficient use of resources and will allow us to treat more patients as we face a growing population.

Other relevant clinical trials include the LiMA study using lisdexamfetamine/placebo to treat methamphetamine use. This trial, like many others, had

to suspend recruitment due to

COVID-19 but is now open again to new patients who suffer from methamphetamine dependency.

One of the most visible parts of the service is the Consult Liaison Team. 2020 has seen a greater presence of this team of nurses (now with a full complement of CNS’s and CNC’s) and doctors in Cumberland, Mt Druitt and Auburn Hospitals. For many of our patients, contact with this team is an important first step towards longer term, evidence-based care.

Towards the end of 2020, the new restructure of WSLHD places the Drug Health Service in a more independent model that allows reporting directly to the LHD executive. Our service will have a greater degree of autonomy and a corresponding increased responsibility for clinical and corporate governance. Ultimately this should lead to an enhanced ability to provide better quality care and to work more cohesively with other services across the LHD. We aim to anticipate and respond to emerging challenges in patient presentation and wider public health issues related to substance use.

ORAL HEALTH, DRUG HEALTHOUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW4

Above: Mount Druitt Oral Health Clinic dental assistant Simona Stan with volunteers Emily Jancek, Pritz French, Maria Vergara and Josefina Balite.

“At Oral Health a total of 4,297 telehealth consultations

were performed.”

31

ALLIED HEALTH OUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW 4

Allied HealthAllied Health has had a productive year in Western Sydney with the 1355*-strong workforce coming together to celebrate key achievements in clinical practice, research and identifying a clear direction for the next few years to improve the health of the people of WSLHD.

The WSLHD Allied Health Strategic Plan 2019/2022 was launched, setting the direction for the Allied Health workforce in WSLHD until 2022. Value-based health care and responding to the needs of vulnerable patient groups form the key focus of this plan. These patient groups include those with a disability, mental illness and our richly diverse population including Aboriginal people and those from Culturally And Linguistically Diverse backgrounds.

The Allied Health workforce has continued to work in partnership with patients, carers and our medical and nursing colleagues to focus on models of care and interventions that are proven to work and let go of things that are of low value and minimal benefit to patients and the organisation.

The COVID-19 pandemic saw the Allied Health workforce mobilise rapidly with targeted strategies developed and implemented by the Allied Health Executive Team to ensure we were able to respond to the rapidly changing environment.

This included achievements such as:

• Upskilling 34 physiotherapists to work in Intensive Care through completion of the Australian

Physiotherapy Association Critical Care Training;

• Immersion and simulation of physiotherapy staff in ICU to be ready to respond to demands including standing up off mobile proning teams;

• Initiation of a COVID-19 Allied Health Casual Pool recruiting and onboarding an additional 41 Allied Health staff to assist with service cover and response to demand surges;

• Allied Health clinicians across all professions in the large facilities undertook additional training to brush up on core clinical observational and screening skills to be ready to assist nursing and medical staff if required.

On 14 October 2019 marked the inaugural International Allied Health Professionals Day - an annual celebration of the range of specialised health professionals who provide therapeutic and diagnostic services across Western Sydney Local Health District (WSLHD). The day was celebrated with morning teas across the District, staff and patients proudly sporting purple Allied Health stickers promoting Allied Health as partners in care.

GrantsIn 2019 six staff from Western Sydney Local Health District (WSLHD) have each received a $5,000 Allied Health research kickstarter grant to undertake new research in collaboration with researchers from the University of Sydney. The grants will be applied to a variety of Allied Health-led projects. The funds are provided by WSLHD, Research and Education Network, Faculty of Health Sciences and the University of Sydney.

Congratulations to the following clinicians:

• Dragana Ceprnja – Health educator and senior physiotherapist at Westmead Hospital

• Sarah Driscoll – Senior dietitian, Blacktown Hospital

• Logan Harvey – Clinical psychologist, Drug Health

• Hannah Kim – Pharmacist, Westmead Hospital

• Veronica Mok – Clinical dietitian, Westmead Hospital

• Jessica Tam and Alison Battin – Speech Pathology, Westmead Hospital

Above, from left: Speech pathologist Patricia Webb proudly displays an Allied Health sticker. Podiatrist Nada Bechara, dietitian Navnita Chetty, training coordinator Reggie Daguio and dietitian Sanzida Rashid. Westmead Allied Health Kickstarter recipients, from left to right, front row, Jacqueline Dominish, Veronica Mok, Logan Harvey, Sarah Driscoll, Prof Vicki Flood, back row, Dragana Ceprnja, Katherine Maka, Jessica Tam.

*1355 individual staff as at 30 June 2020

32

ABORIGINAL HEALTHOUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW4

Across the District we invited Aboriginal health workers and liaison officers to take up training through TAFE to become Aboriginal and Torres Strait Islander Health Practitioners (ATSIHPs).

ATSIHPs have a Certificate III Level qualification and are registered with Australian Health Practitioner Regulation Agency (AHPRA). It is the first time the staff of WSLHD were invited and engaged in this course, with four health worker staff who are participating in the program and are due to finish their studies at the end of 2020. We are also in the process of finalising a role for a lead ATSIHP for the District.

WSLHD has for the first time been fruitful in securing five Aboriginal Allied Health cadets for the district. These cadets are in the process of finalising their respective degrees in Occupational Therapy, Physiotherapy, Radiography and Speech Therapy. Additionally, through an ongoing process, WSLHD has three Aboriginal nursing and midwifery cadets. WSLHD will be welcoming all the cadets into our workforce upon successful completion of their degrees.

WSLHD submitted an expression of interest with the NSW Aboriginal Population Health Training Initiative (APHTI). Generally, only four APHTIs are allocated around the state each year, however the WSLHD submission successfully locked in two positions, a first for the District. The two APHTI roles will undertake a three-year program, which will consist of working for WSLHD while completing a Master of Public Health qualification.

As well as the APHTIs, WSLHD this year was successful at recruiting our very first Aboriginal Health Service Management intern, who has successfully completed her first year. The Health Service Management interns undertake a two-year program, which will consist of working for WSLHD while completing a Master of Health Service Management,

through a collaborative arrangement with the University of Tasmania.

WSLHD has engaged with southwest Sydney and Nepean Blue Mountains for the Greater Western Sydney (GWS) Health Partnership with a focus to collaborate, promote and advocate to achieve better health outcomes for the region’s communities. This is an acknowledgement that GWS is the fastest-growing region in Greater Sydney and includes the largest population of Aboriginal people in this region, state and country. That number is growing, and we will end up with about 2.5% Aboriginal population within this region in the next 20 years.

One of the priorities acknowledged in the GWS health partnership, is the development of the first Aboriginal Health Academy in Sydney, for Aboriginal and Torres Strait Islander students. WSLHD is taking a lead role in this initiative and we are keen to progress the development of the academy over the coming year.

Increased support for Aboriginal women and childrenThe Aboriginal Maternal and Infant Health Service (AMIHS) antenatal clinic continued to grow with access to a range of antenatal, postnatal and other services including Smoking Cessation, Drug Health, Population Health, Diabetes, Centrelink, Police, Housing and NGOs including Greater West Aboriginal Health Service & Marrin Weejali. AMIHS has also increased utilisation of Pregnancy Family Meetings and Aboriginal Family Planning Circles

to support Aboriginal families to take their babies home safely.

We saw Aboriginal Health Services working with Western Sydney Diabetes and Blacktown Hospital High Risk Pregnancy and Gestational Diabetes Clinics to develop a gestational diabetes program for pregnant Aboriginal women. This includes options for an outreach high-risk pregnancy clinic at the Aboriginal Health Hub.

The first stages of capital works projects to create an Aboriginal Health Hub have been completed. This includes improved and expanded clinic spaces for AMIHS antenatal clinic and a new Child and Family Health Clinic; a new conference space and meeting room for all the community to access. Work also started to establish a memorial garden for those from the Aboriginal community who have passed away and who have made a significant contribution to their community. A start was made on the establishment of a birthing garden to acknowledge the importance of the next generation to the Aboriginal community with a special section to honour those Aboriginal babies who have passed.

Permanent tribute to Stolen GenerationAboriginal children who were forcibly taken from their families will be remembered with a special memorial by Western Sydney Local Health District (WSLHD), which was unveiled on National Sorry Day in May this year. The remembrance stone and memorial garden at Mount Druitt Aboriginal Health Hub will be a permanent place for patients, visitors and staff to reflect on past wrongs and also remember anyone from the Aboriginal community who has passed away.

A year of many firstsAbove, from left: WSLHD Aboriginal Health Strategy director Braiden Abala unveils remembrance stone at the Mount Druitt Aboriginal Health Hub. Aboriginal Elder Brendan Kerin from the Local Metropolitan Aboriginal Lands Council conducts a smoking ceremony at Blacktown Hospital.

33

INTEGRATED AND COMMUNITY HEALTH OUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW 4

Above: Westmead Physiotherapist and Osteoarthritis Chronic Care Program coordinator Natalia Ghosn conducting a virtual consultation. Patient Daniel Seipel during an online appointment. Dr Geoffe Mifsud attending to his patients via video conference.

Virtual appointments increaseICH has collaborated with many different services before and during the pandemic and has been supplying our WSLHD community with the best possible support.

Following the Expression of Interest in October 2019, Western Sydney Local Health District (WSLHD)/Western Sydney Primary Health Network (WSPHN) successfully secured funding to develop and deliver three Models of Care (MoC). These models are co-designed with clinicians, consumers and carers to create greater integration of care in the community and address the issue of rising demand for acute hospital care – ‘Value Based Urgent Care, Cardiology In the Community and Rapid Expansion of Care In the Community’.

Pandemic responseTo ensure the safety of our staff and the community, as part of ICH’s response we significantly increased the percentage of appointments delivered via telehealth across all of our services.

28% of ICH services were delivered virtually during the pandemic period, peaking at 34% in May 2020.

During February 2020 Western Sydney Diabetes (WSD) shifted all services (including hospital clinics and Joint GP-Specialist Case Conferencing (JGPSCC)) from face-to-face to telehealth. More than 2,000 occasions were seen via virtual care from February – June 2020 in the diabetes service.

Chronic & Complex Services also pivoted to provide support during the COVID-19 pandemic. They offered

strategies such as development of community outreach swabbing for vulnerable and at-risk community members unable to access testing clinics. They also supported pop-up COVID-19 testing clinics; and provided support to at-risk and isolated members of the community suspected of having COVID-19.

The Public Health Unit developed and implemented an education and training module to surge workforce training for COVID-19 contact tracing, in partnership with Research Education Network, Notre Dame University and Western Sydney University. It has also launched a Public Health COVID-19 surveillance and response plan for Aged Care Facilities (ACF) and developed and implemented the COVID-19 Safety Checklist Inspection Program. This included a plan to review and prioritise education and support for local businesses, plus the launch of

a WSLHD Community Sports COVID-19 safety survey.

Youth Health Service (YHS) developed strategies to provide outreach services for homeless people across the District working. It worked closely with the Specialist Homeless Services in the District to provide information and resources as well as clinical services. YHS provided a number of pop-up screening clinics for homeless and at-risk people. These clinics provided COVID-19 screening and testing as well as delivering around 800 flu vaccinations.

ICH further supported the community through the pandemic by providing over the phone care to community members who have been tested COVID-19 positive. The ICH team provided care to over 360 patients, made over 4500 calls in 30 different languages to people during their 14 days of isolation, and provided clinical assessment and review for COVID-19 positive community patients.

“More than 2,000 occasions were seen via virtual care from Feb – June 2020 in the

diabetes service.”

the pandemic period, peaking at 34% in May 2020.

28% of ICH services were delivered virtually during

34

Collaborative Commissioning is a whole-of-system approach designed to enable and support the delivery of value-driven, outcome-focused and patient-centred health care in the community. The innovative nature of this initiative also allowed us to provide a unique Western Sydney Response-Rapid Response: Care in the Community for COVID-19.

Collaborative Commissioning ModelCollaborative Commissioning leverages the principles of the Quadruple Aim by developing pathways of care tailored to the community’s needs. It aims to incentivise local partnerships for integration across the entire continuum of care, embedding local accountability to deliver value-driven, outcome focused and patient-centred health care.

In partnership with Western Sydney Local Health District (WSLHD), we have been successful in our joint proposal to the NSW Ministry of Health for three new models of care: Cardiology in the Community, Value Based Urgent Care and Rapid Response: Care in the Community for COVID-19.

The models are being co-designed by GPs, specialists and consumers.

They are supported by the Patient Centred Collaborative Commissioning Executive, co-chaired by our Chief Executive Officer, Ray Messom and the Chief Executive of WSLHD, Graeme Loy. To achieve the vision of collaborative commissioning, it is imperative that there is a significant investment in primary care to design, enable and

support the delivery of value-based health care in the community.

Patient Centred Medical Homes play an integral role in progressing these new models of care. Evidence from around the world shows that practices operating as a true patient centred medical home are well positioned to deliver the right care, in the right place at the right time. The opportunity to invest in primary care transformation in Western Sydney has never been greater.

INTEGRATED AND COMMUNITY HEALTHOUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW4

Collaborative Commissioning

“The aim is to deliver the right care, in the right place at the right time.”

Above: Graeme Loy and Ray Messom.

65

4

1

4143WESTERN SYDNEY

DIABETES SERVICES

43,415INTEGRATED CARE

SERVICES

37,352PRIORITY POPULATION

SERVICES

258,428COMPLEX AGED AND

CHRONIC CARE SERVICES

134,196CHILD AND

FAMILY SERVICES

3

7

477,534OCCASIONS OF SERVICE

TOTAL

1 Registered nurse Joseph Toussaint supplied and maintains a six-foot, 400-litre tank home to more than 70 exotic, colourful fish in Blacktown Hospital’s Bungarribee House. 2 The Westmead Applied Research Centre led by Professor Clara Chow was awarded Australia’s inaugural Google.org AI (artificial intelligence) Impact Challenge prize. 3 Jon Iredell is a senior staff specialist in infectious diseases and microbiology at Westmead Hospital. 4 ENABLE graduate Hiro Kojo shows off one of her paintings to the Minister for Mental Health Bronnie Taylor. 5 eMEDs senior clinical analyst Lucy Lin, Dr Jovana Stojkov, eMEDs manager Liz Ellankil and pharmacy director Amy Murray. 6 Professor Howard Lau at the controls of a robot during Australia’s first robotic kidney transplant. 7 Dr Mark Tracy, Christina Maher, Krista Lowe, Matt Boustred and Matthew Crott have developed a device that will precisely monitor the supply of oxygen during the resuscitation of newborns.

2

POPULATION HEALTH KEY ACTIVITIES 2019/20 OUR SPECIALTY SERVICES WSLHD YEAR IN REVIEW 4

5

INNOVATION AND QUALITY

Right: NSW Pathology medical officer Dr Yalda Hakemi.

Digital Health and Patient Safety 37

Research and Education Network 38

WSLHD Quality Awards 40

37

WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019WSLHD EXECUTIVE COMITEE 2019

Above, from left: eMEDs senior clinical analyst Lucy Lin, Dr Jovana Stojkov, eMEDs manager Liz Ellankil and pharmacy director Amy Murray check out the new system. From left to right ED Auburn’s Clinical NUMs Naresh KC and Jodie Burke and nurse Emily Godden.

DIGITAL HEALTH AND PATIENT SAFETYINNOVATION AND QUALITY WSLHD YEAR IN REVIEW5

Digital Health and Patient SafetyIn 2019/20, Auburn ED nurses were the first in NSW to successfully implement the new Cerner FirstNet tracking system, known as LaunchPoint, and use Dynamic Documentation templates to record nursing assessments.

The implementation also aimed to standardise best clinical practice and documentation across the LHD’s 4 Emergency Departments (EDs). This major upgrade to the FirstNet tracking board provided the opportunity to assess the decade-old system in light of current technology and workflows. The hope was that the upgrade would redefine how ED nurses interact with the Electronic Medical Record (eMR).

Nursing staff have been extremely receptive to the change process and the uptake of LaunchPoint and dynamic documentation assessment templates has been phenomenal.

The implementation process has been extremely smooth, with a 93% training completion rate from ED nurses. They have felt supported and prepared for the change due to the comprehensive eMR training. This has resulted in minimal post go-live support required by nurses.

Another NSW Health initiative is a program called ‘Watchlist’, a digital platform launched at Blacktown Hospital piloted by Western Sydney Local Health District (WSLHD).

This Australian-first initiative was developed and implemented in early 2020 by the BMDH Pharmacy department and the WSLHD eMEDs team to improve the processing time of discharge medications*.

Prescriptions now reach pharmacists instantly and they are automatically notified, saving nearly 40 minutes per patient on average. It also means pharmacists have more information about the patient and more time to speak with them about their medications, including what may have changed since before they were admitted to hospital. This will help to avoid confusion, address any concerns and lower the risk of them returning to hospital due to an avoidable medication error.

WatchList also grants status updates at each stage of the dispensing process, which is viewable by all medical, pharmacy, nursing, midwifery and clerical staff. Currently this is handled by a different application, so it reduces the number of programs required for the discharge process.

*Baseline audit has shown the average processing time for discharge medications is 105 minutes. Introduction of WatchList saw this number drop by 29 minutes (28%) to 76 minutes within the first 6 weeks.

LaunchPoint advantages

Automatic presentation of nursing documents to the tracking board;

Quick-find systems via hyperlinks back to the patient record. Less clicks;

Expandable tracking board rows provide quick and easy access to patient information;

Visual reminders for overdue medications, vital signs, pathology and radiology tests;

The simplified tracking board view calls attention to critical patient information.

LaunchPoint-training completion rate from

ED nurses

93%

Decrease in prescriptions processing time with

WatchList

40 minutes

2019/20WSLHD DIGITALSTATISTICS

Auburn EDFirst to implement

LaunchPoint

38

RESEARCH AND EDUCATION NETWORK

Research and Education NetworkIt’s been a year full of challenges and achievements for our Research and Education Network department, with pivots in response to COVID-19 when it comes to education, upskilling of staff and redeployment of allied staff. We saw a continued focus on research, growth on student placement hours and incorporated a range of new teaching methods.

LeadershipIn December 2019, creative actions of students were recognised at the fourth annual ‘Students As Lifestyle Activists’ (SALSA) Youth Voices Action Day at Westmead Hospital. Students from seven participating schools presented healthy eating or physical activity action plans designed and implemented at their school. The program is driven by WSLHD’s Primary Health Care Education and Research Unit (PERU) and aims to increase fruit, vegetable and water consumption, as well as daily physical activity, among high school students.

SALSA Youth Voices is an additional leadership opportunity for students participating in the SALSA peer-led leadership program, delivered to over 5,000 students in Western Sydney in 2019.

Library Services We delivered increased support for research and innovation by providing consultations to clinicians, managers and policy makers that have enabled them to translate research outcomes into innovative policies and practice.

We also launched the new Ovid Discovery Library web interface, resulting in improved access to evidence-based information and library web presence, including a new library chat service, refreshed

library webpages, creation of library guides and frequently asked questions for all of the District libraries.

We delivered new technology at Auburn Hospital library, providing video conferencing technology for use by staff and their patients and we upgraded technology.

During COVID-19 we adapted our delivery to meet the needs of high numbers of staff working remotely, delivery of daily updated information to researchers and others on the treatment of COVID-19 and creating a link to new resources on the library webpage.

Outstanding awards In August 2019, Westmead Hospital cardiologist Professor Clara Chow secured Australia’s inaugural Google.org Artificial Intelligence Impact Challenge $1 million Prize to develop an artificial intelligence program to prevent heart disease.

Prof. Chow will be the first-ever female president of the 68-year old Cardiac Society of Australia and New Zealand (CSANZ). Prof. Chow will serve as president of the CSANZ for 12 months. At Westmead Hospital, Prof. Chow is the program director of community-based cardiac services. She is also a professor of the Faculty of Medicine and Health at the University of Sydney and an academic director at the Westmead Applied Research Centre.

ResearchMore than $9 million has been awarded to researchers within Western Sydney Local Health District (WSLHD) in the 2020 National Health and Medical Research Council (NHMRC) Investigator Grants. Seven researchers within WSLHD have received one of the prestigious grants this year, covering a diverse range of health projects including kidney transplantation, liver disease, heart health and tuberculosis. In addition, Associate Professor James Chong was awarded $1.5 million through the Medical Research Future Fund (MRFF) priority funding round for his work in heart regeneration. Congratulations to: Dr Justin Beardsley, A/Prof. James Chong, Prof. Clara Chow, Dr Caleb Ferguson, Prof. Jacob George, Prof. David Harris, Prof. Jonathan Iredell and A/Prof. Germaine Wong.

In August 2019, a new Kickstarter grant scheme for medical clinicians at Blacktown and Mt Druitt Hospital launched. Mental health, infectious diseases, renal medicine, obesity and heart health were among the topics of research being funded by the $50,000 inaugural Blacktown and Mount Druitt Hospitals Medical Kickstarter grants. These are the first medical Kickstarter grants specifically for Blacktown and Mount Druitt Hospitals (BMDH), funded by Western Sydney University, the Western Sydney Local Health District (WSLHD) Research and Education Network (REN) and Better Foundation.

INNOVATION AND QUALITY WSLHD YEAR IN REVIEW5

Above, from left: Student leaders from seven local high schools presented projects and ideas at the fourth annual Youth Voices Action Day. Professor Clara Chow and her team from the Westmead Applied Research Centre wield their Google.org AI Impact Challenge prize.

39

THE CLINICAL COUNCIL 2019 THE CLINICAL COUNCIL 2019RESEARCH AND EDUCATION NETWORK

Another educational focus for WSLHD in 2019/20 was on nursing. The Nursing Research Centre:

• Launched the Western Sydney Frailty Register

• Nurse researcher awarded NHMRC Investigator Grant – Dr Caleb Ferguson

• Established over 30 clinical nursing research collaborations within the WSLHD

• Published more than 20 peer reviewed manuscripts, two articles in The Conversation with a reach in excess of 50,000 people and 14 countries

• Partnered with local, national and international collaborators to supervise 14 higher degree students

EducationWSLHD confronted a few challenges in the delivery of ongoing training while faced with a global pandemic, however through dedication and resilience we transitioned from face-to-face to online learning and REN developed a COVID-19 Hospital Implementation Education Plan.

WSLHD developed and implemented Allied Health education, training and upskilling COVID-19 response plan (encompassing ICU upskilling, skills training to allow for redeployment of Allied Health, and onboarding/orientation of the first Allied Health casual pool). Approximately 45 casual employees underwent onboarding as part of the first round. Approximately 180 participants in multidisciplinary/ multi-departmental training programs dedicated to COVID-19.

We designed and delivered inter-professional COVID-19 specific simulation-based training to meet both LHD and area-specific needs. We held PPE demonstrations and competency assessments for over 1000 hospital staff, intubation training for ICS, ED and Anaesthetics staff. Basic/Advanced life support and deteriorating patient training for ward and Code Blue teams were provided, as well as system testing activities to evaluate new equipment

or processes and transport routes for patients who are COVID-19 positive.

Other initiatives during this year included:

• Training and education designed to prepare staff to care for COVID-19 patients is ongoing and is run in a variety of areas including simulation spaces and in-situ environments;

• REN provided 1,416,737 Nursing, Midwifery, Medical and Allied Health Clinical placement hours across WSLHD facilities and implemented process efficiencies in 2019/20. Despite COVID-19 restrictions in the second half of the year, student placement hours increased from 1,386,950 in 2018/19 (+2.15%);

• Implemented WSLHD Clinical Supervision Program for Nurses and Midwives; 84 clinical supervisors have been trained, and approximately 370 staff have accessed supervision in the first six months of the program;

• Delivered 36 graduates of VET in Schools Certificate III Health Services Assistance Qualification and implemented frameworks and standardised resources to support career development pathways and skills competencies for nurses and midwives;

• Developed VR-based training applications targeting advanced life support team-leader training, Code Black and, verbal de-escalation and reflective practice and achieved journal publication. As a result of COVID-19, medical education transitioned quickly from teaching trainees face-to-face to online learning. Clinical educators incorporated a new range of teaching methods to enhance learning and increase participation online;

• Creation of clinical skills lab for medical education;

• Innovations in surgical;

• Developed and implemented a new clinical placement model for Pharmacy students;

• Developed an educational program on research for clinical pharmacists; and

• Established a multidisciplinary team to offer research projects to honours students.

INNOVATION AND QUALITY WSLHD YEAR IN REVIEW 5

Above, from left: Dr Caleb Ferguson from Blacktown Hospital has been awarded an NHMRC Investigator Grant for his heart research. Westmead Hospital staff participate in basic life support training. Professor Clara Chow’s research explores new ways to manage heart health.

2019/20RENSTATISTICS

Staff accessed supervision during first 6 months

of WSLHD Clinical Supervision Program

370

Nursing, Midwifery, Medical and Allied

Health Clinical placement hours

1,416,737

Hospital staff at PPE demonstrations

and competency assessments

1000+

On 23 September, Western Sydney Local Health District held its first live broadcast of the 2020 Quality Awards via WSLHD Facebook and YouTube channels. Winners were announced on the show that was hosted by actor, comedian and screen writer Rob Shehadie alongside news presenter and author Samantha Brett. In total 52 quality improvement projects were submitted. Staff also hosted their own COVID-safe virtual watch parties.

WSLHD QUALITY AWARDSINNOVATION AND QUALITY WSLHD YEAR IN REVIEW5

40

In response to COVID-19 the People & Culture team needed to quickly redesign and sustain services to provide for our entire workforce’s needs around being informed, supported, focused and valued. Exceptional collaboration, flexibility and creative problem-solving was needed as the department work with the unions and other internal and external partners. Some of the new initiatives and outcomes include Workplace Wellness mobile teams and centres, a call centre, a range of childcare services, and assistance with COVID-staff clinics.

Board Chair Award

Workplace Wellness in the time of COVID-19 and beyond

The COVID-19 pandemic has been a challenging time for all mental health patients, particularly those who are on clozapine for treatment-resistant schizophrenia. Blacktown Clozapine clinic used an innovative combination of telehealth, partnering with primary care, and on-site dispensing and home delivery of clozapine to keep patients safe and manage their anxiety. All 160 patients remained mentally stable with no hospital admissions or relapses due to COVID-related stress or anxiety, and mental health clinicians formed better partnerships with primary care providers.

Keeping Clozapine Patients Safe During COVID-19 Pandemic

Chief Executive Award

WSLHD QUALITY AWARDS INNOVATION AND QUALITY WSLHD YEAR IN REVIEW 5

41

Inaugural Employees of the Year

Pradeepa Selvaraj Clinical nurse educator,

Gastroenterology/Surgical Blacktown Hospital

Dr Alpha Tung Head of department

Anaesthetics Auburn Hospital

Rory Dunlop Hospital Assistant Grade 2 Cleaner,

Blacktown Hospital

Samantha Tate Acting head of

department Podiatry Westmead Hospital

Transforming the Patient Experience Just Ask It

Delivering Integrated Care Pathways to Community Living Initiative

Patient Safety First Keeping Clozapine Patients Safe During COVID-19 Pandemic

Keeping People Healthy COVID Streetfighters

Supporting our Teams Workplace Wellness in the Time of COVID-19 and beyond

A Safe and Healthy Workplace Contain the Contagion! A Clinician Mission to Eradicate Transmission

Innovation and Research PPE Predict

Education and Training Flipping COVID Facedown

People’s Choice Award Newborn Education and Skills Training

Chief Executive Award Workplace Wellness in the time of COVID-19 and beyond

Board of the Chair Keeping Clozapine Patients Safe During COVID-19 Pandemic

Category Winners

Staff surveys revealed Auburn Hospital nurses and midwives wanted more education on core newborn care skills, and further opportunities to learn and practise specialised newborn care skills. A workshop was developed and run in collaboration with Westmead Hospital NICU, utilising case scenarios and simulation-based education to rehearse specific clinical skills and challenges to better consolidate learning. Participants reported an increase in confidence, knowledge and skills, and better understanding of equipment and procedures.

Newborn Education and Skills Training

Nurse of year Doctor of year Corporate Services Allied Health

People’s Choice Award

ABF Activity Based Funding

ACF Aged Care Facilities

AHPRA Australian Health Practitioner Regulation Agency

AMIHS Aboriginal Maternal and Infant Health Service

APHTI Aboriginal Population Health Training Initiative

ATSIHPs Aboriginal and Torres Strait Islander Health Practitioners

BMDH Blacktown and Mount Druitt Hospitals

BUMP Behaviour Ultimate Management Plan

CALD Culturally And Linguistically Diverse

CASB Central Acute Services Building

CNC Clinical Nurse Consultant

CNE Certified Nurse Educator

CNS Clinical Nurse Specialist

CSANZ Cardiac Society of Australia and New Zealand

EDs Emergency Department/s

eMEDs Electronic Medications Management

eMR Electronic Medical Record

ENABLE Engaging Assertively and Building Links to Empower

FTE Full Time Equivalent

GHiP Get Healthy in Pregnancy

GWS Greater Western Sydney

HCA Health Care Australia

ICH Integrated and Community Health

ICU Intensive Care Unit

JGPSCC Joint GP-Specialist Case Conferencing

JMO Junior Medical Officer

KPI Key Performance Indicator

LGAs Local Government Areas

LHD Local Health District

LiMA Study of lisdexamfetamine for the treatment of methamphetamine dependence

MHS Mental Health Service

MoC Models of Care

MRFF Medical Research Future Fund

MRI Magnetic Resonance Imaging

NHMRC National Health and Medical Research Council

NICU Neonatal Intensive Care Unit

NIDU National Infectious Diseases Unit

NUM Nurse Unit Manager

NWAU National Weighted Activity Unit. NWAU is a measure of health service activity expressed as a common unit, against which the national efficient price (NEP) is paid. It provides a way of comparing and valuing each public hospital service (whether it is an admission, emergency department presentation or outpatient episode), by weighting it for its clinical complexity

PERU Primary Health Care Education and Research Unit

PPE Personal Protective Equipment

PPH Potentially Preventable Hospitalisations

REN Research and Education Network

RIS Radiology Information System

SALSA Students As Lifestyle Activists program

SHEOC State Health Emergency Operations Centre

SRMO Senior Resident Medical Officer

TMHC Transcultural Mental Health Centre

USCC Union Specific Consultative Committee

VMO Visiting Medical Officer

WHMHS Westmead Hospital Multicultural Health Services

WSD Western Sydney Diabetes

WSLHD Western Sydney Local Health District

WSPHN Western Sydney Primary Health Network

WSU Western Sydney University

YHS Youth Health Service

Glossary and References

For more information about out services and partners, visit www.wslhd.health.nsw.gov.au

GLOSSARY AND REFERENCESAPPENDIX WSLHD YEAR IN REVIEW

1 Cancer Institute NSW https://www.cancer.nsw.gov.au/research-and-data2 Social and Health Atlas produced by Epidemiology and Health Analytics. http://wslhdintranet.wsahs.nsw.gov.au:81/services/dsdph_we/Epi/

Publicat/Atlas12/atlasmenu.html 3 NSW Health Statistics. http://www.healthstats.nsw.gov.au/Indicator/dia_typehos/dia_typehos_lhn_trend4 Epidemiology and Health Analytics. Hospitalisations of Culturally And Linguistically Diverse residents of WSLHD, 2017-18 to 2018-19: a brief

overview. Sydney: Western Sydney Local Health District, 2020.5 NSW Health Statistics. http://www.healthstats.nsw.gov.au/Indicator/mum_antegage/mum_antegage_Aboriginality_trend6 Social and Health Atlas produced by Epidemiology and Health Analytics. http://wslhdintranet.wsahs.nsw.gov.au:81/services/dsdph_we/Epi/

Publicat/Atlas12/atlasmenu.html

Inside back cover: Auburn Op Theatres COVID patient surgery training. Left to right: Anuja Robbins (Clinical Nurse Educator), Dr Kanan Shah (VMO Anaesthetist)

WESTERN SYDNEY LOCAL HEALTH DISTRICTPO Box 574 Wentworthville NSW 2145 +61 2 8890 9902 | WSLHD-OfficeoftheCE@health.nsw.gov.auwww.wslhd.health.nsw.gov.au

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