NSLHD News March 26

Get the latest news from across Northern Sydney Local Health District.


Main story Short blurb youth health promotion At NSLHD, there’s a whole team of young people consulting the district on youth-friendly service delivery, initiatives and resources.

Read more on Page x Read more on Page 6

welcome to our new graduate nurses Page 3

Lymphoedema early intervention pilot project Page 4


Message from Acting chief executive Dr Tamsin Waterhouse

Our Hornsby Ku-ring-gai Hospital Vaccination Hub is running smoothly with more than 4000 staff in Phase 1b having now received their first dose of the Oxford/AstraZeneca vaccine. About 50 per cent of our workforce are expected to have been vaccinated against COVID-19 by the end of this week either with the Pfizer vaccine at the Westmead hub or the AstraZeneca vaccine at the Hornsby hub. This is an amazing result and would not be possible without the great efforts of all staff involved. NSLHD staff have also been involved in assisting with the recent flooding in New South Wales and once again our staff have shown their resilience and adaptability to help those people affected. Some of our nursing staff have been providing assistance at the Castle Hill RSL evacuation centre. I would like to thank the staff who have been providing support during this difficult time. I am constantly hearing and learning about the impressive and inspiring things you all achieve every day in the work that you do. The Quality Improvement Awards put a spotlight on this hard work and the delivery of programs and services which have made a real difference to the patients and families we care for. Applications are now open and further information can be found on the NSLHD intranet here. March 2021 sees the latest intake of graduate nurses who have officially started their careers at Northern Sydney Local Health District and I would like to wish them a warm welcome to our district. More than 170 trainee nurses will join our hospitals and services this year

and we are very excited to have them on board. Our district is committed to supporting Aboriginal Torres Strait Islander people to experience positive health outcomes and social equity, so I am very pleased to inform you the NSLHD Board passed a Sorry Statement at their March Board meeting which will be displayed across the district. Developed by the NSLHD Aboriginal Health Service team, it is hoped that Aboriginal and Torres Strait Islander peoples who see and read the statement will feel empowered to discuss their health issues. Finally, I would like to comment on recent coverage of sexual assaults reported in the media. I realise these reports may be triggering or distressing to people who have experienced a recent or past sexual assault. If you need support, I would encourage you seek help from the variety of support services available. At Northern Sydney Sexual Assault Service (NSSAS) the district offers free and confidential counselling and medical care for anyone who has experienced a sexual assault recently or in the past. For assistance please contact the NSSAS on 9462 9477 (8.30am-5.00pm, Monday to Friday) or 9926 7111 (after hours). Dr Tamsin Waterhouse Acting Chief Executive Northern Sydney Local Health District There are other helpline services available 24 hours, including NSW Rape Crisis Services – 1800 424 017, Child Protection Helpline – 132 111, Lifeline – 131114 and NSW Domestic Violence line – 1800 65 64 63.



New RNSH grad nurses

A WARM WELCOME TO OUR NEW GRAD NURSES The first intake of graduate nurses for 2021 have officially started their careers at Northern Sydney Local Health District.

This year a total of 171 trainee nurses will join our hospitals and services and will work in ICU, ED, general surgical and medical, mental health and midwifery. The March graduate intake gathered at Royal North Shore Hospital for orientation this month. They will then be welcomed at Hornsby (15), Mona Vale (5), Ryde (10), RNSH (33), Mental Health Drug and Alcohol (27), Medical Imaging (2), and Community Health (6).

mp felicity wilson welcomes icu grads to rnsh Royal North Shore Hospital’s intensive care unit graduate nurses recently received a visit from MP for North Shore Felicity Wilson.

The graduates spoke with Felicity about their backgrounds and what led them to a career in nursing. Thankfully mannequin patient James (pictured) survived a downturn in his condition and was successfully revived by the new team.



Lymphoedema early intervention pilot: Hornsby and RNSH Early intervention is key

to preventing chronic lymphoedema, which is why lymphoedema

therapists want patients and practitioners to know the early warning signs this Lymphoedema Awareness Month. The lymphatic system works to transport fluid and filter harmful substances from the body. Lymphoedema can occur when this system is compromised by surgery or abnormal swelling typically in the arms or legs, but it can also affect other parts of the body. If patients present with symptoms including swelling, tightness, aching and cellulitis, they should be assessed by a lymphoedema practitioner. Hornsby and Royal North Shore hospitals are both involved in a new pilot program by the NSW Ministry of Health aimed at preventing chronic lymphoedema medical treatments. Sufferers experience through early intervention in breast cancer patients across Northern Sydny Local Health District. Referrals are made through the breast cancer multi-

Occupational Therapist at Hornsby Hospital Megan Hamilton

management training for two lymphoedema therapists. By funding the position of Megan Hamilton, the grant has enabled Hornsby Hospital to offer lymphoedema for the first time. At RNSH, Stephanie Jamison was able to join the Occupational Therapy Department. “Lymphoedema is reversible at the very early stages, but progression of the condition can cause it to become irreversible, so we want to detect it as early as possible,” Stephanie said of the importance of early intervention. The pilot project also provides both departments with a SOZO body

composition analyser machine.

“The device sends a low-level electrical signal through the body,” Stephanie said. “As lymphoedema develops, the amount of fluid will increase, making it easier for the signal to travel through the limb. The device compares limbs at-risk with a normal or healthy range. “It’s non-invasive, it’s quick, and it can give us an insight into whether there’s changes happening before the person experiences any symptoms. “That gives us the chance to apply intervention measures that prevent lymphoedema from being established.”

disciplinary team. The program grant provides funding as well as lymphoedema

stay up to date with Nslhd on social media Facebook

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• /RoyalNorthShore/ • /HornsbyHospital/ • /NSLHD.MHDA/ • /MonaValeHospitalNSW



Staff at Ryde Hospital supporting the Patients Reported Measures program

Patient reported measures to offer new insights Patients are at the centre of what many of us do, but now we will have a greater understanding of how those in our care are faring with the introduction of Patient Reported Measures (PRMs). The new program, which is sponsored by NSW Health, has landed at Northern reflect how a patient is feeling. “It is important to routinely ask for the patient’s perceptions of their own

shown to support clinician decision-making and shared care planning,” he said. “They can be used to raise clinicians’ awareness of patients’ concerns and target interventions that will improve patient outcomes of care.” An example may be a patient indicating high levels of pain leaving the house in their survey. The clinician is then able to specifically address this concern in their consultation via referral to Osteoporosis Re-fracture Prevention Clinic (ORP) at Ryde Hospital on 16 March, with ORP at Royal North Shore and Hornsby Hospitals to follow in April and May respectively. If you would like to know more about PRMs, please email NSLHD-PRMS@health. nsw.gov.au appropriate services. The first service to go live with PRMs was the

health and wellbeing at the point of care; there is good evidence to demonstrate that patients who are more engaged in their healthcare tend to choose less costly interventions.” PRMs are divided into two categories; Patient Reported Outcomes Measures (PROMS) and Patient Reported Experience Measures (PREMS). PROMs capture the patients’ perspectives about how illness or care impacts their health and wellbeing, while PREMs explore the patients’ perception of their experience with health care or services. Davide said PRMs held promise in improving services for not just patients, but clinicians as well. “These measures have been

Sydney with the hope the data collected via patients surveys will tell us more about their health and welfare as well as their health related outcomes and experiences of health services. Patient Reported Measures Officer Davide de Sousa said PRMs will offer insights previous data types could not. “While there is a long history of collecting health service delivery information across NSW, a lot of the measures of health evaluation are focused on outcomes from a clinical perspective,” he said. “Research tells us that clinical indicators alone often don’t


Share your news and achievements. Contact our team on 9463 1722 or email NSLHD-media@health.nsw.gov.au to submit your news.



higher mortality heart attack patients with no known risk factors

The risk factors for heart attacks are widely known, but for some patients, they happen without any prior warning. An international study led by Professor Gemma Figtree has found that these patients make up around 15 per cent of all heart attack patients. The typical risk factors are high blood pressure, high cholesterol, low physical activity, smoking, and obesity, but some patients, like Jennifer Tucker, experience arterial blockage despite not having any of these. Jen was a fit, non-smoking 35-year-old mum of two when she started experiencing tightness in her chest and breathlessness during exercise. A persistent cardiologist convinced her to get an angiogram, which revealed a 90 per cent blockage of her artery. Empowering young people in their health choices is a key aspect of delivering a high standard of care and improving community health. At NSLHD, there’s a whole team of young people (pictured on the front cover) consulting the district on youth-friendly service delivery, initiatives and resources. Since its inception 21 years ago, the NSLHD Quality Award-winning Youth Health Promotion team has amplified the voice and actions of local young people. This input enhances NSLHD services and initiatives that support the health and wellbeing of adolescents and young adults as the team of

“I was absolutely stunned when they told me my heart was 90 per cent blocked,” Jen said. “It was a very lucky escape for me.” The study released in the Lancet found that patients like Jen are significantly less likely to receive medical therapy at discharge, which may be a contributing factor to the poorer outcomes in the group with no prior risk. “Despite their perceived low risk of having coronary disease, they had a much higher mortality rate compared to people who had traditional risk factors explaining a heart attack,” Gemma said. This difference in treatment is particularly pronounced in women.

Professor Gemma Figtree

factors] had a three times higher mortality [risk] than a male heart attack patient with risk factors,” Gemma said. “It shows we need to think beyond traditional risk factors to find out what is driving the increased heart attacks and mortality.”

“A woman who had a heart attack related to plaque in [her] arteries [with no risk To investigate this further, Gemma’s team has been awarded an NHMRC Centre of Research Excellence to develop new approaches to improve outcomes in patients with coronary artery disease. Meet the team helping NSLHD improve youth friendliness

twelve diverse young people aged 15-24 share their unique perspective. The team’s initiatives cover a broad range of hot- button issues for young people including healthy relationships, mental health support, smoking prevention, and food access for young people at risk of homelessness. Charlotte, 16, is a local high school student and has been working as a youth consultant for the last two years. “It’s so important to have the input of young people in the planning and delivery of health promotion initiatives and services they interact with so they’re more accessible and genuine,” she

said. Finn, 20, is a uni student and advocate for young LGBT people. “It’s always important to promote inclusivity and diversity to make sure that the needs of everyone are recognised and met,” he said. “Often, the needs and voices of young people are forgotten, which is why it’s important to consult young people on issues affecting them.” For more information or to book a free consultation go to Youth Friendly Consultations - NSLHD or email NSLHD- YouthHealthPromotion@ health.nsw.gov.au



RNSH Professor AWARDED best 2020 research paper The editorial board of leading Journal of Occupational

Rehabilitation has recognised the work of Royal North Shore Hospital clinical psychologist Professor Michael Nicholas and his team in awarding them best research paper ‘Implementation of Early Intervention Protocol in Australia for ‘High Risk’ Injured Workers is Associated with Fewer Lost Work Days Over Two Years Than Usual (Stepped) Care’. It found that a protocol implemented by key stakeholders (including employer, insurance company, and health care providers) for recently injured workers achieved better return to work outcomes than those undergoing usual care under the NSW workers compensation scheme NSW Health staff with recent work injuries, and identified by a screening published in 2020. The paper is titled instrument as being at high risk for delayed recovery, were recruited for the study, known as WISE (Work Injury harmony week celebrations NSLHD staff celebrated Harmony Week - a time to make an extra effort to celebrate Australia’s rich cultural diversity. More than a quarter of NSLHD staff identify as having a culturally and linguistically diverse (CALD) background. To celebrate Harmony Week NSLHD launched the CALD employee network. The network is designed to bring people together from all backgrounds so they can share and learn from one another’s experiences. All staff interested in getting involved can contact NSLHD- ODTeam@health.nsw.gov.au.

(Left to right): Dr Mick Gleeson (research manager for the project), Professor Michael Nicholas and the late Dr Garry Pearce conducted the study.

Screen Early). The protocol involved engaging the injured staff member, their treating healthcare providers, hospital employer, insurance case manager, and a clinical psychologist to provide targeted care within three instrument used to identify the high-risk workers, the Örebro Musculoskeletal Pain Screening Questionnaire, was developed by Michael and his research colleagues in Sweden. “The significantly superior return to work rates of the early intervention group were sustained over the two-plus weeks of the injury. The brief screening

year follow up phase,” he said. Michael said the WISE study continues to have an impact in practical applications across the country. “NSW Health implemented the protocol for injured health workers in all public hospitals in the state since 2017, and Australia Post has engaged us for a replication trial of the WISE protocol for their injured workers. They recently decided to implement the protocol as their business-as- usual model. “I am so proud our research can have a practical impact and is not just left on the library shelf,” Michael said.



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