NSLHD News March 28

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


Main story Short blurb m tching march at RNSH Royal North Shore Hospital is focused on patient identification this March and is calling on staff and patients to make it front of mind. Page 4 Read more on Page x

celebrating success: quality and improvement awards Page 5

calls for better understanding of heart attack signs Page 7


Message from the Chief Executive Deb Willcox

I was delighted to attend Ryde Hospital’s accreditation summation meeting last week. A lot of work goes into preparing for accreditation and the entire team at Ryde did such a fantastic job. While we need to await the final report, the assessors told us the hospital has met every one of the eight national standards with no recommendations or system improvements. This is an amazing result and all of the Ryde staff should feel incredibly proud. A number of highlights were mentioned, including the hospital’s leadership and impressive clinical governance system, the Yarning Circle and Aboriginal and Torres Strait Islander engagement, the food muncher initiative for sustainability, excellence in palliative care, and the establishment of level four ICU. This is just a snapshot of the many remarkable achievements. I was incredibly proud to hear the assessors describe Ryde as a “wonderful community hospital” and talk about how much of a privilege it was for them to assess it. Thank you to all of our staff at Ryde for your hard work and commitment, and congratulations on such an excellent outcome – you truly deserve it. Hornsby and Royal North Shore are next with accreditation at both hospitals happening in May. I know everyone is working hard to prepare and I would like to thank them for their efforts, particularly at a time when the pandemic is impacting operations.

It was also exciting to see nominations open for the district’s Quality and Improvement Awards this week. Our Quality and Improvement Awards put staff achievements in the spotlight and showcase the hard work and delivery of programs and services that have such a positive impact on the people we care for, our colleagues and the broader community. Like in previous years, the awards will inform our entries into the NSW Premier’s Awards and NSW Health Awards. Lastly, the presence of new Omicron variant of COVID-19 is still being felt by many of us with the number of cases increasing in the community. Thankfully the severity of the disease has not increased but as more people in the community are exposed to the virus it is having significant impact on staff. Your wellbeing remains our priority. We will continue to do all that we can to support you during this challenging period. It is important we continue to do what we can to prevent its spread; please continue to practice appropriate hand hygiene, where a mask where appropriate and get you booster vaccine. Our vaccination clinics have a number of bookings available and it is the best way to ensure you and your patients are protected against the adverse effects of COVID-19.

Deb Willcox Chief Executive Northern Sydney Local Health District



same day joint replacement trial shows promise A trial allowing joint

replacement patients to return home on the same day of their surgery is underway at Royal North Shore Hospital, and early results are promising. Patients like Susan Stackhouse, the first patient to take part in the trial, have nothing but praise for the concept which turns a potential two to five day stay for a hip or knee replacement, into a same day discharge. “I was very excited because it meant I could recover at home in familiar surroundings,” she said. “I’d been two years in pain since the start of COVID-19. My university work reduced me to being in front of a computer eight or more hours a day which exacerbated my pain. “The few months before the operation, I could hardly walk down the road – it was that painful.” Sport orientated and a yogi with 40 years of experience and her own studio, she said she was a little anxious on the morning of the operation, but was at ease when she met those who would be helping her in her rehab. “Everybody was very helpful, they reassured me and made me feel very comfortable,” she said. Orthopaedics Clinical Nurse Consultant Wassim El Abed, who has spearheaded the trial, said the feedback from patients had been stellar.

Surgery patient Susan Stackhouse

“We are still in the trial phase of the program, meaning we are still bumping into small issues and finding out the best way to do things… but so far the feedback has been really positive,” he said. “Patients really enjoy being in their home when recovering, while being cared for by the hospital in the home (APAC) staff and their friends and family.” The trial has strict eligibility criteria, and patients must commit to practicing their rehab exercises and crutch use in the weeks prior to their surgery. “The day of surgery is intense as the patient is seen multiple times by different people – including physiotherapist, occupational therapist, acute pain service, pharmacy, the orthopaedics clinical nurse consultant and orthopaedics team – and is provided with

plenty of education prior to being cleared to discharge. We aim to discharge the patient by 6pm,” Wassim said. “APAC will then see the patient daily for seven days. They are also followed up by the orthopaedic team every day for the first four days as part of their ‘virtual rounding’.” The trial, should it be implemented on a permanent basis, also holds promise in helping others get their surgery quicker. Meanwhile for Susan, who is now almost two months post-op, the results are not just a new hip, but a whole new lease on life. “Since I’ve had the surgery, people have said my whole demeanour has changed, and I am back doing the things I want to do” she said.



Burns Unit NUM Di Elfleet with staff and Bushy with his artwork

Burns unit patient donates art work He is a man from the bush who loves to paint. Bushy, as he is known by everyone, loves to tell stories of his ancestors and Aboriginal culture through art - which patients at RNSH burns’ unit can now enjoy. During his eight-week stay in hospital

staff to enjoy. The painting features Biami, creator of the universe and rainbow serpent, intertwined with the galaxy and one of the nurses, Molly’s, star sign Aquarius after she went to buy the art supplies for Bushy. “Since I was painting, pain wasn’t a huge factor,” Bushy said.

after suffering burns in a fire, Bushy, of the Dharawal people, painted to occupy the hours and block the pain he was feeling. The national park ranger has donated his art work to the burns unit for fellow patients and

“This painting was helpful to shut off. I also painted for other patients and I painted my (plaster) cast.” Ryde named ‘wonderful community hospital’ in accreditation

Ryde Hospital recently underwent its accreditation assessment and has met the eight National Standards with no recommendations and no system improvements required. At the accreditation summation, the assessors described the hospital as a ‘wonderful community hospital’ and many highlights were mentioned. These included the hospital’s leadership and impressive clinical governance system, the Yarning circle and Aboriginal and Torres Strait Islander engagement, the food muncher initiative for sustainability, excellence in palliative care,

and the level four ICU. Ryde Hospital General Manager Heather Gough said the achievement was a result of Ryde Hospital’s team work and high quality care delivered by all the dedicated staff at Ryde. “The assessors were very impressed with the work being done on the frontline and behind the scenes, and the clinical work showcased demonstrated the high quality care and service provided to patients,” she said. “Thank you to all of our staff – I feel incredibly proud of Ryde Hospital and everyone working here.”



The Royal North Shore Ryde service Aged Care Rapid Response team

CELEBRATING STAFF SUCCESS Three years ago Clinical Nurse Consultant Therese Jepson and Staff Specialist Geriatrician Dr James

place on 15 March. Staff were encouraged to dress up wearing colourful socks or ribbons, for example, and match with a colleague, but discretion was left up to the teams to get creative. Nurse Manager of the Division of Surgery and Anaesthesia Sophie Lange said the initiative is about improving practice and education for patients and staff. “Initially we rolled this out as a pilot to a few aged care facilities but then COVID hit, where no one could go in and provide care to these patients and the only way was to come to hospital.” ‘The ARRT of Telehealth’ patient doesn’t unnecessarily need to be transferred to hospital.” Initially the team piloted the initiative with a few aged care facilities, but when the COVID-19 pandemic hit they were able to offer it to all aged care facilities across the district. Therese said there was a lot of perseverance and hard work to get the project across the line. “It took a lot of persistence and hard work, but it has all paid off,” she said. “We are now seeing some of the avoidable admissions to hospital start to decrease.”

“Matching March is all about spreading the word about the importance of checking patient identification prior to all care and treatment,” she said. The RNSH executive team visited many departments and units wearing matching items. The most ‘matched’ department was awarded to 8D (pictured on front cover) for their clear message and inclusion of the whole team. project won a Northern Sydney Local Health District Quality and Improvement Local Solutions Award. Applications are now open for the 2022 Quality and Improvement Awards. The awards celebrate the excellence of staff and put a spotlight on the hard work and delivery of programs and services which have made a real difference to patients and their families. Therese and James encourage others to submit an application. “It’s so important to share our successes, so we can learn from one another and make sure we truly are providing the highest quality care to our patients and consumers,” James said. Application forms and further information can be found here or contact nslhd- awards@health.nsw.gov.au

identification this March and is calling on staff and patients to make it front of mind. Matching March is an initiative by the Patient Identification Taskforce and aims to raise awareness about the importance of correct patient identification. As part of Matching March, ‘Match with a Mate’ day took “It also allowed us to take action straight away, rather than having to jump in a car, drive to see the patient and then work out what’s going on. “It speeds up the time where the care can be provided to the patient and it means the Hardy set out on a mission to improve care for older patients in northern Sydney. Therese and James introduced the use of videoconferencing in the the Royal North Shore Ryde service Aged Care Rapid Response team (ARRT) to treat patients in their homes. “Telehealth enabled us to the see the patient straight up and know immediately whether they required to come into hospital or not,” James said.

Matching March at RNSH Royal North Shore Hospital is focused on patient



Researchers identify the best ways to ease chronic pain With large numbers of people across the community looking for effective and lasting ways

opioid use considering the complex challenges with medication withdrawal and patient fears that their pain will become unmanageable. “Our research indicates that cognitive behavioural therapy is the most effective option to reduce pain, and patients are three times more likely to be able to stop their opioid use if they adopt the self-management strategies promoted through the cognitive based therapies. “With the number of people experiencing chronic pain continuing to escalate, it’s crucial that we’re able to provide the very latest evidenced-based data around the treatments that work and help people manage their pain. It can make a life- changing impact.” One part of the research program is assessing the effectiveness of digital technologies to support those with chronic pain while reducing their reliance on opioids. Associate Professor Claire Ashton-James said with demand for support at an all-time high, they were

investigating the value of a technological approach which can be delivered to a large number of people at any time of the day. “Our research has initially focused on how patients would like to engage with the programs, and one key trend has shown us that the community would prefer to receive consistent SMS messages, rather than tap into an App,” she said. “It’s important that we seek “Our research has led to the development of carefully- scripted messages, videos and patient testimonies. “We anticipate these resources will complement the care provided by clinicians and we are undertaking a clinical trial to test their effectiveness in providing additional support. This trial is being funded by the Ernest Heine Family Foundation and we hope the strategies will directly assist those living with constant pain.” consumer input early to ensure our strategies will be effective and broadly adopted.

to treat pain, researchers at the Kolling Institute are driving nationally significant projects to reduce a reliance on opioid medication and promote proven alternative options. The research by the team from the Pain Management Research Centre follows the latest figures which indicate around 20 per cent of the population experience chronic pain and a large share of those are still relying on opioid treatment to reduce the impact of their pain. Centre Director and RNSH specialist Professor Paul Glare said despite the wide use of opioids, researchers now know they are not an effective, long-term option for most people, and cause a wealth of adverse side effects including addiction issues. “Opioid use is directly linked to an increase in mortality, and now accounts for more deaths than car accidents,” he said. “Our research is focusing on the best ways to reduce

a grand entrance at Hornsby Visitors to Hornsby Ku-ring- gai Hospital will notice a new entrance which has opened to the public.

up area. Visitors no longer need to enter via the STAR building to reach outpatients or the main wards of the hospital, instead are able to come via the

The hospital’s new main entry has opened and connects to the multi-storey car park on Palmerston Road. After more than two years of the main entry being boarded up by construction, the hospital has un-veiled its frontage which is undercover and has a 15 minute patient drop off/pick

The new front entrance at Hornsby Ku-ring-gai Hospital

will be held. The volunteers’ Pink Shop has also moved to its new location, at the front entrance.

main entry and the lift lobby. A new café will be opening in coming months before an official opening of the hospital



Masters soccer players in action

Research prompts calls for a better understanding of heart attack signs, especially during exercise

A new study has directed the spotlight to the risk of a cardiac event for those over 35 playing football, while also highlighting a concerning lack of knowledge around recognising the early signs of a heart attack. Conducted by researchers from RNSH, the University of Sydney and the Kolling Institute, the study surveyed more than 150 masters age amateur soccer players involved in competitive and social games. The research is believed to be the first of its kind to assess cardiac knowledge and beliefs in this higher-risk amateur football group. Senior author Professor Geoffrey Tofler, RNSH cardiologist and University of Sydney academic said the study identified that one in five participants had one or more possible cardiac symptoms during a game in the prior year, but only a quarter of them sought medical attention. “Our research indicates a concerning trend and we hope that by raising awareness of heart health,

we will be able to reduce the risk of a cardiac event such as a heart attack and sudden death,” he said. “We know that strenuous exercise can cause a temporary increase in cardiac risk, but being able to recognise the warning signs of an impending cardiac event will help lower those risks. “It’s important to act quickly on symptoms and if a cardiac arrest occurs, promptly begin CPR and have a readily accessible defibrillator.” Other key findings include: • Almost half of those surveyed had little or no confidence that they would recognise the signs of a heart attack. hypothetical episode of chest pain while playing, less than half would leave the field immediately, while 49 per cent would stay on the field for 5-10 minutes to see if the pain eased, and others would play on. participants said they would use the internet for information about their symptoms before seeing a • In response to a • Three quarters of

doctor. • Less than 40 per cent were aware of the less typical signs of a heart attack. • One high-risk attitude was that nearly half of the participants indicated that if they thought they were having a heart attack, they would prefer someone to drive them to the hospital rather than have an ambulance come to their home. participants agreed that CPR training was important and that defibrillators should be staples at football fields during all games. “These steps could make the difference between life and death for someone experiencing sudden cardiac arrest, as the survival rate decreases by seven to ten per cent for every minute without the use of CPR or defibrillation” he said. Co-author Associate Professor Tom Buckley said encouragingly, the “While the benefits of exercise still far outweigh cardiac risk overall, these measures may further increase the benefit to risk.”




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For the latest information on COVID-19 visit nsw.gov.au/covid-19

© NSW Health July 2021. SHPN (SHEOC) 210681

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