NSLHD News 27 October 2023


Main story Short blurb COncussion clinic wins nsw health award Royal North Shore Hospital’s Concussion Clinic was a joint winner in the ‘Patient Safety First Award’ in the 2023 NSW Health Awards. Page 3 Read more on Page x

celebrating carers week Page 4



Message from the chief executive Adjunct Professor Anthony M. Schembri AM

I had the pleasure of attending the 25th Annual NSW Health Awards and I was delighted to celebrate our finalists and winners. We had four finalists in this year’s award. A big congratulations to Royal North Shore Hospital’s multidisciplinary concussion service which was named a joint winner in the Patient Safety First Award category. The concussion clinic is providing an Australian-first service and it works with the community to provide vital education about concussions. It also runs a specialised multidisciplinary clinic to help patients with post-concussion symptoms return safely to school, study, work and sport. Congratulations must also go to RNSH’s intensive care unit which received a highly commended in the Health Research Award category.

I encourage staff to take a moment to learn a bit more about peri/menopause and its impacts. In some other pleasing news, we received the 2023 People Matter Engagement Survey (PMES) results. A special congratulations to Hornsby Ku-ring-gai Hospital which had the most improved participation rate at 62.5 per cent. They were the winners of the $5000 prize to be used for workplace improvement initiatives. Thank you to all of our staff who took the time to provide valuable feedback. The high-level results for the district are located on the intranet - https://bit.ly/3Q2re84, and the detailed results are now available for dashboard users. Once the results are analysed, all sites and services will be working on PMES 2023 action plans that will be presented to the NSLHD Board later in the year. We also launched the annual NSLHD Safety and Quality Account - https://bit. ly/NSLHD-SQA2023 - which allows our district to reflect on the safety and quality of care provided to our patients, consumers, families, and carers, which is integral in planning to achieve world-class clinical care. The publication showcases our many achievements over the 2022-2023 financial year. In addition, it provides our community with a testament to NSLHD’s ongoing commitment to safety and quality, consumer participation and workplace culture that drives staff to continue to provide safe, high-quality care.

The ICU team was recognised for its research into transforming fluid resuscitation in intensive care.

It is an incredible result for our local health district and I would like to congratulate everyone who took part. I am incredibly proud of our district’s work in supporting women in the workplace with a fantastic new resource the Supporting our People: Menopause in the Workplace Guide - https://bit.ly/3FwzPv5. This new guide provides useful information about a topic that for too long has not been acknowledged, particularly in the workplace. This guide is the first step in recognising peri/menopause as a workplace matter and a springboard into greater awareness about what some of our colleagues may be going through.

Adjunct Professor Anthony M. Schembri AM Chief Executive Northern Sydney Local Health District



RNSH concussion clinic team with NSW Health Secretary Susan Pearce and Deputy Secretary of Regional Health Luke Sloane

Success in in the district at NSW Heath Awards Royal North Shore Hospital’s concussion

service to provide concussion advice to people across Australia. Vicki said it was good to be making a difference with greater awareness about concussion. “Mums, dads and officials are getting quite worried about how many head knocks can we afford and to actually recognise a concussion has occurred is the start of how to manage it,” she said. “It is no longer okay to be knocked on the head or knocked on the body and say, ‘Look, you’ll be alright, dust yourself off, go back on the field’. “We want to make sure that education is at grassroots level - if you have had a head knock or a body knock, just sit it out for a while. And if you’ve got symptoms do not play.” The clinic shared the honours with the Justice Health and Forensic Mental Health Network for their work with Towards Zero Suicides in Custody initiative. The NSW Health Awards – now in their 25th year - recognise personalised, sustainable, and digitally enabled health programs that deliver outcomes that matter most to patients and invest in the wellness of the NSW community. The concussion clinic is also a finalist in the ‘Highest Quality Healthcare’ category in the 2023 NSW Premier’s Award.

clinic was a joint winner in the ‘Patient Safety First Award’ in the 2023 NSW Health Awards. The clinic is Australia’s first multidisciplinary concussion service and has played a vital role in helping patients across the district. Concussion Clinic Nurse Consultant Vicki Evans (Roach) AM was excited by the win. “We were humbled and honoured just to have been nominated. But to win the category - that was even more amazing considering we’ve only been open 18 months,” she said. The service began by producing an educational video, which is now used by the NSW Education Department and New Zealand schools. Vicki said the clinic has had good links with local schools. “It was really evident that education around concussion was needed for schools and mums and dads,” she said. “While the media concentrated on chronic traumatic encephalopathy, the other end of the spectrum, we wanted to get involved at a grassroots level and do something for the community.” A weekly clinic was later opened treating adults and children. In its first year, it treated 51 patients, attracting positive feedback and improving health outcomes. They have also launched a new telephone



Carers’ Week celebrations at RNSH

Carers’ Week celebrations Celebrations recently took place across the district to celebrate National Carers’ Week 2023. The week is an opportunity to raise awareness, recognise and acknowledge the 2.65 million Australians who provide care and support to a family member or friend. There are over 130,000 carers across the Northern Sydney Local Health District alone. The majority are working carers, balancing commitments of both care provision and employment. NSLHD Carer Support Service Manager Barbara Lewis said this year she encourages health staff to continue engaging with carers to provide positive experiences. “It’s essential that carers are included in the patient’s care journey so we can get the best possible health outcomes,” she said. “We are always encouraging staff members to utilise the knowledge and understanding of our patients’ carers as this information is often

so valuable to provide the appropriate care.” NSLHD Chief Executive Anthony Schembri

thanked carers for their enormous contributions across the district.

“Many patients and their carers are engaging with us when they’re vulnerable and may be stressed and overwhelmed by coming into an unfamiliar environment,” he said. “We should never undervalue the importance of a carer’s knowledge and understanding of the person they care for. “Engaging carers in the healthcare journey is critical to delivering good, patient-centred care.” To find out more about Carers’ Week and ways to support carers, contact the Carer Support Service on 9462 9488 or visit their website www.nscarersupport.com.au or Facebook page www.facebook.com/NSLHDcarersupport.

SPREAD THE GOOD NEWS Share your news and achievements. Contact the Media and Communications team on 9463 1722 or email NSLHD-media@health.nsw.gov.au to submit your news.



(Left to right) Brian Burns, Christine Lu, Jacob Pogson, Philippa Heighes, Jillian Eyles, Madeleine Juhrmann, Rosanna Tran, Elizabeth Clarke and Mark Molloy

Collaboration driving research impact The strength of interdisciplinary research across the Northern Sydney (Arabanoo) Precinct was highlighted during a dynamic showcase at the Kolling Institute. The annual event featured the latest research progress across allied health, nursing, medicine, as well as pharmacy, dentistry and public health.

exciting collaboration between engineers from the University of Sydney, orthopaedic surgeons from the NSLHD and global industry partners. Elizabeth said these two examples highlight how interdisciplinary collaboration can achieve outcomes far greater than the sum of the parts. “We would not have achieved the research and innovation goals without any one of the partners and team members on these projects,” she said. Exercise Physiologist Rosanna Tran delivered her presentation on the FORTRESS trial, which is assessing a frailty intervention in hospitals. Funded by the NHMRC, the trial is using a validated screening tool and an evidence- based intervention. Rosanna, who is based at Hornsby Hospital, said the collaborative research will help establish a cost-effective model of care to help manage frailty and its adverse impacts.

The showcase provided an insight into the successful collaborations between the University of Sydney and the Northern Sydney Local Health District, and their impact on the delivery of care. Associate Professor Elizabeth Clarke detailed her interdisciplinary research investigating the use of kangaroo tendons for human ACL reconstructions. This project involved engineers and medical scientists from the Kolling, along with orthopaedic surgeons and an Australian industry partner. Elizabeth also discussed the Kolling Orthopaedic Biomechanics Robotic Arm, an

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Celebrating virtual care Clinicians working in virtual care recently celebrated Virtual Care Awareness Week through a series of webinars. The week, which ran from October 16 to October 22 brings attention each year to virtual care and the increasingly important role it’s playing across healthcare. Acting Clinical Director NSLHD Virtual Care Service Pearl Wang said the week brings important attention to the role virtual care currently plays as well as the role it has in the future of healthcare. “Virtual Care Awareness Week allows us to reflect on our successes, but also to learn from the experience of others so we can NSLHD Chief Executive Anthony Schembri visited the Virtual Hospital based at Royal North Shore Hospital

continue to develop our services to better meet the healthcare needs of Australians,” she said. Pearl said that virtual care enables improved accessibility to healthcare, and she hopes that it will continually enable those in the community to receive the appropriate care from the comfort of their living areas. “I’m very passionate about the potential virtual care has to improve access to healthcare for vulnerable groups, people living in rural areas and those with weakened immune systems or mobility issues,” she said.

RNSH steps up its investment in research pipeline A collection of up-and-coming research leaders will have the chance to travel and extend their professional development thanks to an injection of funds from the RNSH Scientific Staff Council. The council has awarded 11 grants to scientists working within the district and the Kolling Institute. The group of young leaders is driving

research into cancer, chronic pain, and heart disease, as well as gynaecology, spinal cord injuries and musculoskeletal conditions. Their work is helping to broaden our understanding of these complex conditions, and importantly, improve long term health outcomes. The funding will go to cancer researchers Lionel Leck, Bilal Malik and Josef Gillson, pain researchers Karin Aubrey and Alessandra Marcelo, and gynaecology investigator Helena Obermair. Funding will also go to musculoskeletal

Investigative research at the Kolling Institute

researchers Xiaoqian and Elham Vafa, heart disease scientist Weiqian Lee, physics specialist Danielle Chrystall and neuro psychology investigator Ilaria Pozzato, who is driving some innovative research into spinal



DRIVING LGBTIQ+ STRATEGY ACROSS NSLHD Jemma Clifton is on a mission to support and strengthen Northern Sydney Local Health District as a place where everyone is accepted and recognised regardless of their sex, gender and sexuality. Jemma (she/her) has recently

taken on the role of project officer to support the implementation of the NSW Health LGBTIQ+ Strategy across Northern Sydney Local Health District. The strategy marks a significant commitment by the NSW Health system providing direction to all NSW Health organisations and staff so that collectively the system can deliver the best care to LGBTIQ+ people and work with them to achieve optimal health and wellbeing outcomes. Jemma said a key problem she sees is many people have not met a queer, transgender, intersex or sexually diverse person and there is fear and lack of understanding what that looks like and how to be around people like her. “Just by being here I hope to show people that it’s normal,” she said. “I am just a human being and a woman – I might do woman slightly differently to some, but don’t we all. “Part of the amazing gift diversity brings is creating more space for everyone. We all experience the frustrations of having assumptions made about us based on our sex – whether that be roles or what our capabilities are or where our career trajectories can lead to and what things we can be interested in. “This is a special opportunity to expand our social systems, so we all have more freedom to question and express ourselves in broader ways.” Jemma will be working with the PRIDE-plus network who she said was instrumental in creating her role. She will also be working closely with NSLHD directors and hospital general managers in a consultative and advocacy-based position. Jemma is focused on upskilling the workforce with simple tools that create space for everyone to show up as their full selves at work.

Jemma Clifton, Project Officer, NSW Health LGBTIQ+ Strategy

“This could include foundational education on how sex, gender, and sexuality are distinct aspects of a person’s identity,” she said. “It’s also about changing language to unpack the assumptions we implicitly make about a person’s sex, gender, and sexuality, as well as updating data collection to capture patients’ sex, gender, and sexuality more appropriately. “I also want to focus on distributing best evidence-based LGBTIQ+ health standards and resources to services across the district.” Jemma said it is also important to acknowledge people may have concerns about how these changes might impact their ways of working. “It is normal and common for people to experience fear about making mistakes,” she said. “I just want to reassure people these changes are about creating more space for everyone, so our behaviour and language supports all identities.”



Hearing clinics helping local Aboriginal and Torres Strait Islander kids

Hearing check clinics that are now available for Aboriginal and Torres Strait Islander kids across Northern Sydney aged 0-6 who are not yet attending primary school. A partnership between NSLHD and Hearing Australia has led to two clinics opening at both Bungee Bidgel (Hornsby Ku-Ring-gai Hospital) and the Royal North Shore Community Health Centre every Monday. Hearing Australia’s audiologists provide the HAPEE Clinics across Australia, as part of a national strategy and program that is funded by the Commonwealth Department of Health and Aged Care, aiming to reduce preventable ear disease and hearing loss among First Nations children. NSLHD’s Child and Family Health and Aboriginal and Torres Strait Islander team worked with Hearing Australia to establish the clinics and has already made a significant difference in hearing loss detection, prevention and general awareness. NSLHD Child, Youth and Family Health Service Clinical Director and Paediatrician Anne Piper said the clinics play a vital role helping identify cases where symptoms aren’t always obvious. “Children do not always present with any obvious symptoms of an ear infection so it can go undiagnosed and cause long term ear

Audiologist Gabby at the RNSH clinic

damage and hearing loss,” she said. “It is so important that Aboriginal and Torres Strait Islander children have their ears and hearing checked by an audiologist every six months until they are 18 months old, and then once every year until they start school.” NSLHD Aboriginal and Torres Strait Islander Health Service Director Peter Shine said the connection between hearing, community, family and culture is paramount to Aboriginal and Torres Strait Islander children. “Language is integral to every Aboriginal and Torres Strait Islander bub’s connection to community, family, and culture. It’s important, so tots can listen to our elders’ stories and learn our songs,” he said.

RNSH patient rooms receives upgrade The patient lounge and interview room in Royal North Shore Hospital’s Ward 7F has been renewed and upgraded due to a joint fundraising effort.

and acceptance of confronting health information,” she said.

“We wanted to improve our ward environment for our patients, their families and carers to ensure they have a safe place to recover and process the emotions that come with being in hospital.”

The new and improved rooms boasts a combination of new carpet, new furniture, framed photography, puzzles, toys and a small library. The rooms upgrade was funded by volunteering efforts from the Pink Ladies, The Corner Store, staff members and a bequest. The room will also be used by occupational therapists to conduct sessions. Area Stroke Coordinator Susan Day said the idea for the room upgrade came about after she attended a neuropsychology forum and learnt of the positive impacts a calm space for patients and their loved ones. “Research has showed that being in a welcoming calm space can assist in recovery

The upgraded patient lounge



A lifeline for expectant mothers with extreme nausea – more than morning sickness Expectant mothers suffering from

hyperemesis gravidarum (HG) - extreme nausea and vomiting - now have a dedicated service that comes to their home and means they can avoid unnecessary trips to the emergency department. Between two and five per cent of pregnant women will suffer from hyperemesis gravidarum and of those, at least 10 per cent of women will be sick throughout their entire pregnancy. The debilitating medical condition can leave women unable to work, care for other family members or carry out daily tasks. NSLHD’s Clinical Midwifery Consultant Jodie Adams said the district had established a hyperemesis gravidarum service for women who can be treated virtually in their own homes by specialists without the need to travel to a hospital. “For many women, it is debilitating, feeling sick, all day, every day,” Jodie said. “We know that many women will experience postnatal depression or post-traumatic stress disorder as a result of experiencing hyperemesis gravidarum.” If a woman who is suffering from the condition goes to her GP or attends an emergency department within NSLHD, they can be Celebrating our cleaners Our environmental services staff were celebrated on Wednesday 18 October for Thank You Cleaner Day. An afternoon tea was held at Royal North Shore Hospital with Acting General Manager Heather Gough and NSLHD Acting Executive Director of Operations Alison Zecchin joining

Expectant mothers suffering from hyperemesis gravidarum now have a dedicated service that comes to their home

referred to the hyperemesis gravidarum virtual care service for ongoing medication management and support. If required, the service can arrange for the woman to have regular home visits for intravenous fluids by the hospital in the home team, who can even organise grocery shopping or other domestic support for her. “This is a real success. We have never had anything like this before,” Jodie said. Once women have made contact with the service, they are welcome to reconnect if symptoms return, without going back to the emergency department. The service was set up through the NSW Government’s $17 million funding for hyperemesis gravidarum.

HealthShare staff. Thank You Cleaner Day recognises the hard work of cleaning and environmental services staff who play an integral part in our hospitals ensuring our patients have a high quality experience.

Celebrating cleaners across NSLHD



(Left to right) Dr Vincent Oxenham, Sally Byrne, Olivia Munn, Dr Heather Francis and Nicola McKern

NSLHD runs state first neuropsychology registrar program The Northern Sydney Local Health District has established the first Neuropsychology Registrar program in NSW.

neuropsychology graduates being able to access these types of roles as their first job. “A benefit of a program like this is providing a structure for registrars to develop their skills and knowledge required to be a competent neuropsychologist through supervision from experienced neuropsychologists, having access to a variety of clinical settings, participating in research and opportunities to attend and contribute to workshops, seminars and conferences,” he said. He added that the health system also benefits from the increased neuropsychology resources. “As part of the program, registrars can identify where neuropsychology services could be of benefit.” “It allows us to educate multidisciplinary teams on the functional impacts of neuropsychological deficits or neurological conditions, which leads to improved patient care.” Upon successful completion of the registrar program, registrars are eligible to apply for endorsement as a clinical neuropsychologist by the PBA. This endorsement allows them to practice neuropsychology independently. The current registrars are Karina Chan (absent from photo), Nicola McKern and Sally Byrne. Applications for the next intake of the program will begin in January 2025.

The program, which takes place at Royal North Shore Hospital over two years, has seen three registrars get the opportunity to further hone their skills in a firsthand hospital experience. The registrars continue specialised training in neuropsychology under supervision across a range of different services and multidisciplinary teams, as well as access to cross-disciplinary education and research opportunities. Registrar Sally Byrne, who is undertaking the program at RNSH, said the experience was invaluable for her development. “Since undertaking the program I’ve been offered the chance to enhance new graduates’ skills in delivering neuropsychological services for multidisciplinary teams in a supportive environment,” she said. “The program has provided my colleagues and I with a fantastic opportunity to gain experience across a wide variety of settings in the hospital such as neurology, general medicine, geriatric care, mental health, vascular units, and intensive care.” RNSH Senior Clinical Neuropsychologist Vince Oxenham said the program was set up to fill an important gap in new



Travel opportunities creating new partnerships Funding from the Skipper Jacobs Charitable Trust has helped a group of young research leaders broaden their experience and establish new collaborations.

Another researcher to benefit from the travel grant was Samantha Hefferan from the Murray Maxwell Biomechanics Laboratory. Sam visited the University of Auckland, where she was able to use the lab’s high- tech imaging methods to explore the ultrastructure of human tendons, and the impact of disease and injury. “I valued every moment of my three months in New Zealand,” she said. “I gained a lot during my time, not only learning new technical skills but also understanding more about the complexity of independently planning and developing tailored protocols for my research questions.” Academic Director Professor Jim Elliott thanked the Skipper family for their financial backing of the trust, as well as the NORTH Foundation for their support of the travel program. “It has been instrumental in helping individual researchers, raising the international profile of the Kolling Institute and contributing to crucial research progress.”

Close to $40,000 was shared amongst five early-to-mid career researchers, allowing them to travel nationally and internationally to progress their research and develop new skills. One of those to receive funding is Dr Kenji Fujita, an early-career pharmacist with a PhD working in the Ageing and Pharmacology Research Group at the Kolling Institute. Kenji helped develop techniques to calculate the frailty index in older hospitalised patients, while also leading research into the quality of pharmaceutical care. During his trip he led a three-day workshop in Denmark, visited collaborators in Norway and delivered a presentation in Japan, a country with the highest proportion of older adults in the world. “It was a great opportunity to build international collaborations and promote our translational research at the Kolling. I really appreciate this travel grant,” he said.

Sam Heffernan and Dr Kenji Fujita



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