Get the latest news from across Northern Sydney Local Health District.
NEWS NORTHERN SYDNEY LOCAL HEALTH DISTRICT NSLHD
spinal injury research The Kolling Institute has received funding for vital spinal injury research.
Read more on page 5
robot pablo changing rehab patients’ recovery Page 5
COVID-19: pop up clinics and the Virtual hospital Page 7
Leaders in healthcare, partners in wellbeing
experts in the Chief Health Officer’s team at the NSW Ministry of Health. Importantly, all staff and patients were wearing masks in the ED and because of this, we believe the risk of further transmission will be low. I encourage everyone to familiarise yourself with the fact sheets on the correct wearing of face masks which can be found on the NSLHD intranet under the PPE link. It is extremely important you avoid the temptation to touch your mask once it is on, and you maintain hand hygiene and social distancing – these continue to be the key principles in reducing transmission of the virus. I continue to be so proud of the resilience and calm and professional approach that I have seen in the last few days. It will continue to be a challenging few weeks and it is important we continue to support each other. Thank you all for your ongoing commitment to the care of our patients during these challenging times. You and your patients wellbeing remain our priority. message FROM the Chief executive Deb Willcox
Our district prides itself on the high standard of care our staff provide to our patients and their families. I have always been immensely proud of the compassion, respect and dignity our staff show towards our patients. It was therefore not surprising to learn our patients feel the same way according to a recent survey. The Bureau of Health Information’s Emergency Department survey of our patients recorded positive results across all categories, but consistently outperformed the state average in the respect and dignity category, as well as in trust and confidence. When asked about their experience in the ED, 75 per cent of our patients said they would speak highly of their experience to family and friends, second only to Northern NSW Health District at 76 per cent. Congratulations to everyone for this fantastic result. It is truly a testament to the hard work and dedication you all show each and every day. This comes as we continue to experience challenging times with the continued transmission of COVID-19 in the community. Unfortunately, our colleagues at Hornsby Ku-ring-gai Hospital’s Emergency Department have been impacted by the virus in recent days. We are taking a very precautionary approach and are working on the advice of our local public health unit, infectious diseases physicians and the public health
Deb Willcox Chief Executive Northern Sydney Local Health District
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Eating Disorders Service team Caroline Hill, Gabriella Heruc, Simone Jacques
nslhd’s new eating disorders service The newly established Eating Disorders
Increasing staff awareness of the incidence, seriousness and warning signs of eating disorders will assist in screening patients, supporting them and linking them into appropriate services. Accessing evidence-based treatment provides patients with the best opportunity for recovery and quality of life. The new Eating Disorder Service - Simone Jaques (Clinical Psychologist), Gabriella Heruc (Dietitian) and a Psychiatrist (being recruited) - supports staff as they look after patients in their care with an eating disorder. “The team’s role is to support staff and this may be through providing team inservices, attending interdisciplinary team meetings or case conferences or it could be in helping staff to find appropriate services for their patient,” said Caroline. “We also have a small outpatient service for over 18s who live in our LHD and are unable to access any other eating disorder specific services.” Staff can contact the Eating Disorder Service for advice and support for patients with a diagnosed or suspected eating disorder or for further training and inservices. Staff can find out more about the service on the intranet at: https://bit.ly/3fIQMDe
Service is breaking ground for the first time in Northern Sydney Local Health District with a dedicated service supporting clinical staff and the community. With up to 16 per cent of Australians having experienced an eating disorder, NSW Health recognises the serious physical and psychological consequences of eating disorders and the significant burden they place on sufferers and their families. In 2014, the NSW Government established the NSW Service Plan for People with Eating Disorders (the Service Plan), with the soon to be released 2020- 2024 Service Plan aiming to support better access, governance, innovation and quality care. Caroline Hill, Eating Disorder Coordinator, said: “Each local health district has an eating disorder coordinator, however, at NSLHD we are excited to have a dietitian, clinical psychologist and a psychiatrist on board. “Eating disorders have the highest mortality and morbidity of any mental health illness. Many of our patients across our community, outpatient and inpatient services may experience disordered eating behaviours, however, they may not disclose these behaviours due to anxiety, shame or guilt.”
Some members of the team working on the ACP Pilot
advance care planning pilot Northern Sydney Local Health District is piloting an electronic package for managing advance care planning (ACP).
whether a patient has documentation including Advance Care Directives and Appointment of Enduring Guardian, and whether a copy has been presented or scanned • AMBER care bundle – a systematic approach for multi-disciplinary teams to follow when it is uncertain whether a patient may recover Together these components support planning, transfer, intervention and communication of advance care decisions and information. More than 370 resuscitation forms across NSLHD have been transcribed into electronic versions since the project went live on 14 July. ICT Business Analyst Angela Hermes said the ICT team members have worked closely with the eHealth Project Team, NSLHD Clinical Governance Unit and clinicians to deliver
this project. “So far the adoption has been very promising and staff have been enthusiastic about the introduction of the solution,” she said. “Nursing staff are pleased about having a specific location in the eMR for Advance Care Planning documentation and medical staff are impressed that the system will provide prompts of previous Resuscitation plans when patients are readmitted to hospital.” At the end of the 12-week pilot period, an evaluation of the product will be provided to the District Steering Committee and Ministry of Health outlining the pilot findings and recommended future enhancements prior to implementation in the other LHD’s across NSW. For more information, please visit Advance Care Planning on the Intranet.
In 2019 NSLHD and Central Coast LHD were selected as a combined health area by the Ministry of Health and eHealth to pilot the electronic solution for ACP. The scope of the ACP pilot project is for both LHDs to test, implement and support the ACP solution across inpatient areas. The ACP solution is designed to support clinicians to document a patient’s advance care needs and to discuss those needs with the patient and their family or carer. The solution consists of three components: • Resuscitation Plan – an electronic version of the adult and paediatric paper state forms • Advance Care Documentation – recording
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NSLHDNEWS | ISSUE 15| 14 AUGUST 2020
Kolling teams receive funding for spinal injury research An Australia wide trial is set to get underway with hopes it may lead to life-long improvements for
those who experience a spinal cord injury. Led by Professor Lisa Harvey from the Kolling Institute’s John Walsh Centre for Rehabilitation Research, the study represents a collaboration between the University of Sydney and every spinal injury unit in Australia. The NSW Government is investing $2.5 million in the project, with the University of Sydney contributing $500,000. Lisa said the innovative approach is one of the most promising interventions for those with spinal cord injuries. “Researchers will assess the effectiveness of early and intensive physiotherapy on neurological recovery and function in people with a recent injury,” she said. “The type of physiotherapy we are looking at will be directed below the level of the injury to take advantage of the plasticity of the spinal cord, and its ability to self-repair soon after injury. “The treatment will aim to help partially paralysed muscles work again through a range of specific exercises, including walking on a treadmill with overhead suspension and electrical stimulation. “It’s hoped the trial will provide evidence of the rehabilitation patients at Hornsby Ku-ring-gai Hospital’s are recovering from illnesses such as stroke. Pablo is a computer-based robotic device that allows patients to perform strength training and repetitive movements that aid in their recovery to perform daily activities. Up to three patients at a time are able to use the Pablo program using the different devices, which have the potential to reduce the amount of time to recover. Occupational Therapist Taryn Fox said using Pablo was exciting for both staff and patients who no longer needed to use older rehabilitation devices that were less intuitive. “The Pablo allows for a wide variety of therapy; it allows people to complete the 1000 repetitions, as research has shown to improve outcomes, without feeling as though they are completing therapy,” Taryn said. “It records the data through the computer and shows the progress of the patient.” Pablo is an interactive device for therapies for hand, arm, shoulder and trunk. It measures various gripping patterns, strength and range
Patient Bob Flegg with Prof Lisa Harvey
effectiveness of this intervention and its potential to make an immediate and life-long difference to people with a spinal cord injury. “Once we have that evidence, this approach could be incorporated into clinical practice and rolled out on a large-scale across Australia. “We’re very hopeful the treatment will lead to better outcomes for those with a spinal cord injury, improving their ability to live independently, and participate in work and leisure.” This is one of three recent funding grants received by the Kolling Institute for spinal injury research.
robot pablo supporting patients at Hornsby New technology is changing the way
Taryn using Pablo with a patient
of movements. Thanks to the support from the community, through the North Foundation’s Christmas Appeal, the Pablo is now being used by rehabiliation and paediatric patients at Hornsby.
Wear it purple for LGBTQI+ young people It’s nearly time to start
digging out your purple – Wear it Purple Day is on its way. On Friday 28 August, Northern Sydney Local Health District will be celebrating Wear It Purple Day – an initiative that strives to foster supportive, safe, empowering and inclusive environments for young people who identify as gay, lesbian, bisexual, transgender, queer and intersex (LGBTQI+). The focus of the day is ‘We Are The Change’ which encourages staff to think about ways they can contribute to creating effective change for LGBTQI+ young people and all minority groups. On the day staff are encouraged to pop on something purple – clothes, scarf or a hair ribbon – or pick up a Wear it Purple sticker which will be available at all sites. Clinical Nurse Consultant Mental Health Pathways in Practice Coordinator Lizz Whitlam said the district has an important role to play in fostering an inclusive and empowering environment where the diversity of our community is celebrated. “We know that young people who identify as LGBTQI+ have poorer mental health and higher rates of suicide
than other Australians – so campaigns like Wear It Purple Day are really important to facilitate the awareness and start more conversations about LGBTIQ+ people more broadly,” she said. “These campaigns also show the district’s commitment to diversity, inclusion and belonging and making it a priority.” Lizz is part of the newly established LGBTQI+ network which brings together staff who identify as LGBTQI+ and non LGBTQI+ allies to create an inclusive workplace culture that respects all diversity. The group meets monthly to discuss events, strategy, progress and issues for the network. Lizz said: “Like any diverse group, when it comes to engaging the person and delivering care that is holistic
and person-centred, we need to be able to have conversations with an individual that is respectful, non-judgemental, and one of enquiry and curiosity. “The lens has always been heteronormative and there’s nothing in the space for LGBTQI+ in terms of physical health issues, mental health, domestic violence, and drug and alcohol related issues. “I hope the network can influence this moving forward and be seen as a leadership group that can offer advice and expertise by sharing experiences so we can meet the needs of our staff, patients and consumers today and into the future.” To join the LGBTQI network, please contact NSLHD- ODTeam@health.nsw.gov.au.
Do you know the symptoms of meningococcal disease? Parents and young adults are urged to be alert to the symptoms of meningococcal disease as we head into late winter and spring. Meningococcal disease is of fever, headache, neck stiffness, joint pain, dislike of bright lights, nausea, vomiting, irritability, and rash of red- purple spots or bruises that Rapid treatment with antibiotics can save your life and reduce the risk of severe complications. Several vaccines against
doesn’t disappear when pressure is applied. A rash does not always appear or it may occur late in the disease. Symptoms usually occur suddenly and can get worse quickly, so it’s important to seek urgent medical treatment. If you have already seen a doctor but symptoms continue to worsen, consult your doctor again or go to the ED.
meningococcal disease are available in NSW and free for infants, adolescents, and people with certain medical conditions. Consult your GP about the best option for you and your family. For more information about meningococcal disease, visit https://bit.ly/2Fhmvij
caused by a bacterial infection that can lead to serious illness or death, if not recognised and treated in time. While anyone can contract meningococcal disease, infection rates are higher in children aged 0 – 4 years and in people aged 15 – 24 years. Symptoms of meningococcal disease include sudden onset
6 NSLHDNEWS | ISSUE 15| 14 AUGUST 2020
Staff at the virtual hospital
BEHIND THE SCENES OF COVID-19: NURSING TEAM The COVID-19 pandemic has taught Acting District Director Nursing and Midwifery Jenny Neilsen a number of tasks their symptoms. The virtual hospital also covers residential aged care
Jenny’s team runs the clinics at Brookvale and Hillview Community Health Centres, and Hornsby and Royal North Shore hospitals which collectively average 700-800 swabs per day. The team has also recently opened a pop-up testing clinic at Pennant Hills Community Health Centre. The team will take over the remaining COVID-19 testing clinics at Mona Vale and Ryde hospitals to ensure one governance structure is in place. Jenny said her biggest challenge was ensuring there was enough staff to cover the district’s clinics and virtual hospital, and support Sydney LHD with the airport. But she couldn’t speak more highly of the team which is always willing to put up its hand and help out. “They are the real heroes behind this pandemic – all they do is care for people and that makes me proud,” she said. “I’ve got the best bunch of nurses and admin going – they are a great team, always with a smile on their faces.”
across Northern Sydney, which includes 110 nursing homes. Another major part of the team’s job is setting up the pop-up COVID-19 testing clinics, which have included sites at Chatswood, Berowra and Manly. “We work closely with the Public Health Unit which identifies hot spots in our district and then we find a suitable venue to house the testing clinics,” she said. “We learnt a lot from the Manly pop-up clinic, for example, in terms of how you flow people.” Jenny said the flow of the clinic is pivotal to ensuring everything runs smoothly – with every staff member needing to be clear on what their role is. While the Manly clinic took around 3000 swabs in the three weeks it was open – and was the most sought after place for testing in the district – the team managed to perfect the flow so people moved from the front desk to the swab and out the door in under nine minutes.
she never thought she would have to learn – from setting up a virtual hospital to turning around a pop-up COVID-19 testing clinic in 36 hours. Jenny and her team have been at the forefront of NSLHD’s response to the virus, setting up the virtual hospital back in March when the first cases of COVID-19 hit Australian shores. “Doctors and nurses run the virtual hospital – which is designed for those in our community who have tested positive for COVID – and involves our negative hotline and welfare checks,” Jenny said. “Some people may get a daily check via phone, others a few times a week, while some may need a welfare check that requires a nurse to visit them at home.” There is a roving team that visits people in the community who may need bloods taken or a repeat swab. In some cases, people have been taken to hospital following these checks depending on the severity of
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