NSLHD News April 30

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


Main story Short blurb aboriginal and torres strait islander staff network day The Aboriginal Health Service recently hosted its second network day for staff.

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study: more twins born premature Page 4

detect success: new program proves positive in aged care Page 3


Message from Acting chief executive Dr Tamsin Waterhouse

This week is Patient Experience Week, 26-30 April, and our hospitals and services have been focussing on our patients’ experience by holding special events. Patient experience is defined as the sum of all interactions, shaped by our culture, that influence patient perceptions across the continuum of care. It doesn’t matter how small our actions are when it comes to elevating a patient’s experience: it could be a warm smile, listening, even the way in which we address our patients can improve their stay in our hospitals. Please visit the Elevating the Human Experience intranet page to find out more, and join in to reflect on how we put human connection at the centre of everything we do. You can also find downloadable patient experience resources to use and share. It is wonderful to see many staff coming forward for their flu vaccination. All NSLHD staff clinics are open and we have seen around 2000 staff receive their flu vaccination. It is important staff in Category A+ and emergency department staff receive their flu shot by the end of May to meet the NSW Health policy requirement. Staff are reminded of the following: • You need to have a 14-day break between the flu and other vaccinations this year, including for COVID-19

• You need to bring your COVID-19 vaccination certificate when you present for your flu vaccination • You need to bring your Medicare card when you present for your flu vaccination We have also achieved a fantastic result with around 75 per cent of NSLHD staff receiving their COVID-19 vaccination. This comes as we work with the NSW Ministry of Health to expand the vaccination roll out more broadly. Finally, I recently had the pleasure of attending NSLHD’s Aboriginal Health Service’s second Aboriginal and Torres

Strait Island Staff Network Day. It was great to be with so many

passionate and committed people who came together to work out what the district can do better to recruit, attract and retain Aboriginal and Torres Strait Islander staff. Thank you to the team for

organising such a great day. Next week we look forward to

welcoming Deb Willcox back as NSLHD chief executive after her secondment to the NSW Ministry of Health. I would like to extend my sincere thanks to everyone for the fantastic support they have provided while I have been acting in the role.

Dr Tamsin Waterhouse Acting Chief Executive Northern Sydney Local Health District



Aboriginal and Torres Strait Islander Staff Network Day The Northern Sydney Local Health District Aboriginal Health Service recently hosted its second Aboriginal and Torres Strait Islander Staff Network Day. The network day was developed as a priority for the district during the consultation of the NSLHD Aboriginal and Torres Strait Islander Health Services Plan 2017-2022 . Aboriginal and Torres Strait Islander Workforce Manager Gillian Adidi said the day was a great success. “Several breakout sessions were facilitated

Staff at a cultural painting workshop

during the day to engage the network and find out what NSLHD can do better to recruit, attract and retain Aboriginal and Torres Strait Islander staff,” she said. “We identified priorities and future directions to focus on achieving each goal.” NSLHD Acting Chief Executive Dr Tamsin Waterhouse, NSLHD Board Member Brad Goodwin, and Wendy Bryan-Clothier from the NSW Ministry of Health Aboriginal Workforce Unit, attended the day and provided stories of their professional journeys

and educational and career pathways. The day also involved a cultural painting workshop and smoking ceremony by Koomurri. detect success: new program proves positive in aged care

Smoking ceremony by Koomurri

A new hub of resources produced by district staff for aged care facilities is empowering staff to help residents to avoid unnecessary hospital stays. DETECT for residential and aged care facilities (RACFs) is a suite of tools and training developed by the Aged Care Rapid Response Team (ARRT), the Geriatric Rapid Acute Care Evaluation (GRACE) and the Beaches Rapid Access Care of the Elderly (BRACE) teams with support from the Sydney North Primary Health Network . ARRT Clinical Nurse Consultant Therese Jepson said DETECT has been warmly welcomed by the facilities, with the website and face-to-face training particularly well- received. “DETECT has proven to really help frontline residential aged care facility staff identify and manage residents at risk of deterioration and hospitalisation,” she said. “The website includes point of care symptom checkers, clinical decision flowcharts, educational videos, as well as additional resources and contact links.” In response to the pandemic, the ARRT workforce has been supplemented with additional nursing, medical and allied health

staff, which allowed the face-to-face training. “A particular focus of the rollout for ARRT was face-to-face training in each of the 39 residential aged care facilities in the catchment area,” Therese said. “This allowed interactive participation and discussion of typical case scenarios and also built on the foundations of training provided by ARRT throughout 2020, including COVID-19 specific education regarding PPE use and outbreak management.” One of those facilities to benefit from DETECT is Willowood in Chatswood. Facility Manager Stacey Hall said the training had a direct impact on staff and their confidence. “Willowood found the education and the new resources provided by ARRT improved our handover process and identification of deteriorating residents at our facility,” she said. “The management team have noticed an increase in staff confidence in assessing and managing deteriorating residents.” You can view the website for DETECT by visiting www.detect.snhn.net



study: more twins born premature The rate of premature twin births in New South Wales has been steadily rising and is a concerning trend, warns

Professor of Obstetrics and Gynaecology at The University of Sydney and Kolling Institute Director of Women and Babies Research Dr Jonathan Morris. Jonathan and his team at the Kolling’s Women and Babies Research group at Royal North Shore Hospital analysed over 14,000 twin pregnancies from 2003- 2014. The research found 49 per cent of twins were born premature before 37 weeks and 69 per cent of all births were planned either by pre- labour caesarean or induction of labour. “Previous research in singleton pregnancies has shown early birth placed an infant at increased risk of long-term developmental problems,” Jonathan said. “In the short-term, babies born early were more likely to need help with their breathing, be admitted to a neonatal intensive care unit, have jaundice, spend longer in hospital and be readmitted to hospital in the first year of life.” Jonathan said while an early planned birth is sometimes necessary, the aim should be to prolong the pregnancy for as long as it is safe to do so. Lobaba Idris experienced this with her twins Zayn and Layla who were born via planned caesarean at Royal North Shore Hospital at 36 weeks and four days old. In the last weeks leading up to the birth, Lobaba said every day was a relief. In 2019, Lobaba had a stillborn at 21 weeks. “I was keen to stay pregnant for as long as I could, but I

Twins Zayne and Layla

have an autoimmune disease that needs to be monitored, and my baby girl was much smaller than her brother,” she said. “We tried to wait until I was 37 weeks but she was so tiny we just knew it was the right time to have a c-section.” Layla was born at just over two kilograms and Zayn was over 2.6 kilograms. “Waiting as long as we did I think helped. The twins didn’t need to go into special care and could come home,” she said. Twins are known to be smaller than singleton babies, and the management of their growth poses unique challenges as the wellbeing of both twins has to be considered at all times. “Use of singleton growth charts to plot the growth of twins are still being used without considering the different growth patterns which could occur in each twin pregnancy,” Jonathan said. “This leads to healthy, well-grown twins being misclassified as growth restricted, and often results in unnecessary early birth,

exposing these babies to problems associated with prematurity.” In partnership with the North Foundation, Jonathan and his team are raising funds to evaluate and develop fetal growth charts for twin pregnancies. “The growth charts will ensure the growth of twins are correctly monitored according to their own growth capacity, thereby avoiding unnecessary intervention and making it easier to identify twins who are at risk of complications,” he said. Study results will also be used to develop national recommendations and inform clinical guidelines to assist clinicians to determine the best time for twins to be born. “It means the health and wellbeing of hundreds of tiny lives could be improved and it will also reduce the number of twin babies needing neonatal intensive care after birth,” he said. To donate to the study, visit https://northfoundation. org.au/how-you-can-help/ women-and-babies-research/



Dr Emma Scott joins RNSH Endocrinology department It was during her medical training at Royal North Shore Hospital when Dr Emma Scott sparked a keen interest in diabetes. Emma’s interest in diabetes continued to develop during her physician training and

PhD studies at RNSH, undertaking research in assessing the impact of glycaemic variability on the development of complications in Type 1 and Type 2 diabetes. “At this point I became really interested in the use of technology to optimise care, including remote monitoring and virtual care,” she said. “My interests are in pregnancy related research, as well as young adults with Type 1 diabetes or other endocrinology problems.” Emma is hoping to get involved in developing services at RNSH for young adults with Type 1 diabetes including virtual care. featuring in three of the five episodes. The episodes provide insight into how to identify the characteristics of frailty, explain why conversations on frailty are important to improve patient care, and contribute to better multidisciplinary team assessment and management of frailty. The episodes range from eight to 12 minutes each with transcripts available. Staff can access the modules on

“I was drawn to the fact that when we treat someone with diabetes, we can make such a huge impact to their life,” Emma said. “I enjoy the continuity of care, meaning I might meet a patient who is 18 years old, for example, and see them ongoing. I get to form long-term therapeutic relationships with my patients.” Emma is the newest endocrinologist to join the team at RNSH. For the last few years she has worked at the hospital as a locum consultant. From her training years, have contributed to a frailty podcast series produced by the Health Education and Training Institute (HETI). Clinical Nurse Consultant Health and Wellbeing, Older People’s Mental Health Anne Hoolahan, Hornsby Ku-ring- gai Hospital Physiotherapy Manager Katie Lee, and Mona Vale Hospital Physiotherapy Head of Department Jane Woolgar, are part of an expert panel

Dr Emma Scott outside Royal North Shore Hospital

“There’s a real burden for people living with Type 1 diabetes – in terms of having to come to appointments every three months,” Emma said. “The use of technology, like virtual health appointments, means patients can get on with their day and still be treated.”

FRAILTY EDUCATION: PODCAST SERIES Three Northern Sydney Local Health District clinicians

My Health Learning – https://bit.ly/3gAn4Ew Course Code: 320455651

Mona Vale Hospital Physiotherapy Head of Department Jane Woolgar

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CONNECTING TO A SMOKE-FREE FUTURE In the era of Skype weddings and Zoom drinks, some

people have turned to video conference counselling for help in kicking smoking to the kerb. One of those who has been successful in the battle against cigarettes has been Matthew Dawes. The former smoker had tried to give the habit the flick on multiple occasions over the years, but it took enrolling in Northern Sydney Local Health District’s iSCUPI program (Smoking Cessation through Personal Identification via internet) to get him over the line. “I started smoking as a young teenager, most likely because it was the ‘cool’ thing to do,” Matthew, now 47, said. “Over the last 15 or 20 years I had had a few goes at giving up smoking. I had a young family - the time which I need to be around for. “I tried the normal, cold turkey, speaking with the quit line and even Zyban but for whatever the reason they did not work for me and I continued to smoke.” iSCUPI is a free, personalised treatment option for those who wish to give up smoking. People who enrol in the study receive one-to-one counselling

(Left to right): Liam, Michelle, Greg and Matthew Dawes

via videoconferencing, a personalised treatment video and expert-led techniques proven to help people quit. Matthew said a video produced by the program which showed the impact his smoking had and could have on his family was a real eye- opener. “The program has a video that include the known effects from smoking and interplays this with your immediate family,” he said. “While maybe you think you acknowledge these effects and the impact on the family, the video really rammed this home and reinforced the need to give up.” Robin May, the psychologist who co-ordinates the study, said Matthew was just one of a number of people who had

gone through the program. “It’s very gratifying seeing Matt and other former smokers still not smoking,” he said. “Smoking is still the biggest killer of preventable diseases. Pleasingly, our SCUPI trial published in 2019 had a success rate of 65 per cent after six months of quitting.” While the journey to quit was tough, Bonnet Bay local Matthew has certainly been enjoying the benefits of a smoke-free life. “My sense of smell is back and food tastes better; the smokers cough that I always had is gone and I am fitter now than I have been in the last 20 years,” he said. “That meant around 12 months ago, my sons and I could complete the Kokoda trek, something that had I still smoked, I could not have even contemplated.” Participants are currently being sought for the next round of the SCUPI study.

Greg, Matt and Liam shortly after completing the Kokoda trail

If you smoke daily, are over 30 years old and want to quit, please visit www.SCUPI.com.au, email NSLHD-quitnow@ health.nsw.gov.au or call (02) 9463 2517 for more information.



large-scale trial: stem cell therapy knee osteoarthritis Royal North Shore Hospital will help drive one of the world’s largest clinical trials into the effectiveness of stem cell therapy for those with knee osteoarthritis.

Kolling researcher Professor David Hunter will lead the two-year study, which is currently recruiting more than 400 participants for the trial sites at RNSH and the Menzies Institute in Hobart. “We will evaluate whether stem cell injections can improve symptoms and slow the progression of the disease in people with mild to moderate knee osteoarthritis,” he said. “Participants will receive three injections over a 12 month period, with researchers to assess levels of pain, physical activity and quality of life throughout the trial.” All participants will receive the same stem cell product, developed from cells from a single, young healthy person. The study follows some small trials which have indicated stem cell therapy may reduce inflammation, and help the body repair cartilage. David said there is tremendous community interest and many stem cell products available, but to date, there has been no good, rigorous evidence to suggest these products are effective in

(Left to right): Kolling researcher Professor David Hunter and Tom Buttel who has lived with osteoarthritis for most of his life

this context. “It’s really important that we have high-quality trials like this one to produce the evidence that we need around efficacy and safety,” he said. “Osteoarthritis is steadily increasing in prevalence due to our ageing population and the high numbers of people above a healthy weight. “It’s important that we can offer those managing the condition a range of treatment options, on top of the existing conservative approach of weight loss and exercise.” The trial has been welcomed by 61 year old Tom Buttel who has experienced knee osteoarthritis for most of his life after a rugby injury in his attracted some of the world’s leading osteoarthritis experts as David asks all the important questions to help people back on track after a challenging year. You can send in your questions to hello@ jointaction.info and follow

teens. “Osteoarthritis has had a big impact on my life, causing considerable pain and limiting quite a few daily tasks,” he said. “I have found, however, that by maintaining my weight and adhering to a personally- tailored exercise program, I’ve been in a much better position to manage my condition. “I’m very excited by the trial and encouraged that it may be an important step towards a safe and effective treatment for people with osteoarthritis.” Further information about the SCUlpTOR study is available at: tinyurl.com/sculptor-trial

new podcast for those living with osteoarthritis A new podcast for those living with osteoarthritis hosted by Royal North

the podcast and David on Twitter @jointactionorg and @ProfDavidHunter Joint Action is available on the Apple Store, Audible or wherever your get your podcasts.

Shore Hospital’s and Kolling Institute’s Professor David Hunter is aiming to re-engage those who may have been isolated during the pandemic. Joint Action has already


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