Creating healthier communities - Working together - Western District Health Service
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Wo r k i n g t o g e t h e r
C r e a t i n g h e a l t h i e r co m m u n i t i e s
Contents
About WDHS........................................................................1
From the President and Chief Executive..............................2
Our Performance
Financial Overview..............................................................4
Service Performance at a Glance........................................6
Our Vision
Creating healthier communities. Our Services
Services and Programs.......................................................7
Our Mission
To support our community’s physical, mental and social wellbeing by: Patient Admissions and Classification.................................8
• Providing safe, high quality and innovative services
• Building enduring partnerships; and Enhancing People’s Lives
• Delivering customer service excellence.
Caring for our Community....................................................9
Quality and Safety..............................................................10
Our Values
Integrity Transforming Rural Health
We will be open and honest and will do the right thing for the right Community Health and Wellbeing......................................11
reason.
Innovation Enriching Our Team
We will be an industry leader by breaking new ground and improving
Our People.........................................................................13
the way things are done.
Learning and Development................................................14
Collaboration Occupational Health and Safety & Compliance..................15
We will actively work together in teams and partnerships.
Recognising Excellence and Service.................................15
Accountability
We will take personal responsibility for our decisions and actions.
Investing in our Future
Respect Infrastructure.....................................................................16
We will value all people’s opinions and contributions.
Community Support...........................................................17
Empathy Our Volunteers...................................................................18
We will endeavour to understand other peoples’ feelings and
Improving Business Systems and Models..........................19
perspectives.
Major Event Sponsors........................................................19
Gifts over $100 .................................................................20
About This Report
Western District Health Service (WDHS) follows the Victorian State
Government Department of Treasury and Finance FRD30 guidelines Our Board and Management
for its Annual Report, as a public entity under Section 3 of the Organisational Chart..........................................................21
Financial Management Act 1994 (FMA). Corporate Governance.......................................................22
Executive Team..................................................................25
This annual report outlines the operational and financial performance
of Western District Health Service (WDHS) from 1 July 2017 to 30 Senior Staff........................................................................26
June 2018. The relevant ministers for the period were The Hon. Jill
Hennessy MP, Minister for Health; Minister for Ambulance Services, Accountability and Financial Statements
The Hon. Jenny Mikakos MP, Minister for Families and Children; Statement of Priorities.......................................................28
Minister for Youth Affairs, The Hon. Martin Foley MP, Minister for
Legislative Compliance......................................................31
Housing, Disability and Ageing; Minister for Mental Health. This report
is also available on the WDHS website at: Disclosure Index................................................................33
www.wdhs.net/publications Certification.......................................................................34
Front cover: WDHS staff ‘creating Back cover: Registered Nurse, Wendy
Financial Statements.........................................................35
healthier communities’ Herring and Clinical Nurse Specialist,
Coryn Meyers in the Hamilton Base
Hospital Operating Theatre.
About WDHS
Western District Health Service In 1998 the Health Service was established with yy Coleraine District Health Service (CDHS)
(WDHS) is one of Victoria’s leading the amalgamation of Hamilton Base Hospital, providing acute care, residential aged care
Southern Grampians Community Health Services and primary care services to the Coleraine
rural and regional healthcare and Penshurst and District War Memorial Hospital community. Services include medical, dental
providers, delivering a range of high (now Penshurst and District Health Service). and maternal and child health. CDHS also
quality health services. In 2005 Coleraine and District Health Service manages 25 independent living units.
(CDHS) also amalgamated with WDHS. yy Penshurst and District Health Service (PDHS)
Located in Victoria’s Western District, WDHS is The Health Service has 89 acute and subacute providing acute care, residential aged care,
the largest employer in the Southern Grampians beds, 175 residential aged care beds, 35 community services and independent living
Shire, delivering quality healthcare to a resident independent living units and delivers primary units in Penshurst and Dunkeld.
population of 16,200 people, approximately care, youth, community and allied health yy Merino Community Health Centre providing
9,800 who live in Hamilton, the geographic and services. primary nursing, district nursing, visiting
business hub of the region. Based in Hamilton, with campuses in Coleraine podiatry, dietetics and diabetes education
and Penshurst in the Southern Grampians services to the Merino community.
Shire and Merino in the Glenelg Shire, WDHS yy Frances Hewett Community Centre (FHCC) -
incorporates the following sites, services and delivering a broad range of primary care and
facilities: community based services.
yy Hamilton Base Hospital (HBH) - the location yy National Centre for Farmer Health (NCFH) –
of a 75 bed acute hospital, allied health and established in 2008 in partnership with Deakin
education facilities. University to provide leadership to improve the
yy The Birches - a 46 bed facility providing health, wellbeing and safety of farmers, farm
residential aged care, care for people with workers and their families across Australia,
special needs, palliative care and Home Care through research, service delivery and
Packages (HCPs) education.
yy The Grange Residential Care Service -
providing 50 residential aged care beds.
Hamilton
Base
Hospital
EST. 1862
Hamilton Base Hospital
& Benevolent Asylum
established to provide care
for people suffering from
illness and accidents and
for victims of personal
tragedy and social distress
1998 2000 2005 2008 2012 2013 2018
WDHS BIRCHES CDHS NCFH GRANGE $27M $1.9M
Amalgamation of Aged Care Coleraine District National Centre Grange Coleraine and Cancer &
HBH, Southern redevelopment Health Service for Farmer Health redevelopment District Health Dialysis Centre
Grampians at Hamilton amalgamation established in works carried Service $27 constructed to
Community campus including with WDHS partnership with out, including million ‘one support local
Health Services construction Deakin University construction of stop shop’ cancer & dialysis
and Penshurst of the Birches new wing health precinct patients
and District War Residential Care completed
Memorial Hospital facility and Hamilton
to create WDHS Base Hospital
Rehabilitation
Wing opened
1
From the President & Chief Executive
RR Board Chair, Hugh Macdonald, Guest Speaker Clinical Oncologist Dr
Stephen Brown and Chief Executive, Rohan Fitzgerald at the 2017 AGM.
The 2018 financial year saw years of We also commenced advertising for ten new An innovative program was introduced in aged
planning come to fruition. WDHS reviewed nursing positions, with the total cost of the care to improve weight management and the
models of care across a number of areas, changes expected to be approximately $1.5m. dietetics team conducted a comprehensive
introduced new programs and undertook Health Services from across the region review of the WDHS allergen matrix.
substantial capital works projects. signed up to a clinical governance regional We also joined Ka-ree-ta-Ngoot-yoong-Wat-
partnership called the Health Accord. The nan-da which is a multi-agency Indigenous
Regional health services formalised a Accord was developed in response to the Advisory Committee involving both Winda-
collective approach to clinical governance Duckett Review and is intended to improve Mara and Dhauwurd-Wurrung Elderly &
and agreed on strategies to work on quality and safety practices in public hospitals Community Health Service (DWECH).
collaboratively. We continued our emphasis across the Barwon South West Region.
Leading the Way
on the prevention of violence against Customer service excellence is a key element
women locally and regionally. We supported of our strategic plan. To support this direction WDHS and the Southern Grampians
innovative approaches to education through we appointed a Customer Service Officer, community as part of GenR8 Change,
our partnerships with CQUniversity and trained over 400 staff in the delivery of continued their work to tackle youth
SWTAFE. The National Centre for Farmer ‘customer service excellence’ and commenced overweight and obesity rates across the
Health (NCFH) continued reaching out a research project into the effectiveness of region. After two years of community led
internationally and expanded its commercial the role. We also renewed our consumer interventions, the results are in and show
partnerships to improve sustainability. participation plan, which integrates the that estimated overweight and obesity rates
Hospital and community presentations community’s views into the Health Service’s have dropped by 3.6 %. WDHS also adopted
increased and we are continuing to look operations, planning and policy development. the Cancer Council Victoria's Rethink Sugary
at options to make residential aged care Drinks advertising campaign and promoted it
The eyeConnect program was introduced on radio and in print media.
more sustainable. The much anticipated in conjunction with the Melbourne Eye &
results from the second regional survey Ear Hospital. Using telemedicine, the device SWTAFE and collaborating organisations,
into the prevalence of youth overweight and collects information about the condition of a including WDHS are developing an innovative
obesity were released and we commenced patient’s eye and sends it directly to the Eye new program ‘Applying the New Work Mindset in
investigating how we might once again and Ear Emergency Department for review. South West Victoria'. This is the first of its kind in
lead the State with strategies for ‘creating Victoria and focuses on helping students develop
We launched the National Disability Insurance a portfolio of transferable skills, rather than the
healthier communities’.
Scheme (NDIS) at WDHS and registered current practice of narrow, job specific training.
Delivering Quality Care and Services as an accredited NDIS provider. We quickly
became one of the largest providers of We continue to develop new corporate
The Health Service reviewed the way cancer partnerships, as a part of our plan to secure
services are provided, in anticipation of our disability services in the region.
the long term sustainability of the NCFH. This
Cancer and Dialysis Centre opening. A clinical With an increase in the number of orthopaedic year we began working with Metalcorp and
nurse consultant was appointed to develop procedures at WDHS from 127 in 2015 to 222 in Lysn, an innovative online psychology practice.
more integrated services into the future and to 2018, we established a Musculoskeletal Clinic to We also began conducting health and lifestyle
provide senior nursing support in this area. co-ordinate and streamline these services. assessments for farmers in India, as a part of
The number of Emergency Department We strengthened our mortality and morbidity our relationship with Centurion University.
presentations grew over the last 12 months review procedures by introducing a Mortality
and this trend is continuing. Model of care and Morbidity Review Framework, using
changes were made and we recruited a the Limited Adverse Occurrence Screening
Nurse Unit Manager to support Emergency Criteria to identify files for retrospective
and Intensive Care. clinical document review.
2
From the President & Chief Executive
Regional hospitals joined forces to roll out the The evening raised a spectacular $182,000 We are also incredibly fortunate to be
Strengthening Hospital Responses to Family for the Cancer and Dialysis Centre. supported by donors from the local, national
Violence (SHRFV) program and WDHS also The Hospital Door Knock Appeal was once and international community and from a
continues its support of the White Ribbon again a success, raising over $50,000 number of trusts and foundations. The
campaign to end male violence against women. for the Hamilton, Coleraine and Penshurst Health Service was also the beneficiary of
The results from the 20 Minute Rounding campuses and the Op Shop Golf Tournament some very significant bequests for which we
Project are being published and guidelines raised $16,000. This year’s Fun Run are extremely grateful.
for its future integration across the Health coincided with Lake Hamilton’s 40 year We also value and recognise the work of
Service are being considered. celebrations and featured a ‘Beat the Boss’ relay the Coleraine Management Committee and
We are delighted with the input from the for the first time. Over 250 runners and walkers Penshurst Advisory Committee over the last
WDHS Community for Youth Board (C4YB). took part, competing in a range of events, from 12 months in supporting WDHS to deliver
This year we began conducting Youth Board the half marathon to 4km run/walk. high quality services to these communities.
meetings in schools across Hamilton. Professor Rosemary Calder, Director of the Hugh Macdonald and Jen Hutton retired after
The Board has grown substantially and Australian Health Policy Collaboration spoke 13 and 16 years of service to the Board of
its members have been successful in about 'National Action to Improve the Health Directors respectively. Hugh has provided
introducing a Youth Café. of Local Communities' at the 19th Annual excellent leadership to the Board as its
Handbury Lecture. President for the last three years and was
Infrastructure and Technology instrumental in the success of the Charity
WDHS turned the first sod on the Cancer Supporting Our Team House project. Jen’s strong connection to the
and Dialysis Centre redevelopment in WDHS and CQUniversity entered into an community, energetic style and knowledge of
January this year. This $1.9M project has agreement to deliver an innovative pilot program the sector were a valuable asset.
been generously funded by the community to attract locals to study a Bachelor of Nursing. On behalf of the Board of Management and
and is expected to be completed in Students living in the Southern Grampians and Executive we would like to acknowledge the
September 2018. We also received funding Glenelg Shires are given preference for the role the community plays in our success
to replace the nurse call system, chillers and placements, ensuring the skills developed stay and express our thanks to all of our staff
boilers at Hamilton Hospital. in the local community. The program this year and medical team for providing high quality
A $1.2M tender for the Birches significant supported enrolled nurses looking to become care, customer service excellence and for
refurbishment was awarded to Craig Collins registered nurses. Next year the program will supporting WDHS to achieve its vision of
Building. The main entrance area will feature also open up to students commencing study for ‘creating healthier communities’.
a rural streetscape façade, so residents the first time.
feel more like they are living in an everyday From a recruitment perspective, we implemented
community environment. The main dining an online tool to improve the process for people
area will also be extended. applying for work at WDHS.
With greater demand pressures on the We conducted two leadership programs and
hospital’s infrastructure, the DHHS funded provided stress management, and bullying Ian Whiting
a feasibility study into the redevelopment and harassment training for staff across the President
of our Emergency, Intensive Care and organisation.
Radiology departments. Our ‘Meet and Greet’ dinners continued to
Financial Performance be a success and over 120 competitive
netballers hit the court for WDHS’s first ever
We are continuing to build our capacity to netball round robin. Staff also initiated the
provide services close to home for Western Shed a Tonne program and got motivated for Rohan Fitzgerald
District residents, as acute activity increased Active April, with 57 staff notching up a total Chief Executive
by 3.6% compared to previous years. of 1,242 hours and 26 mins of activity.
Residential aged care activity continues to
present challenges and we are investigating We recognise that values based healthcare
is important to providing high quality
Responsible Bodies Declaration
ways to increase occupancy across our
care and our staff are invited to meet In accordance with the Financial
four aged care campuses. Salary and
with the leadership team to develop a Management Act 1994, I am pleased to
wages increased at a proportionately faster
plan for implementing the values in their present the Report of Operations for the
rate than revenue growth for the full year.
departments. Following a suggestion from Western District Health Service for the year
Notwithstanding lean operating margins, the
our staff, we introduced the 52 Cups of ending 30 June 2018.
Health Service once again posted a small
operating surplus of $108,000. Coffee program, which provides the Chief
Executive with a valuable opportunity to
Community Events and Engagement meet with staff one on one over a coffee.
This year we held community forums Continued Support
on thunderstorm asthma and childhood Ian Whiting
vaccinations, after consultation with our It is a privilege to work with such an
amazingly generous community and team President
Community Advisory Committee (CAC). The
committed to service, quality and excellence. 30 August 2018
sessions were well attended and included
presentations from subject matter experts. The in-kind support of our ladies auxiliaries,
Over 300 guests attended the much volunteers and committees is priceless and
anticipated Medicine Ball, featuring an 80’s contributes to the delivery of high quality
cover band, French roving entertainers and services to our community.
cuisine prepared by local chefs.
3
Financial Overview
OVERVIEW
The Financial Statements have been prepared The Health Service achieved 99.21% of Capital income was $3.979m less than
in accordance with Standing Direction 4.2 the total WIES target for the financial year. depreciation charges. Financial asset fair value
of the Financial Management Act 1994, Residential aged care activity was marginally surplus of $82k, revaluation of long service
applicable Financial Reporting Directions, lower than the prior year and all other activity leave of $70k and a joint venture surplus of
Australian Accounting Standards and targets across the Health Service were $21k were recognised in calculating the net
Australian Accounting Interpretations and other achieved. result for the year. Including all items, the
mandatory professional reporting requirements In reviewing operating performance, capital Health Service net assets increased by $6.8m
for the year ended 30 June 2018. purpose income comprising capital grants for the year, representing an improvement of
The accepted indicator of performance is ($804k), residential aged care capital 4.9% compared to the prior year.
the result from continuing operations prior to contributions ($1.1m) and specific purpose WDHS incurred a comprehensive entity surplus
depreciation and capital purpose income. In the donations and bequests ($800k) are excluded. of $6.8m for the 2017-18 financial year.
current year, the result was a surplus of $108k These funds are provided for specific capital The entity surplus is largely attributable to a
($12k in 2017), which is less than 1% of purposes and are not available to support managerial revaluation of land and building assets
operating revenue. Though WDHS exceeded the operations. Depreciation and valuation undertaken this financial year in accordance
DHHS statement of priorities target of a break changes, specific expenditure from capital with current accounting standards, resulting in
even budget for 2017-18, there are a number purpose revenue ($242k) and the surplus on an asset revaluation surplus of $10.8m. The
of factors impacting on the Health Service's disposal of non-current assets ($97k) are also significant comprehensive entity surplus ensures
viability, including salary and wage costs. excluded, being predominantly funded from the Health Service's overall liquidity levels and
Complexity adjusted (WIES 24) inpatient activity capital income sources. other financial indicators remain stable and
was 3.66% higher than the previous year. In the 2017-18 financial year, depreciation substantially above target levels.
The Health Service WIES target for 2017-18 charges of $6.7m were recorded, reflecting the
increased by an additional 160 WIES cost associated with the use of buildings and
(3% increase). equipment in delivering services.
Income by Category 2018 ($’000) Expenditure by Category 2018 ($’000)
Government Grants (80%) Patient Fees (9%) Business Units (1%) Employee benefits (64%) Fee for Service Medical Officers (6%) Supplies/Consumables (9%)
Other Operating Income (7%) Capital Purpose Income (2%) Capital Donations & Bequests (1%) Other Expenses (13%) Depreciation (8%)
800
1,820
6,669
5,183
591 60,676
10,528
6,427
7,051
5,058 50,132
Income by Category – 5 Year Comparison Expenditure by Category – 5 Year Comparison
2018 2017 2016 2015 2014 2018 2017 2016 2015 2014
Government Grants 60,676 57,317 55,433 53,557 51,204 Employee Benefits 50,132 48,072 46,183 44,689 43,555
Patient Fees 6,427 6,488 5,804 6,898 5,947 Fee for Service Medical Officers 5,058 4,731 4,382 4,247 3,785
Business Units 591 528 473 608 655
Supplies/Consumables 7,051 7,686 7,101 6,416 6,213
Other Operating Income 5,183 5,469 5,355 5,119 8,042
Other Expenses 10,528 9,301 9,457 10,156 12,246
Capital Purpose Income 1,820 2,651 3,048 1,379 4,001
Capital Donations & Bequests 800 1,887 1,425 824 1,145 Depreciation 6,669 7,020 6,951 6,924 3,900
4
Financial Overview
Liquidity Position This investment was substantially less than the It is important to maintain the level of
During 2017-18 the Health Service generated $6.7m depreciation expense for the year. investment to provide a strong base for the
positive cash flows from operations of $3m Significant items included in the $2.8m Health Service to improve service delivery
($5m in 2016-17), including $2.7m in capital investment, were the purchase and replacement and efficiency and comply with increasingly
purpose income of which $2.745m of capital of two anaesthetic machines totalling $109k, rigorous service standards.
funds was used to purchase property, plant purchase and installation of two new chillers The Future
and equipment. In total the Health Service's for Hamilton Base Hospital and the Birches
Although WDHS faces ongoing financial
available cash increased by $3.7m to $12.6m $294k, a new Theatre CSSD washer $95K, an
challenges, the organisation remains
at year end. upgrade to the Theatre imaging system totalling
optimistic about its future and will continue
The ratio of current assets to current liabilities $48k, vehicle replacement program $326k and
to identify ways to enhance financial
(excluding patient trust funds) at the end of $1.543m for assets under construction, including
performance and achieve greater operational
the year was 1.47:1 compared to 1.76:1 in the Cancer and Dialysis Centre, the Birches
efficiency and productivity through
the previous year. This remains considerably redevelopment, the steam boiler replacement
continuous improvement processes that meet
in excess of the 0.7 target ratio. program and the upgrade of the nurse call
community needs.
system.
Asset Management Community Support
$2.8m was invested during the year in building
Support from our community, as indicated
works, plant, equipment and infrastructure
by the outstanding $800k received from
upgrades, in accordance with the capital works
donations and bequests, allows WDHS to
budget adopted in September by the Board.
continue to invest in buildings, medical
equipment and technology.
Complexity adjusted (WIES 24) inpatient activity was 3.66% higher than the previous year.
YEAR IN BRIEF 2018 2017 2016 2015 2014
FINANCIAL ($000'S)
Total Revenue 72,877 69,802 67,138 66,109 65,898
Total Expenses 72,769 69,790 67,123 65,508 65,799
Net Result before capital and specific items 108 12 15 601 99
Net Result for the year (inc. Capital and Specific Items) (4,024) (2,470) (2,650) (4,284) 1,146
Retained Surplus / (Accumulated Deficit) 6,363 11,791 17,108 22,041 27,217
Total Assets 175,844 167,861 169,361 167,842 167,613
Total Liabilities 29,815 28,697 27,698 23,439 18,850
Net Assets 146,029 139,164 141,663 144,403 148,763
Total Equity 146,029 139,164 141,663 144,403 148,763
FUNDRAISING ( $000'S)
Income 868 1,913 1,447 854 1,171
Expenditure 68 26 21 27 26
Surplus 800 1,887 1,426 827 1,145
STAFF
Number of staff employed 717 716 731 716 721
Equivalent full time 540.99 538.82 534.11 531.05 547.63
PERFORMANCE INDICATORS ( ACUTE )
Inpatients treated (separations) 7,159 7,161 6,967 7,026 7,197
Complexity adjusted inpatients (WIES24)* 5,497 5,303 5,213 5,142 4,998
Average stay (days) 2.49 2.48 2.68 2.67 2.77
Inpatient bed days 17,803 17,773 18,201 18,758 19,971
Total occasions of non-admitted patient service 49,202 49,631 46,973 37,830 39,208
* WIES - Weighted Inlier Equivalent Separations
5
Service Performance at a Glance
2018 2017 2016 2015 2014
INPATIENT STATISTICS (ACUTE PROGRAM)
Inpatients Treated 7,159 7,161 6,967 7,026 7,197
Average Complexity ( DRG Weight ) 0.77 0.74 0.75 0.74 0.69
Complexity adjusted inpatients ( WIES 24 )* 5,497 5,303 5,213 5,142 4,998
Inpatient Bed Days 17,803 17,773 18,201 18,758 19,971
Average Length of Stay ( days ) 2.49 2.48 2.61 2.67 2.77
HITH bed days 787 420 816 671 631
Nursing Home Type Bed Days 412 604 637 1,091 1,553
Operations 2,911 3,138 2,911 3,127 2,895
Births 172 162 193 191 210
Available Bed Days 28,389 27,877 27,954 27,654 28,613
Occupancy Rate 66.9% 67.4% 70.3% 71.8% 75.2%
Average Cost per inpatient 5,226 $5,147 $4,909 $4,608 $4,344
AGED CARE STATISTICS - (AGED PROGRAM)
High Care
Residents Accommodated 185 189 220 207 185
Resident Bed Days 45,557 50,297 52,790 51,021 39,639
Low Care
Residents Accommodated 23 24 24 29 62
Resident Bed Days 5,121 4,405 3,100 5,665 11,803
Respite
Residents Accommodated 169 182 214 133 139
Resident Bed Days 4,948 3,414 2,764 2,049 2,077
Occupancy Rate 88.50% 91.26% 92.10% 92.48% 84.27%
Home Care Package (HCPs) clients 47 40 36 38 44
HCPs occasions of service 15,128 10,294 9,608 9,843 9,654
ACCIDENT/EMERGENCY OCCASIONS OF SERVICE 7,497 6,960 7,018 6,984 7,155
Outpatient (Non-admitted) Occasions of Service
Physiotherapy 7,394 8,047 6,855 4,114 4,360
Planned Activity Group 7,435 6,626 5,941 5,743 5,319
Speech Pathology 745 925 810 762 658
Podiatry 2,736 3,056 2,993 2,617 2,229
Occupational Therapy 1,787 1,952 1,920 1,753 1,812
Palliative Care 1,842 1,143 2,309 1,428 2,012
District Nursing Service 22,623 23,597 22,123 21,973 21,959
Other (Continence, Diabetes, Dietetics) 4,640 4,285 4,022 3,479 3,198
Total Non-admitted Occasions of Service 49,202 49,631 46,973 41,869 41,547
Cost Per Non-admitted Occasion of Service $243 $219 $191 $171 $169
Meals on Wheels 19,554 21,006 20,382 23,078 26,933
Quality Assurance
Full Accreditation Status YES YES YES YES YES
* WIES (Weighted Inlier Equivalent Separations) are based on the Australian Refined - Diagnostic Groups (AR-DRG) further refined in Victoria by the addition of a few additional DRGs by the Vic-DRG
version 8.* Our Target WIES for 2017-18 (excluding those funded under the Small Rural Health Services Program) was 5,378. The Health Service was 0.79% below target this year.
6
Services & Programs
Acute/Sub-acute • Specialist Nursing • Occupational Therapy National Centre for
• Anaesthetics • Stroke Medicine • Palliative Care
• Transition Care • Physical Activity Programs Farmer Health
• Chemotherapy • AgriSafeTM
• Contracted Services - Pathology, • Urology • Physiotherapy
• Wound Care • Podiatry • Health and Lifestyle Assessments
Radiology and Sleep Clinic • Information and Knowledge Hub
• Coronary Care • Short Term Support
• Day Procedure Primary & Preventative • Public Health Medicine • Research and Development
• Sustainable Farm FamiliesTM
• Ear, Nose and Throat Health • Rehabilitation in the Home
• Training and Education
• Emergency • Audiology • Respiratory Education
• Respiratory Support Group
• Endocrinology • Balance Clinic
• Sexual and Reproductive Health
Administrative
• Endoscopy • Breast Cancer Support Group • Auxiliaries
• General Medicine • Cancer Care Coordinator • Smoking Cessation
• Community Liaison
• General Surgery • Cancer Support Group • Social Support Group
• Facility Management
• Geriatric Evaluation Management • Cancer Support Services • Social Work
• Finance
• Gynaecology • Cardiac Rehabilitation • Speech Pathology
• Health Information
• Haemodialysis • Cardiac Support Group • Stomal Therapy
• Hotel Services
• High Dependency Care • Carer’s Support Group • Telehealth
• Human Resources
• Hospital in the Home • Chronic Disease Management • Women’s Health
• Learning and Education
• Infection Control Program • Workplace Health Programs
• Library
• Intensive Care • Chronic Pain Service • Youth Programs
• Meals on Wheels
• Maxillofacial Surgery • Complex Care • Medical Administration
• Nephrology • Continence Service Aged Care
• Dementia Specific Residential • Occupational Health and Safety
• Neurosurgery • Counselling • Quality Improvement
• Obstetrics • Diabetes Education Aged Care
• Geriatric Medicine • Reception
• Oncology • Discharge Support Service • Security
• Operating Suite • District Nursing Service • Home Care Packages
• Leisure and Lifestyle • Sub Regional Corporate Services
• Ophthalmology • Domiciliary Midwifery • Volunteer Program
• Oral Surgery • Exercise Physiology • Women & Men’s Out & About
• Orthopaedics • Family Planning Activities
• Paediatrics • Hamilton Community Transport • Palliative Care
• Pharmacy • Hospital in the Home • Private Respite Care
• Preadmission Service • Lymphoedema Management • Psycho Geriatric Care
• Psychiatry • Men’s Health • Residential Aged Care
• Rehabilitation Medicine • NDIS • Respite Care
• Specialist Adult Medicine • Nutrition and Dietetics
RR WDHS has appointed a new Oncology Nurse Consultant, Carmen Jacobs to support the new cancer treatment model
of care. Carmen (right), is pictured here with Medical Unit Manager Aisling Cunningham, Receptionist Ingrid Farrow and
Dialysis Nurse, Leonie Eales in the new Cancer and Dialysis Centre.
7
Patient Admissions & Classification
Total Discharges – 5 Year Comparison
Location 2018 2017 2016 2015 2014
Hamilton City 3,121 3,139 2,643 2,350 3,629
Southern Grampians 911 931 728 538 822
Glenelg Shire 806 1,002 807 711 1,029
Moyne Shire 968 779 478 393 636
Other 1,353 1,310 2,311 3,034 1,081
Total 7,159 7,161 6,967 7,026 7,197
Inpatient by Classification – 5 Year Comparison
2018 2017 2016 2015 2014
Public 5,735 5,580 5,274 5,193 5,418
Private 1,249 1,382 1,486 1,576 1,490
Department of Veterans Affairs 120 145 140 201 226
Transport Accident Commission 18 20 21 26 25
Workcover 37 34 46 30 38
Total 7,159 7,161 6,967 7,026 7,197
RR Patient, Gladys Ryan with Customer Service Officer, Paige Cross.
8Enhancing People’s Lives
We support the prevention of illness and promote the health and wellbeing of people in our community. We strive to deliver
customer service excellence and continuously innovate to adapt to the needs of our community. We deliver quality services as
close to home as possible.
CARING FOR OUR COMMUNITY
The WDHS Cancer and Dialysis Centre is The policy reduces the time it takes for
Care Snapshot 2017-18 expected be completed in September 2018 treatment decisions to be made and ensures the
and in anticipation of the opening, a review continuity of care from ambulance notification
2,911 operations
of patients and workflow was carried out. A to treatment and further management. The
173 babies Clinical Nurse Consultant - Cancer Services was project ensures that stroke care is equitable,
appointed and will be a key contact for patients accessible and based on the best available
49,202 outpatient occasions of service
and staff, further enhancing patient care. evidence and resources for patients presenting
17,803 inpatient days in hospital A number of nursing staff have also completed with stroke symptoms.
7,497 ED presentations training in both haemodialysis and oncology,
to ensure an appropriately skilled and flexible PARTNERING TO IMPROVE
25.7% ED patients admitted to hospital workforce as we transition to the new area. SERVICE DELIVERY
55,626 aged care bed days As part of our new oncology model of care
and consistent with the latest cancer treatment Skin Cancer Detection Clinics
research, the WDHS Exercise Physiologist also WDHS has developed a new collaborative
INCREASING CAPACITY initiated one-on-one exercise programs for approach for the management and early
detection of skin conditions including skin
clients on chemotherapy this year.
Supporting People with a Disability cancers. This new approach involves satellite
Customer Service skin cancer clinics across Victoria with our
The National Disability Insurance Scheme (NDIS)
rolled out in October 2017 and WDHS quickly A Customer Service Officer was employed to Men’s Health Nurse Practitioner, providing
became the largest provider of NDIS services in support improved communication for patients, relevant and timely referrals to Dr Werner
the South West region. The NDIS has increased families, carers and staff at WDHS in 2017. Sinclair’s Dermatology Clinic, based at WDHS.
demand for many of our services, including The Project Officer works collaboratively This service means that patients have more
Occupational Therapy, which has been requested with key stakeholders, including Health timely access to a specialist dermatologist.
by 75% of clients referred to WDHS. To meet this Service managers, clinicians, other health
professionals, consumers and carers to identify Responding to Mental Health Issues
demand, a new Occupational Therapist joined
and act on opportunities for innovation in WDHS and the South West Healthcare Mental
the team in May 2018.
the delivery of healthcare to improve patient Health team are working collaboratively to
Emergency Department Changes experiences. Customer service and positive improve the management of patients presenting
The number of patients visiting the Emergency communication sessions were also delivered to to our service with mental health needs. A
Department has increased by over 500 over 400 employees across the organisation, multi-disciplinary Mental Health Workgroup,
presentations in the past twelve months. In to enhance skills and provide insights for staff. with representation from Police, Ambulance
response to this increase, a new nursing Victoria, Nursing, Security and Hotel Services
Early Detection of Lymphoedema was established, to improve communication,
structure was implemented. A new Nurse
Unit Manager was appointed to manage the The Physiotherapy Department is developing review cases, incidents and issues and to
Emergency Department and Intensive Care a Lymphoedema Early Detection Clinic for develop new guidelines. This group will
Unit. This change will further strengthen the men and women post Cancer surgery. WDHS continue to implement new requirements to
service provided to our patients. received funding from Peter’s Project to comply with the NSQHS Standards.
support this initiative with the donation of
Streamlining Orthopaedic Care $12,800 to purchase a SOZO machine to detect Palliative Care in Home Respite
Over the past three years the number of joint Lympohedema in its earliest stages. WDHS Palliative Care has developed a
replacement procedures undertaken at WDHS collaborative program, partnering with the
EyeConnect Project Southern Grampians Shire to deliver funded
has doubled. The Health Service currently has
three orthopaedic surgeons who regularly visit This year WDHS joined the Royal Victorian Eye in-home respite services. The WDHS Palliative
for consultations and Theatre lists. and Ear Hospital’s eyeConnect telemedicine Care team is providing an education plan for
project. eyeConnect is a complete telemedicine carers on end of life care in the home.
A multidisciplinary workgroup was convened
diagnostic platform capturing and transmitting
to streamline the patient’s transition from
surgical to rehabilitation services, with patients
diagnostic information to remote specialists. SPECIALIST RECRUITMENT
The specialist views patient information and
generally discharged from hospital within three
communicates eye treatment instructions to
Director of Anaesthetics
to four days. Dr James Muir stepped down as Director of
staff and patients. This provides immediate
access for patients with eye injuries to a Anaesthetics in January, after 15 years dedication
ENHANCING CARE specialist consultant, without unnecessary to the delivery of safe anaesthetic procedures
Oncology Model of Care travel to metropolitan services. in Hamilton. In June 2018, Dr Eve Shepherd
commenced as Director, following a 16 year
Over recent years WHDS has built its oncology Stroke Management career as a Clinical Anaesthetist. She graduated
service to ensure the community has world
From April 2016 to December 2017 WDHS in Medicine at Charles University in the Czech
class facilities and specialists at its doorstep.
participated in the Victorian Stroke Telemedicine Republic in 1998. Dr Shepherd has since worked
Leading oncologists from the Ballarat
Project. The project outcomes included the in the UK as a Consultant Anaesthetist and in
Regional Integrated Cancer Centre (BRICC)
introduction of a Stroke Call Policy to provide 2017 moved to Australia, where she took up a
and Radiologists from the South West Cancer
an immediate stroke team response for rapid role at the Fiona Stanley Hospital in Perth.
Centre are supported by chemotherapy nurses,
access to medical imaging services, ICU and a
pharmacists and the care co-ordination team.
telemedicine neurologist consult.
9Enhancing People’s Lives
New Obstetrician Gynaecologist A best practice risk screening tool for cognitive Ultimately, the change has given consumers
Dr Clare Myers commences her role at impairment and delirium was also implemented. more choice in their provider and flexibility in
WDHS in July 2018, partnering with Hamilton A highly successful Dementia Forum was also the way the package supports them to remain
Medical Group as a Specialist Obstetrician held for carers, their families and the wider living at home. Until February 2017 WDHS
and Gynaecologist, with a keen interest in community, with over 70 people in attendance. provided case management for 28 Home
Laparoscopic Gynaecology. Dr Myers grew up in Care Package clients. Since the change, the
As part of their continued education, staff
Dunkeld, studying Medicine at Monash University provision of WDHS Home Care Packages has
experienced dementia for themselves using
and graduating in 2000 with Honours. grown by 75%. Home Care Package staff are
virtual reality glasses provided through Dementia
trained in the Consumer Directed model and
Australia’s ‘Enabling Edie’ training program.
AGED CARE are effectively supporting consumers to meet
Red Flag Program their individual needs.
Improving Medication Management
A successful new program is ensuring Aged Care Documentation
Improving medication management has been residents maintain an optimum weight while in
a focus in our aged care facilities and includes Funding for aged care facilities in the public hospital
residential aged care. The Red Flag Program
reviewing the type, dosage and number of system is dependent on the documentation of care,
(RFP) was established to improve the nutrition
medications prescribed in order to reduce, which is increasingly carried out by nurses and
experience for residents who are at risk of
(where possible), nine or more medications care staff. This year WDHS conducted a review of
weight loss. The RFP comprises two main
which can lead to adverse events. A local documentation processes in its aged care facilities.
interventions, firstly a Red Flag is placed
external consultant pharmacist was contracted The review incorporated the content and goals of
on meal trays to highlight 'at risk' residents
to conduct medication reviews and provide handover materials and the Nursing Care Plan. It
who require extra time, correct positioning,
recommendations for inclusion in the shared looked at the frequency, time of day and skill levels
assistance, prompting and / or supervision
clinical record. Pharmacists, doctors, nurses of all staff involved in the Care Plan and how this
during meal times. The second intervention
and residents collaborate to review the type, could be streamlined to guarantee quality, while
involves the provision of ‘mid meal options’.
dosage and number of medications to improve also allowing enough time for direct patient care.
The program has been very successful, with
resident safety and health outcomes. Ongoing reviews are allowing staff to restructure their
sites across WDHS looking to introduce similar
workday to achieve greater efficiencies and more
Better Support for People with interventions.
effective use of their nursing time.
Dementia Aged Care in the Home Mobility Trained Nurse Program
A Cognitive Impairment Workgroup, with Home Care Packages are designed to
The Mobility Trained Nurse Program has been
multidisciplinary and consumer representation assist people to remain living at home as
rolled out to all aged care facilities and the
completed a gap analysis against National independently as practicable. In February 2017
Merino Health Service. This program aims to
Dementia Best Practice Standards, resulting in changes were made to the model of care and
equip nursing staff with the skills and tools
several outcomes. These included improved packages became ‘Consumer Directed’.
to address mobility and transfer issues, for
access to a geriatrician / psycho geriatric Home Care Package subsidies are now patients admitted when Physiotherapists are
services, further embedding of the Montessori allocated directly to the consumer, where they unavailable.
Model of Care and workplace support for staff were previously allocated to providers.
diagnosed with dementia.
QUALITY & SAFETY
ACCREDITATION Aged Care Standards CONSUMER PARTICIPATION
A full assessment of compliance with the
WDHS systems and processes are periodically
AACQA Standards was conducted at the
AND FEEDBACK
assessed against national standards.
Coleraine campus in December 2017. WDHS continues to seek opportunities to engage
Accreditation is a mandatory process for all public
Coleraine achieved reaccreditation in all community members to actively participate
acute health services and providers of residential
four AACQA standards, which drive the in the planning and evaluation of services and
aged care. WDHS participates in several
implementation of safety and quality systems improvement processes. Consumers are involved
comprehensive national accreditation programs,
to improve aged care. In recognition of in several workgroups at WDHS including the
including those conducted by the Australian
consistent and sustained compliance with the Community Advisory Committee, the Consumer
Council on Health Care Standards (ACHS) and the
Standards, WDHS was granted an extension Health Information Committee and the Diversity &
Australian Aged Care Quality Agency (AACQA).
to their current period of accreditation. The Equality Committee.
National Standards PDHS, Grange and Birches facilities will now Consumer Feedback
The National Safety & Quality Health Service be assessed in August 2019.
Feedback assists WDHS to monitor the safety and
(NSQHS) Standards drive the implementation of
safety & quality systems to improve healthcare RISK MANAGEMENT quality of the care provided across its service;
to identify improvements to practice, facilities,
across Australia. The second edition of the The identification, assessment and
systems and equipment. In 2017-18, 728 items
NSQHS Standards was released by the Australian management of risk is critical to the safety
of formal feedback were received. Of these 560
Commission on Safety and Quality in Health Care of patients, visitors and staff. Risks are
were compliments and 168 were complaints or
in November 2017. Our governance committee monitored by the Quality Department and are
suggestions for improvement. Of the complaints,
structure has been revised to facilitate the new regularly reviewed by the Executive Team.
80% were addressed within 30 days, with the
standards, with additional focus given to palliative The WDHS risk management framework
remainder closed within 30-60 days.
and end-of-life care, mental health, nutrition and has been implemented in accordance with
malnutrition. The second edition standards come the Risk Management Standard AS/NZS ISO
into effect on January 1, 2019. 31000:2009.
10Transforming Rural Health
We encourage the development and design of new and innovative practices and processes that lead to system
change. We promote an environment that inspires learning, thought leadership and enables staff to actively
participate in contributing to change.
COMMUNITY HEALTH & WELLBEING
FARMER HEALTH Help-Seeking for Wellbeing OBESITY PREVENTION
An NCFH honours student project focused
Ripple Effect Suicide Prevention GENR8 Change & SEA Change
on help-seeking for social and emotional
The final report on the NCFH Ripple Effect wellbeing among young rural adults in Victoria. Southern Grampians and Portland communities
Suicide Prevention project was received and It identified past experiences and the current are two of only a handful of places in the world
accepted by beyondblue and can be accessed intentions of participants. The findings from reversing levels of overweight and obesity in
on the beyondblue website. the study will contribute to improved prediction children, according to data collected as part
of future help-seeking behaviours in young of GenR8 Change and SEA Change Portland.
rural adults and provide knowledge from the Researchers at the Deakin University Global
community, which will help in the development Obesity Centre (GLOBE) found that children
759 7 measured across Southern Grampians in 2015
Participants Partner of appropriate and effective ways to support
Agencies young rural adults. and again in 2017, have improved their lifestyle
behaviours of fruit and vegetable consumption,
60+
International Links increased their physical activity (including walking
450,000+
Social Community
Champions The international reputation and reach of the and riding to and from school) and reduced sugary
Media
NCFH continued to grow, with involvement in drink consumption. The GLOBE also measured
Teagasc in Ireland and Centurion University in a reduction in levels of overweight and obesity.
India, where we are undertaking 'in partnership' Portland achieved similar exciting results, which
60+ 466
Media Stakeholders farmer lifestyle assessments. A staff member are rarely seen across the globe and particularly
from Centurion completed the Agricultural in such a short period. These results have been
Community
Presentations Health and Medicine unit in 2018. More achieved by the community making hundreds of
recently, the NCFH was approached to work changes, big and small, to make it easier to eat
with the University of Hamburg-Eppendorf and drink healthier foods and beverages and to be
in Germany to assist with a research project more active. The focus now is to build on this early
Crop Harvest
on reducing suicide stigma. We are also part success and grow the number of people involved.
NCFH CROP HARVEST evaluated farmer of the EU Cost as International Observers for
attitudes and behaviours, to prevent Eating Green
improving safety and health in agricultural
agrichemical exposure. The research involved populations in the EU. WDHS is introducing a new policy to support
41 farmers from Western Victoria and the wellbeing of community members and
assessed the effectiveness of monitoring Gear Up for Ag & Safety staff. All food served in the HBH Cafeteria
exposure to agrichemicals and the influence The NCFH collaborated with the US based Ag and at meetings and events will be classified
this has both on agrichemical use and the use Health and Safety Alliance in March 2018 to ‘green’, exceeding the Healthy Eating Advisory
of personal protective equipment (PPE). deliver the ‘Gear up for Ag Health & Safety’ pilot Service’s guidelines. Through this new
program, at three agricultural colleges in Western direction WDHS will not only improve the health
From Inside the Farm Gate
Victoria. This educational program focuses of staff and visitors, but provide a model for
The NCFH has been busy with a number of on the next generation by interacting with Ag other organisations and businesses, to ‘create
research projects and wellbeing programs students at schools, colleges and universities. The healthier communities’.
particularly focused on rural Australian women. program views students as the future decision
Women have played, and continue to play Shake Up Sugary Drinks
makers in agriculture that will influence how
a significant role in Australian agricultural farming families, businesses, industry and its Professor Anna Peeters from GLOBE at Deakin
businesses and communities and engaging them workers will progress into the future. The clear University was keynote speaker at the SGGPCP
in conversations about their experience on the message delivered to students in the program ‘Shake Up Sugary Drinks’ events held in
land can inform initiatives that both support and is ‘sustainable farming must now include an Heywood and Portland. Professor Peeters
promote rural Australian women and their families. environment that connects health, wellbeing and shared key evidence and practical ideas for
'From Inside the Farm Gate’ invited rural safety as an integral part of everyday culture. reducing sugary drinks in our community.
women to share their experience of navigating
tough times. Beyond the Fence Line FALLS RESEARCH
Through digital storytelling, women worked The NCFH worked with the Department of Health 20 Minute Rounding research explored the
together to create personal stories in a safe, and Human Services (DHHS) and Agriculture impact of ‘20 minute staff rounding’ on the
trusted, peer supported environment— Victoria late last year to deliver rural health incidence of falls and fall related injuries
facilitating emotional expression without workshops. The aim was to build government among high risk aged care residents. A major
judgment, building self-confidence, a sense of department staff awareness, understanding finding was that increased observation of
achievement and encouraging positive social and knowledge of health, wellbeing and safety the intervention group, led to zero fall related
contact. considerations for Victoria’s agricultural and fractures during the study period. 20 minute
farming communities, to allow for better design rounding continues at WDHS, with new
Stories are available at www.farmerhealth.org,
and delivery of government policy and services. guidelines now developed. This important
to provide inspiration, promote communication
The 'Beyond the Fence Line' workshops were research will also be published and WDHS will
and encourage reflection, empathy and
conducted at four locations across Victoria and present a poster at the International Forum on
understanding.
were highly regarded by participants. Quality and Safety in Healthcare in September.
11Transforming Rural Health
COMMUNITY EVENTS To mark the end of the '16 Days of Activism
to End Family Violence', WDHS CE Rohan
The animation highlights the important role
professionals and community members play in
Creating Healthier Communities Mural Fitzgerald and SGSC CEO, Michael Tudball also sharing information informally. In rural Australia
In October, over one hundred people of all planted a tree at Hamilton Base Hospital to 'small talk' can help others make important
ages came together to create a colourful mural demonstrate the community’s commitment to decisions in emergencies. The film can be
promoting the WDHS vision ‘creating healthier supporting those effected by family violence. viewed on YouTube.
communities’. Kindergarten, primary and WDHS Support for Community Pollen Monitoring
secondary school children from across the
Events and Groups In collaboration with the University of
region, staff and aged care residents all chipped
WDHS was once again a major sponsor of the Melbourne (UOM), WDHS was involved in a
in to prepare and paint geometric shapes in a
Hamilton Boomers all abilities football team three month pollen monitoring research project.
cheerful colour palette designed by well-known
local artist, Jasmine Mansbridge. The young and provided in-kind and financial support to A pollen monitoring device was installed at
and the young at heart cut and painted shapes the 3x3 Basketball Tournament and Hamilton Hamilton Base Hospital and each day trained
of their choosing, to reflect the diversity of the Eisteddfod. WDHS supported the public access Maintenance staff collected and analysed the
local community and WDHS’s commitment and defibrillator project by continuing to provide samples of pollen collected, sending data back
connection to people in the region. training for local businesses at the three CBD to the UOM for further analysis.
defib locations, Woolworths, Coles and the
Thunderstorm Asthma Forum Hamilton Spectator. Meeting the Needs of Vulnerable
WDHS held a community Asthma Forum in Young People
June, with experts discussing the relatively COMMUNITY PROJECTS A continued focus on paediatric service
new phenomena of thunderstorm asthma, as Balmoral Fire Connect provision saw the Occupational Therapy
well as asthma triggers, treatment, diagnosis Department, in conjunction with Gray Street
and future treatments. The SGGPCP Balmoral Fire Connect Project
Primary School, successfully apply for
won an award at the prestigious 2017 Victoria
a School Focused Youth Service (SFYS)
Growing Community with Cormac Fire Awareness Awards in the Access and
grant to better meet the needs of young
Russell Inclusion Category and was a finalist in the
people vulnerable to, or showing signs of
Overall Category.
International Asset Based Community disengagement from school. As a result, an
Development guru, Cormac Russell The project trialled two strategies to understand eight week, group-based intervention program
generously shared his skills and experiences the dissemination of information from a central for students aged between 9-12 years was
at the SGGPCP ‘Growing Community’ event. hub in a rural community using the Balmoral conducted from October to December 2017.
Feedback showed that many participants Bush Nursing Centre (BBNC). The strategies
changed the way they think and work with were; understanding the flow of bushfire
community members as a result of attending preparedness information from staff at the
this thought provoking and practical workshop. BBNC; and understanding the flow of information
that stems from user groups of the BBNC.
International Women’s Day
Building on this success, further funding
The WDHS International Women’s Day Lunch support was gained through the CFA Summer
proved a powerful opportunity to ‘press Fire Safety initiatives, to develop a short
for progress’ on gender equality with guest animated film based on the findings of the
speakers’ businesswoman, Nadia Tucker and project.
Monivae student, Ella Lithgow.
The film ‘No Such Thing as Small Talk’ has
White Ribbon been professionally developed and will be
The WDHS / Southern Grampians Shire White disseminated across Victoria later in the year to
Ribbon Luncheon was again held to shine a coincide with pre-summer education. RR The award winning Balmoral Fire Connect team - Tiff
light on the 370 plus local incidents of family Heeson (CFA), Maedeh Karkarvandi (RMIT), Jo Brown
violence reported in our Shire each year. (SGGPCP), Louise LeNay (CFA)
Over 120 tickets were sold to the event,
featuring guest speakers Natalie Russell
from VicHealth and Police Superintendent,
Peter Greaney.
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