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Monash Health leads the way
in appropriate imaging
A new app, free from the iTunes
store, has been developed to
provide doctors, nurses and
allied health practitioners with fast, accessible and evidence-
based decision support at the
bedside when they are
considering a referral for
imaging.
The "RANZCR Clinical Decision
Rules" app also can be used to
facilitate shared decision making
with patients, parents, and
carers about why imaging may
or may not be needed for their
particular situation.
Stacy Goergen, Director of
Research, Monash Imaging, and
Adjunct Clinical Professor,
Departments of Medical
Imaging and Surgery, led the
Royal Australian and New
Zealand
College of Radiologists' project to
develop the app as part of a
larger project to create
interactive, web-based
educational modules for
appropriate imaging.
Monash Health in Victoria, is the
only health service in Australia to
integrate the RANZCR web-based
educational modules for
appropriate imaging on its
learning management system with
policy documents on the Monash
Health intranet and now bedside point of care electronic decision
support. The web–based educa-
tional modules are available from
the RANZCR for implementation on
hospital, health service, university,
and professional college learning
management systems.
Documentation of the use of a
validated clinical decision rule
(CDR), when applicable, in the
medical record is good practice
from both the perspectives of
patient safety and organisational
risk management.
Get the App - Bedside Clinical Decision Support
for Appropriate Imaging
AMBUS - A South Australian First
In an Australian first, an
ambulance bus able to carry
and treat 12 patients at a
time will join South Australia’s
ambulance fleet.
The 12m bus can carry six patients on stretchers and
another six sitting. There is
also room for two
clinicians treating patients
and a paramedic drive.
It’ll give paramedics a criti-
cal advantage when
attending major
incidents resulting in
multiple casualties, like
bushfires and car crashes.
Photo: SAAS
http://www.adelaidenow.com.au/
news/south-australia/new-
ambulance-bus-can-carry-up-to-12-
patients/news-story/
aeeaaa2e7658292ed-
c0103f965d1ce6c
February 2016
Change Champions & Associates
Innovation Round Up
Summaries and links to
some of the interesting
innovations project we
have gathered from
Australia and overseas in
2016.
Inside this issue:
Beside CDS for 1
AMBUS 1
Australian Atlas of
Health Care Variation 2
Medicines Clinic 4
U Book 4
Physios in pain
Management in RACF 6
ICE Training Package 8
eCALD Resource 8
Culture Change Insights 9
Dogs4Dementia 9
EI 10
Dr Stacy Goergen,
Director of Research,
Monash Imaging, VIC
http://
www.linkedin.com/
pulse/get-app-bedside
-clinical-decision-
support-imaging-stacy-
goergen?trk=prof-post
Cont on page 2….
The RANZCR CDRs
app will be particularly
valuable in rural and
remote emergency set-
tings where there may be
limited multidisciplinary
support for frontline clini-
cal staff.
It will help to improve the
safety, appropriateness
and efficiency of patient
care across Monash
Health by standardising
pre - test risk assessment
prior to referral for imag-ing. The team plans to
research the
effect of this approach to
appropriate imaging
education on imaging
utilisation and test
positivity rates in 2016.
Completion of the web
based education
modules will be a
prerequisite for Monash
Health interns and ad-
vanced trainees from
2016, to ensure they have
the knowledge base to
enable them to make
wise decisions about
imaging referrals. The
app will reinforce this
training at the bedside.
The app has the joint en-
dorsement of the Austra-
lian College of Emer-
gency Medicine and the
Royal Australian and New
Zealand College of
Radiologists.
The Choosing Wisely Aus-
tralia campaign (http://
www.nps.org.au/media-
centre/media-releases/repository/choosing-
wisely-australia-launching
-in-2015)
initiated by NPS
MedicineWise has also
endorsed the app to
support the Royal
Australian and New
Zealand College of
Radiologists' Choosing
Wisely recommendations.
The CDRs featured in the
app are extensively
validated and,
importantly, each CDR
provides inclusion and
exclusion criteria for the
rule, so clinicians will
know if it applies to their
particular patient.
The conditions covered
are common in the ED
and inpatient settings
and include:
1. Blunt head trauma -
adult and paediatric
2. Cervical spine trauma -
adult and paediatric
3. Suspected pulmonary
embolism - pregnancy
and post-partum
4. Suspected pulmonary embolism - non pregnant
adults
5. Suspected DVT
6. Blunt ankle trauma -
adults and children.
The app is available now
for Apple devices - free
to download from the
iTunes App Store and will
soon be available from
Google Play for android
devices.
To download the app to
your iPhone or iPad, type
"ranzcr" into the search
box on the iTunes Store.
Get the App - Bedside Clinical Decision Support for Appropriate Imaging
(continued from page 1)
Australian Atlas of Healthcare Variation
across Australia, across
areas such as antibiotic
prescribing, surgical,
mental health and
diagnostic services.
It is the first time that data
from the Medicare Benefits
Schedule (MBS),
Pharmaceutical Benefits
Scheme (PBS) and
Admitted Patient Care
National Minimum Data Set
(APC NMDS) have all been
used to explore variation
across different healthcare
settings. The atlas is
presented alongside the first
national
recommendations for
action.
Access the data items within
each chapter or to
download the full version of
the Australian Atlas of
Healthcare Variation
http://
www.safetyandquality.gov.au/
atlas/
In collaboration with
Australian, state and
territory governments,
specialist medical
colleges, clinicians and
consumer representatives,
The Australian Commission
on Safety and Quality in
Health Care has
developed the
first Australian Atlas of
Healthcare Variation.
The atlas presents a clear
picture of substantial
variation in healthcare use
Page 2
Change Champions & Associates
Caption describing pic-
ture or graphic.
Page 3
February 2016
Improving
Consumer and Carer
Engagement in Health Care
29 February, 2016
Pavilion Room, The Arts Centre
100 St Kilda Rd, Melbourne Victoria
Register now for early bird at
http://www.changechampions.com.au
This project presents the
results from a pilot of
community-
based Medicines and
Health Literacy Clinics with
final-year pharmacy
students at the University
of Otago. The clinics are
intended to not only
provide an authentic
learning experience for
the students themselves,
but also to create an
opportunity for improving
health literacy amongst
the Otago population.
The clinics offer a patient-
centred health informa-
tion opportunity to
improve health literacy in
the community. The
HLMC (also known as a
‘Brown Bag Medication
Review’) encourages
patients to bring all of their
medicines and
supplements to a
community setting without
appointment or cost.
Typical discussions centre
around answering patient
concerns, verifying what is
being taken, identifying
medication interactions or
errors and improving
aspects of adherence.
Download the full report
as a PDF from
https://
akoaotearoa.ac.nz/
download/ng/file/group-
7/medicines-clinic-a-novel
-learning-opportunity-for-
understanding-health-
literacy.pdf
Medicines Clinic – A novel opportunity for
understanding health literacy
U Book- Patient Focused Bookings
no administration input
Allows administration
staff to book patients in or-
der of priority and time
waiting
Reduces the amount of
administration time required
to book an outpatient ap-
pointment
Uses a colour coded
system so that staff can
visually track where patients
are in the system
View real time demand
and capacity at the click of
a button down to service
level
Bulk printing of patients
letters
2013/14 there where
16486 referrals
DNA rate sustained @
1.4%
7% reschedule rate by
patient on line saving ad-
ministration time
Year on year increase
in on line bookings
Phase 2 – pilot phase
They identified early on that
the main gains with the U-
book system would be in
the area of follow up
appointments. This is now
being piloted in gynaecol-
ogy service. These
include:
Allows patients to pa-
tients to either phone and
make a mutually agreed
appointment with clerical
staff or directly book on
line via the internet, requir-
ing no administration input
Reduces the amount
of administration time re-
quired to book an outpa-
tient appointment
Uses a colour coded
system so that staff can
visually track where pa-
tients are in the system
View real time de-
mand and capacity at
the click of a button down
to service level
Bulk printing of pa-
tients letters
2013/14 there where
47295 follow up appoint-
ments referrals
Clinical management
of patients who do not
contact us within the
agreed time frames.
These are the patients
that would usually DNA.
Dawn Livesey and the
team at Hutt Valley District
Health Board, NZ are
implementing the U book
system. U Book has been
developed for patients to
be able to make their own
outpatient appointments.
Patients receive a referral
letter inviting them to make
their appointment using
Ubook, or via the usual
method of phoning the
booking office
Patient empowerment is at
the core of the Ubook
concept, but the system
also has the benefit of
streamlining the booking
administration process.
Phase 1- in place
U-book was implemented
in a service by service
phased approach First Spe-
cialist Appointments only.
There are several
components to U-book,
including:
Allows patients to pa-
tients to either phone and
make a mutually agreed
appointment with clerical
staff or directly book on line
via the internet, requiring Page 4
Change Champions & Associates
Page 5
February 2016
www.changechampions.com.au
Health Literacy
Registrations Now Open at http://www.changechampions.com.au
Friday 11 March 2016
Bourke Room, The Hotel Windsor
111 Spring St, Melbourne
VIC, AUSTRALIA
The Physiotherapy Pain Man-
agement Program is an ini-
tiative within UnitingCare
NSW/ACT Arrunga aged
care home. It involves an
innovative non-
pharmacological treatment
approach to care.
The program, which has
been underway for over 4
years looks at the overall
effects of the various pain
interventions used in
managing chronic pain in
the elderly with the view to demonstrate a benefit for
residents in reduced and
better managed pain and
thus improved quality of life.
Physiotherapists attend the
home and carry out the
pain management clinic
four days a week, treating
painful areas with therapy
modalities and interventions
such as hydrocollator heat
packs, massage, joint
mobilisation and TENS
(transcutaneous electrical
nerve stimulation).
Physiotherapist assistants
help by assisting residents to
get to the pain clinic,
assisting with resident
positioning, and preparation
and application of heat
packs.
Some residents who are
unable to visit the pain clinic
are attended to in their
rooms. Every month, the
facility management and
the physiotherapist meet to
review the pain program in
detail. During this time, the
residents’ pain is discussed
and the program is
re-evaluated.
The residents attending the
pain clinic are treated as a
group receiving heat packs
while the physiotherapist
attends to the residents
with interventions, ensuring
privacy and dignity. This
social approach provides
an additional positive
effect, allowing for interaction with other
residents and opens up
discussions for various ways
of dealing with pain.
Data was collected over
eight areas including
analgesia usage, reported
pain levels and activities of
daily living such as activity,
sleep and mobility.
1. Change in dosage/
frequency of medication
2. Change in type of
medication according to
WHO analgesic ladder
3. Change in pain
score/level
4. How pain affects
sleep
5. How pain affects
general activity level
6. How pain affects mo-
bility
7. How long pain returns
after taking medication
8. How has medication
or interventions relieved
pain in the past week
This data has been
collected from residents’
assessments and charts
and are then re-evaluated
using their most recent
documentation (six to nine
months later). The use of
analgesia was then
analysed against the WHO
(World Health Organiza-
tion) analgesic ladder to
reflect the movements of a
treatment plan over six to
nine months for controlling
pain.
The results indicate that most (85%) of the residents
on the program have
improved or maintained
their pain status over time.
With both the sensation
(through medication) and
the source of the pain
(through physiotherapy
interventions) being
addressed, the residents
reported positive
outcomes and improved
quality of life.
Across all eight areas, 11%
of residents improved, 74%
maintained and 15%
regressed. All 40 residents
on the program reported
subjective improvements,
in particular coping better
with their day and enjoying
the therapy interventions.
More information
Celedonia
Laverty, claverty@unitingcarenswact.org.
au or (02) 8878 6481, or Sri Mat-
tapalli, smattapalli@unitingcarenswact.o
rg.au on (02) 8878 6492.
Physiotherapy Pain Management Program
Inviting Stories for our May 2016 Edition
Our readers are interested in
Quality and safety
Patient flow and re-
design
Productivity improve-
ment
Care of older people
Leadership
Integrated care
Green hospitals
Patient experience
Health literacy
Mobile technologies
Submit your story and
pictures to
info@changechampions.com.au
Are you excited about the
achievements of your
innovation project?
We are now inviting
submissions of stories of
around 150-300 words for our
May 2016 newsletter.
Picture, links to other websites
etc are welcomed. Page 6
Change Champions & Associates
The focus of this event is on how the sustainability of implemented initiatives to improve
patient flow has been demonstrated.
Call for abstracts open until 20 March 2016.
Details about the range of topics likely to be covered at http://
www.changechampions.com.au
Calls for Abstracts Currently Open
Sustaining Improvements in Patient Flows 20-21 June 2016, Gold Coast, QLD
Preventing Unnecessary Emergency Department Transfers for Older People 5-6 May 2016, Melbourne, VIC
Share lessons learnt from innovations designed to improve patient safety, quality and
efficiency in hospitals after hours.
Call for abstracts open until 21 February 2016.
More information about the range of topics likely to be covered at http://
www.changechampions.com.au
Page 7
February 2016
Caption describing picture
or graphic.
The Hospital After Hours 23-24 May 2016, Sydney, NSW
Addresses opportunities and challenges by showcasing strategic approaches and
innovations programs that assist to
alleviate demand and capacity pressures on hospital emergency departments
(ED)
enable older people living in the community/residential aged care (RACF’s) to
receive timely, appropriate urgent care
assist vulnerable older people to avoid potentially unnecessary transfers to hos-
pital emergency departments.
Call for abstracts open until 15 February 2016. More information at http://
www.changechampions.com.au
The use of Ice (crystal
methamphetamine) in Aus-
tralia has received much
attention. There is a pressing
need for support for people
who use crystal metham-
phetamine, their families,
friends, and co-workers.
Information is needed that
provides an accurate
picture of the prevalence of
crystal methamphetamine
use in Australia, which
population groups are most
at risk, details of intervention
options available, and steps
that can be taken to help
people who use crystal
methamphetamine receive
the necessary treatment.
Treatment has been found
to be effective in helping
people who use crystal
methamphetamine and
there is a strong need for the
community to work together
to achieve the best
outcomes for all involved.
The National Centre for
Education and Training on
Addiction (NCETA) at
Flinders University, SA, has
developed a Training
Package for health profes-
sionals as part of
the Victorian Government’s
Ice Action Plan.
The Training Package is
designed to meet the needs
of a wide range of frontline
workers including those
from the health and
welfare, education,
criminal justice and trans-
port sectors. It was
developed following an
extensive consultation
process to identify key
learning needs.
This package provides
information and resources
for frontline workers to en-
hance their existing skills
and knowledge. The
Training Package is very
broad and comprehensive
in its approach, but has a
specific focus on the
identification and care of
people who are
intoxicated with, and/or
withdrawing from, crystal
methamphetamine and
their families and carers.
The package provides
useful material to guide
workers’ practice when
assisting clients and their
families, and working with
their colleagues.
The package has 7 inde-
pendent but
complementary modules,
with each containing up to
8 topics. The Training
Package is designed to be
flexible with content that
suits a variety of needs.
The package covers a
broad range of issues
including:
-Information about crystal
methamphetamine and its
use and harms
-How crystal
methamphetamine use
affects people and
communities
-Worker safety and
preventing, managing and
recovering from crystal
methamphetamine-
related critical incidents
.Legal issues
-Using crystal
methamphetamine with
alcohol and other drugs
-Communicating with and
supporting people who
use crystal
methamphetamine
-Preventing and
intervening in crystal
methamphetamine use
-Organisational responses
to crystal methampheta-
mine.
https://
nceta.androgogic.com.au/
ICE: Training for Frontline Health Professionals
eCALDTM Resource Development
New Zealand health
workforce.
The provision of
eCALDTM courses and
resources "for working
with patients" is funded
by the Ministry of Health
as part of the Northern
Regional
Alliance’s Asian,
Migrant and Refugee
Health Action
Programme. http://www.ecald.com/
eCALDTM resources and
courses have been de-
veloped by Waitemata
DHB’s Asian Health
Support Services to
address the need for
CALD cultural
competence training
and information for the Page 8
Change Champions & Associates
Edgar Schein’s, 20 Organisational Culture Change Insights
“Preliminary results from an overseas study
show that the presence of the specially
trained dogs can help support the person with
dementia and carer, extending their capacity
to live at home,” Professor Cunningham says.
“Reduced hospitalisation and delayed
admission to residential aged care are
possible outcomes we will be evaluating as
well as the positive impact these beautiful
dogs can have on the care-giving relationship
and carer wellbeing.”
Assistance Dogs Australia’s Top Dog, Richard
Lord says, “Assistance Dogs Australia is
enjoying working closely with HammondCare
in this ground breaking project.”
“We know that our experience in providing
service dogs for people with physical
disabilities, children with autism and for those
suffering from PTSD will hold us in good stead
when working with the participants in the
project.”
http://www.dogs4dementia.com.au/
A pilot project, which will see people
diagnosed with dementia partnered up
with a specially trained assistance dog,
has been expanded from two to five
states.
HammondCare Dementia Centre’s Dogs 4
Dementia was first launched in NSW and
Victoria in April 2015. It has since been
expanded to include South Australia,
Tasmania and Queensland.
Director of the Dementia Centre, /Prof
Colm Cunningham, says the Dogs 4
Dementia project is expected to bring
significant benefits to people living with
dementia at home with a carer.
“For the first time in Australia we’ll see
expert Dementia Centre consultants
working together with Assistance Dogs
Australia instructors to place dogs with
couples, at a time when a diagnosis of
dementia may have just been received.
“Each couple and dog will be carefully
matched and will be supported by both
organisations for the duration of the pilot.
Page 9
February 2016
Dogs for Dementia Pilot Expanded
Tim Kuppler from the Culture University recently interviewed Edgar Schein, who pioneered
culture change in organisations. Follow the link below to read Dr Schein’s 20
organisational culture insights and watch the interview video excerpt which covers a
concise explanation of the following culture fundamentals:
Don’t over-simplify culture. It’s far more than “how we do things around here.”
Focus on a problem and how culture is influencing it instead of trying to change
culture directly.
Culture is always helping and hindering problem solving. It’s important to understand
both.
Be very specific about behaviour, how it’s impacting your problem and the future
state of the behavior you want to see.
http://www.cultureuniversity.com/20-organizational-culture-change-insights-from-edgar-
schein/
This story can fit 100-150 words.
The subject matter that appears in newsletters is virtually endless. You can include stories that focus on current technologies or innovations in
your field.
You may also want to note business or economic trends, or make predictions for your customers or clients.
If the newsletter is distributed internally, you might comment upon new procedures or improvements to the business. Sales figures or earnings
will show how your business is growing.
Some newsletters include a column that is updated every issue, for instance, an advice column, a book review, a letter from the president, or an
editorial. You can also profile new employees or top customers or vendors.
Page 10
Change Champions & Associates
Page 10
In this full day introductory workshop, you will:
Gain an overview of the science and value of emotional intelligence
Consider the impact on performance of positive and negative emotions in the workplace
including the impact on individuals, productivity and organizational outcomes
Understand six competencies of the Genos International model of emotional intelligence
for leaders
Participate exercises where you try working with the competencies for emotional intelligence
Discover some tips and develop an action plan for improving your own emotional intelligence
Take away your Genos International Introduction to Emotional Intelligence work book
“I’ve learned that people will forget what you said, people will forget what you did but people will never forget how they made you feel”
Melbourne, Adelaide, Canberra, Sydney, Brisbane & Your Facility 2016
REGISTER at http://www.changechampions.com.au
Emotional Intelligence for Leaders
Also available—Strictly confidential leadership self assessments, 180˚ and 360˚ with action planning and
coaching. Enquiries at info@changechampions.com.au
Page 11
February 2016
Page 11
Agile Project Management for Health Care
COURSE REGISTRATION 2016
With Accredited Trainer, Julie Faoro
Melbourne, Adelaide, Sydney and Brisbane
The course will: Explain how to lay the foundations for successful agile projects
Explain how an agile project is managed
Clarify the different management styles needed for successful agile projects (compared to "traditional" projects)
Provide integration with PRINCE2®. Improve time-to-market and project success rates while simultaneously accelerating results by encouraging stakeholder involvement, feedback and effective controls. Achieve better communication and control over projects and adapt project
plans without disrupting the project budget, timescale and scope.
Develop professionalism in employees and include agile certification in em-ployee professional development scheme
Who should attend?
Project Managers, Project Officers, Managers, and team leaders from government, health, aged care and not for profit sectors Any area of the health care system that wish to introduce change on time and on budget.
More details at http://www.changechampions.com.au
Melbourne, Adelaide, Canberra, Sydney, Brisbane & Your Facility 2016
REGISTER at http://www.changechampions.com.au
About Change Champions & Associates
Change Champions & Associates
PO Box 302
Kew VIC 3101
M: 0467635150
E: info@changechampions.com.au
W: www.changechampions.com.au
Innovate with us on our Facebook page
or on Linked In
Change Champions & Associates designs and produces
seminars for health professionals. We also showcase
leadership development, practice development, service
and quality improvement initiatives across the spectrum of
health and interrelated facilities and the across the
continuum of care.
We are a small coalition of the committed working with our
partners to deliver a great seminar experience. We work for
cost recovery, rather than for profit.
In collaboration with our consultants, we aim to provide
valuable and practical learning experiences for a broader
range of professionals from all sectors. These opportunities
will include workshops, in houses at your facility no matter
where (we are strong supporters of those in rural and remote
areas), group and individual coaching sessions delivered by
accredited professionals.
By the end of 2016, our website will be redeveloped to en-
able a more interactive relationship with our supporters,
streamline our seminar registration process and provide
better functionality to enable networking and the sharing of
innovation projects in Australia and New Zealand
and beyond.
Sustain Success Online Resilience Program
Coaching sessions are confidential,
individualized and conducted by
telephone
Put your best foot forward in 2016!
If you are under the pump and not sure that you are
managing as well as you could, this online program, Sustain
Success, will help you to build your resilience at work and
beyond.
Best of all its easy! There is no need to ask your manager for
permission for time off to attend a course. No need to feel
embarrassed about your capacity to cope. No need to
consider withdrawing or watering down decision making
because you feel that your ability and your confidence are
living on different planets.
Developed by revered, organisational psychologist, Kathryn
McEwen, here's an opportunity to reflect on the way work
pressure impacts on the way you function at work and
beyond. You can complete the program, in your own time
and at your own pace.
Better, you will be supported by a Resilience at Work
Accredited coach. This is not a one size fits all program. One
75 minute coaching session is included in the
program
Bitten off More than you can
Chew??
info@changechampions.com.au
Recommended