Strategic directions - Annual Report 2014-2015 - Darling Downs … · 2016-11-10 · 2015 the waiting list had reduced to 244 patients with no one waiting in excess of the clinically

Darling Downs Hospital and Health Service Annual Report 2014-15 11

The Darling Downs Hospital and Health Board’s vision is to be trusted to deliver excellence in ruralandregionalhealthcare.TheDDHHSStrategicPlan2014-18identifiesthekeyinitiativestoachieve this goal, and is supported by the organisational values that underpin its success. It is a living document which guides planning, implementation and review of all aspects of our operations. It focuses on our need to have dedicated trained staff who are supported with clear processes and sustainable resources so they are best placed to deliver quality healthcare.

The Darling Downs Hospital and Health Service Strategic Plan has four key strategic directions:

• Deliver quality healthcare (delivering core health services; improving access to services; reducing the impact of chronic disease; ensuring safe and quality health outcomes; and increasing confidence in the health system)

• Ensure resources are sustainable (balanced operating position; ensuring appropriate costs; maximising revenue; leveraging other providers; and optimising asset usage)

• Ensure processes are clear (collaboration with primary health care and other service providers; deliver more care locally; effective operational planning; review and improve care; increase use of clinical evidence-based decision making; and engage the community and health care consumers)

• Ensure dedicated trained staff (embed a values-based culture; develop, educate and train our workforce; plan, recruit and retain an appropriately skilled workforce; engage clinicians to improve the service; and promote and support the health and wellbeing of our staff).

Our priorities in 2014-15 included:• Reduction of the specialist outpatient waiting list

and ensuring patients were seen within clinically recommended timeframes

• Reduction in the endoscopy waiting list• Ensuring elective surgeries were performed within

clinically recommended timeframes• Achieving the National Emergency Access Target for

patients who present to emergency departments being admitted, discharged or transferred within four hours

• Continued oral health wait list reduction, including dentures and other prosthetics

• Supporting staff through education and training » Launch of Our values in action framework to support

staff to demonstrate values-based behaviour » Inaugural employee awards to recognise and

celebrate staff achievements in demonstrating our values, vision, and purpose

» Online training platform Darling Downs Learning Online (DD-LOL) to facilitate greater access to training

• Safety and Quality – Accreditation maintained for all services

• Delivering improved local facilities including: » Expansion of the endoscopy suite at the

Toowoomba Hospital » Completion of the refurbishment of the

Stanthorpe Hospital maternity unit » Completion of the refurbishment to create a

dedicated palliative care suite and quiet room at the Goondiwindi Hospital

» Ongoing works on the Backlog Maintenance Remediation Program

» Co-location of women’s health clinics, antenatal and postnatal services, family planning and gynaecology in a refurbished facility at Cherbourg Health Service

» Officially opening the Wandoan Primary Health Care Centre

» Completion of the Commonwealth Government capital funded mental health community care unit

• Collaborating with Primary Health Care providers.

Strategic directions

Darling Downs Hospital and Health Service Annual Report 2014-1512

Our performance

Key performance indicators show higher volume of care at DDHHS services

DDHHSEMERGENCYDEPARTMENTATTENDANCES

ELECTIVESURGERIESPERFORMEDDDHHS

NEWPATIENTSSEENATSPECIALISTOUTPATIENTS

CLINICS

ADULTDENTALTREATMENTS (EXPRESSEDASOCCASIONSOF

SERVICE)

OCCUPIEDBEDDAYS ENDOSCOPYPROCEDURESTOOWOOMBA HOSPITAL

4,107342 more patients a month

treated than in 2012-13

1,693

7,296

10,725

23,510 64 more a day

than in 2012-13

2,253188 more a month

than in 2012-13

24% increase since 2012-13608 more a month

than in 2012-13

2012

-13

2013

-14

2014

-15

145,

073

147,

070

149,

180

2012

-13

2013

-14

2014

-15

7,04

0

7,96

5

8,73

3

2012

-13

2013

-14

2014

-15

23,6

19

33,5

15

34,3

44

2012

-13

2013

-14

2014

-15

263,

527

275,

673

287,

037

45% increase since 2012-13

150000

140000

130000

120000

2013

-14

4,06

9

2012

-13

2014

-15

1,81

6

2,93

2

10000

8000

6000

4000

2000

0

35000

30000

25000

20000

15000

10000

5000

0

300000

250000

200000

150000

100000

50000

0

5000

4000

3000

2000

1000

0

250000

200000

150000

100000

50000

0

2012

-13

2013

-14

2014

-15

15,3

62

17,4

35

22,6

58


Growing demand for health services has been managed well in the three years DDHHS has operated as an independent statutory authority. We have worked consistently to reduce waiting lists for our services, and improve timeframes for patients to receive the care they need.

Less time to wait for Emergency Department treatment Not only did DDHHS treat more emergency presentations than ever before, we continued to achieve the Queensland Emergency Access Target (QEAT) from January to June 2015 with 90 per cent of patients who presented to emergency departments admitted, discharged or transferred within four hours.

Improved access to elective surgeryDDHHS has been working hard to improve access to elective surgery and to meet the National Elective Surgery Target (NEST).

In 2014-15, a total of 8,733 elective surgery procedures were undertaken across the DDHHS, with 5,740 of these at Toowoomba Hospital. The table shows the percentage of patients receiving their surgery within the clinically recommended timeframes.

National Elective Surgery Target (NEST)

Urgent Semi-urgent RoutineTarget 100% 97% 98%

DDHHS Actual 99.9% 99.8% 99.9%

Urgent = within 30 daysSemi-urgent = within 90 daysRoutine = within 365 days

DDHHS has continued to deliver more healthcare than contracted under the service agreement with the Department of Health. This is measured in weighted activity units (WAUs)whichprovideacommonunitofcomparison.In2014-15weprovidedfivepercent more services than contracted to our patients and communities.

197PATIENTSADAYARE

DISCHARGEDFROMOURFACILITIESAFTERRECEIVINGTREATMENTASANINPATIENT

409PATIENTSADAYARETREATEDINOUREMERGENCYDEPARTMENTS

728ELECTIVEOPERATIONSA

MONTHAREPERFORMEDAT OUR HOSPITALS

254BABIESAMONTHARE

BORN AT OUR HOSPITALS

Delivering quality healthcare



No dental patients wait longer than recommended for routine treatment

In May 2014, no patients within DDHHS were waiting longer than the clinically recommended timeframe for routine dental treatment (less than two years). This has been maintained during 2014-15 with approximately 78 per cent of people currently waiting less than one year for routine dental treatment.

Record number of endoscopy patients treatedDuring the year, a major campaign was undertaken to increase the number of endoscopies performed and reduce the number of patients waiting in excess of clinically recommended timeframes for endoscopic procedures. In July 2014, in Toowoomba there were a total of 1,751 patients waiting for an endoscopic procedure, and of these 84 per cent were waiting longer than the clinically recommended timeframe. By May 2015 the waiting list had reduced to 244 patients with no one waiting in excess of the clinically recommended timeframe.

Endoscopy outpatients Toowoomba Hospital

0

500

1000

1500

2000

Jul-14 Aug-14 Sep-14 Oct-14 Nov-14 Dec-14 Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15

Total patients Total LW

EMERGENCY DEPARTMENT TRAINING SUPPORTS RURAL STAFF

Dr Sheree Conroy talks to a group of training participants

EmergencySeniorStaffSpecialist and Director of Clinical Training Dr Sheree Conroy undertook a 12-month project to provide support and training for emergency services across rural facilities throughout DDHHS.

TheaimoftheEmergencyMedicineandEducationTraining(EMET)projectwastosupport rural staff and provide opportunities to access training using funding from the Australasian College of EmergencyMedicine(ACEM).

Training was delivered by Toowoomba Hospital-based EmergencyDepartmentconsultants who travelled to almost all DDHHS rural hospitals. Participants included doctors, nurses, medical and nursing students, and paramedics.

The training was as practical as possible, with hands-on simulation training, refreshers on use of vital equipment suchasdefibrillators,case studies, and group discussions on topics such as retrievals and transfers.

Dr Conroy said one of the greatestbenefitsoftheEMETproject was the improved two-way communication between medical staff, which helped contribute to improved patient outcomes.



Outpatients’ waiting list slashedStaff, including especially our ear, nose and throat (ENT) surgeons, orthopaedic surgeons, the Specialist Outpatient Referral Centre, and the General Practice Liaison Officer, coordinated and continued to build on the success of the previous year in reducing the specialist outpatient waiting list. Over 2014-15, the outpatient waiting list reduced by 56 per cent (5,028 patients), including a reduction in long-wait patients from a total of 62 per cent in July 2014 to less than one per cent in June 2015. This meant by the end of June 2015 only 17 patients were waiting in excess of the clinically recommended time. This was the lowest number of any HHS throughout the state. All told, 22,658 new specialist outpatient attendances were provided, 5,223 more than the previous year.

Outpatients Toowoomba hospital (excluding endoscopy)

Total patients Total LW

9000

8000

7000

6000

5000

4000

3000

2000

1000

0

Jul-1

4

Aug-

14

Sep-

14

Oct

-14

Nov

-14

Dec

-14

Jan-

15

Feb-

15

Mar

-15

Apr-

15

May

-15

Jun-

15

More women screened for cancerOur Breastscreen service scanned a record number of women, performing 18,928 screens including 543 (2.9 per cent) to people who identified as Aboriginal and Torres Strait Islander. This was a 25 per cent increase in Aboriginal and Torres Strait Islander participation rates on the previous year.

The Mobile Women’s Health team provided 359 community visits and delivered 2,100 cervical screens.

Birthing services have a busy yearDDHHS operates seven designated birthing facilities. In 2014-15 the distribution of births at these facilities was:

Location BirthsToowoomba 1,941

Kingaroy 398

Dalby 242

Warwick 192

Stanthorpe 110

Goondiwindi 114

Chinchilla 44

Four babies were delivered at other DDHHS facilities.

Chinchilla experienced a baby boom in May when five babies were born in 48 hours at the hospital - two of them on International Midwives’ Day.

Accreditation affirms quality care DDHHS has maintained accreditation across all components of the service. In addition the DDHHS successfully undertook its first International Standards Organisation (ISO) audit in March 2015.

ISO certification is recognised internationally and signifies an organisation has good management practices in place which are directed at realising consumers’ quality expectations and outcomes.

The audit was undertaken by an experienced team of 17 auditors. The ISO auditors examined all operational parts of the DDHHS and visited 24 sites over a 10-day period.

The audit comprehensively examined the health service against the AS/NZS ISO 9001:2008 Quality Management System Standard, the National Safety and Quality Health Service (NSQHS) Standards, as well as National Standards for Mental Health Services.

After a successful Australian Council on Healthcare Standards (ACHS) and International Organization for Standardization (ISO) accreditation. DDHHS is one of the few services with accreditation under two certification bodies.



Mums and Bubs program supports more families During the year, a record number of in-home visits under the “Mums and Bubs” program were provided with 4,451 visits conducted by midwives and child health nurses, an increase of 241 on the previous year. The program gave information on immunisation, breastfeeding and nutrition, providing a safe environment, and the importance of reading to children.

More staff complete Cultural Practice Program The DDHHS Aboriginal and Torres Strait Islander Cultural Capability Plan has been a key focus in 2014-15. As a result there has been a 43 per cent improvement in the number of staff who have accessed and completed the Cultural Practice Program. In 2014-15, 3,337 staff completed the program which supports staff to provide care in culturally appropriate and sensitive ways.

Consumer compliments up by 55 per centAn important way to improve our service is to make it easy for patients, families and other stakeholders to provide feedback. The DDHHS consumer feedback brochure was redesigned this year to encompass compliments, suggestions and complaints. Additional feedback boxes were installed throughout all facilities and the option to provide feedback via an online form was also implemented.

Implementation of the feedback brochure and staff education to encourage consumers to provide feedback lead to a significant increase across all areas.

Compliments increased by 55 per cent while complaints only increased by 16 per cent between the 2013-14 and 2014-15 financial years.

2013-14 2014-15 % +/-Total Complaints 1,214 1,415 16% +

Total Compliments 1,454 2,256 55% +

A number of improvements were made following suggestions received, these included:

• a central lost property process at Toowoomba Hospital• menu changes • improved lighting on path from Pechey Street to

Toowoomba Hospital entrance.

Focus on safety further strengthenedDDHHS is committed to providing safe and quality healthcare. The delivery of a record amount of activity and services has been undertaken with strong clinical governance and a focus on safety and quality.

A new system designed to streamline the clinical auditing process, while improving safety and quality, was launched in July 2014. The Systematic Approach Facilitates Excellence (SAFE) audit program provided a modular approach for teams and units to assess their compliance against the National Safety and Quality Health Service (NSQHS), EQuIP National, and National Mental Health Standards. Data from the SAFE audits provided meaningful information which has been used to continually improve our service.

Maintaining a robust process of examining and reviewing outcomes of care and clinical incidents also provided the service with the opportunity to learn and implement change to prevent re-occurrence of adverse outcomes. All Severity Assessment Code (SAC) 1 clinical incidents (SAC 1 includes all clinical incidents and near misses where serious harm or death is or could be specifically caused by health care rather than the patient’s underlying condition or illness) were systematically analysed, and recommendations made for improvements. As at 30 June 2015, all corrective actions (improvements) from SAC 1 analyses had been implemented within the recommended timeframes.

Staff training and awareness programs support patient-centred careDarling Downs Learning On-Line (DD-LOL) was implemented in July 2014 and staff embraced the ease of accessibility to a range of training programs via the on-line portal available at the workplace or at home.

New training modules included:

• patient-centred care (introduced in late 2014) - 79 per cent of staff completing the training by the end of June

• sepsis awareness (launched in May 2015) - 78 per cent completion rate for eligible staff by 30 June 2015

• Adult Deterioration Detection System (ADDS) module (launched June 2015) - 51.4 per cent of eligible staff completing the program by the end of June 2015

• infection control training was up 15 per cent on the previous year with 90 per cent of staff completing this module.

17Darling Downs Hospital and Health Service Annual Report 2014-15


Tackle Flu campaign successThe “Tackle Flu Before It Tackles You” program was a partnership between our Public Health Unit, the South West Hospital and Health Service, Darling Downs South West Queensland Medicare Local and the Toowoomba Hospital Foundation.

In 2015, 1,414 Aboriginal and Torres Strait Islander people were vaccinated against the f lu, a 25 per cent increase on the previous year.

Number of ‘Tackle Flu’ vaccinations by year

NUMBEROFVACCINATIONS

325

1,06

4

1,41

4

2012-13 2013-14 2014-15

1500

1200

900

600

300

0

Legendary North Queensland Cowboys football player Johnathan Thurston was the face of this year’s Tackle Flu Before It Tackles You campaign

The Dalby Tackle Flu Before it Tackles You clinic was held at the Aboriginal Medical Service, Goondir. Providing vaccinations was Darling Downs Public Health Unit (DDPHU) nurse Josie Crowe, Goondir Dalby manager Ann-Marie Thomas and Goondir nurse Sylvia Hartman.

Roberta Weribone keeps very still as Karen Brown delivers the fluvaccination.


Improving our local facilities

GOONDIWINDI HOSPITAL PALLIATIVECAREROOM

WANDOAN PRIMARY HEALTHCARECENTRE

STANTHORPEHOSPITAL MATERNITYSUITE

CHERBOURGHEALTHSERVICEWOMEN’SANDCHILDREN’SBUILDING

TOOWOOMBA HOSPITAL ENDOSCOPYSUITE

DARLING DOWNS COMMUNITYCAREUNIT

refurbishment funded by budget surplus delivered more comfortable birthing facilities.

$360,000refurbishment funded by

budget surplus also included a new “quiet room”

$950,000 $1.1M

Commonwealth Government funding delivered new community

mental health facility.

$860,000project brought services conveniently together in

one facility.

$2.2M $11.6Mproject funded by budget

surplus doubled operating capacity.

new, improved facility supported by a $750,000 donation from resource company Glencore.


Financial summaryDDHHS achieved a financial surplus of $20.1 million for the year ending 30 June 2015. This represents a three per cent surplus against a revenue base of $643.4 million. This is the third financial year as a statutory body that an operating surplus has been achieved, while still delivering on agreed major services and meeting and improving key safety and quality performance indicators.

Revenue and expenses – financial year ending 30 June 2015 - $(000)’sRevenue 643,401

Expenses

Labour and employment expenses 433,429

Supplies and Services 164,538

OtherExpenses 4,530

Depreciation and revaluation expense 20,770

Total 623,627

Net surplus from operations 20,134

Where the money comes fromDDHHS total income from continuing operations for 2014-15 was $643.4 million. Of this the State contribution was $397 million and the Commonwealth contribution was $167.1 million. Specific Purpose Grants worth $35.6 million were received and own source and other revenue was $43.7 million.

$433.4MILLIONAYEARSPENTON

STAFF COSTS, MOST FLOWING ONTOTHELOCALECONOMY

$20.1MILLIONSURPLUSTOBEREINVESTEDINCLINICAL

SERVICES,NEWEQUIPMENT,ANDINFRASTRUCTURE

$1.7MILLIONADAYSPENT

ONPROVIDINGSERVICES FOROURCOMMUNITIES

$24.5MILLIONSPENTSOFARINTHREE-YEARBACKLOGMAINTENANCEPROGRAM

Aswespendtaxpayers’moneyandprovideadiverseandextensiveserviceprofile,acrossa wide geographical area, our costs and revenues must be carefully managed. A robust accountingandreportingsystemiskeytoensuringsatisfactoryfinancialoutcomesandcontinuing sustainability.

Commonwealth funding $167.1 million (26%)

Specific Purpose Grants $35.6 million (5%)

Own-source and other revenue $43.7 million (7%)

State funding $397 million (62%)

26%

5%

7%62%

Ensuringresourcesaresustainable


Where the money goesDDHHS operates a complex group of services. The table below shows the proportion of the budget spent on services within DDHHS. Total expenses for 2014-15 were $623.26 million averaging $1.7 million per day spent on servicing the communities of the Darling Downs and South Burnett.

Toowoomba Hospital 37%

Rural Health 34%

Mental Health 12%

Other Professional and Support Services 13%

Depreciation 3%

The largest percentage of spend was against labour costs including clinicians and support staff (73 per cent). Non-labour expenses such as clinical supplies, drugs, prosthetics, pathology, catering, repairs and maintenance, communication and energy accounted for 24 per cent of expenditure. Three per cent of expenditure was related to depreciation of our fixed asset base.

Financial outlookThe surplus generated for the DDHHS in the current financial year will be reinvested for better health outcomes for the community.

Generation of a surplus allows reinvestment into capital building and equipment, but also allows for investment in strategic initiatives and retention of a modest contingency reserve to ensure the DDHHS is well placed to meet the ongoing needs of our growing communities into the future.

Capital infrastructure planning studiesPlanning for new or improved facilities is important to inform long-term infrastructure planning.

During the year, we completed a capital infrastructure planning study (CIPS) for the Toowoomba and Baillie Henderson hospitals. The study explored possible infrastructure options to assist in meeting the DDHHS’s projected health service requirements.

CIPS were also done at several rural sites including Kingaroy, Cherbourg, Chinchilla, Dalby, Miles, Murgon, Stanthorpe and Warwick. The Board has agreed to undertake similar studies at the remaining rural sites in 2015-16.

These studies will be used to prioritise local investments, but also to negotiate with the Department of Health about major capital works projects.

Backlog maintenance programWe reached the halfway mark (48 per cent) in the $50.6 million program of maintenance and rehabilitation works to rejuvenate buildings and other facilities across DDHHS over three years.

The State Government provided the funding to fix the backlog of maintenance work, which is in addition to the service’s regular repairs and maintenance expenditure of around $13 million each year.

Some of the common works have included internal and external painting, plumbing, air conditioning upgrades, fencing repairs, improved security and electrical switchboard upgrades or replacements across the DDHHS.

Toowoomba Hospital’s endoscopy suite expanded

EndoscopyNurseUnitManagerDeniseIseppishowsMinisterforHealth and Ambulance Services the Hon Cameron Dick MP three newly installedendoscopeairingcabinetsatthesuite’sofficialopening.

A $2.2 million project to double the capacity of Toowoomba Hospital’s endoscopy suite was officially opened in May.

The project was funded by the previous DDHHS budget surplus and a $1 million donation from the Toowoomba Hospital Foundation, its largest ever.

The refurbishment provides a new operating procedure room, new wait room and three additional Stage 1 recovery spaces, doubling the previous capacity.


MILES HOSPITAL AUXILIARY HONOURED

The Miles Hospital Auxiliary was recognised for their hard work in making their local facility a better place for families and visitors.

The auxiliary’s longest serving member and current president Ailsa Gilmour (pictured) was presented with the 2014 Prime Super Community of the Year Award at the annual Queensland Regional Achievement and Community Awards Gala Dinner. Ailsa accepted the award on behalf of the auxiliary’s 28 members.

The award recognised the group’s 55 years of service to the rural hospital, including raising almost $400,000 in that time.

For their efforts, the hospital auxiliary received $2,500 and a handcrafted glass trophy.


Ensuringresourcesare sustainable

State-of-the-art spinal bed installedToowoomba Hospital is the fourth hospital in Australia to have taken delivery of one of the purpose built beds. The Legacy Turning Bed has been specifically designed for patients with spinal cord damage or other serious trauma. It’s designed to physically turn a patient without requiring any manual handling of the patient, so there’s no pushing or pulling of the patient.

The bed increases the ability to keep the patient in spinal alignment, while decreasing the risk of further injury, so will be of great benefit to both patients and staff, allowing the Orthopaedic Unit to expand its range of services when caring for patients with severe trauma.

It is also ideal for use when caring for patients with a range of serious injuries including fractured pelvis or multiple limb trauma, and the level of patient comfort it provides also makes it ideal for palliative care.

Additional bariatric equipment available

Senior Occupational Health and Safety Practitioner Leann Mischke (left) and Auxiliary Services Coordinator Steve Taylor show some of the specialist equipment used at Toowoomba Hospital for bariatric patients.

In late 2014, the Board approved the purchase of around 100 pieces of bariatric equipment valued at $400,000 for use across the 20 hospitals in DDHHS. Equipment such as specially made hoists and slings will help staff safely care for patients and not risk injuries to themselves in lifting and turning patients.

Some of the specialist bariatric equipment is rated for patients weighing up to 455kg, with the most common load limits between 250kg and 350kg.

DDHHS records indicate that during 2014-15 there were 848 hospital admissions of patients classified as obese.


Our generous supportersThe Toowoomba Hospital Foundation, rural facility auxiliaries and other groups are very generous in raising funds to buy equipment and provide other support. The following are just some of the many examples.

The Toowoomba Rehabilitation Unit Support Team (TRUST) improved stroke patient access to treatment through functional electrical stimulation (FES). The FES uses a mild electrical current to stimulate muscle movement in limbs or body parts that have been adversely affected by stroke. The machines have proven their worth, with patients already achieving results. Patient Jan Mackay used an FES machine throughout her eight weeks in the unit and said the results were clearly evident. After eight weeks of rehabilitation therapy, including daily sessions with the FES machine, Jan was using her arm to feed herself, brush her teeth and write.

The Taroom Hospital has received a donation of an Accuvein 400 from the Taroom Meals on Wheels Association. The Accuvein 400, valued at $7,000, displays on the surface of the skin in real time, a map of the blood vessels underneath, allowing clinicians to check that veins are not blocked and to avoid valves or bifurcations.

The Tara Hospital Auxiliary also donated an Accuvein 400 and a Rapid No Touch Thermometer to Tara Hospital. The Rapid No Touch Thermometer enables the temperature of a patient to be taken three to five centimetres away from the skin.

The Inglewood Multipurpose Health Service was brightened thanks to a donation of a fish tank. The auxiliary provided $750 to purchase the tank and fish to create some visual simulation for residents and added to the homely feel of the residential aged care area. Residents were given the privilege of naming each of the nine fish.

Proceeds from the annual Toowoomba Children’s Hospital Appeal, run by the Toowoomba Hospital Foundation, were used to fund three Panda Warmers valued at $84,691 designed to keep newborn babies comfortably warm. They will be used in Toowoomba Hospital’s birthing suite.

A band of local knitters presented their first delivery of “comfy cups” to Toowoomba Hospital’s Breast Care Nurse in May. The handmade knitted breasts are designed to be used by women who have undergone a mastectomy.

Members of the East Creek Community Centre knitting and crocheting group supported Toowoomba Hospital’s paediatrics unit by donating handmade pillow teddies, along with beanies for premature babies and knitted caps for palliative care patients.

Inglewood Multipurpose Health Service residential care facility residentsDavidMcLeanandJackElsleywithMelissaMcDowall,DenelleMorrison,WendyWestandafishtankdonatedbyauxiliary members.



Ensuringprocessesareclear

DDHHS leads State in the most number of telehealth consultationsUsing video conferencing to access specialist clinical advice provided more care locally for the highest number of patients ever during the year.

Compared to 2013-14, there was an increase of 78 per cent in telehealth events for admitted patients, while non-admitted patients using telehealth increased by 10 per cent compared to the previous year.

The top services using telehealth were midwifery/obstetrics/antenatal services; pre-admission/anaesthetics; and the orthopaedic clinic.

In addition, telehealth events for mental health services led the State with DDHHS contributing 49 per cent of the telehealth service provision for mental health (7,428 of the total state’s 15,499).

Telehealth saved patients approximately 826 nights away from home and more than 440,000 kilometres in travel.

The first national Rural and Remote Telehealth Conference was held in Toowoomba in October 2014. Hosted by DDHHS, the two-day conference was an opportunity to not only showcase local telehealth achievements, but also a chance for staff members to learn from some of the industry’s leaders.

Telehealth occasions of service - non admitted (excluding mental health)

1,90

4

4,08

1

4,49

8

2012-13 2013-14 2014-15

5000

4000

3000

2000

1000

0

1,137MOREENDOSCOPIES

PERFORMED THAN IN 2013-14

20PATIENTSADAYARE

TREATEDATOURREGIONAL CANCERCENTRE

371TELEHEALTHCONSULTATIONS

EACHMONTH,REDUCING THENEEDTOTRAVEL(EXCLUDING

MENTALHEALTH)

7,428TIMESAMENTALHEALTH CONSULTATIONWASDONE VIAVIDEOCONFERENCE

Darling Downs Hospital and Health Service had a strong focus on seeking opportunities to ensure our care is high quality and in line with consumer and community expectations. This was achieved through a host of collaborative initiatives during the year.

CONSUMERS HELP MAKE PUBLICATIONS

EASY TO UNDERSTAND

Consumer Advisory Group members

A consumer advisory group was established during the year to review DDHHS publications used by patients, consumers or other health service stakeholders.

The group meets monthly and members read each brochure, flyerorothermaterialasit’s produced or revised to make sure it is clear, and easy to understand in terms of language, graphics and design.

The process is important to ensure each publication isfitforpurposeandhelpsachieve Standard 2 – Partnering with Consumers – under the National Safety and Quality Health Service (NSQHS) Standards.

The group has also identified some areas to improve our services or make things easier for patients or consumers.

Some examples have included better car parking, signage, purchase of an electric wheelchair at Toowoomba Hospital for volunteers to transport frail or immobile patients, and the introduction of mobile eftpos processing for the pharmacy.


Cancer treatment partnerships deliver enhanced care In July 2014 the Regional Cancer Care Centre at Toowoomba Hospital celebrated its second anniversary. In that time the centre has developed to provide a range of cancer care services. It has fostered an excellent shared-care relationship with Toowoomba’s St Andrew’s Hospital to provide radiation oncology.

Toowoomba Hospital’s Day Oncology Unit is the region’s only chemotherapy unit that also treats paediatrics, so a good shared-care relationship has also developed with the Children’s Hospital and Health Service in Brisbane.

The 24-bed ward consistently runs at capacity, ref lecting the high demand for its services and the dedication of its team.

In 2014-15 the unit recorded almost 7,207 occasions of service, that is times when a doctor saw a patient.

New primary health network to coordinate careDDHHS, as the region’s major public health care provider, and GP Connections the largest local GP network, were successful in their joint bid to operate the new Primary Health Network (PHN) for the Darling Downs and West Moreton regions.

The partnership between DDHHS and GP Connections brings together the primary and secondary health sectors across the region to deliver on the PHNs main objective to improve coordination of care. The aim is to ensure patients receive the right care in the right place at the right time, avoiding duplication of services and improving integration of health care systems.

The PHN commenced formal operations from 1 July 2015, as an independent non-government entity overseen by a board of directors.

Clinical staff supported with dedicated blood products informationThe creation of a transfusion nurse position assisted DDHHS with managing effective and efficient use of blood and blood products, especially as we transition to a DDHHS-managed blood service.

A new online resource described as a ‘one-stop-shop for all things blood’ was launched in October 2014 to assist clinical staff source information about blood products. The intranet page complements the dedicated role of the blood transfusion nurse who works across DDHHS to promote best-practice management and use of blood products.




Community engagement continues to improve service deliveryCommunity engagement is front and centre of our approach to developing and delivering quality services for people in our region. The Darling Downs Hospital and Health Service has many established engagement processes through hospital auxiliaries, support groups, community meetings, volunteer involvement, community advisory networks and partnerships with non-government organisations.

The Board has a comprehensive program of engagement activities that is detailed in the Board section of this annual report.

In October 2014, DDHHS hosted its first organisation-wide community engagement workshop which involved senior clinical and management staff as well as representatives of consumer organisations.

The workshop participants proposed a number of initiatives to improve patient-focused care. One of the recommendations that has been implemented so far was the rollout of a training module which links patient-focused care to DDHHS values.

Some other community engagement examples during the year included:

• More than 50 head and neck cancer survivors, family members, and medical staff got together for the inaugural Toowoomba Hospital Head and Neck Cancer Support Group meeting in April 2015.

• Toowoomba Hospital’s Mums and Bubs program held a second birthday celebration in March 2015. It followed a special care nursery fun day that was hosted in November 2014.

• More than 60 displays offering the latest health and wellbeing information was on show at the biannual Health and Wellness Expo at Pittsworth in April 2015.

Toowoomba Hospital Special Care Nursery Associate Unit Manager Wendy Carlish (left) with Kim Dixon and Tyson Schmidt enjoy Toowoomba Hospital’s second special care nursery family fun day in November.


Employee awardsThe inaugural Annual DDHHS Employee Awards program was held in January 2015. This recognition program acknowledged employees for excellence in demonstrating our values, delivering our purpose, and striving towards our vision. The ceremony was held to coincide with Australia Day awards to recognise and celebrate the significant contributions our staff make to their local communities either in special projects or through core duties.

Most pleasing for those nominated for awards was that the nominations were received from their peers. This indicates the workforce values their colleagues’ efforts and looks to recognise them.

More than 50 nominations were received across all categories of the awards and from all divisions within DDHHS. Thirty individuals and 24 teams were nominated. A number were nominated in multiple categories. The winners of each category were:

DDHHS Values• Caring – Silvia Snuderl (Assistant Business Manager)• Doing the right thing – Leigh Cantwell (Clinical Nurse)

and Sandra Hilder (Quality Improvement Coordinator)• Openness to learning and change – Darling Downs

Learning On-line (DD-LOL) team comprising Dr Sheree Conroy, Hayley Farry, Kate Jurd, Katrina Henry and Vicki Stenhouse

• Being safe, effective and efficient – Geriatric Adult Rehabilitation and Stroke Service (GARSS) represented by Dr Nisal Gange, Samantha Gollan, Ben Stuart and Michelle Crawford

• Being open and transparent – Daniel McDonald (Librarian)

DDHHS purposeSpecialist Outpatient Referral Centre comprising Linda Maunder, Brenda Schwenke, Dr Debbie Carroll, Tess Wootton, Marianne Leonard, Kylie Peterson, Elizabeth Burton, Rayleen Smith, Melissa Curran and Karen Hoskin.

DDHHS visionEar, Nose and Throat (ENT) team comprising Dr Roger Grigg, Dr Ranit De, Dr Suresh Mahendran, Dr Ross Harrington, Dr Garrett Fitzgerald, Dr Martin Hanson, Dr Andrew Pastuszek, Dr Danielle Witshire, Megan Green and Lyndell Jones.

Inaugural employee awards

Darling Downs Learning On-Line team members won the Openness to Learning and Change category at the inaugural DDHHS EmployeeAwards.Theteamincluded(fromleft)KatrinaHenry,HayleyFarrey,ExecutiveDirectorAlliedHealthAnnetteScott,DrSheree Conroy, Kate Jurd, and Vicki Stenhouse.


In 2014-15, DDHHS employed 4,996 staff and we welcomed 492 new employees to our workplaces. In becoming a valued member of the DDHHS team the first step of any new employee is to have access to the relevant details about their role and that of the organisation. In 2014 DDHHS’s orientation and induction package was redesigned and is now provided via an interactive online platform which delivers a comprehensive information source about the health service. A welcome to new staff by both the Chair of the Board and the Chief Executive with personalised messages in relation to the values, expectations and behaviours within the DDHHS is also included.

The orientation and induction package is hosted on Darling Downs Learning On Line (DD-LOL). This web-based platform is available to all staff to access training requirements from work or home.

Our workforceThe workforce is our most important resource in the delivery of health services. Our clinical workforce includes doctors, nurses, and a wide range of allied health and other professional and technical staff. Effective and efficient service delivery also requires support roles in non-clinical staff, including administrative officers, operational officers and trade staff.

DDHHS’s workforce is aging with 41 per cent of our workforce aged 55 years and over. It is probable that a significant proportion of the current workforce will exit within the next five to 10 years, with nursing being the highest area of risk. In addition, the availability of flexible work options mean more people are working part time. We have an Occupied Full-Time Equivalent (FTE) of 3,916 staffed but a headcount of 4,996 employees with just over 2,000 staff accessing part-time employment status.

We value our workforce and believe that the contribution of skilled and committed professionals across all roles within our organisation ensures that the service is able to deliver quality healthcare to our communities. This requires ensuring that there are sufficientnumbersoftherightstaff,withtherightskillmix,intherightplaceattherighttime to deliver patient-focussed care.

492NEWSTAFFJOINED THEHOSPITALAND HEALTHSERVICE

1 in 56PEOPLEINTHEDARLING

DOWNS AND SOUTH BURNETTWORKFORUS

2,600COMBINEDYEARSOFSERVICECELEBRATEDATLENGTH-OF-

SERVICEAWARDSACKNOWLEDGING30YEARSPLUS

1,159COMBINEDYEARSOFSERVICE

FROMVOLUNTEERSATTOOWOOMBAANDBAILLIE

HENDERSONHOSPITALSANDMTLOFTYHEIGHTSNURSINGHOME

Ensuringdedicatedtrainedstaff


Analysis of the current workforce and key trends provides important information for projecting workforce requirements. The following is a breakdown of the workforce profile within the clinical, professional and support divisions of the DDHHS:

Employees by divisions30 June 2015

MOHRI* Occupied

FTE

MOHRI* Occupied

Headcount Clinical divisions

Toowoomba Hospital 1,426 1,789

Rural and Aged Care 1,535 2,129

Mental Health 550 637

Professional divisions (including Clinical Governance)

Medical, Allied Health, Nursing and Midwifery

231 264

Support divisions

Finance (including Infrastructure) 120 122

Workforce 34 35

Other 20 20

DDHHS Total 3,916 4,996

* Minimum obligatory human resource information

DDHHS in 2014-15 had a retention rate for permanent staff of 93.2 per cent, with a separation rate of 6.8 per cent almost identical to 2013-14 statistics of 93.4 per cent and 6.6 per cent rate respectively which infers a stable workforce ratio. No redundancy, early retirement or retrenchment packages were paid during this period.

Training and educationOur value of “Openness to learning and change” means we recognise the need to be a learning organisation. With a staffing profile of almost 5000 employees, DDHHS recognises that ongoing support mechanisms are needed to build and maintain the skill sets to support this outcome.

DDHHS identified a set of training requirements for all employees in order to meet legislative obligations including orientation; work health and safety programs; cultural practice; ethics, integrity and accountability; and patient-centred care. These are delivered through the Darling Downs Learning On-Line (DD-LOL) system. Role-required training programs designed to meet specific work group requirements such as clinical deterioration, child protection, sepsis and basic life support are also available through the DD-LOL online training platform.

DDHHS staff occupation by percentage

48%

20%

13%

10%

8%

1%

Nursing 48%

MedicalincludingVisitingMedicalOfficers(VMOs) 8%

Professional and technical 10%

Managerial and clerical 13%

Operational 20%

Trade and artisans 1%


DDHHS staff full time/part time/casual

Full-time 49%

Part-time 41%

Casual 10%

41%

49%

10%


DD-LOL has the ability to record and supply training records to both staff and managers which offers DDHHS a single point of truth for training compliance reporting. This improved visibility has resulted in a marked improvement of our compliance rates across all training modules.

Cultu

ral p

ract

ice

DD

HH

S O

rient

atio

n

Ethics,Integrity

and

Acco

unta

bilit

y

Firs

t Res

pons

e Evacuation

Inst

ruct

ions

GeneralEvacuation

Inst

ruct

ions

Infe

ctio

n Co

ntro

l

Wor

kpla

ce H

ealth

an

d Sa

fety

Occ

upat

iona

l Vi

olen

ce

Perf

orm

ance

and

Ap

prai

sal

Mus

culo

skel

etal

D

isor

ders

Patie

nt C

entr

ed

Care

2013-14financialyear 2014-15financialyear

100

80

60

40

20

0

Work health and safetyWe are committed to ensuring the health and safety of all within our workplace by having a robust governance framework and continually working towards improving our safety management system.

We are able to demonstrate our capacity to be the Queensland Health leader for statutory Workcover claims. DDHHS has been below the industry average over the past 14 consecutive quarters, an achievement that no other hospital and health service in Queensland has been able to attain.

Workcover absenteeismHours lost (Workcover hours) versus occupied FTE (staff currently working in a position)

0.40

0.35

0.30

0.25

0.20

0.15

0.10

0.05

0.002013-14 2014-15

Target 0.40

Target 0.35

0.33

0.18

Average paid days per accepted Workcover claimAverage days lost (full and partial) 25

20

15

10

5

0

Target 23.41Target 21.8

18.7

13.44

2013-14 2014-15


Average days to first return to workAverage days taken to secure any form of return to work (time lost claims only)

2013-14 2014-15

Target 21.44

Target 17.1

13.94

11.66

25

20

15

10

5

0

Average monthly payments per accepted Workcover claim

2013-14 2014-15

Target $2,360Target $2,150

$2,150$1,955

2500

2000

1500

1000

500

0



Working for Queensland Employee Opinion Survey (WfQ 2015)DDHHS participated in the annual 2015 Working for Queensland employee survey held in April/May 2015 and 2,235 staff took the opportunity to respond to the survey which was a significant increase in participation from past years.

DDHHS Working for Queensland participation rates

27%

30%

45%

2013 2014 2015

50

40

30

20

10

0

The survey results provide measures of the workplace climate across DDHHS and the wider Queensland public service agencies. It explores insights to employee engagement, job satisfaction and leadership within our organisation benchmarking to like agencies.

The 2015 WfQ results for DDHHS showed positive improvement in areas of employee engagement, job security, performance assessment, organisational leadership and organisational trust.

It is recognised that employee engagement plays a vital role in organisational performance. Through surveys such as these, value is placed on the responses and consultative action planning occurs with staff to continue to work on identified areas that require improvement.

Staff length of service awards A ceremony was held for those employees who have reached 30, 35, 40 and 45 years of service in the past 12 months to formally recognise the dedication of these long-serving employees.

Eighty-one employees including nurses, administration officers, wards persons, a psychologist, plaster technician and dental technician were honoured for more than 2,600 combined years of service.

DDHHS staff length of service awards are held each year to coincide with Queensland Week in June. In 2014-15 the DDHHS acknowledged 724 employees for 5, 10, 15, 20, 25, 30, 35, 40 and 45 years of service.

Years of Service Number Awarded5 229

10 165

15 82

20 92

25 75

30 53

35 20

40 6

45 2

TOTAL 724

VolunteersOver many years an extraordinary number of volunteers have freely contributed their time and energy to assist our patients and relatives. Volunteers enhance the core services provided by our staff. Their generosity of spirit and willing approach adds to the welcoming atmosphere of our health services and assists in contributing to a positive experience for patients, their families and visitors.

We are lucky to have 192 volunteers who give their own time to help others at Toowoomba Hospital, Baillie Henderson Hospital, and Mt Lofty Heights Nursing Home. Between them, these volunteers have provided 1,159 years of service. There are also many more volunteers who contribute greatly to our rural and aged care facilities.

We have more than 260 volunteers across our health service, each of whom give their own time to help others.

Each year we hold a ceremony during Volunteers Week to thank our volunteers and present certificates of appreciation. This year Oakey Hospital’s long-term volunteer George Lipman was acknowledged for his ongoing support of the rural facility.

Documents

Strategic directions - Annual Report 2014-2015 - Darling Downs … · 2016-11-10 · 2015 the waiting list had reduced to 244 patients with no one waiting in excess of the clinically