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Casterton Memorial Hospital

PARTNERSHIPS FOR IMPROVEMENT

SAFETY & RISK MANAGEMENT

DEDICATION TO SERVICE

PERSON CENTRED CARE

EFFECTIVE GOVERNANCE

SERVING THE CASTERTON & DISTRICT COMMUNITY

CMH Striving for excellence by…..

2012-2013

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Contents

CMH Strategic Plan Inside front cover

President’s Report 1-2

Hospital Officers 3

Board of Management 4

Finance & Activity Overview 5-6

Statement of Priorities 7-9

Accreditation 9

Our Model of Care 10

Demographics of our Service 10

Service Model 11

Services to our Community 12

Clinical Governance 13

Consumer, Carer & Community Participation 14-16

Quality & Safety 17-22

Consumer Satisfaction 23

Health Promotion 24

Volunteers 25

Our Supportive Community 26-27

Life Governors 27

Human Resources 28-29

Staff List 30

Functional Organisational Chart Inside back cover

Committee Composition Chart Inside back cover

Casterton Memorial Hospital - Service & Quality of Care Report 2012-2013

On behalf of the Board of Management, staff and community I am pleased to present to you the Service and Quality of Care Report incorporating results from our 105th Annual Report of the Casterton Memorial Hospital for the year ended 30 June 2013.

Presentation of this Service and Quality of Care Report to the community is an important document to provide you, our stakeholders, information on our services, quality and risk management and benchmarking against state-wide indicators.

The information in this report, we trust, provides you with confidence in the performance and outcomes of your health service.

In what has been a difficult budgetary year we are pleased to report a marginal operating surplus of $22,878 before the application of depreciation expense and capital grant inflows.

This small surplus has been achieved through maximisation of revenue initiatives, expense containment and the Commonwealth reinstatement of the mid -year budget cut imposed by the State in response to the Commonwealth Governments grant reductions to the State.

In spite of a difficult budgetary year, Casterton Memorial Hospital has been able to maintain activity across its acute, aged residential care, primary care and home based support services. Acute service separations were 591 compared to 482 in 2011/12 and Glenelg House, our 30 bed high care residential care facility, occupancy for the year has been maintained at 99.65%. District nursing, home support and community transport services have all remained steady and have increased in some sectors.

Specialist visiting services have increased including physicians, surgeons and psychologists. This year Casterton Memorial Hospital has also seen an increase in service up-take for Tele-health episodes, whereby members of the community can access their specialist via video conference or Skype technology from within our facility.

Casterton Memorial Hospital has achieved the majority of its key performance indicators set in its 2011/2013 Strategic Plan with 65% ( 13 ) KPI’s 100% completed and the remaining ( 7) KPI’s within 90% of completion.

A new three (3) year Strategic Plan has been set for 2013/2015 and this plan seeks to extend on the sound progress of our 2011/13 plan. Strategic objectives and outcomes for facilities and assets, corporate and clinical governance, quality improvement and risk management, human resources and services development all form part of our ongoing strategic directions.

Some of the achievements in 2012/13 have included:

Australian Council on Healthcare Standards re-accreditation for a further 4 years Aged Care Standards Agency Accreditation for 3 years Board member recruitment with Mr Gerald Smith and Mrs Karen Black joining the Casterton Memorial Hospital team Community survey collation and report card delivered to the householders Hydrotherapy Feasibility study and business case review completed Increased personnel resource to primary and community health function Sub-regional Obstetrics and Gynaecologist appointment, Person Centred Care training for whole staff group and Board over three days Fire ring main replaced Nurse / medical training simulator unit commissioned.

Casterton Memorial Hospital has also ostensibly achieved its commitment to the Victorian Government’s Health Priorities Framework for 2012/13, as can be reviewed in this report.

President’s Report

CMH Board of Management

President, Mr. Graham

Sheppard with Manager

Nursing Services

Ms. Mary-Anne Betson and

Chief Executive Officer Mr.

Owen Stephens.


CMH Board of Management Members,

Mr. Terry Baker (OAM), Mr. Graham

Sheppard and Fr. Andrew Hayes along

with CEO Mr. Owen Stephens and

Manager Nursing Services

Ms. Mary-Anne Betson met with Leader

of the Opposition the Hon. Tony Abbott

MHR and Federal Member for Wannon

the Hon. Dan Tehan MP during their

visit to Casterton.

President’s Report cont/...

Mr Graham Sheppard President Board of Management

Casterton Memorial Hospital continues to collaborate with its regional health service partners including the newly established Victorian Government initiative of the Barwon South West Sustainable Hospitals project, our own area South West Sub-Regional Corporate Services and Steering Group collaborative, Deakin University Medical School, Royal Adelaide Hospital Medical Intern program, University Nurse graduate placements and Casterton/Coleraine Medical Clinic Medical Practice Registrar program.

On behalf of the Board of Management and community of Casterton and district, we thank all our dedicated staff, medical officers of the Casterton/Coleraine Medical Clinic under the management of Partners Drs Coulson and Prozesky, visiting specialists and allied health personnel, ambulance service paramedics, partner organisations and, of course, our dedicated groups of volunteers whom support Casterton Memorial Hospital and the community in so many ways.

I would especially like to acknowledge and recognise this year the 21st year of operations and fundraising support by the Casterton Memorial Hospital’s Murray to Moyne Cycle Relay team and committee having raised $157,752.49 in this time. A fantastic achievement in support of Casterton Memorial Hospital’s needs.

Finally I wish to thank and commend the work of my fellow Board of Management colleagues and Executive in Mary-Anne and Owen in managing and keeping the directions of Casterton Memorial Hospital efficient and relevant for the community that we serve.

CMH Board of Management members met with Leader of

Opposition the Hon. Tony Abbott MHR, Federal Member for

Wannon the Hon. Dan Tehan MP and Glenelg Shire Council

Mayor Cr. Karen Stephens to discuss rural health issues and

national health reform in May 2013.


Hospital Officers

Responsible Ministers: Principal Officers:

Commonwealth Government Australia: Chief Executive Officer

The Hon Tanya Plibersek MP, Minister for Health & Ageing Mr. O. P. Stephens: B.Bus., A.C.H.S.E.

State Government Victoria: Manager Nursing Services

The Hon David Davis, MLC, Minister for Health & Ageing Ms. M. Betson: N.P.,R.N., R.M., Cert. Critical Care, Nurse Immuniser,MNsg.,FACN,

Hospital Board of Management: Nurse Unit Manager Acute Ward/AHS/Education Officer

President: Mrs. J. Coulter: R.N.,R.M., Cert IV Training& Assessment

Mr. G. Sheppard Nurse Unit Manager Night Nurse in Charge /Quality Improvement

Vice President: Mrs. H. Dillon: R.N.,R.M.Grad Cert Ad Nsg Practice (Rural Remote)

Fr. A. Hayes Nurse Unit Manager Acute Ward/AHS

Members: Mr. S. Gill: R.N. Cert Aged Care

Mr. T. Baker (OAM) Nurse Unit Manager OR/Emergency/Infection Control Officer

Mrs. K. Black Mrs. H. Gill: R.N.Cert Infection Control & Sterilisation MCNA

Mrs. C. Brown Nurse Unit Manager Residential Care

Mr. R. Dalby Mrs. K. Sealey: R.N., MCNA.

Mr. P. Green Nurse Unit Manager Community Health

Dr. T. Halloran Ms. S. Bramall: R.N., Grd Dip CH

Mr. G. Smith Nurse Unit Manager Primary & Community Care

Audit Committee Ms. A. Pekin: R.N., Nurse Immuniser, Grad Cert Daibetes Ed., BA., Grad DipEd (Psychology)

Mr. O. Stephens - CEO Nurse Unit Manager District Nursing Service

Mr. G. Sheppard – Independent Member *Mrs S. Nolte: R.N.

Mrs. B. Toma – Finance Officer Planned Activity Group Co-ordinator

Mrs. C. Brown – Chair (1/7/2012 – 15/11/2012) Mrs. J. Annett: EN, Diversional Therapist

Mr. R. Dalby – Independent Member Mrs S. Neill: Cert II Financial Svs., Cert III Disability

Mrs. K. Black – Chair (15/11/2012 – 30/6/2012) After Hours Supervisors

Visiting Medical Staff: Mrs. S. Dehnert: R.N., R.M., IBCLC , Nurse Immuniser, Grad Dip Child Maternal Health Dr. B. S. Coulson: M.B.B.S., D.R.O.G., F.A.C.R.R.M. Mrs. H. Dillon: R.N.,R.M.Grad Cert Ad Nsg Practice (Rural Remote)

Dr. M. Prozesky: M.B., ChB, (South Africa) Mrs. A. Jenkins: R.N., Grad Cert Palliative Care, Grad Cert Ad Nsg Practice (Rural Remote)

Dr. R. Taheri: M.B. (Mashad Uni Iran) G.P. Registrar Mr S. Bryan: R.N. B.N. Grad Cert Ad Nsg (Emergency Nursing)

*Dr. N. Osman: M.D. (uni Gezira-Sudan) G.P. Registrar Mr. S. Makore: R.N.

Dr. S. Ansari: M.B.B.S. (Army Medical College – Pakistan) Dr. Y. Zhang: M.B. (Uni of Med Sciences – Guangzhou) Administrative & Finance Officer

Dr. T. N. Halloran: B.D., B.Sc. (Hons) Mrs. B. Toma

Mr. P. H. Tung: M.B., B.S., F.R.A.C.S. Health Information / Quality Improvement

Mr. S. Clifforth: M.B., B.S., F.R.A.C.S Mrs. H. Rees: Clinical Coder

Dr. G. Coggins: M.B., B.S., F.R.A.C.P. Catering Services Supervisor

Dr. C. de Kievit: M.B., B.S., D.R.A.N.Z.C.O.G., F.A.C.R.R.M. Mr. M. Nolte

Dr. K. Fielke: M.B., B.S., D.R.A.N.Z.C.O.G., F.A.C.R.R.M. Environmental Services Supervisor

Dr. P. Goodman: M.B., B.S., D.A., D.Obst., R.C.O.G., F.R.A.C.G.P. *Mrs. L. Carter

Dr. J. D. Muir: M.B., ChB, D.A., F.R.C.A. Mrs. E. Harvey

Dr. T. J. Hodson: M.B., M.B.S., F.R.A.N.Z.C.O. Maintenance Coordinator / Safety

Dr. S. Perry: G.P. Anaesthesia F.R.A.C.G.P., B.M.B.S. (Flinders), B.S.C., D.C.H. Mr. R. Tomkins

Dr. B. Gavankar: M.D., D.G.O., D.A., M.B.B.S. Meals on Wheels Coordinator

Emeritus Ms. V. Ross

Dr. A. F. Floyd: M.B., B.S., D.Obst, R.C.O.G. * Resigned during year


Board of Management

Mr. Graham Sheppard

President

Secondary College

Educator

Current Term of

Appointment:

01/07/2012 - 30/06/2015

Fr. Andrew Hayes

Vice President

Catholic Priest

Current Term of

Appointment:

01/07/2011 - 30/06/2014

Mrs. Karen Black

Board Audit Officer

Customer Service Officer

Current Term of

Appointment:

01/07/2012 - 30/06/2015

Mr. Roger Dalby

Builder

Current Term of

Appointment:

01/07/2011 - 30/06/2014

Dr. Timothy Halloran

BDS, Bsc (Hons)

Dental Practitioner

Current Term of

Appointment:

01/07/2012 - 30/06/2015

Mr. Peter Green

Management, Risk

Management &

Education

Current Term of

Appointment:

01/07/2011 - 30/06/2014

Mr. Gerald Smith

Timber Harvest

Coordinator

Current Term of

Appointment:

01/07/2012 - 30/06/2015

Mrs. Chris Brown

Community Services

Support

Current Term of

Appointment:

01/07/2010 - 30/06/2013

Mr. Terry Baker (OAM)

Deakin Medical School -

Community Liaison

Officer

Current Term of

Appointment:

01/07/2011 - 30/06/2014

The Board of Management is appointed by the Governor-in-Council,

from nominations received by the Hospital. The Hospital is an

incorporated body under, and regulated by the Health Services Act

1988.

Board Members each serve a three year term, and may be eligible

for re-nomination at the conclusion of each of their terms.

The role of the Board of Management is to oversee and monitor the

operations of the Hospital and to develop in accordance with its

mission and strategic objectives, the future directions for the

Hospital.


Finance & Activity Overview 2012/2013

The Casterton Memorial Hospital’s financial statements of account for the year ended 30th June, 2013 have been completed in accordance with the Australian Audit and Accounting Standards and the Financial Management Act 1994.

Casterton Memorial Hospital’s 2012/13 result has been pleasing given the difficult financial budgetary year.

Our small Operating Surplus of $22,878 is considerably reduced, when compared to the 2011/12 result, but still within the set Budget for the reporting period. This net operating surplus was achieved despite a Department recall of ($248,838); the result of under achieved DVA activity targets set within our budget, also the impact of a $66,540 reduction to our 2012/13 Commonwealth Aged Care subsidies.

We have managed to maintain Salary and Wages expenditure within a 3.79% increase on 2011/12. Other operating expenditure, with the exception of Fuel, Light and Power, has been managed within budget parameters. Private Inpatient revenue is consistent with 2011/12 generating a revenue contribution of $226,748. Residential Aged Care fees, including accommodation payments totalled $782,228. Total combined fees raised provided an increase of $78,937 or 8.49% on prior year.

Cash has been well managed and our cash holding as at 30 June 2013 reports a $445,365 increase on the 2011/12 balance. Interest earned on investment activities in the 2012/13 year increased by $21,207 or 23.92%. Department Capital grants increased from $18,000 in 2011/12 to $141,326 in 2012/13. The Department cash injection of $112,626 in the later part of the financial year, being non-recurrent specific funding, has assisted with purchases of additional clinical equipment across all program areas.

Employee leave entitlements as at the end of the reporting period have seen an 8.86% increase in Long Service Leave and 8.13% in Annual Leave. The Department Long Service Leave Non-Current Debtor increased by $68,987 in 2012/13. Capital contributions to property, plant and equipment upgrade during the 2012/13 year totalled $115,133. As at the end of the 2012/13 reporting period the facility is not holding, in trust, any accommodation bond monies.

Entity Net result for the reporting period is a deficit position of ($643,744) and includes $939,338 of unfunded depreciation expense. Entity Comprehensive result for the year reports $761,762 compared to the 2011/12 deficit result of ($431,122). This turnaround is a direct result of a Managerial revaluation of fair value of buildings, based on indices issued by the Valuer-General Victoria (VGV). The net effect was an increase to our Revaluation Reserve by $1,405,506. The revaluation recognition date is 30 June 2013.

Our liquidity position, with a current asset ratio of 1.39 remains stable and is consistent with past years.

The Hospital’s services including Acute separations, Dialysis activity, Urgent Care presentation and Primary Care services all have remained constant. Our Residential Care occupancy rate for the year was 99.65%.

Casterton Memorial Hospital continues with sound management of their financial operations and business activities by maintaining an operating surplus, holding adequate cash reserves and an asset ratio remaining comfortably within the Department’s benchmark. Future demands on funding, continued productivity savings and budget restrictions will necessitate sound management practices to continue. Increased importance on planned allocation and monitoring of resources across all program areas will be a major focus for the 2013/14 reporting period.

CMH Administration staff, Mrs. Barb Toma and Mrs. Pauline

Carmichael working on CMH finances.


Finance & Activity Overview 2012/2013

Five Year Financial Comparative Statement 2008/09 2009/10 2010/11 2011/12 2012/13

Total Operating Revenue 6,437,618 6,680,037 7,897,120 8,579,473 8,771,881

Total Operating Expenditure 6,303,840 6,639,028 7,670,478 8,228,150 8,749,003

Operating Surplus/(Deficit) 133,778 41,009 226,642 351,323 22,878

Capital Purpose Income 428,766 387,015 336,157 166,768 272,716

Depreciation Expense 361,680 921,369 930,204 949,213 939,338

Net result for the year 200,864 -(493,345) -(367,405) -(431,122) -(643,744)

Share of Comprehensive Income Joint Venture 37,717

Asset Revaluation (increments/decrement) 6,989,008 - 1,405,506

Retained Surplus/Accumulated Deficit 7,789,700 7,334,072 6,966,667 6,535,545 5,891,801

Total Assets 18,212,964 17,853,140 17,710,333 17,435,253 18,409,321

Total Liabilities 1,688,069 1,783,873 2,008,471 2,164,513 2,376,819

Net Assets 16,524,895 16,069,267 15,701,862 15,270,740 16,032,502

Total Equity 16,524,895 16,069,267 15,701,862 15,270,740 16,032,502


Statement of Priorities for 2012 / 2013

STATEMENT OF PRIORITIES AGREEMENT

The Board of Management Casterton Memorial Hospital entered an agreement with the Victorian Department of

Health in 2012-2013 year to achieve a number of priority actions in line with the State-wide Victorian Health Priorities

Framework for 2012 to 2022.

This agreement between the Department and CMH details funding levels for CMH in line with agreed service and

activity levels to be achieved and a requirement for us to achieve a number of deliverables associated with the

Victorian Health Priorities Strategic directions for the State.

The Strategic Priorities and the deliverables agreed to by CMH are herein listed for your review of our attainment or

progress with the deliverables set for 2012-2013.

PRIORITY: DEVELOPING A SYSTEM THAT IS RESPONSIVE TO PEOPLE’S NEEDS

ACTION DELIVERABLE OUTCOME

Work and plan with key partners and service providers to respond to local issues including issues of distance and travel time experienced by some rural and regional Victorians

Maintenance and expansion of CMH Community Transport program to better meet the needs of our changing population demographic.

Ongoing service need determined. BOM approved additional funding to increase service from 2 to 3 days per week.

ACHIEVED

Explore opportunities to develop strategies that support greater service responsiveness for diverse populations.

Development of community based psychological support services from CMH including paediatric / adolescent support.

Psychologist service has expanded to 6 sessions per week with increased public mental health plan General Practitioner referrals. Consultant sessions 2011/12 totalled 5; due to Psychologist relocation 2012/13 increased to 71 sessions.

ACHIEVED

PRIORITY: IMPROVING EVERY VICTORIAN’S HEALTH STATUS AND EXPERIENCES


Collaborate with key partners such as members of local PCP, the newly formed Medicare locals, community health services and Aboriginal health service providers to support local implementation of relevant components of the Victorian Health and Wellbeing Plan 2011-2015.

Primary Healthcare personnel resources allocated for participation in Medicare Local in collaboration with Southern Grampians / Glenelg PCP.

Additional personnel, Nurse Unit Manager - Primary and Community Care, employed as part of the Community Health / District Nursing services re-orientation. Focus increased toward ML / PCP and other community health collaborations.

ACHIEVED

Consider new models of care and more coordinated services to respond to the specific needs of people with priority clinical conditions.

Develop clinical pathways resulting in more timely and appropriate referrals.

CMH internal procedures directing best case referral / transfer destinations for particular clinical needs in place. Awaiting further work from Barwon South West Sustainable Hospitals project to consolidate region wide patterns.

75% ACHIEVED


PRIORITY: EXPANDING SERVICE, WORKFORCE AND SYSTEM CAPACITY


Develop collaborative approaches to deliver professional education training and support.

In conjunction with local Medical Practice, continue to support the placement of Medical Interns from Deakin Medical School and Royal Adelaide Hospital.

RAH Intern program continuing, also Deakin Medical student placements with CC Medical practice at CMH.

ACHIEVED

Identify opportunities to address workforce gaps by optimising workforce capabilities and capacity, and exploring alternative workforce models.

Implementation of collaborative practice model for Rural Isolated Practice Endorsed Nurses (RIPEN) at CMH and in accordance with Barwon South West Plan.

CMH fund holder and mentor for BSW RIPEN program.

ACHIEVED

PRIORITY: INCREASING THE SYSTEM’S FINANCIAL SUSTAINABILITY AND PRODUCTIVITY


Identify opportunities for efficiency and better value service delivery.

Develop best practice systems for waste management and energy consumption via CMH Environmental Management Group.

Waste management best practice and financially efficient model in place. Based on Energy Consultant review and report, CMH lighting changing over to LED systems.

90% ACHIEVED

Develop and support alternative arrangements that drive greater financial productivity and sustainability through more efficient purchasing of non-clinical services.

Expand our Sub-Regional Corporate Services Group to identify potential consortia efficiencies.

Southern Grampians / Glenelg Sub-Regional Corporate Services Group continues to identify shared approaches to consortia work, reducing costs and personnel needs. Now collaborating further with BSW Sustainable Health Services Project.

90% ACHIEVED

Examine and reduce variation in administrative overheads

Review and benchmark administrative overhead costs with a view to maximising efficient capacity of the administrative functions of CMH.

Administrative functions reviewed to identify possible efficiency. Bench marking being pursued through Sub-Regional Corporate Services Group.

80% ACHIEVED

PRIORITY: IMPLEMENTING CONTINUOUS IMPROVEMENTS AND INNOVATIONS


Develop and implement improvement strategies that better support patient flow and the quality and safety of hospital services

Medication management improvement in collaboration with SWARH agencies with development and implementation of E-Medication management systems.

CMH preparation commenced and awaiting SWARH trial site to initiate the implementation of E-Medication.

50% ACHIEVED

Develop and implement strategies that support service innovation and redesign.

Person Centred Care Program to be delivered across whole organisation to focus and develop care provision to the individual from the whole staff group with improvements measurement based on Victorian Patient Satisfaction Monitor data outcomes.

3 day PCC workshop completed this year for 96 staff and 9 Board members. Policies, processes and organisation guidelines encapsulate PCC approach. PCC Steering committee established of Board and staff to develop on-going PCC actions and improvement changes.

Statement of Priorities for 2012 / 2013 cont/...


PRIORITY: INCREASING ACCOUNTABILITY & TRANSPARENCY


Implement systems that support streamlined approaches to clinical governance at all levels of the organisation.

Review quality systems to reflect improved process and recording of outcomes in line with the National Safety and Quality Health Service Standards.

ACHS conducted gap analysis demonstrating CMH’s initial high compliance to NSQHSS. Work committees in place to align our Quality systems with NSHQSS as required.

90% ACHIEVED

PRIORITY: IMPROVING UTILISATION OF E-HEALTH AND COMMUNICATIONS TECHNOLOGY


Maximise the use of ICT infrastructure to better connect to a broad range of health care and other health related workforces.

Participation with South West Alliance Rural Health IT Networks through user groups, committees and executive to ensure roll out of IT clinical systems including medication management and the electronic health record.

BOM Strategic direction is to utilise and maximise our preparedness and capacity for improved health services and corporate management through implementation of ICT systems.

90% ACHIEVED

Trial, implement and evaluate strategies that use ICT as an enabler of better patient care.

In conjunction with Southern Grampians / Glenelg PCP roll out pilot of tele-health for our communities.

Pre-Anaesthetic tele-health pilot established with Hamilton Anaesthetists. To commence August, 2013.

95% ACHIEVED

Statement of Priorities for 2012 / 2013 cont/...

Accreditation means that we have been able to successfully demonstrate that our Quality and Safety management systems and processes along with our commitment to Continuous Improvement meet the required standards. This is achieved through external surveys undertaken by relevant external Accreditation authorities. These surveys are based on sets of standards and criteria that outline the expected level of practice that supports quality and safety in healthcare. Hospital Accreditation has had a major change due to Commonwealth Health Reforms and a new National Accreditation Program (Australian Commission for Quality and Safety National Accreditation Standards) was introduced across Australia in January 2013. There are 10 National Quality and Safety Standards which are designed to set a nationally uniform set of clinically based Quality and Safety standards for application across healthcare organisations. In July 2012 CMH underwent a successful Periodic Accreditation survey with the Australian Council on Healthcare Standards, to re-affirm our continued Accreditation status. We were very successful with this survey and ongoing Accreditation was granted with many standards being upgraded to the “Excellent” level of achievement. As well as an Accreditation survey we also undertook a Gap Analysis against the 10 National Standards which confirmed that we were well on the way with our achievement of these standards. Our focus will now be on improving our systems where gaps were identified. During September 2012 Glenelg House underwent Aged Care Accreditation through the Aged Care Standards Agency achieving a further 3 year Accreditation status with all 44 standards met.

All staff are to be congratulated on these outstanding achievements for both the hospital and Glenelg House, which confirms our commitment to providing a quality and safe healthcare service to all clients of our organisation. During 2012/13 CMH re-affirmed its commitment to Hospital Accreditation through the Australian Council on Healthcare Standards “Equip National” program. This program includes a survey against the 10 Nationally required Quality and Safety Standards as well as an additional 5 other primarily Governance and management standards. Achievement of this Accreditation will require a whole of organisation approach and CMH is already preparing for our next Accreditation event in 2014.

Accreditation


Our Model of Care

Demographics of Our Service

Casterton Memorial Hospital is classified as a Small Rural Health Service (SRHS) under the Department of Health Policy and Guidelines. This classification allows Casterton Memorial Hospital, a Small Rural Health Service, to direct service delivery within our budget which will best meet the needs of our community. This service and planning decentralisation of the Hospital is important for flexibility from year to year or as circumstances may alter, but also allows at the local level to identify and target community needs. It is the role of the Board of Management to utilise information available on our local area to maximise the health gains for our community. Casterton Memorial Hospital fulfils its mission through provision of acute, residential high care and community health/primary care services from its modern facility, as well as services into the home.

Casterton Memorial Hospital was established in 1908 and is situated in the northern sector of the Glenelg Shire within the township of Casterton. Nestled amongst rolling hills and river red gums of the Glenelg River valley, it is located on the Glenelg Highway, 359 kms west of Melbourne and 42 kms east of the South Australian border.

The Shire has a total population base of 20,200 and Casterton rural north has a catchment population of 4,500. Our catchment area includes the townships of Digby, Merino and Sandford and the surrounding rural localities. Casterton Memorial Hospital provides services to all within its population base as well as neighbouring shires.

As a Rural Health Service, the hospital is provided flexibility in its funding base to ensure that services provided directly to our community within budget, will best meet the needs of our community. The Board utilises local area information available to plan for and provide the most appropriate care and intervention options for our local catchment area to maximise health gains and status for our community.

The Hospital provides a range of acute health, aged residential care and primary healthcare services incorporating 15 medical/surgical inpatient beds, operating theatre, 2 bay urgent care centre, dialysis chair and 30 bed high care residential care facility ‘Glenelg House’. The Hospital also provides an extensive range of allied and primary healthcare personnel and programs along with visiting consultant services. All of these services are provided from our facility ensuring effective triaging and access of best care in best possible time for our patients and clients.

The Board of Management and staff at the Casterton Memorial Hospital are committed to providing strong and efficient health and community services to meet the needs and expectations of the community it serves.

INSERT MAP AS PER EMAIL REQUEST


Service Model June 2013

ACUTE SERVICE

General Practitioners x 5 (Private Practice) GP Student Deakin University Medical School Royal Adelaide Hospital Rotational Interns

VISITING CONSULTANTS / PRACTITIONERS

Obstetric / Gynaecology Physicians General Medicine Surgeons Ophthalmologist Specialist Anaesthetist Satellite Dialysis (Royal Melbourne) Acute Beds 15 (Gen. Medical & Surgical) Theatre with 2 bed recovery Urgent Care - 2 bay (24/7) Digital Radiology Services - Bendigo Radiology Community Rehabilitation Nursing Home Type Palliative Care Infection Control Officer Ambulance Service Infection Control / CSSD Integrated Health Promotion

AGED & RESIDENTIAL CARE

30 Bed High Care Residential Facility Support Groups / Resident’s Committee Diversional Therapy

EDUCATION & WORKFORCE DEVELOPMENT

Clinical Nursing Student Placements

Flinders University

Deakin University

Latrobe University

Uni SA

South West TAFE

TAFE South Australia

Medical Clinical Placements

Deakin University Medical School

Royal Adelaide Hospital Intern Rota-

tions

Work Experience Placements

In-House Education & Competencies

PRIMARY CARE

Planned Activity Group (3 days) Maternal & Child Health Centre Community Health Co-ordinator Community Development Officer

Diabetes Education, Monitoring & Support Group Women’s / Men’s Health Programs Drug Awareness & Education Osteoporosis / Falls Risk Prevention Alcohol & Drug Information Asthma Education & Mentoring Primary Mental Health Team Counsellor Better Health Self Management Program Strength & Balance Programs Walking Group Cardiovascular Disease Circuit Program

Visiting Chiropractic Service District Nursing (7 days) Domiciliary / Midwifery Physiotherapy Psychologist Speech Therapy Meals on Wheels Home Maintenance Services Podiatry Occupational Therapy Dietetics Community Bus & Car Transport Service Community Room Facilities Audiology Aged Care Assessment Team (W’bool) Advanced Care Planning Personnel

INFRASTRUCTURE SERVICES

Administration / Finance / Secretarial

Maintenance Personnel

Catering Services (Functions)

In-House Laundry

Meeting & Function Facilities

Consulting Rooms

Short Term Accommodation

Video Conferencing Facilities

Community Transport

SWARH IT Alliance Network

Ambulance Victoria Fixed Wing

Helicopter Emergency Service (HEMS)

Medical Specialists Video Conferencing

Medicare Consultation Facilitation


Services to our Community

Hospital 2012/13 2011/12

Total Multi-stay Inpatient Separations* 319 326

Total Same Day Inpatient Separations* 272 165

Bed Days* 2,915 2,860

Total WIES 384.43 355.23

% Occupancy Rate Staffed Beds 53% 52%

Average Length of Stay** 3.2 3.9

% Public Bed Days 83% 67%

% Private / Compensable Bed Days 17% 33%

Obstetrics / Gynaecology 19 11

Operations / Procedures 131 126

Urgent Care Presentations 1,570 1,595

Glenelg House Residential Care

Residents Accommodated 39 40

Bed Days 10,912 10,911

Average Daily Occupancy 29.89 29.81

% Occupancy Rate Full Year 99.65% 99.37%

Planned Activity Group

Attendances 1,050 1,015

District Nursing

Home Visits 4,133 3,605

Kilometres Travelled 17,653 25,996

Community Health

Attendance (contacts) 637 1,428

Allied Health

Physiotherapy Attendance 1,931 1,634

Speech Therapy Attendance 25 6

Dietetics Attendance 72 114

Occupational Therapist Attendance 100 17

Antenatal Sessions 0 0

Meals Produced

Hospital / Residential Care / Other 71,178 70,107

Meals on Wheels (HACC Assessed) 4,892 5,600

Home Maintenance Program (HACC Service)

Number of Clients 107 91

Number of Visits 1,119 1,224

Number of Hours 1,209 1,311.65

* Does not include newborn transfers

** Excludes Nursing Home Type Patients

Other services facilitated from Casterton Memorial

Hospital through private practitioners include:

Audiology

Child Maternal Health

Visiting Medical Specialists

Radiology Services

Ophthalmology Services

Podiatry Services

Psychology Services

Drug & Alcohol

Physiotherapy

Meals on Wheel Volunteers Ms. Joy Harvey and Ms. Sue

McCallum prepare to head out into the community to

deliver meals.

The CMH Maintenance Department has been kept busy

this year with the Home Maintenance Program


Clinical Governance

The Casterton Memorial Hospital’s Clinical Governance Policy framework is an organisational approach that supports overall management and improvement of quality and safety of health care services. The Quality Committee and Clinical Committee, which are subcommittees of the Board of Management, monitor safety and quality throughout the organisation and report back to the Board on current rates, trends and issues in these areas.

As part of CMH ongoing promotion of “Person Centred Care” throughout the organisation, preparation commenced on improving menu planning, meal choices and dining experiences for Glenelg House residents and patients. Preliminary investigations, client consultations and costings were undertaken along with a number of external ‘fact finding’ visits. Thanks go to those facilities who willingly offered their advice and the benefit of their experiences in providing quality catering services. Further planning and implementation strategies are being finalised for the 2013/2014 year. Involving consumers in their care planning and delivery continues through work in areas such as goal directed care planning, discharge summary strategies and the initial planning for the construct of a Consumer Advisory Committee. These actions fit within CMH strategic objectives and compliment state client participation initiatives. Ongoing participation in quality and safety data collections, external databases and external reviews continue to provide opportunities to identify improvement opportunities in clinical effectiveness and risk. Commonwealth health reforms have resulted in some clinical review programs ceasing which in turn has given us the opportunity to improve our own internal review systems. This has led to improvements in areas of Warfarin management, pathology collection work practices, medication storage practices, clinical documentation, clinical management of specific types of Accident and Emergency presentations, and additional visiting medical officer representation on hospital committees to name a few. In addition, the hospital implemented a new system to enhance the recognition of clinical deterioration with new and improved communication processes and vital sign recording systems. The organisational Falls Management Policy also underwent major reform following consultation between departments. Improved communication of management strategies, recording systems and staff education have resulted in a gradual but ongoing reduction in reported falls across the facility. Medical appointment, credentialing and scope of practice systems are in place to ensure that visiting medical officers and other clinical staff are appropriately qualified, have up to date skills and maintain the necessary experience to provide the best possible care to patients and clients. Internal development and appraisal systems monitor staff compliance to organisational policies / procedures. As well, ongoing professional development and competency based training programs all contribute to ensuring that employee skills and knowledge continue to meet and enhance our quality & safety requirements. This year CMH has implemented a number of major upgrades to our information, communication and technology systems all of which have been successfully implemented. Staff are to be congratulated on their uptake of these change management processes.


Consumer, Carer & Community Participation

CULTURAL RESPONSIVENESS

Casterton Memorial Hospital’s Cultural Diversity Plan

was developed using the Department of Health’s,

“Cultural Responsiveness Framework” as outlined

below;

Standard 1 - A whole of organisation approach to

diversity responsiveness is demonstrated.

Standard 2 - Leadership for diversity responsiveness is

demonstrated by the Health Service.

Standard 3 - Accredited interpreters are provided to

patients who require care.

Standard 4 - Inclusive practice in care planning is

demonstrated, including not limiting to

dietary, spiritual family attitudinal and

other cultural practices.

Standard 5 - CALD Consumer, Carer and Community

members are involved in the planning,

improvements and review of programs and

services on an ongoing basis.

Standard 6 - Staff at all levels are provided with

professional development opportunities to

enhance their cultural responsiveness.

The Australian Bureau of Statistic’s data continues to reflect very low numbers of persons from non English speaking backgrounds in the Casterton area (5.8% ABS 2011 Census). CMH continues to develop and work on enhancing person centred care for all consumers. This year the organisation focussed on introducing and developing the concept of person centred care (PCC) not only for culturally diverse clients but for all consumers. The PCC program was run organisation wide with a full day of professional development offered and taken up to 96% of staff, board members and volunteers. The program focussed on respect and acknowledgment that all persons are individuals and bring different life stories and experiences to their episode of care. The expansion of this programme will see development of consumer participation and culturally sensitive care. CMH also continues to support and celebrate new cultures in to the workforce and community. The CMH site at the local show saw a cultural cooking experience to community members, with Indian meals being prepared.

CMH Staff, Board Members & Volunteers participated in

Person Centered Care professional development days.

CMH staff member Mr. Christo Jose prepared “A Taste of

India” for community members at the local show as part of

CMH’s Cultural Diversity Plan.

Glenelg House resident Mrs. Shirley Widdicombe

participates in the artwork activities conducted by

volunteer Kim Leonard as part of NAIDOC week.



DOING IT WITH US NOT FOR US

PARTICIPATION STANDARDS AND INDICATORS The five standards for consumer, carer and community participation in Victorian public health services have been incorporated into the everyday functioning of the Casterton Memorial Hospital (CMH). As a method of highlighting the Victorian Department of Health’s Five New Standards, consumers’ stories will be told to describe a sample of the standards, result areas and indicators that were achieved throughout the year. 1. The organisation demonstrates a commitment to consumer, carer and community participation appropriate to its diverse communities. CMH recognises the important part community members play in the development and planning of services provided by our organisation. Upon evaluating recent community surveys and recognition of community feedback received in written and spoken formats, the Board of Management has commenced the process of establishing a Community Advisory Group. This will provide a forum whereby consumers, carers and community members will be able to participate and ‘have a say’ in the machinations of our hospital. It is envisaged our organisation will be able to provide a more enhanced and richer level of care as a result of our new initiative. 2. Consumers and where appropriate, carers are involved in informed decision-making about their treatment, care and wellbeing at all stages and with appropriate support. Consumers and carers have been involved in the development of care plans, in District Nursing, for a number of years. The care plans are reviewed three monthly and assist all people receiving the delivered care the ability to ‘have a voice’ in the process of determining care options, reviewing services delivered and developing short and long term plans for the future. Planned Activity Group participants and their carers commence an intake process when they first start to attend Day Centre activities. This initial interviewing and collaborative process informs the Planned Activity Co-ordinator and volunteers working in Day Centre of the likes, dislikes and nuances of those attending sessions. However, compared to the care plan process occurring within the district nursing service, the amount of detail needed to provide comprehensive care and the involvement elicited by the consumer and their carer was at a level that we considered could be improved on. After reviewing empirical and anecdotal evidence, conversing with consumers and carers and collegial conversations, Planned Activity Care Plans have been developed and will be trialled in the coming year.

Planned Activity Group Coordinator Mrs. Sheila

Neill discusses care plan needs with client Mrs.

Val Hooper.



DOING IT WITH US NOT FOR US cont/...

3. Consumers, and, where appropriate, carers are provided with evidence-based, accessible information to support key decision-making along the continuum of care. CMH has the benefit of being a stand alone, independent hospital with the capacity of ‘knowing its community and being able to respond to their needs’. This is achieved via collaborations and partnerships with other health facilities in our area. Working in conjunction with other organisations enables us to provide ‘best practice’ care to our community using many technological and innovative approaches.

CASE STUDY

An elderly lady, living on her own on a farm out of town, with a supportive family who visit her daily, required specialised clinical nursing care. She no longer drives herself but is still able to participate in her community by family and friends transporting her to events or services. She receives district nursing care and most times she has excellent health. She did, however, develop a health issue which required nursing intervention and after assessment by our district nursing team it was determined that further specialised nursing intervention was needed to compliment her existing management. In order to provide care adhering to “best practice” CMH liaise with colleagues from larger health facilities. This is possible with the use of Information and Communication Technology (ICT) that is an innovation used by staff throughout CMH. The ICT enabled our client to be further assessed with her daughter and district nursing having input from Casterton. After feedback from district nursing staff, a management plan was developed which incorporated clinical assessment from nursing staff in two locations via video link. ICT has enabled district nursing to implement specialised care to clients in a shorter time frame. This efficient collaboration and use of services between health facilities, equated to a speedy resolution of her issues and a timely end to her health concerns. All parties were satisfied. This wonderful collaboration and use of services equated to a speedy resolution of her issues and a timely end to her health concerns. All parties were satisfied.

4. Consumers, carers and community members are active participants in the planning, improvement, and evaluation of services and programs on an ongoing basis. CMH is fortunate in having the capacity to run sustainable community health programmes as well as community members who are cognisant for the need to maintain their health and actively participate to enable this to occur. The Men’s Day is a wonderful example of this process in action. Initially designed to enable local men, caring for their wives, to meet and socialise once a month, this event has become a luncheon where men, of all walks of life, however mainly the more mature men of our community, gather one day per month, in the local hotel, for a bar meal and a chat. The formation of the event, the process that occurs and the activities taking place during the lunch, are a result of feedback received from the male participants. The event is now growing in attendees each month and is a typical ‘blokey’ event held without fuss or fanfare.

The Men’s Day has been a successful

program introduced during the year

5. The organisation actively contributes to building the capacity of consumers, carers and community members to participate fully and effectively. CMH Primary and Community Care has reviewed policies, procedures and documentation used when delivering care to our consumers, carers and community. The measures used to ensure the safety of all concerned has been paramount as evidenced by the development and implementation of a number of assessment tools and action plans. These include: Vulnerable Persons’ Register, Carers Support plan, Active Service Model action plan and Diversity plan. The use of these applications will be monitored and reported back to the community in the future. Primary and Community Care are committed to supporting and caring for the community in their own homes whilst putting safety measures in place that physically and psychologically enable people to feel independent and secure in their own environment.


Quality & Safety

FALLS PREVENTION & MONITORING

Definition of a fall: a sudden, unintentional change in position

causing an individual to land at a lower level on an object, the

ground, the floor or other surface.

If a resident / patient is found on the floor it should be assumed

they have fallen unless they are cognitively unimpaired and

indicate they put themselves on the floor.

Falls are the leading cause of injury related hospitalisation and

injury related death in persons aged 65 and above. Studies have

shown that approximately 20% of all presentations of older

persons to emergency departments in Australian hospitals were

fall related and of these 50% are admitted. A third of people

over 65 and a half of people over 80 years of age have a fall at

least once a year. In Australian hospitals 38% of patient

incidents involve a fall.

At CMH we implemented a new falls risk assessment in 2010

into both Glenelg House and the Acute Ward. This Falls Risk

Assessment Tool (FRAT) is based on best practice, in 2013 we

reviewed this assessment tool, provided staff with refresher

education regarding the tool and added some new strategies to

help prevent falls / minimise effects from falls. We are also in

the process of extending falls risk screening and assessment to

Primary and Community Care in a more structured approach.

In the future all District Nursing Service clients will have a falls

risk screening completed using the Falls Risk for Older People

screening and assessment to all clients 65 years and older or

younger clients who have presented following a fall to CMH

Accident and Emergency Department.

The new strategy that was introduced was commenced in

conjunction with the assistance of the physiotherapist. CMH

policy regarding bed heights was that for high fall risk clients,

their bed be positioned at the lowest possible height, however

it was concluded that for some high falls risk clients it would

actually lower their risk of falling if their bed height was

positioned at a height which eased their ability to get in and out

of bed. Individual assessed bed heights are attended to by the

physiotherapist and then a strip is attached to the wall so all

staff are aware of the height the bed is to be maintained at.

Family members are consulted and consent obtained before

bed height assessment by the physiotherapist.

Mrs. Ethel Humphries takes a walk under the close

supervision of Physiotherapist Mel Roll

0%

20%

40%

60%

80%

100%

Minor Injury Major Injury Without Injury

23%

2%

75%

22%

2%

76%

28%

0%

72%

2010/11

2011/12

2012/13

Hospital Falls Injury Rates as a Percentage of Total Falls Reported

0%

20%

40%

60%

80%

100%

Minor Injury (2-3) Major Injury Without Injury

19%

0%

81%

23%

5%

72%

28%

0%

72%

Glenelg House Falls Injury Rates as a Percentage of Total Falls Reported

2010/11

2011/12

2012/13


Quality & Safety

SAFE USE OF BLOOD AND BLOOD PRODUCTS

Casterton Memorial Hospital continues to administer

blood and blood products to members of the community

to improve their well being. The hospital adheres to the

NHMRC / Australasian Society of Blood Transfusion

(ASBT) Clinical Practice Guidelines on the Use of Blood

Components (2001); this standard is under review in

administrations of these products. CMH is in the process

of developing a new blood prescription form. This form

will be used by medical and nursing staff to improve

safety and convenience when administering blood and

blood products.

All Registered Nurses that undertake the administration

of blood and blood products are required to complete a

course each year to gain competency and build on their

existing knowledge on blood administration. Education

for Registered Nurses is by Blood Safe E-Learning

Australia. This course is designed to improve clinical

transfusion practice and patient blood management

knowledge.

PREVENTING AND MANAGING PRESSURE INJURIES

Many patients admitted to hospital are at risk of developing pressure injuries. In line with Standard 8 of the ACHS we

are in the process of updating our pressure risk assessment by adopting the Braden Scale Risk Assessment Tool for all

patients admitted to the Acute ward. Once assessed patients will have intervention plans in place depending on their

level of risk. These interventions will include frequent position changes, use of various pressure reducing devices,

continence assessments and incontinence management, nutritional assessments and dietary modification where

required.

Pressure Injuries are reported through the VHIMS clinical management assessment system which in turn identifies

causes and suggest modifications to care to reduce the risk of further injuries.

Where able pressure injuries are

managed in house using our Wound

Management Plan. The Barwon

Regional Wound Management

Consultant can be utilized to provide

advice and ongoing education.

Staff are educated in pressure injury

reduction and management through

Wounds West online education on

SOLLE education system.

RN Mr. Shane Gill ensures that blood is administered safely to

patient Mrs. Shirley Cottier.

3.81%

7.51%

0% 0%0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

Jan-Jun 12 Jul-Dec 12

Transfusion where informed Consent notdocumented Low Rate Desirable

Peer Group Rate

CMH Rate

0 0

0.36

0 0

0.63

0.05

0.63

0.49

0.68

0

0.2

0.4

0.6

0.8

Jan-Mar 12 Apr-Jun 12 Jul-Sept 12 Oct-Dec Jan-Mar 13

Pressure Ulcer Rate per 1000 Bedays Stage 1 Glenelg House Rate

Statewide High Care Rate


Quality & Safety

14

18

9

0 0 0

0

5

10

15

20

2010/11 2011/12 2012/13

Total Patient Related Medication Incidents Acute

Ward

Total Total Adverse Outcomes

6.65

7.16

7.51

4.23 4.36

4.76

3

5

7

9

Jul-Sept 12 Oct-Dec 12 Jan-Mar 13

Incidence of 9 or more medications per 1000 beddays

Glenelg House Rate Statewide High Care Rate

MEDICATION SAFETY

As medicine is the most commonly used treatment in hospitals it also has the most potential for error that may cause adverse outcomes for patients. It is vital that hospitals have robust systems that support the safe prescribing, dispensing, supplying and administration of medications.

Nursing staff reconcile medications upon admission. This process is conducted in conjunction with the patient and identifies and documents all the patient’s medications. This ensures that clinicians are aware of patient’s complete medication history. Patients are educated on new medications and a detailed explanation of the drug and any possible side effects is provided. An information print out is also provided. When a patient is discharged they are given a copy of their discharge summary that details discharge medications and further instruction is given by nursing staff. Medication access and storage systems are used to ensure that high risk medications are managed securely and safely with regular monitoring undertaken. Comprehensive internal policies and procedures provide guidance on safe medication management practices. Compliance to policy is regularly monitored and audited to ensure consistent application and work practices by staff. Staff also undertake rigorous competency based testing, and training in safe administration and management of medications ensuring that only appropriately credentialed staff administer medications. We have established relationships with the local Pharmacy who regularly undertake audits and Medication reviews whilst contributing to the medication quality and safety system through representation on the hospital’s Clinical Committee. The Pharmacist also regularly reviews Glenelg House medication systems and undertakes medication reviews to monitor that multiple drug prescription is minimised wherever possible. Glenelg House are very proactive in reducing and minimising where possible multiple drug use and have an active program of sedative and psychotropic drug use reduction. Whilst Glenelg House will actively continue this minimisation culture, the total number of drugs taken does not always reflect this proactive approach. This can be seen from the Public Residential Aged Care Performance Indicator of 9 or more medication use which remains above the State benchmark levels. Hospital wide performance data is collected monthly and communicated to the Hospital’s executive as well as at staff level. This data is used to identify trends and issues and provides us with an opportunity to identify improvement needs. CMH has an open culture and we will always communicate medication incidents to patients through our Open Disclosure Policy. Medication related incidents are recorded on the VHIMS incident recording system. These are analysed, trended and reported to the Clinical Committee, Quality Committee and Board of Management and staff who monitor them closely. This year CMH undertook a project to improve the level of reported medication incidents that relate to missed administration. Through the implementation of additional resources, monitoring systems and additional staff communications there was a reduction in the level of these types of reports by one third in Glenelg House and by two thirds in the Acute Sector. Staff are to be congratulated for their efforts in this area. We are continuing our efforts in this area and have included supervised medication rounds to our arsenal of improvement strategies. It is hoped that through this we will continue to improve in this area. Total clinically related incidents overall for the Acute Sector reduced by half for 2012/13. For 2012/13 there were no adverse ef-fects to residents or patients as a consequence of a medication incident.

Further work is being planned for 2013/14 in regard to reviewing and improving our medication management systems in response to the National Safety and Quality Health Service Standards.


Quality & Safety

Infection control is an integral part of CMH’s

ethos and is encouraged and promoted in all

aspects of care and for all levels of staff.

CMH is proud to report that the level of

Healthcare Acquired Infections (HAIs) at our

hospital remains at a very low percentage of

people and no Multi Resistant Organisms

(MRO’s) such as MRSA & VRE being diagnosed

or transmitted within our facility in the

previous 12 months. HAIs are a major problem

in Australia causing pain and suffering to many

people and enormous healthcare costs, thus

many initiatives have been instigated at both a

national and state level to prevent these from

occurring. CMH participates in many of these

programs.

Hand hygiene is reported to the Department

of Health through Hand Hygiene Australia 3

times per year by auditing the ‘5 moments of

hand hygiene’. All staff have been educated in

hand hygiene and should be attending to this

practice before touching a patient, before a

procedure, after a procedure or body fluid risk,

after touching a patient and after touching

patient surrounds. The results of these audits

are reported to the CMH executive and any

issues addressed as they arise.

Cleaning audits are undertaken internally on a

monthly basis by the Infection Control Officer

and the Manager of Environmental Services

and 3 audits (2 non-external undertaken by a

trained auditor from within the facility and 1

external audit undertaken by a trained

independent auditor) are completed with the

results submitted to the Department of Health.

CMH always records results markedly higher

than the required 85% compliance rate.

Hand Hygiene is paramount in the hospital environment, Dr Geoff

Coggins performs hand hygiene before commencing a procedure in

theatre.

PREVENTING & CONTROLLING HEALTHCARE ASSOCIATED INFECTIONS

100 98 9998 100 99

9085 85

0

10

20

30

40

50

60

70

80

90

100

V High Risk High Risk Moderate Risk

CMH External Cleaning Audit Results

Jul-11 Jul-12 Acceptable Level


Quality & Safety

PREVENTING & CONTROLLING HEALTHCARE ASSOCIATED INFECTIONS cont/...

An influenza vaccination program is undertaken in March/April annually with staff uptake of this vaccination numbers

reported to the Department of Health. The required compliance with vaccination rate (as set by the department) for

the current season was 70% but CMH was very proud to be able to submit a compliance rate of 97% of Category A

staff (those with patient/resident contact) and 77% of Category B staff (no patient contact) thus having one of the

highest compliance rates in the state and way above what was required. This rate of compliance highlights how

committed CMH is to preventing our clients from acquiring an infection whilst in our care.

An Antimicrobial Stewardship program has been introduced throughout the facility in recent months. This program

aims to promote safe and judicious use of antibiotic therapy to aid in reducing antimicrobial resistance. Over-use

and /or inappropriate use of antimicrobials both in healthcare facilities and in the community has led to a marked

increase in resistant bacteria, an increase in the risk of patient harm from the acquisition of these bacteria and the

use of toxic antimicrobials to treat these infections, infection with MRO’s and increased healthcare costs.

Regular auditing of many other practices is also undertaken – food safety (externally by the Environmental Health Of-

ficer), sterilisation services, clinical practice, surveillance for MRO’s, waste, water for bacteria and legionella, out-

breaks, use of personal protective equipment, standard and transmission based precautions, to ensure that CMH is

compliant with all current best practice.

A comprehensive and up to date policy and guideline manual is in use, with all policies and guidelines being

referenced to all current Legislation, Australian Standards and Guidelines, and best practice models. This manual is

updated regularly and when new practices are introduced.

RN Muza Makore ensure that

equipment is thoroughly cleaned

prior to sterilisation in the CSSD

unit


Quality & Safety

CMH prides itself in providing fresh and wholesome cooked meals to patients, residents and clients. A review of meal

choices and meal delivery systems is currently underway with the aim of enhancing the food choices and overall

dining experience and therefore having a flow on effect to positive weight management.

Dietetic staff regularly visit CMH to assist in the planning of appropriate dietary care for clients. Resident’s in Glenelg

House are regularly reviewed by the Dietician as well as a monthly check by nursing staff to ensure that they are

maintaining a healthy and manageable weight range.

Data is collected quarterly under the Public Residential Aged Care Performance Indicators on weight loss management.

This information demonstrates that Glenelg House is successful in improving nutritional status for residents.

0.36

0

0.72

0.98

0.75 0.78

0

0.4

0.8

1.2

Jul-Sept 12 Oct-Dec 12 Jan-Mar 13

Rate of Weight Loss > 3 kg per 1000 beddays

Glenelg House Rate Statewide High Care Rate

Dietician Jess Nobes, discusses healthy eating options with

Glenelg House Resident Mr. John Roberts.

UNPLANNED WEIGHT LOSS

Nutrition performs a vital function in maintaining

health however during times of illness, injury or

infection, unplanned weight loss often occurs.

Risk screening is conducted throughout all CMH

services and involves identifying risk factors that

may contribute towards weight loss / gain or

nutritional deficiency. For those identified as

being at risk, care staff implement an individualised

person centred care approach to care planning and

weight management.

Wholesome, freshly cooked meals are prepared daily by the

CMH Catering Department.


Consumer Satisfaction

COMPLAINTS

CMH encourages all consumers to provide feedback on our services, there are Suggestion, Comment and Complaint

forms in easily accessible areas throughout the facility.

All complaints received are treated in an impartial, confidential and respectful approach. Any feedback received is

seen as a way to improve our services to the community and will work towards reaching a mutually satisfying result

for all parties involved.

Each service area of CMH regularly distributes satisfaction questionnaires, from which we gain valuable knowledge on

what the consumer appreciates about the service and also what areas can be improved upon. These results are

presented at staff meetings so that staff are aware of how their hard work is appreciated by the community.

SATISFACTION WITH YOUR HOSPITAL

The Victorian Patient Satisfaction Monitor (VPSM) is a patient satisfaction survey that is distributed to randomly

selected patients from all Victorian public hospitals. The information received from this program is vital to CMH as it is

also another form of feedback which is used to improve our services to the community. Also our results are compared

with the results of hospitals of similar size which allows us to benchmark our results.

This program has concluded at the end of the 2012-2013 year, and will be replaced by the Victorian Health Experience

Measurement Instrument (VHEMI) which is due to commence in 2014.

VPSM GRAPH - CMH - Benchmark data - Overall Individual Care

Index

83

91

90

90

91

90

90

85

89

86

88

85

84

86

78

84

81

82

77

79

80

70 80 90 100

Access & Admission

General Patient Information

Treatment & Related

Information

Complaints Management

Physical Environment

Discharge & Follow Up

Overall Care Index

CMH Jun-Dec 12 “D” Hosp Av. State Average


HEALTH PROMOTION

Casterton Memorial Hospital (CMH) is involved with Health Promotion activities for the community members living in

and around Casterton and surrounding district. We are committed to improving the health and well being of all

consumers within our region and achieve this through a variety of ways.

CMH is a member of the Southern Grampians Glenelg Primary Care Partnership (SGGPCP). We believe this

partnership enables us to increase our capacity to provide health promotion activities to our community and to work

with other organisations to provide an integrated approach to health promotion.

SGGPCP has developed a Strategic Plan and an Action Plan which outlines key focuses for our region. Out of these

documents an Integrated Health Plan (IHP) was developed which specifically relates to health promotion.

Partnerships are a crucial aspect of the IHP and health organisations are encouraged by the Department of Health to

pool resources to maximise impact on the health and well being of all people.

CMH Primary and Community Care then designs and develops their own local plan following the themes and strategies

from the SGGPCP Integrated Health Plan. This process enables a ‘grass roots’ approach to health promotion whilst

incorporating a collaborative, systematic and resourceful way to planning and promotion of health and well being.

Community Health Nurse, Ms. Paula

Layley-Doyle helps out with the

“Bike ’n Blend” activity at the Kelpie Festival.

Lisa Curry visited Casterton during the year and

joined the CMH walking group on a stroll

around the town


Volunteers

Left: The Friends of Glenelg House visit residents every

Wednesday. Bingo is one of the many activities held

during their visits.

Right: Volunteer Mr. Keith Edwards plays cards with Planned

Activity Group client, Mr. Sydney Osborne.

Left: Planned Activity Group clients work on their sewing

projects under the watchful eye of Volunteer

Mrs. Joyce Trezise

Right: Volunteer Mr. Warren Burt assisting Planned Activity

Group member Ms. Sheryl Patton off the Community Bus.


Our Supportive Community Casterton and district community members, businesses, service groups and fund raising committees continue to support the activities, planning and development of our facility. This support is very much valued and reinforces our strong community spirit.

During 2012/2013 CMH fundraising committees and the community have contributed $30,805 to our facility to assist with maintaining our modern well equipped hospital, aged care facility and community health development. We also acknowledge and appreciate the general donations received from families, community members, staff and estates.

Volunteers provide purposeful activities and roles, and as such are greatly appreciated by staff and the community we serve. Their contribution extends to activities including delivery of Meals on Wheels, bus driving, visiting, entertainment and diversional lifestyle activities. It is through our volunteers that we are able to foster community connection and participation for our residents and their families.

The Hospital also appreciates the input and contributions from the businesses and the broader community through our community surveys, questionnaires and Hospital Card Program. This community spirit contributes to Casterton Memorial Hospital being a proud facility and also supports our continual effort to provide the best quality services to meet the changing needs of our community.

The Board of Management sincerely thanks all Casterton Memorial Hospital supporters for their generous, tireless and invaluable support during 2012/13.

Fundraising Committee

CMH Hospital Social Club $1,000.00

CMH Ladies Auxiliary $1,942.20

CMH Murray to Moyne $12,592.98

CMH Hospital Card Program $6,050.00

CMH Staff $4,074.60

Community Member Support

Donations in Memory of Community Members $2,037.00

Anonymous $205.85

Ann Hindson $500.00

Betty Donehue $50.00

Clive Goodes $90.00

Elizabeth Bre $100.00

Estate Eileen Day $76.70

Estate Edna McConchie $65.95

Robert Boyle $20.00

Estates

Equity Trustees - Estate John MacPherson $1,000.00

Equity Trustees - Estate Stanley Health $1,000.00

Total Donations $30,805.28

The CMH Board of Management and staff would like to thank the Casterton & District Community for their ongoing support.


Our Supportive Community cont/...

CMH Life Governors

Bunnik, Mr A. Burston, Sir S.G.W.

Collins, Mr D. Cowland, Mr R.

Edge, Mr E Flanders, Mrs E.

Floyd, Dr. A. F. McEachern, Mrs N. J.

McKinnon, Mrs C. Moffatt, Mrs M.

Nicol, Mr R. Ross, Mrs J. (OAM)

Sandow, Mr P. J. Simson, C. R. & K. L.

Squire, D. Thompson, Mrs R. G.

Recognised for Service and Dedication to

Casterton Memorial Hospital CMH Board of Management President, Mr. Graham Sheppard

congratulates Mr. Edwin Edge on becoming a Life Governor of CMH.

Life Governors

The CMH Murray to Moyne committee participated in their 21st Murray to Moyne relay this year, here members Mrs. Barb Toma, Mr. Troy

Robbins and Mr. Shane Gill head out on a training ride before this years event.


Human Resources

Category Labour Category – Full Time equivalent (FTE)

Staffing June Current Month June Year to Date

2012 2013 2012 2013 2012 2013

Nursing 60 54 38.98 37.32 39.96 37.58

Administration & Clerical 9 10 8.15 8.24 8.21 8.42

Hotel & Allied Services 46 48 25.64 29.12 27.24 31.23

Ancillary Staff (Allied health) 1 0 0 0 0.20 0

OCCUPATIONAL HEALTH & SAFETY

Occupational Health and Safety forms an integral part of the day to day operation of Casterton Memorial Hospital. The Safe Environment / OH&S Committee consist of representatives from each of the designated work group areas as well as management representatives. This committee meets quarterly to discuss and address any concerns or issues that may arise and undertake regular inspections of the workplace. All Designated Work Group Representatives undergo the initial 5 Day Course for OH&S Representatives along with regular refresher courses. Staff are encouraged to act and work in a safe manner and to report any incidents or near misses. Through the operation of the Safe Environment / OH&S Committee, Minimal Handling Committee, staff education and incident reporting, through VHIMS, Casterton Memorial Hospital is continuing to ensure the safety of staff, patients and visitors.

The Casterton Memorial Hospital Work-Safe Industry indicative performance rating is 0.758158. This represents that the comparison of Casterton Memorial Hospital claim costs compared to remuneration is 24.18% better than the average for our industry over the past three years. No workcover claims were registered during 2012-2013 and the facility has currently a nil claims history.

WORKFORCE DATA

During the 2012/13 year Casterton Memorial Hospital employed a total of 112 staff, 41 full time, 55 part time and 6 casual across the labour categories as detailed in the following table. Statistics provided are consistent with information provided in the entity’s MDS/F1 datasets which are reported on a monthly basis to the Department of Health.

Each year CMH recognises a staff member who has

contributed to the reputation and success of CMH.

It is with great pleasure that the CMH Employee of

the Year Award for 2012 was presented to Mrs

Karen Perry.

In recognition of her care and dedication to the res-

idents of Glenelg House through all facets of her

work, from personal care and support, to activities

and program organisation and delivery which

enhances the lives of so many people.

The Board of Management of CMH and colleagues

thank Karen on behalf of all our residents and their

families.


Human Resources

5 Years

Ann Beever

Nicola Jones

Grace Makore

Muza Makore

Smart Makore

William Malone

Carol Northcott

Teresa Sealey

Patricia Tait

10 Years

Paula Gunning

Helen Kirby

Barb McDonald

Martina O’Connell

Diane Southern

20 Years

Janice Annett

25 Years

Helen Dillon

Debra Gartlan

Robyn Reilley

35 Years

Cherryl Rees

YEARS OF SERVICE

Mrs. Donna Nesbitt & Mrs. Sue Nolte received awards for 35 Years of Service at the 2012 Annual

General Meeting from CMH Board of Management President, Mr. Graham Sheppard.

EDUCATION & TRAINING

Continuing education and skill development are essential in the changing face of

healthcare. During the last 12 months CMH committed to continue, support and

encourage staff to increase their skill base. Education is provided both internally and

externally through lectures, seminars and conferences. This year a total of 1848

education hours were clocked by staff over 53 different courses offered during the last

financial year.

Nursing Staff can now

practice their clinical

skills on the Mega Code

Kelly Advanced

Mannequin Simulation

Equipment.


Staff List

REGISTERED NURSE: ENROLLED NURSE: HEALTHCARE ATTENDANT: CATERING:

Betson, M.A. Beever, A. Kent, B.M. Clode, J.M.

Brown, D.M. Bogie, R. Craig, E.A.

Bryan, S. Bowman, I.T. DIVERSIONAL THERAPY: Gould, D.A.

Coulter, J.M. Bryan, B.H. Bunworth, R.K.* Green, J.R.

Dehnert, S.D. Condon, C.A. Perry, K. M. Jackson, B.J.

Dillon, H.V. Cook, J.M.* Watts, A.M.E. Jordan, J.

Farquharson, J.L. Cunningham, C.J. Kensen, M.D.

Gartlan, D.A. Galpin, S.P. ADMINISTRATION: Morrison, B.J.*

Gill, H.L. Johnson, C.D. Bandel, G.M. Murphy, J.L.*

Gill, S.M.D. Johnson, K.M. Betinsky, M.J. Murrell, J.A.

Gunning, P.S. Jones, N.M. Carmichael, P.G. Naylor, J.H.

Jenkins, A.J. Kirby, H.M. Davis, S.S. Nolte, M.R.

Jose, C. Makore, G. Hulm, L.S. Norman, J.J.*

Kettle, L.J. McArlein, K.M. Jarmain, L.J.* Northcott, C.J.

Macpherson, G.A.* Nesbitt, D.A. Rees, H. Ross, V.L.

Makore, M Owens-Brownbill, P.J.* Shone, C.M. Sealey, D.J.

Makore, S. Perri, D. Stephens, O.P. Smith, S. L.*

Makwati, O. Russell, M.R. Toma, B.G. Southern, D.L.

Matthews, J.A. Tait, P.M. Stanislawski, H.

McEachern, B.M. Tibbles, W.K. ENVIRONMENTAL SERVICES: Talbot, P.J.

McGrath, K.A. Wombwell, S.M. Bellinger, C. Twardowski, G.M.

McKinnon, D.R. Bunnik, I.

Nolte, S.J.* NURSING ATTENDANT / Carter, L.M.* MAINTENANCE:

O’Connell, M.P. PERSONAL CARE WORKERS: East, J.A. Malone, W.J.*

Rees, C.M. Brooker, A. J. Edwards, K.D. Naylor, M.L.

Sealey, K. Mahanda-Makore, C. Harvey, E.T. Richardson, D.J.

Sheahan, V.J. Mercer, M.M. Hurrell, J.A. Ryan, P.D.

Taylor, A.C Parsons, K.L. Jones, P.A. Tomkins, R.W.

Zippel, W.J. Reilley, R.F. Louden, D.J.

Sealey, T.B. McDonald, B.A.J.

COMMUNITY HEALTH: Thurkle, E.R. Smith, C.L.

Bramall, S.N.

Layley-Doyle, P.L. PLANNED ACTIVITY GROUP:

Pekin, A.M. Annett, J.M.

Neill, S. * denotes resigned during year


Vale

Mr Adrian Bunnik

13th July 1943 ~ 19th May 2013

The Board of Management of Casterton Memorial Hospital respectfully acknowledges the life and service given to CMH by Mr

Adrian Bunnik, Board Member for 35 years and Life Governor of CMH.

Adrian was born in the Netherlands on the 13th July 1943. Soon after he immigrated to Australia. Adrian was a Master Plumber

and Gas Fitter by trade and had a successful business in this field for some 40 years in Casterton.

Adrian was appointed to the CMH Board in 1975 and served on numerous Hospital Committees over that time from Finance,

House & Works, Project Control Groups and the Board of Management.

Adrian was elected President of Casterton Memorial Hospital for the year 1981/82 and awarded Life Governor status for the Cast-

erton Memorial Hospital in 1993 in recognition for his commitment to the Board and Hospital. Mr Bunnik, over his time on the

Board, saw many changes in the physical facility at CMH culminating in our major $7 million redevelopment being completed in

2003. Adrian was part of a governance team that has led this hospital through financial, planning and quality improvement

successes over the years and Adrian, as part of that team, operated effectively on behalf of the Government, Community and for

benefit of CMH.

Adrian was a dedicated member of the Casterton Community being involved with service organisations such as Rotary and

assisting with community projects.

Adrian was married to Rae and had two children David and Michelle.

Thank you for your dedicated service to CMH and our community.

Casterton Memorial Hospital—Functional Organisational Chart

Casterton Memorial Hospital—Committee Composition

DEPARTMENT OF HEALTH

BOARD OF MANAGEMENT

CHIEF EXECUTIVE OFFICER / EXECUTIVE

QUALITY COMMITTEE

BOARD OF MANAGEMENT

EXECUTIVE COMMITTEE

QUALITY COMMITTEE

PRINCIPAL COMMITTEES

Executive

Audit

Quality

Medical Staff

Credentials

Medical Appointment

Visiting Medical

Services

Director of Medical

Services

Visiting Medical Staff

Pharmacist

NURSING

SERVICES

Wards

Theatre

Day Centre

Community Health

Infection Control

District Nursing

Nursing Personnel

HIGH CARE

RESIDENTIAL

SERVICES

Residential Care

Assessment

Standards

Monitoring

Certification

Accreditation

ADMINISTRATIVE

SERVICES

Finance Reporting

IT/Information Systems

Office Control

Health Information

Reception

Human Resources

Payroll

Supply Services

Risk Management

Contracts

OH&S

ENVIRONMENT

& CATERING

SERVICES

Food Supply

Linen

Waste Disposal

Laundry

Housekeeping

Function

Meals On Wheels

MAINTENANCE

SERVICES

Plant &

Equipment

Building

& Maintenance

Garden & Grounds

Essential Services

Home &

Maintenance

Fleet Management

CLINICAL SERVICES

Theatre/A&E/Pharmacy

Infection Control

Residential Care

Primary Care

Medical Offers

Medication Advisory

Transfusion

Vulnerable Children

STAFF & CONSUMER COMMITTEES

Residents’ Committee Acute/Residential/DN

Primary Care Minimal Handling

Health Information Catering/Dietary Services

Environmental Services Administrative Services

Compliance After Hours Supervisors

DEPARTMENT HEADS

Executive

Department Heads

Charge Nurse/Unit

Managers

BOARD

SUB-COMMITTEES

Executive

Audit

Quality

Facility Fabric, Assets &

Works Review

Medical Staff

Credentials

SAFETY & OH&S

OH&S Designated Work Group

Representatives

Safety Data

Risk Management

Compliance

Environment

Minimal Handling

Casterton Memorial Hospital

63-69 Russell Street, Casterton, Victoria 3311

Phone: (03) 555 42 555 Fax: (03) 55 811 051 Email: [email protected]

Website: www.castertonmemorialhospital.com.au

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