Portland District Health Annual Report 2005 - South West Alliance of ...

Portland District HealthAnnual & Quality of Care Report 2004 - 2005

History of Portland District HealthPortland District Health was formed on the 1stJuly 2003, with the amalgamation of the Portlandand District Community Health Centre and thePortland & District Hospital.This latest phase of evolution builds on a rich historyof community service that commenced with theestablishment of a Benevolent Society on the 30thMay 1849 and which led to the establishment of aBenevolent Asylum the forerunner of the hospital.The history of the Community Health Centre canbe traced to early meetings in 1979, which werefollowed by the election of a provisional committeein June 1980, and the opening of a centre on the18th September 1981.Portland District Health now provides an integratedhealth service delivery model comprising acute,primary health and aged residential care services.The aim of the amalgamation was:• to improve the access of patients and clients toa broad array of servicesAbove : Portland & District Hospital ~ circa 1912• to create a ‘one stop health delivery service’where community services are coordinated,streamlined and duplication avoided.Through amalgamation, the attraction andretention of primary care staff has been improved,service delivery has expanded and the constructionof a purpose built primary care facility is beingpursued.Above: Portland and District Community HealthCentre at the time of amalgamationAbove: Portland & District Hospital at the time of the amalgamation

PORTLAND DISTRICT HEALTH2nd Annual ReportIndex of ContentsBoard of Management - Profile 3Comparative Statistics 40Compliance IndexInside Rear CoverDonors & Sponsors 46Divisional ReportsGeneral & Administrative Services 33Medical Services 24Nursing Services 19Primary Care & Community Services 26Financial Analysis 42Financial Statements 48Certification 49Revenue & Expense Statement 50Balance Sheet 51Statement of Cash Flows 52Notes to Accounts 53Auditor General’s Report 72Health Service Agreement Report 41History Inside Front CoverInside Front CoverMission, Vision & Values Statements 2Officers and Office Bearers 43Organisational Chart 4Other Reports 39President & Chief Executive Officer’s report 6Quality of Care Report 11Services provided by Portland District Health 51

Board of ManagementVincent GannonPresidentBusiness ManagementAppointed November 2002Merlyn MenzelR.N., Assoc Dip Welfare StudiesSenior Vice PresidentOffice ManagerAppointed November 2002Greg AndrewsEnvironmental HealthOfficerAppointed November 2002Andrew WilsonB.Com., A.S.A.TreasurerBusinessmanAppointed November, 1998William BassettB.Ec, LLBSolicitorAppointed March, 1993James HarpleyB MetallurgySenior Process EngineerAppointed November 2003Marianne Kuljis,M. Psychology - (Clin & Health),B Sc., (Hons Psychology)Grad Dip Ed.,HR ManagerAppointed November, 2004Jennifer PurdiePhD Engineering,B.Eng (Chemicals & Materials,1 st Class Hons)ManagerAppointed November 2003Resigned January 2005Ian StanfordB.Bus (Land Eco)Cert Business ( Acc)Property Valuer / AccountantAppointed November, 1998Resigned March 2005Carmen WardGrad Dip Spec Ed,Grad Dip Reading EdSchool PrincipalAppointed November 20023

DIRECTOR OFMEDICAL SERVICESAudiologyDental / Dental Nursing(Clinical)Health InformationImagingMedical StaffPathologyQuality CoordinatorVisiting ClinicsVisiting Medical ServicesContracted Specialist Services- Human ResourcesPortland District Health – Organisational ChartBOARD OF MANAGEMENT SUB-COMMITTEESCredentialsAudit & ComplianceExecutiveInformation ManagementMedical Appointments AdvisoryPhysical ResourcesCHIEF EXECUTIVEQualityOFFICERVisiting Medical StaffDIRECTOR OFFINANCED/CEODIRECTOR OFNURSINGASSISTANT DONDIRECTOR OFPRIMARY &COMMUNITY CAREAccounting ServicesAdministrationAuditInformation TechnologyPayrollQuality CoordinatorReceptionSecretarialSupplyCatering ServicesEngineering ServicesEnvironmental ServicesQuality CoordinatorSafety and SecuritySea View House / RespiteAccident & Emergency - NursingAcute Inpatient NursingDistrict NursingDrug & AlcoholInfection ControlPalliative CarePost Acute CareQuality CoordinatorReturn to Work - CoordinatorTheatre / CSSDVolunteersNurse EducationAged CareComplaints & Patient AdvocacyNon Inpatient ServicesQuality CoordinatorRehabilitationReturn to Work - FacilitatorSpecial Clinical ProjectsAllied HealthAllied Health SupportBusiness SystemsCommunity NursingCounselling SupportIn-Home CareMaternal & ChildHealth ProgramsWomen’s HealthYouth HealthHealth PromotionHACC GroupsKoori Hospital LiaisonContracted Specialists Services~ Human ResourcesContracted Specialist Services~ Human ResourcesContracted Specialist Services~ Human Resources~ PhysiotherapyContracted Specialist Services~ Human ResourcesContracted Specialist Services~ Human Resources4

Services provided by Portland District HealthPortland District Health is a Public Hospital with 69 approved acute beds, 30 nursing home beds and a 58 placeSupported Residential Service. Through its primary and community care division, Portland District Health also offersa diverse range of community health services. A listing of services provided by the organisation is set out below.Medical:Accident & EmergencyAnaestheticsChemotherapyDay SurgeryDermatologyDiagnostic Imaging- CT Scanning- Doppler UltrasoundEndoscopyENT SurgeryGeneral medicineGeriatricsHigh Dependency UnitObstetrics & GynaecologyOperating Theatre & RecoveryOphthalmologyOral SurgeryOrthodonticsOrthopaedicsPaediatricsPain ManagementPathology (Contract Service)PhysicianPsychiatryRehabilitationRenal DialysisSurgery GeneralUrologyMedical Ancillary:Aboriginal Liaison OfficerAudiologyDental ClinicDietitianHealth InformationOccupational TherapyOrthoticsPharmacy ( Contract Service)PhysiotherapyPodiatrySexual AssaultSocial WorkerSpeech PathologyNursing:Asthma EducatorBreast Cancer CounsellingBreast Care NurseCancer SupportCardiac RehabilitationContinence Advisory NurseDiabetic NurseDischarge planningDistrict Nursing ServiceDomiciliary Midwifery CareDrug & Alcohol WithdrawalEducation CentreHospital in the HomeHospital to HomeImmunisation ServiceInfection Control NurseNursing Continued:Lactation CounsellorLiving with CancerLymphoedeamaMaternity Enhancement ServiceNursing HomeHome OxygenPalliative CarePharmacy supportPost Acute CareRehabilitationRespite CareSterile SupplyStomal Therapy (Nurse)Postgraduate Nurse TrainingOther:Antenatal ClassesEngineeringEnvironmental ServicesEquipment Borrowing ServiceFood Services DepartmentGeneral Administration and Clerical,Accounting, PayrollHospital LibrarySafety & SecuritySupplyPersonal Laundry Service forInpatientsPrescribed Waste RemovalPrimary Care PartnershipsPrimary & Community HealthServices to Other Agencies:Accounting Services- Heywood Rural HealthFuel Card- Community Health Centre- Western Dist. Employment AccessImmunisation serviceInfection Control AdviceIT Service Support- Heywood Rural Health- Coleraine HospitalMedical Administration- Casterton HospitalOccupational Therapy andSpeech Pathology- Special Development School- Dartmoor Bush Nursing Service- Heywood Rural HealthPayroll- Community Health Centre- Lewis Court HostelSpeech Pathology- Kindergartens and SchoolsSupply- VariousSterile SupplyServices From AndWith Other Agencies:Australian Red Cross- Blood BankBreastscreen Victoria- BreastscreeningGlenelg Shire Council- Maternal & Child Health Care- Meals on WheelsSouth West Aged Care- Aged Care AssessmentSouth West Alliance of Rural Hospitals- Information TechnologySouth West Health Care- Audiology- Bio Medical EngineeringWestern District Health Service- Linen• Student PlacementsWork Experience Placements- Secondary School StudentsAdelaide University- Diagnostic ImagingAquinas College CU- Bachelor of Nursing - ClinicalCharles Sturt University- Podiatry -ClinicalDeakin University- Bachelor of Nursing - Clinical- Grad Dip Students (Theatre& Midwifery)LaTrobe University- Medical Ancillary- Health Information- Occupational Therapy- Speech Pathology- Physiotherapy- Podiatry - ClinicalFlinders University SA- Bachelor of Nursing-ClinicalMelbourne University- Medical Ancillary- Health Information- Occupational Therapy- Speech Pathology- PhysiotherapyMonash University- Medical UndergraduateRMIT- Bachelor of Nursing - ClinicalUniversity of Ballarat- Midwifery Nursing- Bachelor of Nursing-ClinicalVictoria University of Tech.- Bachelor of Nursing-Clinical5

President & Chief Executive Officer’s ReportThe past year has presented many challenges andopportunities for Portland District Health (PDH).The major challenge has been workforce issues thathave impacted on our ability to meet activity targets.This has resulted in a loss of revenue and the needto strategically reposition the health service, so as tomanage and forecast the best mix of resources andtheir allocation for future service delivery.The primary focus of our efforts has, and will continueto be on the quality of services, the expected outcomesand cost of those services and access.Over recent months Portland District Health hasworked very closely with the Department of HumanServices (DHS) in developing a Financial RecoveryPlan. This framework will ensure the ongoing viabilityof Portland District Health and its ability to providetimely access to affordable quality services for thePortland district. We are very grateful for the supportand flexible approach DHS has taken in workingwith Portland District Health towards positioning thehealth service to meet future needs.The medical workforce issue is aligned with thenational trend of an ageing and diminishing number ofgeneral practitioners (GPs), nurses and staff generally,working in rural Australia. For Portland, the impactof this trend was the inability of the local GPs tosustain the workload associated with maintaining an‘on call after hours service’ with the available numberof doctors. It was necessary to negotiate an immediateshort-term solution that would support the present‘on call service’ whilst negotiating a more sustainablemodel.Negotiations with the GPs did find a short-termsolution, and with the cooperation and collaborationof the GPs, a more sustainable model of primarymedical care, including an after hours ‘on call’ serviceis being developed.Other factors that contributed to the downturn inactivity include the inability to recruit nursing staffand the resignation of Obstetrician and Gynaecologist(O&G) Dr Fulvio Bencina. The impact has been adecline in the number of births at PDH. Every effortis being made to recruit doctors with obstetric skillsand to date the outcome looks promising.The organisation has also taken action to ensure thatsufficient numbers of midwifery trained nursingstaff are available and have introduced an innovativenew model of care known colloquially as the ‘MidModel’. Similar models to this are increasingly beingintroduced across the state in order to cope with thescarcity of trained staff.In June 2005, the Chief Executive Officer (CEO),Alwin Gallina completed his contract with PortlandDistrict Health. Pending a permanent appointmentto the position, Dr Syd Allen was appointed ActingCEO.The Board thanks Dr Allen for the leadership heprovided, particularly in negotiations with the GPs,during this challenging period.AccreditationIn August 2004, Portland District Healthunsuccessfully underwent an organisation wide surveyby the Australian Council of Healthcare Standards(ACHS). The matters underpinning the nonaccreditationrelated to unresolved issues of corporateand clinical governance within the organization.These related to:• After hours on call service• Credentialing processes• Involvement of GPs in clinical forums and qualityactivities• Development of a model of obstetric andmidwifery services following the resignation ofDr Bencina.In March 2005 ACHS resurveyed the health serviceand awarded accreditation backdated to August2004. The Board extends their congratulations to thePortland District Health team on achieving such anexcellent result within such a short time frame.Capital Works ApprovalIn April we learned that the nursing homeredevelopment would be funded as part of the StateBudget. In early June the Minister for Aged Care theHon. Gavin Jennings officially announced this at afunction held at Portland.Minister for Aged Care, the Hon. Gavin Jennings6

In addition to this the hospital will have a purposebuilt day surgical unit constructed. This unit willbe better placed to meet the needs of the increasingnumber of patients who are having their surgeryundertaken on a day stay basis.These projects have a budget of $7.5 m and should becompleted by October 2006.is to improve the quality of obstetric care for thewomen of Portland. A by-product of this initiative isa more comprehensive care approach for patients withwomen’s health concerns.Sea View HouseAnother exceptionally good piece of news during theyear was the conversion of the Sea View House loanfrom a commercial loan to a treasury-approved loan.This will secure savings of some $0.8m over the lifeof the loan and further contribute to the financialsuccess of Sea View House, which currently enjoysfull occupancy.Palliative CareWe were delighted to officially open the refurbishedspecial care ward in the presence of the members ofthe Portland Bay Rotary Club, which had done somuch in the way of fund raising to make the projectpossible. The unit, which has been open since 2ndMarch 2005, has attracted very favourable comment.Dr van der Veer providing care in the new Women and Children’s clinic.Currently the specialist obstetrician and gynaecologistsfrom the Warrnambool Wentworth Woman’s Clinicvisit weekly. The clinic also has the services of aGP Obstetrician consulting weekly and SpecialistPaediatricians who consult fortnightly. Midwives arenow also being introduced to the staff in the clinicand it is envisaged that each antenatal clinic will havethe active participation of a midwife.Trauma TrainingA large number of enthusiastic staff and medicalofficers have completed their training in Basic TraumaLife Support. This training builds on a trial project (inwhich Portland District Health staff also participated)where the protocols for preparing a casualty fortransfer to a recognised trauma unit were developed.Members of Portland Bay Rotary Club in the refurbished palliative careroom they supported with fund raising.Women and Children’s ClinicAn exciting new development in the quest to improvequality of care for the women and children of Portlandcame into existence in April 2005. After considerableconsultation with midwives, GP’s, specialists andexternal consultation, it became clear that a centralisedapproach to women’s health was needed.Premises were obtained and the clinic startedoperating in April 2005. The purpose of the clinicOverseas NursesIn an effort to address the chronic shortage of Div1 registered nurses, the hospital recruited 5 nursesfrom Zimbabwe, Sth Africa & the UK to fill rolesin Theatre, Dialysis, A&E and the wards. These staffappreciate the beautiful working environment thatPortland offers and bring a fresh perspective to theorganisation.Dental ClinicOur Dental Clinic has been successful in securingadditional funding to address the waiting lists forpublic dentistry, which had grown to alarmingproportions. With this funding it has been possible toemploy two dentists and make significant inroads intothe waiting list, which is still larger than desired. Weare confident that if present trends can be maintainedthis issue will have been largely addressed by this timenext year.7

Primary Care ServicesOur primary care staff have been successful inintroducing innovative new programs to addresscommunity needs. One such program is the healthyheart project. This program aims to take a proactiveapproach to heart health, particularly for men in theage range of 30-60.Primary care staff arranged a pilot for this program inpartnership with community participants. From thisa second phase of the project has commenced withfunding of $40,800 being made available by way ofthe William Buckland Foundation.In this program participants have their level of riskassessed against key criteria and are then offeredassistance with physical activity, diet and medication.were completed and several items of equipment werepurchased including:• Provision of new compactus unit to the HealthInformation department and rearrangement ofoffice areas to accommodate this installation• Replacement of air handling equipment for thekitchen• Installation of equipment to provide emergencyback up to the geo thermal hot water system• Drainage upgrade near the main building• Purchase of new ultrasonic cleaning unit forCentral Sterile Supply Department.• Purchase of new endoscopic equipment• Purchase of lifting equipment• Purchase of new mattresses for acute units.In-home Child CareFunded from the Commonwealth GovernmentDepartment of Family and Community Services, thisinnovative program offers child care 24 hrs / day, 7days per week and assists PDH to be a family friendlyworkplace. Six contracted childcare workers providethe care to children of hospital staff.Award - Bev McIlroyWe congratulate Bev McIlroy who was recognised inthe inaugural 2004 Rural Victorian Alcohol and DrugAwards. Her award recognised her significant energyand skills and provision of outstanding leadership andsupport for workers in the alcohol and drugs sector.Emergency ResponseThe organisation takes seriously its responsibilitiesin relation to maintaining a professional responsecapability to emergencies that could occur in thecommunity. To this end over 30 specific contingencieshave been risk assessed and response plan developed.To maintain these skills a full exercise based on abush fire emergency occurred in October 2004 andsomewhat prophetically was followed by a large fire inFebruary in the Dunmore forest.Tsunami Fund RaisingOur staff were touched by the plight of the BoxingDay tsunami victims and through a payroll deductionscheme raised over $4500.00.We commend the staff for their initiative. Ourresidents in Sea View house also took this cause toheart, organising a morning tea which raised some$2000.Equipment PurchasesAlthough a tight year financially, several major projectsMajella King retrieving a medical history in the Health InformationDepartment.Other issues of note• The hospital has received the results for two wavesof the statewide patient satisfaction surveys,which reveal a high level of patient satisfactionwith the services provided by the Health Service.• The Roy Aitken Memorial Scholarship foracademic excellence was awarded to Ms RaeleneBeckman, who is a 3rd year student nurse fromBallarat Aquinas College.• The Bert Wilmot Memorial Scholarship whichencourages ongoing education for staff was shared,being awarded to Miffy Maddox, Jo Spurge, SamSharp, Emily Wombell and four Accident andEmergency staff to undertake Basic Trauma LifeSupport training.• The organisation continues to play an importantrole on several sub-regional initiatives such as:the Southwest Alliance of Regional Hospitals(SWARH), which continues to deliver state ofthe art information technology infrastructureand services.8

StaffThe efforts of our staff are appreciated particularlyover what has been a difficult year.We acknowledge the role these staff play in providingquality care to our patients, residents and clients.We also express our thanks to our Visiting MedicalOfficers for their participation and interest in thehospital, which includes their membership of anumber of hospital sub-committees and internalcommittees and participation on the on call roster.We would like to acknowledge the service provided toPDH and the community by Dr Peter Reid who aftermany years of service resigned in March 2005 to takeup a position in Mount Gambier.We congratulate those members of staff that havetaken the initiative to further develop their skills andundertake ongoing education. Board members alsohave undertaken governance training through theNOUS organisation.With limits on our expenditure, emphasis has beenplaced in providing education locally, and we thankour local educators including Bruce Caslake, TheaBrown, Jenny Ridler, Lyn McNaughton, NoeleneMabbitt, Gaynor Denboer, Lisa Pietschmann, MiffyMaddox, Caroline Berry, Loren Drought & JennySmith.To those staff members who left during the yearwe thank them for their services and support. Wewelcome new staff appointed during the year andtrust that their time at Portland District Health issatisfying and enjoyable.Board Appointments – Portland District HealthWe welcomed Marianne Kuljis to the Board inNovember 2004.Mr Matt Pistner was also appointed to the Boardhowever he received a transfer in his work beforebeing able to take up his position.During the year we said farewell to Dr Jenni Purdiewho took up a senior position as manager of PointHenry Smelter and to Mr Ian Stanford who resignedin March 2005 after serving since 1998.The Board expresses its appreciation to retiringmembers Mr Andrew Wilson, Mr William Bassettand Mrs Carmen Ward who have indicated that theyare not seeking reappointment.In November, Mr Vin Gannon was re-electedPresident of the Board of Management.We thank all members of the Board for thecontributions they have made to the organisationduring this difficult period. The willingness ofmembers to give so generously of their time is greatlyappreciated.Community SupportThe community has again been generous in its supportand we thank the service clubs and auxiliaries, oursponsors, volunteers, other groups and individualsthat have provided support to the organisation duringthe year both financially and through their voluntaryassistance. This support is most appreciated and hasmade events such as the fete, and Murray to Moynepossible.The efforts of our volunteers daily brighten the lives ofour patients, residents and clients.The contribution made to the patients from visitsby the clergy and community organisations is wellreceived and appreciated.Department of Human ServiceThe Department of Human Services (DHS) has beenextremely supportive of the organisation during thisdifficult period. We look forward to the guidance andsupport of the DHS through our Regional Director ofHealth, Mrs Jan Snell, and officers of the Department,Mr Geoff Iles, Ms Jill Dunbar, Mr Gerry Sheehanand Mr Stuart Müller to securing the best health andsupport services for our district community.Outlook for 2005/2006Despite the difficulties of the past year, PortlandDistrict Health has much to look forward to.We look forward to the commencement in early Julyof Marie Shea our new CEO. Marie comes to us witha wealth of experience from a range of senior roles inthe health field.We look forward to the review of the organisation’sstrategic planning that will better align clinical servicesand service provision with human resources.We look forward to a successful year as we rebuild ourfinancial situationWe look forward to an exciting year of capital worksas our new nursing home takes shape and our daysurgical unit is constructed.We look forward to the development of the conceptof a medical centre to assist with our on- call rosterand shortage of medical staff.Vin GannonPresidentBoard of ManagementDr Syd AllenActing Chief Executive Officer9

Services provided in 2004/05During the year 5,080 acute inpatients were treated.In addition to this our organisation also provided:• 9,635 patient treatments in the Accident &Emergency department, many of these afterhours and on weekends.• 15,896 ‘meals on wheels’ to the community,courtesy of our wonderful volunteers who play avital role in helping our elderly to maintain theirindependence at home.• 20,258 days accommodation to residents in oursupported residential facility, Sea View House,including 737 respite days.• 10,516 bed days to 76 residents in our aged careresidential facility, Seymour Cundy Wing• We also offered a diverse range of Communityand Primary Care services which includesamongst others:• Counselling• Diabetes education• Cardiac rehabilitation• Youth support10

Quality of Care ReportMeeting Standards / QualityWithin Australia, health care services are reviewed andoverseen by various external professional bodies, onbehalf of the State and Commonwealth governmentdepartments.Through this independent process health care servicesare able to demonstrate their commitment to qualityand the achievement of standards. In the case ofPortland District Health we are able to demonstrateour commitment to you by the fact that we currentlyhold accreditation under two nationally recognisedaccreditation systems for health services. These are asfollows:• Australian Council of Health Care Standards• Aged Care Standards Agency.Increasingly health care agencies are coming underscrutiny for their clinical performance. For Boards ofManagement this means clinical governance is equallyas important as corporate and financial governance.Portland District Health works within an evolvingquality framework laid down by accrediting bodiesand other key industry groups such as the VictorianQuality Council.Expectations and standards continue to rise andhealth agencies must adapt and change.ACHS -Australian Council of Health CareStandardsThe ACHS is an independent not for profit nationalorganisation, dedicated to improving the quality andsafety of health care in Australia.Fourteen (14) standards cover all aspects of health careincluding the safety of the environment for patientsand staff, maintaining medical records, managementof finances, assets and staff and the way we improveour services for our patients.As part of the requirements of maintainingaccreditation, the organisation undertakes selfassessmentand participates in surveys by externalsurveyors. A key part of this process is the follow upof recommendations made by the surveyors.ACSA -the Aged Care Standards Agency.Under Commonwealth legislation all aged carefacilities need to show a high level of quality and safetyin the services they provide in order to have ongoingfunding from the Commonwealth government.The Aged Care Standards Agency (ACSA) is thebody responsible for overseeing compliance with theCommonwealth’s aged care standards.In May 2005, our nursing home participated in itsscheduled support visit by the Aged Care StandardsAgency securing a very favourable report. This wouldindicate the facility is well placed to undertake itsmajor survey in June 2006Issues to be assessed will include:1. Management systems, staff organisationaldevelopment (training for staff, meeting budgetsetc.)2. Health and personal care for residents.3. Resident lifestyle4. Physical environment and safe systems (enoughbathrooms and toilets, high standards of cleaningetc)Several other departments and services within theorganisation have also been accredited or approvedunder other systems. For example,• The laboratory is accredited by the NationalAssociation of Testing Authorities (NATA).• Our District Nursing Service has beenindependently audited against standardsdeveloped by the Department of Veterans Affairsand by the Home and Community Care program(HACC).• Our Food Services department complies with therequirements of the Food Safety Plan.• Our Engineering department has achievedForm 10 certification for essential service &maintenance.Clinical Risk ManagementClinical risk management is a systematic approachto:• Minimising and where possible eliminating risks;and• Minimising the impact of adverse events if theydo occur.There is a sharpening focus on how well hospitalsundertake clinical governance and clinical riskmanagement and adverse events in hospitals nowattract wide press coverage.Within Portland District Health an increasinglywell-developed clinical risk management program isevolving. This program takes on board the lessonsand learning of other organisations such as theVictorian Quality Council’s Safety And QualityFramework, Coroners findings, and DHS Risk Watchpublication.Issues such as credentialing and registration,orientation for medical staff, monitoring of adverseevents, review of incident reports, review of coronial11

findings in other organisations, development ofappropriate policies and procedures are just someof the areas that are examined in this clinical riskmanagement program.During the past year the clinical risk managementprogram has been further strengthened byimprovements in the following risk areas:• Credentialing & scope of practice• Participation in the Limited Adverse OccurrenceScreening’ (LAOS) Project• Clinical case reviews.• Root cause analysis of medication incidents.• Falls prevention• Wound management• Sharps incidents• Infection controlCredentials and Scope of Practice -Medical StaffIn order to provide good professional performanceand minimise clinical risk it is vital that our medicalofficers and staff are qualified to undertake theirduties.For example only suitably qualified medical staffare permitted to perform anaesthetics or undertakeobstetrics within the hospital.This process, known as credentialing, occurs beforea medical staff member is appointed. A specialistcommittee comprised only of medical staff undertakesthis. A representative of the appropriate College is inattendance to provide independent expert advice.The credentialing committee checks and advises thehospital’s Medical Appointments Advisory Committeeas to whether an applicant is suitably qualified forthe position they have applied for. This committeealso advises as to what limitations to practice shouldapply.During the year, a discussion document was preparedoutlining the Clinical Scope of Practice for alldisciplines of the Portland District Health medicalworkforce. This document was accepted by all VMOsand incorporated into the Credentialing policy. Thecredentialing process was conducted incorporatingthe guidelines from the Australian Council forSafety and Quality in Health Care. In all disciplinesrepresentatives of the relevant colleges were inattendance to comment on the college requirementsfor credentialing.Portland District Health has completed this processand all VMOs of the service, are fully credentialed towork within their limitations (scope of practice). Theprocess is ongoing and all VMOs will be credentialedevery 3 years, to ensure that all disciplines complywith the quality and safety standards of PDH.‘Limited Adverse Occurrence Screening’ (LAOS)ProjectPortland District Health has been participating inthe Otway Division of General Practice “LimitedAdverse Occurrence Screening” (LAOS) Projectfor approximately 2½ years. This Clinical RiskManagement Program is part of the Departmentof Human Services Strategy for “Improving PatientSafety in Victorian Hospitals”. The project has beenimplemented across the state (in Rural Victoria), andfrom this, we are starting to see state-wide trends inissues in patient safety.A selection of medical records are copied and sent offsite to a doctor in another area for review. Doctorsfrom other towns provide feedback on our care, toensure that we are doing our best. Your own doctormay also be involved. Educational issues arisingfrom the record may then be discussed confidentiallyby doctors at a quality improvement meeting. Thisallows clinical lessons to be learned and shared withother doctors, hospitals and services across the region.Your personal information is not collated, reproduced,published or used for any other purpose.Recommendations on clinical and systems issuesare discussed at hospital quality forums, theserecommendations are responded to by each individualhospital. The recommendations are forwarded to allthe General Practitioners and hospital Chief ExecutiveOfficers participating in the program.Since the last Quality of Care Report (12 months ago),603 records have been received from the 10 hospitalsparticipating. Of these 603 records, 38 cases wereregarded as potentially containing an adverse eventand 57 cases were regarded as presenting educationalopportunities.Some issues resulting in recommendations in this lastyear have included:• GP management of patients with unstableangina• Registrar training and supervision• Dealing with a poorly compliant patient• Home Medicines Review Program• Warfarin Guidelines• Training for patient decision making in PalliativeCare• Reviews of hospital narcotics and major traumaprotocols12

This process in Risk Management cannot find and fixall problems in relation to patient safety in Hospitals,it does however, aim to provide us with a snap shot ofwhat GPs see as our most pressing problems in RuralHospitals.Through consultation and working together, wecan look at ways to best address these issues, to thebenefit of all. Therefore by sharing experiences at 10small rural hospitals the philosophy of learning fromeach other’s mistakes, and putting systems in placeto prevent the same problems recurring elsewhere,resulting in a happier, healthier community.Clinical Case ReviewsAnother tool utilised in quality of care improvement isthat of clinical case reviews. It is a no-blame approachwith the aim of improving health outcomes.The Director of Medical Services, Dr Meindert vander Veer has conducted 10 reviews. These reviews aremultidisciplinary and involve doctors, nurses andsupport personnel. As a result of these reviews, systemerrors are identified and rectified.Several areas of improvement have been identifiedincluding:• Equipment management• Policy or procedure review• Documentation standards• Staff educationBetter Practice in Medication ManagementIn 2005 Portland District Health introduced aPharmacy Nurse position into the Pharmacy Serviceas a result of an identified clinical risk gap, to improvethe organisation’s performance in medicationmanagement.Patients Receiving Medication Counselling 20051009080706050403020100Feb March April May JuneFig. 1Pharmacist, Glen Bennet - Hullin.Patients are vulnerable to mistakes being made in themany steps involved in the ordering, dispensing andadministration of medications.There are many causes of medication error some ofwhich may be – inadequate knowledge of patientsand their condition, inadequate knowledge ofmedications, calculation errors, illegible handwriting,and confusion regarding medication names.Best practice indicates that admission should providean opportunity for all patients to have their medicationsreviewed. A criteria was developed to screen patientsat most risk of medication problems – age over 75,on four or more medications, on medications with anarrow therapeutic window eg Warfarin, referred byadmitting doctor.The target for patients meeting the criteria to receivemedication counselling was set at 90%; this wasexceeded in 3 out of the 5 months.In response to a growing number of medicationincidents the Pharmacist, Director of Medical Servicesand the pharmacy nurse now perform a Root CauseAnalysis (RCA) of all medication incidents.Utilising a no blame approach, all medicationincidents are analysed to identify the system errorleading to the event.Staff involved are debriefed, counselled and educated,learning from the errors thus reducing the risksassociated with administering medications.13

Patient Education - MedicationsInvolving and educating patients about theirmedications prior to discharge reduces the risk ofinadvertently taking the same medication, which mayhave two different brand names.‘At risk’ patients are identified using specific criteriaand referred for medication counselling with thepharmacist and pharmacy nurse.In the 5 months since the introduction of this positionpatients receiving discharge pharmacy lists has risenfrom 66% to 87% (Fig 2). This was achieved as adirect result of the nurses working with the pharmacistto improve this area of the service.120100806040200% of Medication Incidentswhich have MultidisciplinaryReview2004 2005Fig. 2Discharge Planning - MedicationsThe pharmacy nurses involvement with dischargeplanning has resulted in a smoother transition,particularly for patients returning to or enteringnursing homes or hostels. The nurse explores a rangeof issues using a checklist to assist the process. Issuescanvassed include management of medications, use ofdosette or Webster pack, knowledge of medicationsbeing taken, reasons these are being taken andinstructions, over the counter medications, storagepractices, compliance with instructions, expiry datesand other issues.Falls PreventionFalls constitute the largest percentage of incidentsat Portland District Health, which is a similarsituation to most other organisations and is mainlydue to the ageing population. A greater awareness offalls prevention strategies, such as risk assessments,exercise, equipment and education help in reducingthe incidence of falls has been needed to deal withthis.At Portland District Health a Falls Prevention Programwas introduced in 2003 and over the past 12 monthsfurther enhancement of this program has occurred.There has been ongoing staff education combinedwith the use of falls prevention strategies, new fallsprevention equipment and upgraded risk assessmentprotocols. Increasingly there has a greater emphasison assessing people at risk of falling and puttingstrategies in place to reduce the incidence. This isevidenced by Fig. 3 which shows a marked increase incompletion of the assessment form between July 2004and June 2005.120%100%80%60%40%20%0%Patient Handling Risk Assessment -Completion of MR158 on AdmissionJuly '04 Dec '04 June '05Fig. 3Pressure Ulcer Point Prevalence StudyAlong with other acute care hospitals PortlandDistrict Health participated in the state-wide PressureUlcer Point Prevalence Study referred to as PUPPS. Itwas illustrated by the study in the previous year thatthe on going monitoring had paid dividends as wewere able to increase the level of scrutiny, thereforeidentifying 31% of patients on this day as having highrisk of pressure ulcers. Whilst we received a higherresult than the previous year we have identified areasfor improvement. The purchase of new mattressesfor all the acute beds will assist in the preventionof pressure points. Along with the survey a staffeducation program was conducted developing theability to assess patient risk of developing pressureareas, particularly if movement is limited due tosurgery or other condition.Regular wound management study days are conductedthroughout the year to improve skin and woundmanagement practice.Sharps incidentsAnalysis of sharps (Fig. 4) injuries to staff has revealedthat all of the injuries related to a failure in procedureas opposed to an equipment or storage issue. Thispresents us with a difficult challenge as every one ofus are prone to making a slip up from time to time.Ideally we would like to devise systems that eliminateexposure to this risk or would separate staff from14

the risk however this is impractical at this stage. Tohelp combat this, compulsory education sessions onthe correct procedure for the disposal of sharps havebeen introduced to supplement education providedat orientation.The introduction of a user friendly manual ‘What todo following needle-stick injury’ is now also availablein every department.4.543.532.521.510.50Registration of StaffSharps Injuries By CauseSelf Other Staff equipmentFig. 420042005Nursing staffNurses from both Divisions 1 and 2 are registeredwith the Nurses Board of Victoria. Every nurse isrequired to present the annual practicing certificate,either at the beginning of the year or when startingemployment.We can assure the community that all our nurses areproperly registered.Our nursing educators ensure staff are clinicallycompetent to perform lifesaving and technicallyadvanced care.Allied Health StaffOur Allied Health staff are all members of theirrespective professional bodies and this is confirmedon appointment.We ensure Allied Health staff have access to ongoingeducation and research related to their specialty.Corporate Services StaffThere are a number of staff of different categoriesunder the heading of corporate services. Several ofthese staff require professional qualifications in areassuch as accounting, information technology, healthinformation management, engineering and foodservices. A large number of staff require recognisedtrade qualifications such as our plumbers, electricians,carpenters, gardeners and chefs. Reviewingqualifications and registration certificates is animportant role for Divisional Heads. Portland DistrictHealth also employs essential staff in positions thatdo not require formal qualifications. They do though,participate in a range of training programs to makesure they are able to do their work according to jobspecifications.Maintaining competencePortland District Health also has a process in place toensure that staff maintain their competence. Undera new system introduced in the past year, staff mustparticipate in annual mandatory training in areassuch as• Minimal lift• Basic life support• Medication management• Fire and safety• Infection controlStaff educationStaff knowledge is a valued resource at PortlandDistrict Health and systems are in place to ensure staffhave access to ongoing professional development.• The staff orientation program is conductedmonthly for all new staff.• Compulsory health and safety updates for staffare provided on a monthly basis.• In house training and lectures• Invited speakers for study days• Support for staff to attend seminars, study days,conferences• Internet access for staff• Portland District Health has many subscriptionswith research organisations to help staff find andidentify current best practice• Staff participating in units of research incollaboration with local universities.• We provide specialised accredited trainingopportunities for post graduate nurses (GraduateNurse program & Peri operative nursing)A diverse range of topics are available including woundmanagement, diabetes education, clinical practiceworkshops, cytotoxic chemotherapy, personal assault& crisis management.Training records are maintained to assist withmonitoring the participation by staff in on goingeducation. It is an expectation of staff that they attendrelevant training in their area of practice to ensurethat they are keeping up to date. The organisationsupports and encourages staff undertaking furtherstudies and has a range of assistance available.15

Complaints and ComplimentsBecause your care is our prime concern we want toknow if you are not satisfied with services or treatmentprovided. (We also like to hear when we do thingswell.)We view each complaint as a window of opportunityfor us to learn of the improvements that need to bemade with our services.During 2004-2005 we received 1354 complimentsand 74 complaints.From these complaints the following areas werereviewed:• Notification to parents when children arrive inrecovery to reduce unnecessary delays• Admission process for patients in an agitated stateto avoid escalation of agitation• Removal of urethral catheters to reduce risk oftrauma to the patient• Recording custody of patients’ medications toavoid delay at discharge• Improving the quality of the reception bell at theA&E waiting room to ensure staff are alerted toall presentations• The process for checking accuracy of mergedrecords when patients attend at admissions• Prioritizing needs to minimize disturbance tosleeping patients.Follow Up Telephone callsAnother source of useful feedback is derived from thefollow up telephone calls.After discharge efforts are made to contact patientsto check that all is well, that information has beenadequate and that arranged services have beencommenced.In 2004-05, 60% of our inpatients were contacted inthis way and their feedback sought. This is down onthe previous year (74%) however this is attributable tothe fact that we have now commenced follow up phonecalls to people who have presented to the Accident &Emergency Department to gather feedback on howwe are performing in this area.In addition to the numerous compliments receivedwe found that opportunities for improvement fellinto main areas these being:• Communication• Information about care• Pain management• Privacy & rights• Treatment• Waiting TimesThis information is reviewed with staff both medicaland nursing with a view to improving our service.Infection ControlInfection control is aimed at minimising thetransmission of infections and promoting healthyoutcomes. It is an essential part of quality healthcare.Portland District Health has an Infection ControlPlan to ensure that infection control strategies are inplace.There are 5 key areas that the Infection Controlcommittee has prioritised.• Leadership• Monitoring of Infection control• The Environment• Prevention of Adverse events• Protecting Health Care Workers and Visitors1. LeadershipActivities include:• Regular review and updating of policies andprocedures against best practice• Development of Influenza Pandemic ContingencyPlan in conjunction with DHS guidelines, whichwill see us well prepared should the situationarise• Development of appropriate Code Brown– External Disaster response to outbreakmanagement and isolation precautions2. Monitoring of Infection ControlThe infection control committee monitors this processand works with the Infection Control coordinator tomanage actions required to achieve best practice.Areas of specific monitoring include• Prevention of adverse events• Surveillance of hospital acquired infection• Tracking equipment that has been sterilised tothe patient• Monitoring of antibiotic usage and ensuring thatit is appropriate to the organism.• Monitoring of surgical infections.• Food safety auditsAnother area of monitoring undertaken on a subregional basis is that of compliance against the acceptedstandard AS/NZ 4187. PDH performs extremely wellagainst its peers in the Barwon South Western regionas can been seen by Fig. 5.16

120%100%Agency Compliance - AS41874. Prevention of Adverse EventsThere is a system in place for monitoring and reportingthe functioning of all equipment used for cleaningand sterilising equipment used for patient care. Staffreceive education relating to the management of thisequipment and the cleaning processes required.80%60%40%20%0%Agency 1Agency 2Agency 3Agency 4Agency 5Agency 6Fig. 5PORTLANDAgency 83. The EnvironmentInternal & external cleaning audits are undertakento review the cleanliness of the organisation, they arealso reported to Department of Human Services forcomparison. Portland District Health has performedexceptionally well under these audits and continues tomaintain an excellent standard.For 2004-05 Portland District Health scored 97% inthe external audits undertaken.This result coincides with the feedback received frompatients via telephone surveys and comment cards.For example in the latest patient satisfaction surveyresults our patients reported 100% satisfaction withcleanliness.Portland District Health continues to contribute tothe Hospital Acquired Infection Surveillance System(VICNISS) -, which is benchmarked across the state.Indicators gathered relate to surgical site infection,hospital wide infection and vaccination rates. Onceagain Portland District Health consistently receivesfavourable results.Infection Control Officer, Ros Jones providing an immunisation injectionto staff member Lynne West.5. Protecting Health Care Workers and VisitorsA priority is the protection of staff, patients and visitorsagainst infections. Staff immunisation of Hepatitis B,Mumps, Measles and Rubella, and Mantoux screeninghave been offered and the uptake continues at a steadyrate. A new “mobile” delivery mode of the InfluenzaVaccination this year has proved very successful witha marked increase in the total number of recipients(Fig. 6).250200150100500Flu Vax Participants2001 2002 2003 2004 2005Fig. 6The implementation of Compulsory Education daysfor all staff has markedly improved the awareness ofinfection control systems and provided staff with theopportunity to address any infection control, staffhealth or other issues as they arise.The Infection Control Coordinator has deliverededucation on infection control issues to various groupswith in the community, which were well attended andwell received.Assessment of Risks - Pre admissionThe majority of patients undergoing surgicalprocedures in theatre are assessed prior to admissionfor risks that may present as a result of an anaestheticor associated with their condition or the procedure.A visit to the Pre admission clinic is an important partof patient care, as information is gained on any specialneeds, education, medication services or treatmentthat may be required during the hospital stay orplanning for your discharge.17

During the hospital stay there is an ongoing riskassessment of your needs. The doctor or nursing staffcaring for you will monitor your care each day.Portland District Health is able to provide educationrelating to your needs for pain management or yourproposed length of stay.Sub Acute /RehabilitationThe sub-regional rehabilitation program is committedto providing the best possible outcomes for all patientsadmitted to the program. In the past 12 months, fifty(50) patients have been able to access this level of carelocally within the acute hospital setting. The programaims to achieve the maximum level of re-integrationinto the community by:• Timely admission as agreed by the consultantphysician• Effective assessment of needs• Structured care planning and implementation• Discharge from the program being a smooth,seamless transition with an appropriate serviceplan in place.We offer:• Information• An individually tailored program• Appropriate exercises• Home modification advice• Aids and equipment• Communication with general practitioners andspecialistsThe program aims to:• Increase your independence and enable you to domore;• Give you a greater understanding of the physicaland emotional changes associated with yourhealth problems;• Assist you to further develop your skills inmanaging these changes;• Provide support for you and your family inmanaging your condition.Deaths in HospitalDuring 2004 / 2005 there were 103 deaths in thehospital. In some situations of unexpected death orcertain disease processes there is a requirement forthese to be reported to the coroner. Not all deaths thatare reported to the coroner will result in an inquest.In some cases where the death is non reportable,the hospital may, with the relative’s consent, seek apost mortem to assist with the review of the cause ofdeath.Of the 103 deaths that did occur in the hospital, 18were reported to the coroner.18In common with other hospitals, Portland DistrictHealth has a mechanism in place to review deaths toensure that the appropriate care has been given andthat the death has not occurred because of somethingavoidable.In most cases deaths that occur have been expected,resulting from the patient’s age or condition.Some times patients have come in to the hospitalduring the palliative stage of their illness to allow painand discomfort to be better managed.Managing your Health InformationIt is essential that information about you is keptconfidential and only provided to staff involved inyour care. Our staff have education relating to privacyand sign a confidentiality agreement.You may gain access to information about yourtreatment and care. The process for this is governedby the Freedom of Information Act.For the past year there were 39 requests for healthrecords under the FOI Act. 35 of these were grantedin full and one in part. For two requests no documentsexisted and one other request was not proceededwith.How do I make a complaint or give acompliment?The designated Complaints Officer is the DeputyDirector of Nursing.Complaints may also be directed to the HealthServices Commissioner on (03) 86015200 or tollfree 1800 136 066.Avenues for giving a compliment or making acomplaint are not limited to this however. Otheravenues for raising a concern include:• Discuss with the Department or UnitManager• Complete a Department Improvement Form• Complete a Patient Comment Card• Inform the staff making a Discharge Followupphone call.• Written letter or direct contact with the CEO,DONWhen a complaint is received every effort is madeto resolve the issue. Details are reported to thequality committee and a summary is forwarded tothe Health Commissioner.A complaint may be made anonymously, howeverif a name is provided we can provide feedback tothe person on the outcome.

Nursing DivisionKey Points• Introduction of Pharmacy Nursing Supportposition in February• Seven new Graduate nurses commenced inJanuary• Completion of ward clerk trainee positions inSeymour Cundy Wing and North ward• Commencement of Personal Care Attendanttrainee positions in Seymour Cundy Wing & SeaView House• Successful submissions for equipment fundingfor Seymour Cundy Wing & Operating Theatre• Successful achievement of 2 years accreditationthrough ACHS• Implementation of Code Blue Resuscitationsystem response across the organization• Completion of trauma pilot program inconjunction with Bendigo Health care group• Development of collaborative relationship withDeakin University in the provision of clinicaleducator• Participation in Pressure Ulcer Point surveillanceprogram• Successful recruitment of 5 overseas trainedregistered nurses• 30 nurses completing Advanced Trauma LifeSupport Program• Completion of the Rotary Palliative Care project• Donation from the Starlight Foundation of themulti purpose entertainment centre for childrenin hospital.• Seven Division 2 nurses completed Medicationadministration endorsementPerformanceThe emphasis for this past year at Portland DistrictHealth (PDH) has been on professional development,quality and safety, supported by a vigorous internaleducational program. In excess of 180 staff attendededucation courses specific to their area of expertise.Acute Inpatient CareUnit Managers Heather Wormington and BryanBowman continue to guide the acute unit, focusing onproviding excellence in clinical care while maintainingthe personal approach that is synonymous withPortland District Health philosophy.In an era of specialization, the emphasis in rural areasneeds to be on multiskilling to meet the challengeof providing medical, surgical and obstetric serviceswithin one clinical department.The continuation of the Sub Acute RehabilitationProgram has seen 58 patients benefit from thisindividualised health care program. Under the expertguidance of Sue Morrissey, Penny Wallis, WayneLeishman and other Allied Health staff have continuedKathryn Eyre, Director of Nursingin this multidisciplinary model of care within Portlandhospital in collaboration with other health agencies inSouthern Grampians /Glenelg region.Equipment purchased this year has improved wardresources:50 new mattresses will ensure comfort along withmaximum pressure relieving capabilityA wonderful effort from the Portland Bay Rotary clubhas seen the development of the Palliative Care suite.A donation from the CWA has provided toilet bagswith basic essentials for patients who may have hadan emergency admission.Over 130 babies were born this year at PortlandDistrict Health, under the excellent care of Mr. Das,Dr. Martin, Dr Rieger, Dr van der Veer and theObstetricians from Wentworth Clinic Warrnambool.Despite receiving an extremely positive responsefrom the women of Portland & District we continueto experience difficulty attracting midwives to ourhospital. This is an issue across the state of Victoria.In excess of 1,000 surgical patients were admittedthrough the Day Procedure Unit in the past 12months. More than 80% of surgical procedures atPortland District Health are completed as Day Staypatients. The Dialysis unit provides care and supportfor 8 patients attending the unit on a regular basis.The unit is available 3 days per week and also allowsfor a patient holiday program.Post Acute Care / Discharge planningThe post acute care program has enjoyed another19

usy year. 364 client’s accessed services through theprogram.This regional program enables clients with complexdischarge needs to be discharged from the hospitalback into the Portland community. This programis well recognized as a quality service improving thetransition for consumers from public hospitals totheir home setting.Discharge Planning has grown considerably this yearas knowledge levels and staff abilities have increased.Donna Eichler and Una Cancian have assessed 88clients in the past 12 months. The development ofa discharge planning manual and resource folder willenable a timely and appropriate referral process tooccur. Discharge planning has had a positive impacton the co-ordination and planning for discharge,making the transition from hospital back to thecommunity smooth and efficient.Infection ControlThe Infection Control management at PortlandDistrict Health has seen the commencement ofRos Jones in the coordinator role, following theretirement of Carol Pietschmann. Ros is responsiblefor overseeing cleaning and sterilization standards,administering staff immunizations and meeting thespecial needs of acute and aged care patients.A great advantage is the combination of this role withEnvironmental Services, as most infection controlbegins with the cleanliness of the facility. PortlandDistrict Health have participated in the Departmentof Human Services trial for monitoring hospitalacquired infections under VICNISS and we havereceived positive feedback on our participation andresults. The wonderful clerical support provided byJanice Anderson enables the excellent developmentand maintenance of reports and records required bythis division.Accident & Emergency DepartmentThe Accident & Emergency (A&E) Department hasseen a change of command during this year. JennyRidler has handed the role over to Linzi Donlan.Linzi who comes from the UK has many ideas for theongoing development of this dynamic department.9,635 patients were seen in the A&E Department inthe past year.Bendigo Health Care Group involved PortlandDistrict Health staff in a rural trauma project. Theaim being to improve the response and transporttimes of major trauma to Metropolitan TraumaServices through improved collaboration betweenVisiting Medical Officers, Rural Ambulance Victoriaand nursing staff.The Accident & Emergency Department staffcontinues to advance their utilization of the Medtrakelectronic database for emergency patients.Improved disaster protocols have been developedfollowing staff attendance at chemical, biological andradiological (CBR) strategic planning programs andthe introduction of an organisation wide medicalemergency (Code Blue) response. Compulsorystaff education in Basic Life Support has been leadexceptionally well by Noelene Mabbitt.The process of receiving, recording and triagingpatients has improved following the merging of healthinformation management and patient triage.Sue Jensen and Lindy Bird, enable Portland residentsto receive their life sustaining treatment locally bysupporting chemotherapy services in the Accident &Emergency Department.Operating TheatreThe operating theatre nursing teams, ably lead by JulieSealey, demonstrate a range of special skills which areenhanced by specific education in surgical nursingand through maintaining statewide networks withoperating room nurses.A diverse range of surgical procedures have beencarried out by local and visiting surgeons, supportedby local anesthetists Dr Reid & Dr Martin. In the pastyear over 2100 surgical procedures were undertaken. Anumber of new equipment items having been trialedand subsequently purchased to improve the qualityand safety of surgical procedures and ensure paritywith theatres in other regional and metropolitan areas.A successful DHS submission enabled the purchase ofnew endoscopy equipment.Theatre staff with the new ultrasonic cleanerDuring the year Dr Reid resigned from the anaestheticdepartment. Dr Martin is now being supported in thedelivery of anaesthetic services by locums as required.20

The Central Sterilising Services Department (CSSD)has implemented many changes to ensure compliancewith Australian Sterilising standards. Validationfor CSSD according to Standards ASNZ 4187 wassuccessfully obtained and will be undertaken on anannual basis.Tania Hollis successfully completed her traineeshipthrough Mayfield Education Centre.Pre admission / Pain & EmesisA visit to the Pre-admission clinic with Jenny Craig& Erica Clarke will ensure a smooth and uneventfulprocess is achieved when a patient has an electivesurgical procedure. Risk analysis is undertaken and thearrangement of pre-operative tests and postoperativesupports is attended. This prior planning facilitatesthe smooth transition through the surgical phase.If pain management is a requirement a visit byLoren Drought will assist in the identification andimplementation of pain management treatments toensure the patient has a pain minimized recovery. Tosupport this process, nursing staff have undertakeneducation in intravenous (IV) pain protocol, patientcontrolled analgesia (PCA) pump and femoral blockmanagement.District Nursing ServicesHazel Antony continues to manage the DistrictNursing Services. This expert team of nurses provideclinical care to clients within the Portland communityenabling people to remain within their home oralternatively to be discharged from hospital andremain in the care of a competent nurse.District Nurse, Peter Moodie attends to a dressing.Nursing staff are skilled in working autonomouslywhilst maintaining vital health links with localmedical services.The District Nursing Services are measured forcompliance against Home and Community care(HACC) and Department of Veteran Affairs (DVA)required standards. The ongoing requirement forcontinuous quality improvement is managed throughthe auditing program.The District Nursing Service also provides localpalliative care support. This service offers health careand emotional supports to patients living with a lifethreatening illness. Equipment has been purchasedfollowing the receipt of funding from the BarwonRegional Program.The District Nursing Service also coordinates thePortland District Health Volunteer Program. Thisservice, expertly coordinated by Annette Hinchcliffe,has seen excellent growth in the number ofvolunteers.Currently there are 20 volunteers on the roster,enabling their participation in patient transfers,Palliative Care, Aged Care activities and assistancein the Acute units. The hospital volunteers are adedicated and enthusiastic group of people sharingtheir time, skills and life experiences with staff andpatients. The hospital will continue to enhance thevolunteer program. Volunteers within the hospital areenthusiastic about extending the volunteer service tofurther assist staff and patients. I am sure all staff andpatients appreciate the supreme effort of volunteersfreely given to them.Aged Residential CareJulie Burke, Unit Manager and her wonderful team ofaged care specialist staff continue to provide excellentcare to the residents of Seymour Cundy Wing andtheir families. A visit from the Aged Care Standardsagency during the year was positive ensuring theongoing compliance with the Aged Care accreditationprocess. The aim of residential care is to provide amodel of care, which closely resembles that of a homeenvironment, empowering residents with autonomyof choice in their daily lives and activities.Resident lifestyle is recognized as paramount toimproving quality of life. Activity support hourscontinue to reflect this need, in the provision ofactivity coordinators, 7 days per week. An increase inthe demands of staff participation in aged care saw theintegration of nursing graduates undertake a rotationthrough Seymour Cundy Wing. This initiative hasenabled new nursing graduates to achieve skills,experience, and appreciation and respect for thespecialist care required in aged care.Danielle Stuchberry has completed her Ward Clerktraineeship, receiving nominations in the WestvicTrainee of the year award.21

The increased demands for documentationmanagement to support the requirements forcontinuous quality improvement create heavydemands on this valuable role in the aged care unit.PhysiotherapyDavid Walker continues to lead the team ofPhysiotherapists providing much needed care to thepatients at Portland District Health.The Physiotherapy Department has provided morethan 1100 hours of treatment to inpatients both inthe acute and aged care sectors.The physiotherapy department has been extensivelyinvolved in the implementation of the individualcomprehensive treatment program required in therehabilitation process.Physiotherapy staffPharmacyThe Nursing department has continued to oversee theday-to-day management of the contracted Pharmacyservice provided by Amcal Pharmacy’s Glenn Benett-Hullin.The introduction of 2 part time Division 1 nursesinto the service has resulted in an improvement inindividual support given to patients in regard to theirmedication management. The nurses are responsiblefor performing a Root Cause Analysis on all medicationincidents to improve our performance and reducerisks associated with medication administration anddispensing.This year the pharmacy technicians along with thepharmacist have completed a formulary, whichidentifies the range of medications available, andthus will assist the doctors when ordering for theirpatientsGlenelg Southern Grampians Drug TreatmentServiceBev McIlroy continues to provide excellent leadershipof her specialised team. The multi skilled team havebeen able to provide a stable model of service deliveryto enhance workforce capacity and service direction.The emphasis this year has been on consolidation ofpractices and initiatives to establish sustainable andconsistent service delivery to meet the demands ofour various agreements with Department of HumanServices, Portland District Health, service partners,clients, the staff and the community.We have achieved 100%+ targets for Glenelg SouthernGrampians Drug Treatment Service thanks to theongoing commitment and energies of our Portlandand Hamilton based staff.Succession planning and training has been a significantpart of our strategic planning. Our ‘growing ourown’ strategy is working well for us, with anotherstaff member Sue Johnson achieving Certificate IV~Alcohol and Other Drugs and working in alliedhealth support.Our commitment to the community this year has seenus working with schools and school leavers. This hastaken the form of information and education sessions,support with policy development, early interventionand prevention initiatives such as communitydreaming and creating conversations. The invitationsto be involved in the school programs have increased150% this year, due in no small part to the approachof our school liaison staff Jodie Outtram and DebbieCobby.Partnerships have been established and strengthenedin this year. An alliance with a Geelong based youthservice, Barwon Associated Youth Services andAccommodation (BAYSA) has seen the successfulintroduction of a youth outreach program whereyoung people and their families are able to seekadvice and support from skilled youth workers in anoutreach model. This program has enhanced the workother agencies are doing with young people.We have been well supported by our service partners:Police, Courts, Portland Housing Program, diversionprograms, mental health services to mention a few.New staff welcomed, Mrs. Carol Pietschmann asAlcohol Education Research Fund project coordinator,and Mrs. Helen Hegarty as pharmacotherapy supportworker.We wish to acknowledge the ongoing medical supportand mentoring offered to the team and to PortlandDistrict Health by Drs Roger Brough and DavidRichards.We gratefully acknowledge the generosity ofWarrnambool Regional Alcohol and Drug Service22

(WRAD) in facilitating this access for pharmacotherapysupport.Breast Care /Stomal TherapyThis specialised stream of health care has seen theretirement of Ann Roberts. Her knowledge andcontribution will be greatly missed. We welcome JulieCampbell to the breast care role and Jenny Ward tothe Stomal therapy position. Earlier referral processesand pre-operative education and counselling havecontinued. Formal education sessions for staff haveenhanced awareness of these valuable roles.In many instances care has been provided fromdiagnosis and throughout the breast cancer journey.This has included eduction and counselling.Professional DevelopmentNurse Educator, Thea Brown organizes, conducts andmanages the nursing education calendar, displayinga wide range of internal and external educationalprograms. Thea has been joined by Jenny Ridler &Lyn McNaughton who provide clinical support ona daily basis to the clinical areas of the organsiation.The commitment of Portland District Health todeveloping staff and maintaining competency ismanifested by the participation of staff in on goingeducation.It is mandatory that staff attend an education daywhich encompasses sessions on Advanced And BasicLife Support (ALS/BLS), Medication Management,Infection Control, Fire & Safety and Back InjuryPrevention.Seven new graduate nurses commenced in January2005, to replace the 5 nurses from 2003 who werecompleting their program.Regular in-service programs have been availableto ensure staff receive the latest information onequipment and nursing techniques. 30 staff completedthe Advanced Trauma Life Support program.Collaborative relationships have continued withDeakin University and RMIT with utilization ofnursing staff as Clinical educators at Deakin Universityand Clinical facilitators for the many students whoattend Portland District Health.The Back Injury Prevention Program at PortlandDistrict Health has continued to advance under theexpert direction and management of Miffy Maddox,Caroline Berry & Jenny Smith. The education, adviceand assistance provided by this team have enabledthe staff to feel confident in the manual handlingapproach to care provision.Many education programs will be held in conjunctionwith Hamilton, Heywood, Coleraine and Castertonhealth agencies to maximize resources and access toprofessional presentations. Training and educationhas now moved into a new era with programs beingoffered On Line, via video and teleconferencing.Nursing AdministrationThe nursing administration team of Maureen Patterson,Assistant Director of Nursing, the Nursing UnitManagers and the After Hours Nursing coordinatorscontinue to manage daily staffing issues, patientcare management, and complaints management andproject development.The nursing division relies on the expertise of theclerical staff in their documentation development,record and data base management. In this we arewonderfully supported by Kat Warner, Sue Holmes,Sian Ruis, Elaine McNeilly, Andrea Stafford, MarleneTait, Danielle Stuchberry, Janice Anderson & AbbyWilson.The nursing division also enjoyed the support of theexecutive team, which was greatly appreciated.Finally thanks must go to the Allied Health,Primary Care, Medical, Catering, Environmentaland Maintenance services for all their wonderfulcontributions.OutlookTo continue in the development and evaluation of theCaseload Midwifery model.To further advance the rehabilitation unit within theacute and community services.To adequately prepare and implement the proposedredevelopment of the Day Procedure Unit and theAged Care facility.To continue to develop an innovative nursing educationenvironment to ensure adequate recruitment andretention opportunities.Kathryn EyreDirector of Nursing23

Medical Services DivisionKey Points• Clinical Case Reviews: In order to improve thequality of services over a wide range of clinicalservices, a total of 10 case reviews was conductedfrom January 2005 – June 2005. Outcomes fromthese have improved systems related to quality ofclinical care.• Credentialing and Scope of Practice: A documentwas prepared outlining the Clinical Scope ofPractice for all disciplines of the Portland DistrictHealth medical workforce. This document wasaccepted by all VMO’s and incorporated into theCredentialing policy. The credentialing processwas conducted incorporating the guidelines fromthe Australian Council for safety and Quality inHealth Care. In all disciplines representativesof the relevant colleges were in attendanceto comment on the college requirements forcredentialing.• PDH has completed this process and all VMO’s ofthe service, are fully credentialed to work withintheir limitations (scope of practice). The processis ongoing and all VMO’s will be credentialedevery 3 years, to ensure that all discipline complywith the quality and safety standards of PDH.• Documentation Audits: Documentation auditsto ensure compliance with the quality standardsare conducted on a monthly basis. From theseaudits improvements in clinical note keeping arebecoming evident. The current documentationpolicy has been updated to reflect the changein quality requirements. Audits will now beconducted to ensure compliance with the policy.• Mortality and Morbidity Meetings: All deathsat PDH are audited to ensure best care wasprovided at all times. The results of these auditsare discussed in a multidisciplinary forum.• Maternity Services: 2004 – 2005 saw the birthof the Woman and Child Health Clinic inPercy Street. The Wentworth women’s Clinic,Warrnambool Pediatricians Group and GPObstetricians operate from these premises. Theseservices are being integrated with midwiferyservices of PDH. We hope to expand this serviceto incorporate some Family and Child HealthServices.Performance2004/2005 has been a turbulent year with variousissues relating to the medical workforce beingaddressed.The continuation of Medical services after hours hasbeen a problem and a more permanent solution to theproblem is being addressed at present.Medical recruitment remains a high priority ofPortland District Health. We are actively seekingGP’s, anesthetists and obstetricians to complementour current workforce.OutlookOur ultimate aim is maintenance and provision of afull range of appropriate quality medical and alliedservices to the community.An exciting future awaits PDH with a major projectbeing that of establishing a PDH Medical Centre toensure accessibility to GP’s. I am positive that theafter hours situation will be solved within the comingyear.Recruitment will continue to ensure continuationof services. As we have an aging specialist medicalworkforce, succession planning will includerecruitment of specialist medical staff to Portland.RadiologyDoctors Woolner and MartinKey Points• Nancy Woolley retired in early June after 20 yearsas Radiology Receptionist/Medical typist. Nancyis currently holidaying overseas before returningto take up retirement at ‘Allora’ near Heywoodwhere she and her husband Les have establishedan olive grove.• Other staff changes have seen the addition ofMarlene Tait as Receptionist/Medical Typist, andJillian Goldsworthy has joined us in this area aswell.• Meegan Mulvogue is with us as Radiographeruntil early December when we hope to obtainthe services of a new Graduate Radiographer.• Visiting radiology group Western DistrictRadiology have two new radiologists Dr JohnNagorcka and Dr Neale Walters who now attendour Radiology department on a rotating roster24

with the other radiologists from the group.• Radiographers Robin Parry and Petrina Thomasand Radiographer/Sonographer Graham Bates,continue to upgrade and update as part of theirrespective continuing professional development(CPD) requirements. Robin has also recentlycompleted her Certificate Of ClinicalCompetency in Mammography and is currentlystudying for an Advanced Diploma Of BusinessHuman resources (HR).• Nurses Megan Bunge & Lynne Mc Naughtonhave attended various upgrade courses as wellin the last year, including Professional AssaultResponse Training (PART) training.• Robin has given radiation safety in-services to theTheatre staff early this year. All staff in Theatreare now participating in personal radiationmonitoring.• In line with accreditation standards, the RadiologyDepartment has introduced Glutaraldehydefree developer chemistry in the processor.This initiative ensures safe practice in a safeenvironment.• August 2004 saw the purchase of a state of theart Philips mammography machine that wasinstalled to replace older style equipment. As theorthopantogram (OPG) dental machine sharedthe mammography room, the opportunitywas taken to relocate it to another part of thedepartment thus forming a pleasant dedicatedMembers of the Radiology department staff.25mammography room.• Breastscreen sessions continue to run on Tuesdayand Thursday mornings, with an average of 25clients per week. Robin now performs all theBreastscreen examinations.PerformanceComparing statistics with 2003/04 has seen slightincrease in both patient and examination numbers bya factor of 400, however workload units are relativelysteady.OutlookTo work towards maintaining accreditation status atthe August 2006 survey.It is planned to introduce Computed Radiography inthe near future, with many benefits including:• Transfer of images to remote location for reportingif necessary• Images stored on CD• Images available to view on Web/Dr’s Surgery/Ward/A & E• Less repeat radiographsStaff are continuing to upgrade & update theirknowledge and expertise in accordance with theirprofessional body guidelinesDr. Meindert Van Der VeerDirector Of Medical Services

Primary and Community Health ServiceAs the Director responsible for ‘primary andcommunity health,’ I am pleased to report that the Staffhave provided increased services, developed innovativeprograms, and further streamlined their care withinthe integrated health service. The following representsa summary of the events and achievements for theyear. The Senior Practitioners and Health ProgramsManager have not only provided managementsupport but also met their clinical target hours, and Ipersonally thank them for their commitment duringthe year,Business SystemsPrimary care staff Keith Kallie, Casey Millard and Rae HumphriesThe following information has been provided byKeith Kallie the Business Systems Manager. We havea full year of consistent data, which will assist us inplanning and reviewing our services, from our clientinformation database.Key Points• The role of the business systems departmentincorporates both data management andreporting, as well as administrative support to allprimary care staff at 2 locations.• Congratulations to the administration team(Casey Millard, Rae Humphries and MareeMatters) for their continued efforts in providingexcellent service to both staff and clients. Thisimportant role of ‘first point of contact’ is vitalto the success of the any community orientedservice.• We would also like to farewell Terry Engel andacknowledge her efforts as part of the businesssystems team. Terry was an integral member ofour team but has moved on to a new role with theCommonwealth Rehabilitation Service. We wishher well in her new position.PerformanceIt has been a successful year for the primary care teamin reaching their statistical targets for this financialyear. We have reached full compliance with the DHSset goals and are looking forward to maintaining thiseffort in the year to come. Congratulations go to allstaff for their diligence in their stats recording andworking together as a team to reach our targets.OutlookThe goal of the business system department will beto continually improve our statistical performance.We aim to streamline our processes and provideprimary care staff and clients with a high level ofservice. Keeping abreast of technological changes andreporting requirements will be one of the major goalsfor us this year.Primary Care NursingThe following information has been provided byRosemary Cole Senior of Community Nursing.Incorporates• Community Health Nursing,• Diabetes Education• Family Planning• Asthma & Respiratory Education• Continence Nurse• Breast Care & BreastScreen Nurse.• Maternal & Child Health (Glenelg ShireContract)Groups offered include Epilepsy Support Group,Fawthrop Walking Group, Parkinsons SupportGroup, Water Exercise Group, and Old Timers.Programs offered include Cardiac Rehabilitation (8weeks & ongoing exercise component), DiabetesEducation (6 weeks), Towards a Healthy Heart,3RPC (sessions weekly) Asthma Friendly schools,Emergency Asthma Training.PerformanceOur Primary Care Nurses possess a broad range ofknowledge, skills and experience, particularly in theimportant areas of Diabetes, Asthma & Respiratorymanagement & education, Cardiovascular health,Continence, PAP Screening and Breast Care. TheNurses are committed to maintaining high standardsof service, evidenced this year by• Continued high numbers of diabetes clientsbeing serviced• Successful “revamp” of Cardiac Rehab exercise &education sessions• Up skilling in Spirometry to provide “GoldStandard” Lung Function Testing• Conducting the Successful “Towards A HealthyHeart Program”26

• Promoting a variety of “do-able” physical activityoptions• Continuing to run a wide range of programsand groups that are of obvious individual andcommunity benefit• Promoting & conducting screenings for SkinCancer, Blood Pressure & Diabetes.OutlookWe aim to continue to provide quality servicesand programs to clients, which meet communityneeds and organisational priorities whilst providingmeasurable outcomes for meaningful evaluation.We also intend to increase health-promoting optionsfor clients through improved co-ordination andexpansion of existing programs. We look forward toanother busy and successful year and many positiveclient outcomes.Maternal and Child HealthThe maternal and child health nurses continue toprovide an early intervention and support service towomen and newborns in the Glenelg Shire Councilregion. This is a contracted service on behalf of theGlenelg Shire for the provision of maternal and childhealth services to the area. This service provides ahigh quality primary health service for newborns andparents which:• Enhance their health, safety and wellbeingthrough community based involvement andfamily support.• Enhance the social development of children; and• Promotes self-help and the independence inindividuals.Service Initiatives / VariationsNo new initiatives / variations to the service duringthis reporting period. There have been somediscussions with (D.W.E.C) Windamara, Dhauwurd– Wurrung Aboriginal Elderly Citizens AssociationLtd. regarding a Maternal and Child Health Nurseattending for sessions.Monthly Service StatisticsAnnual report and centre-by-centre statistics have beensent to DHS, copies also sent to Shire and PortlandDistrict Health. All centres have similar figures to lastyear except Casterton where there has been a largedecrease in birth notifications - approximately 50%down on last years figures.Counselling & SupportThe following information has been provided byMerrilyn Risk the Senior of Counselling and Support.This Incorporates:• Senior Social Worker• Mental Health Worker• Relationship Counsellor• In Home Child Care Coordinator• Social Monitoring and Support• Koori Liaison Officer• Youth Health WorkerKey Points• The team has continued to provide counsellingand support to the community as well as provideSocial Work to the acute sector of the hospital• ‘Men On The Move Program’ established andnow ongoing. Group of community membersmeet and make furniture to sell, proceeds go tocharity.• Carol Guidera joined our team to provideparenting and relationship counselling one toone or group work• “Counseling in Community Health Centres”draft policy from DHS has been instrumental inthe development of the team• Gerry Leonard (Mental Health Worker) hasbeen recently trained in Mental Health First Aid,he will provide mental health awareness to ourcommunity in the coming months• In conjunction with Primary Mental HealthTeam, a six week Stress Management course wasdelivered through TAFE• The team provided assistance to Food forThought, Diabetes, Cardiac Rehabilitation, andTowards a Health Heart Programs.• The team has also been involved with AdvancedCare Planning for the community• Critical Incident Stress Management has beenprovided to external organisations• Strengthening of linkages with cross borderservices has occurred, to further enhance servicedelivery.• Community Transport car was updated withassistance from Portland Aluminum and UnitedWay.• The team was able to provide emergencyrelief “Food Vouchers” to the community inconjunction with Salvation Army• Sam Sharp (Youth Worker) is developing a sexualhealth promotion guide in conjunction with theWomen’s Health Worker.• Sexual health promotion has been delivered toover 1,000 secondary school students.• A young parents group has been establishedand is continuing to grow. This is communitycollaboration in conjunction with the Glenelg27

Shire, Windamara, Dhauwurd-WurrungAboriginal Elderly Citizens Association Ltd(DWEC) and Portland Housing.• Koori Hospital Liaison review by DHS wasundertaken by PDH to further improve thecare for Aboriginal and Torres Strait Islanderpatients.• The establishment of the Glenelg AboriginalServices Advisory Group in conjunction withShane Nichols, Aboriginal Services Manager,DHS.PerformanceDevelopment of team policies and protocols.Establishment of processes to deal with casemanagement, clinical supervision, client allocationand referrals.Department of Human Services have providedtraining in Single Session Therapy, for thoseundertaking counselling, the aim to provide a moretimely response to the communityDevelopment and Marketing Flyers for TeamPrimary & Community Care volunteer, HeatherBurton won the Barwon South West Rural HealthAward. Her contribution has been for 21 years toTelecare service.The development and implementation of the “In-Home Child Care” Program, this program providesquality childcare in the home of the childrenOutlookProvide community with a greater awareness ofCounselling & Support TeamDevelop stronger partnership with other serviceprovidersIncrease programs and services from the Counselling& Support TeamHealth Promotion And HealthProgramsThe following information has been provided by JackiCarmody the Health Programs Manager.Key PointsHealth Promotion is the process of addressing healthissues within a community, engaging communitymembers in improving their health and developingstrategies and interventions to promote positivebehavior change now and into the future.Portland District Health provides a wide range ofhealth promotion programs and services to thePortland and District community.To incorporate new guidelines by the Departmentof Human Services, a review of the health prioritiesaddressed by Portland District Health occurred inearly 2004. As a result of the review, the priorityareas were changed to reflect the changing needs ofthe community, region and state. Working towardsaddressing the current burden of disease, four keypriority health areas were identified and selected bythe health promotion unit for 2004/2005 (physicalactivity, chronic disease, mental health and socialconnectedness and nutrition). Within each area,programs were developed and implemented to addresssuch needs.2004 saw the completion of the Towards a HealthyHeart pilot and the beginning of a research focusinto the prevention of heart disease in men. One ofthe key strategies for the health promotion unit in2005/2006 will be to conduct a research programto evidence the Towards a Healthy Heart model andpromote its framework throughout the health sectoras an evidenced intervention for reducing heartdisease. I would like to thank Keppel Prince andthe participants for thier assistance in piloting theprogram – the new research program would not havebeen possible without the support of the programfacilitators, key stakeholders, consumer representativesPhotographer: Ebony Yuill - Photo courtesy of the Portland Observer.Towards a Healthy Heart Pilot group with Vicki Barbary (CommunityHealth Nurse) keeping a watch over the physical activity.and participants of the original pilot.Performance2004/2005 has seen many changes within the HealthPromotion Unit of Portland District Health. Thefocus for the unit has shifted from one off programsto planned and evaluated long term interventions.Some of the programs, groups and activities providedincluded:Physical Activity• Take it on Hockey28

• Fawthrop Walking Group• Water Exercise• Glenelg Walking Strategy• Stepping Out / 10,000 StepsChronic Disease• Parkinson’s Support Group• Epilepsy Support Group• Living Longer Living Stronger• Tai Chi• Cardiac Rehabilitation• Towards a Healthy Heart• Quit Smoking Program• Bin the Butt• Heart Week• Diabetes Week• 3RPC ProgramMental Health and Social Connectedness• Mental Health Week Comedy Show• Live Life Think Health (Community Newslettersponsored by Portland Aluminum)• Men on the Move• Family Violence Program• Library Bus Run• Old Timers Out and About (Portland)• Old Timers Out and About (Narrawong)• Telecare and Telelink• Community Transport• KISSE (Sexual Health and Reproduction)• International Women’s DayNutrition• Kids Stuff Festival Milk Shakes• Primary School Nutrition Needs Assessment• Food for ThoughtOutlookIn 2005/2006 the health promotion unit has identifiedseveral key objectives:• To create and promote an evidenced frameworkfor preventing cardiovascular disease in men• To consult with key stakeholders and communitygroups to conduct a needs analysis to establish amen’s health strategy.• To identify the gaps and to develop a programstrategy to address the early intervention needs ofchildren within the region• To develop an integrated health promotionplan with the Department of Human Services,Glenelg Shire Council, South West Health Care,Western District Health Care and the Glenelg andSouthern Grampians Primary Care Partnershipfor 2006-2009• To develop a quality improvement programfor health promotion and health programs thatis of the highest quality (spanning programplanning through to program evaluation) andbenchmarking with other health promotionunits.I would like to take this opportunity to thank theindividuals and organisations that have supportedand sponsored any of our programs and strategiesin the past year. To the volunteers who help plan,deliver and evaluate our efforts, thank you for yourinvaluable contribution.I look forward to working with the community,health professionals and organisations in the next yearto address the health needs of our community.Women’s Health – Health PromotionThe following information has been provided byLynda Smith (Donehue) the Women’s HealthResource Worker.Key Points• The Glenelg and Southern Grampians positionformulates part of the Barwon South WesternRegion Women’s Health, which includes workersbased in Warrnambool, Colac and Geelong.• Based at our Otway Street Campus- traveling tothe Primary Care Partnership office in Hamiltonone day per week and visiting Casterton regularlyhas seen the increase in the utilization of theWomen’s Health Resource Worker across thetwo Shires. Over 22,000 kms have been traveledduring the 2004-2005 financial year.• Negotiations with peak bodies to deliverregional training include: Royal Women’s Drugand Alcohol Unit, Jean Hailles Foundation,Family Planning Victoria, Thea O’Connor-Body Image Consultant and Elizabeth Mallorpsychotherapist.• Support was given to the following groups tosecure funds for activities: Western DistrictHealth Services - Breast Health and Body imageboosters, Portland Mental Health Committee- Women’s Night of Fun, Casterton MemorialHospital- Midlife messages for women, GlenelgOutreach - Nelson Women’s Health FocusGroup, Heywood Secondary College- CrossCultural mural, Portland Neighborhood House- Pilates classes, PDH - Menopause sessionsand International Women’s Day Celebrations inHamilton, Casterton and Portland.29

Performance2005 has seen the birth of an exciting new healthpromotion strategy collaborating with our YouthHealth worker called KISSE, which concentrateson sexual health and education around SexuallyTransmitted Infections and Contraception. With overnine schools and 1,000 students already accessinginformation.OutlookTo continue to improve the communities awarenessand knowledge of women’s health and promoteongoing improvements. Finalize the KISSE Strategyand implement to it’s full potential, - attempt to securefunds to ensure it’s success. Continue to increaseaccess that embraces diversity.Occupational TherapyThe following information has been provided by JillSwinton the Senior of Allied Health.The Occupational Therapists provide a comprehensiverange of programs and services aimed at maximisingthe independence and well-being of communitymembers in response to their needs. This encompasseshealth service based (i.e. acute rehabilitation, and agedcare) and community based services for all age groupsand includes individual and group therapy, healthpromotion, home modifications, and education. Ourachievements for the year include the following.• The Occupational Therapy Department finishedthe 2004 -2005 year on a successful note byachieving 98% of the targeted contact hoursin community health. This was despite the OTdepartment not having a full complement of stafffor 6 months.• Jacki Barnett commenced as a new graduate inJanuary 2005. Jacki has been working in rotationthrough community health, paediatric services,acute wards, rehabilitation and aged care.• Briony Trace returned in February and is currentlyworking one day a week with paediatric clients.• Catherine Mclnness commenced in Marchworking in rehabilitation for Portland DistrictHospital 3 days a fortnight.• Jill Swinton and Joan Cannon continue providingservices to the acute and community sector.• Joan has maintained the essential equipmentloan service, which has seen items prescribed andloaned to patients and community clients.• Specialist Children’s Services - Early Intake• Aged care facilities - Lewis Court, SeymourCundy Wing, Seaview House Consultancy• Close working relationships with communityservices at the Glenelg Shire, CommunityOptions• Rehabilitation Trip to The McKellar Centre,Geelong• Undergraduate clinical placements have beenprovided for students from Latrobe Universityand Deakin University• Nursing student and work experienceopportunities have been provided which havebeen beneficial to those involved. These initiativesmarket the role and importance of occupationaltherapy in the integrated delivery of both hospitaland community based services at Portland DistrictHealth.PodiatryPodiatrist Donna ShepherdDonna Shepherd Senior Podiatrist has provided thefollowing information.The Podiatry Department at Portland District Healthhas seen some highs and lows during the past year,continuing to provide the only public podiatry servicein Portland to Home and Community Care (HACC)clients. Increased demand saw the waiting list forreview clients creep out to six and a half monthscausing much community concern. Fortunatelyabout this time the culmination of much work sawthe department benefit from the flexible funding trial.This enabled an increase in hours available, and as aresult the financial year was able to end with a waitinglist review time of four and a half months.Mid June 2005 saw a big move for podiatry, fromOtway Street where it had been for over thirteenyears to the Health Services Building (area formerly30

occupied by blood bank). This fortunately causedlittle disruption to clients as reception staff havebeen vigilant in confirming changes prior toappointments.Continuing to support Podiatry student ruralplacement programs from La Trobe and Uni SAhas this past year again been beneficial to all partiesinvolved and we are looking forward to expandingthis in the coming years, with plans afoot!Community education was limited somewhat in thepast year due to client pressures although highlightsincluded speaking to Portland Probus Ladies and theDiabetes Support Group.The 2005 -2006 will bring more changes with anothernew ‘home’ and new treatment chair on the way. Thisdepartment has enjoyed the support of staff frommany areas this past year, but to single out a few whohave especially made the relocation an easier process,Casey, Keith, Rae and Maree for all that they do tomake each day flow well; Ros Jones, Environmentalservices and Central Sterile Services Departmentstaff for their support and services; Steve Jones andthe maintenance staff - especially Stuart- for all theirattention to make a space a suitable treatment areaand Toni Young and the medical records staff formaking me fit right in. Finally to Sam Ireland andPrimary Care Staff for the work put into achievingextra funding and being there.DieteticsThe following information has been provided byFiona Storer the Senior Dietitian.Key Points• 2004-2005 was a year of consolidation for theDietetics Department with our three staff FionaStorer, Vinotha Vijayapalan and Jacqui Pantercontinuing to revise work practices to meet bestpractice.• Inpatient, outpatient and home visit servicescontinued, whilst we also participated in the neworthopaedic ward rounds, and initiated servicesto the new rehabilitation program.• The dietetics department initiated an ongoingnutrition support service to the Royal Children’sHospital Outreach Clinic for children with Type1 Diabetes.• Regular visiting services to Lewis Court• Home for the Aged and Portland SpecialDevelopment School continued.• Outreach Service to Dartmoor Bush NursingCentre continued on a monthly basis.• Visiting Dietetic Services to Heywood RuralHealth ceased in August 2004 when GlenelgOutreach took over provision of these services.• Nutritional risk screening of residents of SeymourCundy Wing was initiated to meet best practiceguidelines.• Jacqui Panter attended the International Congressof Clinical Nutrition and the Australian and NZNutrition Societies annual conference in Brisbanein August 2004 and Vinotha Vijayapalan attendedthe National Dietitian’s Association of Australiaconference in Perth in May 2005, providing thedepartment with a valuable update of professionaldietetics skills.• In addition, during 2004-2005 dietitians attendedprofessional development sessions on body image,weight management, diabetes management,cardiac rehabilitation, public health nutritionand gastrointestinal nutrition, further enhancingclinical, community and public health nutritionskills.• All dietitians attended Personal Assault ResponseTraining during 2004-2005.• As an amalgamated Department we were able totake our first ever Dietetic Student placement.In October 2005 two third year dietetic studentsfrom Monash University completed their ruralnutrition placement. As a result of a positiveexperience, these students have elected to returnto Portland in July 2005 to complete an eightweek community nutrition placement• In-servicing of nursing, catering andenvironmental staff re such topics as dysphasiamanagement and diabetes management occurredthrough 2004-2005.• The Food for Thought Healthy Lifestyleprogram involving Dietetics, Physiotherapy andCounselling Departments continued. Two newprograms commenced this year, with positivefeedback from participants.• The format of the Cardiac Rehabilitation Programwas reviewed in January 2005, with such eventsas supermarket tours now being included as aregular component of the program.• Jacqui Panter and Vinotha Vijayapalan placedconsiderable effort into the development andimplementation of the “Towards a HealthyHeart” program, which commenced in August2004.• The Diabetes Education Program ran severaltimes during 2004-2005.• A fun and educational Health Promotion31

activity was held at the Portland KidzstuffFestival in January 2005, with around 100children participating by making their own fruitsmoothies.• Many other community nutrition talks andhealth promotion displays were provided to localbusinesses and community organizations duringthe year.Performance2004-2005 has been a challenging year for theDietetics Department. Inpatient services altered withthe decrease of bed numbers and the initiation ofrehabilitation services, whilst demand for outpatient,health promotion and community services continuedto grow. Our emphasis on continuing professionaldevelopment has maintained a high level clinical skills,these skills being placed into practice with the diverserange of acute and community services provided bythe department. In addition, changes in managementpractices of the department have enhanced our abilityto provide best practice care for Portland and DistrictCommunityOutlook2005-2006 looks to be another eventful and challengingyear for the dietetics department. Improvement inbest practice care and department management willbe ongoing, with a formalized Management andQuality Assurance Plan being implemented. We willstrengthen our ties with Universities through provisionof dietetics student training, resulting in completionof nutritional needs assessment of primary schoolchildren in the Portland and District. We will alsocontinue to foster optimal nutritional health for theentire Portland and District Community crossing thespan from primary to tertiary health care.Speech PathologyThe following information has been provided by Jenni-Lee Rees as a Certified Practicing Speech Pathologist.Key PointsSeveral inservices to nursing staff on the topic ofdysphagia have been conducted both in the acute andaged care sectors over the course of the year with aview to increasing staff knowledge about the signs,risks and management requirements associated withswallowing difficulties.The Rehabilitation Unit requirements for speechpathology services have meant a shift in focus onservices in order to accommodate the increase inpatientneeds within the hospital environment.Unfortunately, the demand for rehabilitation hourshas necessitated a decrease in the number of hoursavailable for preschool age therapy services.A number of work experience and nursing studentswere hosted throughout the year.PerformanceThe role as full time Speech Pathologist at PortlandDistrict Health requires knowledge and competencyin a wide variety of key areas. Jenni-Lee Rees waspleased to attend the Speech Pathology AustraliaNational Conference held in Canberra in May. Shereceived partial funding from the Rural ProfessionalImprovement Fund to attend. Of particularinterest was a workshop on infant and child feedingproblems.In February, Jenni-Lee undertook a 2-day course inMelbourne about increasing the use of verbs in youngchildren to increase their range of vocabulary. Thiscourse was given a most enthusiastic reception by allwho attended.In order to improve the diagnosis of dysphagia withacute patients, Jenni-Lee completed a course incervical auscultation. This involves using a stethoscopeto listen to key sounds made during a swallow andidentifying the presence of sounds associated withaspiration.Caroline Shepherd attended a 2-day course in Adelaideto learn about the Picture Exchange CommunicationSystem, which is used to help autistic children improvetheir everyday communicative efforts.OutlookJenni-Lee and Caroline Shepeherd have fulfilledthe requirements for Speech Pathology Australia’sContinuing Professional Development scheme andare now eligible to use the title Certified PracticingSpeech Pathologist.Due to the ongoing success of using fully trainedDysphagia Nurses to assess patients for the presence ofdysphagia when the speech pathologist is unavailable,Western District Health Service have decided tofollow our example. Jenni-Lee Rees will train up toten staff in Hamilton in October 2005.Samuel J IrelandDirector Primary andCommunity Health32

General and Administrative Services DepartmentsWhilst across the organisation it has been a difficultyear, there have been exceptional results recordedfor departments within the General Services and theAdministrative Service Division.A highlight for these services was their performancein the August accreditation survey, with the surveyorsglowing in their compliments and commendations.The announcement towards the end of the year offunding for the Aged Care Project / Day Surgicalprojects provided a welcome boost as does participationin the world first pilot for the Virtual Services Projectwhich will trial the use of remote medical consultationvia sophisticated IT / Video links.This past year we welcomed Ros Jones as EnvironmentalServices Supervisor / Infection Control Nursetaking over from Carole Pietschmann who we sadlyfarewelled.Carole who is highly regarded by us all, ostensiblyretired, however the drug and alcohol service managedto coax her into another valuable role within PortlandDistrict Health – a role which she no doubt will excelin.Thank you to Kevin Tait, Wayne Pettingill, WendySculley, Steve Jones, Ros Jones and Steve Hendersonand their staff for an excellent contribution to PortlandDistrict Health.The next year offers much to be positive about.Engineering ServicesThe Engineering Department had a very productiveyear completing a substantial works and equipmentlist, maintaining essential services compliance, andundertaking plant and equipment upgrades.Ward Maintenance - This year the closure of SouthWard for annual maintenance went very well. Theseworks were completed utilising both in-housetradesmen and sub-contractors. Again we thank thestaff and VMO’s for their support.Plant Upgrades – The past year has seen a continuedeffort towards ongoing plant upgrades. Much of theplant has been upgraded in recent years, however thereis still plant remaining, requiring cyclic upgrades.These tasks will be scheduled in the future.Essential Services – Checks and repairs continueregularly at specified intervals and quarterlyinspections by Stokes Consulting take place to ensureongoing Form 15 Essential Services Compliance ismaintained. Again the Engineering Services staff areto be commended for the diligent manner in whichthey conduct and record these mandatory tasks.Contract Management – Throughout the past yearJanice Anderson has implemented a system to ensurewe meet the legal requirements of Worksafe, in regardto record keeping and compliance. It is essential tohave a system in place to record inductions, copiesof insurances, certificates and Red Card certificates.Earlier this year Alan and Jenny Rivett were successfulin tendering for the garden and grounds contract.Since this arrangement has been in place, there hasbeen a noticeable improvement to the visual aspectof the facility and many favourable comments havebeen received.Energy Reduction – As reported last year, all DHSfacilities are required to meet new energy reductionstrategies. Notwithstanding that we have already metand exceeded the required reductions with water andgas, in the past year we have managed to reduce ourpower consumption by 6,000 kWh. We will continueto implement strategies to reduce electricity use.Project Control Groups – Engineering Services hasbeen heavily involved in the design development forthe Aged Care and Day Procedure Unit. Flowing fromthis the department also has involvement in relocatingthe Dental Suite and Pharmacy. As part of this thedepartment has been working with the architects,service engineers and user groups. Design has beenfinalised with works due to commence. We thank thevarious user groups for their contributions.Refrigeration Mechanic / Electrician – Peter Reynoldscompleted his training, attaining excellent resultsand we have signed his early apprenticeship release.This in-house service has enhanced the department’sservice provision and has realised financial gains.Works & Equipment – Completed Tasks• Kitchen / cafeteria evaporative coolerreplacement• Replace illuminated signs at main entrance andAccident & Emergency• Replace kitchen exhaust unit• Palliative Care Suite• Women and Children’s Clinic• Ongoing plant upgrades• Rework radiology• South Ward closure• Create dual consult suite – Pre admissions• Relocate Nurse Unit Manager’s office in SouthWard• Spoon drain west spine• Plans finalised for the dental suite• Installation of double glazing in North Ward33

We would like to thank the Engineering Services stafffor their continued support and the manner in whichthey perform their tasks.Environmental ServicesCongratulation to Ros Jones and staff on the highstandard of service provided during the year.The Environmental Services Department continuesto deliver a high quality service to Portland DistrictHealth, which is evident by the two commendationsthe department received from the recent ACHSSurvey- Standard 5.1.3 Infection Control & 5.1.9Waste Management. The credit lies with each andevery member of the environmental services team,well-done team.Environmental Services cleaning role incorporates allareas within the hospital environment along with theOtway Street and their campus, Wentworth Womenand Children’s Clinic, Allied Health, Dr Taylor’srooms and Drug and Alcohol service. This departmentendeavours to maintain a very clean, pleasant and safeenvironment for all patients, staff and visitors whoutilise the facility.Key Points• Internal cleaning audit results continue todemonstrate our commitment to cleanlinessby delivering consistently high scores. Thisis substantiated be the compulsory externalcleaning audit we are required to participatein by returning and audit result of 97%. TheVictorian Public Hospitals Cleaning Standardshave recently raised the acceptable cleaning scorefrom 80 % to 85 %.• Sadly the department farewelled CarolePietschmann, Nathan Nejasmic and RachaelMcKenzie, we wish them well in their newventures.Education OfferedThe majority of the Environmental staff haveenthusiastically embraced the opportunity forpersonal development and undertaken the educationthat has been offered.• Thirteen members of the Environmental Servicesteam are currently undertaking Certificate IIIin Health Support Services (Cleaning SupportServices). Originally a two-year course, allmembers will have completed the course in 12months and are due to complete the course byAugust this year.• Five members of the Laundry Service arecurrently undertaking Certificate III in LaundryOperations (Existing Worker program). This isa two-year course however members will havecompleted this course in 18 months; they are dueto complete their course in February 2006.• Two Staff members each month are rosteredto attend compulsory education whereby theypartake in Occupational Health & Safety,Infection Control, Fire safety, Basic Life Supportand No lift education.• BOC training – Safe handling of oxygencylinders.• Micro Fibre in-service.• PART- Professional Assault Response Training.• Physiotherapy in-service by David Walker– Discussing issues and injuries that can affectenvironmental services staff and providingeducation and simple techniques and exerciseson how to avoid injury.Appointments• Ros Jones was appointed as the Infection Control& Environmental Services Manager• Shiralee Newton has been appointed to theoutdoors maintenance position.• Janne Morrison is the newly appointed OH&Srepresentative for Environmental Services.• Tanya Hollis is the newly appointed Porter.• The department welcomes, Lynne West, PatLeyonhjelm, Rhonda Hill and Maxine King.PerformanceOverall the department has had a very dynamicyear with reviewing of department processes andwork practices, many quality activities have beenundertaken, changes in roles have occurred and amajor goal of 2005 –2006 is implementation ofthe Waste Wise Program throughout the hospitalcampus.Food ServicesKey Points• Upgrade of cleaning practices and more frequenttiming of audits, to compliment introduction ofmicro fibre cleaning.• 9 staff commenced the Certificate III inHospitality (Operations) being provided throughthe University of Ballarat.• Upgrading of menu to a more seasonally basedmenu and addition of vegetarian meals to themain menu.• Altered salad options to provide an increasedvariety.34

• Limiting processed food utilised by the kitchen,by cooking more fresh produce.• Contracts for the provision of prisoner meals andMeals on Wheels have been extended.• Increased liaison with Dietetics Departmentto update Food Services staff knowledge ofalternative diets e.g. diabetic, low fat and toenhance the meals provided to increase menuchoice and variety.Performance• Food Safety Audits were conducted, with the FoodServices Department passing all requirements.• Regular visits from the Environmental HealthOffice for the Glenelg Shire Council were alsoconducted.• Our first Apprentice Chef in many years hasobtained excellent results during her placementswith external service providers and has engagedin additional work experience with a variety oflocal service providers.• Tom Treloar, Christie Parsons and Ben Marshallhave all moved on to further endeavours and wewish them well. Brad Pumpa, Barbara Pumpa,Tamara Holien, Melissa Currie and Kylie Dawsonall joined the Department and we also welcomedback Emma Walters from Maternity Leave.Outlook• We intend to continue to provide nutritious,fresh cooked meals that meet the needs of ourclientele.• To continue improving staff knowledge throughregular in-services conducted with internaldepartments.• Participation and achievement of annual FoodSafety Audit and to participate in ACHSAccreditation.• Provision of diet specific menus to clientele.• Continued upgrade and review of menu.• As funds permit we will further upgrade kitchenequipment.• Decrease in waste by increasing the amount ofwaste processed by the worm farm, giving greateremphasis to recycling, reduced usage of portioncontrol stock and interaction with suppliers toreduce excess packaging.• Our Apprentice Chef will complete herapprenticeship in October 2005 having obtainingexcellent results during her placements.Information, Communications andTechnology DepartmentKey PointsThe Information, Communications and TechnologyDepartment (ICT) has improved the communicationsnetwork over the past year by commissioning a largequantity of new equipment to support the growingdevelopment of organisation’s services, including thenew Women and Children’s, Clinic.This department has also been heavily involved witha number of developments within the South WestAlliance of Rural Health.Portland District Health is to be a pilot site for thenew Virtual Services Project, which will allow doctorsto assess patients at remote sites by video. This willenable rural communities to access specialist healthcare and support services without having to leave theirlocal community.PerformanceThe total downtime for all users during the year wasless than 0.02%.All data is securely archived to DVD. Enhancedbackup facilities have been installed.OutlookThe development of health care services to thecommunity in the future will depend heavily on ICTservices for effective delivery.It is important to manage the effective upgrade pathsfor our systems and to continue the integration ofvendor services.Through strategic planning we will continue to increaseand implement innovative solutions to help minimisecosts. The deployment of new applications, includingthose developed by the South West Alliance of RuralHealth Services (SWARH) member committeesthrough various projects, together with the abilityto access resources never before available, has vastlyimproved the value received from this investment inour Information Technology (IT) resources.The assistance of IT Technician Nik Kedzia and thesupport from Information Technology staff withinSWARH has been crucial to our continued success inthe delivery of IT services, thank you Nik.There is always room for improvement in servicedelivery, and this department actively monitors it’sown performance. The recent staff satisfaction survey,conducted by an independent source, has provided35

information that will help us to enhance this service,and we are always ready to adapt.We are fortunate in belonging to a dedicated team ofpeople - the staff of Portland District Health, and weextend our thanks for their continued active support.Another busy year will follow.Sea View HouseStan and Frances Fredericks, residents of Sea View House, celebrating 60 years of marriageKey Points• Achievement of ACHS accreditation.• Advance Care Planning.• Department of Human Services-Desk top Audit.• Funding for Falls Prevention which enabled theof purchase exercise equipment for residents.• Mosaic plaque by residents.• Six (6) Staff members completed Cert III / IVCommunity Services (Aged Care Work)• Staff member completing Cert III CommunityServices (Aged Care).• Staff member completing Cert III Hospitality• Two (2) staff undertaking Cert IV in Health(Nursing)• Video & T.V. purchased for staff education.Performance2004 – 2005 has been a busy year with full occupancyof rooms. Respite places are proving very popular andwe have been booked well in advance for these places.Our staff have provided an excellent standard of careand have been willing participants in completingfurther education.Our service undertook accreditation along with therest of Portland District Health and celebrated thesuccessful result in March 2005. We believe Sea ViewHouse to be amongst the very first to achieve thisstatus.Congratulations to staff on excellent results in study- Kerry Hancock, Judith Hillier, Gloria Gower,Kareen Beasley, Roslyn Marshall and Sonia Brown forachieving Certificate III & IV Community Services(Aged Care Work). Well done on this fantasticachievement.During the year an authorised officer from theDepartment of Human Services completed a desk topaudit / evaluation using an assessment system based onthe principles of Health Services Act 1988 (The Act) andthe Health Services (Supported Residential Services)Regulations 2001. The evaluation demonstrated that36

Sea View House SRS was compliant with the HealthServices Act 1988 and the Health Services (SupportedResidential Services) Regulation 2001.Activities 2005Storeman, Michael GreenThe residents at Portland Sea View House havehad a very interesting and exciting time trying anabundance of new activities this year. Thanks to ouractivities assistants Rosie Collins, Debbie Taylor andFrances Kelly.Some of the popular activities being offered at PortlandSea View House include:• Indoor Lawn Bowls• Indoor / Outdoor Croquet• Piano Lessons• Knitting Groups for the Greater Community• Chair Aerobics• Kitchen “Herb” Garden• Poetry Workshop• Bingo• Musical Sing a longs• Bocce• Modified Indoor Darts Competition• Walking Groups• Creative Writing• Mosaic Creations• Fete Organisation• Library Group• Birthday PartiesIn addition to this there have also been some fantasticbus trips to Port Fairy, Halls Gap and Tower Hill justto name a few. It’s a wonderful chance for Sea Viewresidents to go on scenic drives and reminisce.Residents also have the opportunity to go for picnicsand eating out in Portland. Fish and Chips is alwaysvery popular!A few months ago the residents were invited to attendC.E.M.A. arts centre to see a fashion parade organisedby the Portland Secondary School. All of the clothesused in the parade were ‘pre-loved’ items. Ourresidents had a great time and enjoyed a scrumptiousafternoon tea.Neighbourhood House very successfully organiseda ‘Mock Wedding’ and invited Portland Sea ViewHouse. A group of residents attended the weddingand had a very enjoyable time.For the first time this year Portland Sea View Houseorganised a ‘Fun Bowls Day’ at the Portland RSLMemorial Bowling Club. Lewis Court, SeymourCundy, Portland Aged Care and Heywood RuralHealth were invited. Hot lunch and indoor bowls wason the agenda for the day. Over 40 people attendedand everyone is keen and excited at the prospectof another day out at the Portland RSL MemorialBowling Club.So as you can see Portland Sea View House has anextremely successful activities program and is verygrateful to all the volunteers who donate their valuabletime and assistance.OutlookQuality of Care and Quality of Lifestyle for residentsare the foundation on which our supportive servicesat Sea View House are built.We look forward to providing services that enable ourresidents to maintain their independence and enrichtheir lives.Phil HynesD/CEOWayne ArmisteadDirector of FinanceChef, Kylie Dawson37

Sea View House ~ A Resident’s ViewThe past twelve months have been a time ofconsolidation for Sea View House and its residents.Our first year was busy with establishing our newcommunity within the Portland concept; this secondtwelve months has seen us firmly visible in the townas a vibrant, capable addition to life here in theSouthwest area of the State.Highlights of the year, which were featured in our earlydays, continued during this second time-sphere, withthe Choir leading the Christmas celebrations withseveral Carols. They sang again for CommonwealthDay, and came to the fore at Easter time with songssuitable for the occasion. The Easter Bunny calledduring the judging of our Easter bonnets, and gaveeach of us an Easter Egg—a gift from Management,which we all enjoyed.Our great Christmas party was held in style again, andthe inclusion of two invited guests for every residentadded to the fun and informality of the occasion.Santa Claus’ visit during the festivities was hailed, andhe had a gift for every resident--- again a generoustouch from Management.Visiting musicians come regularly to lead Communitysinging each week, and our “Bingo” caller is anotherregular and generous caller.Several community groups and school studentsentertained residents at times, and their talents areappreciated.Sea View House receptionist, Lyn Barnett and resident Connie Bremner.38The continuing goodwill and care shown to all who liveat Sea View House is wonderful, and the staff are to becommended highly for their patience and cheerinesswith each one of us on all occasions. It is now aneasy task to keep nearly sixty people comfortable andrelaxed, warm, well fed and individually attended to,but Wendy and her well-chosen staff command ourwarmest gratitude and respect.To all connected to the smooth conduct of Sea ViewHouse, we residents say a hearty “Thank you.”Betty JenningsPortland Sea View House(Mrs Jennings passed away 25th July 2005and will besadly missed by all at Portland Sea View House.)Relaxing in Sea View House.

Other ReportsBuilding Condition ReportIn accordance with legislative requirements buildingcondition inspection reports are undertaken on aregular basis. Recommendations arising from thesereports have been incorporated in to the ongoingworks and equipment program and site and servicesplanning.Portland District Health has also obtained thenecessary Form 15 certification in connection withthe Essential Services LegislationNational Competition PolicyThe organisation complies with the requirements of theNational Competition Policy and State CompetitiveNeutrality Policy as revised.ConsultantsDuring the year Portland District Health utilisedthe services of 8 consultants. The cost of these being$123,987Fees & ChargesPortland District Health charges fees in accordancewith the Department of Human Services’ directives.Industrial Relations and Occupational Health &SafetyDuring 04/05 4382 hours were lost as a result ofWorkcare claims or 2.10 EFT. This compares with8736 hours and 4.20 EFTlost in 03/04.No hours were lost as a result of industrial actionduring the last financial year.Pecuniary InterestMembers of the Board of Management are requiredto notify the President of the Board of any pecuniaryinterests, which might give rise to a conflict of interest,in accordance with Hospital policy. Refer also Note25 of the Financial Statements.• Hospital Wide Policy Manual• Waste Control Policy Manuals• Board and Operational Policy & Procedure• Safety Requirements for Contractors, EqualEmployment Opportunity Policy, QualityAssurance Policy, Safety and Infection ControlManuals, Information Booklets for staff,department heads and patients.Whistleblowers Protection Act 2001Portland District Health has policies and proceduresin place to enable total compliance with the Act andwhich provide a safe environment in which disclosurescan be made, people are protected from reprisal andthe investigation process is clear and provides a fairoutcome. The privacy of all individuals involved in adisclosure is assured of protection at all times. PortlandDistrict Health is committed to the principles of theAct and at no time will improper conduct by PortlandDistrict Health or any of its employees be condoned.A copy of the policy is available upon request. Websites of interest for complaint procedures are:http://www.ombudsman.vic.gov.auhttp://www.health.vic.gov.au/hscDisclosuresSince the introduction of the Act in 2002 therehave been zero disclosures and zero notification ofdisclosures to the Ombudsman or any other externalagency.Disclosures will be received by the Assistant Directorof Nursing, Portland District Health’s designatedComplaints Officer or to the Ombudsman, Level 22,459 Collins Street Melbourne, Victoria 3000.Telephone 1800 806 314PublicationsPortland District Health has published variousdocuments, which are available from administrationand include:• By Laws and Standing Orders• Board Member Information Folios• Missions, Visions and Values Statements• Freedom of Information Policy• Strategic Plan• Palliative Care Policy39

Comparative Statistics for the Past Five YearsService / Indicator Sub Item 00/01 01/02 02/03 03/04 04/05Number of Inpatients -Hospital 5,025 5,359 5,420 5,191 4,978-Nursing Home 69 71 62 74 76Number of Inpatient Days -Hospital 16,784 17,234 17,488 15,294 13,761-Nursing Home 10,699 10,748 10,803 10,800 10,516Daily Average -Hospital 46.0 47.2 47.9 41.9 37.7-Nursing Home 29.3 29.4 29.6 29.5 28.8Average Stay (Days) -Hospital 3.4 3.2 3.2 2.9 2.8-Nursing Home 155.1 151.4 174.2 145.9 138.4Number of Beds Available -Hospital 69 69 69 69 69-Nursing Home 30 30 30 30 30Koori Health Liaison Officer Contacts 382 340 1,447 643 386Accident & Emergency 11,332 11,427 9,489 12,192 9,635Births 161 171 189 142 133Community Health :Dental Clinic Treatments 1,816 740 12 285 312Diabetic Service 844 1,077 1,046 621 1,772Dietitian Treatments 1,201 919 1,009 785 1,190District Nurse Visits 11,727 12,516 12,900 10,536 10,752Hospital In The Home 15 12 26 27 17Mammography Screening 915 961 823 1,019 863Meals On Wheels Delivered 19,984 22,721 17,989 18,249 15,896Meals Served (Total) 139,965 141,261 162,289 164,638 152,897Occupational Therapy 754 815 1,271 687 1,103Podiatry 285 369 345 359 671Operations Performed 2,230 2,210 2,178 2,354 2,143Physiotherapy Treatments Inpatients 8,489 7,096 7,250 6,895 6,158Outpatients 7,201 6,236 6,400 6,285 6,196Speech Pathology 499 596 397 442 897Ultrasound Attendances 2,695 2,945 2,804 2,709 3,154X-Ray Inpatients 1,430 1,401 1,441 1,303 1,217Outpatients 12,384 12,245 12,241 12,179 12,602Examinations 15,000 14,670 14,668 14,249 14,632Staffing:Number of Staff Employed) 281 294 314 348 351Number of Staff Employed (Eft) 188.32 205.55 219.91 241.23 249.10Time Lost Through Workcare Claims (Eft) 3.82 4.02 4.80 4.20 2.10Time Lost Through Industrial Disputes (Hrs) 0.00 0.00 0.00 160.00 0.00Sick Leave As % of Basic Salaries 3.2% 3.4% 4.2% 4.2% 4.3%Costs:Cost Per Inpatient Day: -Hospital $724 $735 $791 $1,033 $1,212-Nursing Home $112 $118 $143 $171 $201Cost Per Inpatient Treated -Hospital $2,413 $3,181 $3,086 $3,098 $3,284-Nursing Home $21,471 $22,586 $26,211 $25,054 $27,84240

Health Service Agreement ReportAs part of the 2004/2005 Health Service Agreement with the Department of Human service, activity and efficiencytargets were set. Set out in this report is a summary of the activity levels.ITEM / INDICATOR 03/04 04/051. Discharged Patients (separations)Acute Same Day 2537 2523Overnight Stay 2751 2434Nursing Home Type 5 2Total Separations 5293 49592 Admitted Patient Bed DaysAcute 15294 13875Nursing Home Type 77 10Total Admitted Patient Days 15371 138853 Total Acute Patient Weighted Inlier Equivalent Separations 3107.53 2942.634 Average Inlier Equivalent DRG Weight 0.60 0.595 Average Length of Stay of Admitted Patients 2.90 2.80Acute Excluding Same Day (Days) 5.18 4.66All Acute Admitted Patients (Days) 2.89 2.79Nursing Home Type (Days) 15.4 5Average Length of Stay of Admitted Patients (Days) 2.90 2.806 Occupancy - Admitted Patients7 Non-Admitted Patient Occasions of ServicesAccident and Emergency 12,192 9,635Other Non-Admitted Patient Services 36,788 39,898Total Occasions of Service 48,980 49,5338 EfficiencyAdmitted Patient Costs ($000s)Acute $14,644 $15,259Other $1,105 $1,285Total Admitted Patient Costs ($000’s) $15,749 $16,544Non-Admitted Patient Costs ($000s)Accident and Emergency $854 $968Other $5,668 $6,285Total Non-Admitted Patient Cost $6,522 $7,253Total Acute Hospital Costs $22,271 $23,797Total Residential & Other Costs $1,854 $2,116Total Entity Costs ($000’s) $24,125 $25,913Cost per Admitted Patient $3,125 $3,336Cost per DRG Weighted Admitted Patient $5,115 $5,625Cost per Bed Day $1,039 $1,191Cost per Occasion of Service $124 $1269 Residential Services - Patient CostsNursing Home - Patient Costs ($000’s) $25,054 $27,842Total Patients (Numbers) 74 7610 Residential Services - Bed DaysNursing Home 10800 1051611 Quality Assurance - Accreditation Status 2 yrs to August 200641

Comparative Financial Analysis2003/04 2004/2005Description $’000 $’000Total Expenses 24,125 25,913Total Revenue 23,271 24,45Operating Surplus/(Deficit) (854) (1,462)Retained Surplus at 1st July(854) (1,462)Adjustment Resulting in Changein Accounting PolicyRetained Surplus 30 June (854) (1,462)Total Assets 31,854 30,906Total Liabilities 7,640 7,654Net Asset 24,214 23,252Asset Revaluation -Contributed Capital 25,068 25,068Equity Injection 500Retained Earnings (854) (1,462)Total Equity 24,214 24,106The information requirements listed in The directions of the Minister for Finance part 9.1.3 (iv) have been preparedand are available to the minister, Member of Parliament and the public on request.*As a result of the amalgamation between the Portland & District Hospital and Portland and District CommunityHealth Centre on the 1/7/2003, there is no comparative data for periods prior to this date42

Officers and Office BearersBoard MembersPresident:Senior Vice President:Junior Vice President:Treasurer:Members:Auditors:Internal Auditors:Bankers:Executive StaffActing Chief Executive OfficerChief Executive Officer:Director of Medical Services:Director of Nursing:Director of Primary Care:Deputy Chief Executive Officer:Assistant Director of NursingFinance Manager:Senior StaffAfter Hours Nursing Coordinators:Engineering Services Manager:Food Services Manager:Director of Pharmacy:Mr V GannonMrs M MenzelMr G AndrewsMr. A WilsonMr W E Bassett, Mr J Harpley, Ms M Kuljis,Dr J Purdie (Resign. Jan ’05) Mr I D Stanford (Resign. Feb ’05),Ms C Ward.Auditor General Victoria, Agent – Coffey, Hunt & Co.WHK Archer GroupANZ Banking GroupDr S Allen, P.S.M., M.B, B.S., B.H.A., F.R.A.N.Z.C.O.G.,F.R.C.O.G., A.C.H.S.E.Mr A Gallina, B.H.A. (NSW), Grad. Dip. Mgt., M. Bus., R.N.,R.M., F.A.I.M., F.C.H.S.E., C.H.E.Dr M van der Veer, M.B., Ch.B., F.R.A.C.G.P., M.R.A.C.M.A.Mrs K Eyre, RN DIV1, BN, M.Health Mgt. AFCHSE, MRCNAMr S Ireland, Elec. Eng. Cert., BHA, M Bus., AFCHSE, CHEMr P S Hynes, Dip. H.A.Mrs M Patterson, RN DIV1., RM., B.N., Cert. Critical CareMr W Armistead, B. Com., C.P.A., M.Bus.Mrs H Anderson, RN DIV1., RMMiss E Barker, RN DIV1.,RM,BN,Cert. Lymphodoema.Mrs E McCarthy, RN DIV 1, RM, BNMrs J Westlake, RN DIV1.Ms. D. Orme, RN DIV1.,RMMrs R. Flower, RN DIV1 RM,BN, IBCLCMrs A Stephenson, RN DIV1. (Relieving)Mr S Jones, I.H.E.A., A.F.C.H.S.E.Mr S HendersonMr G. Bennet-Hullin , B.Pharm., M.P.S., M.R.Pharm.(Contract Service)Mr D Walker, B.App.Sc. Physio., Grad.Dip. Manip.Ther.Mrs R Parry, ARMIT, Dip.App. Sci. (Med. Rad),CCPM.Mrs B McIlroy, RN DIV1., R.M.Ms T. Young, B.HIM.Chief Physiotherapist:Chief Imaging Technologist:Drug & Alcohol Unit Manager:Health Information Manager:Infection Control Officer / Environmental Mrs C Pietschmann, RN DIV1.,Cert.I.C.,Cert Peri. Op.,Cert.Intensive Services Supervisor Care ( Resigned January 2005)Mrs R Jones RN Div 1 , Cert I.C. Accredited Cert. ofImmunisationAccredited, HIV& Hep C counsellor,(Commenced January 2005)I.T. ManagerLaboratory Manager:Nurse Educator:Nursing Unit Managers:Mr K TaitMr C van Diemen, B.App.Sc. (St. John of God Pathology)Mrs A Brown, RN DIV1, RM, BN.MRCNAMrs H Antony, RN DIV1, (District Nursing)Mr B Bowman, RN DIV1, R.M. (North Ward)Mrs J Burke, RN DIV1, (Nursing Home) BNMrs H Wormington, RN DIV1. ( South Ward)Mrs J Sealey, RN DIV1. (Theatre)Ms J Ridler, RN DIV1, (Accident & Emergency)(Resigned January 2005)43

Officers and Office BearersNursing Unit Managers:Pay Officer:Primary Care SeniorsCounselling & SupportCommunity NursingPrimary Care Programs andBusiness Systems Ext),Assoc MAPSAllied HealthVolunteers Co-ordinator:Medical StaffVisiting Medical Officers:Anaesthetists:Specialist Surgeon:Medical StaffVisiting Surgeons:Specialist Physician:Visiting Obstetrician & Gynaecologist:Visiting E.N.T. Specialists:Visiting Ophthalmologist:Visiting Paediatrician:Visiting Pathologists:Visiting Radiologists:Orthopaedic Surgeon:Ms L Donlan, RN Div 1,Grad Dip A&E, Grad Dip Teach &Assess’tEmergency Nurse Practitioner (UK) (Accident & Emergency)(Commenced March 2005)Mrs P A CainMs M Risk, RN Div 1, BSW.Mrs R Cole, RN Div 1,RM,BN, Grad Cert (Diab.Ed),MCH, FCNA.Ms J Carmody, BBEHAVSC, BBUS(HONS) Post Grad Dip PsychMs J Swinton, RN DIV1,B. Sc. (OT)Ms Annette HinchcliffeDr. Maan Bashour M.D.Dr. Baghat Bassili MB. ChB B.Sc.Mr J Das, M.B.,B.S.,F.R.C.S.,F.I.C.SDr M Martin, MB.BS.Dr W Rieger, B.Pharm., B. Sc.(Hons), MB. ChB.Dr. J. Risk, MB.BS.Dr M van der Veer, MB. ChB., F.R.A.C.G.P., PG.DIP.GP.,M.R.A.C.G.P. AF.A.C.H.S.E.Dr C Woolner, MB.ChB., D.R.C.O.G., D.Occ. Med.,F.R.A.C.G.P.Dr. S. Hindley, (locum tenens) B.Sc., MB.BCh.Dr. D. Singh, MB.BS., F.R.A.C.G.P.Dr. Paul Goodman, MB.BS., D.A., R.C.O.G. F.R.A.C.G.PDr M Martin, MB.BS, F.A.C.R.R.M.Dr J Stapleton, MB.,F.A.N.Z.A.Dr. A Fielke MB.BS. D.A.Mr. J. Das, M.B.BS., F.R.C.S., F.I.C.S.Mr S Clifforth, MB.BS., F.R.A.C.S.Mr D Bird, MB.BS., F.R.A.C.S.Mr P Tung, MB.BS., F.R.A.C.S.Dr D Taylor, MB.ChB., F.R.C.P,.,F.R.A.C.P.Dr. C. Beaton, MB. ChB., F.R.A.N.Z.C.O.G., M.R.C.GP.,F.R.C.O.G.Dr. K. Braniff, MB.BS., F.R.A.N.Z.C.O.G.Dr. E.Uren, MB.BS., F.R.A.N.Z.C.O.G.Ms M Cass, MB.BS.,F.R.A.C.S.Mr. L Ryan, F.R.A.C.S.,D.L.O.Dr V Lee, F.R.A.C.O., F.R.A.C.S.Dr G Pallas, B.Med.,F.R.A.C.P. (Paed)Dr. N. Thies, MB.BS., D.CH., F.R.A.C.P. (Paed)Dr C M Pilbeam, B.Med.Sc., MB.BS., Ph.D., F.R.C.P.A.,M.I.A.C.Dr N Houghton, MB.BS.,(Lond), M.R.C.S.,L.R.C.P., F.R.A.C.R.,Dr J M Rogan, MB.BCh., B.A.O., D.M.R.D.,F.R.A.C.R., (Lond),F.R.A.C.R.Dr. J.Nagorcka, MB.BS., F.R.A.C.R.Dr. N. Walters, F.R.A.C.R.Mr P Kierce, MB.BS.,F.R.A.C.S, (Ortho)., F.A.,Orth.A.44

Visiting Orthopaedic Surgeon:Visiting Urologist:Visiting Psychiatrists:Visiting Psychologist:Visiting Oral Surgeon:Visiting Alcohol & Drug Physician:Visiting Orthodontist:Visiting Dermatologist:Dental Officer:Visiting Dental OfficersMr N A Sundaram MB.BS.,M.Ch.,(Orth),F.R.C.S. (Edin.&Lond)F.R.C.S. (Orth), L.R.C.P., M.R.C.S., F.R.A.C.S. (Ortho).,F.A. Ortho.A.Mr. R. Grills, M.B. B.S., F.R.A.C.S.Mr B Mooney MB.ChB., B.A.O. F.R.C.S.I., M.Ch., F.R.A.C.S.Dr M.Duke., MB.BS., M.R.C.Psych., F.R.A.N.Z.C.PMr.J.ClarkMr B Robinson, B.D.Sc.(Adel), B.Sc.Dent.(Hons), M.D.S.Dr D Richards, M.B.B.S, A.P.S.A.D.Mr C Stanley, M.D.s., B.SC.(Hons)Dr Suresh Chandra, M.B.B.S. (Melb), F.A.C.D. (Melb).Dr L.CoxDr. M. Stubbs.,Dr K Stock, B.D.Sc.,Dr M Thow, B.D.Sc.Staff by Gender and Employment StatusMale Male Female FemaleCategory of Staff Numbers Numbers Numbers Numbers2004-2005 2003-2004 2004-2005 2003-2004Full-Time 24 23 71 67Part Time 11 12 214 202Casual 1 1 24 2736 36 309 296Staff Numbers in Equivalent Full TimeIn equivalent full time terms the following staff were employed :Category of Staff 00/01 01/02 02/03 03/04 04/05Nursing 124.77 120.43 123.29 134.34 132.50Administration & Clerical 24.24 19.26 22.50 21.79 20.74Medical & Allied Health 15.41 25.84 24.36 26.79 40.57Other Support Services 38.38 40.02 49.76 58.31 55.51Total 202.80 205.55 219.91 241.23 249.3245

Donors & SponsorsDonors $ $Dipalo, Thelma (Estate of the late) 5560 Portland Aluminium 11600Donation In Memory of Sam Englezos 1000 Portland Ladies Bowling Club 278Donation Various Under $50 58 Portland Lutheran Ladies 300Fund Raising ~ Net takings (Rodeo, Fete,Murray to Moyne 41433 Portland Masonic Community 250Jenkins-Fry, Wilma (In memory of Safeway Social Club 300Alfred Sibbison) 100 Sport & Recreation Victoria 10000Lucas, Mrs Cora 100 United Way - Donation 1000Mibus, Mr Ted 50 United Way - Surf for Life 2000Oborn, Moira 100 Wiese, M & S 200Phillips, K & HL 50 William Buckland Foundation 41080Total $115,458SponsorsAction Auto Pro - PortlandAdmella’s OrchardAFL Hall of FameBarrettes WinesBassett and Sharkey SolicitorsBetter Health ChannelBrookesCameron Young AccountantCoastal WholesalersColletts Amcal PharmacyDreamworld on the Gold CoastDuck Inn CaféFamily Video LandFlag Staff Hill - WarrnamboolGlenelg Warehouse and Action CentreHollick’s Wine - CoonawarraKelso WinesKFC – WarrnamboolKingsley WinesLa Pochetta - WarrnamboolMc Donald’s - HamiltonMc Donald’s - WarrnamboolMelbourne Food and Wine FestivalMortlake Buskers FestivalMuffin Break - WarrnamboolRemo PartenzaPharmacyPinky’s Pizza - PortlandPortland AluminiumPortland Coast WaterPortland Gymnastics ClubPortland IGA SupermarketPortland SignworksPortland Star CinemaPortland Surf InPortland YMCAPump House Springs WarrnamboolQuit VictoriaRosanna Bramente Premier BalloonsSafeway PortlandSungold MilkSoverign HillVideo Ezy - PortlandWendy’s – WarrnamboolWilliam Buckland FoundationSincere ThanksPortland District Health sincerely thanks each and everyDonor and Sponsor for their support.We also acknowledgethe numerous donations made to specific fund raising projects , individual departments and wards.46

We pay tribute to those individuals who previously have been recognised for their support of the PortlandDistrict Hospital and Portland & District Community Health Centre.As at 30th June 2005Life Members of the former Portland & District Community Health CentreAssociation for the BlindPortland Neighbourhood HouseMrs Shirley ElliottMr Jack FinckMr Jeff BaulchMrs Gwen FinckMrs Marilyn BaulchMr Jeff KnuckeyMr David HarrisMr W (Bill) CollettMrs Anne LanyonLife Governors of the former Portland & District HospitalAitken, Mrs. M.E.Apex Club of PortlandOugh, Mr. A.K.Baxter, Percy (Trust) Panozzo, Mrs. S.Barker, Mr R Pettit, Mr. P.Brownlaw, Miss E.J. Plantinga, Mrs. M.Chipperfield, Mr. B.Portland AluminiumEdwards, Mrs. BrendaPortland Professional Women’s Service ClubEdwards, Mrs. Betty Poon, Mr. S.Elford, Mrs. P.Pritchard, Mrs. S.I.Farrands, Miss S.M.Rotary Club of PortlandFyfe, Mrs. S.Saunders, Mr. E.A.Godfrey-Smith, Mrs. P.Sharrock, Mrs. M.M.Jennings, Mrs. M.L.Smith, Helen Macpherson (Trust)Kermond, Mrs. J Smith, Mrs. R.Lighbody, Miss E. Stewart, Miss J.Lions Club of PortlandWigan, Mr. J.C.McDiven, Mrs. B. Wilmot, Mrs. P.Maling, Mr. W.G.C. Wombwell, Miss J.Mitchell, Mrs. P.Distinguished Service Award of the former Portland & District HospitalDas, Mr J. 1994Presentation and Distribution of this ReportThis report is released to the public at the Annual General Meeting and is also available as follows:Web Site: www.pdh.net.auDistribution mailing listConsumer Advisory NetworkFrom Portland District Health AdministrationYour Feedback is welcomed and may be made on the enclosed form47

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PORTLAND DISTRICT HEALTHFINANCIAL STATEMENTSFOR THE YEAR ENDED30th JUNE, 200549

Portland District HealthAccountable Officer’s, Chief Finance Accounting Officer’s and Member of Responsible Body’s DeclarationWe certify that the attached financial statements for Portland District Health have been prepared in accordance with Part 4.2 of the StandingDirections of the Minister for Finance under the Financial Management Act 1994, applicable Financial Reporting Directions, Australian AccountingStandards and other mandatory professional reporting requirements.We further state that, in our opinion, the information set out in the statement of financial performance, statement of financial position, statementof cash flows and notes to and forming part of the financial statements, presents fairly the financial transactions during the year ended 30 June 2005and financial position of the Hospital as at 30 June 2005.We are not aware of any circumstance which would render any particulars included in the financial statements to be misleading or inaccurate.................................................................................................ChairpersonMr Vincent Gannon................................................................................................Chief Executive OfficerMrs Marie Shea................................................................................................Chief Finance & Accounting OfficerMr. Wayne Armistead25thAugustDated the ................................................................................of ........................................................................................................2005Portland, Victoria50

FinancialsPortland District HealthStatement of Financial Performance for the Year Ended 30 June 20052004-05 2003-04Note $’000 $’000Revenue From Ordinary Activities 2,2a 24,451 23,271Expenses From Ordinary ActivitiesEmployee Benefits 15,501 14,109Fee for Service Medical Officers 2,568 2,558Agency Costs - Nursing 120 72Supplies and Consumables 2,641 2,975Borrowing Costs 195 220Depreciation and Amortisation [3] 1,786 1,639Share of Net Result of Associates & Joint Ventures accounted 31 34for using Equity ModelOther Expenses From Ordinary Activities 3,071 2,5182b 25,913 24,125Net Result for the Year (1,462) (854)Total Changes in Equity other than those resulting from Changes in Contributed Capital (1,462) (854)This Statement should be read in conjunction with the accompanying notes.51

Portland District HealthStatement of Financial Position As At 30 June 20052005 2004Note $’000 $’000AssetsCurrent AssetsCash Assets [7] - 286Receivables [8] 615 326Inventory [9] 222 242Prepayments 17 42Other Assets [10] 216 471Total Current Assets 1,070 1,367Non Current AssetsReceivables [8] 842 628Property, Plant and Equipment [17] 28,994 29,859Total Non Current Assets 29,836 30,487Total Assets 30,906 31,854LiabilitiesCurrent LiabilitiesPayables [11] 1,237 1,254Interest Bearing Liabilities [12] 298 293Employee Benefits [13] 2,470 2,256Other Liabilities [14] 315 551Total Current Liabilities 4,320 4,354Non Current LiabilitiesInterest Bearing Liabilities [12] 1,793 1,878Employee Benefits [13] 1,541 1,408Total Non Current Liabilities 3,334 3,286Total Liabilities 7,654 7,640Net Assets 23,252 24,214EquityContributed Capital [16] 25,568 25,068Accumulated Surpluses/(Deficit) [16] (2,316) (854)Total Equity 23,252 24,214This Statement should be read in conjunction with the accompanying notes.52

Portland District HealthStatement of Cash Flows for the Year Ended 30 June 20052004-2005 2003-2004$’000 $’000NoteCash Flows from Operating ActivitiesReceiptsGovernment Grants 18,450 17,006Capital Grants - Government 312 295Patient Fees 4,367 4,898Donations 34 385Interest 8 12Other 335 628GST Recovered from ATO 729 828Total Receipts 24,235 24,052PaymentsEmployee Benefits (15,322) (13,607)Supplies and Consumables (6,665) (7,644)GST Paid to ATO (1,907) (1,254)Total Payments (23,894) (22,505)Net Cash Flows From Operating Activities [19] 341 1,547Cash Flows from Investing ActivitiesPurchase of Properties, Plant and Equipment (957) (702)Proceeds from Sale of Properties, Plant and Equipment 53 103Net Cash Used in Investing Activities (904) (599)Cash Flows from Financing ActivitiesRepayment of Borrowings (346) (356)Contributed Capital from Government 500 -Net Cash From/(Used in) Investing Activities 154 (356)Net Increase/(Decrease) in Cash Held (409) 592Cash at July 1 2004 286 (306)Cash at June 30 2005 [5] (123) 286This Statement should be read in conjunction with the accompanying notes.53

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 1: Statement of Accounting PoliciesThe general purpose financial report has been prepared on an accrual basis in accordance with the Financial Management Act 1994, AustralianAccounting Standards, Statements of Accounting Concepts and other authoritative pronouncements of the Australian Accounting Standards Board,and Urgent Issues Group Consensus Views.It is prepared in accordance with the historical cost convention, except for certain assets and liabilities which, as noted are at valuation. Theaccounting policies adopted, and the classification and presentation of items, are consistent with those of the previous year, except where a change isrequired to comply with an Australian Accounting Standard or Urgent Issues Group Consensus View, or an alternative accounting policy permittedby an Australian Accounting Standard is adopted to improve the relevance and reliability of the financial report. Where practicable, comparativeamounts are presented and classified on a basis consistent with the current year.(a)Amalgamations and MergersAssets and Liabilities of the amalgamated entities were taken up at book value at date of amalgamation. Crown assets acquired remain theproperty of the Crown, however they are reported as assets of the entity, because effective control passes to the entity along with a substantialbenefit. Amalgamation between Portland & District Hospital and Portland and District Community Health Centre occurred on 1 July2003.(b)Adoption of International Financial Reporting Standards (IFRS)For reporting periods beginning on or after 1 January 2005, all Australian reporting entities are required to adopt the financial reportingrequirements of the Australian equivalents to International Financial Reporting Standards (IFRS).Portland District Health has established a project team to manage the transition to A-IFRS, including training of staff and system and internalcontrol changes necessary to gather all of the required financial information.The project team has analysed all of the A-IFRS and A-IFRS Financial Reporting Directions to identify the accounting policy changes thatwill be required.The known or reliably estimable impacts on the financial report for the year ended 30 June 2005 had it been prepared using A-IFRS are setout in Note 29.(c)ReceivablesTrade debtors are carried at nominal amounts due and are due for settlement within 30 days from the date of recognition. Collectability ofdebts is reviewed on an ongoing basis, and debts which are known to be uncollectible are written off. A provision for doubtful debts is raisedwhere doubt as to the collection exists.(d)InventoriesInventories are valued at the lower of cost and net realisable value. Cost is determined principally by the weighted average cost method.(e)Other Financial AssetsOther Financial Assets are valued at cost and classified between current and non-current assets based on the Hospital Board of Management’sintention at balance date with respect to the timing of disposal of each investment. Interest revenue from other financial assets is brought toaccount when it is earned.(f)Revaluation of Non-Current AssetsSubsequent to the initial recognition as assets, non-current physical assets, other than plant and equipment, are measured at fair value. Plantand Equipment and Furniture and Fittings are measured at cost. Revaluations are made with sufficient regularity to ensure that the carryingamount of each asset does not differ materially from its fair value at the reporting date. Revaluations are assessed annually and supplementedby independent assessments, at least every three years. Revaluations are conducted in accordance with the Victorian Government Policy PaperRevaluation of Non-Current Physical Assets.54

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Revaluation increments are credited directly to the asset revaluation reserve, except that, to the extent that an increment reverses a revaluationdecrement in respect of that class of asset previously recognised as an expense in net result, the increment is recognised immediately as revenuein the net result.Revaluation decrements are recognised immediately as expense in the net result, except that, to the extent, that a credit balance exists in theasset revaluation reserve in respect of the same class of assets, they are debited directly to the asset revaluation reserve.Revaluation increments and decrements are offset against one another within a class of non-current assets.(g)DepreciationAssets with a cost in excess of $1,000 are capitalised and depreciation has been provided on depreciable assets so as to allocate their cost (orvaluation) over their estimated useful lives using the straight-line method. Estimates of the remaining useful lives for all assets are reviewed atleast annually. This depreciation charge is not funded by the Department of Human Services.The following table indicates the expected useful lives of non current assets on which the depreciation charges are based.2004-2005 2003-2004Buildings Up to 50 years Up to 50 yearsPlant and Equipment Up to 10 years Up to 10 yearsMedical Equipment Up to 10 years Up to 10 yearsComputer Equipment Up to 5 years Up to 5 yearsMotor Vehicles Up to 5 years Up to 5 yearsLeased Assets Up to 5 years Up to 5 yearsOther Equipment Up to 10 years Up to 10 years(h)PayablesThese amounts represent liabilities for goods and services provided prior to the end of the financial year and which are unpaid. The normalcredit terms are usually Net 30 days.(I)Interest Bearing LiabilitiesInterest bearing liabilities in the Statement of Financial Position are carried at face value less unamortised discount/premium. Any discount/premium is treated as an interest charge and amortised over the term of the debt. Interest is accrued over the period it becomes due and isrecorded as part of other creditors.(j)Goods and Services TaxRevenues, expenses and assets are recognised net of GST except for receivables and payables which are stated with the amount of GST includedand except where the amount of GST incurred is not recoverable, in which case GST is recognised as part of the cost of acquisition of anasset or part of an item of expense or revenue. GST receivable from and payable to the Australian Taxation Office (ATO) is included in theStatement of Financial Position. The GST component of a receipt or payment is recognised on a gross basis in the Statement of Cashflows inaccordance with Accounting Standard AAS 28.(k)Employee BenefitsEmployee benefit liabilities are based on pay rates expected to apply when the obligation is settled. On-costs such as Workcover andsuperannuation are included in the calculation of leave provisions.55

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Long Service LeaveThe provision for long service leave is determined in accordance with Accounting Standard AASB 1028. The liability for long service leaveexpected to be settled within 12 months of the reporting date is recognised in the provision for employee benefits as a current liability. Theliability for long service leave expected to be settled more than 12 months from the reporting date is recognised in the provision for employeebenefits as a non-current liability and measured as the present value of expected future payments to be made in respect of services provided byemployees up to the reporting date. Consideration is given to expected future wage and salary levels, experience of employee departures andperiods of service. Expected future payments are discounted using interest rates on national Government guaranteed securities with terms tomaturity that match, as closely as possible, the estimated future cash outflows.Wages and Salaries, Annual Leave and Accrued Days OffLiabilities for wages and salaries, annual leave and accrued days off expected to be settled within 12 months of the reporting date are recognisedas a current liability, and are measured as the amount unpaid at the reporting date in respect of employees’ services up to the reporting date andare measured as the amounts expected to be paid when the liabilities are settled.SuperannuationThe amount charged to the Statement of Financial Performance in respect of superannuation represents the contributions made by PortlandDistrict Health to the superannuation fund.Employee Benefit On-CostsEmployee benefit on-costs are recognised and included in employee benefit liabilities and costs when the employee benefits to which theyrelate are recognised as liabilities.(l)Borrowing CostsBorrowing costs are recognised as expenses in the period in which they are incurred, except where they are included in the costs of qualifyingassets.Borrowing costs include:- interest on bank overdrafts and short term and long term borrowings:- amortisation of discounts or premiums relating to borrowings:- amortisation of ancillary costs incurred in connection with the arrangement of borrowings:- finance charges in respect to finance leases recognised in accordance with AAS17 “Accounting for Leases”.The capitalisation rate used to determine the amount of borrowing costs to be capitalised is the weighted average interest rate applicable to theHospital’s outstanding borrowing during the year.(m) Nursing HomeThe Seymour Cundy Wing Nursing Home is an integral part of the Hospital and share its resources. An apportionment of land and buildingshas been made based on floor space. The results of the two operations have been segregated based on actual revenue earned and expenditureincurred by each operation.(n)Leased Property and EquipmentA distinction is made between finance leases which effectively transfer from the lessor to the lessee substantially all the risks and benefitsincidental to ownership of leased non-current assets, and operating leases under which the lessor effectively retains all risks and benefits. Wherea non-current asset is acquired by means of a finance lease, the minimum lease payments are discounted at the interest rate implicit in the lease.The discounted amount is established as a non-current asset at the beginning of the lease term and is amortised on a straight-line basis overits expected economic life. A corresponding liability is established and each lease payment is allocated between the principal component andthe interest expense. Operating lease payments are representative of the pattern of benefits derived from the leased assets and accordingly areexpensed in the periods in which they are incurred.(o)Revenue RecognitionRevenue is recognised in accordance with AAS15. Income is recognised as revenue to the extent it is earned. Unearned income at reportingdate is reported as income received in advance.Amounts disclosed as revenue are, where applicable, net of returns, allowances and duties and taxes.56

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Government GrantsGrants are recognised as revenue when the Hospital gains control of the underlying asset. Where grants are reciprocal, revenue is recognisedas performance occurs under the grant. Non-reciprocal grants are recognised as revenue when the grant is received or receivable. Conditionalgrants may be reciprocal or non-reciprocal depending on the terms of the grant.Indirect Contributions- Insurance is recognised as revenue following advise from the Department of Human Services.- Long Service Leave - Revenue is recognised upon finalisation of movements in LSL liability in line with the arrangements set out in the AcuteHealth Division Hospital Circular 16/2004.Patient FeesPatient fees are recognised as revenue at the time invoices are raised.Private Practice FeesPrivate Practice fees are recognised as revenue at the time invoices are raised.Donations and Other BequestsDonations and bequests are recognised as revenue when the cash is received. If donations are for a special purpose they may be appropriatedto a reserve, such as specific restricted purpose reserve.(p)Fund AccountingThe Hospital operates on a fund accounting basis and maintains two funds: Operating and Capital funds. The Hospital’s Capital Fund includesunspent capital donations and receipts from fundraising activities conducted solely in respect of this fund.(q)Services Supported by Health Services Agreement and Services Supported by Hospital and Community Initiatives.The activities classified as Services Supported by Health Services Agreement (HSA) are substantially funded by the Department of HumanServices while Services Supported by Hospital and Community Initiatives (Non HSA) are funded by the Hospital’s own activities or localinitiatives.(r)Comparative InformationWhere necessary the previous year’s figures have been reclassified to facilitate comparisons.(s)Rounding OffAll amounts shown in the financial statements are expressed to the nearest $1,000.(t)Contributed CapitalConsistent with UIG Abstract 38 ‘Contributions by Owners Made to Wholly-Owned Public Sector Entities’ and Financial Reporting Direction2 “Contributed Capital”, transfers that are in the nature of contributions or distributions, have been designated as contributed capital.(u)Portland District Health has applied the going concern basis, in the preparation of this financial report. The going concern basis continues tobe appropriate with the expected renewal of the Health Service’s bank overdraft and a letter of comfort provided by the Department of HumanServices to continue to support the operations of Portland District Health has been received.57

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 2: RevenueHSA Non HSARevenue from Operating Activities 2004-2005 2004-2005 2004-05 2003-04Recurrent $’000 $’000 $’000 $’000Government Contributions:- Department of Human Services 16,133 - 16,133 15,095- Dental Health Services Victoria 283 - 283 68- State Government - Other 745 - 745 685- Commonwealth Government 855 - 855 755Indirect Contributions by Human Services 415 19 434 403Patient & Resident Fees (refer note 2c) 2,101 23 2,124 2,313Capital Purpose IncomeState Government Capital Grants- Targeted Capital Works and Equipment 312 - 312 192Commonwealth Government Capital Grants 30 - 30 103Donations & Bequests - 34 34 385Interest - 11 11 12Other - 523 523 350Sub-Total Revenue from Operating Activities 20,874 610 21,484 20,361Revenue from Non-Operating ActivitiesDiagnostic Imaging - 1,128 1,128 995Supported Residential service - 1,621 1,621 1,678Meals on Wheels - 165 165 134Proceeds from Sale of Non-Current Assets (refer note 2d) - 53 53 103Sub-Total Revenue from Non-Operating Activities - 2,967 2,967 2,910Total Revenue from Ordinary Activities 20,874 3,577 24,451 23,271Indirect Contributions by Human ServicesDepartment of Human Services makes certain payments on behalf of the organisation. These amounts have been brought to account in determining the operating result for theyear recording them as revenue and expensesNote 2a: Analysis of Revenue by SourceAcute Aged Primary OtherRevenue from Services Supported by Health Care Care Health 2004-05 2003-04Services Agreement $’000 $’000 $’000 $’000 $’000 $’000Government Grants- Department of Human Services 15,641 - 1,419 396 17,456 16,631- Dental Health Services Victoria - - - 283 283 68- Commonwealth Government - 381 - - 381 381Indirect Contributions by Human Services- Insurance 384 34 12 4 434 403- Long Service Leave 214 - - - 214 -Patient & Resident Fees (refer note 2c) 403 1,665 33 23 2,124 2,313Other - - - 244 244 63Sub-Total Revenue from Services Supported by Health 16,642 2,080 1,464 950 21,136 19,859Service AgreementsRevenue from Services Supported by Hospital and Community InitiativesBusiness Units- Diagnostic Imaging - - - 1,128 1,128 995- Supported Residential service - - - 1,621 1,621 1,678- Meals on Wheels - - - 165 165 134Other ActivitiesCapital Purpose Income - - - 312 312 107Proceeds from Sale of Non-Current Assets (refer note 2d) - - - 53 53 103Donations and Bequests - - - 34 34 385Other - - - 2 2 10Sub-Total Revenue from Services Supported by Hospital - - - 3,315 3,315 3,412and Community InitiativesTotal Revenue from all Sources 16,642 2,080 1,464 4,265 24,451 23,27158

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 2b: Analysis of Expenses by SourceAcute Aged Primary OtherCare Care Health 2004-05 2003-04$’000 $’000 $’000 $’000 $’000 $’000Services Supported by Health Services AgreementEmployee BenefitsSalaries and Wages 9,382 1,398 1,336 144 12,260 10,889WorkCover 172 40 33 9 254 318Long Service Leave 96 15 11 8 130 130Superannuation (refer note 23) 963 125 120 33 1,241 1,317Non Salary Labour costsFees for Visiting Medical Officers 1,740 - - 42 1,782 1,762Agency Costs - Nursing 120 - - - 120 72Supplies and ConsumablesDrug Supplies 425 17 - - 442 516Medical and Surgical Supplies 1,256 35 42 33 1,366 1,680Food Supplies 217 52 9 - 278 276Other ExpensesDomestic Services 241 41 2 - 284 275Insurance Costs funded by DHS 384 34 12 4 434 403Repairs and Maintenance 578 52 14 - 644 598Patient Transport 102 - - - 102 72Other administrative expenses 907 62 61 263 1,293 864Sub Total Expenses from Services Supported by 16,583 1,871 1,640 536 20,630 19,172Health Services AgreementServices Supported by Hospital and CommunityInitiativesEmployee BenefitsSalaries and Wages - - - 1,443 1,443 1,328WorkCover - - - 30 30 26Long Service Leave - - - 18 18 18Superannuation (refer note 23) - - - 125 125 83Non Salary Labour costsFee for Service Medical Officers - - - 786 786 796Supplies and ConsumablesMedical and Surgical Supplies - - - 365 365 354Food Supplies - - - 190 190 149Other ExpensesDomestic Services - - - 9 9 7Repairs and Maintenance - - - 85 85 70Administrative Expenses - - - 154 154 130Sub-Total Services supported by Hospital - - - 3,205 3,205 2,961Hospital and Community InitiativesDepreciation and Amortisation (refer note 3) 1,045 245 101 395 1,786 1,639Audit FeesAuditor General’s - - - 10 10 10Other -Borrowing Costs (refer note 4) 41 - - 154 195 220Share of Net Result of Associates & Joint Ventures - - - 31 31 34for using Equity Model (refer Note 21)Written Down Value of Assets Sold (refer note 2 d) - - - 56 56 89Total Expenses for Ordinary Activities 17,669 2,116 1,741 4,387 25,913 24,12559

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 2c: Patient and Resident FeesTotalTotalPatient and Resident Fees Raised: 2004-05 2003-04Recurrent $’000 $’000Acute- Inpatients 403 632- Outpatient 33 55Residential Aged Care- Nursing Home 1,665 1,619Other 23 7Total 2,124 2,313Note 2d: Sale of Non Current Assets2004-05 2003-04$’000 $’000Proceeds from Disposal of Assets- Motor Vehicles 53 103Total Proceeds from Disposal of Assets 53 103Less: Written Down Value of Assets Sold- Motor Vehicles (56) (89)Total Written Down Value of Assets Sold (56) (89)Net gain on disposal (3) 14Note 2e: Analysis of Expenses by Business Unit for Services Supportedby Hospital and Community Initiatives2004-05 2003-04$’000 $’000Diagnostic Imaging 1,169 1,042Sea View House 1,528 1,532Meals on Wheels 126 113Dental Clinic 269 85Palliative Care 42 40Catering 39 42Other Activities:Fundraising 18 35Total 3,191 2,88960

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 3: Depreciation and Amortisation2004-05 2003-04$’000 $’000Depreciation:Buildings 573 573Plant & Equipment 423 451Medical Equipment 181 165Computer Equipment 305 228Motor Vehicles 93 88Other Equipment 74 72Total Depreciation Expenses 1,649 1,577Amortisation:Leased AssetsPlant and Equipment 56 55Other Equipment 3 6Computers 2 1Total Amortisation Expenses 61 62Total Depreciation and Amortisation before Joint Venture 1,710 1,639Information Technology Joint Venture - Computers 76 92Total Depreciation and Amortisation 1,786 1,731Allocation of Depreciation /AmortisationServices Supported by Health Services Agreement 1,428 1,311Services Supported by Hospital and Community 358 328InitiativesTotal Depreciation and Amortisation 1,786 1,639Note 4: Borrowing Costs2004-05 2003-04$’000 $’000Finance Charges on Finance Leases 41 42Interest on Borrowings - Short Term 154 178Finance Lease Liability 195 220Note 5: Cash AssetsFor the purposes of the Statement of Cash Flows, cash assets includes cash on hand and in banks, and short term deposits which are readilyconvertible to cash on hand, and are subject to an insignificant risk of change in value, net of outstanding bank overdrafts.2004-05 2003-04$’000 $’000Cash at Bank - 286Bank Overdraft (123) -Total (123) 28661

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 6: Financial Instruments(a) Interest Rate Risk ExposureThe Hospital’s exposure to interest rate risk and effective weighted average interest rate by maturity periods is set out in the following timetable. Forinterest rates applicable to each class of asset or liability refer to individual notes to the financial statements. Exposure arises predominantly fromassets and liabilities bearing variable interest rates.WeightedInterest Rate Exposure as at 30/6/2005 Average Interest Floating 1 Year Greater thanRates Interest Rate or Less 1 Year 2004-05 2003-04% $’000 $’000 $’000 $’000 $’000Financial AssetsCash Assets 2.6% - - - - 286Receivables 2.3% 615 - 842 1,457 954Other Assets 2.3% 216 - - 216 471-Total Financial Assets 831 - 842 1,673 1,711Financial LiabilitiesPayables 3.5% 1,237 - - 1,237 1,254Borrowings:- Overdraft 3.8% 123 - - 123 -- Lease 8.7% 4 - - 4 216- Treasury Corporation Victoria - Current 5.7% 171 - - 171 240- Treasury Corporation Victoria - Non-Current 5.7% 1,793 1,793 1,715Total Financial Liabilities 3,328 - - 3,328 3,425Net Financial Assets and Liabilities (2,497) - 842 (1,655) (1,714)(b) Credit Risk ExposureCredit risk represents the loss that would be recognised if counterparties fail to meet their obligations under the respective contracts at maturity. Thecredit risk on financial assets of the entity have been recognised on the statement of financial position, as the carrying amount, net any provisionsfor doubtful debts.(c) Net Fair Value of Financial Assets and LiabilitiesThe carrying amount of financial assets and liabilities contained within these financial statements is representative of the net fair value of eachfinancial asset or liability.2004-05 2003-04Net Fair Value Book Net Book NetValue Fair Value FairValueValue$’000 $’000 $’000 $’000Financial AssetsCash at Bank - - 286 286Trade Debtors 1,457 1,457 954 954Other Assets 216 216 471 471Total Financial Assets 1,673 1,673 1,711 1,71Financial LiabilitiesPayables 1,237 1,237 1,254 1,254Borrowings* 298 298 2,171 2,171Total Financial Liabilities 1,535 1,535 3,425 3,425*Net fair values are capital amounts(Net fair values of financial instruments are determined on the following basis:1. Cash, deposit investments, cash equivalents and non-interest bearing financial assets and liabilities (trade debtors, other receivables, trade creditorsand advances) are valued at cost which approximates net fair value.2. Interest Bearing Liabilities amounts are based on the present value of expected future cash flows, discounted at current market interest rates,quoted for trade (Treasury Corporation of Victoria)62

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 7: Cash AssetsOperating Capital2005 2004$’000 $’000 $’000 $’000Current - - - 286A.N.Z. Bank - - - 286Note 8: Receivables2005 2004Current $’000 $’000Patient Debtors 199 162Other Trade Debtors 323 95Revenue Receivable - DHS - 72Revenue Receivable - Other 70 -South West Alliance of Rural Hospitals 36 10Total Current 628 339Non CurrentDHS Debtor 842 628Total Non Current 842 628Total Receivables 1,470 967Less Provision for Doubtful Debts (13) (13)Total 1,457 954Note 9: Inventory 2005 2004$’000 $’000Pharmaceuticals 44 62Catering Supplies 24 22House Keeping Supplies 15 18Medical and Surgical Supplies 104 110Administration Stores 35 30Total Inventory 222 242Note 10: Other Financial Assets2005 2004$’000 $’000Money Held in Trust 16 29Refundable Entrance Fees 80 263SRS Ingoing Debtors 120 179Total Other Assets 216 47163

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 11: Payables2005 2004$’000 $’000Trade Creditors 1,023 972Accrued Expenses 75 155GST Payable 139 127Total Payables 1,237 1,254Note 12: Interest Bearing Liabilities2005 2004Current $’000 $’000Bank Overdraft 123 -Australian Dollar Borrowings:- Finance Lease Liabilities (refer Note 15) 4 53- Loan - Treasury Corporation Victoria 171 -- Trade Bills - NAB - 240Total Australian Dollar Borrowings 298 293Non-CurrentAustralian Dollar Borrowings:- Finance Lease Liabilities (refer Note 15) - 163- Loan - Treasury Corporation Victoria 1,793 -- Trade Bills - NAB - 1,715Total Australian Dollar Borrowings 1,793 1,878Total Interest Bearing Liabilities 2,091 2,171Note 13: Employee Benefits2005 2004$’000 $’000CurrentLong Service Leave 626 526Accrued Wages and Salaries 432 430Annual Leave 1,373 1,255Accrued Days Off 39 45Total Current Employee Benefits 2,470 2,256Non-CurrentLong Service Leave 1,541 1,408Total Non-Current Employee Benefits 1,541 1,408Movement in Long Service LeaveBalance 1 July 1,934 -Provision made during the year 361 2,082Settlement made during the year (128) (148)Balance 30 June 2,167 1,934The following assumptions were adopted in measuring present value:2,005 2,004Weighted Average Increase in employee costs 2.6% 2.7%Weighted average Discount Rates 2.4% 2.5%Weighted Average Settlement period 12.5 1264

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 14: Other Liabilities Total Total2005 2004$’000 $’000Provision for Fee Sharing 39 39Monies Held in Trust 216 471Other - PCP 60 41Total 315 551Note 15: CommitmentsAs at 30th June 2005, Portland District Health had commitments totalling $2,089,000 which includes the contribution made to South WestAlliance of Rural Hospitals of which Portland District Health is committed for a further 1 year.Not Later than Later thanone year one year andnot later than Total Totalten years 2005 2004Capital Commitments $’000 $’000 $’000 $’000Other - SWARH - - - 321Sub-Total - - - 321Lease CommitmentsOperating Lease 64 57 121 95Finance Lease 4 - 4 216Loan 171 171 1,793 1,964 1,955Sub-Total 239 1,850 2,089 2,266Total 239 1,850 2,089 2,587Note 16: Equity 2005 2004$’000 $’000Accumulated Surpluses/(Deficit)Balance at Beginning of Year (854) -Net result for the Year (1,462) (854)Accumulated Surplus/(Deficit) at the end of the financial year (2,316) (854)Contributed CapitalBalance at the beginning of the reporting period 25,068 -Capital Contribution received during the period (refer Note 25) - 25,068Capital Contributed From the Victorian Government 500 -Balance at the end of the reporting period 25,568 25,068EquityBalance at beginning of reporting period 24,214 -Total Changes in Equity Recognised in the Statement of Financial (1,462) (854)PerformanceCapital Contributed From the Victorian Government 500 -Amalgamation - 25,068Total Equity at Reporting Date 23,252 24,21465

Portland District HealthNotes to an Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 17: Property, Plant and Equipment2005 2004$’000 $’000At CostBuildings 665 474Less Accumulated Depreciation 115 86550 388Plant & Equipment 6,323 6,183Less Accumulated Depreciation 4,030 3,5432,293 2,640Medical Equipment 2,328 2,047Less Accumulated Depreciation 1,718 1,539610 508Computer Equipment 1,814 1,590Less Accumulated Depreciation 1,487 1,116327 474Other Equipment 592 517Less Accumulated Depreciation 346 271246 246Motor Vehicles 575 570Less Accumulated Depreciation 262 194313 376At ValuationCrown Land (at 2003 Valuation) 2,900 2,900Buildings (at 2003 Valuation) 22,900 22,900Less Accumulated Depreciation 1,145 57321,755 22,327Total Property, Plant & Equipment 28,994 29,859Reconciliation of the carrying amounts of each class of land, buildings, plant & equipment at the beginning and end of the current and previous financialyear are set out below:Crown Buildings Plant & Medical Computer Other Motor TotalLand Equipment Equipment Equipment Equipment Vehicles$’000 $’000 $’000 $’000 $’000 $’000 $’000 $’0002005Opening Balance at start of Year 2,900 22,715 2,640 508 474 246 376 29,859Assets bought to account via -amalgamationAdditions - 170 137 282 225 77 87 978Disposals - - - - - - (57) (57)Depreciation Expense - (580) (484) (180) (372) (77) (93) (1,786)Carrying amount at end of year 2,900 22,305 2,293 610 327 246 313 28,99466

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 18: Leased AssetsTotalTotal2005 2004$’000 $’000CostFinance Leased Assets- Plant & Equipment 6 308less Accumulated Amortisation (2) (114)Total Written Down Value 4 194Reconciliation of the carrying amounts of Leased Assets at the beginning and end of the current and previous financial year are set out belowLeased Assets Leased Assets$’000 $’000Carrying amount at start of year 194 -Transfer of assets on amalgamation - 261Additions - -Expires (188) (5)Amortisation Expense (2) (62)Carrying amount at end of year 4 194Note 19: Reconciliation of Net Cash Used in Operating Activities to Operating Result2005 2004$’000 $’000Net Result for the Year (1,462) (854)Depreciation 1,786 1,731Long Service Leave Expense 342 583Long Service Leave Paid (128) (148)Loss on Sale of Assets 3 (14)Changes in Operating Assets and Liabilities:Increase/(Decrease) in Payables (20) 308Increase/(Decrease) in Borrowings (97) (168)Increase/(Decrease) in Employee Benefits 347 626Increase/(Decrease) in Other Current Liabilities (224) (423)(Increase)/Decrease in Prepayments 25 21(Increase)/Decrease in Stores 20 (6)(Increase)/Decrease in Receivables (506) (307)(Increase)/Decrease in Other Current Assets 255 198Net Cash Flows From Operating Activities 341 1,54767

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 20: Lease LiabilitiesAggregate Lease Expenditure contracted for at Balance Date. 2005 2004Operating Lease $’000 $’000Not later than one year 8 49Later than 1 but not later than five 6 46yearsTotal 14 95Finance LeaseCommitment in relation to financeleases are payable as follows:Not later than one year 4 53Later than 1 but not later than five years - 163Total 4 216Minimum Lease Payments 4 216Less Future Finance Charges - (36)Total 4 180Representing Lease LiabilitiesCurrent 4 102Non-Current - 209Total 4 311Note 21: S.W.A.R.H. AllianceThe Hospital has 11.40% interest in the S.W.A.R.H. Alliance whose principal activity is the implementing and processing of an informationtechnology system and an associated telecommunication service suitable for use by each member hospitalThe hospitals share of assets, liabilities and income is: 2005 2004$’000 $’000Current AssetsCash Asset 83 87Receivables 36 10Prepayments 6 30Total 125 127Non-current assetsBuildings 158 166Plant & Equipment (112) (95)Total 46 71Total Assets 171 198Current LiabilitiesPayables 41 45Employee Entitlements 17 10Total Liabilities 58 55Share of Net Result of Associates & Joint Ventures (31) (34)for using Equity ModelThese assets and liabilities are included in the Statement of Financial Position for Portland District Health.68

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 22: Contingent Liabilities/AssetsAs at balance date the Board of Management is unaware of the existence of any contingent liabilities/assets that may have a material effect on theStatement of Financial Performance as a result of any future event which may or may not happen.Note 23: SuperannuationSuperannuation contributions for the reporting period are included as part of salaries and associated costs in the Statement of Financial Performanceof the Hospital.The name and details of the major employee superannuation fund and contributions made by the Hospital are as follows:Contribution for the year 2005 2004$000 $000Health Super Fund 1,366 1,400Total 1,366 1,400The unfunded superannuation liability in respect to members of State Superannuation Schemes and Health Super Scheme is not recognised in theStatement of Financial Position. Portland District Health’s total unfunded superannuation liability in relation to these funds has been assumed byand is reflected in the financial statements of the Department of Treasury and Finance.The above amounts were measured as at 30 June of each year, or in the case of employer contributions they relate to the years ended 30 June.All employees of the agency are entitled to benefits on retirement, disability or death from the Government Employees Super Fund. This fundprovides defined lump sum benefits based on years of service and annual average salary.In accordance with the Directions of the Minister for Finance under the Financial Management Act 1994, contributed income sector bodies arerequired to make certain disclosures regarding superannuation. Accordingly the following items are disclosed;(i) Name of the Fund - Health Super Fund(ii) Total contributions made by the Hospital to the schemes during 2004-05 were $1,366,475(iii) As at balance date there were no outstanding contributions in respect of the 2004-05 financial year;(iv) Contributions are paid in accordance with the Hospitals Superannuation Act 1988 and the State Superannuation Act 1988;(v) There were no loans made from the Hospitals Superannuation Fund to the Hospital.Note 24: Valuation of Land & BuildingsPortland & District Hospital contracted the services of Alison Mcleod AAPI from Land Link Property Group to revalue the land and buildingsowned by Portland & District Hospital. Valuations were completed on 30/6/03 and totalled $2,900,000 for Land (previously $1,000,000 - 1999)and $22,900,000 for buildings (previously $19,000,000 - 1999). These assets were transferred to Portland District Health on 1st July 2003 and inthe Board of Management’s opinion, there is no material change to the value of these assets.Note 25: Amalgamation Portland & District Hospital and Portland & District Community Health CentreAn order pursuant to Sections 8(1), 33(7), 34(1) and 65 of the Health Services Act 1988 confirmed that the amalgamation of Portland and DistrictHospital and Portland & District Community Health Centre proceed and that the new entity would be known as Portland District Health.The order took effect on 1 July 2003.The net assets of the two entities were recognised as Contributed Capital in the Statement of Financial position of the new Entity.Portland & District Portland and District TotalHospital Community Health 2003CentreTotal Assets 33,175 238 33,413Total Liabilities 8,237 108 8,345Net Assets 24,938 130 25,06869

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 26: Remuneration of AuditorsAudit fees paid to the Victorian Auditor-General’s Office for audit of the Hospitals financial reportTotalTotal2004-2005 2003-2004$’000 $’000Paid as at 30 June 2005 4 4Payable as at 30 June 2005 6 6Note 27: Segment ReportingHospital Hospital Nursing Home Nursing Home Primary Care Primary Care Other Other Total Total2005 2004 2005 2004 2005 2004 2005 2004 2005 2004$’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000 $’000Segment Revenue from 16,642 15,623 2,080 2,034 1,464 1,364 4,265 4,250 24,451 23,271Total Revenue 16,642 15,623 2,080 2,034 1,464 1,364 4,265 4,250 24,451 23,271Allocated Segment Expense 16,624 15,738 1,871 1,639 1,640 1,306 3,991 3,803 24,126 22,486- Depreciation and 1,045 1,039 245 215 101 96 396 289 1,787 1,639Total Expense 17,669 16,777 2,116 1,854 1,741 1,402 4,387 4,092 25,913 24,125Net Result from Ordinary (1,027) (1,154) (36) (180) (277) (38) (122) (158) (1,462) (854)ActivitiesSegment Assets 30,215 31,128 468 485 134 149 89 92 30,906 31,854Total Assets 30,215 31,128 468 485 134 149 89 92 30,906 31,854Segment Liabilities 7,411 7,402 185 186 46 44 12 8 7,654 7,640Total Liabilities 7,411 7,402 185 186 46 44 12 8 7,654 7,640The major product/services from which the above segments derive revenue are:Business SegmentsHospitalNursing HomePrimary HealthSupported Residential ServiceServicesAcute HealthAged CarePrimary CareSupported Residential ServiceGeographical SegmentPortland District Health operates predominantly in the South West of Victoria. All revenue, net surplus from ordinary activities and segment assetsrelate to operations in Portland, Victoria.70

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 28: Responsible Person Related Disclosures(a) Responsible PersonsThe names of persons who were Responsible Persons at any time during the financial year for the purposes of the Financial Management Act 1994are:Mr. Christopher J. Conway Mr. Vincent Gannon Mr. Ian StanfordMr. Andrew Wilson Mrs Merlyn Menzel Mr. William E. BassettMr. Stephen Garner Ms Jennifer Purdie Mr Greg AndrewsMrs Carman Ward Mr. James Harpley Ms Marianne KuljisMr. Alwin GallinaDr. Peter (Syd) Allen (Acting CEO)Mrs Marie Shea (CEO, appointed 4/7/05)Responsible Ministers The Hon. John ThwaitesThe Hon. Bronwyn Pyke(b) Remuneration of Responsible PersonsNo responsible person received remuneration from the Health Service in relation to their duties as responsible persons.The remuneration of the Accountable Officer who is not a member of the Board is reported under “Executive Officer Remuneration(c) Amount Attributable to other transactions with Responsible persons:TotalTotalResponsible Person Transaction 2005 2004$’000 $’000Mr. Christopher J. Conway Physiotherapy Services 2 56Dr. M. Thow Dental Services - 1(d) Executive Officer RemunerationThe number of Executive Officers whose total remuneration exceeded $110,000 are shown below in their relevant income Bands:2005 2004No.No.$150,000-$159,999 1 171

Portland District HealthNotes to and Forming Part of the Financial Statements for the Year Ended 30 June 2005Note 29: Impacts of adopting AASB equivalents to IASB standardsFollowing the adoption of Australian equivalents to International Financial Reporting Standards (A-IFRS), the Agency will report for the first timein compliance with A-IFRS when results for the financial year ended 30 June 2006 are released.It should be noted that under A-IFRS, there are requirements that apply specifically to not-for-profit entities that are not consistent with IFRSrequirements. The Agency is established to achieve the objectives of government in providing services free of charge or at prices significantly belowtheir cost of production for the collective consumption by the community, which is incompatible with generating profit as a principal objective.Consequently, where appropriate, the Agency applies those paragraphs in accounting standards applicable to not-for-profit entities.An A-IFRS compliant financial report will comprise a new statement of changes in equity in addition to the three existing financial statements,which will all be renamed. The Statement of Financial Performance will be renamed as the Operating Statement, the Statement of Financial Positionwill revert to its previous title as the Balance Sheet and the Statement of Cash Flows will be simplified as the Cash Flow Statement. However, forthe purpose of disclosing the impact of adopting A-IFRS in the 2004-2005 financial report, which is prepared under existing accounting standards,existing titles and terminologies will be retained.With certain exceptions, entities that have adopted A-IFRS must record transactions that are reported in the financial report as though A-IFRShad always applied. This requirement also extends to any comparative information included within the financial report. Most accounting policyadjustments to apply to A-IFRS retrospectively will be made against accumulated surplus/(deficit) at the 1 July 2004 opening balance sheet date forthe comparative period. The exceptions include deferral until 1 July 2005 of the application and adjustments for:- AASB 132 Financial Instruments: Disclosure and Presentation;- AASB 139 Financial Instruments: Recognition and Measurement;- AASB 4 Insurance Contracts;- AASB 1023 General Insurance Contracts (revised July 2004); and- AASB 1038 Life Insurance Contracts (revised July 2004).The comparative information for transactions affected by these standards will be accounted for in accordance with existing accounting standards.The Agency has taken the following steps in managing the transition to A-IFRS and has achieved the following scheduled milestones:- established a steering committee to oversee the transition to and implementation of the A-IFRS;- established an A-IFRS project team to review the new accounting standards to identify key issues and the likely impacts resulting from the adoptionof A-IFRS and any relevant Financial Reporting Directions as issued by the Minister for Finance;- Portland District Health’s Finance Staff participated in an education and training process for finance staff to raise awareness of the changes inreporting requirements and the processes to be undertaken; and- initiated reconfiguration and testing of user systems and processes to meet new requirements.This financial report has been prepared in accordance with Australian accounting standards and other financial reporting requirements (AustralianGAAP). We have not identified any items with a significant difference between Australian GAAP and A-IFRS that will potentially have a materialimpact on the Agency’s financial position and financial performance following the adoption of A-IFRS. The following tables outline the estimatedsignificant impacts on the financial position of the Agency as at 30 June 2005 and the likely impact on the current year result had the financialstatements been prepared using A-IFRS.The estimates disclosed below are the Agency’s best estimates of the significant quantitative impact of the changes as at the date of preparing the 30June 2005 financial report. The actual effects of transition to A-IFRS may differ from the estimates disclosed due to:a) change in facts and circumstancesb) ongoing work being undertaken by the A-IFRS project team;c) potential amendments to A-IFRS and Interpretations; andd) emerging accepted practice in the interpretation and application of A-IFRS and UIG Interpretations.72

Portland District Health is a body corporate, listed in the Health Services Act 1988, and operates under the provisions of thisact.The Minister responsible for the administration of the Health Services Act is the Minister for Health, The Hon. Bronwyn PikeMLA.The functions of Portland District Health are:a) To oversee and manage the hospital.b) To ensure that the services provided by the hospital comply with the requirements of the Health Services Act and the objectsof the hospital.The Board consists of up to 12 members appointed by the Governor in Council. Each member of the Board holds office for a termnot exceeding three (3) years and is eligible for re-appointment.The registered office of the Portland & District Hospital is Bentinck Street, Portland 3305.Telephone 03 55210333Glossary of termsACHS - Australian Council on Health Care StandardsDHS - Department of Human ServicesEFT - Effective Full TimeEQuIP - Evaluation Quality Improvement ProgramHITH - Hospital in the HomePCP - Primary Care PartnershipsSWARH - South West Alliance of Rural HealthVMO - Visiting Medical OfficerWIES - Weighted Inlier Equivalent SeparationAdverse Events- An untoward event, which is not the result of the patients disease.Audit – An official review or assessment of results of documents in order to determine performance outcomes.Benchmarking- the continuous process of measuring and comparing products, services and practices with similar systems forcontinual improvementBest Practice – the way leading edge organizations mange the delivery of world class standards of performance in all aspects oftheir operations.Clinical indicators- A measure of the clinical management and outcome of care, a method of monitoring patient care and serviceswhich attempts to identify problem areas, evaluate trends and therefore direct attention to these issues.Credentialed- Authorized to provide specific client care and treatment, within defined limits, based on an individuals licence,education, training, experience and competence.EQuIP- Evaluation and quality Improvement programImproving performance- continuous study and adaptation of processes in order to achieve desired outcomes and meet the needsand expectations of customers.Incident- An event which could have or did lead to unintended or unnecessary harm to a person, and /or a complaint, loss ordamage.Multidisciplinary- care or a service given with input from more than one discipline or profession.Overall Care Index- To obtain reliable measures of patient satisfaction, an Overall Care Index is calibrated based on patientresponses to 27 questions. The overall care index is on a 0-100 scale.Sentinel event- An untoward incident of great significance to the patient.Risk management- the culture processes and structures that are directed towards the effective management of potential opportunitiesand adverse events.Photos courtesy of M. Rogers & Portland Observer