Being For Others - Calvary Health Care Bethlehem

B e i n g Fo r O t h e r s

Calvary Health CareBethlehem strives to bea continuing source ofhealing, hope and nurturingto the peopleand communities we serve.Calvary Health Care Bethlehem 2009 –10 Annual Report2

Organisation chart................................................................................................. 4Message from the LCM Province Leader........................................................... 5Message from the National Board Chair............................................................ 6Message from the CEO......................................................................................... 7SERVICE PROFILE.................................................................................................. 8Neurological and palliative care......................................................................... 8SERVICE PERFORMANCE..................................................................................... 9Statement of priorities.......................................................................................... 9Financials............................................................................................................... 10Performance priorities ........................................................................................ 11QUALITY AND SAFETY.......................................................................................... 12Continuum of Care Governance Committee....................................................... 12National Standards Assessment Program......................................................... 12Medication management...................................................................................... 13Falls management................................................................................................. 14Pressure ulcers and wound management.......................................................... 14Feedback................................................................................................................ 15Patient and family satisfaction............................................................................ 15Safe Practice and Environment Governance Committee.................................. 16Emergency management...................................................................................... 16Equipment and resources management............................................................. 16Occupational health and safety........................................................................... 17Information Management Governance Committee............................................ 17PEOPLE AND CULTURE......................................................................................... 18People and Culture Governance Committee...................................................... 18Human resources review..................................................................................... 18Wellness Group..................................................................................................... 18Mary Potter Week................................................................................................. 19International Nurses’ Day..................................................................................... 19Staff and volunteer milestones............................................................................ 19RESEARCH, EDUCATION AND ETHICS................................................................ 20Centre for Education and Development.............................................................. 20Motor Neurone Disease research....................................................................... 20Scholarships.......................................................................................................... 20Research applications.......................................................................................... 21SERVICE DEVELOPMENT...................................................................................... 22Model of Care........................................................................................................ 22Neurological Ambulatory Service....................................................................... 22Community Palliative Care Service..................................................................... 23Care Planning......................................................................................................... 23Electronic referrals............................................................................................... 23Government sponsored projects......................................................................... 23Gippsland Region Palliative Care Consortium ................................................... 24Community Pharmacy Project.............................................................................. 24Ensuring People Have A Say................................................................................ 25Redevelopment...................................................................................................... 25COMMUNITY ENGAGEMENT................................................................................ 26Community support............................................................................................... 26Fundraising and project support......................................................................... 26Creative Connections............................................................................................ 27Volunteer services................................................................................................ 27Health promotion................................................................................................... 28The thoughtfulness of others............................................................................... 29Outline organisation............................................................................................. 30Being For Others................................................................................................... 31Calvary Health Care Bethlehem 2009 – 10 Annual Report CONTENTS3

Organisation chartLCMHCNational BoardLCMHCNational ExecutiveCEO/ MedicalDirectorDirector ofClinical ServicesDirector of Quality/Risk& Service ImprovementDirector of Finance& Business ServicesDirector of MissionEducation,Training &ResearchI.T. & I.M.Pastoral Care&BereavementVolunteerServicesBusinessDevelopmentProjectsAllied HealthManagerDeputyDirectorof NursingClinicalDirectorNeurologyClinicalDirectorPalliativeCalvary Health Care Bethlehem 2009 –10 Annual ReportAllied HealthDepartmentsNurse UnitManagersCommunityPalliative CareManagerFinanceNeurologicalAmbulatoryManagerHospitalServicesHumanResourcesCorporateDevelopment4

Message from the LCM Province LeaderAct justly, love tenderly and walk humbly with God. Micah 6:8When I reflect on the year in review,it is natural to focus on the manychallenges that are part and parcelof any health care system. Thereare multiple realities at play at anyone time and we find ourselves inconstant negotiation.However, there are also ultimatetruths that guide and nurture us,such as this beautiful verse from theprophet Micah. When I enter theservices I constantly witness thetransformative power contained inthis gentle verse.Act Justly:The gift of life is sacred andpeople experience this whenthey are treated with dignity andcompassion. Justice is very muchabout being seen and being heard.It is about feeling truly valued. WhenMother Mary Potter founded theLittle Company of Mary in 1877she must have known this in a verydeep way.Through “being for others” sheresponded to people’s needs inways that valued their dignity andconfirmed their worth. Today thequality of this care is a hallmark ofLittle Company of Mary Health Care.Love Tenderly:People know that they are lovedby the way they are treated and,essentially, by the way they feel.Mary Potter is known to have saidthat there are “many flowers in thegarden of God’s Church”.This speaks of acceptance of allpeople and celebrating the gift ofdiversity. Healing is about attendingto the whole person; body, mindand spirit. It is beautiful to seepeople being cared for in ways thatgive expression to our connectionto spirit.Walk Humbly with God:At Little Company of Mary HealthCare our identity is given expressionthrough service and being forothers. It is when people are mostvulnerable that they especiallyneed to be supported and deeplycared for. As we are invited to enterpeople’s lives, our very presenceis an expression of love. It is aprivilege to engage in this tenderwork as we humbly journey alongside them.You have my assurance of continuedgratitude, support and prayer inappreciation of your contribution toLittle Company of Mary Health Careand the healing ministry of Jesus.LCM PROVINCE COUNCILmembers as at 30 June 2010Province LeaderSr Jennifer Barrow LCMProvince CouncillorsSr Juliana Coulson LCMSr Monica Whelan LCMSr Jennifer Barrow LCMProvince Leader,Sisters of the Little Companyof Mary AustraliaCalvary Health Care Bethlehem 2009 – 10 Annual Report5

Service ProfileNeurological and palliative careCalvary Health Care Bethlehem is a recognised providerof specialist palliative care and a statewide provider ofspecialist care in progressive neurology.Our dedicated interdisciplinary teams provide highquality, compassionate care across our hospital basedand ambulatory services. Our model of care supportsthe integration of these services to ensure that patientsand their families are supported according to theirneeds and can be transitioned seamlessly from onelevel of care to another.Our 70-bed inpatient facility provides one 30-bedprogressive neurology unit and two 20-bed palliativecare units. Patients are admitted for pain and symptommanagement, restorative care, respite care and endof-lifecare. The interdisciplinary inpatient team worksin collaboration with our own ambulatory services, thepatient’s general practitioner, medical specialists andother health professionals or services to deliver optimalcare and seamless discharge planning.The Neurological Ambulatory Stream provides threeareas of service; multidisciplinary outpatient clinics,specialist allied health and neurological nursingconsultancy in the community setting and theNeurological Day Centre.Both streams provide interdisciplinary support topatients at home or in residential care facilities byproviding practical assistance, care coordination,advice on symptom management and psychosocialand bereavement support. The community based andoutpatient services are complemented by the daycentres, providing patients with social interaction,promoting wellbeing and providing day respite forcarers. These services also provide support to otherhealth and community service providers ensuringpatients are able to remain at home and receiveappropriate care in their local communities.Our ambulatory services provide care to patientsin their home and other community settings. Theseservices cover two designated service streams,‘Community Palliative Care Services’ and ‘NeurologicalAmbulatory Services’. The Community PalliativeCare Stream provides two types of service; theinterdisciplinary specialist community based serviceand the Palliative Care Day Centre.Calvary Health Care Bethlehem 2009 –10 Annual ReportOur staff provide care that is given with love,compassion and respect.8

123456Statement of prioritiesStrategic priority Deliverables AchievementWorkforce developmentDevelop SpecialistModel of CareCommunity engagementCorporate governanceSustainability ofmodel of careService excellence• Research and education framework:two new external research projects,restructure Centre for Education andDevelopment• Best Practice Australia staff survey –action plan implemented, MA mission audit• Workforce strategy implemented – KeyPerformance Indicator (KPI) staffturnover, maintain HR KPI• Redesign outpatient service• Reconfigure community and day centres• Review GEM and inpatient services• Nurse practitioner model implemented incommunity• Establish Community Advisory Board• Implement corporate and community plan –KPI Increased donations• Two health promotion activities• Business Continuity Plan implemented• Audit compliance• Legal compliance software implemented• Complete project with Department ofHealth (DoH) on service stream datacollection• Business case developed for tertiary levelservice as recommended byMotor Neurone Disease Collaborative• Update Kingston redevelopment serviceplanning with DoH and Southern Health• Care planning completed – improvementpatient satisfaction• Achieve accreditation• Consumer participation – consumeradvocate role outlined and established• Information technology plan implemented• Review of capital expenditure required forfacility upgrade and service developmentPartial3Partial33In progressIn progress3Partial3333In progress_3In progress3Partial33Calvary Health Care Bethlehem 2009 – 10 Annual Report Service Performance9

Service PerformanceFinancialsSummary of Financial Results ($’000)2009/10 2008/09 2007/08 2006/07 2005/06Total Revenue 25,504 24,205 23,560 21,496 19,272Total Expenses 25,152 23,881 22,394 21,284 20,595Operating Surplus / (Deficit) 352 324 1,166 212 (1,323)Retained Surplus 9,477 9,095 8,111 7,635 7,423Total Assets 15,323 14,463 14,185 12,918 13,582Total Liabilities 5,846 5,338 5,384 5,283 6,159Net Assets 9,477 9,125 8,801 7,635 7,423Total Equity 9,477 9,125 8,801 7,635 7,423Performance prioritiesa. Financial performance(i) Operating result2009-10 actual ($m)Annual operating result $0.799(ii) Cash management/liquidity2009–10 actualCreditors 24Calvary Health Care Bethlehem 2009 –10 Annual ReportDebtors 60Net movement in cash balance ($m) $0.233b. Service performanceQuality and safety2009–10 actualHealth service accreditation 100%Cleaning standards 85%Hand Hygiene Program compliance 60%Victorian Patient Satisfaction Monitor 73% Met benchmark10

c. Activity and Funding2009–10ActivitySub Acute InpatientAchievementGEM (non DVA) 10,273Palliative Care - Inpatient 11,927GEM - DVA 40Palliative Care - DVA 578NHT (non DVA) 127Ambulatory22,945SACS (non DVA) 3,156Revenue IndicatorsAverage Collection Days 2010 2009Private 63 44Debtors Outstanding as at 30 June 2010Under 30days31-60 daysCategory 30 June 2010FTENursing 113.7Administration and Clerical 17.2Medical Support 7.4Hotel and Allied Services 21.7Medical Officers 4.5Ancillary Staff (Allied Health) 33.7198.2Over 90daysTotal30/6/10Total30/6/09Private 40 9 - 49 74Employees (by FTE)Calvary Health Care Bethlehem 2009 – 10 Annual Report Service Performance11

Quality and SafetyContinuum of Care Governance CommitteeThere are two subgroups of the Continuum of Care Governance Committee:Clinical Practice and Medication Advisory. The significant quality improvementand risk management work of these subgroups this year includes the review of:• operational processes relating to clinical handovers, team meetings,patient goal setting, care planning, family meetings and discharge planning• separation review meeting arrangements (i.e. morbidity and mortality) toimprove case selection, problem identification and remediation strategies• policies to ensure we meet standards, best clinical practice andlegislative and regulatory requirementsIt is very pleasing to report that during our November 2009 Organisation-Wide Survey for accreditation, the ACHS Surveyors endorsed ourmanagement of medications, falls and pressure ulcers and thesethree aspects of clinical governance were each awarded “ExtensiveAchievement” ratings.National Standards Assessment Program (NSAP)The Clinical Practice subgroup also carried out work related to NSAP;a quality improvement initiative funded by the Australian Government.Palliative Care Australia supports specialist palliative care services to identifyopportunities for improvement via interdisciplinary self-assessment against13 national standards.In March 2010, our clinical staff critiqued our systems, practices and policiesagainst these 13 standards and identified the following quality improvementactivities; a review of patient information brochures, methods to evaluatecare plan implementation, and provision of information for non-Englishspeaking patients and their families.Calvary Health Care Bethlehem 2009 –10 Annual Report12

Medication managementIn all hospitals, medication errors commonly cause adverse events forinpatients and are primarily related to the administration of medicationsby clinical staff.While the rate of medication related incidents at CHCB increasedfrom last year, there were no adverse outcomes for our patients. Staffreporting of such incidents is to be encouraged and contributes to systemand practice improvements. This year we increased medication chartaudits to quarterly and changed the audit chart format to rapidly identify,communicate and manage errors in medication prescribing. A “reflectivepractice journal” was implemented to support staff in reviewing incidentsand factors that contribute to medication errors.Medication errorsCalvary Health Care Bethlehem 2009 – 10 Annual Report Quality and Safety13

Quality and SafetyFalls managementCHCB provides care to patients who, as a feature of their illness, are likely tofall. This year and previous year data demonstrate that the rate of patient fallscontinues to fluctuate and that we must be vigilant in identifying patientsat risk and manage that risk accordingly. A retrospective audit, using fallsincident data from 2007/08 and 2008/09, determined a profile of patientswho fall, in order to develop risk reduction strategies. Significantly, the auditidentified time of fall, location of fall, diagnosis and patients’ mobility levelsas contributing risk factors. Potential remediation strategies will be testedover the coming year.Falls ratesPressure ulcers and wound managementCalvary Health Care Bethlehem 2009 –10 Annual ReportOur patients have a tendency to develop serious pressure ulcers as adirect consequence of their immobility and deconditioning. Pressure ulcerand wound management is complex and requires a high level of skill andexpertise. Our Wound Management Advisory Group has worked to develop:a Wound Assessment Chart and Mobilisation & Repositioning Plan; monthlycompliance audits of chart completion resulting in

FeedbackCHCB values feedback received frompatients, their friends and families,staff and other service providers.Opportunities for feedback are providedthrough formal patient satisfactionsurveys, suggestion boxes, writtenand verbal complaints and informalacknowledgement (e.g. letters ofCompliments ReceivedPatient and family satisfactionThis year, a short Patient SatisfactionSurvey was piloted on St Joseph’sand St Luke’s wards. The surveywas distributed by our Volunteerservice and 26 patient responseswere received. Overall care wasrated as ‘good’ or ‘excellent’ by76% of respondents on St Joseph’sward and 65% of respondents on StLuke’s. This valuable survey assessedthe patient/carer experience withour services and highlightedissues to be addressed relating toappreciation and thank you cards).This year we received significantcomplimentary feedback and severaluseful suggestions to improveour food services and our builtenvironment, which have all beenaddressed.Negative feedback is always a valuable opportunity for us to hear firsthand from our patients. This year, patients and/or their families lodgedfive written complaints. These complaints were addressed and resulted inimproved key processes and improved professional development of ourstaff. The nature of these complaints involves one or more of the issuesoutlined in the following table:AccessDischarge/TransferDelay in admissionTreatmentInadequate nursing careDelay in treatmentCommunicationPoor attendance/discourteousInadequate informationclinical practice, hospitality and theinvolvement of patients and theirfamilies in decision making and careplanning. This survey will eventuallybe implemented in all wards and theambulatory service areas, and willcomplement other formal patientsatisfaction surveys including theDepartment of Health ‘VictorianPatient Satisfaction Monitor’ and the‘Victorian Palliative Care SatisfactionSurvey’.AtmosphereNoisy environmentRightsProperty lossCalvary Health Care Bethlehem 2009 – 10 Annual Report Quality and Safety15

Quality and SafetySafe Practice andEnvironment Governance CommitteeThere are three subgroups of the Safe Practice and EnvironmentGovernance Committee: Emergency Management, EquipmentManagement and Occupational Health & Safety. The significant qualityimprovement and risk management work of these subgroups this yearincludes the following achievements:Emergency management achievements• Patient emergency evacuation mats installed and staff trained in their use.• Emergency fire and evacuation procedures manual and ‘e-learning’module have been reviewed and updated.• A business continuity plan for patient services has been drafted.Equipment & resources management achievements• Upgrade of syringe drivers for administration of medication to patients.• Ceiling hoists for lifting patients have been installed in the wards.• Upgrade of hi/lo beds and mattresses.• Modifications to our toilet flushing systems, heating and hot waterservices, as well as rainwater harvesting and recycling, have reducedgas and water consumption by approximately 50% and 10%, respectively.• An enhanced management reporting system for the EngineeringDepartment to ensure all legislative reporting is completed efficiently.CHCB remains committed to reducing our environmental impact and tointroduce sustainable practices wherever possible. Sustainable practiceswill be implemented in accordance with our environmental policy andenvironmental management plan.Calvary Health Care Bethlehem 2009 –10 Annual Report16

Occupational health & safety achievements• A 97% Food Safety rating from independent auditor,Australian Food Hygiene Services.• A 97% attainment of minimum standards for our in-house cleaningprogram as assessed by our consultant for Infection Control.• Increase in security cameras and deployment of duress alarms inCHCB gardens.• Upgrade of slide sheets on patient beds to improve patient manual handling.• Introduction of Bullying and Harassment Contact Officers to support staff.• Review of our WorkCover systems, by external consultants, Ascentor,that led to the introduction of the ‘Injury Master’ software system, which hasimproved efficiency and reduced work injury costs.• Commendation by WorkSafe Victoria for our manual handling systems.• Implementation of a garden beautification program.Rotarian Graham Sycamore gardeningwith working bee helpers.Information Management Governance CommitteeThe Information Management Governance Committee incorporatesInformation Technology, Telecommunications and Medical Records.The significant quality improvement and risk management work that hasbeen addressed this year includes:• Audit of clinical policies and procedures to ensure all Medical RecordForms cited in these policies were current, have appropriate titles andmedical record numbers and are consistent with the policies prescribingtheir use.• Development of an operations manual for routine functions of theInformation Technology and Communications Support Service, andthe articulation of the CHCB/LCMHC Standard Operating Environmentwhich is used to ensure new computers comply with the organisation’srequirements.Calvary Health Care Bethlehem 2009 – 10 Annual Report Quality and Safety• Specification of a new telephone system which is a major undertakingin response to failing infrastructure.17

People and CulturePeople and Culture Governance CommitteeThe significant quality and risk management work of this committee this year includes the followingachievements:Human resources reviewFollowing last year’s review of Human Resources(HR) policies, procedures and systems conductedby the Victorian Health Industry Association(VHIA), CHCB has implemented many of therecommendations. A HR Manager has beenappointed and has initiated a range of activities.These include training and increased awarenessof workplace issues such as Bullying andHarassment, Equal Employment Opportunity,provision of support to managers, supervisorsand staff in respect of employee and industrialrelations issues. Consequently, this willstrengthen CHCB’s capacity to attract and retainexceptional staff.Best Practice Australia (BPA) – Staff Satisfaction SurveyEvery two years, CHCB participates in a review of our services to monitor our staff satisfaction.This review is conducted by an external agency, BPA, and provides us with information andstrategies to assist us to improve our workplace. This year:• A review of organisational communication revealed that people desired more information in avariety of styles. This has lead to revitalised staff forums, the introduction of a formalcommuniqué to all staff and a recommitment to collaborative planning and consultationprocesses.• Our Mission, Vision and Values are our guiding statements and we have now complementedthem by adding our Values in Action statement. This statement expresses the behaviours thatwe desire as we engage in the work that we do.Wellness Group – staff living well and wiseCalvary Health Care Bethlehem 2009 –10 Annual ReportWellness is a holistic approach to living well.It is the integration of the spirit, body and themind; and the understanding that everything wedo, feel, think and believe has a direct impacton our state of health. Research studies relatedto wellness indicate that staff who take goodcare of themselves and make healthy lifestylechoices are healthier, happier, more productive,are absent from work less, and have lowerhealthcare costs.We highlight: healthy dietary choices withseasonal Wellness-sponsored lunches; healthpromotion with ‘quit smoking’ advice andresources; physical improvement by walking inthe Global Corporate Challenge, participating ingroup training and yoga, and swimming in theMS MegaSwim.Equally important is the psychological self careof our staff. We encourage using the EmployeeAssistance Program and other social activities.We continue to acknowledge the efforts ofCHCB staff by offering support for the ‘WeightWatchers at Work’ program, with a number ofinspirational staff successfully achieving theirweight loss and fitness goals. Hard-workingnursing staff are also encouraged to have some‘time-out’ during their breaks with Wellnessfundedmonthly magazine subscriptions.In 2010, the Wellness committee funded a staffchoir facilitated by an external choir leader. Thestaff choir ran for eight weeks with the choirperforming a fabulous musical item at the staffforum. All choir members surveyed said singingin the choir had a positive impact on their feelingsof wellbeing.At CHCB, Wellness recognises that by ‘livingwell and wise’ we can continue to sustain ourfocus on ‘being for others.’18

Mary Potter WeekEvery year CHCB recognises and celebrates thebirthday of Sister Mary Potter, the foundress of theLittle Company of Mary. Fr Pat Bourke celebratedMass and Sr Pauline Pervan spoke of her vocationjourney as a Sister of the Little Company of Mary.The liturgy included Missioning of the Executive.The event was attended by Sr Juliana Coulson,Sr Bernadette Fitzgerald and Walter Kmet representingNational LCM Healthcare.International Nurses’ DayOn the 12th of May 2010, nurses at CHCB invitedmembers of the multidisciplinary team to join them incelebrating International Nurses Day;a special day to recognise the important contributionsnurses make to society. It was a multicultural event withnurses from many different countries coming togetherto chat and share food from their native countries withtheir colleagues. The wonderful work nurses at CHCB do,each and every day, was acknowledged and recognised.Notably, ten CHCB nurses received the AnnualCoordinators’ Award for Nursing Excellence in 2010.Staff and volunteer milestonesYears ofservice51015202535NameFelix Bolanos, Akiko Bradshaw-Ikeuchi, Karen Bolger,Kim Boniwell, Andrew Churchyard, Amanda Cula,Emma Finch, Geom Fremouw, Michael Hartley, Lilita Hi,Geraldine McKellar, Michele Meachen, Josephine Milone,Janet Mostovoy, Sharon Sandvik, Mira Sapozhnikov,Judith Van Opstal, Patricia Walburgh, Susan Wilkins,Francesca Williamson, Elizabeth Albrecht, Eva Anthony,Rosa Costa, Janet Dimelow, Shirley Hyacinthe, Angela LaffanBeverley Phillips, Judy Sime, Inge TruckenbrodtRaymond Allen, Pauline Cheung, Elizabeth Cole,Edward Donald, Deborah Hanby, Joanne Harris,Christine Limmer, Sandra McConnell, Cathryn McMahon,Kathy Milutin, Anna Smith, Malini Somaiya, Qwee Teoh,Lynn Watson, Harald Farinski, Margot TravellynRoxanne Maule, Mary Wilsdon, Pat Mulcahy, Margaret O’DriscollSusan Alexander, Voula Dandoulas, Yvonne Hepponstall,Vladislava Kazda, Peter Quinlan, Leanne VellaTeresa Krajewska, Judith LawrenceSusan NeedhamMary Potter Week celebrationsincluded a ‘So You Think You CanBake’ competition, judged by ourown chef, King (top) with a winningtiramisu baked by Cynthia Persifrom the Pharmacy department(middle). Our ‘Bethlehem’s GotTalent’ quest was hosted by theirresistible Esther Goldenbum(bottom).Calvary Health Care Bethlehem 2009 – 10 Annual Report People and Culture19

Research, Education and EthicsCalvary Health Care Bethlehem 2009 –10 Annual ReportScholarshipsCentre for Education and DevelopmentThe Centre for Education and Development strives to inspire success inclinical practice by supporting staff with customised education, training andopportunities in a wide range of curriculum areas.At the November 2009 Organisation-Wide Survey, our Graduate NurseProgram, Return To Practice Program and three Palliative Care programs allreceived high praise from the ACHS Surveyors and resulted in an “ExtensiveAchievement” rating.Motor Neurone Disease (MND) research findingsIn December 2009, Dr Fiona Fisher over and above supporting loved(left), Neuropsychologist, gave two ones with the physical changesposter presentations at the 20th of the disease. These findingsInternational Symposium on ALS/ highlight the need for increasedMND in Berlin. Based on clinical awareness and support for personsresearch findings, Fiona presented with MND and their families aboutwork investigating the frequency the ‘non-motor’ symptoms ofof social communication, behaviour MND. Fiona’s work was supportedand thinking changes in MND, by the 2009 MND Victoria Researchand how the presence of such Grant from the Motor Neuronechanges impacted caregivers. Her Disease Research Institute.research indicated that noticeableWith additional funding obtained,changes in thinking, behaviourFiona and her team continue theand social communication abilitiesresearch to better understandwere present in over one thirdhow emotions are perceivedof participants. Anxiety was alsoand interpreted in MND, andidentified as a significant issue forhow communication impactsboth patients and their families.interpersonal relationships.For caregivers, changes inbehaviour were most challenging,We are delighted to continue to support our staff with their professional development and this year the followingstaff were recipients of CHCB-funded scholarships:NameDepartmentCourse of StudyAnna HaebetsLyn WatsonJennifer RossYao HuangSocial WorkSt Luke’s WardSt Joseph’s WardSt Luke’s WardMaster of Social WorkAnatomy & Physiology (pre Medication Endorsement)R.N. Div 2 – Medication EndorsementPost Grad Diploma Nursing (Cancer & Palliative Care)20

Research applicationsThe following research applications were approved by CHCB’s Research Ethics and Ethics Committeeand/or were in progress during 2009-10:Principal investigatorMs Gerry McKellarMs Anne Horne-ThompsonDr Susan MathersMs Malini SomaiyaDr Katrinia McFerranAssoc. Prof. Matthew KiernanDr Paul TalmanDr Michael SummersMr Roy BatterhamDr Louisa NgDr Fary KhanDr Paul TalmanDr Fiona FisherDr James HoweDr Susan MathersMs Maryanne McPheeDr Alexia PavlisMr Mathew StaiosDr Fiona FisherDr James GillespieDr Chong Meng TayDr Mina BorromeoDr Jim HoweDr Susan MathersDr Katrina ReardonDr Louise PetersProjectCHCB gratefully acknowledges the significant contribution of the following Research Ethics and EthicsCommittee members:Mrs Rosalie Jones (Chairperson)Dr Jane FischerMr Tony RyanMr Des McCarthyFr Norman FordMs Shannon ThompsonDr Susan MathersDr Jim HoweCr Margaret EsakoffMr Peter LumleyMr John De BonoEffect of physiotherapy on palliative patients’ ability to cope with breathlessnessAn investigation into music, music therapy and anxiety in MNDThe Continuous Care PilotSupporting families to support children with life-threatening illnessINSPIRATIonAL (INSPIRAtory Training in Amyotrophic lateral Sclerosis)Evaluation of the Continuous Care PilotEffectiveness of a peer support intervention in MND and Multiple SclerosisCognitive and behavioural changes in MND: exploring the impact on caregiversEmotion Recognition in progressive neurological conditions: Impact oncommunication, behaviour and caregivingDescriptive Analysis of the Calvary Health Care Bethlehem Specialist Palliative Care ModelOral health status and dental treatment needs of patients with Motor NeuroneDisease in Victoria, AustraliaPredictors of stress and coping in Palliative Care NursesCalvary Health Care Bethlehem 2009 – 10 Annual Report Research, Education and Ethics21

Service DevelopmentModel of CareThrough integrating our hospital based and ambulatory services, theCHCB model of care ensures that patients and their families are supportedaccording to their needs and are transitioned across services as required.The ongoing process of developing our model of care aims to enhance theefficiency, safety, quality and value of our care and improve the outcomes ofthat care for our patients.A friendly smile works wonders to lift the spirits.Neurological Ambulatory ServiceThe Neurological Ambulatory Service incorporates outpatient clinics, a rangeof specialist physicians, community based consultancy and day centre care.Following the Department of Health review of our non-admitted services,there were a number of recommendations for changes to our model of careto better reflect our status as a statewide provider of services to patients withprogressive neurological conditions.Calvary Health Care Bethlehem 2009 –10 Annual ReportConsequently, CHCB no longer provides primary care nursing to patients withprogressive neurological conditions. Primary care nursing services had longbeen a part of what CHCB provided and in response to the review, this levelof care was transferred to other nursing service providers. Subsequently, anew consultancy was formed and we now provide Neurological Nursing andAllied Health Consultation services, which aim to enhance patient care throughimproved coordination, collaboration and delivery of statewide secondaryconsultation to other agencies.Highly skilled Registered Nurses work closely with specialist physicians andthe outpatient service to improve staff awareness of a patient’s condition,timely intervention and to facilitate efficient outpatient service use.The Neurological Day Centre has reviewed the number of days of serviceto better meet demand and a Leisure and Lifestyle Coordinator has beenappointed to develop and manage the programs delivered in this setting.A Neurological Ambulatory Service (NAS) Manager has been appointed tocoordinate the service. Access and Intake roles have also been implementedto coordinate and facilitate new referrals and admissions to the NAS.22

Community Palliative Care ServiceThe Community Palliative team has been reorganised and a CommunityPalliative Manager has been appointed to coordinate this service. Intake nurseshave also been appointed to coordinate and facilitate referrals and admissions tothe service.The Palliative Care Day Centre continues to operate two days per week and hasmoved to a new staffing structure, sharing the Leisure and Lifestyle Coordinatorrole to coordinate programs delivered to patients in the day centre setting.Care PlanningA care planning tool has been trialled and introduced to the inpatient teammeeting which then allows staff, patients and family/carers outside of themeeting to know and understand the current issues, interventions and plans.This tool will be implemented across both inpatient and outpatient settingsand aims to involve the patient and their carer/s in goal setting and agreedmanagement plans.Electronic referralsAs part of an update to the inpatient management software system (iPM),to enable collection of data for reports to the DoH, CHCB has moved to apaperless system of referral to internal staff and services within CHCB. Thiswill be further augmented with a planned move to an electronic medicalrecord in the next 12 months.Government sponsored projectsPatients, and their families,receive high quality,compassionate care.CHCB has been part of several Government funded projects over the lastyear: The Palliative Care Pathway in MND, Collaborative Care in MND andthe Continuous Care Pilot Project. These projects address the importanceof service collaboration in order to focus on the client’s priorities, planrealistic care options and anticipate future needs. Reports from the projectsadvocate health and disability service reform to allow services to be unitedand streamlined. Through this ‘continuous care’ model, ambulatory servicescan help a person or health professional struggling with such neurologicalconditions, anywhere in the community, and provide the right advice at theright time to better manage the situation.Through the strength of these service partnerships we will continue todevelop our outreach activities, particularly in the areas of Telehealth andsatellite services, education, training and research.Calvary Health Care Bethlehem 2009 – 10 Annual Report Service Development23

Service DevelopmentGippsland Region Palliative Care ConsortiumTo further develop CHCB as a statewide provider of tertiary neurologicaland palliative care services, the initial work of Southern MetropolitanRegion Palliative Medical Specialists and the Gippsland Region PalliativeCare Consortium, a strategic plan has been put in place. This plan willprovide local consultancy services to improve patient access to specialistpalliative care services and to provide education and support to localpalliative care agencies and general practitioners in the Gippsland region.After months of consultation and planning, a CHCB consultancy team,consisting of medical, nursing and social work personnel, visit the regionmonthly, augmented with weekly teleconferences and phone supportbetween visits. Challenges do exist, but this is the start of an importantcollaborative partnership.Community Pharmacy ProjectThe Palliative Care for People at Home Initiative funded the ‘Pharmacy inCommunity Palliative Care Project’ which concluded at the end of June 2010.The major activities and outcomes of the project were:• Over 380 medication review screenings were undertaken.• Over 52 home visits to undertake further medication management reviews.• An audit of the provision of emergency (just in case) medications that willprovide CHCB with directions for the future and potential cost savings.Calvary Health Care Bethlehem 2009 –10 Annual Report• 100% of staff surveyed reported that their knowledge, understanding andmanagement of palliative care medications had improved.• 60% of staff surveyed have changed their palliative care medicationspractice.• Submission of a final report to the Victorian Department of Health andCommonwealth Department of Health and Ageing.The project finished on time and on budget, with the development of atoolkit available via the CHCB website. This toolkit includes:• Patient medicine information leaflets (PILs) on nine medications that havebeen translated into seven languages.• Mp3 audio files for people who are from culturally and linguisticallydiverse communities, are vision-impaired and/or who have poor orinadequate health literacy.• Tools used throughout the project and an extensive resource listing.24

Ensuring People Have A SayImagine not being able to say “my nose is itchy” or “I need a drink” or “I love you”.Imagine losing your ability to speak. This occurs with many patients at CHCB.Our Speech Pathologists work with their interdisciplinary colleagues to ensurepeople have the means to express their needs and wishes and to accesstechnology for life.In addition to communicating with pen and paper, there are also other optionsavailable that help our patients. These include devices such as a Lightwriter, TellusSmart, Allora or ‘eye gaze’ systems that use a computer and camera to track eyemovements to activate an on-screen keyboard. With this innovative technology,patients can type a message that is then audibly verbalised by the computer.In partnership with ComTEC Yooralla, CHCB runs a clinic every six weeks thatoffers a state-of-the-art technology and communication service for CHCB patients.Staff and patients using communication technology.RedevelopmentThe relocation and redevelopment of CHCB has been part of our strategicplan for over 10 years. Now, however, the aging and deteriorating facility iscompromising CHCB’s operational sustainability, in addition to our reputationas a specialist provider.The configuration of the current site is no longer suited to the delivery ofmodern health services and hinders the development of our model of careand expansion of services. The poor physical fabric and infrastructure posesrisks to patient safety and optimal outcomes, and with 60 beds in sharedrooms, compromises the dignity and privacy of patients. The substandardsite creates work inefficiencies and threatens to affect staff recruitment andretention.Work on the plan to relocate to Kingston with Southern Health continues.However, the current Kingston Calvary plan involves staging with othercomponents on the Kingston site and is occuring over an extended period.Over the last 12 months, CHCB and DoH have also explored the optionof rebuilding on our existing site. A plan for a new inpatient building and afeasibility study with costings to support the proposal has been completed.CHCB believe that redevelopment of the existing Caulfield site providesa more cost effective solution, in a shorter time frame, and allows us todeliver a more efficient model of care to meet community demand. CHCBis continuing to work with Southern Health and DoH to complete a businesscase that delivers the best options for CHCB.Calvary Health Care Bethlehem 2009 – 10 Annual Report Service Development25

Community EngagementCommunity supportWe thank the Rotary Clubs of Glen Eira, Brighton Beach, Brighton North,Caulfield, Elsternwick, Brighton and Bentleigh Moorabbin Central; MonashUniversity; Caulfield RSL club and Glen Eira City Council for their continuedinterest and significant contributions during the past year. Major highlightsincluded:• A ‘Song-a-thon’ of Shakespearean period songs, performed by classicalsinging students of Monash University’s Arts department that linked thestudents with CHCB and raised funds for our Creative Connections program.• A major garden working bee, involving support in cash and/or kind fromRotary clubs, Parks Victoria, the Sunshine Foundation, Chelsea Men’sShed and Penhalluriack’s Hardware & Nursery, resulted in waterreticulation to four garden areas, positioning of four new seats andplanting of 250 new plants for the benefit of patients and their families.• A quiz night, hosted by the Rotary Club of Glen Eira, raised funds for CHCB.Fundraising and project supportFundraising support from the community and the Department of Health forMotor Neurone Disease (MND) and MND associated communications projectshas allowed four special patient rooms to be designed and developed. In theserooms, patients without speech or the use of limbs can now feel a sense ofindependence and self-reliance. Furthermore, staff and volunteers are able toleave patients who would otherwise need frequent attention.Litewriter and Dynavox aid-to-communication equipment have beenpurchased through the generous support of the Marian & E.H. Flack Trust,Scobie and Claire MacKinnon Trust and Eric Norman Sweet Trust.Calvary Health Care Bethlehem 2009 –10 Annual ReportWe are grateful to Dawn Nance and her committee for organising andhosting a Gala ball at Docklands as a fundraiser for MND. CHCB were thegrateful recipients of $10,000 from the event proceeds.Invited speaker and VFL legend Peter Hudson with devoted fan, Nic (left), and the winning CHCBquiz night team (right).26

Creative ConnectionsWith the generous support of the Williamson Foundation, the Barr FamilyFoundation, the Dame Elizabeth Murdoch Foundation and the MonashUniversity Music Department, the Creative Connections program hascontinued to support families with children who have experienced, or arepreparing for, the death of a loved one.In response to the need for improved access to grief support for childrenwithin the community, a new program website has been developed andlaunched (www.bethlehem.org.au/creativeconnections). The websiteprovides information about children and grief including links to supportservices both within and outside CHCB. The Creative Connections team hasalso strengthened relationships with international researchers in childhoodgrief to assist us in the ongoing evaluation of the program during 2010-2011.Volunteer servicesVolunteer Services are an important part of the holistic care team at CHCBand provide ongoing support to the wards, day centres and administrativesupport to various departments.In the past year, ten CHCB volunteers completed formal volunteer trainingand receive an Accredited Certificate III for Delivering Care Services usinga Palliative Approach. These volunteers also completed training in hand andfoot massage to offer patients.CHCB volunteers, and staff, including our Volunteering companion dogs,Pete and Toby, attended the Minister of Health Volunteer Awards at ParliamentHouse in May 2010. Raising the profile of our Volunteering Palliative VisitingPets Program, the dogs were the first visiting pets to be welcomed intoParliament House and attracted great attention and many pats!Our Visiting Pet, Pete, drops in to see a patient (left) and visiting Parliament House (right)volunteers: Yvonne, Tracey (D.C. coordinator), Pat and Zoe (V.S. Manager), L to R.Calvary Health Care Bethlehem 2009 – 10 Annual Report Community Engagement27

Community EngagementHealth PromotionCHCB has commenced a collaborative health promotion project with OurLady of Sion, Box Hill using enquiry-based learning through engagement toexplore health care issues. The project aims to:• enhance community awareness of Palliative Care and Motor Neuron Disease• strengthen community connections between two Catholic organisations• provide students with the opportunity to further engage in social enterprise• provide students with a forum to express their talents• build community through collaborative engagement.Our plan is to expand this initiative to include other schools, multi faithdimensions and collaborative interactions.CHCB was pleased to join the Southern Metropolitan Region PalliativeCare Consortium in sponsoring the play ‘Four Funerals in One Day’.The play was written by Alan Hopgood (below), who also played the roleof Clarrie. The play explores the power of story in people’s lives and thehuman impact on patients and professional carers involved in palliativecare. The play portrays a message of hope; that “every person leavesa footprint”. ‘Four Funerals in One Day’ is able to succeed in its healthpromotion role by beautifully mingling humor and tenderness.The strength of this play is that it manages to present palliative care in away that educates and also entertains.Calvary Health Care Bethlehem 2009 –10 Annual ReportActor and playwright, Alan Hopgood.28

The thoughtfulness of othersThere are many ways in which people financially support CHCB. All donationsare gratefully accepted as they help us to support others. Donations aremade in the following ways:• a single gift• an annual gift• a donation in memory of a loved one• a bequest• in response to an appeal.All donations of $2.00 and over are tax deductible and donors may specify thepurpose for which the funds are to be used. However, gifts for unspecifiedpurposes help us to flexibly respond to the most urgent needs.All correspondence concerning financial support for CHCB should be directed to:Chief Executive OfficerCalvary Health Care Bethlehem476 Kooyong RoadCaulfield South, Victoria 3162List of donors ($500 and over) 1 July 2009 - 30 June 2010Trust Company LtdCollier Charitable FundEstate of the late MargaretAlice BostonLord Mayor’s CharitableFoundationSidney Myer FundThe Gandel Charitable TrustThe Hugh WilliamsonFoundationThe Eric Norman SweetTrustThe Marian & E.H. FlackTrustThe Scobie and ClaireMacKinnon TrustMr and Mrs Michael TabakMND - Ball(Balls At Night Charity)Baxter Percy CharitableTrustDr Sharon KeelingDame Elisabeth MurdochAC DBEMr Kevin WareingSally HinsonSunshine FoundationPeter M JohnsDr Lindsay JonesRotary Club of BentleighMoorabbinCHCB Card Ladies Auxiliary$50,000$34,136$32,466$20,000$20,000$20,000$20,000$15,000$14,249$14,249$11,000$10,000$10,000$10,000$10,000$7,500$6,052$6,000$5,000$5,000$5,000$4,200The Rotary Club of Glen EiraMr Bradley RobertsRotary Club of Pakenham IncBetty & John LaidlawEstate of the late BartoloSaltalacchiaMrs Margaret HenryMrs Geraldene McDonaldThe William Angliss (Victoria)Charitable FundMs Mary DraycottMrs Stephanie JohnstonMs Jenny RogersParade CollegeMr George KyriakosSisters of Mercy GoulburnCongregation - Sr AngelaJordanMs Sophie BurnsMrs June ZiebellMr Ray & Mrs Merle FoxNorman HillMr Neville HindeMs Patricia Jones-JowettDr. Penelope A MartinMs Malvina MiliauskasMrs Elizabeth RidgwayMs Shirley LandyMr Leo ConnollyMs Kay McKenzie$4,000$3,000$3,000$2,500$2,000$2,000$2,000$2,000$1,600$1,500$1,500$1,380$1,330$1,135$1,105$1,050$1,000$1,000$1,000$1,000$1,000$1,000$900$800$750$750Mr & Mrs MichaelHaeslerAll Souls OpportunityShopMr Iossif PodlabenioukMr John SuttonM K NolanMr Pino AndronacoMs Yvonne BrakeyMr Jim DarbyMs Sandra FallaMr John GibsonMr & Mrs G HuntleyMrs Jessie JansMr Paul JonesMs Joyce LaurenceMr & Mrs Ken & JeanMacDonaldMr Brendan MadiganMs Noreen McCarthyMiss Roberta O’CarrollMr Jacob PushettMrs Maisie RowlandMrs Ruth SoawyerEstate of the lateThelma LavenaMaxwell-MacleodMr Russell WatersMr Peter Woodhouse$700$600$600$600$550$500$500$500$500$500$500$500$500$500$500$500$500$500$500$500$500$500$500$500Calvary Health Care Bethlehem 2009 – 10 Annual Report Community Engagement29

Community EngagementCalvary Health Care Bethlehem 2009 –10 Annual ReportOutline organisationList of senior staff members as at 30 June 2010CORPORATE STAFFChief Executive OfficerDr Jane FischerFINANCE & BUSINESSSERVICESDirector of Finance & BusinessServicesMr Andrew HluchanicAccountantMr Haja MohideenHospital Services ManagerMr Barry DanielsHuman Resources ManagerMrs Joanne SherlockCorporate & CommunityDevelopment ManagerMr Bob Slater, AMMISSIONDirector of MissionMr John De BonoResident Chaplain(Catholic Church)Rev Fr P Bourke OSAManager Volunteer ServicesMs Zoe PeltekiPastoral Care/ BereavementServices CoordinatorMs Christine LimmerQUALITY/RISK & SERVICE NURSINGIMPROVEMENTDirector of Clinical ServicesDirector of Quality/Risk & Ms Shannon ThompsonService ImprovementDeputy Director of NursingMr John BelfrageMs Judy LawrenceIT Support OfficerNurse Unit ManagerMr Damian KhoSt Joseph’s WardEducation Coordinator Ms Charlotte ChidellMs June Davis(until February 2010)Health Information Services Mr Gary CoxCoordinator(from May 2010)Ms Elaine ElliottNurse Unit ManagerSt Luke’s WardMs Bernadette SheehyMEDICAL STAFFNurse Unit ManagerMedical DirectorSt Teresa’s WardDr Jane FischerMs Fran WilliamsonClinical Director NeurologyNeurological AmbulatoryDr Susan MathersServiceNeurologistsMs Rosemary LeechDr Jim HoweNeurological & Palliative DayDr Andrew ChurchyardCentresDr Paul TalmanMs Tracy NeaveDr Katrina ReardonDr Kate KotschetCommunity Palliative CareServiceNeuro/Palliative SpecialistMs Melinda PoonDr Greg Stefanou(until September 2009)Palliative SpecialistsMs Caroline EdwardsDr Alexandra Burke(from September 2009)Dr Scott KingPsychiatristsDr Melinda KempDr Brendan SpenceALLIED HEALTHPROFESSIONAL STAFFAllied Health ManagerMs Claire Duane(Acting until October 2009)Ms Millissa Fromer(from October 2009)Chief Music TherapistMs Karen BolgerChief Occupational TherapistMs Ruth SkeneChief PharmacistMs Ka-Yee ChenChief PhysiotherapistMs Karol ConnorsChief Social WorkerMs Claire DuaneMs Malini Somaiya(Acting until October 2009)Chief Speech PathologistMs Maryanne McPheePROFESSIONAL SERVICESSolicitorsMiddletons LawyersAuditorsAuditor General VictoriaBankersCommonwealth BankingCorporation30

Being For OthersPeople have stories to tell.This is one way we create meaning, make sense of life and get in touch with our inner world.The Pastoral Care and Bereavement Team enables patients and families to be heard,to voice their thoughts and express their feelings.This engagement happens through listening, through sharing and holding of the story.Being for others is a gentle presence allowing people to be acknowledged and not alone in theirjourney. As we travel together we can experience healing and meaning and hope.Participating in rituals is a powerful way that people connect to others and their inner world.At CHCB the “Ceremony of Remembrance” and “Remembering Lives”ritualise this part of our human journey.Calvary Health Care Bethlehem 2009 – 10 Annual Report31

Calvary Health Care Bethlehem476 Kooyong RoadSouth Caulfield Vic 3162Telephone: 03 9596 2853Facsimile: 03 9596 3576www.bethlehem.org.auABN 81 105 303 704ACN 105 303 704Edited by The Science of CopyPrinted by Valiant Press