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NEWSLETTER For innovators in healthcare & beyond M AY 2 0 1 4

Tele-Health: Its Time Has Come?

Contents P. 1

Tele-Health: Its Time Has Come? Prof. Branko Celler Project Director CSIRO National Telehealth Trial

P. 6

Why Are They Still Here? Bridie Egan Social Work Department, St Vincent’s Hospital Melbourne

P. 8

Occupational Therapy Competencies Australia Catherine Studdert & Nadege Van Drempt on behalf of the OTCA Team

P. 11 The Enhanced Management of Orthopaedic Surgery (EMOS) at Coffs Harbour Health Campus Andrew Wong Orthopaedic Care Coordinator Coffs Harbour Health Campus P. 12 When Financial Downturn and Mental Health Collide Char Weeks Innovation Leader, Change Champions & Associates P. 14 The Living Conditions Program Mercy Splitt Catholic Community Services NSW/ACT P. 15 UPCOMING WORKSHOPS P. 43 Challenges Integrating Health Care Services Dawn Skidmore

Prof. Branko Celler Project Director, CSIRO National Telehealth Trial

Telehealth has many different meanings to different people. Most commonly in Australia it refers to tele-consultations between specialists and patients located either in remote areas or in residential care facilities. This is presently being reimbursed by Medicare. However one of the more important and value adding aspect of telehealth service delivery in the future will be at home telemonitoring of patients with complex chronic conditions such as congestive heart failure (CHF), Chronic Obstructive Pulmonary

Change Champions & Associates Newsletter - MAY 2014

Disease (COPD), diabetes, and morbid hypertension. Telehealth technologies can be used in general practice, community health centres, community nursing setting and delivery of specialist consultations to better manage patient flows, optimise clinician time and triage patients before they see a clinician. Telehealth is also used in palliative and end-of-life care, in the management of cystic fibrosis, cancer and numerous other conditions. (Continued p. 3.)


UPCOMING workshops If you are reading this as a PDF, click on the page number to be taken straight to that workshop page. Why not consider printing out one of our workshop posters for your bulletin board at work? Help spread the word! Workshops with Alice Rota- Bartelink  The ABC of BOC– Working with Older Adults with Complex Care Needs Adults Who Display Behaviours of Concern [p. 17]  The Challenge of Long Term Alcohol Abuse in Older Adults [p. 35]  The Service Providers Toolkit: Improving the Care of Older Homeless People [p. 36] Workshops with David Schwarz  Proven Governance: How Effective is Your Board or Management Committee? [p. 16] Workshops with Kathryn McEwen  Building Resilience at Work [p. 18] Workshops with Elise Wald  Making a Difference in Sleep- [p. 19]  How to Influence Behaviour Change in Patients with Chronic Illness [p. 20]  How to Influence Behaviour Change in Patients with Severe and Persistent Mental Illness [p. 21] Workshops with Robyn Attoe & Daryl Oehm  Sex, Sexuality and Culture: Addressing Social Diversity in Aged Care [p. 22] Workshops with Robyn Attoe  Managing Behavioural and Psychological Symptoms of Dementia [p. 23]  Bathing without Battles [p. 24]  Delirium and the Older Person [p. 25] Workshops with Kylie Agllias  Working effectively with clients experiencing family estrangement [p. 26] Workshops with Julie Faoro  The Long Stay Patient [p. 27] Workshops with Glenn D. Payne  Social Media Workshop [p. 28] Workshops with Char Weeks  Manage Your Energy Not Your Time [p. 15]  The New Leaders Toolkit [p. 29]  Managing Up (How to help your boss add value to your work) [p. 30]  Creating a Culture of Innovation [p. 31]  The Change Implementer’s Toolkit [p. 32]  Moving Forward: Accepting and Embracing Resistance to Change [p. 33]  Handy Hints for the Novice Conference Presenter [p. 34] Workshops with Stephanie Newell & Mitchell Messer  Pathways to a Consumer Focused Organisation– Government and Managerial Approaches [p. 37]

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Tele-Health: Its Time Has Come? Continued from p. 1. The international evidence for the benefits of telehealth for

Each site represents a different model of care for the

the management of chronic disease is now overwhelming.

management of chronic disease ranging from a hospital

The Whole System Demonstrator (WSD) Programme of the

based chronic disease management program staffed by

UK Department of Health provided the following Headline

specialist clinicians to GP only community care.

Findings in December 2011. Test patients are supplied with an easy to use clinical − 15% reduction in A&E Visits

monitoring unit from Telemedcare which measures blood

− 20% reduction in emergency admissions

pressure, pulse oximetry, glucometry, spirometry, ECG, body

− 14% reduction in elective admissions

temperature and body weight as well as administering a

− 14% reduction in bed days

range of clinical and wellbeing questionnaires. Patients can

− 8% reduction in tariff costs and

also message or video conference with their clinical care

− 45% reduction in mortality rates

coordinator.

Other smaller and more targeted studies report reduction in

Given the wealth of international evidence it could be asked

hospitalisation of up to 60%, and high levels of patient

what objectives are being met by this trial that have not

satisfaction.

been already reported internationally. This project has many unique characteristics designed to provide statistically robust

In the US, the Veterans Health Administration (VHA)

evidence to Government that can help inform decision

introduced a national home telehealth program, Care

makers and determine future funding models. As well as

Coordination/Home Telehealth (CCHT) in 2003 to coordinate

reporting on health care outcomes, this trial is also studying

the care of veteran patients with chronic conditions and

health-economic outcomes, acceptability of the service to

avoid their unnecessary admission to long-term institutional

patients and carers as well as clinicians, the impact of

care. Between 2003 and 2007, the census figure (point

workplace cultures and the need for organisational change

prevalence) for VHA CCHT patients increased from 2,000 to

management.

31,570 (1,500% growth). CSIRO is also developing novel risk stratification and decision Routine analysis of data obtained for quality and

support algorithms to monitor on a daily basis changes in the

performance purposes from a cohort of 17,025 CCHT

patient’s health status and to alert the clinical care

patients shows the benefits of a 25% reduction in numbers

coordinator so that a timely and optimal response can be

of bed days of care, 19% reduction in numbers of hospital

mounted to avoid unnecessary hospitalisation. We will also

admissions, and mean satisfaction score rating of 86% after

be able to automatically generate a report on the patient’s

enrolment into the program. Veterans now being monitored

condition and upload it to the PCEHR databases so that it can

are in excess of 600,000.

be available to the patient’s GP and other clinicians for viewing.

CSIRO is currently undertaking a trial called Home monitoring of Chronic

Whilst full results of this trial will not be available until April 2015, preliminary data have been encouraging. Patients are

Disease in Aged Care which is an

uniformly positive on the benefits of the tele-monitoring and

initiative funded by the Australian

report increasing awareness of their condition and a much

Government.

greater capacity for self management. We have collected many examples where an exacerbation in the patient’s condition has been detected and early intervention either

The trial is being carried out in six locations in five states

avoided hospitalisation or resulted in a better outcome. A

along the Eastern coast of Australia and involves 25 test

typical example as reported by the Clinical Care Coordinator

patients and 50 case matched control patients at each site.

is as follows. (Continued p. 4.)

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“I noted from measurements taken 18.2.14 that Patient X had a very slight decrease in SpO2 (2% from baseline), drop in spirometry and increase in temp (though technically still afebrile). She had reported a change in how she was feeling and her cough in her COPD questionnaire. I messaged via the TMC Unit and then decided to call her on 19.2.14. Though patient had commenced oral antibiotics the previous week (initiated by GP after I recommended she see him) she had not improved and had more cough. I then contacted outpatient department to establish if her Respiratory Physician had a vacancy in his clinic that day and secured it for her. I contacted patient with the appointment time and produced a report for the Consultant.� (Reported by the Clinical Care Coordinator)

We’ve even produced a case study video (http://

remunerated for their participation, and are be

tinyurl.com/casestudyvideo) to showcase examples of

concerned that telehealth may disrupt the traditional

patients who have been actively engaged in the trial and

patient doctor relationship.

seeing positive outcomes. 3.

The evidence is strong that telehealth for the management of chronic disease

Community nurses often become strong advocates of the benefits of telehealth, but may initially see it as disruptive of their normal patient centric work practices.

is well accepted by patients and leads to improved healthcare outcomes and

4. Lack of capability or willingness in some local health districts to embrace change and carry out the necessary

reduced hospitalisation, so why has

organisational

telehealth not yet become an accepted

introduce a new mode of health service delivery into

model of health service delivery in Australia?

change

management

required

to

established service models and workplace cultures. In our own trial we have experienced all of these concerns and have had to work through many organisational and

There are many reasons that will be fully identified as the

workplace issues, but in most cases Clinical Care

CSIRO trial reaches completion. A preliminary analysis

Coordinators and Project Officers have recognised the

however suggests:

benefits to their patients and have become strong advocates of at home telemonitoring. General Practitioners are also

1.

Lack of funding models for telemonitoring of patients at

becoming more involved as they begin to recognise the

home, reflecting the fact that Medicare traditionally

benefits to their own patients. Similarly a number of our

only funds services delivered by clinicians to patient

partners in the trial are now considering how to sustainably

face to face. Funding for telehealth however is available

retain and grow telehealth services within their own

from the Commonwealth through it Consumer Directed

organisations, based on the many positive patient

Care (CDC) initiative.

healthcare outcomes and organisational efficiencies that are becoming evident.

2.

Limited support from GPs who are often unaware of the international evidence, cannot see how they can be

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(Continued p. 5.)


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Many early adopters have been predicting a massive boom in the use of telehealth for more than a decade. However it may be that at long last that is becoming a reality. The most recent prediction comes from Ronald S. Weinstein, M.D., Director of the Arizona Telemedicine Program who in an interview with the Association of American Medical Colleges said, “Virtualization of health care is

the future of medicine. Many hospital and private practice services will be outsourced by telemedicine. I think that is on the close horizon. We’re estimating that 50 percent of all medical transactions will be done electronically by 2020.” A similar future can also be predicted with some confidence for Australia if we are to retain a sustainable universal healthcare system and a vibrant and efficient primary care and aged care sector as our population ages and the burden of chronic disease increases.

By Prof. Branko Celler FIEEE, FTSE, FACHI, FIEAust

Project Director, CSIRO National Telehealth Trial Principal Scientist | Digital Productivity and Services Flagship Computational Informatics CSIRO

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‘Why are they still here?’ Factors that influence numbers of days spent waiting for discharge for patients with no fixed address who are deemed medically ready Bridie Egan General Medical/Intensive Care Social Worker Social Work Department, St Vincent’s Hospital Melbourne

The care of homeless patients is of particular interest to St

1) A pilot study completed by the author focussed on patients

Vincent’s Hospital Melbourne (SVHM) however responding to

admitted to acute units who were identified as being

their needs can be complex and challenging. For SVHM this is

homeless. Preliminary findings from this study indicated that

a key social justice priority and it is also high on the agenda of

this patient group uses a high number of days waiting for

the State Government’s Victorian Homelessness Action Plan

discharge (WFD) once medically ready (MR) and are more

2011-2015.

likely to experience primary homelessness with no fixed address (NFA) (Egan, 2012).

Homeless patients generally require extensive input from social work clinicians in public hospitals, especially in relation

It was thus important to better understand the discharge

to discharge planning. However, managing the range of issues

pathways for those admitted to the acute wards with NFA as

this patient group presents in order to determine their

well as key demographic information and attendance at

discharge pathways and needs can be influenced by the type

follow up care.

of admitting unit, difficulty in obtaining demographic information and complexity of dual diagnoses. The majority

2) The second study considered whether service delivery

of research into medically ill homeless people has focused on

models could be developed to reduce average length of stay

emergency department admissions and there is little data

(LOS) whilst also improving the continuity of care for this

available concerning those being discharged from acute units.

patient group.

In response to this lack of information two studies were undertaken to further our understanding of the needs of this patient group. 6

Change Champions & Associates Newsletter - MAY 2014

(Continued p. 7.)


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The aims of this study were:

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Opinion

 53% of the total sample had at least one

re-presentation to SVHM within 12 months of the To identify factors that influence the number of days spent

audit being completed

waiting for discharge (WFD) for patients with NFA who were deemed MR, including factors impacting on continuity of care.

 62% had outpatient follow up appointments

booked, however only 48% attended these

To calculate the financial impact of missed opportunities for the hospital to attract additional revenue where the length of stay (LOS) exceeded the Victorian state average,

 46% accessed two or more programs/services

within SVHM to facilitate discharge planning

according to the Diagnostic Related Groupings (DRG’s) This research highlights that patients with NFA admitted to A sample of 34 patients listed as having NFA over a 24

acute wards at SVHM attract higher numbers of WFD bed

month period (January 2010 - December 2011) was

days than DRG averages and they are more likely to use

identified and an audit tool was developed to capture

multiple internal programs at SVHM to facilitate discharge.

relevant data including demographic information, continuity

This patient group is more likely to have multiple co-

of care and impact on the health service.

morbidities and to re-present to the hospital within a 12 month period post discharge but is less likely to attend

SVHM LOS data for the sample was compared with the

outpatient appointments.

Victorian State average LOS according to DRG’s and calculations were made on the ‘missed opportunity’ for the

The final phase of this body of research will utilise these

hospital to obtain additional revenue.

results to inform possible process improvements and the development of an integrated model of care to optimise

Results:  Patients had a combined LOS of 313 days (average of 9.2 days)  53% had a LOS above the State average. SVHM could

discharge planning for patients with NFA.

Work around prioritisation and consultation with medical staff to discuss and identify alternative outpatient follow-up options. Additionally, education to Patient Services Clerks regarding the collection of homeless patient demographic

have attracted an additional revenue of approximately

and contact details upon admission (such as mobile phone

$73,000 if those bed days were used to treat additional

numbers) would be worthwhile to ensure these patients can

patients with similar issues/conditions

be contacted for follow up care and support.

 A total of 84 days were spent WFD after patients were deemed to be medically ready to leave the hospital  Factors contributing to the WFD days included patients waiting for an available bed at SVMH’s ‘Cottage’ (a short stay ‘home-like’ environment for peo-

Acknowledgements This study was funded by SVHM’s Research Endowment Fund and acknowledges expert support from Sonia Posenelli, Dr Carrie Lethborg, Cheryl Apperley, Danielle Moss, Kathryn Dalton and Una McKeever.

ple experiencing homelessness) and for crisis accommodation via external support services. For more info, please email:  26% had a known forensic history and 55% of those have returned to prison since the audit was completed  77% had drug and alcohol issues, 59% had mental health issues and 52% of this cohort had dual diagnoses

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Process

improvements could include practice guidelines for Social

Change Champions & Associates Newsletter - MAY 2014

Bridie.EGAN@svhm.org.au


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Occupational Therapy Competencies Australia (OTCA) Website (otca.net.au) Supporting the development, achievement and evidencing of occupational therapy students’ graduating The University of Newcastle │ La Trobe University │ James Cook University Charles Sturt University │ University of Western Sydney By Catherine Studdert & Nadege Van Drempt on behalf of the OTCA Team.

At the end of 2010 an Office of Learning and Teaching Grant

Therapists had been recently revised by

was awarded to the University of Newcastle and its four

Occupational Therapy Australia (OTA)

partner universities to create a student-focussed website to

support the development of and evidencing of Occupational Therapy students’ graduating competencies. In September

There was no existing National framework for evidencing competence

National Registration was introduced in 2012

2011, the early work of our Project Team (Susan Ryan,

requiring students to evidence their competencies

Catherine Studdert, Paul Sijpkes, Carol Hills, Kim Nguyen,

prior to graduating and becoming registered to

Carol McKinstry, Lee Zakrzewski, Michael Curtin and Matthew

practice

Yau) was presented at the Change Champions & Associates

To engage students in their learning using

conference entitled: Innovative Strategies For Engaging and

technology in an interesting way, particularly as

Supporting

many students are tech-savvy familiar with a

Net

Generation

Students

(http://

www.changechampions.com.au/resource/Joel_Pilgrim.pdf).

variety of media.

Fast forward 3 years, and we are excited to tell you that the

The initial research undertaken by the team with

team have successfully achieved exactly that: they have

students, practice educators and Heads of Schools with

designed, developed and implemented the Occupational

occupational therapy programs showed they wanted

Therapy

resources and tools that would provide:

Competencies

Australia

(OTCA)

Website,

an

innovative and interactive student-centred website where students can find a range of tools and resources to help guide

 Examples of competent practice

them, better understand and gauge their competency

 A way to better understand practice

development, and to evidence, track and store their

 A way to gauge their competency development

achievements.

 A way to better understand the competency requirements and Standards

Why was OTCA created?

 A way of showing and evidencing their developing competence

The need for an Occupational Therapy student-centred website was identified because: 

 An ePortfolio where students could store and track their record of achieved competence and evidence.

The 2010 Australian Minimum Competency Standards for New Graduate Occupational (Continued p. 9.)

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Change Champions & Associates Newsletter - MAY 2014


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How does OTCA support students to achieve and

to self-assess their competence by ticking achieved

evidence their competencies?

competency statements with the option to describe how they achieved it and upload supporting evidence. If appropriate, the practice educator can verify the

Central to OTCA is its framework of two key tools:

achievement.

Competencies 1.

The

three

Occupational

Therapy

Competency

facilitate all aspects of preparing for and making the

Development Levels (Emerging, Consolidating and

most of valuable fieldwork placements. Thus students

Competent to Graduate) – designed to help students and

their

educators

gauge

their

can use the cycle to guide them to prepare for practice,

competency

write a letter to their practice educator, develop their

development 2.

learning objectives, self-assess and evidence their competence and reflect on their placement and plan for

The Occupational Therapy Practice Process designed to

their next.

help students better understand the general steps of practice from the request for service/referral for a new client, identifying and prioritising the client’s main issues, developing goals, intervention and evaluation. This is an interactive tool through which students can access a range of resources (videos, audio, documents, quizzes, etc) to support their competency development.

Matrix (OTCEM) (Figure 1.) – a competency evidencing containing

a

range

of

A secure customised ePortfolio where students can record, track and store their their letter to their educator, learning contract, reflections, self-assessed OTCEM, supporting evidence and any other appropriate item of achievement. So by the time they graduate, students will have a number of useful artefacts tions, reports and letters they can provide as evidence

The Occupational Therapy Competencies Evidencing mechanism

including documents, forms, case studies, presenta-

Other tools unique to OTCA include: 

The Practice Placement Cycle (Figure 2.) designed to

competency

statements mapped to the 2010 Standards (OTA) embedded within each Occupational Therapy Practice Process Step against the three levels. Students use this

that they are competent to graduate and safe to be registered to practice. The ePortfolio also enables students to see how far they have come in their professional journey. Additionally, ePortfolios may be used to assist new graduates with job interviews and once they are ready to start practicing. (Continued p. 10.)

Figure 1: OTCEM

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Change Champions & Associates Newsletter - MAY 2014

Figure 2: Practice Placement Cycle


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How can OTCA be used to further engage students in their learning? A range of fun, educational resources providing exemplars of competent practice and professional behaviour can be accessed through the Steps of the Occupational Therapy Practice Process, including: 

Examples of forms used in practice settings

Videos featuring students, real clients, practice educators and lecturers

Interactive quizzes related to each process Step

Personal growth resources.

Where is the OTCA Project up to now? The OTCA Website was launched at the University of Newcastle in May 2013. The five project partner universities are now using OTCA with their occupational therapy students. Five additional Universities have now subscribed to use the website in their programs, with a number of other universities expressing tremendous interest. Exciting updates and tools will continue to be added. OTCA has been presented nationally and internationally and will be presented in Japan in June and at a multidisciplinary forum at the University of Newcastle. Rebecca Pockney, Gjyn O’Toole, Amelia Reddall and Nadege Van Drempt are now involved with the team at the University of Newcastle.

OTCA – Beyond 2014? The OTCA Website has been designed for Australian Occupational Therapy students. However, it has been identified that this valuable tools’ innovative framework has great potential to be adapted for use in other disciplines and internationally.

For further information or to enquire about how you could utilise this innovative and valuable resource, please contact Project Manager:

Catherine Studdert Phone: +61 (02) 49216629 Email: catherine.studdert@newcastle.edu.au

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The Enhanced Management of Orthopaedic Surgery (EMOS) at Coffs Harbour Health Campus Andrew Wong Orthopaedic Care Coordinator Coffs Harbour Health Campus

The Enhanced Management of Orthopaedic Surgery (EMOS)

was launched at Coffs Harbour Health Campus in November 2013. Coffs Harbour is located halfway between Sydney and

Prehabilitation and planning to optimise patients pre-operatively

Brisbane. It has a population of approximately 70 000

Use of pre-operative analgesia and nutritional supplements

people but provides medical services to another 50 000 in

Spinal anaesthesia with local infiltration

the surrounding areas.

Use of tranexamic acid

Early mobilisation within 7 hrs of surgery

Active patient participation

It is a region with a higher

percentage of older population. Osteoarthritis currently affects around 8% of the population. A report for Arthritis Australia conducted by Access

Standardisation has been achieved through the formulation

Economics predicted that this figure will increase to 11% by

of the EMOS pathways for Total Hip Replacement and Total

2050, which prompted us at CHHC to plan how best we

Knee Replacement patients as well as through ongoing

could meet an increasing demand for total hip and knee

education of staff. This has led to a reduction in variation

joint replacement at our facility.

and a reduction in length of stay with our EMOS patient group as opposed to the non-EMOS patient group. To date,

High volumes of Total Hip Replacement and Total Knee

30 patients have undergone Total Knee Replacement or

Replacement surgeries are performed at Coffs Harbour

Total Hip Replacement surgery under the EMOS program

Health Campus each year with same to better length of stay

and 51 patients utilising standard care, with length of stay

as compared to peer hospitals. The aim of this program was

being 3.86 days and 5.19 days respectively.

to investigate how the length of stay could be further

feedback from patients who have utilised the EMOS

reduced and patient satisfaction improved. Extensive

program has been positive.

Preliminary

consultative processes involving both hospital staff and patients were performed highlighting local issues with

The current plan for the EMOS program at Coffs Harbour

current joint replacement processes. A literature search

Health Campus is to further achieve standardisation of joint

was

the

replacement processes through the development of a

management of Total Hip Replacement and Total Knee

patient education DVD to be used at all hospitals

Replacements.

surrounding Coffs Harbour. Furthermore, with justification

also

conducted

for

current

evidence

in

of beneficial results, plans are for EMOS pathway to Overwhelmingly, a solution to meet the aims of the program

transition to standard care in the future.

while addressing some of the local issues pointed to the Enhanced Recovery or Fast-track Model of Care.

The

principles which Coffs Harbour Health Campus decided to

For more info contact:

adopt include:

Andrew.Wong@ncahs.health.nsw.gov.au

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When Financial Downturn and Mental Health Collide Char Weeks Innovation Leader Change Champions & Associates There is mounting international evidence that suggests a spike

estimated at $1,675 million in direct (e.g. coronial inquests,

in suicides and attempted suicides during harsh economic

police and ambulance services, counseling support for friends

times such as the Great Depression, global financial crisis and

and relatives) and indirect costs. Of the estimated 65,000

more recently, during Greece’s financial turmoil

1,2,3

.

Australians who attempt suicide each year, around 38,000 first present at a hospital emergency department5, suggesting that

The reasons for suicide are complex. Economic downtown and

crisis has been a key motivator for seeking help. This raises

personal financial distress have been well documented as

questions of where and how the precipitants of suicide

precipitants of death by suicide. Recent research indicates a

attempts or the patient’s own recognition that they may be a

link between economic downturn and risk of cognitive decline

danger to themselves and others, are recorded. There appears

3

in middle aged Americans .

little available information about how many Australians who attempt suicide do so because of unbearable financial distress.

In recent years, the American Association of Suicidology has attempted to raise awareness about the link between

In recent years, we have seen a stronger investment in mental

economic decline and suicide rates. The association cites a

health programs across the continuum of care, support

direct relationship between unemployment rates and suicide

networks, consumer advisory groups, websites, media

with unemployed people being two to four times more likely

campaigns and help lines.

3

to suicide than those who are employed .

Perhaps, one of the most

memorable and humorous push media campaigns is beyondblue’s, Man Therapy, designed to raise men’s

This relationship between unemployment and suicide is deeply

awareness about the common symptoms of anxiety and

concerning considering that Australia is in the grip of its own

depression. This television advertisement aired during three

transition

weeks of cricket in 2014 and apparently attracted 19,000

from

post

industrialisation

to

technological

revolution. This is particularly noticeable in the recent and

visitors to its website, mantherapy.org.au during this time6.

proposed job losses in the Australian manufacturing sector. Looking forward, with technology as an enabler, the pace of

As they say, you can lead a horse to water, but you can’t make

change is likely to increase exponentially. For some, this

it drink.

mourning of the loss of the familiar, the stable, and the

frustrating for loved ones when a sufferer is so incapacitated

reliable may seem unrelenting and exhausting. For others,

by thought distortions that they are unable to get out of bed

future employment and financial uncertainty and concerns

and shower, let alone purposefully navigate their way through

that “the lucky country” may not be quite so, may be

the maze of programs on offer and figure out which part of

disturbing.

what program will help them to make the difference that will

And for those so genetically, economically or

socially predisposed, future uncertainty may precipitate an

With all the good will in the world, it can be

become the first step in their recovery.

erosion of psychological wellbeing. As a pull intervention strategy, the Australian Government is Suicide has the third highest burden of illness in Australia

rolling out its Partners in Recovery Program where the focus is

behind all cancers and cardiovascular disease. In 2012, more

on bringing together a team of services and supports across a

Australians died from suicide than road related car accidents

multiplicity of sectors to facilitate recovery for people with

and deaths attributed to skin cancers4. According to KPMG,

severe and persistent mental illness7.

the economic cost of suicide in Australia in 2012 was (Continued p. 13) 12

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This program has great potential if the person at the centre

debt. (Some larger banking and financial organisations

of the care is sufficiently empowered to be able to articulate

such as American Express and National Australia Bank

their needs and to have those expressed needs respected

have excellent supportive care to debt reduction

and acted upon as appropriate and without prejudice. There

programs in place).

is also potential for the social determinants of health, including financial wellbeing, to be actively integrated into a

Health, legal professionals, business and credit providers’

wholistic recovery plan.

capacities to be able to understand the actual needs and capabilities of the sufferer lie at the heart of building partner-

Since time immemorial, some people have worried about

ships toward recovery. For example, bankruptcy is often

having enough money to pay their bills and feed their family.

suggested as the obvious escape from pernicious financial

Does it not seem strange that service delivery for two

distress. But such a well intentioned suggestion may be

common and often interrelated issues, mental health and

perceived by the sufferer as more the final straw in a psycho-

financial distress remains so very early 20th century. Is it not

logically torturous battle within that ignites further mental

reminiscent of the days of waiting for the milkman, the

decline. Who can forget the ABC’s heart wrenching Landline

butcher, the baker and the greengrocer to deliver purchases

story, Losing the Farm8, where a farmer who had just put

for the Sunday meat, three veg and pudding lunch before the

down his last few sheep because they were unfit for sale, then

advent of that ubiquitous one stop shop, the supermarket.

took his own life.

The growing number of services and resources available for

This disconnection with the person who is liable for the

people with mental health concerns who are also suffering

payment of a debt may be exacerbated when the

financial hardship appear dishearteningly at odds with:

professional:

1.

the stigma, either real or perceived, still attached to financial failure or mental illness or both.

2.

the insidious nature of mental illness progression.

3.

the person’s ability to seek help, perhaps as a result of deep shame, denial, severity of illness, a sense of futility or a belief that if the financial problem was resolved they might feel better and vice versa.

4.

or comply with the normal run of business, taxation or even personal household bill responsibilities. the person’s vulnerability to unscrupulous purveyors of debt resolution services. 6.

fee free legal advice. greater transparency about processes that dispassionate creditors can take to recover a debt together with affirmative action options for people with mental illness that are recovery focused and lead to debt resolution. 8.

health legal and financial professionals including debt collection agencies’ ability to work as a cohesive,

13

persons’ true values; and or, 

feels that they don’t have the skills to provide advice about how to access financial advice and assistance or health care; and, or

believes that they are just doing their job in applying pressure to collect the debt.

The opportunity exists for primary care consultations to include family history of mental illness, assessment of financial situation, employment security, gambling history, values and behaviours around credit acquisition/management, budgeting and saving.

easy access to financial and budgeting advice, advocacy, counseling and services, consumer credit services and

7.

has been neither willing nor able to connect with the

the person’s vulnerability and ability, including paralysis of thought, to be able to deal with threats from creditors

5.

To be able to tap deeply into a patient or client’s true values requires that professionals be able to put aside their knowledge and suspend their own judgment to seek first to understand and then generate a plan that can meet each parties objectives. That can be equally confronting both for professionals whose strengths lie in supporting client recovery and those with a focus on the bottom line. __________________________________________________

supportive team towards a client centred improvement

For more info, email Char Weeks at:

journey that builds a sense of achievement, confidence

info@changechampions.com.au

and esteem for the client and progressively reduces

(References on p. 44)

Change Champions & Associates Newsletter - MAY 2014


TABLE OF CONTENTS

Articles

Upcoming Events

Resources

Opinion

The Living Conditions Program A case-management program assisting people affected by hoarding and/or squalor Mercy Splitt Service Manager, Hoarding and Squalor Consultancy Homelessness, Mental Health & Disability Catholic Community Services NSW/ACT

The Living Conditions program, which is offered by

many years, for various reasons) and make realistic

Catholic Community Services, is a Case Management

decisions about discarding them. This can be a lengthy and

program which assists people affected by hoarding and/or

traumatic process in which the client is supported through

squalor, within Sydney, the Illawarra, the Southern

a multi-disciplinary approach and the setting of realistic,

Highlands and the Hunter Region.

achievable goals within set time frames.

A referral can be made by service providers, health

Catholic Community Services has developed a training

practitioners, family, neighbours, or by the person them

package targeted at paid employees at any level within

self, which is then followed by a comprehensive assess-

Community, Health and Government sector, family,

ment to identify unmet needs. These needs include

friends, neighbours, or volunteers unsure of how to

tenancy related, financial, medical or support with linkag-

approach a situation.

es back into the community, due to the social isolation as a result of the impact of the hoarding and/or squalor.

The Hoarding and Squalor workshop provides attendees with a greater understanding of possible reasons as to why

The program encourages independence by involving the

people hoard and/or live in squalor, and learn the skills to

client in the decision making process and empowering the

engage and gain trust.

person to be able to take maximum control of the situation to achieve desired outcomes.

The Living Conditions Program

For more information, please visit http:// www.catholiccommunityservices.com.au/services/ programs/living-conditions-program

is not a 'clean up service'. ...Rather, the service aims to assist someone to sort through their own items (that have accumulated over 14

Change Champions & Associates Newsletter - MAY 2014

Or contact Mercy Splitt at msplitt@chcs.com.au


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Articles

Upcoming Events

Resources

Opinion

Change Champions & Associates presents a brand new workshop

NE

Manage Your Energy Rather Than Your Time

W !

Full Breakfast Workshop with Char Weeks

If you are over trying to manage your time so that you can do everything on your wish list on time all the time, this workshop might be for you. Join Char Weeks for this practical and inspiring workshop which could change the way you do everything.

15 August 2014, 07.00-09.30 Melbourne, VIC Register today!

15

www.changechampions.com.au

Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

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Opinion

NE

W !

PROVEN GOVERNANCE: How effective is your Board or Management Committee?

A practical and challenging Master Class with expert David Schwarz for executives and leaders who not only wish to make a difference, but want that difference to be measurable. Proven Governance is a powerful test of a

and organisations. In simple terms, many

Board/Committee's resolve to embed its

individuals and organisations espouse lofty

values and principles into the fabric of the

values and principles. However, the actual

Board/Committee itself.

behaviour of those in governance may, or they may not be, aligned with these

Proven Governance is underpinned by the

espoused values and principles. The key is

belief that the actual values to which

that the organisation is able to articulate,

individuals and organisations say they are

by reference to practical examples, the

committed to, will, and should, find a place

way

in the actual behaviour of those individuals

governance of the organisation.

their

values

are

built

into

Thursday, 24 July 2014 in Melbourne VIC (09.00-17.00) Friday, 25 July 2014 in Sydney NSW (09.00-17.00)

Register online: www.changechampions.com.au 16

Change Champions & Associates Newsletter - MAY 2014

the


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Articles

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Resources

Opinion

Need some practical tools to help you unravel and prioritise those complexities to deliver the best outcomes for your clients?

The ABC of BOC Working with Older Adults with Complex Health Care Needs Who Display Behaviours of Concern Join recognised expert, Dr Alice Rota Bartelink, in this full-day practical case-study workshop.

Workshop Content This practical case study day offers a vibrant, supportive, but strictly confidential forum for professionals who are: 

Uncertain about where to start unraveling complexities in caring for older adults who display behaviours of concern

Keen to understand the implications of behaviours of concern e.g. the impact and flow-on effect on staff, patients, clients, residents etc.

Interested in discovering tools and techniques to be able to more effectively identify and prioritise the management of behaviours of concern displayed by clients

Recognise the need to be able to measure the success of behaviour interventions and management plans

17

DATES 09 May 2014 – Auckland, NZ 23 May 2014 – Perth, WA 06 June 2014 – Sydney, NSW 20 June 2014 – Mackay, QLD 22 Aug 2014 – Hobart, TAS 

in-house opportunities!

REGISTER ONLINE!

www.changechampions.com.au

Change Champions & Associates Newsletter - MAY 2014


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Articles

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Opinion

BUILDING RESILIENCE AT WORK

A Full Day Workshop for Leaders and Leadership Teams The most valuable assets in any organisation are their people. Today’s executives and leaders appreciate the need to be on top of their game all of the time; regardless of the pressures they face from an ever changing environment. They are expected to be able to support their teams through a myriad of challenges while maintaining a positive work environment. This practical workshop is for the emotionally intelligent: those who understand that RESILIENCE is a key characteristic of a healthy, productive and sustainable team.

Who Should Attend Executives, managers and team leaders from any government or professional or industry sector. Delegates are welcome to bring case studies for discussion in strictest confidence.

12 May 2014 In Auckland, NZ It is not too late to register!!!

KATHRYN MCEWEN is an organisational psychologist, company director and executive coach. Join her for this stimulating workshop, purposely designed to provide you with the strategies and tools you need to build resilience at work.

For more info, or to register online please visit:

WWW.CHANGECHAMPIONS.COM.AU 18

Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

Resources

Opinion

Workshop with Elise Wald

Making a Difference

In Sleep

A workshop on sleep therapy techniques so you can assist patients to improve their sleep without medication

For allied health professionals, GPs, nurses, sleep technicians and any other professional working with chronic and complex conditions

Thursday, 19 June 2014 09.30-16.30 in Melbourne, VIC - with Elise Wald www.changechampions.com.au 19

Change Champions & Associates Newsletter - MAY 2014


Articles

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Upcoming Events

Resources

Opinion

How to influence

BEHAVIOUR CHANGE

in patients with chronic illness 2-day workshop with Elise Wald

    

21 09 17 15 23

& & & & &

22 10 18 16 24

May 2014 - Darwin, NT, Australia June 2014 - Perth, WA, Australia July 2014 - Sydney, NSW, Australia September 2014 - Dunedin, New Zealand September 2014 - Auckland, New Zealand REGISTER ONLINE TODAY!

20

www.changechampions.com.au

Change Champions & Associates Newsletter - MAY 2014


Articles

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Upcoming Events

Resources

Opinion

How to influence

BEHAVIOUR CHANGE in people with severe and persistent mental illness 2-day workshop with Elise Wald

   

15th & 16th May 2014 — Melbourne, VIC, Australia 21st & 22nd July 2014 — Sydney, NSW, Australia 17th & 18th September 2014 — Dunedin, New Zealand 25th & 26th September 2014 — Auckland, New Zealand

Register online today! 21

www.changechampions.com.au www.changechampions.com.au Change Champions & Associates Newsletter - MAY 2014


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Articles

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Opinion

Sex, Sexuality & Culture Addressing Social Diversity in Aged Care

16 July 2014– Mackay, QLD Workshop with Robyn Attoe & Daryl Oehm Culture, gender identity, sexual orientation and sexuality are integral to personal identity and our sense of well-being. Without attention to social diversity it is difficult to provide person centred quality aged care.

This interactive workshop is designed to:  draw on your experiences working with culture & sexuality in aged care,  address similarities in cultural and LGBTI competencies,  draw on broader issues of diversity in our community, and;  plan strategies to provide aged care that is respectful of emotional and

physical needs.

22

www.changechampions.com.au

Change Champions & Associates Newsletter - MAY 2014


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Articles

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Opinion

Managing Behavioural & Psychological Symptoms of Dementia One day workshop with Robyn Attoe

Up to 90 % of people who have dementia will experience behavioural and or psychological symptoms during the course of their illness .

16 May 2014 - Perth, WA 18 July 2014 - Mackay, QLD + In house opportunities available at your facility

OUTLINE 1.

Discuss the different types of dementia, the changes to the brain and the behaviours staff may see in each type of dementia

2.

How to communicate effectively with the person with dementia (PWD)

3.

How the environment impacts on behaviour and how staff can modify the environment to reduce BPSD

4.

Discuss and define Psychological Symptoms of dementia and how to manage them

5.

How staff can assist in the transition from home to hospital or residential care by identifying the needs of the PWD and then providing a detailed strengths based care plan for the PWD

6.

23

Discussion of case studies and more ‌

www.changechampions.com.au

Change Champions & Associates Newsletter - MAY 2014


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Articles

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Resources

Opinion

A practical workshop with Robyn Attoe

Bathing

Without

Battles

The process of bathing is usually pleasurable and relaxing for most people! In contrast, bathing can be both a distressing and

30 May 2014

traumatic experience for people with dementia and their carers.

Perth, WA

This workshop will assist you to see bathing as not a task to be performed but rather a human interaction that can be pleasant for both carer and the person with dementia. This workshop is suitable for: 1. Anyone who works in the Aged care field including home

17 July 2014 Mackay, QLD + in house opportunities available at your facility

care workers and supervisors 2. Anyone partnering in care with a person with dementia

Register online!

3. Hospital and Residential Care Staff

www.changechampions.com.au 24

Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

Resources

Opinion

Delirium

And the older person

“You would have to be half mad to dream me up.”

-Lewis Carroll, Alice in Wonderland

Full day workshop with Robyn Attoe “Delirium in older hospitalised people is often overlooked or misdiagnosed due to limited staff knowledge of delirium features or a perception that all cognitive impairment is due to dementia” (Australian Government Department of Health and Ageing). Delirium is a serious medical problem which results in increased length of stay in hospital, premature institutionalisation, morbidity and mortality in the elderly. Needless to say the cost to the healthcare system is enormous! This practical workshop by recognised dementia behaviour expert, Robyn Attoe, is designed to assist anyone working with older people:  to recognise the delirious patient early  improve knowledge about delirium management

15 May 2014 - Perth, WA + in house opportunities available

www.changechampions.com.au 25

Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

Resources

Opinion

Working effectively with clients experiencing

family estrangement

Full Day Workshop with Kylie Agllias   

09th May 2014 – QLD (09.15-16.30) 16th May 2014 – SA (09.15-16.30) 30th May 2014 – VIC (09.15-16.30)

or as an in-house at your organisation Visit the website for more details or to register online!

26

www.changechampions.com.au Change Champions & Associates Newsletter - MAY 2014


Articles

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The

Upcoming Events

Resources

Opinion

Long Stay Patient A workshop with Julie Faoro

Many of you will have met Joan. She is a 74 year old widow who was living independently at home prior to presenting at your hospital ED in an altered conscious state. On assessment and investigation, layers of medical issues appear and need unravelling. Moving on, our Joan is still in hospital after 154 days. She's frustrated and bored. There is no agreed discharge plan and Joan just wants to go home. Your team are reluctant to discharge Joan because they are yet to be convinced that all her layers of issues have been resolved. These sorts of long stays are preventable. And this workshop with serve as a valuable investment for your hospital in preventing these long stays. Is this your patient? Could you do with some help to free up her bed? Ideal audience: ANUM's, discharge planner, case manager, care co-ordinators, performance analysts and anyone else who genuinely cares about Joan and her need to live out her days independently and in her own home.

DATES     27

8 & 9 May 2014 – Auckland, NZ 22 & 23 May 2014 – Perth, WA 19 & 20 June 2014 – Sydney, NSW 17 & 18 July 2014– Brisbane, QLD

Change Champions & Associates Newsletter - MAY 2014

Learning Objectives  To identify patients that may benefit from the

application of the long stay model prior to consuming excessive bed days  To learn how to engage all stakeholders in

the implementation of the long stay program  To develop knowledge and skill in the appli-

cation of the tools and methodology related to the long stay program model

Register online today! WWW.CHANGECHAMPIONS.COM.AU


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Opinion

SOCIAL MEDIA Full day WORKSHOP with Glenn D. Payne

28 May 2014 - 09.30-16.30 The Business Centre 365 Little Collins St, Melbourne, VIC Register online!

www.changechampions.com.au 28

Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

Resources

Opinion

The New Leaders Toolkit Full day workshop with Char Weeks

A Practical Workshop on the Stuff That’s Not in the Book 13 May 2014 – Adelaide, SA 27th May 2014 – Perth, WA 20th June 2014 – Gold Coast, QLD 5th August 2014 – Brisbane, QLD 9th September 2014 – Sydney, NSW 24th October 2014 – Melbourne, VIC + in house opportunities also available!

Register online: www.changechampions.com.au

29

Change Champions & Associates Newsletter - MAY 2014


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MANAGING UP (How to help your boss add value to your work) Ever bounced into your boss’ office to eagerly report on project progress, only to be met with a quizzical stare? Ever been stopped mid-sentence by a boss who has no idea what you are talking about? Ever been asked to cut to the chase when you thought you were actually giving a brief summary? Did their eyes glaze over half way through a perhaps long winded explanation? Feel a bit anxious when going into a meeting with your boss?

what is important to them as a leader and manager.

Here is a 3 hour workshop that will help

Better understand how to tap into your boss’ skills and expertise to enhance each others’ roles, to build trust, respect

you to make those meetings with your boss a much more

Understand the broader context in which your boss works and

and capability. 

mutually rewarding

Identify strategies to ensure that you and your boss are on the same page in update meetings and that you are more clear

experience

about what to do when you get back to your desk. 

Build confidence in presenting information to your busy boss to elicit a considered, timely and appropriate response.

Register online!

www.changechampions.com.au

2014 WORKSHOPS 09 23 18 01 05 22

May 2014 – Adelaide, SA May 2014 – Perth, WA June 2014 – Gold Coast, QLD August 2014 – Brisbane, QLD September 2014 – Sydney, NSW October 2014– Melbourne, VIC

+ in house opportunities also available!

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Change Champions & Associates Newsletter - MAY 2014


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Articles

Upcoming Events

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Opinion

Creating a Culture of Full day workshop with Char Weeks

This practical workshop draws upon the best international literature and focuses on how to create a culture of innovation in health and aged care.

2014

Delegates will learn a step by step approach to creating a

12 MAY 2014– SA

culture of innovation in their organisation:

26 MAY 2014– WA

 Define what constitutes “innovation” as a

pre-requisite for culture change  Understand the DNA of innovators and how they

inspire others  Consider case studies of innovation in organisations

19 JUN 2014– QLD 04 AUG 2014– QLD 08 SEPT 2014– NSW 23 OCT 2014– VIC

 Look at strategies and tools for fostering innovation in

your organisation  Develop a road map for fostering innovation in your

In-house opportunities also available

organisation after the workshop

www.changechampions.com.au 31

Change Champions & Associates Newsletter - MAY 2014


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Articles

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Opinion

The Change Implementer's

Toolkit 101

FIRST TIME MANAGING A PROJECT OR PROGRAM? Excited and enthusiastic about the opportunity to expand your horizons by working on a new initiative? Expert on the topic area? What about your expertise on how to manage change? Not too many ideas…. Great! You are the ideal participant in this full day, introductory, interactive workshop.

AUDIENCE For health, aged, primary community care, local government, member associations and not for profits professionals who are new to working on projects. Note: This is a novices only workshop. If you dream at night about the work of the greats in change management (i.e. Kotter, Bridges, Lewin, Senge, MossKanter etc.), you are too experienced to attend.

Register today! Visit www.changechampions.com.au 32

Change Champions & Associates Newsletter - MAY 2014

DATES 07 May 2014 – Adelaide, SA 21 May 2014 – Perth, WA 16 June 2014 – Gold Coast, QLD 30 June 2014 – Brisbane, QLD 03 September 2014 – Sydney, NSW 20 October 2014– Melbourne, VIC + in house opportunities available


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Opinion

Moving Forward Accepting and Embracing Resistance to Change

This master class will enable you to: EXPLORE reasons for and sources of resistance to change both more broadly and in the context of your role as a change agent, leader, implementer or recipient

LEARN strategies for anticipating, addressing and managing resistance to change and any unintended consequences

DISCUSS ways to build dynamic coalitions for sustainable change

MANAGE the messages, manage people and networks, develop competencies, find comfort zones

Who should come? New leaders and project managers from any industry or public sector who are keen to develop their skills in Change Management

UPCOMING DATES 05 MAY 2014 - Adelaide, SA 19 MAY 2014 - Perth, WA 11 JUNE 2014 - Gold Coast, QLD 28 JULY 2014 - Brisbane, QLD 01 SEPT 2014 - Sydney, NSW 16 OCT 2014 - Melbourne, VIC

DELGATES ARE TO BRING: 1. Organisational chart with names of position holders de-identified 2. Project proposal or implementation strategy or a change resistance issue (real or hypothetical) 33

Change Champions & Associates Newsletter - MAY 2014

REGISTER ONLINE: www.changechampions.com.au


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Articles

Upcoming Events

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Opinion

Handy Hints For the Novice Conference Presenter Are you doing great work but rarely present in public? This is a workshop for the novice conference presenter who needs practical tools to become a confident speaker.

Workshop Program 

Introduction

Do you recognise the rabbit in the headlights?

Write a bio that promotes your Best Asset– YOU

Write a great abstract

Learn from the experts

Preparing your presentation

Managing yourself, the venue and the AV

Practice delivering a presentation

Train yourself to answer questions well BRING A 5 MINUTE PRESENTATION

34

Upcoming Dates 06 MAY 2014 - Adelaide, SA 20 MAY 2014 - Perth, WA 12 JUNE 2014 - Gold Coast, QLD 29 JULY 2014 - Brisbane, QLD 02 SEPT 2014 - Sydney, NSW 17 OCT 2014 - Melbourne, VIC

www.changechampions.com.au Change Champions & Associates Newsletter - MAY 2014


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Opinion

The Challenge of Long Term Alcohol Abuse in Older Adults A practical in-house master class with Alice Rota-Bartelink on managing older clients living with Alcohol Related Brain Injury (ARBI)

Workshop Outline 

Introduction

Alcohol & Alcoholism

Symptoms

Alcohol and the Ageing Body

Comorbidity

Alcohol and the Brain

The Role of a Neuropsychologist

Treatment

Managing Challenging Behaviour

Aggressive Behaviour

Self Care Practices - Staff

Case Profile

Conclusion

Download the PDF flyer from our website www.changechampions.com.au and fill out the expressions of interest form 35

Master Class Aim To facilitate the transfer of skills and knowledge gained through evaluative research into the provision of appropriate support to clients living with alcohol related brain injury (ARBI) this presentation will provide education on the effects of long-term alcohol abuse on an older person and advice on strategies to assist service providers with managing behaviours of concern among older clients living with ARBI.

“This Master Class aims to improve the life quality of this often forgotten and neglected group of people by providing participants with an understanding of their unique set of care needs and imparting the skills required to enhance the delivery of effective care and support.” - Alice Rota-Bartelink

Make an inquiry for your facility!

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The Service Providers Toolkit: Improving the Care of Older Homeless People In-house master class with Alice Rota -Bartelink

Homeless and the Aged 

Introducing Nigel: Case profile

Defining homelessness – primary, secondary and tertiary

IN-HOUSE WORKSHOP

Characteristics of an aged homeless population

Advocating for the older homeless person

This workshop is available as an

Navigating complex service systems

in-house at your organisation.

Understanding life roles and the significance of

Download the PDF flyer from

engaging in meaningful activities

our website to read more info

Facing the challenge of “behaviours of unmet need”

and to fill out the expressions

The Service Providers Toolkit

of interest form.

36

www.changechampions.com.au

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Articles

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Book an in-house for your facility!

Pathways to a Consumer Focused Organisation – Governance and Managerial Approaches It is timely for health care organisations, from boards to

With facilitators Stephanie Newell & Mitchell Messer

IN-HOUSE MASTER CLASS For more details please visit our website and download & fill out an expressions of interest form. We’ll then get back in touch with the relevant information

Visit

front-line staff, to gain a clear understanding of consumer participation and consumer experience principles.

Set within the context of the current health reforms and expanding mandatory requirements this Master Class is a strategic exploration and examination of the health consumer participation trilogy: consumer engagement, consumer involvement and consumer partnerships for organisationwide quality improvement.

Audience Profile Board members, health services executives, clinicians, safety & quality co-ordinators/managers, risk managers, clinical governance managers and health consumers.

www.changechampions.com.au

To download official flyer & register your expression of interest 37

Change Champions & Associates Newsletter - MAY 2014


Articles

Upcoming Events

Resources

Opinion

Confidential Coaching Service With experienced certified executive coach

Feel like you’ve bitten off more than you can chew? Get the support you need, when you need it . Suitable for emerging managers working in health, aged, primary and community care and especially those new to program, project and other funded initiative management and those who are:   

working in isolated regions or just working in isolation those with little previous experience sufferers of imposter syndrome (i.e. feeling way out of your depth or certain that your lack of skills will shortly be discovered)

Receive support and advice in the areas of:  Strategic planning, program      

implementation Relationship management, networking/ collaboration building and management Working with a Board/Committee Managing up Working with staff Brain storming Management self development

Telephone coaching service available in or out of hours. (Hourly rates) Face to face coaching also available by appointment. Email: info@changechampions.com.au 38

Change Champions & Associates Newsletter - MAY 2014


Articles

Upcoming Events

Resources

Opinion

International RESOURCES Community services: How they can transform care Edwards N, The King’s Fund (2014). This paper looks at the changes needed to realise the full potential of community services for transforming care. The Transforming Community Services policy, launched in 2008, was mainly concerned with structural changes. While the emphasis on moving care closer to home has resulted in some reductions in length of hospital stay, it is now time to focus on the bigger issue of how services need to change to fundamentally transform care. The paper is based on contributions from a working group of community providers convened by The King’s Fund, which was tasked with exploring how community services can help deliver the transformation in care that was promised by the 2008 policy. http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/community-services-nigel-edwardsfeb14.pdf

Cellulitis Clinical Pathway Lakes DHB, NZ This document is a pathway document has been approved by the Lakes District Health Board, NZ, Clinical Pathways Clinical Governance Group. It was issued in December 2012 and has been reviewed in May 2013. http://www.lakesdhb.govt.nz/Resource.aspx?ID=24968

Validation of an advanced practice physiotherapy model of care in an orthopaedic outpatient clinic François Desmeules, Panagiota Toliopoulos, Jean-Sébastien Roy, Linda June Woodhouse, Marc Lacelle, Manon Leroux, Steven Girard, Debbie E Feldman, and Julio C Fernandes. In Canada, new models of orthopaedic care involving advanced practice physiotherapists (APP) are being implemented. In these new models, aimed at improving the efficiency of care for patients with musculoskeletal disorders, APPs diagnose, triage and conservatively treat patients. Formal validation of the efficiency and appropriateness of these emerging models is scarce. The purpose of this study is to assess the diagnostic agreement of an APP compared to orthopaedic surgeons as well as to assess treatment concordance, healthcare resource use, and patient satisfaction in this new model. http://www.biomedcentral.com/1471-2474/14/162

Tweets about hospital quality: a mixed methods study Felix Greaves, Antony A Laverty, Daniel Ramirez Cano, Karo Moilanen, Stephen Pulman, Ara Darzi, Christopher Millett Background Twitter is increasingly being used by patients to comment on their experience of healthcare. This may provide information for understanding the quality of healthcare providers and improving services. http://qualitysafety.bmj.com/content/early/2014/04/19/bmjqs-2014-002875.full 39

Change Champions & Associates Newsletter - MAY 2014


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Upcoming Events

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Opinion

Australian RESOURCES Depression in older age: A scoping study National Ageing Research Institute Prepared by Ms Betty Haralambous, Ms Xiaoping Lin, Dr Briony Dow, Ms Carolyne Jones, Dr Jean Tinney and Dr Christina Bryant Funded by beyondblue: the national depression initiative Depression affects people of all ages, but this study was particularly focused on the knowledge and information available about depression and anxiety amongst older people. This study aimed to identify the gaps in current knowledge about diagnosis and treatment of depression and anxiety amongst older adults (those aged over 65 years) in Australia in order to identify priority areas for Australian research into older age depression. http://www.beyondblue.org.au/docs/default-source/default-document-library/bw0143---nari-2009-full-report---minusappendices.pdf?sfvrsn=4

Older adults with cancer and clinical decision-making: the importance of assessing cognition Wee-Kheng Soo, Department of Geriatric Medicine, Eastern Health, Box Hill, Victoria Cognitive impairment presents unique clinical challenges in the management of older adults with cancer. With an ageing population, the recognition and management of cognitive impairment is likely to become more important in oncology practice. Currently, screening for cognitive impairment is not routinely performed in oncology. However, screening has been shown to detect cognitive deficits in a significant proportion of older adults with cancer. This can have a significant impact on treatment decisions, including determining suitability for cancer therapy and capacity to provide informed consent. In addition, cognitive impairment can enhance the risk of complications from cancer and its treatment. Early identification can facilitate appropriate decision-making and interventions to minimise its consequences. Further research is needed on recognition and management of cognitive impairment in older adults with cancer. This article provides an overview of cognitive impairment in older adults with cancer, with the aim of informing clinicians on the importance of assessing cognition. http://www.cancerforum.org.au/Issues/2013/November/Forum/Older_adults_with_cancer.htm

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Change Champions & Associates Newsletter - MAY 2014


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Upcoming Events

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Opinion

Australian RESOURCES Gaining a new respect for the other guys: scripted scenarios for inter professional education in paediatric emergencies Ann Lazarsfeld-Jensen & Donna Bridges, Charles Sturt University This project aimed to find ways of staging and evaluating simulations as a tool of Interprofessional Education. A series of scripted paediatric emergencies was used to create an intense learning environment to explore knowledge exchange and shared learning between GP registrars and paramedics. Although simulation is a familiar tool in medical education, its use in interprofessional education (IPE) is difficult to facilitate because of its many dimensions. http://ro.ecu.edu.au/cgi/viewcontent.cgi?article=1421&context=jephc

POSTER: Green Light ProjectImproving patient access to Liverpool Hospital Intensive Care Unit Start Date: 25/02/2013 Completion Date: 30/12/2014 The Green Light project will measurably improve access to Intensive Care Unit beds at Liverpool by improving the timely and safe transfer of patients into ICU and to wards.

http://www.archi.net.au/documents/our-services/innovations/green-light.pdf

Smoke hazard during a bushfire event Dr Monika Nitschke, Department of Health – South Australia This presentation is about short term public health impacts from bush fire smoke. https://www.agedcommunity.asn.au/files/bushfire-workshop-2013/bushfire-advice_nitschke.pdf

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Australian RESOURCES SOCIAL ISOLATION: Its impact on the mental health & wellbeing of older Victorians COTA—Vicotira

It is well-known that lacking friends and social networks is bad for physical health. The Paper outlines research which is now suggesting that being socially isolated can also affect mental health, increasing the risk of experiencing mental illnesses such as dementia, depression and anxiety. COTA Victoria argues that maintaining opportunities for social participation should be a key factor when policy affecting older people is framed. The experience of social isolation requires a multi-faceted, holistic policy response. http://www.cotavic.org.au/wp-content/uploads/2014/02/Working-Paper_Social-Isolation.pdf

Patient safety – handover of care between primary and acute care Policy review and analysis Dr Lesley Russell, Ms Jennifer Doggett, Dr Paresh Dawda, Mr Robert Wells The Integrated Care Working Group (ICWG) of the National Lead Clinicians Group (LCG) commissioned the Australian Primary Health Care Research Institute (APHCRI) to undertake a review of evidence and policy around patients‟ transitions between the primary and acute sectors. http://www.leadclinicians.health.gov.au/internet/lcg/publishing.nsf/Content/0BC80B14F241017BCA257A590021F2E8/$File/ Transitions%20of%20Care%20report%20FINAL%207May13.pdf

SEXUALITY: Dementia Friendly Environments Government of Victoria 

Strategies for sexual and sensual expression

Strategies for intimacy between residents

Strategies for staff training and awareness

http://www.health.vic.gov.au/dementia/strategies/sexuality.htm 42

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Challenges integrating health care services Dawn Skidmore dawn.skidmore.au@googlemail.com

As a consultant I am frequently asked to help health care

Are you facing these challenges? Are you in the health care

organisations deliver health care reforms, and in particular,

sector committed to making a difference but not knowing

achieve more integrated services.

where to start?

Many of my health care clients are striving to ensure their

Firstly seek out and make friends with your Medicare

health systems are sustainable, of high quality, safe, and fit

Local. Medicare Locals (MLs) are ideally placed to act as

for future health needs. Many are working to achieve

the binding agent for various health sectors at a local level.

seamless integration of care between sectors, struggling to

MLs are locally governed and directed by local clinicians

achieve continuity of care for patients and families and

and other community leaders who are in touch with local

how to establish effective governance models to create

areas. They are regional primary health care organisations

support and maintain the delivery of quality care involving

working to better connect health services locally and to

multiple providers.

Others are facing the challenge of

find the service gaps that need to be addressed to ensure

empowering and supporting the primary care sector to

communities and consumers get the health services they

better engage with the rest of the health care system.

need closer to home.

Common difficulties include:

Medicare Locals are making a difference by working with

The need to balance the interests and values of all

primary health care professionals, to introduce new

stakeholders involved in the continuum of care

models of health care delivery through expanded

The fragmented, complex, and often impersonal

multidisciplinary health care teams. They also:

health services, that patients and carers report are becoming increasingly difficult and frustrating to

services across their designated region

navigate  

Conflicting priorities and timeframes for action of the

Support greater coordination of primary health care

Identify and address local service gaps and determining

various stakeholders and parts of the system

priority areas relevant to primary health care to create a

The need for governance mechanisms that meet the

more equitable system

needs of the community while maintaining the

Drive quality improvement through best practice

integrity of individual sectors and

Report on population health outcomes through Healthy

Gaps in evidence and understanding on how to

Communities Reports, published annually by the National

achieve the required outcomes and health service

Health Performance Authority

reforms.

Establish effective partnerships with other health, community, social and aged care providers, including Local

Of course these challenges are not unique to Australia. But

Hospital Networks, to support local health and care

whilst health care reform is occurring across the globe,

services

achieving the enablers such as pooled funds and its

Enhance access to after hours and primary mental health

associated partnership working may be easier to realise in

care services and supporting the uptake of e-health

some countries. In Australia, the complex funding divides

initiatives including Personally Controlled Electronic Health

between primary and secondary health care represents an

Records (PCEHR).

important barrier.

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(Continued p. 43.)


Articles

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Opinion

Why not see how working with your Medicare Local can

you may well be able to strengthen the integration and care

help you overcome some of the challenges you face?

coordination processes.

Once you have done this, consider that there, in my opinion,

I have seen a number of successful models of integrated

a number of key requirements that need to be in place if

care across Australia. In each of these, patient/community

health service integration is be achieved. Perhaps not

engagement is an important component. For example

surprisingly, this starts with effective leadership, commit-

patients and the community participate through patient

ment to collaborative and partnership working and a shared

experiences and stories. Integrated information communica-

vision and commitment to quality and safety. After all,

tion technology systems are another common feature.

health sector integration is dependent on a these

These systems have been designed to support clinical

foundations, along with effective policy and robust and

information sharing and there is an agreed and committed

transparent systems of governance. Only then can effective

use of data and quality improvement tools in planning,

and sustainable working relationships be realised. Change

delivery, and evaluation of continuous improvement.

management needs to be managed locally; with committed

Consider

resources and an approach that aligns with organisational

including

cultural values.

learning opportunities can provide training to support new

how

continuous

inter-professional

professional and

development,

inter-organisational

ways of working, aligning cultures and goals and identifying Partner organisations need to agree on the shared priorities,

workforce capacity across the health care system and

including clinical priorities, and enter into joint strategic

continuum of care.

needs assessment (taking a geographical population focus). The following strategic planning needs to be conducted with

Good luck in supporting your health care organisation to

input from providers and users. If you can identify and use

deliver health care reforms and at the same time achieve

appropriate incentives (such as any pooled funding) then

more integrated services!

Policy context In 2009, the Commonwealth Government produced A healthier future for all Australians – final report of the National Health and Hospitals Reform Commission recommending that to achieve increased health care effectiveness and efficiency, there was a need for changes to healthcare governance in Australia. In 2010 Australia’s First National Primary Health Care Strategy Building a 21st century primary health care system was produced heralding regional service integration as one of the five key building blocks. Both of these key policy documents demand improved integration of care between the primary care and hospital sectors. Australia's primary health care sector, the care you get outside of hospitals, has been reformed through the development of 61 Medicare Locals (ML) across Australia.

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ARTICLE: When Financial Downturn and Mental Health Collide, Char Weeks (p. 12) REFERENCES: 1,

Wahlbeck K, McDaid D. Actions to alleviate the mental health impact of economic crisis. World Psychiatry, 2012, October,

11(3):139-145. 2

Kentikelenis, A, Karanikolos M, Papanicolas I, Bascu S, McKee M, Stuckler D, Health effects of financial crisis: omens of a

Greek tragedy. Lancet, Volume 378, Issue 9801, Pages 1457 - 1458, 22 October 2011. 3

Haiken M, Suicide Risk in Time of Financial Crisis – real connection. Forbes, http://www.forbes.com/sites/

melaniehaiken/2011/08/10/suicide-risk-in-times-of-financial-crisis-a-real-connection/2/ 4

KPMG’s Health Economics, The Economic Cost of Suicide in Australia, October 2013.

5

Woodward, A. Suicide is Everyone’s Business. Article in http://www.lifeline.org.au/About-Lifeline/Media-Centre/Media-

Releases/Media-Release-Files/Why-Suicide-Prevention-is-Everyone-s-Business 6

beyondblue . Media Releases. Men responding in large numbers to beyondblue TV campaign. Jan 2014. http://

www.beyondblue.org.au/media/media-releases/ men-responding-in-large-numbers-to- beyondblue-TV-campaign 7

Partners in Recovery Initiative, http:www.pirinitiative.com.au. Accessed 12 April 2014

8

ABC Landline, Losing the Farm, 6 April 2014, http://www.abc.net.au/landline/archives/landline_201404.htm. Accessed 12

April 2014

Innovation in Health Conference June 16th and 17th 2014 Novotel Hotel St Kilda, 16 The Esplanade, St Kilda, VIC The Victorian Healthcare Quality Association, in association with the Centre of Research Excellence in Patient Safety and the Australasian Association for Quality in Health Care is proud to announce our upcoming two-day conference showcasing quality improvement initiatives which have won major awards across Australia over the previous 12 months. Who should attend? This conference is directed at Quality Managers, Nursing and Medical leaders and Executives who want to keep abreast of innovative practice by healthcare workers which has beenrecognised as being outstanding by their peers. Booking? http://www.trybooking.com/81291 Enquiries? vhqasn@gmail.com which will be accessed daily for any inquiries

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Change Champions & Associates Newsletter - MAY 2014


PO Box 302 Kew, Victoria 3101 AUSTRALIA E: info@changechampions.com.au W: www.changechampions.com.au

Change Champions & Associates invites you to contribute to this publication! Are you or your organisation working on a new project or initiative? We’d love to hear about it! Please send us a 1 page article highlighting the major aspects of the initiative you are part of. Email articles, suggestions and advertising enquiries to Diane Vatinel at: info@changechampions.com.au

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Change Champions & Associates Newsletter - MAY 2014

Change Champions & Associates Newsletter MAY 2014  

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