St Andrew's Hospital Annual Report 2015/16

ANNUAL REPORT 2 015 2 016

600 OF THE BEST PEOPLE IN SOUTH AUSTRALIA.

CONTENTS

Mission Vision Values

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Chairman’s and CEO’s report

4

Highlights

5

Nursing & Clinical Services

7

Quality and Risk Management

8

Standards indicator report

9

Finance and administration

14

People, organisational development and workplace safety

15

Information systems Engineering and support services

16

Current research and ethics projects

18

Medical education

19

Foundation

21

Donations

22

Financial report

23

Organisational structure

26

Board of Governors

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MEDICA L A ND SURGICA L E XCELLENCE ST ANDREW’S IS A 201-BED PRIVATE SURGICAL HOSPITAL OVERLOOKING ADELAIDE’S SOUTH-EASTERN PARKLANDS. IT HOUSES NINE STATE-OF-THE-ART OPERATING THEATRE SUITES, AN 18-BED CRITICAL CARE UNIT, AN UP-TO-DATE EMERGENCY DEPARTMENT, PLUS TWO PROCEDURE ROOMS, AN ANGIOGRAPHY SUITE, A DAY-PATIENT SUITE, AND ARGUABLY SOUTH AUSTRALIA’S MOST COMPREHENSIVE PRIVATE CANCER-CARE FACILITY. THE TEAM AT ST ANDREW’S HAS RECEIVED NUMEROUS NATIONAL QUALITY AND CLINICAL EXCELLENCE AWARDS, SUPPORTING OUR BELIEF THAT WE HAVE SOME OF THE BEST PEOPLE IN SOUTH AUSTRALIA WORKING HERE.

MISSION

V ISION

Medical and surgical excellence.

St Andrew’s will be known as the best private hospital in Australia, with a culture where relationships matter.

•a positive culture based on teamwork that allows us to attract and retain the best staff

We will achieve this by creating an environment that promotes:

• s ound business and financial practices to maintain a stable base for future growth

• quality health care supported by exemplary customer service • best-practice patient care and support • partnerships with patients, carers and consumers that facilitate a service responsive to their needs

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VA LUE S We care, we create, we deliver.

•a strong affiliation with the Uniting Church and its agencies • i nnovation and creativity in all of our pursuits • t he use of up-to-date facilities and equipment.

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CH A IRM A N’S A ND CEO’S REPORT

IN OUR 80TH YEAR IT IS PLEASING TO REPORT THAT 2015-16 WAS WITH ONGOING GROWTH IN THE NUMBER OF PROCEDURES AND Ken Williams

Stephen Walker

A YEAR OF CONTINUING SUCCESS FOR ST ANDREW’S HOSPITAL,

The strong growth in demand for our services requires us to ensure that we continue to upgrade and enhance our building infrastructure and facilities to meet the continually evolving requirements of modern health care. Therefore, it is very pleasing to report that we recently commenced construction of a new wing of the hospital on the existing location. This state-of-the-art building will considerably enhance the existing operating theatre facilities, and will allow for relocation and greater optimisation of other existing patient facilities and amenities, including considerable enhancement to our day-procedure recovery suite.

A great deal of planning and consultation with both internal stakeholders and the local community was undertaken to develop plans for this project, and to manage issues that inevitably arise during construction.

We have strived to minimise the temporary disruption to the local community during the construction phase, and acknowledge the forbearance of local residents during the construction of what will be a significant contribution to the hospital’s facilities for the long term.

In addition to this exciting building development we have also committed to funding an Engineering Services Master Plan (ESMP). This master plan is a 10-year commitment to replacing and upgrading our major fixed plant and equipment. In the first three years alone we have allocated over $6 million to replacing key electrical and mechanical services fixtures.

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SEPARATIONS, AND FURTHER INCREASES IN THE BREADTH AND COMPLEXITY OF THE HOSPITAL’S MEDICAL AND SURGICAL ACTIVITIES.

Our continuing strong financial performance and sound balance sheet has allowed us to embark upon both the development and engineering upgrade with confidence, and it will ensure that the hospital retains its role as one of the leading private hospitals in Australia.

St Andrew’s remains the leading hospital for robotic surgery in South Australia, and in this past year we have seen an expansion of this high-end technology into the general and colorectal surgery specialties.

The combination of both the public contract and the private work sees us perform over 500 robotic cases per year, covering urology, ENT, gynaecology and now general and colorectal surgery.

The introduction of neurosurgery to St Andrew’s is another exciting chapter in the growth of our clinical services. We have had Professor Rob Fraser, Dr David Hall and Dr Michael Selby providing expert spinal surgery for some time, and it is now a great pleasure to welcome Dr Catherine Cartwright and Dr Simon Sandler to the team. They will certainly enhance our reputation in spinal surgery, but will also establish a neurosurgical unit at St Andrew’s and undertake cranial surgery in the very near future.

Our relatively new Human Resources Division has achieved some excellent outcomes for the year, and the attainment of our self-insurance status from ReturnToWork SA was certainly a highlight. This enables us to manage our own workers’ compensation claims, and it has lifted the bar on our management of work health and safety.

The commitment to our staff safety, wellbeing and development is really important to us. We have certainly ticked all of these boxes, with significant learning and development programmes, a range of staff health activities, and many events to celebrate our 80th year.

During the year it was a pleasure to welcome a number of international and interstate visitors to St Andrew’s, who came to look at our safety and quality systems and how we operate. All of our visitors, and in particular those from Hong Kong and the United Arab Emirates, were very impressed with our organisational culture and the results we achieve, and they left with a lasting impression and fond memories of St Andrew’s. As Australia’s largest stand-alone independent private hospital, it is important for us to collaborate with other health providers, and our networking this past year has enhanced the number and quality of these relationships.

However, our proudest achievement is the way in which we look after our patients. The feedback we receive from all of the health insurance funds, and through our national benchmarking surveys and audits, clearly demonstrates that we are an exemplar hospital We would like to thank all our dedicated nursing staff and medical specialists, our non-nursing and administrative divisions, and the work of the St Andrew’s Hospital Foundation, all of whom have worked very hard over what has been another outstanding year for the hospital.

Stephen Walker Chief Executive Officer

Ken Williams Chairman

HIGHLIGHT S

SELF-INSURER STATUS WITH RETURNTOWORK SA ACHIEVED APRIL 2016

INTRODUCTION OF NEUROSURGERY

AWARDED FULL ACCREDITATION AGAINST THE DIAGNOSTIC IMAGING ACCREDITATION SCHEME (DIAS) STANDARDS (22 JUNE 2016 – 22 JUNE 2020)

HAPPY 80TH BIRTHDAY ST ANDREW’S HOSPITAL

OUTSTANDING RESULTS FROM THE BEST PRACTICE AUSTRALIA – PATIENT, STAFF AND MEDICAL SPECIALISTS SATISFACTION SURVEYS

UPGRADE AND REPLACEMENT OF MAJOR PLANT AND EQUIPMENT

UPGRADE AND EXPANSION OF THE WESTERN CAR PARK

ST ANDREW’S FOUNDATION NURSING AND LEADERSHIP DEVELOPMENT SCHOLARSHIPS

EASTERN CLINICAL DEVELOPMENT— COMMENCED APRIL 2016

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Nursing & Clinical Services

NUR SING DI V ISION

PERSONIFYCARE

INTERVENTIONAL CARDIOLOGY

2015/16 bought a significant change within the Nursing Division at St. Andrew’s. Although the number of individuals in senior positons has remained unchanged, there has been a significant change in the roles and position titles within the division to accommodate a more complex service delivery. The Director Nursing and Clinical Services role is now underpinned by two Associate Director of Nursing (ADON) positions, one responsible for the management of the ward areas and the second for the procedural areas.

In 2015/16, St Andrew’s undertook a trial of Personifycare, a software program to enhance interactions with post-operative patients who had undergone breast surgery. Mobile devices allow staff, medical officers and patients to interact on a regular basis, driven by the individual patient’s condition. The software supports staff to enquire about patients’ progress and provides the ability for patients to respond in a timeframe that suited them. Patients are able to easily escalate concerns to a clinical expert – both nursing staff and the patient’s surgeon – facilitating early intervention.

St. Andrew’s has provided a highcalibre interventional cardiology service for a number of years in our angiography suites. This year, there have been some additional complex types of procedures undertaken.

Chronic Total Occlusions (CTOs) are present in 20 – 40 per cent of patients where coronary angiography has taken place. (D.Baim 2006). This provides the patients who are clinically appropriate with this option instead of cardiac surgery. This procedure requires special wires and equipment using an antegrade/retrograde approach, or both. Professor Steve Worthley and Dr Joseph Montarello have performed a number of these procedures since January this year, and this has also provided the opportunity for nursing staff to increase their skill levels in order to participate in this care delivery to patients.

Mr Adrian Saunders was awarded the ADON – Wards role in July 2015.

Adrian has over 20 years’ experience within St Andrew’s, as well as senior roles in the Private Sector interstate.

His tacit knowledge gained from a variety of senior roles, along with his clinical expertise, supports a stable platform in the division.

Ms Kay McDonald was appointed ADON – Procedural Area in May 2016.

Her previous tenure in a similar position at a large private hospital in Adelaide, as well as her work in both New Zealand and the UK, brings a wealth of experience. Ms Tina Donaldson has also joined the senior management team in the new positon of Quality and Risk Manager. Tina has extensive experience in the area of quality and comes from a high-quality hospital in the Adelaide area.

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The trial and outcomes were presented at both the Health Informatics Conference (HIC) in Melbourne and the Royal College of Surgeons in Adelaide.

Both audiences were impressed in relation to both the trial and the outcomes it delivered.

The feedback from patients, surgeons and staff was extremely positive.

St Andrew’s will expand Personifycare to a larger group of patients’ in 2016/17.

Staff have also increased their skill levels to participate in the mitralclip procedure, where the patient would traditionally undergo a mitral valve repair during cardiac surgery.

This procedure is performed by both Professor Worthley and Dr Montarello, with the addition of cardiothoracic surgeon, Mr Robert Stuklis.

In March this year, Professor Worthley, Dr Montarello and Mr Stuklis used the mitral clip as an alternative to surgical mitral valve repair. Mitral clip is a less invasive technique that reduces mitral regurgitation and improves patient symptoms in a selected cohort.

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QUA LIT Y A ND RISK M A N AGEMENT St Andrew’s is committed to delivering excellence in patient care and clinical services, and our vision is to provide safe and high-quality care for all of our patients.

This is articulated to all our staff and volunteers via the Safety & Quality Framework that defines the care provided at St Andrew’s Hospital as patient-focused, driven by information, and organised for safety.

AC CREDITATION St Andrew’s Hospital is accredited with the Australian Council on Healthcare Standards (ACHS).

Accreditation is recognised as an important driver for safety and quality improvement. Accreditation provides public recognition by a health care accreditation body of the achievement of a set of accreditation standards by an organisation, and their level of performance in relation to these standards. ACHS accredits St Andrew’s against the National Safety and Quality Health Service (NSQHS) standards set by the Australian Commission on Safety and Quality in Healthcare.

In mid-November 2016, the hospital will undergo an external organisation-wide survey with ACHS. During this process, the hospital will be formally assessed against the 10 NSQHS standards, as well as the five ACHS EQuIP standards. The hospital is hoping to build on its achievements from the periodic review undertaken in 2014, with pleasing results.

In June 2016, the hospital was awarded full accreditation against the national Diagnostic Imaging Accreditation Scheme (DIAS) standards. The purpose of this scheme is to ensure safety and quality standards for diagnostic imaging practices.

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Measuring our performance UNDERPINNING OUR COMMITMENT TO DELIVERING EXCELLENCE AND CONTINUOUS IMPROVEMENT IS THE DESIRE AND ABILITY TO CONTINUALLY MEASURE HOW WELL WE ARE PERFORMING ACROSS THE ORGANISATION. THIS PERFORMANCE MEASUREMENT INCLUDES CLINICAL INDICATOR MONITORING, CLINICAL AND NON-CLINICAL AUDITS, INDEPENDENT STAKEHOLDER SURVEYS, PATIENT FEEDBACK MECHANISMS AND ACCREDITATION SURVEYS.

Patient feedback continues to be an integral part of informing us on patient safety and quality. Many of the compliments received were about our staff, recognising them for being welcoming, caring, cheerful, friendly, efficient, helpful and professional in the excellent care they provide.

In late 2015, the hospital also engaged an external company, Best Practice Australia, to measure patient satisfaction. The results indicate that the patients surveyed were extremely satisfied with the overall quality of their most recent admission (99 per cent).

A large number of other performance indicators are monitored internally and provide a platform to address and improve quality and safety.

The following is a sample of performance indicators that are measured and monitored to further improve patient safety and quality at St Andrew’s Hospital.

The hospital’s participation in the ACHS Clinical Indicator Program, and submission to the MyHospitals website, enables us to benchmark our results against our peers.

E xternally- benchmarked performance indicators STANDARD 2: PARTNERING WITH CONSUMERS BEST PRACTICE AUSTRALIA (2015)

Patients satisfied that the hospital met their most important expectations

SAH Rate 94%

Patients satisfied that the nurses met their most important expectations

SAH Rate 95%

Patients satisfied with the overall quality of their most recent admission

SAH Rate 99%

0%

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50%

100%

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E xternally- benchmarked performance indicators STANDARD 3: PREVENTING AND CONTROLLING HEALTHCARE INFECTIONS

Hand Hygiene - High rate desirable

SAH Rate 94%

0%

50%

100%

STANDARD 3: PREVENTING AND CONTROLLING HEALTHCARE INFECTIONS SAH Rate 0.6

Staphylococcus aureus Bacteraemia (per 10,000 bed days) - Low rate desirable

0.0%

1.0

2.0

3.0

4.0

5.0

6.0

7.0

8.0

9.0

10.0

Australian Standard Rate 0.8

STANDARD 8: PREVENTING AND MANAGING PRESSURE INJURIES SAH Rate 0.04%

Rate of Pressure Injury acquired in hospital per OBD % - Low rate desirable

0.00%

1.00% ACHS Private Average 0.05%

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2.00%

E xternally- benchmarked performance indicators STANDARD 9: RECOGNISING AND RESPONDING TO CLINICAL DETERIORATION SAH 0.0% Arrest Call

SAH Rate 2.33%

Rapid Response Call Rate (Rapid Response Calls per number of admissions)

The ACHS acceptable rate is between 1.79% and 2.86%

0.00%

2.00%

4.00%

ACHS Private Average 1.73% STANDARD 10: PREVENTING FALLS AND HARM FROM FALLS SAH Rate 0.19%

Rate of falls per OBD % - Low rate desirable

0.00%

1.00%

2.00%

ACHS Private Average 0.3%

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80 Y E A R S CA RING FOR SOUTH AUSTR A LI A

80TH BIRTHDAY CELEBRATIONS CONCLUDED WITH THE SPECTACULAR GALA DINNER AT ADELAIDE OVAL. OVER 400 PEOPLE ATTENDED AND ENJOYED WORLD CLASS VIEWS, SUMPTUOUS FOOD, AWARD WINNING WINE AND ENTERTAINMENT BY INTERNATIONALLY RENOWNED ARTISTS.

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FIN A NCE A ND A DMINISTR ATION

FINANCE

ADMINISTRATION

This year significant work was undertaken with RosterOn, a rostering and time-and-attendance system from Allocate Software. This hospital-wide system will standardise the method for planning shift rosters and recording actual times worked by staff. With an interface to the payroll system, the need to process paper-based timesheets will be removed. Clinical and divisional managers will have greater visibility of staff availability and costs, which will allow them to manage their human resources more efficiently.

A concierge service was introduced into the reception area to welcome our patients on arrival, assist them to meet appointments and to simply offer a helping hand with anything they need.

From the positive feedback received to-date we note that this service is well regarded and acknowledged as another leading innovation among South Australian private hospitals.

CAPITAL St Andrew’s continues to make significant capital investments to support our commitment to medical and surgical excellence. Capital expenditure was $4.2m in the financial year 2015-16, and major purchases included: • neurosurgery microscope • Stealth cranial navigation system • ultrasound system • Olympus processors and light sources • theatre power-tool package • greenlight laser • anaesthetic machine In addition to our normal capital expenditure, construction of the Eastern Clinical Development (ECD) is well underway. An extensive business case was prepared by our finance staff, tested by BDO (our company auditors) and validated by independent consultants KPMG, before final approval by the board in April 2016.

The ECD is a major investment in capacity expansion and will be funded by a mixture of existing cash reserves and bank finance. A thorough tendering process was undertaken to find the best financing opportunity for the project. Finance staff have provided ongoing support to the project through cost monitoring and cashflow management.

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Despite the ever-increasing complexity of health fund arrangements, our eligibility, customer liaison and claims assessment team works closely with health funds and doctors’ rooms to ensure that all patients are well aware of their financial position, prior to arrival at the hospital. We aim for a smooth admission process with no surprises.

SUPPLY The supply team continues to provide effective services to support the hospital’s theatre and ward areas, and to provide the essentials of food and general supplies to all other nonclinical areas.

MEDICAL RECORDS AND CLINICAL CODING Our coding staff continue to maintain a high level of skill and contemporary knowledge in their field of work.

Staff attend the Health Information Management Association of Australia national conference and share learnings with each other. This year a number of external audits have been conducted, which have confirmed our high level of coding accuracy and competency.

PEOPLE , ORGA NISATION A L DE V ELOPMENT A ND WORK PL ACE SA FET Y

SIGNIFICANT ACHIEVEMENTS DURING 2015-16 INCLUDED: In order to meet our strategic and organisational goals, the ability to attract, retain and develop the very best people is key. In an increasingly challenging marketplace—where competitor activity is strong, and skilled, quality resources are finite— St Andrew’s must critically evaluate and self-reflect on what it takes to deliver on our desire to truly be an employer of choice, and achieve a work environment that is safe, enjoyable and rewarding for all.

Over the last year, the Human Resources Division has undertaken a significant body of work to embed process improvements and implement new systems to enhance the hospital’s performance across human resource management (HRM), organisational learning and development, and workplace health and safety (WHS).

Key projects have included a review of St Andrew’s HRM, WHS and injury management policies and procedures; enhancing electronic learning platforms for the delivery of clinical education; and fine-tuning our managers’ skills and knowledge to ensure our people are engaged and well supported. The division’s work plans across the three pillars of HRM, organisational development and WHS have driven progressive change and better positioned the hospital to meet the ever changing needs and expectations of our staff and other stakeholders.

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•A ttainment of self-insurance status in April 2016, which will enable the hospital to self-manage workers’ compensation claims to achieve the best outcome for an injured worker

•F acilitation of in-house management toolkit sessions for directors and managers on legislative responsibilities, tough conversations and addressing performance gaps

•S uccessful negotiation of the nursing division enterprise bargaining agreement

•U tilisation of the hospital’s human resource information system (HRIS) to open up employee access to training information, individual education portfolios and certifications, and improve HRM reporting

•D esign of the hospital’s Learning and Development Framework to support the achievement of our strategic organisational learning and development goals • I ncreased investment in clinical education, with targeted initiatives around clinical standards for the nursing division •D esign of leadership and management programmes to strengthen the confidence and capability of our managers •O rganisation-wide workforce planning, with an emphasis on new clinical services and the commissioning of the new Eastern Clinical Development

•B enchmarking the hospital’s WHS and injury management performance indicators with interstate private hospitals •S t Andrew’s Healthier Work Life Programme to maximise employee wellness and a healthier workplace •S haring the hospital’s approach to HRM, learning and development, and WHS with interstate and international visitors.

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INFORM ATION SYSTEM S

ENGINEERING & SUPPORT SERV ICE S

DURING THE 2015-16 FINANCIAL YEAR THE INFORMATION

THE 2015-16 YEAR PROVED TO BE

SYSTEMS DEPARTMENT HAS BEEN FOCUSED ON IMPROVING OUR

ONE OF EXCITING CHALLENGES FOR

UNDERLYING TECHNOLOGY INFRASTRUCTURE IN SUPPORT OF

THE ENGINEERING AND SUPPORT

THE WHOLE OF HOSPITAL STRATEGIC PLAN.

SERVICES DEPARTMENTS. THIS

The department has recently converted the old incoming Telstra PSTN telephone trunk with the latest technology—Session Initiated Protocol (SIP) Connect. SIP Connect is Telstra’s Global Voice over Internet Protocol (VoIP)-based solution that interconnects St Andrew’s existing unified communications (UC) phone system for all inbound and outbound calls. Some of the benefits to the hospital include:

The Internet of Things (IoT) is now a reality at St Andrew’s Hospital. It is anticipated to be a large growth area into the future. Mobotix cameras and intercoms have been installed to all entrances of the main building to provide an added level of security to hospital staff and visitors. This, combined with IP-connected door sensors, allows for mobile remote communication and control of out-ofhours door entries.

• improved productivity—SIP Connect allows for the ready deployment of powerful new communication and collaboration features

There has also been a large investment in encouraging medical-equipment servers to be brought on board with Information Systems. This will prove to add a centralised professional IT discipline to any new implementation.

A standardised approach to things such as high availability, disaster recovery, backups, security, service level agreements, contracts and support, will prove invaluable into the future.

• reduced call costs—we can now manage costs by aggregating voice and data networks (multiple locations behind one trunk) and other associated administration charges, which reduces expenses and inefficiency • increased scalability—voice channels and data services can be added or removed quickly at minimal cost • improved management—the new technology simplifies moves, adds and changes to our service, and improves call reporting, allowing for greater control, forecasting and budgeting • greater flexibility—Telstra’s cloud infrastructure and network solutions will provide additional availability and redundancy as we grow.

Information Systems bedded down the ongoing maintenance and support aspects subsequent to the recent adoption of IP-based telephony systems. Cisco IP telephones have been adopted as the desktop standard.

Trials are continuing for a planned wifi mobile handset implementation.

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The hospital wifi network has been expanded to not only meet the requirements of our visiting specialists, but now also staff mobile applications.

A number of Microsoft tablets have been purchased and distributed to our Nursing Division to assist with these workflows.

Patient/guest access to wifi has been provided to the Cardiac Unit and to the Chemotherapy Suite. It is planned to expand this service to our patients and guests throughout the hospital in the very near future.

IS PARTICULARLY TRUE WITH REGARD TO THE WORKS ASSOCIATED WITH THE EASTERN CLINICAL DEVELOPMENT (ECD) AND THE ENGINEERING SERVICES MASTER PLAN PROJECTS. Engineering and Support Services consists of: • Maintenance Department • Capital Works • Dietary Services • Bio Medical Services • Cleaning Services • Security Services • Property Services (Leases) ENGINEERING This department is kept extremely busy in providing preventative and corrective maintenance services to the hospital and related off-site facilities.

CAPITAL WORKS In addition to routine maintenance and repairs, we have completed significant works incorporated with the Early Works component of the ECD project, including: • removal of one of the diesel generator sets • relocation of a second diesel generator sets • relocation of the waste compactor.

DIETARY SERVICES This year we welcome new Dietary Services Manager Mr Paul Smith.

Paul brings a fresh new approach, as well as seven years of experience with the Royal Adelaide Hospital.

Dietary Services have retained the prestigious HACCP Accreditation again this year, as we have each year since first achieving the standard in March 2006. This high standard of meal service is provided on a “paddock to plate” basis. That is, our meals are all freshly cooked and designed by dieticians to support patients’ needs, such as modified textures and special dietary foods (gluten-free, lactose-free, low potassium, low fibre, high protein, and modified consistencies).

BIOMEDICAL ENGINEERING SERVICES The Biomedical Engineering Services Department is staffed by two qualified and experienced biomedical engineers.

Maged Shenouda and Colin Hill have continued to provide an excellent standard of service to the hospital, providing technical support to the new and exciting technologies being employed in the St Andrew’s theatres.

In particular, our biomedical engineers have provided support to every cardiac procedure performed in St Andrew’s for the entire year.

In addition to providing services to St Andrew’s, we extend our service provision to clientele outside the hospital.

Tasks provided by the department during the year include: • preventative maintenance— 2,217 instances • corrective maintenance— 1,262 instances • external work—47 instances.

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CLEANING SERVICES ISS Healthcare Services have continued to provide a high level of cleaning services to St Andrew’s.

The quality of services provided is evidenced by the fact that: • 5 ISS staff have been nominated for “HERO” Awards • 2 ISS staff have been nominated for “Apple” Awards • both Cathy Palmer and Jane Morris are recipients of the National Innovation Award.

In addition to the provision of the cleaning services (which includes making beds in all ward areas), ISS also carry out specialised services in our theatre to comply with vancomycin-resistant enterococci (VRE) and methicillin/multi-resistant staphylococcus aurea (MRSA) cleaning schedules.

We continue to work with our major contracting service providers to create innovative ways to improve the quality of services to the hospital.

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CURRENT RE SE A RCH A ND ETHIC S PROJEC T S ALL RESEARCH IS ADMINISTERED BY THE RESEARCH AND ETHICS COMMITTEE.

WE ADHERE TO AUSTRALIAN STANDARDS IN THE CONDUCT OF ALL RESEARCH OR PROJECTS. ST ANDREW’S IS COMMITTED TO CLINICAL RESEARCH AND CURRENTLY SUPPORTS THE FOLLOWING PROJECTS. • Collection of data for the Australian Orthopaedic Association National Joint Replacement Registry • The South Australian Audit for the Clinical Management of Advanced Colorectal Cancer • Bi-National Colorectal Cancer Audit • Prospective evaluation of a model to predict outcomes following Endovascular Aortic Aneurysm Repair (EVAR) • Magnetic Resonance Imaging (MRI) vs Computed Tomography (CT) for radiological assessment of fusion following anterior lumbar interbody fusion (ALIF) • Spine Tango Registry for spinal surgery—Mr David Hall’s private patients, St Andrew’s Hospital

• The SNAPSHOT Acute Coronary Syndrome (ACS) Registry • Application to become an Authorised Prescriber for the Trabecular Metal Glenoid Augment (TMGA) • International long-term follow-up study of patients implanted with a PORTICO valve.

• The South Australian Prostate Cancer Clinical Outcomes Collaborative (SAPCCOC): In pursuit of a state-wide population-based cancer registry • The Australian Prostate Cancer BioResource • BlastGen for couples with implantation problems or previous miscarriage

• A prospective MRI evaluation of multifidus structure and composition following percutaneous facet joint denervation in chronic lower back pain • Understanding the basis of female infertility through analysis of ovarian cells • Use of Glubran2 to prevent seroma formation after mastectomy and/or axillary lymphadenectomy • Determining the prevalence and fertility outcomes in couples undertaking IVF when the female partner has ultrasonographically defined endometriosis • Australian Breast Device Registry • A Clinical Evaluation of the Medtronic Polymer-Free Drug-Eluting Cornary Stent System in De Novo native Cornary Artery lesions – (PolymerFree DES Trial) • Actioning end of life care and advance care directives in an emergency department context • Clinical evaluation of a novel suture anchor for rotator cuff repairs • Arthroscopic Trans-Osseous Knotless • The Effect of Intraperitoneal Local Anaesthetic on Functional Recovery Following Bowel Surgery: A Prospective Randomised Blinded Trial • Magnetic Resonance to Manage Breast Disease • Fertility SA BioResource • BIO I Master.BioMonitor 2 • Fertility Understanding through Registry and Evaluation (FUTuRE Fertility)

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MEDICA L EDUCATION IN 2016 ST ANDREW’S ENTERED INTO ITS SEVENTH YEAR IN PARTNERSHIP WITH THE UNIVERSITY OF ADELAIDE, OFFERING POSITIONS FOR 6TH-YEAR MEDICAL STUDENTS TO ATTEND ROTATIONS AS PART OF THEIR “SELECTIVE” PROGRAMME. THE SELECTIVE PROGRAMME AIMS TO OFFER MEDICAL STUDENTS THE OPPORTUNITY TO EXPERIENCE PRACTICE SETTINGS OTHER THAN IN TEACHING-HOSPITAL WARDS. TEN STUDENTS ARE PARTICIPATING IN THE PLACEMENT THIS YEAR. At St Andrew’s this attachment involves students participating in four-week rotations in cardiology, urology or breast/endocrine specialties. Each of the speciality placements relies on one consultant who volunteers to supervise the rotation and facilitate assessments during the students placements.

The supervising consultants are all keen for the students to be exposed to the variety of specialty areas offered at St Andrew’s, and this is facilitated by a flexible programme and by enthusiastic medical officers who are willing to teach and be involved in the programme.

Most students are rotated through at least one robotic theatre session and one cardiac theatre session.

On behalf of the medical students, we would like to thank the cardiac and robotic surgeons involved, as these opportunities are not something students are exposed to elsewhere.

There are also many other medical officers from a variety of specialty areas who are willing to have medical students in their theatre sessions and support this learning opportunity, and this has proved to be invaluable to the students.

The feedback from the students has been very positive, including such comments as: “The best part about the attachment was the variation in surgery. It really expands the learning instead of complete focus on one sub-speciality area.”

“Particularly useful for people unsure of which specialty they would like to pursue, as there was exposure to lots of specialties.”

“It was excellent to be able to see open heart surgery. It was one of the highlights of my medical degree.”

The cardiology students attend a variety of sessions in the angiography lab and attend sessions supported by the consultants from Adelaide Cardiology.

Peter Sage continues to supervise these students and has proven again to be an inspirational teacher. Feedback from this rotation continues to be very positive. For example: “The clinics at St Andrew’s Medical Centre were particularly valuable.

Patients were willing to have me there and the doctors were excellent teachers (with Dr Sage being the highlight).”

The urology students are supervised by the consultants at South Terrace Urology, in particular this year Darren Foreman and Andrew Fuller.

These students experience a number of different robotic procedures as well as urological surgical lists. They also spend a session with the stomal therapy nurse.

The breast/endocrine students, once again supervised by Melissa Bochner, work with a number of the breast/ endocrine surgeons in theatre and in the St Andrew’s Breast Clinic.

They spend a morning session with the breast-care nurse following patients through from theatre the previous day.

The breast/endocrine and urology students all attend a two-day session at Adelaide Radiotherapy and two sessions in the Chemotherapy Suite working with Dr James Dickson and Dr Trevor Malden.

All students attended sessions with Rev Peter Morel on “Grief, loss and breaking bad news”, and a session with the Intensive Care Unit (ICU) consultants. Both of these sessions received positive feedback and again is another aspect of the unique program at St Andrew’s.

“The ICU ward round was a valuable experience. The ICU consultant was a willing teacher and it made me appreciate the spectrum of sicker patients that are managed at St Andrew’s.”

And in regard to the dealing-withgrief session: “We learn about this throughout our degree but it is always a good topic to revisit.”

Due to the merger of Adelaide Pathology Partners and Clinpath, they were unable to facilitate this rotation, but we are planning to reintroduce it in 2017.

The success of this program is due to the time and commitment given by the consultants involved. The willingness of surgeons, anaesthetists, cardiologists, and nurses to share their knowledge makes this rotation an exceptionally good learning opportunity for students.

“Very well organised rotation.”

“Interesting to get exposure to the private health system.”

“Lots of one-on-one contact with consultants.”

On behalf of the students, we would like to thank all those involved for their time and commitment. Dr Trevor Malden has provided a significant amount of his time to students since the programme’s inception. Trevor retired at the end of September 2016 and we will miss his input. We are very grateful for the time he has dedicated.

THANK YOU TO ALL MEDICAL OFFICERS WHO PROVIDED INPUT AND SUPPORT: Michael Berce Melissa Bochner John Bolt Julie Bradley Michael Brown Jim Burnett Daniel Cehic Georgy Chacko Trevor Collinson Rod Cooter James Dickson Patrick Disney Darren Foreman Andrew Fuller Tabitha Healey David King Jim Kollias Quoc Lam Clayton Lang Trevor Malden Bill McLeay Joe Montarello Nick Murray Susan Neuhaus Robert Parkyn Steve Petito Peter Sage Luay Samaraie Maria Santos

Raj Singh-Rai Govindarajan Srinivasan Robert Stuklis Peter Sutherland Harminder Takhar Marcus Teo Charles Tie David Walsh David Walters Richard Wells Robert Whitfield Malcolm Wicks Phil Worley Michael Worthington Stephen Worthley Glenn Young.

Thanks also to the Critical Care Unit consultants and to the many anaesthetists who volunteer their time to educate students while they are in their theatre sessions.

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St A ndrew ’s Hospital Foundation IN THIS 80TH YEAR OF THE HOSPITAL, OUR FOUNDATION CELEBRATES ITS 16TH YEAR. OUR FOCUS HAS BEEN TO REVIEW, RENEW AND LAUNCH INTO THE FUTURE WITH AN OPEN MIND. WE HAVE CERTAINLY ACHIEVED THAT AND LOOK FORWARD TO WHAT LIES AHEAD. THE FOUNDATION CONTINUES TO MAKE SIGNIFICANT PROGRESS IN EXECUTING ITS STRATEGIC GOALS AND SUPPORTING ST ANDREW’S HOSPITAL AS IT MAINTAINS ITS REPUTATION AS ONE OF AUSTRALIA’S LEADING INDEPENDENT PRIVATE HOSPITALS. As always, much of our work would not be possible without our volunteer group. This year the group includes over 80 dedicated members of the community, who give of their time and expertise. The camaraderie amongst this group is a pleasure to observe.

Friendships have been forged, lunch groups gather and life events are shared. Some volunteers are this year celebrating 20 years of service to St Andrew’s. The power of volunteering is certainly evident within these walls.

We are delighted to welcome John Coates to the position of Coffee Shop Manager. With a wealth of experience in hospitality and volunteer management, John has seamlessly transitioned into his new role and has made a significant positive impact in the coffee shop and the volunteer group. Under John’s watchful eye, the coffee shop has returned record profit, which has enabled us to maximise the financial support we can provide to the hospital.

We continue to receive financial support from many in the community.

Patients and their relatives, corporate organisations, suppliers and our medical officers support the Foundation, which in turn enables us to provide significant support to the hospital. This year, we have contributed over $960,000, with highlights including:

As always, Foundation Assistant and volunteer Valerie Turnbull has provided wonderful support to the Foundation and the volunteer group. Valerie’s long association with the hospital means she continues to provide administrative and event support guided by a wealth of knowledge and experience.

• purchase of 8 iPads for the Chemotherapy Suite • purchase of a “cold cap” for the Chemotherapy Suite • ongoing funding for the da Vinci XI surgical robot • installation of a retractable sun shade for the coffee shop • contributions towards cardiac facilities in the Eastern Clinical Development.

The Friends of St Andrew’s Hospital group continue to assist our endeavours through their annual membership fee. I would like to acknowledge and thank HPS Pharmacy and Dr Jones and Partners Medical Imaging for their continued support of this initiative.

talk about cardiology and its development over time. His address left us all looking forward to the opening of the new angiography services in the Eastern Clinical Development and the positive outcomes this will bring for cardiac patients in the future.

I would like to thank my fellow directors for their guidance and support. Similarly, the hospital provides much-appreciated operational support for the Foundation, which enables the team to focus on the task at hand.

We look forward to the future with great anticipation, and know that with such dedicated leadership and support from our community great things are ahead for the Foundation and St Andrew’s Hospital.

Chris Wright Chairman

This year, we hosted our first Friends of St Andrew’s Hospital High Tea, which was a huge success and filled historic Waverley House to capacity.

Cardiologist Mr Daniel Cehic gave a thoroughly entertaining and informative

The Foundation team are a dynamic group, and with the leadership of Foundation Manager Amy Bredon, continue to bring new ideas to the table driven by clear strategic direction.

This year we farewelled Coffee Shop Manager Tony Malavazos as he left St Andrew’s to pursue other interests. We thank him for his hard work during his time as part of the foundation’s team.

2015_2016 ANNUAL REPORT

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DON ATION S WE WOULD LIKE TO ACKNOWLEDGE THE INDIVIDUALS, COMMUNITY GROUPS AND SERVICE PROVIDERS WHO HAVE SO GENEROUSLY SUPPORTED THE WORK OF THE ST ANDREW’S HOSPITAL FOUNDATION. THEIR SUPPORT ENHANCES THE QUALITY OF CARE PROVIDED TO OUR PATIENTS AND THEIR FAMILIES. Mr Robert Adam Mr and Mrs V J Agius Mrs Margaret Baker Mr and Mrs R Baker Mr Ben Beamond Mr Graham Blacket Dr Martin Borg Mrs Amy and Mr Robert Bredon Miss Carolyn Byrne Rev Don and Mrs Lesley Catford Mr Brian and Mrs Marion Chapman Ms Margaret Clark Mrs Margot Coles Ms Maren Cowley Mr Keith and Mrs Janet Crawford Mrs Jillian Crouch Mr John Davis Mrs Marlene Dixon Mr Lindsay J Durham Mr Scott Elliot Mr and Mrs C Errock Dr Douglas Fahlbusch Mr Malcolm and Mrs Janet Forrest Mr Graeme French Dr Andrew and Dr Karyn Fuller Mrs Janice Gale Rev Ion Gaskill Mr Anthony Gaynor Mr Peter and Mrs Denise Graham Mr Peter and Mrs Ros Griffiths Ms Natalia Gulacsi M D Hannemann Dr Hugh and Mrs Jo Harley Ms Rosemary Higgins Mr Terry Holland Dr R A Hunter Mr Peter and Mrs Sonya Kerin Ms Klementine Lutz Mr Richard McKay AM and Mrs Jean McKay Mr Peter and Mrs Pamela McKee Mr Neil McKenzie Mr Ian McSporran Mr Bob Major

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Dr David Matison Mr Frank Mottershead Prof Robert Norman Mr Malcolm Pitcher Mr Thomas and Mrs Margaret Prendergast Mrs Rosemary Rice Mr Bob Rigoni Mr Glen Robinson Mr Ian Rose Mr Bill and Mrs Charlene Santos Ms Amanda Seaton Mrs Gloria Seidel Ms Kern Simons Mr Leigh Simpson Mr David Smith Mrs Robyn Soraghan Ms Rosa Stanton Dr Peter Stavrou Mrs Shirley Stone Mr Ian Thamm Mr Terrance Thornton Dr Walford and Mrs Susan Thyer Ms Vicky Trimpino Mr James Trott Mrs Ros Tucker Mr Malcolm Tyrrell Ms Dawn Volle Mr Philip Walker Dr Darren Waters Mr Kent Wilson Mr Brian and Mrs Mary Withers Mrs S L Wong Mr Barry Worrall Adelta Legal The Pickard Group The Sterling Foundation Westmead Fertility Clinic Willunga Hair WE GRATEFULLY ACKNOWLEDGE DONATIONS RECEIVED IN MEMORY OF THE FOLLOWING PEOPLE WHO HAVE BEEN IN OUR CARE. Mrs Lidia Furlani Mr Alan Habbershaw Mrs Rebecca Hill Mrs Barbara Holmes Miss Kerry Rowe Mr Giovanni Severin Mr Kevin Tucker

WE GRATEFULLY ACKNOWLEDGE THE KIND CONTRIBUTION OF THE MEDICAL SPECIALISTS WHO HAVE PARTICIPATED IN THE 6TH-YEAR MEDICAL STUDENT CLINICAL PLACEMENTS PROGRAMME AND HAVE KINDLY DONATED TO THE MEDICAL EDUCATION RESEARCH FUND. Mr Michael Berce Dr Melissa Bochner Mr John Bolt Dr Michael Brown Mr Jim Burnett Dr Daniel Cehic Dr Gregory Chacko Dr Steve Chryssidis Mr Trevor Collinson Dr Patrick Disney Mr Clive Hoffman Mr David King Mr Jim Kollias Dr Jimmy Lam Dr Clayton Lang Mr Matt Lawrence Mr Bill McLeay Dr Joe Montarello Dr Jamie Morton A/Prof Susan Neuhaus Mr Markus Nikitins A/Prof Martin Oehler A/Prof Robert Parkyn Mr Randal Sach Dr Peter Sage Dr Lucy Samaraie Dr Maria Santos Mr Richard Sarre Mr Rajinder Singh-Rai Mr Tony Sparnon Dr Govindarajan (Srini) Srinivasan Dr Peter Steele Dr Rob Stuklis Mr Peter Sutherland Dr Charles Tie Dr David Walsh Dr David Walters Mr Richard Wells Mr Robert Whitfield Mr Malcolm Wicks Mr Phil Worley Mr Michael Worthington Prof Stephen Worthley A/Prof Glenn Young

FIN A NCI A L REPORT

STATEMENT OF FINANCIAL POSITION AS AT 30 JUNE 2016

AUDITOR

2015/2016 $,000

2014/2015 $,000

Current assets

37,816

33,184

Non-current assets

76,556

77,184

114,372

110,368

(Extract from audited accounts)

Total assets

Current liabilities

17,396

17,016

597

619

17,993

17,635

Non-current liabilities Total liabilities Net assets

96,379

92,733

Total accumulated funds

96,379

92,733

ST ANDREW’S HOSPITAL STATISTICS 2015-2016 2015/2016

2014/2015

OBDs medical surgical

51,830

51,530

Separations

28,314

27,868

1.83 days

1.88 days

12,292

12,291

Day Suite procedures

5,310

5,360

Emergency Department attendances

4,214

4,015

Emergency Department admission

1,763

1,515

20 minutes

20 minutes

Average length of stay Theatre procedures

Emergency Department average waiting time Workforce statistics – employees

2015_2016 ANNUAL REPORT

BANKER Commonwealth Bank of Australia 96 King William Street Adelaide SA 5000 SOLICITORS

BDO Chartered Accountants Level 7 420 King William Street Adelaide SA 5000

627

598

(383 Nursing)

(367 Nursing)

DW Fox Tucker Level14 100 King William Street Adelaide SA 5000 Rossi Legal Level 7 185 Victoria Square Adelaide SA 5000

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ECD TIME L A P SE

01 | 12 | 2016

24

22 | 04 | 2016

13 | 10 | 2016

25 | 08 | 2016

15 | 07 | 2016

02 | 09 | 2016

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Organisational structure 2015 -2016

BOARD OF GOVERNORS

CHIEF EXECUTIVE OFFICER - STEPHEN WALKER

DIRECTOR BUSINESS

DIRECTOR NURSING AND

DIRECTOR OF ENGINEERING

PERFORMANCE AND

CLINICAL SERVICES -

AND SUPPORT SERVICES -

DEVELOPMENT -

MS JACQUIE WILEY

MR PETER COOPER

MS SHARON KENDALL

Associate Director Nursing – Wards Mr Adrian Saunders

Maintenance Controller Mr James Crinson

Associate Director Nursing – Theatres Ms Kay McDonald

Manager – Dietary Services Mr Paul Smith

DIRECTOR OF HUMAN RESOURCES - MS REBECCA WYNESS HR and Organisational Development Coordinator Ms Alison Sarles Graduate Nurse Coordinator Mrs Kerry Holm WHS Manager Mr Cos Lamberto

DIRECTOR OF FINANCE MR GARRY CRISPIN Manager – Patient Services Mrs Meredith Staggs Management Accountant Mr David Ormsby Financial Accountant Mr Stuart Campbell Supply Manager Mr John Ioannou Payroll Supervisor Ms Sharyn Wood

Clinical Manager Theatre Ms Leandra Spencer/ Ms Renee McHugh Clinical Educator Theatre Ms Anne Sherlock/Ms Kath Reval

DIRECTOR OF MEDICAL

Clinical Manager Recovery/ Anaesthetics Ms Sharon Blaney

DR CHRIS FARMER

SERVICES -

Day Patient Suite Ms Sharon Maslen

DIRECTOR OF

Clinical Manager – 2nd Floor Ms Liz Knight/Ms Caroline Guest

MR GREG LAING

INFORMATION SYSTEMS -

Clinical Manager – 3a Ms Karen Shannon Clinical Manager – Cardiac Ward Ms Lisa Walters Clinical Manager – 4th Floor Mrs Sarah Schulze Clinical Manager – Angiography Suite Mrs Joyce Restell

DIRECTOR OF EMERGENCY SERVICE DR STEVEN SCHUELER

DIRECTOR OF CRITICAL CARE UNIT -

Clinical Manager – Critical Care Unit Ms Edel Silke

DR ALEX WURM

Clinical Manager – Emergency Service Ms Catherine Turner

St Andrew’s Hospital Foundation Manager Mrs Amy Bredon

Clinical Manager Day Chemotherapy Suite Ms Lisa Mucklow

St Andrew’s Hospital Coffee Shop Manager Mr John Coates

Bookings Manager Ms Viv Gill

Coordinating Chaplain Rev Peter Morel

Quality and Risk Manager Ms Tina Donaldson

Project Coordinator (ECD) Ms Anne Sherlock

Case Manager Ms Elizabeth Jones Pre Admission Coordinator Ms Annie Filsel

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Bio Medical Engineer Mr Maged Shenouda

Board of Governors

Rear (l-r): Prof R Fraser, Mr R McLachlan, Mr D Walters, Mr G Crispin, Mr S Walker, Dr D Cehic, Mr T Lambert, Mr K Williams, Rev R Miller.

Front (l-r): Ms S Kendall, Ms S Furey, Ms S Daw, Dr R Armstrong, Dr M Sutherland, Ms M Phythian, Ms J Wiley, Ms R Wyness.

Absent: Mr J Sweeney

CHAIR

BOARD MEMBERS

EX OFFICIO MEMBER

Mr K G Williams BEc (Hons) MAppFin MAICD

Dr R J Armstrong PhD MA MBA FCPA FCIA

Rev R Miller The Moderator’s Alternate SA Synod Uniting Church in Australia

Dr D Cehic MBBS FRACP FCSANZ DEPUTY CHAIR Dr M F Sutherland MBBS FFARACS FANZCA

Ms S M Daw GAICD, FGLF (03) Prof R D Fraser AM MBBS MD FRACS FAOrthA Ms S C Furey LLM (Corp & Commercial), BEc (Acc) GAICD, GDLP, CTA, CA Mr T Lambert BE (Civil), MEnvSt, GradDip BusMgt Mr R McLachlan BBus(Prop) GradDipMktg Ms M Phythian RN Mr J L Sweeney MBBS FRACS Mr D J Walters MBBS DDU FRACS

2015_2016 ANNUAL REPORT

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St A ndrew ’s Hospital 350 South Terrace Adelaide, South Australia 5000 Telephone 08 8408 2111 Facsimile 08 8232 0328 www.stand.org.au