St Andrew's Hospital Annual Report 2018/19

Annual Report

18 19

Contents 03 Mission, Vision and Values 04 Chairman’s and CEO’s Report 05 Highlights 06 Nursing and Clinical Services 11 Measuring Our Performance 14 Finance and Administration 18 People, Organisational Development and Safety 20 Information Systems, Engineering and Support Services 22 Current Research and Ethics Projects 24 Medical Education 26 Foundation 29 Financial Report 30 Organisational Structure 31 Board of Governors

18/19 Annual Report

Medical and Surgical Excellence St Andrew’s is a 240-bed private surgical hospital overlooking Adelaide’s south-eastern parklands. It houses eleven state-of-the-art operating theatre suites; a 28-bed cardiac unit; an 18-bed critical care unit; an up-to-date emergency department; a new procedural suite complete with DOSA (Day of Surgery Admission); an angiography suite; and, arguably, South Australia’s most comprehensive private cancer-care facility.

In addition to these facilities, we believe that we have some of the best people in South Australia working for St Andrew’s. This belief is supported by the team’s numerous national quality and clinical excellence awards.

Mission

Vision

Medical and Surgical Excellence.

St Andrew’s will be known as the best private hospital in Australia, with a culture where relationships matter. We will achieve this by creating an environment that promotes: •q uality healthcare supported by exemplary customer service, •b est-practice patient care and support, •p artnerships with patients, carers and consumers that facilitate a service responsive to their needs, •a positive culture based on teamwork that allows us to attract and retain the best staff, ound business and financial practices to •s maintain a stable base for future growth, •a strong affiliation with the Uniting Church and its agencies, • i nnovation and creativity in all our pursuits, • t he use of up-to-date facilities and equipment.

Values We Care, We Create, We Deliver.

03

Stephen Walker

David Whitbread

Chairman’s and CEO’s Report

Welcome to the 2018/19 Annual Report. It is pleasing to say at the outset that we have had another successful, positive and dynamic year at St Andrew’s.

Last year, we dedicated much of our annual report to highlighting the completion of our Eastern Clinical Development (ECD) and the many awards we received. This year, we are delighted to report that not only was the building a construction success, but it has been an outstanding enhancement to the diverse and wide range of services we provide.

The change management process for such a significant addition should not be underestimated, and our staff, specialists and volunteers handled it with the passion and dedication we are familiar with. The Procedural Suite has been extremely busy, resulting in a significant increase in patient activity and we are so pleased with how this has been managed. Similarly, the new Cardiac Unit has had an increase in cardiac patients, and we have received excellent feedback on the outstanding patient rooms from patients.

Not surprisingly, our new underground 200-bay car park is fully utilised and widely appreciated by our staff, providing them safe and secure access to the hospital, keeping their cars out of the elements of the weather.

Needless to say, the considerable preparatory work put into the ECD has paid off; the building was completed very close to time and budget and, most importantly, it is operating efficiently and to design.

However, we have not stopped there.

We are now focussing on our Master Plan where we have identified strategies to further enhance our hospital. As we write this report, we are planning the installation of a new Cardiac CT service, after

hours chest pain service, continued upgrades to patient rooms, and the major upgrade to our staff cafeteria.

There are many more exciting future initiatives, including the proposed development of a new medical centre on South Terrace.

Another major initiative for St Andrew’s has been the decision to expand and improve our Information Technology (IT) resources and systems. There is no doubt that IT has the ability to be a “game changer” in the provision of healthcare. Having said this, it is important to be careful about the systems that are adopted and how they are managed and implemented.

We have increased our resources in IT with the appointment of some skilled and experienced staff, and we have been diligent in the adoption of some new systems that will absolutely support the provision of patient care and the monitoring of performance. This includes the development of a business intelligence/clinical information system, upgrade to our patient administration system (TrakCare) and upgrade of our finance system (Epicor). There are plans for more sophisticated systems to be rolled out in the coming financial year.

The Annual Report highlights some wonderful clinical achievements here at St Andrew’s that include a world first cardiac procedure in our Angiography Suite with the deployment of an artificial mitral valve; an Australian-first paediatric robotic procedure in conjunction with the Women’s and Children’s Hospital; the introduction of minimally invasive cardiac surgery; and a highly acclaimed training video that we produced on the Massive Transfusion Protocol.

The link to the training video is currently on the BloodSafe website which has 500,000 registered users https://bloodsafelearning.org.au/ resource-centre/videos/.

Our continued excellent clinical performance, together with the extremely positive patient feedback, is what we are most proud of. There is no doubt that we have a dedicated and skilled team, all contributing to our well-recognised patient safety and quality outcomes.

The Board of St Andrew’s provides sound governance, and works cohesively with senior management to set the strategic direction and to monitor performance of the hospital.

We have a skills-based board that provides the required expertise, ensuring this important role is effectively undertaken. It was a delight to welcome back both Mr David Walters (General Surgeon) and Ms Susy Daw to the Board. David will be taking on the role of Chair of our Medical Advisory Committee and Susy will be taking on the role of Chair of our Risk Management Committee.

The private health care sector continues to face challenging times with the steady decline of private health insurance membership. This has been precipitated by the growing view that there is a lack of value in the cost of private health insurance and the burden of out-of-pocket expenses. We, as a private hospital, are part of that problem and need to be part of the solution. We can assure you that we are doing our bit to bring that value to our patients. Apart from the service we provide, we work diligently with other key stakeholders to deal with these industry-wide issues.

We are proud that, given these challenges, we continue to hold our head up high as a proud South Australian private hospital that punches well above its weight. We are proud of the fact that we provide a diverse range of clinical specialties and that we are the largest independent private hospital in Australia.

We would like to thank and acknowledge the entire St Andrew’s team including our dedicated nursing staff and medical specialists, our non-nursing staff, volunteers, our board and foundation, all of whom have contributed to another successful and outstanding year.

Stephen Walker Chief Executive Officer

David Whitbread Chairman

Highlights

Eastern Clinical Development Awards wiltshire & swain Architects European Healthcare Design Awards 2018 – under 20,000m2 Australian Institute of Architects (SA) Award for Public Architecture 2019

Significant capital investment Our major capital purchases were: • anaesthetic machine, • patient administration system upgrade, • spinal & imaging table, • ultrasound system, • heater-cooler units, • cardiac, urology, thoracic and orthopaedic instruments, • video ureteroscopes, cystoscopes and gastroscope.

In 2018 Dr Stephen Kinnear received the award of Medal of the Order of Australia (OAM) in the General Division of The Order of Australia.

• Dr Stephen Kinnear (Anaesthetist) In recognition for service to medicine, particularly to anaesthesiology.

Eastern Clinical Development Awards Mossop Construction + Interiors 2018 Master Builders Association (SA) Building Excellence Award Category: Excellence in a Commercial/Industrial Building $20M to $50M

Medical student placements Epicor Excellence Award for SaaS (Cloud) deployment ACHS EQuIPNational Periodic Review November 2018 Self Insurance Renewal until 31 March 2023

Breast care team, Finalist, Excellence in Person Centred Care - Team Award “What matters to you?” Day Length of service awards

Australia Day Awards We are pleased to advise that two of our medical specialists received the award of Member (AM) in the General Division of The Order of Australia in 2019.

• Dr Randall Sach (Plastic Surgeon) For significant service to medicine as a plastic surgeon, to international relations, and to professional organisations, and • Dr Rod Cooter (Plastic Surgeon) For significant service to medicine, to plastic and reconstructive surgery, and to professional medical bodies.

Eastern Clinical Development Awards RCP Project Management IPM Project Management Achievement Awards 2019 AIB South Australia Professional Excellence in Building Award Winner

Nursing and Clinical Services Clinical handover Clinical handover is a fundamental component of ensuring the provision of excellent clinical care. There is no one standard way clinical handover is undertaken; it is practised in a multitude of ways, in numerous healthcare settings, every day.

The process of handover has been the subject of discussion and research within the healthcare sector for a long period of time, as it has been recognised that the quality of the handover has the potential to impact on patient outcomes.

As part of its commitment to quality care, St Andrew’s initiated a full review of the nursing clinical handover process with staff consultation, as to how the process of clinical handover should occur.

Two working groups with representatives from ward staff, consumers and nursing management were formed to review both the nursing handover process and the time required.

One group examined shift lengths and crossover time to ensure staff were able to deliver a high quality clinical handover. The other examined the process of handover, what would it look like, who it should involve, and any other changes to enhance the process of handover.

The outcome of the reviews produced a number of recommendations. One of these recommendations was to extend the time for nursing handover each day. This increase of time was costed, ratified by the Board and implemented in April 2019.

The importance of increasing patient involvement in the handover process was a main focus of both groups, in line with St Andrew’s continued focus on patient centred care.

The changes were introduced in April 2019, after extensive education for staff which included the introduction of a team-based model of care with team leaders that perform the basic clinical handover behind closed doors. This is followed by handover with the patient at their bedside, with the team members providing direct care to that patient.

While still early days, informal feedback from staff has been very positive with positive outcomes identified for patients and staff alike.

SA Health Nursing and Midwifery Excellence Awards As an organisation, we believe it is important to recognise and celebrate the outstanding role nurses have in the provision of care to all South Australians.

As such, St Andrew’s was once again a proud sponsor of the SA Health Nursing and Midwifery Excellence Awards held in May 2019, at the Adelaide Convention Centre.

St Andrew’s was represented in three of the nine award categories, with our Breast Care team again reaching the finals for the fourth consecutive year for Excellence in Person Centred Care – Team Award. This exceptional team is the only group to reach the finals on more than one occasion. This outstanding achievement recognises our dedicated team of nurses for the provision of support to our breast surgery patients.

We also celebrated Clinical Managers Lisa Walter’s and Lisa Mucklow’s nominations for Excellence in Practice, and Jacquie Wiley’s nomination for Excellence in Leadership.

Breast Care team - Lindy Irwin, Jenny Duurland, Zara Connelly, Sarah Siedlaczek, Jodie Bowering, Amanda Jones and Lisa Maggs.

18/19 Annual Report

HighLife artificial mitral valve

Robotic paediatric case In March 2019, a team of dedicated St Andrew’s Hospital surgeons and nursing staff, in conjunction with staff from the Women’s and Children’s Hospital, performed our first procedure in our robotic theatre on a nine-year old paediatric patient. This was an Australian-first procedure involving the daVinci robot.

We are so proud to be associated with the Women’s and Children’s Hospital and to be able to perform this procedure using cutting-edge technology at St Andrew’s Hospital.

Medical and nursing teams from both sites met weekly in the lead up to the surgery, ensuring all aspects of care were covered. The patient (Tomas) and his parents visited St Andrew’s prior to the surgery.

Tomas, his parents and the surgeon were extremely happy with the outcome of the surgery, with Tomas commenting that he would be able to attend school regularly again due to the life changes the surgery had provided him.

We would like to acknowledge and thank all members of our highly skilled nursing team who participated in the procedure and provided Tomas with such excellent care.

Nursing EBA St Andrew’s nursing staff approved a new Enterprise Bargaining Agreement (EBA) with a 73% YES vote on 17th December 2018. The EBA negotiating group worked hard to gather information and provide feedback for inclusion.

Nursing staff representatives were: • Jacquie Furmage • Cris Ayling • Janelle Freeman The EBA recognises the commitment of our nursing team by delivering a number of key components: • one Enterprise Agreement covering all nursing staff and replacing the previous two agreements, • wage increases of 4.4%, 3.0% and 3.0% across the life of the

Enterprise Agreement, with the first increase effective from the first full pay period on or after 1st September 2018, • increased professional development entitlements for all staff, • increased allowance provisions for additional qualifications, • the introduction of paid family and domestic violence entitlements, • paid meal breaks for hospital coordinators working after hours and on weekends.

Although not part of the EBA, the low-cost undercover carpark that is accessible to all St Andrew’s staff members, ensuring easy parking where staff walk from the undercover carpark directly into the hospital, is openly appreciated.

A world first HighLife trial was undertaken on Friday 28th June in our angiography suite.

This involved deploying an artificial mitral valve via the vascular system (the valve inserted through a vessel in the groin), preventing the need for open heart surgery. The team effort of both medical and nursing staff resulted in a great outcome for the patient.

Specific anaesthetic and recovery staff, along with Anaesthetic Clinical Educator Jenny Slade, anaesthetic nurse Kim Canete, Recovery Clinical Educator Kathy Humphries and recovery nurse Simone Tulloch, were all briefed about the expectation for this patient. Staff were provided with video links on how the valve would be deployed and several research papers were sourced for their perusal prior to the procedure day. Through collaboration with the Cardiac Unit Clinical Manager Lisa Walter and Angio Clinical Manager Joyce Restell, an education session was provided by the CEO of HighLife. A question and answer session was held at the end of the presentation, providing an excellent forum to tease out the case and provide a platform where all eventualities were identified and planned for. All staff worked hard to ensure they were prepared and, although the case took a little longer than expected, the patient was successfully transferred to ICU and looked after by Cardiac Unit staff overnight. The patient experienced an excellent outcome and participated in a media interview 48 hours later.

This trial was approved by the St Andrew’s Hospital Human Research and Ethics Committee who will have oversight of the ongoing trail.

07

Nursing and Clinical Services continued

18/19 Annual Report

MIS (minimally invasive surgery) for cardiac surgery In conjunction with Dr James Edwards, St Andrew’s Hospital has commenced MIS cardiac surgery in the second half of 2018 with excellent patient outcomes.

MIS cardiac surgery is performed through small incisions and does not require the surgeon to break the breastbone. Due to the very nature of the procedure and the minimally invasive approach, there is commonly a quicker recovery time with the patient spending less time in hospital.

It is important to realise that patients need to meet specific requirements for this surgery. The cardiothoracic surgeon at all times decides the surgical approach that meets the individual patient’s needs, ensuring the best outcome. The purchase of procedural specific instrumentation shows an ongoing commitment from St Andrew’s in the area of cardiothoracic surgery.

Opening of CSSD In February 2019, we opened our new Central Sterilising Services Department (CSSD). The new CSSD is fully compliant with the new AS/NZ4187 standards which will come into operation in 2020. The area was designed with the input of clinical staff and incorporates state-of-the-art washers and sterilising equipment.

As part of the build, we have developed a separate loan kit area, with Radio Frequency Identification (RFID) tunnel to ensure system management for all loan equipment required for multiple surgical procedures.

These new areas are on the “hot floor” adjacent to theatres, ICU and radiology, to ensure excellent patient flows and quality outcomes.

Massive transfusion protocol

The fruits of an $8,000 South Australian Blood Management Council grant were realised this year when St Andrew’s own film on massive transfusion protocol and subsequent e-learning package were released.

The project was a collaborative effort between St Andrew’s, Clinpath Laboratories and the BloodSafe program. The ethos of St Andrew’s was evident as staff participated in the project, voluntarily giving of their own time, while the grant secured the services of a professional production company.

Clinical Education A range of clinical education evenings and workshops held throughout the year were targeted at meeting the needs of the organisation. The well-attended sessions included an interactive neurological and spinal assessment evening, professional documentation and gynaecological procedures and post-operative care. The free clinical education program for St Andrew’s staff is an essential strategy aimed at ensuring our patients and their families receive the best possible care.

The value of the project as a tool to educate clinicians within the private sector to manage a critical bleed has been recognised by requests from SA Health and Clinpath Laboratories to use it for their own training purposes. BloodSafe e-learning Australia will be releasing the co-branded film within their global suite of online courses later in 2019.

We are proud to be a chosen partner in this initiative and recognise its contribution to managing this process at a critical time in a patient’s journey.

“What matters to you?” Day

Patient safety and quality

St Andrew’s Hospital celebrated “What matters to you?”

Day on Thursday 6th June 2019. This was our third year of participation in what is a growing international movement of asking patients what is important to them.

On the day, we invited patients throughout the hospital to write about what matters to them on a handmade leaf. The leaves were then gathered by our staff and volunteers and displayed on a tree in the main reception area for a week.

Each of the participating clinical areas had a “What matters to you?” Day ambassador who helped facilitate these important conversations. A shared morning tea was also provided, and nurses were asked to reflect on the conversations they had with patients.

With 106 of our patients responding, we received valuable feedback and enjoyed seeing our patients and staff interact in this meaningful way. The information we received was collated and reviewed as part of our commitment to providing the best possible care to our patients.

“What matters to you?” Day provided us, yet again, with an opportunity to celebrate all that our teams do every day to ensure our patients receive care tailored to meet their individual needs.

1. Meals 3.9%

4. Communication 10.2% 2. Care 4.7% Felt listened to, Individual, Prompt, Information, Updates.

Competent, Safe.

5. Health 13.4% 3. Environment/ facilities 9.5% 6. Family/Loved Décor, Noise, ones support 16.5% Cleanliness, Equipment.

8

1 2

7. Other 20.5% Garden, Consider what others don’t have in healthcare, Education, Sleep, Rain, A balcony of fresh air.

8. Staff 21.3% Caring, empathetic, professional, friendly.

3 4

7

5 6

Our Visiting Medical Officers (VMOs) continue to play an important role in ensuring patient safety and quality by participating in our clinical governance committees.

Engagement with our VMOs has been further enhanced through a range of specialty craft group meetings.

Since December 2018, the hospital has met with representatives from the following specialties: • • • •

Gynaecology Surgery, ENT Surgery, Gastroenterology, Colorectal Surgery.

The meetings have resulted in a range of patient safety initiatives including refining the hospital’s credentialing processes, improved clinical documentation, identification of emerging instrumentation and enhancements in IT access in the procedural suite.

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 and quality framework which defines that the care provided at St Andrew’s Hospital is patient-focused, driven by information, and organised for safety.

Hospital accreditation 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. It is public recognition by a healthcare accreditation body of the achievement of a set of accreditation standards by an organisation and their level of performance in relation to these standards.

In November 2018, the hospital completed a periodic review with ACHS. This assessment entailed two ACHS surveyors spending three days at St Andrew’s Hospital to verify the hospital’s compliance to the relevant National Safety and Quality Health Service Standards (NSQHSS) and ACHS EQuIPNational Standards.

The surveyors spent time talking with staff, patients and key committee members, as well as reviewing documentation, systems and practices. The feedback from the survey team was very positive and we are confident that we will make a successful transition to the second edition of the National Standards which came into effect in early 2019.

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 about patient safety and quality.

In 2018, 81% of the feedback received was complimentary.

A large proportion of this was about our staff, recognising them for being welcoming, caring, cheerful, friendly,

efficient, helpful and professional in the excellent care they provide.

The Department of Veterans’ Affairs Annual Patient Satisfaction Summary (2017-18) indicated the hospital’s overall rating remains a very high 9.1/10, with 88% of patients indicating they would recommend St Andrew’s to family and friends.

are monitored internally. Action is taken to address performance indicator results that fall outside expected norms.

The following are samples 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 enables us to benchmark our results against our peers. A large number of other performance indicators

Patient feedback These indicators are created from the feedback submitted on the feedback form which is available to patients in hard copy as well as online via the hospital’s website. The indicators are the rate of compliments, compliments with issues, and complaints.

81% Compliments 18% Compliments with issues 1% Complaints

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Average length of stay Over time we have seen a decreasing length of stay (time in hospital) as well as surgeries now being performed as day surgery.

2018-19

1.72

1.77

2017-18

1.85

2016-17

0

1.0 DAY

2.0 DAYS

Infection Control Indicators Hand hygiene National Benchmark 80.0% Higher rate is a good result.

The hospital hand hygiene rate is 82.4% and the national benchmark is 80%. Hand hygiene is one of the ways to reduce the Staphylococcus aureus bacteraemia rate.

SAH: 82.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Rapid response calls with Cardiopulmonary Arrest Rapid response calls are made when concern exists for the patient condition and extra help is required to prevent that condition from worsening.

Benchmark 0.048%

Lower rate is a good result.

The rate of rapid response calls with cardiopulmonary arrest is 0.053% which is slightly higher than the ACHS private national average of 0.048%.

The increase in indicator rate resulted in a review which showed some of the arrests were sudden and had no early signs which could be acted on prior to the event.

SAH: 0.053%

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

0.35%

0.40%

0.45%

0.50%

Falls The hospital monitors its falls rate in a number of ways, including the total number of falls and the number of falls that occur in patients over the age of 65 (over 65 patients are the high risk group of patients for falling).

Benchmark 0.22% Lower rate is a good result for both of these indicators.

The rate of falls is 0.207% which is lower than the ACHS Private National Average is 0.215%. this is an outstanding result.

SAH: 0.21%

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

0.35%

0.40%

0.45%

0.50%

0.35%

0.40%

0.45%

0.50%

Falls in patients over 65 Benchmark 0.34% The rate of falls in patients over the age of 65 is 0.284% which is lower than the ACHS private national average of 0.343%. This is an outstanding result.

SAH: 0.28%

0.00%

0.05%

0.10%

0.15%

0.20%

0.25%

0.30%

11

Finance and Administration Our finance team continues to work closely with all areas of the hospital, providing key support services such as billing, payroll, accounts payable, accounting, clinical costing and financial reporting. We have a strong, reliable team whose experience continues to grow.

our regular annual capital spending program was around $1.8M, which allows us to maintain a high level of good quality medical and surgical equipment, to improve our IT systems and to purchase new plant and equipment. Our major capital purchases are:

This year, we worked extensively with PowerHealth Solutions to improve our clinical costing system. We received funds from the Independent Hospital Pricing Authority to assist with our submission of the 2017/18 National Hospital Cost Data Collection, which also helped us to strengthen our in-house costing skills. We have also worked with Dr Daniel Cehic from GenesisCare and Harvard University on a Time Driven Activity Based Costing model which has the potential to further improve our clinical costing accuracy.

• anaesthetic machine,

Our Epicor (ERP) system was upgraded in March 2019 to the latest cloud version, delivering improved finance, purchasing and supply systems. The cloud software will always be contemporary, as upgrades are done twice per year, whilst also saving on in-house computing resources. The first phase of the upgrade was implemented efficiently with no interruption to our business.

We are now developing other Epicor modules to help maintenance, biomedical and clinical staff perform their work more efficiently and develop a better understanding about the cost of services.

The finance team has again worked with BDO as our external auditors.

We have completed the Statutory Accounts for 2018/19, which reflect a healthy and improved performance this year. The audit was completed in a satisfactory manner and confirms our performance and current financial position.

Capital Our Engineering Services Master Plan continued during 2018/19 and we spent $1.6M on major refurbishments to the hospital’s water and sewer services, medical gas storage, suction plant and public lifts. In addition,

• patient administration system upgrade, • spinal & imaging table, • ultrasound system, • heater-cooler units, • cardiac, urology, thoracic and orthopaedic instruments, • video ureteroscopes, cystoscopes and gastroscope.

Administration During the past year, our Patient Services team has farewelled almost 90 years of St Andrew’s experience with the retirement of three longterm staff members. It reminded us that, although technological advances in the last 30 years have been immense, providing a seamless admission process for our patients still remains our highest priority. Despite uncertainties for some patients with recent changes in the private health insurance industry, we aim to ensure everyone is fully informed about their own level of cover prior to being admitted to the hospital.

Health Information Management The Health Information Management Service has continued to strive for best practice in service delivery with the introduction of a range of initiatives over the last twelve months.

Education and skills development has been a key focus with expansion of the hospital-wide coding and documentation programme for both clinical and non-clinical staff. This included education and system changes to support the implementation of ICD-10-AM 11th edition from 1st July 2019.

A new Clinical Coder salary and career structure has been adopted to ensure we continue to attract and retain qualified and experienced staff in what is nationally a skills shortage and aging workforce area. In recognising this shortage, St Andrew’s Hospital has developed a Clinical Coding Internship program to provide placement opportunities to external Health Information Management Association of Australia (HIMAA) trainees to gain handson experience before entering the workforce. This is an Australian first with considerable interstate interest in the framework and outcomes.

St Andrew’s Hospital continues to be represented on a number of state and national committees in the health information and coding fields, with a number of professional development events being held at the hospital for both public and private health sector staff. The most recent presented by Professor Harrison of Flinders University on the new World Health Organisation (WHO) clinical classification ICD -11. The hospital also provided its first professional practice placement for a Health Information Management student at the Masters level from Latrobe University, Melbourne.

The hospital’s offsite record storage is being transitioned to a new service provider, under the Synergy Uniting Church contract which will deliver significant cost savings along with improved record management capabilities. This is scheduled for completion by the end of September 2019.

Supply The Epicor ERP cloud upgrade has resulted in both warehouse procedural improvements and administrative efficiencies in the Supply Department.

New hand-held barcode scanners now provide a real-time Wi-Fi solution for the management of inventory throughout the hospital. Supply staff have continued to work with clinical staff to assist with better organisation and identification of supplies in the perioperative stores.

The Supply Department has continued to focus on proactive cost reduction initiatives, in conjunction with clinical staff, to achieve good quality and value for money purchasing. This year, savings of over $350,000 was achieved with one main improvement being the change from Interlink to the superior NeutraClear and SmartSite system.

Not only was the ECD building a construction success, but it has been an outstanding enhancement to the diverse and wide range of services we provide.

18/19 Annual Report

Our continued excellent clinical performance, together with the extremely positive patient feedback, is what we are most proud of. There is no doubt that we have a dedicated and skilled team.

People, Organisational Development and Safety

18/19 Annual Report

People Our workforce has grown significantly over the last two years with the expansion of the hospital’s clinical facilities and subsequent increase in activity levels. An injection of new staff, particularly in the nursing division, has augmented our workforce’s current capabilities and continued to strengthen the depth of the hospital’s clinical team.

Our strong focus on recruiting people who inherently fit with the hospital’s culture and values has not been compromised in a highly competitive environment, where experienced and highly skilled specialist nurses are in short supply. The hospital has continued to maintain a turnover of less than 3% and successfully recruit to key positions with high calibre candidates. Our Graduate Nurse Program has once again achieved outstanding results with 100% of the 2018 graduates gaining ongoing employment. The 2019 program saw the introduction of a Procedural Suite pathway to support the workforce demands of this area.

The nursing staff re-negotiated their Enterprise Agreement which was resoundingly voted up by nurses in December 2018. The hospital continues to benchmark terms and conditions of employment for all employees to achieve an environment where rates of pay are attractive and Modern Award entitlements are passed onto all employees, where relevant, to maintain a work environment that is equitable and fair for all.

St Andrew’s Day was celebrated on 30th November. The hospital’s founder, Sister Janet Hay, had a strong affinity with the patron saint of St Andrew’s, with her family originating in Scotland and being devout followers of the Presbyterian Church. The day is about marking its historical significance, and thanking our staff for their daily contributions,as we strive to achieve our organisational mission of medical and surgical excellence. This year, the hospital recognised and celebrated milestone years of service from 10 to 30 years for 58 of our people.

Stephen Walker personally welcomed and acknowledged every staff member who attended a presentation during the day, with staff sharing their recollections, stories and experiences of working at St Andrew’s Hospital.

The hospital has farewelled a number of retiring staff over the last 12 months, with the following people giving 20 or more years of service: Karin Pfeiffer - 33 years Ward Clerk 2nd Floor Susan Saies - 28 years Registered Nurse Stomal Therapy Jocelyn Brockhoff - 27 years Registered Nurse Procedural Suite Maxine Wells - 25 years Clerical/Hospital Reception Deirdre Victorsen - 22 years Dietary Services Assistant

Organisational Development St Andrew’s has continued to place high value on professional development, clinical education and management/leadership initiatives and programs. The hospital has collaborated with specialist program facilitators to design customised programs targeting our organisational requirements and reflecting our values and culture.

The learning environments that our facilitators create are built on active participation, engagement and practical skill coaching with an emphasis on relevant learning outcomes and transition of new knowledge into the workplace.

Our leadership team has enhanced and continued to develop their skills and knowledge in strategic thinking, coaching for performance and managing stressors in the work environment. These programs are foundation pieces to embed a positive, high performance culture across the hospital.

The nursing division undertook a comprehensive review of the appraisal process in 2018. The redesigned performance discussion tool integrates nursing practice standards and encourages our nurses to use critical thinking skills to evaluate their own clinical practice, discuss their strengths, and identify development opportunities.

Effective communication with our workforce is a key driver of engagement, retention and team performance. Following a staff survey in late 2018, the hospital launched a mobile phone communication app in February to enhance our communication suite and enable our people to access

hospital-wide communications anytime, anywhere. Staff have enjoyed receiving a broader range of communications using a variety of mediums including the CEO’s quarterly update video.

WHS and Injury Management There has been considerable change as a result of significant work undertaken in the work health and safety space over the last 12 months.

In July 2018, we welcomed Libby Brooke as WHS Manager. Libby has led work to continue to improve WHS systems, with her expertise in manual handling benefiting all work areas through delivery of in-house, tailored manual handling education and training. The hospital has continued to embed an electronic WHS reporting system as well as improving safety awareness and engagement. Injury prevention and effective utilisation of the early intervention program have also been focus areas.

In February 2019, ReturnToWorkSA (RTWSA) confirmed that the hospital’s self-insurance had been renewed following an evaluation in late 2018. There were no nonconformances reported against the RTWSA Performance Standards or the Code of Conduct for SelfInsured Employers, which was a very pleasing outcome.

The successful relocation of staff to the hospital’s new CSSD facility early in 2019 was the result of a carefully considered transition plan and excellent collaborative work between the WHS and CSSD teams. The new facility was comprehensively evaluated against a range of potential WHS risks in consultation with the work area team and HSRs. Training needs analysis and training plans were developed, and strong communication and engagement with workers were key to support a smooth transition into the new facility.

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Information Systems During the 2018/2019 financial year, the Information Systems Department has sought to build upon and expand its already sound base.

The Information Systems Department resources have been aligned to support the significant growth in operational activity as well as to support Information Technology’s (IT) ever-increasing strategic importance within today’s healthcare industry. An added focus has been placed upon Business Intelligence, state-of-the-art Healthcare Clinical Information Systems, and superior Help Desk customer service.

All of these focus areas have been appropriately resourced.

Stage One of the implementation of a sophisticated data warehousing and reporting capability is now complete. This will enable data from

the various different feeder systems to be linked and analysed in an efficient and timely manner.

St Andrew’s’ patient information system, TrakCare, has been upgraded to the latest T2018 release. This upgrade has provided St Andrew’s with improvements to existing workflows as well as additional functionality to be explored, with a view to implement throughout the coming year.

The St Andrew’s/Intersystems relationship is now stronger than ever. We continue to work together and endeavour to move closer towards the goal of a fuller Electronic Medical Record (EMR).

We have become actively involved in the wider Intersystems’ user group community and seek to both contribute and influence the TrakCare development roadmap in line with the St Andrew’s Hospital’s strategic direction.

Engineering and Support Services The new plant includes but is not limited to: • new chillers,

Another good year, building on the successes of last year.

The Engineering Department has spent the 2018/19 year becoming familiar with the modes of operation, controls and intricacies of all the new plant and equipment that provide the energy and occupied space conditioning for the hospital.

18/19 Annual Report

• diesel generators, • tri-generation plant, • cooling towers.

In addition to assisting with last year’s delivery of the Eastern Clinical Development building, with its new cardiac unit, procedural rooms, car park and staff gym, this year we also assisted with the delivery of the relocated CSSD from its previous location on the ground floor to an area on the first floor immediately adjacent to the theatres, improving work flow efficiencies.

All the time this was being rolled out, we were also heavily engaged in the Engineering Services Master Plan (ESMP). The ESMP is a programmed, structured approach to manage the replacement of our aging plant and infrastructure in a timely manner,

over a ten year period. Year 2018/19 was the fourth year of the ten year plan and the following was achieved: • replacement of compromised hydraulic system, • refurbishment of lift controls (lift 3), • reticulation of hot and cold water, • upgrade of medical air, • design works for the medical gases bottle store, • design works for the suction vacuum plant upgrade.

Engineering and support services consist of: • maintenance, • capital works, • dietary services, • biomedical engineering • cleaning, • security, • property (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 the routine maintenance and repairs, we have completed significant capital works, including the redesign of the first floor walls around Lift 4, to allow easier access for bed bound patients.

The modernisation of some of our patient bedrooms and ensuites, converting the shared ensuite to single rooms each with its own facility.

Dietary services The Dietary Services Department continued to retain our Hazard Analysis and Critical Control Points (HACCP) accreditation and have done so since 2005, being one of the few hospitals in Australia to do so.

This high standard of meal service is provided on a “paddock to plate” basis where our meals are all freshly

cooked and designed by dietitians to support patient’s needs such as modified textures and special dietary foods (gluten free, lactose free, low potassium and low fibre and high protein modified consistencies).

Tasks provided by the Biomedical Services Department include:

We are looking forward to the opening of the refurbished staff cafeteria later in 2019.

Cleaning services

Biomedical engineering services Biomedical Engineering Services Department is staffed by three qualified and experienced biomedical engineers.

Maged Shenouda, Colin Hill and Paul Wood 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 of the hospital.

• preventative maintenance, • corrective maintenance, • external work.

ISS Healthcare Services has continued to provide a high level of cleaning services to St Andrew’s. We have recently celebrated the fifth year of our association.

In addition to providing cleaning services, including the making of beds in all ward areas, ISS also carry out the specialised services for the theatre, Vancomycin Resistant Enterococci (VRE) and Methicillin/Multi-resistant Staphylococcus aureus (MRSA) cleaning schedules.

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

17

Current Research and Ethics Projects

18/19 Annual Report

All research is administered by the St Andrew’s Human 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 a number of projects, including: • 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 • Spine Tango Registry for Spinal Surgery – Mr David Hall’s Private Patients, St Andrew’s Hospital • Application to become an Authorised Prescriber for the Trabecular Metal Glenoid Augment (TMGA) • The South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC): In pursuit of a state-wide population based cancer registry • The Australian Prostate Cancer BioResource • A prospective MRI evaluation of multifidus structure and composition following percutaneous facet joint denervation in chronic lower back pain • Australian Breast Device Registry • A Clinical Evaluation of the Medtronic Polymer-Free DrugEluting Coronary Stent System in De Novo native Coronary Artery lesions – (Polymer-Free DES Trial) • Magnetic Resonance to Manage Breast Disease

• Fertility SA BioResource • Fertility Understanding through registry and Evaluation (FUTuRE Fertility) • The couple in the spotlight of fertility treatment. Can couplebased approach improve the standard of care and shared decision making?

• Mitral Valve Repair Clinical Trial (MAVERIC Trial) • STREAM Trial: Stimulation Resulting in Embryonic Aneuploidy using Menopur • AMPLATZER™ Amulet™ Left Atrial Appendage Occluder Randomized Controlled Trial

• To establish a living bank of gastrointestinal tissue to develop new treatments and new preventative strategies for digestive diseases.

• ConfirmRxTM: Effects of Patient Posture and Physical Activity • Colonisation of Probiotic in Neoplasia • WAveCrest Vs. Watchman TranssEptal LAA Closure to REduce AFMediated STroke 2 • Feasibility study of the HighLife 28mm trans-septal trans-catheter mitral valve in patients with severe mitral regurgitation and at high surgical risk

• Evolution of prostate MRI and reporting: Audit of MRI vs prostatectomy • The significance of rectal cancer patients with positive lymph node threatening circumferential resection margin (CRM) or positive pelvic side wall nodes on magnetic resonance imaging (MRI).

• Onyx ONE Study; A Randomized Controlled Trial with Resolute Onyx in One Month DAPT for HighBleeding Risk Patients • Australasian Cardiac Outcomes Registry Ltd TAVI Registry • A Prospective, Multi-Center, Randomized, Controlled Trial to Demonstrate the Safety and Effectiveness of the MiStent II for the Revascularization of Coronary Arteries.

19

Medical Education Medical Student Selective Program (MBBS) 2019 The year 6 MBBS program consists of two semesters. One semester of a selective program incorporating Medicine, Primary Care, Psychiatry and Surgery, and a Student Selected Experience (elective); the other consists of hospital internship placements. The selectives are 4 four-week placements with a community emphasis. St Andrew’s has now been involved in the 6th year selectives program for 10 years, offering placements in breast/endocrine, urology and cardiology, and is the only private hospital to do so.

Throughout the ten rotations, twenty five students will have attended 15 in breast/endocrine, four in cardiology, and six in urology by the end of the year.

A consultant in each of the specialty areas supervises the students who present a PowerPoint presentation to them and other staff upon completion of their rotation. The supervising consultants are keen for the students to be exposed to a variety of specialty areas offered at St Andrew’s, and this is facilitated by a flexible program, as well as by the cooperation of the medical officers who are willing to be involved. Dr Melissa Bochner has supervised the breast/endocrine students; Dr Peter Sage has supervised the cardiology students; and Dr Raj Singh-Rai, Mr John Bolt, Mr Arman Kahokehr and Dr Johnathon Cho have each supervised the urology students.

Although the students are assigned to one specialty area, the opportunities to experience a variety of surgical procedures are maximized during the rotation. This flexibility has been consistently recognised in the feedback statements provided by students as a positive attribute of the program. All students this year have been able to attend a session in the cardiac theatre and the following morning when attending a session with the ICU consultants.

Students have observed robotic procedures and participated in surgical sessions in vascular, plastics, breast/endocrine, urology, spinal/neuro and orthopaedics.

They have also gained knowledge from anaesthetists both in assigned sessions and in sessions working with the surgeon. Many surgeons allow the students to scrub into procedures, firstly attending a practical session with Leanne Batten, Clinical Placement Coordinator, who teaches the skills of scrubbing, gowning and draping on their orientation day.

This session has been well received by all students with the following comments received: “It was a great opportunity to re-visit correct scrubbing technique after a period away from surgery’; I was grateful for the refresher.” “Really thorough induction into using skin-man scrub technique.”

Not all of the cardiology students’ sessions are procedural. They also spend time with the various consultants at Adelaide Cardiology (GenesisCare) experiencing consulting sessions, exercise stress ECHO, sleep clinic, CT reporting, angio lab sessions, trans-oesophageal ECHO’s and EP lab sessions. The breast/ endocrine students spend sessions with the consultants in the Breast Centre to provide an insight into the care of these patients both pre and post operatively. A session with the breast care nurses and stomal therapy nurses provide the students with an insight to the holistic care that St Andrew’s provide.

This year a suturing workshop was run by plastic and reconstructive surgeon Mr Quoc Lam. The instruments and sutures were supplied by Johnson & Johnson.

All of the medical students who attended found this workshop to be very useful, and comments were made on how they felt their practice of suturing had improved.

Adelaide Radiotherapy Centre (GenesisCare) continues its involvement by facilitating a two-day

18/19 Annual Report

program introducing the students to this specialty area. Dr Jones & Partners Medical Imaging also has a session with Dr Randell Brown sharing his knowledge with the students. Consultants from both Adelaide Oncology & Haematology and South Terrace Oncology have provided exposure to the specialty of oncology. The students also have a session with Clinpath Pathology, touring the facility at Mile End and working with a pathologist looking at specimens through the multiheader microscope.

Rev Peter Morel facilitates a session with all of the students on delivering bad news, where he shares his experiences and gives the students practical tips and resources for further reading. Feedback from this session continues to recognise the importance of developing this skill and how this session has benefited and prepared students for their future careers.

The feedback received from the students continues to be positive, a sample of comments are indicative of the comments received: “Flexibility, opportunity to see a broad range of surgical specialties, procedures, radiology and oncology, with many opportunities to scrub into operations. It was great attending a combination of both inpatient and outpatient encounters, the friendly atmosphere, having surgeons who are willing to teach, and it was so nice that Leanne introduced us to the surgeon before every operation.”

“Really great exposure to variety of surgical specialties. Leanne is very accommodating with placing us in fields of interest. She is an excellent co-ordinator, very organised and able to answer any questions we had. Best administration management I have come across in uni. Good teaching by the surgical staff. Good additional sessions with radiation oncology and medical oncology.”

Thank you to all those involved, with special thanks to the consultants who continue to support the program: The success of this program is due to the time and commitment shown by those involved. The many consultants who continue to share their knowledge, the breast care, breast centre and stomal therapy nurses, the theatre and angio nurses, the ICU team, Rev Peter Morel, the staff from Adelaide Radiotherapy Centre, Adelaide Cardiology, Clinpath, Dr Jones & Partners, Adelaide Oncology & Haematology and South Terrace Oncology, all work in developing and running such a diverse and successful placement opportunity.

Mr James Aspinall Mr Michael Berce Dr Melissa Bochner Mr John Bolt Dr Julie Bradley Dr Michael Brown Dr Randell Brown Mr Jim Burnett Dr Catherine Cartwright Dr Rick Catterwell Dr Daniel Cehic Dr Georgy Chacko Dr Jonathan Cho Mr Trevor Collinson Dr Rod Cooter Dr James Dickson Dr Patrick Disney Mr James Edwards Mr Darren Foreman Mr Andrew Fuller Mr Philip Game Mr Clive Hoffmann Dr Tom Jaensch Mr Arman Kahokehr Mr David King

Dr Steve Kinnear Mr James Kollias Mr Quoc Lam Mr Clayton Lang Mr Mark Lewis Dr James McLean Mr William McLeay Dr Joe Montarello Mr James Moore Dr Jamie Morton Dr Mary Moss Dr Nicholas Murray A/Prof Susan Neuhaus A/Prof Robert Parkyn Dr Peter Sage Dr Luay Samaraie Dr Simon Sandler Dr Maria Santos Dr Tarik Sammour Dr Samuel Sidharta Dr Bob Singh Dr Raj Singh-Rai D Michael Smith Dr Luigi Sposato Dr Govindarajan Srinivasan

Dr Peter Steele Dr Robert Stuklis Dr Karen Teo Dr Michelle Thomas Dr Sarah Thompson Dr Charles Tie Dr James Trumble Mr Paul Varley Dr Fabiano Viana Mr David Walsh Mr David Walters Mr Adam Wells Mr Richard Wells Mr Robert Whitfield Mr Michael Whitehead Dr Thuc Nhi Wilson Mr Roger Woods Mr Philip Worley Mr Michael Worthington Prof Stephen Worthley A/Prof Glenn Young

St Andrew’s Hospital Foundation

18/19 Annual Report

Reaching strategic goals and celebration.

With only one year remaining in our three year plan, we reached some significant highs. Our drive to be donor focused and relationships driven provided clear direction for the year.

The establishment of the Hay Society and Waverley Network saw a significant increase in activity.

The Hay Society recognises those who have made the ultimate gift to St Andrew’s Hospital by leaving a bequest, whilst the Waverley Network acknowledges our major donors. The launch of both groups was well received and well patronaged.

During February, the foundation was the recipient of funds raised from the West Beach Surf Life Saving Club’s Pink and Blue Swim/Walk, supported by the West End Community Fund.

Proceeds from the event were donated to breast care services at St Andrew’s, enabling the creation of a bespoke treatment room for our breast care patients. Thank you to everyone involved in what was a spectacular community event.

Our Annual Appeal was a success, with us exceeding our fundraising target. Our aim of raising $30,000 for three new treatment chairs was surpassed, resulting in the purchase of four chairs.

The hospital Golf Day held at Royal Adelaide Golf Club was once again enjoyed by all and $10,000 was raised from the event. Thank you to major sponsor Clinpath Laboratories and the many hole sponsors and supporters who were involved in the event.

Our main funding projects for the year have included: • continued support for three staff scholarship programs, • four treatment chairs for the chemotherapy suite, • AED Heart Start monitors for the hospital,

The foundation board has supported the department through a year of review and growth and provided expert guidance. I would like to acknowledge their commitment.

Director Dr Mary White resigned from the board during the year and we gratefully appreciate her 14 years of dedicated service to the foundation.

Thank you to the foundation team, led by Director Amy Bredon with the assistance of Foundation Assistant Valerie Turnbull and Coffee Shop Manager John Coates.

Chris Wright Chairman

• continued funding for da Vinci robot, • creation of a breast cancer treatment room and purchase of equipment, • refurbishment of the second floor patient lounge.

The Friends of St Andrew’s Hospital group celebrated their association with the hospital through the annual Christmas in July High Tea. Our guest speaker, cardiologist Dr Sam Sidharta, gave a highly engaging and entertaining presentation highlighting the current trends in cardiology, with a particular focus in the work being carried out at St Andrew’s Hospital with Adelaide Cardiology (GenesisCare).

Our SALA Art Exhibition held in the coffee shop art gallery provided a stunning backdrop for our customers during August. Proceeds from the sale of works supported the work of the foundation. Thank you to all our exhibitors.

Our volunteers play such an important role within the hospital and foundation.

Our coffee shop, patient transport and administration volunteers are integral to the St Andrew’s family. Our heartfelt thanks goes to them all.

HAY SOCIETY

WAVERLEY NETWORK To find out more about Hay Society and Waverley Network visit the foundation page at www.stand.org.au or call 8408 2005.

Donations 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.

A/Prof Jane Andrews Ms Zoi Athanasopoulos Ms Lisa Agius Mr Robert Adam Mr Ben Beamond Mr John Bishop AO Mr Graham Blacket Mrs Mollie Bradford Ms Pamela Buchdahl Mr David Bullock Mrs Sarah Bullock Mr Richard Blake Mrs Margaret Blake Mr David Bandini Rev Don Catford Mrs Lesley Catford Mrs Denise Cotterill Mr Keith Crawford Mrs Janet Crawford Mrs Jillian Crouch Miss Anastasia Carabelas Ms Peggy Carolan Ms Nicole Calabro Ms Angela Cross Mr Leigh Cohen Mr John Davis Dr Christoper Dibden Mr Raymond Dixon Mrs Marlene Dixon Mr Max Duhring Mr Wayne Darling Mr & Mrs Chas Errock Dr Darren Foreman Prof Robert Fraser AM Mr Graeme French Hon Roger Goldsworthy AO Mrs Lyn Goldsworthy Dr Ian Gould AM Mr Peter Graham Mrs Denise Graham Mr Brett Graham Mrs Ros and Mr Peter Griffiths Miss Gweneth Grundy Ms Kathy Guthrie Mr Allan Goodman Mrs Margaret Goodman Mr Ben Guerin Dr Hugh Harley Mrs Jo Harley Mr & Mrs Haynes Ms Kerry Hetzel Ms Meagan Huebl Mrs Marlene Holman Ms Benita Healy

18/19 Annual Report

ISS Cleaning Ms Andrea Johansen Mrs Tracy Jones Mr Neville Kenyon Dr Michael Kitchener Mr David Klingberg AO Mrs Margaret Klingberg Mr Elliot Keane Mrs Sau Lau Ms Margaret Leith Ms Klementine Lutz Mr Geoffrey Lake Mrs Judith Lloyd Mundulla Concert Committee Dr Robert Murray Mr Ian MacDonald Mrs Margaret MacDonald Mr Michael Madigan Mrs Lesley Madigan Dr David Matison Mr Ian McFarlane Mr Richard McKay Mrs Jean McKay Mr Peter McKee Mrs Pamela McKee Dr Neville Minnis Mrs Lynette Minnis Mr Bill Mitchell Miss Helen Mickan Ms Wendy Nicholas-Smith Ms Sue Nudl Mr Lindsay Oxlad Mr E O’Loughlin Mr Harold Pape Mrs June Pearce Mr Brad Polling Mr Anthony Price Mr Simon Polling Mr Sydney Pryor Mr Michael Randle Mr Robert Read Miss Cheryl Russell Mrs Patricia Rogers Mrs Priscilla Shea Mr David Smith Mrs Robyn Soraghan Mr Bruce Spangler Mrs Carolyn Spangler Dr Peter Stavrou Mr Peter Sutherland OAM Dr Mary Sutherland OAM Mr David Sanders Ms Alison Sarles Dr Mark Schoeman Mrs Merryn Schoeman

Ms Amanda Seaton Mrs Rosalie Scutter Miss Jenny Steele Scott OAM Mr Steve Swartz Mrs Bev Swartz Dr David Taplin Mrs Fran Taplin Mrs Ros Tucker Mr Malcolm Tyrrell Ms Dayna Tils Mr Paul Macsai The Butterfly Tarts The Marshall Family The Sterling Foundation Ms Dawn Volle Ms Joanne Walkley Mr Ian Wallage Mrs Rosemary Wallage Willunga Hair Chammy Wong Mr Barry Worrall Ms Lynnie Wells West End Community Fund West Beach SLSC Mr Glen Walmsley Mrs Elizabeth Wilson

We gratefully acknowledge donations received in memory of the following people who have been in our care.

Ms Brenda Aynsley Mrs Melody Butcher Dr Davor Hribar Mrs Mary Krichauff Mr David Nitschke Mrs Genevieve Payne Mr Ashley Pinnington

We gratefully acknowledge the kind contribution of the medical specialists who have participated in the 6th-year medical student clinical placements program and have kindly donated to the medical education research fund.

Mr Paul Varley Mr James Aspinall Mr Fabiano Viana Mr Michael Berce Dr Melissa Bochner Mr David Walsh Mr David Walters Mr John Bolt Mr Adam Wells Dr Michael Brown Dr Michael Whitehead Dr Randell Brown Mr Robert Whitfield Mr Jim Burnett Dr Thuc-Nhi Wilson Dr Catherine Cartwright Mr Roger Woods Dr Rick Catterwell Mr Philip Worley Dr Daniel Cehic Mr Michael Worthington Dr Georgy Chacko A/Prof Glenn Young Dr Jonathan Cho Mr Trevor Collinson Dr Patrick Disney Mr James Edwards Mr Darren Foreman Mr Philip Game Mr Clive Hoffman Dr Tom Jaensch Mr Arman Kahokehr Mr David King Dr Steve Kinnear Mr Jim Kollias Mr Clayton Lang Mr Matthew Lawrence Mr Mark Lewis Mr James McLean Mr William McLeay Dr Joe Montarello Mr James Moore Dr Jamie Morton Dr Mary Moss Dr Nick Murray A/Prof Susan Neuhaus A/Prof Rob Parkyn Mr Richard Pope Dr Peter Sage Dr Luay Samaraie Dr Tarik Sammour Dr Simon Sandler Dr SamuelSidharta Dr Varjeet (Bob) Singh Mr Michael Smith Dr Luigi Sposato Dr Govindarajan Srinivasan Dr Peter Steele Dr Robert Stuklis Dr Karen Teo Dr Michelle Thomas Dr Sarah Thompson Dr Charles Tie Dr James Trumble

Financial Report Statement of Financial Position as at 30 June 2019 2018/19 $,000

2017/18 $,000

22,665

25,955

Non-current assets

124,305

124,270

Total assets

146,970

150,225

Current liabilities

25,126

23,977

Non-current liabilities

6,909

15,351

Total liabilities

32,035

39,328

Net assets

114,935

110,897

Total accumulated funds

114,935

110,897

(Extract from audited accounts)

Current assets

St Andrew’s Hospital Statistics

Auditor 2018/2019

2017/2018

Occupied bed days

58,122

53,683

Separations

33,741

30,396

1.72 days

1.77 days

14,225

12,996

Day suite procedures

6,190

5,638

Emergency Department attendances

4,366

3,901

1,737

1,552

17.61 minutes

17 minutes

702

707

Average length of stay Theatre procedures

Emergency Department admissions Emergency Department average waiting time Workforce statistics – employees

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

Bankers Commonwealth Bank of Australia 96 King William Street ADELAIDE SA 5000 ANZ 121 King William Street ADELAIDE SA 5000

Solicitors DW Fox Tucker Level 14 100 King William Street ADELAIDE SA 5000 Rossi Legal Level 7 185 Victoria Square ADELAIDE SA 5000

Organisational Structure Board of Governors Chief Executive Officer - Stephen Walker Director Nursing and Clinical Services Ms Jacquie Wiley Associate Director Nursing – Wards and Privacy Officer Mr Adrian Saunders Associate Director Nursing – Theatres Ms Nicole Russell-Higgins

Quality and Risk Manager Ms Tina Donaldson Case Manager Ms Elizabeth Jones Pre Admission Coordinator Ms Tricia Fanning Clinical Educator Recovery/ Anaesthetics Jenny Slade/Kathryn Humphries

Clinical Manager Theatre Ms Leandra Spencer/ Ms Renee McHugh

Director of Finance Mr Garry Crispin

Clinical Educator Theatre Ms Kath Reval

Patient Services Manager Mrs Meredith Staggs

Clinical Manager Recovery/ Anaesthetics Ms Sharon Blaney

Management Accountant Mr David Ormsby

Clinical Manager/Procedural Suite Ms Sharon Maslen Clinical Manager – 2nd Floor Ms Liz Knight/Ms Heather Grady Clinical Manager – 3rd Floor Ms Karen Shannon/Sam Barton (Acting CM) Clinical Manager – Cardiac Ward Ms Lisa Walter Clinical Manager – 4th Floor Mr Simon Dunbar Clinical Manager – Angiography Suite Ms Joyce Restell Clinical Manager – Critical Care Unit Ms Edel Silke Clinical Manager – Emergency Service Ms Catherine Turner Clinical Manager – Day Chemotherapy Suite Ms Lisa Mucklow/Ms Lyndee Powell Bookings Manager Ms Viv Gill

18/19 Annual Report

Financial Accountant Mr Stuart Campbell Supply Manager Mr John Ioannou

Director of Engineering And Support Services Mr Peter Cooper Maintenance Controller Mr James Crinson Dietary Services Manager Mr Paul Smith Bio Medical Engineer Mr Maged Shenouda

Director of Information Systems Mr Greg Laing Director of Emergency Service Dr Steven Schueler

Health Information Manager Mrs Lorraine Van Gemert

Director of Critical Care Unit Dr Alex Wurm

Director of Human Resources Ms Rebecca Wyness

Director of Foundation Mrs Amy Bredon

HR and Organisational Development Coordinator Ms Alison Sarles Graduate Nurse Coordinator Mrs Kerry Holm WHS Manager Ms Libby Brooke Injury/Claims Manager Carly Leaker HR Manager Rachel Stephenson

St Andrew’s Hospital Coffee Shop Manager Mr John Coates Coordinating Chaplain Rev Peter Morel

Board of Governors

Rear (L-R): Ms J Wiley, Ms S Furey, Mr J Sweeney, Mr D Whitbread, Mr G Crispin, Prof R Fraser, Rev R Miller Front (L-R): Ms R Wyness, Dr M Sutherland, Mr T Lambert, Mr S Walker, Dr D Cehic, Ms S Daw. Absent : Mr D Walters

Chair

Board Members

Ex Officio Member

Mr D Whitbread BEc, FCA, FAICD

Dr D Cehic MBBS FRACP FCSANZ

Deputy Chair

Ms S M Daw GAICD, FGLF (03)

Rev R Miller Min.Dip.; Grad.Dip.Ed. The Moderators Alternate, SA Synod Uniting Church in Australia

Dr M F Sutherland MBBS FFARACS FANZCA

Prof R D Fraser AM MBBS MD FRACS FAOrthA Ms S C Furey BEc (Acc), LLB (Hons), LLM, FCA, GAICD Mr T Lambert BE (Civil), MEnvSt, GradDip BusMgt Mr J L Sweeney MBBS FRACS Mr D J Walters MBBS DDU FRACS

27

350 South Terrace, Adelaide South Australia 5000 Telephone 08 8408 2111 Facsimile 08 8232 0328 www.stand.org.au

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