The Sum of the Whole 2009 Annual Review
St Vincent’s Hospital | Sacred Heart | St Vincent’s Private Hospital | Mater Hospital | St Joseph’s Hospital | St Joseph’s Village
Together, we are stronger.
The Sum of the Whole
A Unified Approach
Collectively our healthcare facilities produce an effect that is greater than their individual capabilities. Our single efforts seamlessly combine to make the SV&MHS Mission a reality.
Forging strong partnerships, SV&MHS integrates research and educational endeavours into all aspects of patient care.
Engaging the Community
Responding to need, acting with vision and serving with compassion, SV&MHS works with those we serve to build, strengthen and empower communities. An intrinsically reciprocal relationship, SV&MHS would not be what it is today without community support.
Enrichment of the human experience is central to SV&MHS. Achieving wellness through physical and spiritual wellbeing, we acknowledge the uniqueness of each individual and the inherent need to treat the whole person.
contents Our Mission
St Vincent’s Private Hospital
Chairman and CEO’s foreword
St Joseph’s Hospital
St Joseph’s Village
Caring for our people
Nursing at SV&MHS
St Vincent’s Hospital
our mission The Values of St Vincents & Mater Health Sydney derive from the Mission and traditions of the Sisters of Charity and Sisters of Mercy. Firmly grounded in the Christian tradition, our Values seek to give form to our activities and are at the core of our Code of Conduct and Code of Ethical Standards. Inspired by the Values of the Sisters of Charity and Sisters of Mercy, our Mission is to bring the healing ministry of Christ to all we serve. Our vision is to serve the community through excellence in care, teaching and research in both public and private health and aged care services, and to reach out to the poor and the marginalised. In doing so, we maintain our fundamental respect for the skills and talents of our staff and our profound respect for the humanity of every individual patient.
Together, we continue our mission.
Together, we serve the community.
our values Compassion Justice Human Dignity Excellence Unity Mercy Hospitality Respect
We accept people as they are and display kindness and sensitivity to them.
We act with integrity and believe that people have the right to good healthcare without discrimination.
We treat all people with care, acknowledging each person is unique in the eyes of God.
We excel in all that we do so that we can positively promote the healing ministry within our society.
We create a community in which we collaborate with gentleness as a sign that we value one another.
We respond to those in need by providing the best possible treatment and care.
We welcome people with kindness and do all that we can to assist their health and wellbeing.
We are open to all people who need our care and our time, acknowledging that they have the right to our services.
corporate information St Vincents & Mater Health Sydney (SV&MHS) is the NSW based arm of St Vincent’s Health Australia, formerly the Sisters of Charity Health Service group, which together with its partners, is one of Australia’s leading Catholic not-for-profit diversified healthcare providers. St Vincents & Mater Health Sydney comprises St Vincent’s Hospital, Sacred Heart Hospice, St Vincent’s Private Hospital, the Mater Hospital, St Joseph’s Hospital and St Joseph’s Village. Collectively, SV&MHS provides a range of acute and sub-acute services from primary prevention through to tertiary level care across community, outpatient and inpatient settings as well as residential aged care. In partnership with universities and affiliated research institutes, the work of SV&MHS is supported by a significant investment in teaching and research.
Our History The facilities comprising SV&MHS have a diverse and rich history, grounded in the Gospel. All were founded by the Religious Congregation of the Sisters of Charity or, in the case of the Mater, by the Congregation of the Sisters of Mercy, North Sydney. These dedicated, energetic religious women, in pursuing their Christian ministry, have always engaged broad based community support to respond to the healthcare needs of those they serve, especially among the poor and disadvantaged. St Vincents & Mater Health Sydney continues to express the healing ministry of the Sisters of Charity and the Sisters of Mercy. St Vincents & Mater Health Sydney was established in January 2001 by the merger of the Sisters of Charity health facilities at Darlinghurst and the Mater Hospital, which was owned and operated by the Sisters of Mercy. In March 2005, St Joseph’s Hospital Auburn and St Joseph’s Village Auburn joined SV&MHS, bringing all the NSW health facilities of the Sisters of Charity under an integrated organisational and governance structure. Together, the facilities provide acute medical, surgical, obstetric and diagnostic services in a comprehensive range of specialties; sub-acute services (palliative care and rehabilitation); medical and nursing teaching and research; mental health services; drug and alcohol services; aged care medical and residential services and general community health programs. On July 1 2009, Mary Aikenhead Ministries was established by the Congregation of Religious Sisters of Charity of Australia to continue the Congregation’s various health and aged care, education and welfare ministries. Under Mary Aikenhead Ministries the Sisters’ facilities, including SV&MHS, are now governed by a group of Trustees, consisting initially of two members of the Congregation and three lay colleagues. One of the major objectives of Mary Aikenhead Ministries is to continue to build on the charism and traditions of the Sisters of Charity of Australia to ensure that each of the works for which it is responsible operates in conformity with the teaching, discipline and law of the Roman Catholic Church.
The new entity was granted canonical status as a public juridic person of pontifical right by the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life. The establishment of Mary Aikenhead Ministries marks the first time a public juridic person of Pontifical Right has been granted in Australia and sets an important precedent for other religious orders in the country.
St Vincent’s Hospital Sydney St Vincent’s Hospital is Australia’s second oldest hospital. A major public hospital and a principal referral hospital, St Vincent’s specialises in heart/lung transplantation, bone marrow transplantation, cardiovascular services, cancer, neurosciences, infectious diseases, mental health and drug and alcohol services. The Hospital operates a major Emergency Department service, providing trauma services for the Sydney CBD. The Hospital has a long standing reputation for treating patients with acute, complex needs from across NSW and Australia.
Sacred Heart Hospice Under the management of St Vincent’s Hospital, Sacred Heart provides palliative care, rehabilitation and cancer services. Sacred Heart is one of Australia’s leading inpatient palliative care providers and offers a community service to support patients at home. The Rehabilitation Department provides a consultation service to St Vincent’s Hospital, St Vincent’s Private and Sydney Hospital. Sacred Heart also houses St Vincent’s Hospital’s radiotherapy service.St Vincent’s Hospital and Sacred Heart function as part of the South Eastern Sydney and Illawarra Area Health Service under a Memorandum of Understanding with the Area Health Service and the NSW Minister for Health.
St Vincent’s Private Hospital St Vincent’s Private Hospital is a world class medical and surgical facility, providing overnight and day only care across a broad spectrum of specialties. The acute Private Hospital cares for patients from the local community, rural areas, interstate and overseas. With over 300 specialist consultants accredited to admit patients, specialist services are provided in major fields of medicine and surgery with the exception of obstetrics, paediatrics and psychiatry. St Vincent’s Private Hospital is a leader in many areas including cardiac care, cancer, neurosurgery, orthopaedics, head, neck and reconstructive surgery, laser and laparoscopic surgery. Part of the St Vincent’s Campus, the Hospital works closely with St Vincent’s Hospital and Sacred Heart to offer an integrated range of services for patients seeking private healthcare.
Affiliation with St Vincent’s Clinic St Vincent’s Hospital, Sacred Heart and St Vincent’s Private Hospital are affiliated with St Vincent’s Clinic which is a major ambulatory component of the St Vincent’s Campus. The Clinic provides investigative and diagnostic services for patients referred from across NSW.
The Mater Located on Sydney’s North Shore, the Mater is a renowned private hospital specialising in cancer services; joint replacement; bone and sport injuries; maternity and women’s health; heart, lung and vascular services and urology and cochlear ear implantation.
A major public hospital in western Sydney, St Joseph’s Hospital’s core services are palliative care, medical rehabilitation, aged care and aged care psychiatry. The Hospital operates as part of the Sydney West Area Health Service through a Memorandum of Understanding with the Area Health Service.
St Joseph’s Village St Joseph’s Village is a Commonwealth funded residential aged care facility. It comprises independent living units, hostel apartments, dementia care and community services. The facility plays a significant role in providing a continuum of care to elderly residents within the Auburn community.
Research Affiliations St Vincents & Mater Health Sydney is a leader in medical research, both directly and through valued partnerships with a number of affiliated research institutes. Key institutes include: Darlinghurst Campus Garvan Institute of Medical Research: an internationally recognised and respected medical research institute, with particular standing in gene based research and over 400 scientists, students and support staff. Victor Chang Cardiac Research Institute: a major health research institute with 150 scientists and support staff. The Institute’s focus is on heart disease and cardiovascular biology, cardiovascular research training and facilitating the rapid application of research discoveries to patient care. Institute of Virology: incorporates the world leading National Centre for HIV Epidemiology & Clinical Research, a facility of the University of New South Wales and the St Vincent’s Centre of Applied Medical Research. The Institute comprises over 300 of the nation’s top scientists working on viral hepatitis, HIV/AIDS and other sexually transmitted infections. Clinical Research Unit for Anxiety Disorders: a facility of the University of New South Wales focussed on research and treatment of anxiety and depression. John Plunkett Centre for Ethics: a facility of the Australian Catholic University that focuses on the study of ethical issues in healthcare and biomedical research. North Sydney Campus Melanoma Institute Australia: a leading centre for melanoma research, clinical care and training which aims to lessen the incidence of melanoma related deaths in the community. Patricia Ritchie Centre for Cancer Care and Research: providing cancer clinical care and oncology clinical trials.
Education and Teaching Partners St Vincents & Mater Health Sydney works with a large number of education and teaching partners to support its leadership role in the delivery of healthcare services, including University of New South Wales, University of Notre Dame Australia, University of Technology, University of Tasmania, Australian Catholic University, University of Sydney, Macquarie University, Charles Sturt University, University of Newcastle, University of Queensland, University of Western Sydney and University of Wollongong. Partnerships include student placements on each of SV&MHS’ three campuses, hosting academic chairs in medicine, surgery, psychiatry, palliative medicine, pharmacology, pharmacy, nursing research, cardiothoracic nursing and palliative care nursing. The Organisation also works with teaching partners to provide leadership and formation programs for staff.
Social Outreach and Advocacy Associated Organisations Sisters of Charity Outreach Sisters of Charity Outreach was formed in 1990 and operates from the St Vincent’s Campus to raise the status of women and families in metropolitan Sydney and rural NSW. Funded substantially by St Vincent’s Private Hospital, Outreach is committed to breaking the effect of destructive family behaviour by fostering self dependence and representing society’s voiceless. Key services include an accommodation crisis centre for women and children, transport services for country people visiting the city for treatment, court support, confidential counselling, legal assistance and support. Mercy Foundation The Mercy Foundation is conduced by the Sisters of Mercy and receives funding support from The Mater. The Foundation provides practical support for people working to eliminate poverty and creates a more just social order.
St Vincent’s Hospital | Sacred Heart | St Vincent’s Private Hospital | Mater Hospital | St Joseph’s Hospital | St Joseph’s Village
St Joseph’s Hospital
St Vincents & Mater Health Sydney St Vincents & Mater Health Sydney’s cross campus investment in research includes: Cunningham Centre for Palliative Care: a multidisciplinary academic centre, in partnership with the University of New South Wales, University of Notre Dame Australia and Calvary Health Care Sydney, which includes research, education, academic leadership and quality service in palliative care. Urban Mental Health Research Institute: conducts research into the provision of mental health services in inner Sydney. Nursing Research Institute: a partnership with the Australian Catholic University which includes nursing research and the translation of research into clinical care.
St Vincents & Mater Health Sydney also has advocacy collaborations with the City of Sydney, Asylum Seekers Centre, Sisters of Charity Advocacy Network, Catholic Health Australia, Caritas Australia and others.
chairman and CEO’s foreword
2009 saw new partnerships forged; new models of care were introduced to further our objectives in treating the whole person. It was a year in which we reached out to the community – who in turn provided unprecedented support. It was a watershed period where we pushed the boundaries both geographically and with innovative treatments to further our status as a leader in healthcare delivery. As you will see from this Annual Review, despite the dynamic nature of the year in terms of our growth, organisational transformation and evolving surroundings, we are encouraged by two traits that have intractably remained the same; the unwavering commitment to our Mission and Values and the fact that what we have achieved all that we have, often against a stormy back drop. While 2009 proved a sobering year in terms of the St Vincent’s trust fund losses sustained during the global financial crisis, both our staff and supporters never lost sight that our very beginnings were borne out of weathering storms, encapsulated by the Francis Spaight’s turbulent voyage from England carrying our five pioneering Sisters of Charity in 1838. Not only did we weather the storm but in virtually every direction, on the St Vincent’s Campus we have been engaged in crucial capital works projects. Through ongoing investment in research, we have made major
inroads this year in establishing the St Vincent’s Research Precinct – the creation of a research hub that will facilitate the development of novel diagnostic, treatment and prevention strategies to improve the prevention and management of disease. Stage 1 of the St Vincent’s Research Precinct – the Lowy Packer Building was completed in October 2008 and is today functioning very effectively. The Lowy Packer Building houses the St Vincent’s Centre for Applied Medical Research and the Victor Chang Cardiac Research Institute. Stage 2 of the Precinct will see St Vincent’s continue to work with its research and teaching partners to develop the Precinct in light of the recent advice that the University of New South Wales will establish the bulk of the Institute of Virology on its Kensington Campus. Stage 3 of the St Vincent’s Research Precinct – The Kinghorn Cancer Centre is a joint project of St Vincent’s Hospital and the Garvan to build a major cancer centre. In the 2009 May Budget we were delighted by the announcement of $70 million in Federal Government funding. This was bolstered by a $25 million gift from the Kinghorn Foundation for the Cancer Centre. Accompanied by Prime Minister Kevin Rudd and Health Minister Nicola Roxon, along with our Garvan partners, we commenced construction in March 2010 of the $110 million project which will integrate world class cancer research with best practices, rapidly translating research findings to patient care. The facility will house 250 clinicians and researchers and will focus on translational research and personalised medicine. As we write this foreword, it is with great excitement that St Vincent’s staff from Mental Health, Alcohol & Drug Services and Community Health will start work in the $46 million O’Brien Centre. In a partnership between the Hospital and the NSW
Government, the O’Brien Centre will integrate these St Vincent’s services under the one roof which will create opportunities to lift these services to even higher peaks. St Vincent’s is located in an area characterised by a population with the highest concentration of homelessness, drug, alcohol and mental health issues as well as people living with HIV and hepatitis C. From both a practical and a Mission perspective, the establishment of the O’Brien Centre is a monumentally important project in our 150 year history. Furthermore, our endeavours in mental health research received a significant boost with the recent establishment of the St Vincent’s Urban Mental Health Institute. In late 2009 we were informed that St Vincent’s will receive almost $3 million over three years as the state’s lead hospital in the National Partnership in Homelessness. St Vincent’s will now be working with a number of agencies to establish an exciting new program of healthcare delivery for the homeless. As part of our Mission to provide outreach to communities in need, we place great value in looking at ways to support regional and rural communities whose access to healthcare is compromised by their remoteness, socio-economic factors or workforce shortages. Particularly in Griffith and Wollongong we believe we can provide some assistance in establishing projects that will help these communities to attract doctors and nurses.
St Vincent’s Hospital | Sacred Heart | St Vincent’s Private Hospital | Mater Hospital | St Joseph’s Hospital | St Joseph’s Village
This year we have aptly chosen The Sum of the Whole – together we are stronger as the theme for our 2009 St Vincents & Mater Health Sydney (SV&MHS) Annual Review. In a year in which we both confronted major challenges and achieved monumental milestones, our endeavours throughout 2009 highlighted just how effectively our unified approach has benefited SV&MHS. Indeed there can be no doubting that collectively our facilities produce an effect that is greater than their individual capabilities to truly make our Mission a reality.
Following on from the preparation of a financial feasibility study, we have been working closely with Griffith City Council and representatives of the local community to develop a small 40-bed St Vincent’s private hospital in Griffith. Under the proposal, SV&MHS will operate the Hospital which will be owned by Council. The aim is to fund the capital cost of the Hospital through community and government support.
From both a practical and a Mission perspective, the establishment of the O’Brien Centre is a monumentally important project in our 150 year history.
St Vincents & Mater Health Sydney is working with the University of Wollongong and NSW Health to explore the feasibility of establishing an academic health complex in Wollongong. Under the proposal, SV&MHS will operate the private hospital and potentially the collocated medical suites and primary healthcare centre forming part of the clinical, teaching and research complex. We are hopeful of attaining a major capital grant from the Commonwealth Government in the near future to make this proposal feasible. Still on the theme of pushing the boundaries, for the first time in Australia, a number of organisations have come together to establish a collaborative palliative care academic institution. The Cunningham Centre for Palliative Care has been established through the collaboration of the Sacred Heart Hospice, the University of New South Wales, the University of Notre Dame Australia and Calvary Health Care Sydney. 2009 saw the Centre establish the state’s first Chair of Palliative Care Nursing. Another major milestone for St Vincent’s in 2009 was the installation of the Toshiba Aquilion ONE CT thanks to the generosity of the Curran Foundation. The scanner can image an entire organ like the brain or heart in one rotation showing real time
functions such as blood flow and movement. St Vincent’s is the only public hospital in the state currently operating this diagnostic service. The nature of our Mission means we should measure success beyond new buildings and equipment. In all of these developments we have not lost sight of our Mission and Values: to serve the community through holistic services founded in charity, care and compassion. And therefore perhaps the most gratifying achievement at St Vincent’s in 2009 was the result of the NSW Health Patient Survey Initiative which saw the Hospital achieve a patient satisfaction rating of 91.5 percent; higher than all of St Vincent’s Hospital’s peer group of principal referral tertiary hospitals. 2009 was a momentous year for St Vincent’s Private Hospital; our centenary year. To honour this milestone the Hospital engaged with our staff and community in a very meaningful way, providing several opportunities to stop and reflect on where we have been, what we have achieved and where we are headed. From its humble six-bed beginnings in 1909, St Vincent’s Private has become a powerhouse player in the Australian private healthcare sector. The Hospital’s patient outcomes are without peer – highlighted
by the Australian Council on Healthcare Standards Periodic Review in late 2009. We are particularly proud that this has all been achieved in the context of an unwavering commitment to the Mission and Values of our founding Sisters. 2010 is also shaping up to be a major year for St Vincent’s Private Hospital as we start to give form to our master planning process to build the new Private Hospital. Throughout 2010, we will further refine our various site options and in parallel with this, identify future needs and service areas to be expanded. When completed, it is anticipated the plans will provide a clear direction for growth not only for St Vincent’s Private but also for the Campus’ clinical objectives in general. The Hospital will also continue its journey to attain Magnet recognition in 2010 – the first private hospital in Australasia to attain this highly sought after designation for clinical excellence. At the Mater, 2009 proved a definitive year that has seen the Hospital metamorphosis from a hospital to a campus. This transition is not only significant in terms of its size, but most importantly, the shift to a campus means that the Mater is becoming a community of healthcare professionals.
What we are experiencing is a growing cohort of our top clinicians having a greater and more meaningful presence on the Mater Campus.
Equally monumental for the Mater Campus was the opening of the Poche Centre in early 2010 which incorporates the Melanoma Institute Australia, housing specialist consulting rooms, together with research and teaching facilities. The establishment of the Poche Centre will help put the Mater on the world stage in terms of its research endeavours. Key Mater clinical areas were also significantly expanded and revamped with new equipment during 2009 including renal, radiology and obstetrics. The Patricia Ritchie Centre for Cancer Care and Research will also see a major expansion following the acquisition of the cottage next door. In July 2009 the area on the first floor of the Mater, which was formerly the Executive Administration, became a 14-bed inpatient rehabilitation ward and was named the JM Agnew Wing, in honour of Sr Josephine Mary Agnew RSM. As a continuation to the refurbishment of the entrance foyer and coffee shop areas, the Mater created an innovative garden concept, known as the ‘Healing Garden.’ The garden will enable patients and their families, together with visitors and staff, to enjoy the serenity of this carefully crafted garden. Over at St Joseph’s Hospital and St Joseph’s Village we continue to work towards securing a future vision that will see the 120 year presence of the Sisters in the west go from strength to strength. In a challenging environment we are working with NSW Health to identify the long term clinical services for St Joseph’s Hospital and we are confident this will be finalised in 2010.
The past 12 months have witnessed some fundamentally important changes to our national governance structures both in relation to the Congregation as well as the healthcare services of the Sisters of Charity. On July 1 2009 Mary Aikenhead Ministries (MAM) was established by the Congregation of Religious Sisters of Charity of Australia to continue the Congregation’s various health and aged care, education and some welfare ministries. Under MAM the Sisters’ facilities, including SV&MHS are now governed by a group of Trustees, consisting initially of two members of the Congregation and three lay colleagues. One of the major objectives of MAM is to continue to build on the charism and traditions of the Sisters of Charity of Australia. The establishment of MAM marks the first time a public juridic person of pontifical right has been granted in Australia and sets an important precedent for other religious orders in the country. The first MAM Sydney mission gathering was held in late October on the St Vincent’s Campus. Representatives of all the major health, outreach and education facilities were represented from St Vincent’s College through to the Victor Chang Cardiac Research Institute. We are encouraged that the establishment of MAM has already provided the leadership framework to engender a genuine understanding of how we see ourselves into the future, to ensure that the complexities of our Mission have been examined and re-examined.
recently conducted a six month national governance review which has led to the approval of a new governance model. The review showed that as the national body, the various organisations that comprise SVHA act as independent regions, and in doing so limit their full potential – strategically and operationally. In a large part this has been driven by a complex governance structure. St Vincents Health Australia’s new governance structure addresses these challenges, while preserving the strengths of our current model, particularly the strength around local ownership, autonomy and engagement. This new structure will include: • Establishment of a single national governing board, with responsibility for governing all SVHA facilities, replacing the existing regional and national boards. • Creating strong community advisory boards, focused on local stakeholder engagement, service planning, Mission and clinical governance. • Retaining a regional management structure of regional chief executive officers and executive teams. Implementation of this structure will occur over the coming six months, with the new single board commencing operation on 1 October 2010. Under the governance of a single board, this is an exciting time for SV&MHS as we have the opportunity to truly harness our expertise across Australia, to bring to life a flagship national Mission program focused on service of the poor and marginalised.
St Vincent’s Health Australia (SVHA) – the national parent entity of SV&MHS –
We hope that you enjoy this 2009 SV&MHS Annual Review and that the theme of The Sum of the Whole – together we are stronger resonates as loudly for you as it does for us.
Paul Robertson am Chairman St Vincents & Mater Health Sydney
Steven Rubic CEO St Vincents & Mater Health Sydney
This transition culminated in the opening of the Mater Clinic in mid 2009 – the attainment of a 28 year dream. The Mater Clinic, located in Gillies Street, includes orthopaedic, cardiology and obstetrics and gynaecology consulting suites, three day surgical theatres, two research areas and pathology services. More than fifty Mater specialists are now consulting at the Clinic.
This year saw a major expansion of our Carinya Dementia Unit at St Joseph’s Village. The development was particularly timely in terms of the proportionately high concentration of elderly in the Auburn area.
St Vincent’s Hospital Department
St Vincent’s Private Hospital
St Joseph’s Hospital
2,348 630 96 1,421
Gastro Medicine and Surgery
General Medicine and Surgery
Gynaecology and Obstetrics
Head and Neck Surgery
Neurosciences Oncology Ophthalmology
Aged Care Psychiatry
Total Admissions including day stay
Day Only Admissions
Total Bed Days
Total Non Inpatients
Orthopaedics and Rheumatology
Total Admissions including day stay
Total Admissions including day stay 21,636
Total Bed Days
Palliative Care Unit
Day Only Admissions
Medical Rehabilitation Unit
Thoracic Medicine and Surgery
and Rehabilitation Unit
Aged Care Assessment
and Neurosciences Unit
Total Non Inpatients (Alcohol, Drug, Emergency, Mental Health, Other) 646, 767
Day Only Admissions Total Bed Days
St Joseph’s Village
Independent Living Units (self care)
Community Aged Care Places
Total Total Admissions including day stay
Separations 690 59
Ear, Nose and Throat
Gynaecology and Obstetrics
Head and Neck Surgery
Neurology Neurosurgery Ophthalmology
28 249 79
Orthopaedics and Rheumatology
Thoracic Medicine Urology Vascular Surgery
62 1,276 594
Total Admissions including day stay Day Only Admissions
Total Bed Days
Together, we lead.
St Vincents & Mater Health Sydney (SV&MHS) has a single Board which exercises governance responsibility within a national framework established by St Vincent’s Health Australia (SVHA). The legal entities comprising SV&MHS are: · St Vincent’s Hospital Sydney Limited. · Sacred Heart Hospice Limited. · St Vincents & Mater Health Sydney Limited, which operates the Mater Hospital and is the vehicle for groupwide operations. · St Vincent’s Private Hospital. · St Joseph’s Hospital Limited. · St Joseph’s Village Limited. · Trustees of St Vincents & Mater Health Sydney Limited. The Directors of SV&MHS serve as Directors of the companies limited by guarantee and as an advisory board to the Congregation of the Religious Sisters of Charity of Australia in respect of St Vincent’s Private Hospital. St Vincent’s Hospital Sydney and Sacred Heart Hospice report to South Eastern Sydney and Illawarra Area Health Service (SESIAHS) for performance but not governance. Similarly, St Joseph’s Hospital reports to the Sydney West Area Health Service (SWAHS). Memorandums of Understanding with the NSW Minister for Health, SESIAHS and SWAHS define the roles and funding arrangements of these entities as Affiliated Health Organisations under the Health Services Act 1997. In fulfilling its role, the SV&MHS Board acts within the delegations and approvals provided by the Trustees of Mary Aikenhead Ministries and the National Board of SVHA.
Board of Directors The Board of SV&MHS comprises up to 14 Directors appointed by the National Board of SVHA with the approval of the Trustees of Mary Aikenhead Ministries. Each Director is a Director of St Vincent’s Hospital Sydney Limited, Sacred Heart Hospice Limited, St Vincents & Mater Health Sydney Limited, St Joseph’s Hospital Limited, St Joseph’s Village Limited, Trustees of St Vincents & Mater Health Sydney Limited and a Responsible Officer in respect of St Vincent’s Private Hospital. Mr Paul Robertson AM B Comm FCPA Director – Appointed 27 March 2008 Chairman – Appointed 31 October 2009 A former Executive Director of Macquarie Bank, Mr Robertson has extensive experience in banking, finance and risk management. In 2003 Mr Robertson was awarded a Member of the Order of Australia for his service in the area of children’s health and welfare. Mr Robertson holds board and committee positions with a variety of organisations including St Ignatius College Riverview, the Jesuit Province of Australia, Ursuline Sisters Province, Social Ventures Australia, Cheviot Bridge Limited and the Financial Markets Foundation for Children. Dr Tracy Batten MBBS MHA MBA FRACMA AICD Director – Appointed 6 July 2009
Dr Batten is Chief Executive Officer of SVHA and has extensive experience in the healthcare industry. During her career, Dr Batten has held a number of senior medical management positions including Director, Clinical Services/Chief Medical Officer at St Vincent’s Hospital Melbourne. More recently Dr Batten held a number of senior executive roles including Chief Executive Officer of Dental Health Services Victoria and Chief Executive of Eastern Health, Victoria. Dr Batten holds a number of board appointments within St Vincent’s Health Australia Limited, St Vincent’s Healthcare Limited, St Vincent’s & Holy Spirit Health Limited and St Vincent’s Health Melbourne.
Professor Donald Chisholm AO Director – Appointed 25 May 2009
Sr Rose Holman RSC BHA Director – Appointed 1 February 2008
Professor Chisholm is currently a Principal Research Fellow of the Diabetes and Obesity Program at the Garvan Institute of Medical Research. Prior to his recent retirement, Professor Chisholm was an endocrinologist at St Vincent’s Hospital; a position he continues to hold in an honorary capacity. In 1999 Professor Chisholm was made an Officer of the Order of Australia for service to medicine and medical research and is a leader in the fields of diabetes research, patient care, medical education and the organisation of medical services.
Sr Rose is a Religious Sister of Charity who has held a number of clinical and administrative roles within SVHA. Currently a member of the pastoral care team at St Vincent’s Private Hospital, Sr Rose has previously held board appointments with St Vincent’s Clinic, St Joseph’s Village, St Vincent’s & Holy Spirit Health Limited, St Vincent’s Hospital Toowoomba, Holy Spirit Northside Private Hospital and Mt Olivet Community Services.
Mr Jim Dwyer OAM BA LLB Director – Appointed 15 October 2007 Mr Dwyer is a Partner in the Litigation & Dispute Resolution Group of Allens Arthur Robinson. He has many years of litigation experience in large commercial disputes and in the intellectual property field. He has worked with major corporations in the banking, music, entertainment, broadcasting, sport and electronic industries. Mr Dwyer has held a number of directorships, including an appointment to the Legal Aid Commission of New South Wales as the Representative of the New South Wales Attorney-General. He is currently the Chairman of Sony Foundation Australia and Permanent Secretary of the Court of Arbitration for Sport, Oceania Registry. Mr William (Liam) Forde BSc (Economics) AICD Director – Appointed 30 September 2009 Mr Forde has many years experience in senior finance and managerial positions both in Australia and overseas. He was Chief Executive Officer of Baulderstone Hornibrook Proprietary Limited from 2002 to 2005, following 15 years as Director of Finance for the company. Prior to his role with Baulderstone Hornibrook, Mr Forde was Director of Finance with Simpson Holdings. He is currently a Director of Westpac Banking Corporation’s Westpac Funds Management Limited, Chairman of Hastings Funds Management Limited, Non-Executive Director of Lynas Corporation Limited and Director on the Advisory Board of Rose Corporation. Mr Bruce Hawker BA (Hons) LLB Director – Appointed 27 March 2008 Co-founder and Managing Director of public affairs firm, Hawker Britton, Mr Hawker has extensive experience in government relations, campaigning and strategic communications across the public and private sectors. He is a member of the International Association of Political Consultants and American Association of Political Consultants.
Sr Joanne Kirk RSM Dip Teaching Grad Dip Admin Director – Appointed 1 February 2004 Sr Joanne is a North Sydney Sister of Mercy who held the position of Congregational Leader for two terms. Sr Joanne holds a number of board appointments including a directorship with The Friends of the Mater and Chair of the Trustees of Catholic Health Care Services. Mr Ian Martin BEc (Hons) AD Dip AICD Director – Appointed 1 July 2004 Mr Martin has over 20 years experience in investment management and investment banking. He is a former Chief Executive Officer of BT Financial Group and Global Head of Investment Management and Member of the Management Committee of Bankers Trust Corporation, a global investment bank which was acquired by Deutsche Bank in 1999. Early in his career he spent eight years as an economist with the Australian Treasury, Canberra. He was inaugural Chairman of the Investment and Financial Services Association. Mr Martin holds a number of board appointments including directorships with GPT Group and Argo Investments Limited, Chairman of The Wayside Chapel Foundation and is a member of the Commonwealth Government’s Superannuation System Review Panel. Mr Robert McCuaig FRICS Director – Appointed 1 January 2003 Mr McCuaig is co-founder of the global organisation now known as Colliers International, a property services company which specialises in advice, marketing and management of commercial, industrial, hotel, retail and residential property, and is currently a Consultant to Colliers International. He is an independent Director of Brookfield Multiplex Capital Limited and Chairman of Arabian Real Estate Investment Trust.
Ms McPhee has extensive experience as a non-executive director and senior executive in international consumer facing industries including aviation, retail, tourism and most recently with Qantas Airways Limited. She is a Director of AGL Energy Limited, Vice President of The Art Gallery of NSW, a member of the Advisory Council of JP Morgan and Advisory Board of Marsh McLennan Companies. Previous board appointments include Deputy Chair of South Australia Water and Director of the Coles Group Limited, Perpetual Limited, Primelife Corporation Limited, CARE Australia and Tourism Council Australia. Mr Steven Rubic BHA MBA FAICD FAIM AFACHSE Director – Appointed 7 July 2008 Mr Rubic was appointed Chief Executive Officer of SV&MHS in March 2008. Prior to his current appointment Mr Rubic was the Executive Director of St Vincent’s Private Hospital, a position he held from 1997. Mr Rubic has extensive experience in the health services industry with a strong background in general administration and leadership across public, private and aged care facilities. He is currently a Director of the Health Industry (Superannuation) Plan, the Garvan Institute of Medical Research, the Garvan Research Foundation, a member of the Second Tier Default committee, a member of the Australian Commission on Safety and Quality Health Care (private hospital sector committee) and is a past Chairman of the NSW Private Hospitals Association. He has completed an MBA and is a fellow of the Australian Institute of Company Directors. Professor Peter Smith RFD MD FRACP FRCPA FAICD Director – Appointed 7 February 2006 Professor Peter Smith is Dean of the Faculty of Medicine at the University of New South Wales. He specialised in cancer medicine and research following study in Australia, USA and Germany. Professor Smith has held senior hospital management posts in Brisbane and Melbourne and senior academic appointments at the Universities of Queensland, Melbourne and Auckland. He has served in a consulting role to Government, including as Chair of the recent Inquiry into Vietnam Veterans Cancer Incidence and Mortality. Professor Smith is currently a Director of the Garvan Institute of Medical Research, NewSouth Innovations and a number of research centres and institutes. Ms Shaune Noble BHA MPH ACIS Company Secretary – Appointed 2004
Retired Associate Professor Deborah Green BSS (Syd) Director – Appointed 1 August 2004; Retired 8 May 2009 Ms Belinda Hutchinson AM BEc FCA Director – Appointed 30 September 1999; Retired 29 September 2009 Mr Nicholas (Nick) Curtis BA Hons Director – Appointed 1 January 2001 Chairman – Appointed 31 August 2004; Retired 30 October 2009
Senior Executive Team SV&MHS has a matrix management structure which supports local management of each facility whilst maximising the benefits of shared common services, strategic planning and support across all facilities. Mr Steven Rubic Chief Executive Officer Mr Jonathan Anderson Executive Director, St Vincent’s Public Health Services Mr Robert Cusack Executive Director, St Vincent’s Private and Mater Hospitals Mr Mark Hales Director of Mission and Corporate Relations Ms Kerrie Field General Manager Human Resources and Electronic Media Solutions Mr Calum Laurie Chief Financial Officer Ms Shaune Noble General Manager Corporate Governance and Planning Mr David Roffe Chief Information Officer Ms Michelle Wilson Executive Director, St Vincent’s Clinic Mr Jose Aguilera Director of Nursing and Clinical Services, St Vincent’s Private Hospital Ms Vicki Dean General Manager, St Joseph’s Village Ms Leslie Everson Director of Operations, St Vincent’s Hospital Mr John Geoghegan Director of Operations and Nursing, St Joseph’s Hospital Ms Helen Miller Executive Director Aged Care and Sub Acute Services including St Joseph’s Hospital, St Joseph’s Village and Sacred Heart Hospice Ms Barbara Paris Director of Nursing and Clinical Services, the Mater Hospital Ms Maeve Tumulty Director of Nursing and Patient Care, St Vincent’s Hospital Dr Brett Gardiner Director of Clinical Governance, St Vincent’s Hospital Ms Grainne O’Loughlin Director of Allied Health, St Vincents Hospital
Ms Sandra McPhee DipEd FAICD Director – Appointed 1 January 2003 Deputy Chairman – Appointed 30 September 2009
stewardship The facilities of St Vincents & Mater Health Sydney (SV&MHS) have inherited a rich tradition from our founding Congregations, the Sisters of Charity and the Sisters of Mercy. Core to this tradition is the defining Mission to serve the poor and marginalised in our communities. This spirit of service is not only reflected in the many works of charity that are undertaken across SV&MHS, but also in the programs that are run for the community and are not funded through our general operating structure. This commitment to go above and beyond is a hallmark of our desire to respond to the needs of the most marginalised. Each year a stewardship report is prepared and presented to the Board. The report summarises the contributions that have been made in the previous financial year and is divided into four areas: • Works of Charity – one-off responses to people or communities in need. • Community Benefit – a planned approach to healthcare whereby SV&MHS supplements the cost of public healthcare or significantly reduces income potential to support its Mission. • Social Accountability – service provision that is above and beyond the core services of SV&MHS. • Donations in Kind – donations that do not incur a direct cost to SV&MHS. Throughout the 2008/2009 financial year, SV&MHS contributed in excess of $25 million.
Works of Charity Works of charity are one-off responses to people or communities in need and often involve care for the most marginalised and disadvantaged. A snapshot of these activities include: A Unique Wedding Day In a true act of Christian love, Pastoral Care at St Vincent’s Hospital enriched the patient and human experience for a terminally ill 44-year-old Hospital inpatient. Diagnosed with liver cancer and admitted to the Hospital on numerous occasions, the patient did not respond to chemotherapy. With her health deteriorating rapidly, the pastoral care team set about granting her last wish – to marry her partner of nine years in the presence of their three-and-a-half-year-old daughter. Within 48 hours the team held a wedding service on the Hospital’s Oncology Ward. Transforming the conference room, the ceremony was presided over by an Anglican Minister and was followed by an intimate reception complete with a wedding cake. Dignified and sensitive, the service was attended by a small number of family, friends and staff. This special wedding day is just one example of the uniqueness of care offered by SV&MHS. East Timor – A Story of Hope Manuella Soares had never seen an escalator before arriving at Sydney airport. A long way from home Manuella lives in a refugee camp in East Timor, a country torn apart by violence and political unrest. For those living in the refugee camp basic healthcare is a luxury. However, in 2009 an initiative of St Vincent’s Clinic saved the life of one young woman and her unborn baby.
Partnering with the Bairo Pite Clinic, the St Vincent’s Campus aims to treat up to 10 patients a year from East Timor. A story of hope and survival, Manuella had a lifesaving cardiac procedure at St Vincent’s. Her experience is just one of many that epitomise stewardship and the collaborative efforts between hospitals, doctors, administrative staff and partner organisations.
Community Benefit Community benefit is a planned, organised and measured approach to meeting a community need. In line with the Mission and Values of SV&MHS, these projects are provided over and above core services. Examples of community benefit include: The Nuns’ Run Connecting the St Vincent’s Campus with the broader community, the Nuns’ Run was a unique event to raise cancer awareness and crucial funds for the establishment of the new Garvan St Vincent’s Cancer Centre. Over 13 wintry days, Sisters Helen Clarke and Leone Wittmack walked the 400 kilometres from Dubbo to Darlinghurst. The epic journey commenced in May, at Taronga Western Plains Zoo, Dubbo, and was strongly supported by local communities in Dubbo, Wellington, Molong, Orange, Bathurst, Lithgow and Katoomba and finished with a fun run at Centennial Park. Supporting Medical Services in Moree Engaging with communities ear, nose and throat services at St Vincent’s Clinic work in partnership with Aboriginal Medical Services in Moree. Focusing on children the Otolaryngology Department at St Vincent’s Clinic provides regular clinics, whilst also educating and supporting local medical services.
Maternity Outreach The Mater Hospital’s Maternity Unit provides outreach services for those in the community who require additional support; many of these services extend beyond the hospital stay and encompass the wider family. Within 48 hours of discharge, discharge planners provide home visits for those who are unable to seek assistance from existing services within the community. For families expecting a second or subsequent child, information sessions take place to focus on the development of positive family relationships. The unique role of grandparents in family life is acknowledged with specific information evenings to outline current baby care practices. The Maternity Unit continues to assist pregnant women who are asylum seekers, trafficked or homeless with many of the Hospital’s obstetricians and paediatricians assisting at no charge.
Social Accountability Social accountability is a planned, documented and evaluated approach to service provision for core services that are above and beyond the level of funding received from key funding providers. For example, funding shortfalls in existing care, the provision of funding for research and equipment or the replenishment of public hospital capital.
Greening SV&MHS Connecting with the environment and promoting care of the earth for future generations, SV&MHS is re-doubling efforts to ensure its efficient and effective management of waste and related environmental issues throughout 2009. St Vincents & Mater Health Sydney continues to reduce its carbon footprint and is set to make further inroads in 2010 with the implementation of its Environmental Stewardship Strategy. Care for Cancer Patients Achieving wellness through physical and spiritual wellbeing St Vincent’s Hospital offers a range of services to meet the unique needs of its many cancer patients. Women undergoing treatment are assisted to manage related issues with ‘Look Good Feel Better’ workshops, the workshops are designed to restore the patients’ positive self image. Funded through a trust fund, a breast care nurse is available to provide information and support for women and their families before, during and after treatment. Cancer nurse coordinators directly engage patients to manage the care process and ensure their individual needs are met and clinical psychologists help patients to better cope with difficulties associated with their illness.
Auburn Carers’ Support Group A service of St Joseph’s Hospital, the Auburn Carers’ Support Group provides education, information, emotional and social support to carers within the Auburn Local Government Area. Having celebrated its 10th anniversary in 2009, the group meets monthly and is integral to the wellbeing of the individual carer.
Hand to the Land Each year the Mater Hospital conducts wellness weekends for women in remote areas of NSW. The weekends greatly assist women with their physical and emotional health and, in turn, the program helps in further supporting their families.
In Donnybrook, Ireland, close to the tomb of Mary Aikenhead there are countless rows of black crosses. Commencing with the first women who walked the foundation with Mary Aikenhead, the Foundress of the Sisters of Charity, each black cross bears the name of a deceased Sister of Charity. In one of the rows amidst the many names a cross bares the insignia Baptist de Lacy. Here marks the resting place of the first Rectress of St Vincent’s Hospital, Sydney – the first Catholic hospital to be established in Australia. Sr Baptist de Lacy’s story is an extraordinary one. The vision, courage and determination which inspired Sr Baptist to commence a Catholic ministry of healthcare in Australia has formed and shaped the Mission of St Vincent’s Health Australia – a Mission that has served the Australian community for over 150 years. The origins of this Mission are deeply embedded in this extraordinary vision to care for the sick, the poor and the marginalised. Today the complex group of facilities and services in the Sydney region of St Vincent’s Health Australia bear little resemblance to the house, Tarmons, in Potts Point which was bought by the Sisters to house the first patients. Yet, the Mission which inspired these humble beginnings remains as relevant, inspiring and challenging as it did back in those early days. Mission underpins St Vincents & Mater Health Sydney – Mission is the foundation, the reason for existence and the inspiration for a journey through times of blessing, growth, challenge and struggle. The Mission is rooted in the healing ministry of Christ and the overarching values of love, hope, compassion and justice which were defined by the creation of Mary Aikenhead Ministries in 2009.
Mary Aikenhead Ministries (MAM) was established by the Congregation of Religious Sisters of Charity of Australia to succeed to, carry on and expand various health and aged care, education and welfare ministries conducted by the Sisters of Charity of Australia. Officially established on July 1 2009, MAM was granted canonical status as a public juridic person of pontifical right by the Congregation for Institutes of Consecrated Life and Societies of Apostolic Life on 25 April 2008. Under MAM the many ministries that have been established and developed by the Sisters of Charity, since their arrival in Australia from Ireland in 1838, are now governed by a group of Trustees, consisting of members of the Congregation and lay colleagues. The Trustees will ensure that the heritage, tradition and the charism of the Sisters are taken purposefully into the future.
Mission Office The Mission Office supports and coordinates a range of programs and events across the facilities of St Vincents & Mater Health Sydney (SV&MHS), working closely with Pastoral Services, the team ensures that the Organisation’s rich Catholic heritage underpins the culture of SV&MHS. Promoting and developing an ethical culture within SV&MHS and awareness of the Code of Ethical Standards for Catholic Health and Aged Care, the Mission Office works closely with the Plunkett Centre for Ethics. The work of Mission is facilitated through a range of initiatives including ‘The Gift,’ a staff retreat program, orientation programs, staff development and team building exercises, reflection and prayer groups and especially through the ritual, liturgical and sacramental life of each campus.
Mission permeates all activities across SV&MHS and ensures that the Organisation’s distinctive identity remains core in the delivery of healthcare.
St Vincent’s Private Hospital Centenary A year of jubilee was declared in 2009 as the centenary of St Vincent’s Private Hospital was celebrated. This milestone reinforced the strength of the vision of the Sisters of Charity and their remarkable foresight in shaping the healthcare landscape within NSW. Themed ‘Celebrating 100 years of Excellence in Compassionate Care,’ the centenary marked the 100th anniversary of the Hospital that was founded on 7 October 1909. In light of the significance of this milestone, a range of activities marked the occasion, highlights included the centenary dinner in May at the Art Gallery of NSW and the centenary mass held at Sacred Heart Church in October, presided over by His Eminence Cardinal George Pell.
Pastoral Services Pastoral Services, including Pastoral Care and Chaplaincy Services, provides spiritual support to patients as they experience the illness, pain and loss that often accompany a stay in hospital. Spiritually based, the Services recognise that a patient may undergo not just physical uncertainty, but also questioning and vulnerability at a personal and spiritual level.
Pastoral Care provides an ear for listening and a presence that often allows the patient to ask questions without judgment – Why me? What does it mean? Why am I so afraid? Pastoral Services provides this through: •T he spiritual and emotional support of patients, families and staff. • Being in touch with the person’s inner search or questions. • Journeying with people as they tell and reflect on their story. • A spiritual presence regardless of the religious belief or non-belief of a patient. Pastoral Carers:
Pastoral Services are a key component of the multidisciplinary healthcare offered across SV&MHS and reaffirms the Organisation’s commitment to holistic care.
•M eet people in the present moment, regardless of their faith, beliefs or philosophies. • Offer spiritual and emotional support. • Compassionately support patients, family and staff through difficult times. • Provide sacramental ministry. • Assist and liaise with denominational chaplains. • Coordinate and facilitate prayer and liturgy, especially memorial services, spiritual reflections and other rituals where needed.
The team provides a service of companionship to those in crisis as they work to integrate their beliefs and values within their present physical, emotional, sociological and psychological situations.
Fundamentally linked to the Mission and Values of SV&MHS, Pastoral Services provides a ministry of healing beyond the rudiments of physical treatment and towards holistic care.
Mary Aikenhead Ministries
research St Vincents & Mater Health Sydney has a long tradition of taking a leading role in medical research and prides itself on its commitment to the translation of research findings into better outcomes for patients. The St Vincent’s Campus is regarded nationally as one of the largest and most successful bio-medical research hubs. Throughout 2009 the forging of new partnerships and ongoing investment in research resulted in the provision of strategies to continually improve the prevention and management of disease. An example of the success of this strategy is the commercialisation of Macrophage Inhibitory Cytokine (MIC-1/GDF-15) related technology for both therapeutic and diagnostic applications in the treatment of obesity and inflammatory diseases and management of cardiovascular disease. Professor Samuel Breit and co-workers at St Vincent’s Centre for Applied Medical Research were the first to clone MIC-1 and are a leading international group in studies of this important protein. In partnership with Novo Nordisk, St Vincent’s will continue to progress research on the MIC-1 technology. In 2009 the HIV Immunovirology research program, under direction of Professor Anthony Kelleher, developed a range of potentially clinically useful laboratory assays that measure a person’s immune function and competence. These assays assess the function of certain immune white blood cells, known as CD4 T lymphocytes, by measuring the ability of the cells to become activated and express signaling molecules when exposed to foreign bodies such as disease causing microorganisms. The assays have been patented and may lead to future commercialisation and diagnostic application for both chronic viral disease and for those suffering from autoimmune diseases and hereditary immunodeficiencies. The research program continues to develop a novel methodology for inhibiting HIV replication that may offer promise as a novel therapeutic. A major focus for 2009 was further development of the St Vincent’s Research Precinct. Phase 3 development will result in the establishment of the Garvan St Vincent’s Cancer Centre and will realise the promise of personalised medicine for cancer patients through the creation of a world renowned facility where research cancer findings swiftly move into clinical care and clinical challenges drive laboratory research. The newly created Clinical Research Program (CRP), under the direction of Professor Andrew Carr at St Vincent’s Centre for Applied Medical Research, aims to consolidate and provide a support base for clinical research initiatives on Campus and incorporates clinical services, allied health support units and compliance departments. The Program’s objective is to promote excellence in clinical research, support and training, manage risks and to provide advice to the Board on ethical and research governance matters. The CRP incorporates the former Clinical Trials Centre, HIV Clinical Trials Unit and the Antiretroviral Toxicity Research Group.
The Cunningham Centre for Palliative Care The Cunningham Centre for Palliative Care (CCPC) was established in late 2007 to promote excellence in palliative care research, education, clinical practice and quality care throughout NSW and beyond. A collaboration between Sacred Heart Palliative Care, the University of New South Wales (UNSW), the University of Notre Dame Australia (UNDA) and Calvary Health Care Sydney, the Centre is in part funded by the Cancer Institute NSW. Largely housed within Sacred Heart, CCPC also maintains an office at Calvary Health Care, Kogarah. In 2009 CCPC announced the appointment of Professor Jane Phillips as the first NSW Academic Chair in Palliative Nursing. The conjoint appointment with UNDA marks the completion of the initial recruitment phase for the Centre. Professor Phillips joins Associate Professors Katherine Clark and Elizabeth Lobb, also linked with UNDA; and the UNSW Chair of Palliative Medicine, Professor Jane Ingham, who together create the Centre’s core academic staff. Since its inception a number of independent research projects have been conducted and numerous links have been established with national research groups. In 2009 the Centre was involved in a wide range of palliative care research and education projects including clinical trials to identify the impact of a number of different medications on symptom management; studies to explore the impact of videoconferencing and telemedicine interventions on education and clinical care in rural settings and the exploration of the psychological impact of cancer and poor prognosis on patients and carers. All studies are congruent with the Centre’s broad aim of improving care and support for patients, and their families, with a life limiting illness. A new research structure was established at Sacred Heart. The revised structure supports the development of new palliative care research projects, from protocol development through to completion and publication of results, and will serve to better support and guide both experienced and novice researchers.
Garvan St Vincent’s Cancer Centre The Garvan St Vincent’s Cancer Centre will realise the promise of personalised medicine for cancer patients by creating a world renowned facility where research findings swiftly move into clinical care and clinical challenges drive laboratory research.
The Cancer Centre has been made possible by a $70 million funding package from the Federal Government as well as through the generosity of the Kinghorn Foundation and philanthropic donations collectively amounting to $40 million. Construction of the Cancer Centre will commence in early 2010 with anticipated completion in mid 2012.
Melanoma Institute Australia The Poche Centre will be the largest melanoma treatment and research centre in the world. Made possible from the donation of $40 million from philanthropist Mr Greg Poche, the purpose built Centre is a world class, integrated cancer treatment centre that further expands the existing Mater cancer services. Its establishment will enable the very best possible care for melanoma patients. Melanoma Institute Australia’s purpose is to be a global leader in melanoma treatment, research and education. Dedicated to minimising the devastating impact of melanoma on the community, the Melanoma Institute Australia is affiliated with St Vincents and Mater Health Sydney as well as the University of Sydney. Housed in the Poche Centre, at the Mater Hospital, the Melanoma Institute Australia will be officially opened in March 2010.
Patricia Ritchie Centre for Cancer Care and Research The Patricia Ritchie Centre for Cancer Care and Research is located at the Mater Hospital and houses a busy clinical chemotherapy service, research office and multidisciplinary teams in breast cancer, gynaecological cancer and head and neck cancer. These are closely linked to surgical, radiation oncology and diagnostic services within the Hospital and many clinicians have academic appointments at the University of Sydney. When diagnosed with cancer, patients enter an increasingly complicated world. With complex treatment programs and numerous medical specialties involved in care, survival rates are improving. However, navigating this maze and returning to optimal function afterwards is a significant challenge. At the Mater cancer care is provided in a coordinated multidisciplinary environment where treatments are dovetailed and a sense of security is provided as the team supports both patient and family.
At the Patricia Ritchie Centre staff are committed to offering a range of clinical trials to patients with breast cancer, who make up the majority of the Centre’s patient group. Working closely with national and international academic groups, the Centre has been involved in practice changing breast cancer research over the past 10 years, particularly in relation to HER2 positive breast cancer treatment. The committed financial support of The Friends of the Mater assists key researcher salaries to make many of the Centre’s endeavours possible. A unique study undertaken during 2009 was the ORBT trial. Bringing together expertise in surgery, oncology, pain management and psychological care, the study tracks 50 women through the first 12 months of their breast cancer journey. The aim is to identify factors that promote optimal recovery. Funded by the MBF Foundation, the study will facilitate treatment choices to minimise side effects of therapy. Other research throughout 2009 focused on a companion study of follow up needs of breast cancer patients and the study of educational resources for patients with cancer pain – the study demonstrated significant improvements in pain control for those with advanced cancer. The Cancer Council NSW now makes these resources available to patients throughout Australia.
Plunkett Centre for Ethics A joint venture of St Vincents & Mater Health Sydney (SV&MHS) and the Australian Catholic University, the Plunkett Centre for Ethics promotes compassion and fellowship, intellectual and professional excellence as well as fairness and justice. The Centre’s primary focus is on the realisation of these values in the provision and allocation of healthcare. The Centre expresses this commitment through research, teaching and community engagement as informed by the Catholic tradition. Activities include research; the promotion of research; research training and supervision; the development and teaching of courses; the ethical review of professional practice; an ethics consultation service and participation in public discussions.
The facility will consist of research laboratories; clinical data management and analysis suites; clinical review suites; multidisciplinary meeting rooms which will include high level video and audio conferencing facilities as well as patient coordination and clinical service areas.
Accessing the best cancer treatment may involve participation in the clinical trial of promising new therapies. These trials offer patients access to revolutionary medications years before they are readily available.
In 2009 the Centre published a book and authored or co-authored five articles in peer reviewed literature. Sixty-four consultations were undertaken, 26 of which were sought by healthcare professionals working across SV&MHS. Clinical ethics in-service programs were conducted at the St Vincent’s Campus and at The Children’s Hospital at Westmead. Undergraduate students and postgraduate students at Australian Catholic University were educated through the Centre. In addition, a medical student, from the University of New South Wales, conducted an independent learning project, on the role of family conferences in end of life care, at the Centre. 27
research Dr Stephen Buckle was awarded a discovery grant by the Australian Research Council for a project which focuses on the ‘sceptical materialism’ of the eighteenth century Scottish philosopher David Hume. Important research for the Plunkett Centre, Hume’s epistemology and ethics form the background for modern utilitarian thought to which the Centre often responds.
The Institute of Virology’s primary goal is to house pre-clinical and translational research teams, who are predominantly laboratory based at St Vincent’s Centre for Applied Medical Research, alongside public health, behavioural, biostatistical and clinical and therapeutic research groups. The strategic plan requires significant expansion of personnel and it is estimated that an additional 160 research and support staff are required.
The Institute aims to adopt the concept of ‘molecules to populations’ research through integration of enhanced drug discovery, preclinical work-up and early studies of candidate interventions in humans utilising the skills of established wet research laboratories and clinical service units on the St Vincent’s Research Precinct and purpose built facilities on the University of New South Wales campus.
Located at St Vincent’s Hospital, the Research Office coordinates and manages all activities relating to the Human Research Ethics Committee (HREC) and conducts research governance reviews for St Vincents & Mater Health Sydney and the Garvan Institute for Medical Research. Throughout 2009 the HREC reviewed 170 studies and the Research Governance Officer assessed over 100 site specific assessment applications. The St Vincent’s Hospital HREC is one of the top two committees in the state with regard to approval times. In collaboration with NSW, the HREC Executive Officer and Research Governance Officer worked to develop NSW Health’s ‘Operations Manual for Human Research Ethics Committees and Research Governance.’ This document will be released in July 2010. In addition, the Research Office embarked on a project to develop standardised policies and processes relating to research and research governance across the St Vincent’s Campus. The St Vincent’s Hospital HREC applied for National Health and Medical Research Council ‘National Certification to Review of Multi-Centre Research,’ the process of certification will commence in January 2010. Should the application be successful the HREC will be permitted to review and approve research conducted nationally.
St Vincent’s Centre for Applied Medical Research and the National Centre in HIV Epidemiology and Clinical Research The vision for the Institute is driven by the need to bring together research, clinical and laboratory services into a single facility. The Institute has grown to its present state and proposes to grow further, by developing areas of emerging public health importance including: •M ultidisciplinary translational research focused on infection and immunity. • The prevention and treatment of viral hepatitis and sexually transmitted infections. • The integration of academic and clinical skills to reflect a ‘molecules to populations’ philosophy by translating new knowledge into clinical practice. • The translation of research developed in Australia to solutions in South East Asia, building on existing physical presence in both Thailand and Cambodia.
This will allow the Institute of Virology to grow and develop its research capacity in collaboration with Research Precinct partners. The provision of modern high quality facilities will attract new infrastructure funding and collaborators. This will in turn leverage cutting edge laboratory and clinical expertise on the Campus to develop new diagnostic and therapeutic options for the betterment of population health. ‘The Institute of Virology’ is a working title. The final name of the Institute is under consideration and is likely to reflect an institute of national and regional significance which highlights the public health and applied research priorities of infectious diseases and immunity.
St Vincent’s Centre for Applied Medical Research – Clinical Research Program A recently formed clinical research group, the Clinical Research Program (CRP) incorporates the former Clinical Trials Centre, HIV Clinical Trials Unit and the Antiretroviral Toxicity Research Group. The Program provides high quality clinical trial services across the St Vincent’s Campus for the implementation of academic, pharmaceutical and investigator-initiated phase I through to IV clinical studies. The CRP has 20 years of expertise in multi-centred, investigator-driven clinical research projects, its future major focus. In 2009 80 clinical research projects were undertaken and encompassed a broad range of medical disciplines including cardiology, neurology, oncology, pain medicine, palliative care, rheumatology and infectious diseases, particularly HIV infection and hepatitis C. As well as phase I to IV drug studies, the Program engages in the study of potential vaccines, gene therapies and immunotherapies and is gaining specialisation capacity in pharmacokinetic sub-studies. The Program is staffed by 10 study coordinators, an administration officer, a clinical research manager, research fellow and program head.
‘Faces in the Street,’ St Vincent’s Urban Mental Health Research Institute (UMHRI) derives its name from the Henry Lawson poem about marginalised people in inner city Sydney. The Institute’s principal aim is to enable research into aspects of understanding the problems, prevention, early intervention, holistic management, rehabilitation and recovery programs for urban populations, based on the experiences of Sydney’s inner city population – a community characterised by the highest levels of homelessness, drug and alcohol abuse and mental illness in Australia. In partnership with primary care providers, the non-for-profit sector and St Vincent’s Hospital, St Vincents & Mater Health Sydney will continue to evolve an integrated service delivery system to reduce acuity, minimise disability, promote mental health and support the recovery of people with mental illness. Since its establishment Dr Helen Vidler has been appointed Research Coordinator of the Institute, this will be followed by the appointment of more research staff in 2010. The Institute’s first projects will focus on homeless people at both ends of the lifecycle and the evaluation of some aspects of service delivery already underway within the mental health service. Throughout 2010 the Institute aims to develop links with potential stakeholders, understand the research needs and undertake pilot projects, with the aim of hosting a research meeting in early 2011 to showcase projects undertaken.
Victor Chang Cardiac Research Institute Following relocation to the Lowy Packer Building in late 2008, the Victor Chang Cardiac Research Institute has undergone a rapid period of growth and expansion, with continuing success in 2009. From humble beginnings in 1994 with just two full-time staff, the Institute now employs over 120 research staff across 12 research programs, including 30 PhD and honours students.
Synonymous with the highest level of achievement in cardiovascular research, the new building has allowed integration of the Institute’s basic and clinical research programs. It has also provided the much needed space for new ancillary core equipment and machinery, including an x-ray crystallography machine, a confocal microscope facility and a next generation genome sequencing machine. The new space and state-of-the-art equipment supports the Institute’s commitment to making important discoveries in cardiovascular biology and medicine. Furthermore, the Institute maintains its reputation as a centre of excellence, where Australia’s brightest minds can focus their curiosity, build their knowledge and make a real difference to human suffering, by rapidly translating research into new preventative, diagnostic and therapeutic advances. Victor Chang researchers collaborate with scientists from all over the world, leading to discoveries with impact on a global scale. In 2009 the Institute reported its research achievements in some 43 papers – many in journals of the very highest international stature and impact. Professor Peter Macdonald’s work on the preservation of donor hearts, published in the American Journal of Transplantation, is just one example. The research outlines the development of a new treatment to extend the time a heart can remain healthy after removal from the donor and before being transplanted, from six to approximately 14 hours.
St Vincent’s Urban Mental Health Research Institute
This discovery, which should greatly increase opportunities for patients to receive a heart transplant, highlights the Institute’s integration of basic and clinical research programs, made possible by the world class facilities available at the St Vincent’s Research Precinct.
education The facilities of St Vincents & Mater Health Sydney (SV&MHS) have academic partnerships in medical, nursing and allied health practice. Key partners include the University of New South Wales, University of Notre Dame Australia, Australian Catholic University, University of Sydney, University of Technology Sydney, University of Tasmania, and TAFE NSW.
These partnerships reinforce SV&MHS’ commitment to the ongoing training and development of healthcare professionals within a values based organisation. Whilst the education of health professionals is a core priority, SV&MHS is also committed to supporting the further training and development of staff in all areas and at all levels.
Don Harrison Patient Safety Simulation Centre The Don Harrison Patient Safety Simulation Centre serves as an invaluable educational resource for the Campus. The Simulation Centre provides a unique opportunity for staff to practice team performance skills that are crucial in providing safe patient care. Training focuses on team work, task management, decision making and communication. Teams from the Emergency Department, Intensive Care Unit and Trauma Services undergo training on a weekly basis, whilst the Anaesthetics Department attend every third week and conduct regular crisis management workshops. A forerunner in education targeted at the deteriorating patient, the Centre assisted 200 nurses and doctors from the St Vincent’s Campus and 100 clinicians from the South Eastern Sydney and Illawarra Area Health Service to further develop their competencies. In partnership with the University of New South Wales and the University of Technology Sydney, the Centre engaged in
a scenario based pilot project. The project enabled final year medical students and undergraduate nurses to experience the importance of doctor-nurse collaboration, resulting in better patient care. Engaging with the community throughout 2009 the Centre provided basic life support and first aid training for members of the Curran Foundation and other community groups. The work of the Don Harrison Patient Safety Simulation Centre is made possible through the generous support of SIRENS and the Curran Foundation.
Postgraduate Medical Education St Vincent’s Hospital provides recognised and college accredited postgraduate education programs in a range of speciality areas including emergency, physician, anaesthetics, pathology, surgical and orthopaedic training. Vocational training is also provided for senior residents and registrars in most specialities. The Hospital is accredited by the NSW Institute of Medical Education and Training as a primary allocation centre for interns and residents. This year witnessed the expansion of postgraduate intern and resident training with an additional lecture program focussing on clinical management, acute patient care and surgical simulation. This development enables junior medical staff to clinically build on their already solid academic foundation.
Based at St Vincent’s Hospital the Eastern and Greater Southern PreSET Surgical Network hosted numerous postgraduate training courses throughout 2009, including an extracorporeal membrane oxygenation (ECMO) retrieval symposium. The symposium was held in light of swine flu respiratory failure cases and the central role St Vincent’s Hospital played as a receiving site for cases requiring artificial lung support.
St Vincents & Mater Health Sydney Australian Catholic University Nursing Research Institute The St Vincents & Mater Health Sydney (SV&MHS) Australian Catholic University (ACU) Nursing Research Institute (NRI) was launched in 2009. Located on the St Vincent’s Campus, the Institute provides a solid base for nursing led, clinically focussed, patient outcome oriented, multidisciplinary research and presents research development opportunities for nursing students, staff and allied health professionals across SV&MHS. With strong emphasis on translational research the Institute conducted 19 research projects in 2009, all of which focussed on improving patient care, quality and safety. Research results can be seen in the ongoing implementation of best practice and changes in clinician behaviour to improve patient outcomes. The majority of research is conducted on a multi-site basis involving vigorous collaboration with health clinicians from
Both Director, Professor Sandy Middleton, and Deputy Director, Professor Kim Walker, hold joint appointments with ACU. Other NRI research staff include Senior Research Fellow, Dr Liz McInnes, as well as 18 research assistants, PhD and honours students, support staff and most recently, Jed Duff as newly appointed Clinical Research Fellow at St Vincent’s Private Hospital.
University of New South Wales St Vincent’s Clinical School The St Vincent’s Hospital Clinical School facilitates training of approximately 315 undergraduate medical students, 104 postgraduate students and over 25 elective national and international students. In addition, the School provides significant support to all facets of St Vincent’s Hospital, in both clinical services and management. Apart from clinical academics, of which Dr Russell Clark is a new part-time appointment, the School’s teaching staff includes 176 conjoint staff members of St Vincent’s Hospital, St Vincent’s Private Hospital and St Vincent’s Clinic. The School welcomed Professor Richard Epstein as the new Conjoint Professor of Medical Oncology. Dr Darren Gold, Senior
Lecturer in Surgery, was voted ‘best teacher’ by the students. Dr Tony Grabs, Senior Lecturer in Surgery, resigned his academic post after a distinguished career with the School and has undertake a senior management role within St Vincent’s Hospital. The School continues to lead the Faculty of Medicine in the output of research publications; with 255 publications the School exceeds its closest competitor by 80. Already strong by virtue of research collaboration and conjoint appointments, the School’s relationship with the Garvan Institute will be enhanced with the new Cancer Centre on the Darlinghurst Campus. In 2009 the School embarked on its first strategic planning exercise. In alignment with University and Faculty plans, the School has adopted four strategic objectives: • Student Experience To refine and improve performance in teaching including the ongoing successful implementation of the new undergraduate curriculum and strengthening feedback to students and teaching staff. • Research To strengthen the breadth and depth of research performance of the Clinical School’s staff and students and encourage research amongst the clinician and scientist community at the Darlinghurst Campus and beyond. • Community Engagement To improve the management of key relationships, take a strategic approach to active participation in community service initiatives and build the School’s unique identity in line the Mission and Values of the Sisters of Charity.
• Capabilities and Resources To provide efficient and effective support systems, encourage ongoing staff professional development whilst meeting budget expectations.
University of Notre Dame Australia The University of Notre Dame Australia officially opened its School of Medicine and School of Nursing on the site of the Sacred Heart Church in Darlinghurst in 2008, with the University’s medical students commencing clinical placements at the St Vincent’s Campus under the 2006 Memorandum of Understanding between St Vincents & Mater Health Sydney (SV&MHS) and the UNDA. St Vincents & Mater Health Sydney also has a clinical partnership with the University, enabling nursing students to undertake their 33 week clinical placements at SV&MHS facilities.
University of Tasmania Bachelor of Nursing Degree Since its 2006 introduction, 120 students have graduated from the St Vincents & Mater Health Sydney (SV&MHS) University of Tasmania two year fast track Bachelor of Nursing degree program. Throughout 2009 a total of 134 students continued clinical placements across SV&MHS campuses. A total of 64 students are anticipated to be the fifth cohort to commence the course in early 2010.
all disciplines. Many of the projects are supported by grants from the St Vincent’s Clinic Foundation, SV&MHS Nursing Research Grants Scheme, the Curran Foundation and The Friends of the Mater Foundation as well as significant funding from the Australian Research Council and National Health and Medical Research Council.
Together, we improve patientsâ€™ lives.
St Vincent’s Hospital
Owned and operated by Mary Aikenhead Ministries, formerly the Congregation of the Sisters of Charity of Australia, the Hospital is located within the South Eastern Sydney and Illawarra Area Health Service (SESIAHS). It operates under a Memorandum of Understanding between the Board of St Vincents & Mater Health Sydney (SV&MHS), the SESIAHS and the NSW Minister for Health and reports to SESIAHS for performance but not governance. The Hospital manages Sacred Heart Palliative Care and Rehabilitation through a formal agreement and is located on the Darlinghurst Campus along with St Vincent’s Private Hospital and St Vincent’s Clinic. Also closely located on the Campus are St Vincent’s affiliates the Garvan Institute of Medical Research, the Victor Chang Cardiac Research Institute, the National Centre in HIV Epidemiology and Clinical Research and the St Vincent’s Centre for Applied Medical Research. St Vincent’s Hospital is a 326-bed facility which provides acute care services to inpatients and outpatients from the local community, across NSW and Australia. With an international reputation, St Vincent’s is recognised as a centre for excellence in clinical care, research and education.
Speciality areas of expertise include heart and lung transplantation; bone marrow transplantation; cardiology; cancer; acquired immune deficiency syndrome/HIV; respiratory medicine; mental health and drug and alcohol services. The Hospital provides a comprehensive range of community health services in the local community, a community that is home to Australia’s largest concentration of homeless people. These services reinforce the Mission and Values of the Sisters of Charity and include mental health; drug and alcohol; diabetes; dementia and generalist community care. Research is a core Hospital activity and specialist research units include the Centre for Immunology, Clinical Trials Centre, Clinical Research Unit for Anxiety Disorders and the Urban Mental Health Research Institute. Key research areas include cancer, immunology, HIV and cardiovascular disease.
St Vincent’s Hospital is a leading Australian tertiary acute care hospital. Opened at Potts Point in 1857 by the Sisters of Charity, St Vincent’s Hospital relocated to its current Darlinghurst location in 1870.
St Vincent’s Hospital is a teaching hospital of the University of New South Wales and maintains a close association with the Australian Catholic University, the University of Sydney, the University of Technology Sydney, the University of Tasmania and the University of Notre Dame Australia. 33
Together, we heal.
a year in review A year of proud achievements, St Vincent’s Hospital continued to respond to the evolving healthcare landscape and tailored its services to meet healthcare reforms, advances in technology and shifts in patient demographics, whilst remaining firmly committed to its Mission. Construction of an integrated mental health, alcohol and drug and community health facility progressed. A significant development for the Darlinghurst Campus, the O’Brien Centre will be fully functional by April 2010. Strongly embodying the Mission and Values of St Vincent’s, the O’Brien Centre will improve interventions for at-risk individuals and groups. The sharing of skills, resources, knowledge and priorities will result in better access to services that are tailored to the individuals’ needs. Ultimately the O’Brien Centre will improve outcomes and wellbeing. In collaboration with the Garvan Institute, St Vincent’s Hospital announced its intention to establish a cancer centre within the St Vincent’s Research Precinct. Development of the Garvan St Vincent’s Cancer Centre (GSVCC) is supported by a $70 million funding package from the Federal Government. The GSVCC will integrate the best practice clinical care of St Vincent’s Hospital with the Garvan’s internationally acclaimed cancer research. Set to house over 350 researchers and clinicians the purpose built Cancer Centre will focus on translational research and the development of an innovative and personal approach to patient care. Enabling researchers and clinicians to work side-by-side the Cancer Centre will facilitate a multidisciplinary effort in the national and international fight against cancer.
Continuing to focus on research, funding commitment from the Federal Minister for Health facilitated the National Centre for HIV Epidemiology and Clinical Research with $17.7 million. The monies will further the understanding of immunity against HIV and hepatitis C and will be administered through the National Health and Medical Research Council. Throughout 2009 St Vincent’s Hospital furthered dialogue with the University of New South Wales in relation to the establishment of the Institute of Virology Building. As redevelopment works progressed, the ‘Little House’ was farewelled with the St Vincent’s Diabetes Centre relocating to the Garvan Institute. Originally opened in 1980 for ambulatory management, the Centre’s aim was and is to keep people with diabetes out of hospital. Federal Minister for Health and Ageing, Nicola Roxon, and Deputy Premier and Minister for Health, Carmel Tebbutt, were welcomed to the Darlinghurst Campus as part of the NSW and Commonwealth health reform consultations. Minister Roxon outlined the National Health and Hospital Reform Commission’s recommendations and openly discussed priorities to improve Australian health services with staff. The visit also incorporated a tour of the St Vincent’s Research Precinct. Remaining at the forefront of healthcare, the Hospital commenced a trial of the Edwards SAPIEN Transcatheter Heart Valve. The trial has resulted in the successful implantation of over 40 percutaneous valves with overall positive results. Cardiologists at St Vincent’s Hospital are now mentoring other organisations, nationally and internationally, in the use of core valves and Edwards SAPIEN percutaneous valves.
In 2009 St Vincent’s Hospital sought to develop a strategic response for the needs of the homeless community. Central to this response is the St Vincents & Mater Health Sydney Mission and prioritisation of the development of a homeless health framework which will ensure close collaboration of physical health, mental health and drug and alcohol services. The framework will identify requirements for the provision of a more holistic and cohesive service for those who are or at risk of homelessness and will result in a Hospital wide response. The strategy will also identify mechanisms for structured communication and collaboration between government and non-government agencies, whilst raising community awareness of the Hospital’s homeless health initiatives. In line with the homeless health framework, St Vincent’s Hospital successfully secured funding for a three year period, from NSW Health, for assertive outreach support and coordinated exit planning for the Emergency Department. It is anticipated that health outcomes for one of the Hospital’s most marginalised communities, the homeless, will improve through this strategic response.
The official name for the Urban Mental Health Research Institute was unveiled in 2009. Named by Dr Peter Rofe after Henry Lawson’s poem ‘Faces in the Street,’ the Institute works to understand key issues surrounding mental health in a city environment. A focal point for the brightest minds in the field to work, share knowledge and expertise, ‘Faces in the Street’ supports the development of enhanced prevention and care strategies through research and evaluation. The concept of the Institute was initiated in 2007 following a significant seeding donation from a St Vincent’s Hospital benefactor. The intention of the donation was to focus on mental health and the inner city with significant reference to the disadvantaged and marginalised. Positively promoting the healing ministry, St Vincent’s Hospital continues to excel in patient care. The 2009 Patient Survey Round resulted in an overall satisfaction rate of 91.5 percent, this compares to a rating of 88.2 percent in 2008. A NSW Health initiative, the Patient Survey Round assesses information relating to patient experiences within healthcare services. A testament to its Mission and Values, St Vincent’s Hospital was rated highest amongst its peer group of principle referral group A hospitals in the state.
Throughout the year a number of system improvements were initiated, including the rollout of MedChart. A major St Vincent’s initiative, the electronic medication management system provides capacity, safety and quality. A web based system, it replaces paper based systems for electronic prescribing; clinical pharmacy review, medication administration recording; sophisticated real time decision making; configurable rules and alerts; safety and quality reporting; electronic transfer of prescriptions and charts and multiple formularies. MedChart places St Vincent’s Hospital at the forefront of medication management.
Throughout 2009 the Hospital witnessed significant improvements to patient access. Considerable progress was seen in the time taken for a patient to transit from the Emergency Department into a bed and/or Medical Assessment Unit. With an ever increasing workload and evolving challenges, the Hospital’s achievements are accounted to the dedication of staff and their ongoing commitment to the Mission and Values of the Sisters of Charity. 35
solveigh Extraordinary response to community crisis
As 16-year-old Solveigh Brandhorst trudges through the tropical Daintree Rainforest, where she lives in far north Queensland, it is almost impossible to believe that only a few months ago she was at death’s door – literally. Catastrophically ill in August 2009, Queensland Health turned to St Vincent’s Hospital to save this young girl’s life. Solveigh’s story is one of personal strength, collaboration and an extraordinary response to community crisis. Returning from a holiday with her mother to their homeland Germany, Solveigh arrived at Cairns airport feeling a little unwell. As the days passed Solveigh lost her appetite, felt rather tired, had severe back ache and could no longer sleep. Rapidly deteriorating, Solveigh was admitted to Mossman Hospital and was listed as critically ill. Within hours Solveigh was placed in a medically induced coma and transferred to Townsville Hospital. She would later be diagnosed with swine flu – H1N1. By the time Solveigh had been transferred to Townsville Hospital via helicopter the outlook was grim – her lungs had deteriorated so severely that conventional mechanical ventilation was now failing to support her.
Solveigh was in need of urgent Extracorporeal Membrane Oxygenation (ECMO) – a process whereby a machine continuously pumps blood through a membrane oxygenator to remove carbon dioxide and add oxygen. ECMO would support Solveigh’s heart and lungs, keeping her alive so she would have the opportunity to receive treatment for H1N1. With only three ECMO machines in Queensland, at the time, and at the height of the H1N1 pandemic, they were all already in use. Queensland Health turned to the NSW Health ECMO Medical Retrieval Service and within hours, St Vincent’s Hospital prepared to save the life of critically ill Solveigh. A team of four medical and perfusion staff were dispatched direct from St Vincent’s to Townsville Hospital with the ECMO machine in tow, the team commenced their race against time to save Solveigh. Accompanied by the retrieval team, her mother and step-father, Solveigh arrived at the Intensive Care Unit at St Vincent’s Hospital. Still in a medically induced coma she was unaware of her dire situation. Over the coming 16 days staff from across the Hospital would work with Solveigh and her family to save her life.
In an effort to alleviate worries, the St Vincent’s team of doctors regularly conversed in German with Solveigh’s Hamburg based father to keep him closely updated on the situation. During this time staff developed a special rapport and fondness of Solveigh, her mother and step-father. “As a young, fit and healthy patient we were particularly hopeful that Solveigh would make a full recovery. Having said that, this truly remarkable outcome would have been impossible without the extraordinary teamwork and the compassion of so many involved in her care. Solveigh’s story highlights the unique work of St Vincent’s Hospital and our extraordinary collaborative response to community need during the H1N1 crisis of 2009. Without this response, a number of young people, like Solveigh, from across Australia would simply not be with us today,” explains Professor Allan Glanville, Director Thoracic Medicine. Today, Solveigh remembers very little of her time in Sydney. However, she sums up the events of August 2009, “And now thanks to you all I can continue my life.”
Within hours St Vincent’s Hospital prepared to save the life of critically ill Solveigh.
acute program The Acute Program was established in line with the organisational restructure of St Vincent’s Hospital. The Program brings together various departments and disciplines from the former Medical Program, Surgery Program, Intensive Care Unit and Peri-operative and Interventional Services Program.
Emergency Department The Emergency Department continues to be a major centre of activity at St Vincent’s Hospital. Throughout 2009 the Department experienced an increase in the acuity and severity of patient illnesses and treated an added number of patients from a multitude of Sydney events. In 2009 the Department strengthened its relationship with the Hospital’s aged care team. Collaboratively establishing the Medical Admissions Unit, the Unit has resulted in a decrease in the length of stay of aged care patients within the Department. Promoting positive working relationships, the Department and the Intensive Care Unit continue to operate an exchange program for members of the nursing team. Heavily supported by the generosity of SIRENS in 2009, along with many other purchases, additional ultrasound equipment was introduced to improve procedures of central venous cannulation of acutely ill patients. Engaging with the community, the Department participates in disaster preparedness exercises throughout the Sydney metropolitan area and is actively involved in disaster management preparations within the South Eastern Sydney and Illawarra Area Health Service. In 2009 the Department resumed its services to the City2Surf providing a multidisciplinary team to treat participants at the Bondi Pavilion station.
Intensive Care Unit 2009 proved to be one of the most active years for the Intensive Care Unit with over 100 percent occupancy for the majority of the year. Despite the complexity of case load, the Unit and its staff continued to excel in the delivery of quality patient care. The onset of swine flu (H1N1) tested the Unit’s capability and flexibility. Collaborating with the Royal Prince Alfred Hospital, the Unit provided an
extracorporeal membrane oxygenation (ECMO) retrieval service and, above and beyond the Unit’s patient load, proved successful in its ability to support these patients. Key to H1N1 activities was the collection of patient data through the Department of Health. The data assisted clinicians in the Northern Hemisphere. As the sole provider of heart and lung transplantation in NSW, the Unit engaged in the Edwards SAPIEN percutaneous valve and CoreValve trial whereby all heart and lung transplant patients were transferred to the Unit for 24 hours post-procedure. In March 2009 the NSW Health Intensive Care Unit Bed Board Critical Care Resource System went live. The system enables the NSW Medical Retrieval Service to access crucial information to locate critical care beds throughout the state. The Unit continues to be generously supported by the Curran Foundation, most recently Intensive Care acquired 20 new screens for bedside monitoring, four end tidal carbon dioxide sensors, two bronchoscopes and one ventilator. Continuation of education is a high priority for the Unit. In association with the Australian Catholic University Graduate Certificate in Critical Care Nursing, eight students from St Vincent’s Hospital and St Vincent’s Private Hospital are participating in the Registered Nurse St Vincent’s Hospital Intensive Care Unit Clinical Program. These students continue to be supported by the Malinda Jarry Trust Fund set up specifically for staff education and development.
Interventional Services The Department encompasses a wide range of services including interventional, diagnostic, pre-operative and recovery for the Hospital’s Medical Imaging, Day Procedure Centre and, in association with the Hospital’s Heart Lung Program, Cardiac Catheter Laboratories and Electrophysiology Laboratory. The Unit serves a large portion of the Hospital’s daily admissions, including both inpatients and outpatients.
In the latter half of 2009 the Unit witnessed 13 percent growth in overall activity, with 5,524 patient admissions from 1 July until 31 December 2009. This compares to 4,815 patient admissions for the same period in the previous year. As innovative new models of day surgery and day of surgery admission are embraced, the Unit anticipates further growth in 2010.
Medical Sub-specialties Gastroenterology The Gastroenterology Department provides a comprehensive clinical service in inpatient management and in the hepatitis clinics. The Unit also runs an endoscopy service incorporating diagnostic and therapeutic capabilities. In 2009 the appointment of Dr Alissa Walsh enabled the establishment of an inflammatory bowel disease clinic at St Vincent’s Hospital and Dr David Williams continued to research pancreatic cancers with the use of endoscopic ultrasound pre-operatively for staging. Neurosciences Committed to the diagnosis and treatment of brain, nervous system and neuromuscular disorders, the Department of Neuroscience amalgamates neurology and neurosurgery. The Department provides a comprehensive inpatient as well as an outpatient diagnostic electrophysiological service for neuromuscular and cerebral diseases. It operates a leading Stroke Unit which specialises in clot-dissolving therapy as well as outreach services at Wollongong and Nowra. In addition, the Department acts as a consultative service for the MS Society. Sub-specialty expertise are in stroke, dementia, multiple sclerosis, movement disorders, Parkinson’s disease, neurooncology, myasthenia gravis, myopathies and neurological complications of immune deficiency. All fields of complex neurosurgical practice are undertaken with expertise in pituitary surgery, spinal surgery, functional stereotaxy and skull base surgery.
The Department continues to actively engage with the National Health and Medical Research Council to attract funding and performs numerous clinical trials in the specialty of neurology. Internal collaboration with occupational therapy and the trauma service has resulted in extensive research and education in relation to the improved care of patients with head injuries.
Vascular Services Vascular Surgical Services provide a comprehensive vascular and renal transplant and dialysis service to St Vincent’s Hospital. The Department offers a full range of state-of-the-art vascular and endovascular services, principal areas of interest include treatment of complex aortic, cerebrovascular and lower limb arterial reconstruction.
Patient Flow/Admissions The Patient Flow Unit manages admissions, bookings, surgical waiting lists and bed allocations and continues to focus on the provision of necessary care in a timely manner. Addressing demand, capacity and access issues, the Unit ensures continuous enhancement of the patient journey. Key to the Unit’s activities are collaborative partnerships with all of the Hospital’s programs and services, these partnerships result in the minimisation of delays in the admission and discharge of patients.
In 2009 the renal transplant service relocated to the Prince of Wales Hospital, however, the Department continues to provide haemodialysis and peritoneal dialysis access services for patients on the St Vincent’s Campus.
In 2009 the Unit witnessed an increase in surgical waiting lists and acuity of patients presenting to the Emergency Department. Following an active winter due to seasonal demand and H1N1, the Unit identified positive trends resulting from strategies to meet demand.
Throughout the year the Department introduced a number of major new treatment modalities including the care of patients with complex thoracoabdominal aortoiliac aneurysms.
As the Unit moves towards 2010 it continues to monitor efficiency and places greater emphasis on increasing morning and weekend discharge rates to ensure the timely discharge of patients.
Incorporated into the Department is the Vascular Laboratory at St Vincent’s Clinic. Conducting in excess of 10,000 studies each year, the Laboratory supports all of the Hospital’s vascular medicine and vascular surgical patients and operates a vascular ultrasound service for the St Vincent’s Campus. Approximately 20 percent of the Laboratory’s workload includes studies for venous thrombosis in pre and post-operative orthopaedic patients.
The appointment of a Director of Education and Research will expand the future focus of the Laboratory’s research and education. Appointment of Vascular Surgeon, Dr Ravi Huilgol, in January 2009 enabled the introduction of complex endovascular techniques. In addition, Dr Huilgol provides an outreach service to Wagga Wagga, he attends clinics and operative surgery is performed every three weeks.
Peri-operative Services comprises Anaesthetics, the Recovery Unit, Scrub Scout Sterile Processing Centre and Support Services. Incorporated into the Services are nine operating theatres that cover both elective and emergency surgery and encompass all specialties with the exception of obstetrics and paediatrics.
Renal Ambulatory Care The Unit provides haemodialysis and peritoneal dialysis for patients with acute and end stage renal failure. Servicing both St Vincent’s Hospital and St Vincent’s Private Hospital the Unit offers a 24 hour on call service for urgent dialysis. The education and assessment of patients with chronic renal impairment, hypertension and renal transplantation are managed in three outpatient clinics
and within the Unit. In addition, a home training program is provided with extensive follow up for community based peritoneal dialysis patients and includes a 24 hour telephone counselling service. Haemodialysis activity continues to increase – averaging at 34 admissions a day and over 10,000 treatments per year. In 2009 the Unit welcomed the installation of new dialysis machines which resulted in the performance of technologically advanced treatments, including haemodiafiltration and blood volume monitoring. Previously such treatments were only available to a limited number of patients. The Unit’s dietetic services expanded with the appointment of a part-time dietitian and the generosity of the Curran Foundation enhanced the patient experience with the installation of Foxtel.
Surgery Sub-specialties St Vincent’s Hospital has both a predictable elective surgery and emergency surgery load and the Acute Program manages all of the Hospital’s surgical services. Set to better cope with challenges, the Program is developing a new model for emergency surgery. Based on NSW Health Emergency Surgery Guidelines and consultant driven, the model will enable emergency and/or trauma surgery to be performed during hours. As a result, trauma and/or emergency cases will receive timely treatment, patient flow from the Emergency Department will improve and, where possible, after hours cases will be avoided. Colorectal Surgery The Department is involved in the treatment of all aspects of colon and rectal surgery, including selective laparoscopic procedures, sphincter saving cancer surgery and colonoscopy and polyp surveillance. In 2009 a new Visiting Medical Officer with advanced laparoscopic skills was appointed. The appointment of Dr Gareth Owen will result in an increase in the number of laparoscopic colorectal resections performed.
As the Department moves towards 2010 it prepares to install a patient hoist system for the Stroke Unit, as generously donated by the Curran Foundation, and continues the Hospital wide educational roll out of the Post Traumatic Amnesia Scale.
The Department engages in a number of pre and postgraduate education programs including a weekly vascular radiology conference at St Vincent’s Hospital, attended by radiologists, renal physicians, cardiologists, vascular surgeons and vascular physicians. Further vascular education occurs at a monthly vascular laboratory ultrasound meeting, a forum open to ultrasonographers and interested specialties.
Gynaecology The Department of Gynaecology provides a range of services including emergency surgery, elective surgery, education and training. Active in laparoscopic gynaecological surgery, the Department uses the laparoscopic skills laboratory for registrar training. 39
Ophthalmology With a solid presence in ophthalmic care, the Department offers virtually all ophthalmic subspecialties including cornea, vitreo-retinal surgery, medical retina and oculoplastics. Caring for both inpatients and outpatients the Department facilitates a wide range of specialist clinics including oculoplastics, glaucoma and medical retina. In 2009 the Department unveiled a new phaco-emulsification machine for cataract surgery. The Department continues its focus on education and routinely teaches registrars in the area of phaco-emulsification surgery. Orthopaedics Over 1,500 orthopaedic procedures are carried out each year across the St Vincent’s Campus. Further growth has continued in the areas of adult joint reconstruction and arthroplasty surgery, including hip and knee replacement and revision joint surgery as well as foot, ankle and shoulder surgery. The area of musculoskeletal oncology also continues to grow. The Department recently welcomed Dr Warren Kuo and Dr Andrew Higgs. Otolaryngology – Head and Neck Surgery The Department continues to provide leadership in the field of otology, neuro-otology and skull base surgery as well as head and neck cancer surgery. With strong expertise in cochlear and brainstem implantation, the Department is also an Australian leader in the management of acoustic neuromas. In close collaboration with Plastics and Reconstructive Surgery, the Department cares for the majority of head and neck surgical oncology cases within the Hospital. In 2009 additional facilities in the microsurgical skills laboratory facilitated the provision of temporal bone and advanced rhinology teaching and workshops. In collaboration with the Garvan Institute research continues in the areas of head and neck cancer as well as cochlear stem cell. The Department continues to provide two advanced training positions in otolaryngology and head and neck surgery for the Royal Australasian College of Surgeons as well as teaching for medical students from the University of New South Wales. Plastics and Reconstructive Surgery At St Vincent’s Hospital a comprehensive range of plastic and reconstructive surgical
services are provided including skin cancer surgery, major and minor reconstructive surgery after excisional procedures for head and neck cancer and limb tumours, maxillofacial reconstruction after trauma or congenital defects, breast reduction/ augmentation reconstruction, other aesthetically related surgery of the face and trunk, with extensive microsurgery services and soft tissue hand surgery procedures. The highly publicised Sydney shark attacks and the ensuing surgery at St Vincent’s Hospital provided new insight into optimum treatment pathways for such trauma. The Department continues to provide reconstruction services in collaboration with head and neck cancer surgery. In collaboration with the Garvan Institute active research continues within the various specialties of the Department. Upper Gastrointestinal Surgery The Department provides a comprehensive service for diseases of the upper gastrointestinal tract. Advanced laparoscopic techniques, endoscopic ultrasound and the da Vinci Surgical System are used where appropriate to assist both diagnosis and treatment. In 2009 the Department performed an increasing number of liver resections and other upper gastrointestinal malignancies.
concise information on the type and severity of injured patients. Throughout the year, the Service cared for 120 patients with an injury severity score greater than 15. Continuing collaboration with the Hospital’s Rehabilitation Service, the Trauma Service participated in the collation of data for the Motorcycle Accident Rehabilitation Initiative (MARI). The result will be the review of all motorcycle accident presentations and the project will continue throughout 2010. The Service also participated in a similar pedestrian accident study. Together with Medical Imaging and the Information Technology Service Centre, the Service facilitated image access for its two larger referral centres at Griffith and Wagga Wagga. The result is optimal management of patients awaiting transport to St Vincent’s Hospital through the clear communication of treatment with staff.
Urology The Department continues to excel in management of the whole spectrum of urological conditions and provides world class services in the areas of uro-oncology, brachytherapy and lithotripsy. Throughout 2009 the Department continued its pioneering tradition particularly with its use of robotic technology, the da Vinci Surgical System.
Preparing for 2010 the Service is set to roll out an educational program for post traumatic amnesia testing; the program will assist the Occupational Therapy Department in administering the test after hours to patients with head injuries.
The Hospital continues to provide consultant urology services to Dubbo, Liverpool and Bowral.
As 2009 comes to a close the Service awaits introduction of the NSW Trauma Service Plan.
Twenty Three Hour Unit Trauma Service Operating in a consultative capacity, the Service reviews all major trauma patients on the day of admission and is a major service provider for the South Eastern Sydney and Illawarra Area Health Service. Minor trauma patients are viewed on the wards. In 2009 the Service introduced a new trauma database, Collector. Provided by the NSW Institute of Trauma and Injury Management, the database provides both the area and state health services with
The 23 Hour Unit cares for short-stay surgical patients. Establishment of the Unit has improved access, as it ensures availability of beds throughout the Hospital for longer or unplanned stays. Throughout 2009 a number of projects were implemented to improve the Unit’s 23 hour policy, to reduce delays and surgical cancellations. In addition, proactive protocol based planned surgical care and discharge were explored to improve efficiency in patient care.
The Alcohol and Drug and Mental Health Program at St Vincent’s Hospital provides comprehensive inpatient and outpatient services. Recovery orientated, the Program is guided by constant input from primary healthcare and non-government organisational partners, consumers and carers. The Program maintains strong academic and research links with the University of New South Wales. Specific areas of interest include health policy, ongoing training for mental health professionals and clinical research.
Alcohol and Drug Service The Service provides treatment and support to those experiencing problems related to alcohol and/or drug use and continues to take an innovative approach to both service delivery and harm reduction. Much work is done to help individuals understand the complexities of the effects of alcohol, tobacco and drug use either on themselves or their loved ones. As an acute care hospital, St Vincent’s experiences some of the most complex physical drug health issues. Alcohol and Drug Information Service The Alcohol and Drug Information Service (ADIS) is a 24 hour anonymous, confidential specialist telephone helpline for NSW callers, including people dependent on alcohol and drugs, family members, concerned others and health professionals. ADIS provides advice, crisis counselling, information and referral for assistance on most issues regarding alcohol and other drugs. Opened in 1982, ADIS received approximately 40,000 calls in 2009 and operates a range of targeted services for specific groups. Telephone services include the Drug and Alcohol Specialist Advisory Service (DASAS), Methadone Advise Conciliation Service (MACS) and the Stimulant Treatment Program (STP). In addition, ADIS maintains an extensive database containing information on around 2,000 alcohol and drug treatment services in NSW. Clinical Services Team The Clinical Services Team (CST) comprises an alcohol and drug hospital liaison clinical nurse consultant, medical registrar and a small team of psychologists, health education officers and/or drug and alcohol counsellors.
The team provides face-to-face counselling for inpatients and outpatients at St Vincent’s Hospital and the general public with alcohol and drug problems or questions. Gorman House Open seven days a week, Gorman House supports those with severe drug and alcohol dependency. With a short term, non-medical harm minimisation program, staff at the 20-bed non-medical residential detoxification unit offer respect and compassion to all clients. In 2009 Gorman House collaborated with Rankin Court to better facilitate the buprenorphine detoxification of heroine users. The generosity of the Order of Malta ensures funding for the 24/7 operation of Gorman House until July 2010. Moving towards 2010, Gorman House will combine with other services across St Vincent’s Hospital to form part of a new homelessness health unit. Establishment of the unit will facilitate improved collaboration and coordination of homeless healthcare, social welfare and services provided by other non-government agencies. NSW Quitline The NSW Quitline is a confidential, specialist telephone counselling and information service primarily designed to help smokers quit smoking tobacco. Collocated with the ADIS call centre, the two services share customised technology and management. The number of calls managed by the service has risen each year to approximately 58,000 in 2009. In its sixth year and funded by the Cancer Institute NSW, the NSW Quitline received tender for a 12 month extension of its services and recruitment strategies. This resulted in the employment of specialist staff fluent in Arabic, Chinese and Vietnamese. ADIS was also contracted for the ACT Quitline.
alcohol and drug & mental health program
Rankin Court The Rankin Court Treatment Centre provides ongoing care, clinical management and social assistance to clients accessing its methadone and buprenorphine pharmacotherapy. Rankin Court cares for approximately 320 opioid dependent outpatients each year. Rankin Court provides assessment, support, referral and case management for individuals needing opioid treatment, prevention and education for HIV and an onsite hepatitis C clinic as well as mental health assessment and treatment. 41
Throughout 2009 Rankin Court continued to liaise with other health, welfare, education, housing and employment services. In 2009 reorganisation of the team structure enabled better management of complex care cases and relationships were developed with Justice Health, the City of Sydney and various Commonwealth Government departments.
General Adult and Early Intervention Services Aboriginal Mental Health Service The Aboriginal Mental Health Service provides professional mental health services to Indigenous clients in the inner city. In addition to working with individual consumers, outreach activities take place in boarding houses and on the street.
Stimulant Treatment Program The Stimulant Treatment Program (STP) is designed to assist people experiencing harm associated with stimulant drug use and associated physical and mental health issues. In operation since 2006, the STP is a pilot program with Hunter New England Area Health Service.
Outreach services assist in bridging the gap between Government and community, with outreach partners including Mission Australia, the Haymarket Centre, the Aboriginal Medical Service, Housing NSW, Hope Street and City Women’s Hostel.
In 2009 a STP information brochure was produced for statewide distribution, the program extended collaboration with ACON and positive preliminary findings resulted from a NSW Health evaluation of the program.
Mental Health Services Anxiety Disorders (CRUfAD) The Clinical Research Unit for Anxiety Disorders (CRUfAD) is a joint facility of St Vincent’s Hospital and the University of New South Wales. CRUfAD incorporates the Hospital’s Anxiety Disorders Clinic and is classified as a World Health Organisation collaborating centre in mental health. In 2009 research areas included dementia and epidemiology, as supported by two National Health and Medical Research Council program grants and funding from the Commonwealth Department of Health and Ageing continued to support eHealth initiatives. In addition to the face-to-face treatment for anxiety disorders offered at the Anxiety Disorders Clinic, CRUfAD conducted a randomised controlled trial of web based treatment compared to face-to-face treatment. Patients in each group made similar progress, however the web treatment required only eight percent of clinician time. Throughout 2009 CRUfAD expanded web work and by the end of the year had treated some 1,200 adults who met criteria for an anxiety or depressive disorder. Those treated through the virtual clinic found the treatment satisfactory and benefited exceptionally with minimal relapse.
The success of the ‘Connections’ aboriginal art therapy program, established in 2001, was evident in 2009 with the unveiling of a mural. Created by over 150 consumers, the mural was installed in the current Caritas building and, upon completion of the O’Brien Centre, will be relocated in 2010. Grants from City of Sydney and Carers NSW made the project possible. In 2009 Aboriginal and Torres Strait Islander Loss and Grief Workshops were established. Held at the Aboriginal Women’s Healing House, Picton, the workshops provided mutual support and a culturally safe environment to deal with social and emotional issues. Throughout the year the Service established strong links with Centrelink, age, disability and other health services to provide education and open up training opportunities for consumers. Facilitated by Centrelink and developed by WorkVentures, a short computer course will be offered in 2010. Specifically designed to assist Indigenous people in upgrading computer skills, each participant will take home their own computer. Honoured for excellence in innovation, Ms Kaylene Simon was recognised at the 2009 South Eastern Sydney Illawarra Health Awards for Mental Health Programs. The award highlighted her work with Aboriginal and Torres Strait Islanders and contributions to the promotion and acceptance of mental health consumers within the South Eastern Sydney and Illawarra Health catchment area. Caritas Caritas is a 27-bed acute inpatient unit. Under the Mental Health Act 2007, Caritas provides voluntary and involuntary inpatient care during an acute phase of mental illness until the consumer is sufficiently recovered to be treated in the community. Throughout 2009 a team of multidisciplinary staff prepared for the Unit’s move to the O’Brien Centre. Activities included review of the
The activity program at Caritas continued to evolve throughout the year – development of diverse group and individual activities were in direct response to the unique needs of consumers. Therapeutic mealtimes were introduced to enhance the relationship between staff and consumers; the result is personalised and ambient mealtimes. In 2009 there was a sustained and significant decrease in the use of seclusion. The total number of seclusions decreased from 280 in 2008 to 149 in 2009. This reduction in seclusion and restraint highlights the Unit’s commitment to national mental health strategies. Community Mental Health In collaboration with the City Women’s Hostel, the St Vincent’s Mental Health Acute Care Service supports the transition from homelessness to independent housing for women with mental health disorders. The recovery focused approach for hostel residents has resulted in a reduction in the need for acute mental health interventions. A weekly mental health clinic was established within the City Women’s Hostel and hostel staff attend regular mental health training. Since 2005 referrals from the City Women’s Hostel to St Vincent’s Hospital have decreased from 44 to two, furthermore, the move of hostel residents to medium or long term housing has increased from five percent in 2005 to 36 percent in 2010. The project was runner up in the NSW Premier’s Public Sector Awards in the ‘engaging with community’ category and was a finalist in the 2009 South East Sydney Illawarra Health Quality Awards. City Women’s Hostel now prioritises referrals from women who are ready for discharge from the Hospital’s mental health inpatient unit. Consultation-Liaison Psychiatry Consultation-Liaison Psychiatry delivers mental health services to patients of St Vincent’s Hospital who have a primary medical condition that may be associated with or manifested by a mental disorder or who have a known mental disorder associated with or complicated by a medical problem. The Service also works closely with patients who self-harm and/or have made suicide attempts.
Providing advice and support to specialists who have primary clinical responsibility for these patients, the Service offers short to medium term treatment to patients with an ongoing relationship with St Vincent’s Hospital. The Service is critical in helping a range of patients to cope with their condition/s. Other activities include the provision of in-service education, support and advice to local general practitioners. In collaboration with Queen Elizabeth Hospital, Adelaide, the Service operates under a parallel clinic model. In 2009 the Service produced a conjoint clinic manual outlining a scheme for the screening of patients with diabetes. Throughout the year the Service utilised music and coping cards to assist patients in dealing with their chronic illness and/or depression. Community Rehabilitation The multidisciplinary Community Rehabilitation team provides psychosocial interventions for people accessing the St Vincent’s Hospital Mental Health Program. Key to the Service is the belief that an individual with a mental illness has the right to a meaningful life, centred on their personal goals and values. Community Rehabilitation provides a range of services including assistance in re-establishing connections with the consumer and their local community, regaining stable accommodation or to pursue employment or study goals. The Service is made possible through the development of strong partnerships and an awareness of local community resources. The Community Rehabilitation Service works with consumers on an individual basis and offers group sessions on a range of topics. In 2009 group sessions included ‘staying well and taking control,’ an educational opportunity to explore communication skills and self esteem; ‘healthy lifestyles,’ practical support and advice on diet, exercise and good mental health and the ‘coffee group,’ an opportunity to break through the barriers of social isolation.
inpatient model of care including staff levels as well as the development of clinical pathways and operational manuals to reflect the new model of care. Set to be centred on the individual and their needs, care in the new facility will be underpinned by the strengths of recovery models and evidence based practice.
Central to the Service is the promotion of hope. As a result interventions are strength based and wellness focused. HIV, Hepatitis C and Mental Health Service The HIV, Hepatitis C and Mental Health Service (H2M) marked its 10,000th assessment in 2009. 43
In association with Immunology and Infectious Diseases Ambulatory Care the Service addresses clinical issues surrounding hepatitis C and, in 2009, engaged in a study of emotional responses to possible diagnosis of anal cancer. Program for Early Intervention and Prevention of Disability The Program for Early Intervention and Prevention of Disability (PEIPOD) works with individuals, aged between 16 and 25, who have experienced the recent onset of a major mental illness. The multidisciplinary team provides intensive support across inpatient and ambulatory settings as well as psychological and psychosocial interventions to assist recovery. In 2009 PEIPOD developed strong partnerships with local non-government organisations for the early identification of mental health problems and the improvement of access to services. Over the past year PEIPOD implemented a new model of vocational rehabilitation – individual placement and support. The integrated model brings together external employment services and mental health clinicians to assist consumers in finding employment. In close collaboration with the Oasis Youth Support Network’s crisis accommodation service and other local not-for-profit organisations PEIPOD continues to operate the Kings Cross Youth at Risk Project. At the NSW Early Psychosis Forum, PEIPOD presented a paper on how the service overcomes the challenges of providing an effective early intervention service to young people who are homeless and have complex needs. Psychiatric Emergency Care Centre Collocated with the Emergency Department, the Psychiatric Emergency Care Centre (PECC) provides emergency assessment and management of psychiatric illness and/or disorders, acute behavioural disturbance as well as co-morbid drug and alcohol problems requiring immediate intervention and treatment. Nurse led, PECC celebrated its fourth anniversary in 2009 and introduced a clinical nurse consultant to provide emergency assessment and management of complex mental health and drug and alcohol issues. A resource for both medical and nursing staff, the integrated role has improved the level and standard of care provided to these high risk groups. Valuing education, throughout the year numerous nurses within the Centre commenced or attained master or doctorate level degrees.
Urban Mental Health Research Institute In 2009 the Urban Mental Health Research Institute was officially named ‘Faces in the Street.’ The Institute works to understand key issues surrounding mental health in a city environment. A focal point for the brightest minds in the field to work, share knowledge and expertise, ‘Faces in the Street’ supports the development of enhanced prevention and care strategies through research and evaluation. The Institute successfully hosted its first research planning session; the session brought together a broad range of academics, stakeholders and clinicians. Throughout the year the Institute applied for a number of research grants, specifically in the area of healthcare of the homeless. As the Institute prepares for 2010 it looks forward to the move to the soon to be completed O’Brien Centre and to building on the foundations of 2009. The concept of the Institute was initiated in 2007 following a significant seeding donation from a St Vincent’s Hospital benefactor. The intention of the donation was to focus on mental health and the inner city with significant reference to the disadvantaged and marginalised. Psycho-geriatric Service The Psycho-geriatric Service uses a multidisciplinary, community based and general practitioner focussed model and offers a comprehensive outreach psycho-geriatric assessment as well as short and medium term case management for clients. The Service cares for clients as inpatients and in the community. A major innovation in 2009 was the establishment of ‘Club Bright,’ a group therapy program developed by clinical psychologists to support residents in aged care facilities who are experiencing depression and anxiety. The program is a direct response to the high rate of referrals, from residential aged care facilities and general practitioners, for assessment and management of depressive and anxiety syndromes. Prevalent in older adults, depression and anxiety can be a debilitating and isolating experience. ‘Club Bright’ provides support and strategies to manage mood. To date, ‘Club Bright’ has been successful with positive feedback from participants and facilities involved and was awarded second prize in the NSW Positive Living in Aged Care Awards.
cancer and immunology program
Clinical Psychology in Cancer Services
Family Cancer Clinic/ Medical Oncology
Supporting both patient and family, this Service provides psychological support to both inpatients and outpatients receiving haematological or oncological treatment.
Over the past decade, scientists have discovered specific inherited factors or genes, that can contribute to the development of some forms of breast, ovarian, prostate, colorectal and other types of cancer. The Hospital’s Family Cancer Clinic offers hereditary cancer risk assessment, genetic counselling and genetic testing to individuals concerned about their personal and/or family history of cancer.
The Service assists patient and family through all aspects of their journey; from diagnosis, to reintegration or palliation. Patient focussed, the Service liaises with a range of disciplines to ensure holistic care and facilitates regular in-service training and debriefing sessions for Hospital staff. Integral to the Service is the continual engagement in quality improvement projects. In 2009 a new model of care for patients completing cancer treatment was assessed; a bone marrow transplant project focused on improving psychosocial care for patients recovering from transplantation and a supportive care tool was developed to ensure patients are routinely screened for psychosocial and other care needs.
Dental The Dental Department cares for inpatients at St Vincent’s Hospital and St Vincent’s Private Hospital and provides oral assessment for those with head and neck cancer, HIV and heart disease. Collaborating closely with the Emergency Department, the Department facilitates the management of dental trauma. In 2009 the Department was recognised for its novel approach to primary trauma management.
Genetic testing can significantly influence treatment decisions and facilitates personalised care with treatments tailored to an individual’s genetic profile. In 2009 patient numbers increased by 30 percent.
Haematology and Bone Marrow Transplantation The Unit provides comprehensive therapeutic services for the treatment of malignant and benign blood diseases and therapeutically focuses on bone marrow transplantation. The Service also provides outreach services with large monthly clinics in Wagga Wagga and Griffith. 2009 was a monumentally important year for the Service with a record number of bone marrow transplants taking place – 44 allogeneic and 24 autologous transplants. Furthermore, the Service initiated a haploidentical transplant program using parents or partially matched siblings as marrow donors. An Australian first, the Hospital performed a cord blood transplant, using cord blood sourced from China.
In 2009 the number of clinical trials available to haematology patients expanded significantly. Dr Sam Milliken was contracted to the NSW Institute of Medical Education and Training for a six month period to review medical oncology training across the state. In association with Dr Lesley Ashton of the Children’s Cancer Institute Australia, Associate Professor Anthony Dodds was awarded a National Health and Medical Research Council grant to study the rate and risk factors for second malignancy following bone marrow transplantation in Australia. As the Service moves towards 2010 it prepares for the 35th anniversary of bone marrow transplantation.
Haematology and Oncology Ambulatory Care Haematology and Oncology Ambulatory Care (HOAC) provides a range of treatments for patients with cancers and haematological diseases. Therapies primarily include outpatient chemotherapy, blood product support, bone marrow biopsy/aspirates, admissions for bone marrow transplants and aphaeresis procedures. A team of cancer care coordinators assist in all aspects to support the patient throughout their journey.
The Cancer Program was enhanced this year with the addition of the Hospital’s Immunology, HIV and Infectious Diseases Unit as well as Dental Services. The Program continues to deliver high quality, state-of-the-art care in all of these areas. The new Cancer Centre building project, a joint venture between St Vincent’s Hospital and the Garvan Institute of Medical Research, was boosted by a $70 million Federal Government grant in 2009. To date, the Program has provided significant input towards the planning and conceptualisation of the new Cancer Centre.
In 2009 a number of emerging chemotherapy and monoclonal antibody treatments were administered and today HOAC is the sole NSW centre to offer Yondelis, a promising therapy for patients with advanced sarcoma, on the special access scheme.
Cancer care coordinators prepared for a nurse led peripherally inserted central catheter (PICC) line insertion clinic, for the delivery of chemotherapy and other cancer treatments, PICC will be in operation by early 2010.
Throughout the year patients continued to benefit from the generosity of the Nelune Foundation. The Foundation funded 2.6 full-time psychologists, a part-time breast care nurse coordinator and a part-time neuro-oncology nurse coordinator. The patient transport service was expanded, with the addition of two vans and drivers, to enable patients to attend treatments. In addition, the Foundation supported many patients who could not afford treatment or aides. Support from the Nelune Foundation made possible the holistic care of many patients.
The Transplant Lifetime Clinic (TLC) continues to go from strength to strength. An initiative of the bone marrow transplant team, TLC improves patient outcomes for those who are more than two years post allogeneic transplants. To date HOAC is the only centre in NSW to offer such a service to adult patients. HOAC continues to be generously supported with the Nelune Foundation presenting 10 Sony PlayStations and a range of DVDs for the enjoyment of patients. The Australian Federal Police donated monies for the enhancement of patient amenities including the purchase of televisions and laptops with wireless internet access to relieve boredom during lengthy treatments.
Immunology and Infectious Diseases Ambulatory Care Immunology and Infectious Diseases Ambulatory Care (IBAC) provides outpatient treatments for those with HIV, general immunology disorders, infectious diseases and viral hepatitis. A multidisciplinary Unit, the team uses state-of-the-art diagnostics and monitoring to provide world class treatment. Offering day treatments and investigations IBAC works with the patient to develop individual medication management programs to meet their complex needs. Immunology and Infectious Diseases Ambulatory Care continues to engage in HIV and viral hepatitis clinical trials and in 2009 commenced the administration of post exposure prophylaxis, a treatment used to prevent HIV infection. The Unit continues to operate outpatient clinics and provides outpatient treatment for approximately 1,500 men and women living with HIV. Currently IBAC supports 50 HIV positive patients by meeting the dispensing costs of some or all of their vital medicines. In 2009 the Unit’s HIV services benefited from the introduction of an automated appointment reminder service and appointment of a HIV care coordinator; the Unit witnessed an increase in the number of immunology patients requiring Intragram infusions and other treatments; patients benefited from the introduction of new fibre
and pro-biotic supplements to assist in the management of adverse gastrointestinal symptoms and in roads were made in the treatment of Multiple Sclerosis patients with Natalizumab IVI and the establishment of a massage clinic. Caring for those with viral hepatitis, the Unit successfully integrated the non- invasive FibroScan technique as a standard assessment for liver fibrosis. In line with demand, specialist nursing hours increased at the Viral Hepatitis Clinic at Rankin Court. A project in relation to the enhanced treatment for hepatitis C in opioid substitution settings (ETHOS) commenced, this project is outcome orientated and aims to increase treatment uptake of patients accessing the Hospital’s drug and alcohol services.
The Department also benefited from the generous donation of $100,000, from an unnamed donor, for the purchase of new chemotherapy chairs and the establishment of an exercise program for cancer patients. Shown to improve general health, bone health, fatigue and depression as well as reducing the risk of reoccurrence for breast and prostate cancers, the program commenced in December with the expertise of the Physiotherapy Department and the appointment of a part-time physiotherapist. An active year for the Department, Professor Robyn Ward resigned and Professor Richard Epstein was appointed. Highly regarded internationally, Professor Epstein brings oncology experience from centres in England, Singapore and Hong Kong and will establish laboratory research at the new Garvan St Vincent’s Cancer Centre. Continuing the Department’s outreach to rural communities Associate Professor John Grygiel conducts peripheral clinics in Orange and Bathurst, whilst Associate Professor Eva Segelov continues her role as a clinical academic.
Medical Oncology The Medical Oncology Department takes a holistic approach to cancer care. Offering the best available treatment and caring for the whole person, the well established multidisciplinary team supports patients and their families. 2009 saw the clinical trial of newly discovered biological agents for the treatment of cancers. With encouraging preclinical results, the Department prepared to trial a virus injected into head and neck cancers and commenced assessment of a new alpha radioactive particle to treat patients with the spread of prostate cancer to the bones.
Radiation Oncology The Department specialises in the treatment of all adult cancers, key services include brachytherapy and total body irradiation for bone marrow transplantation. Throughout 2009 the Department engaged in a number of clinical trials in the areas of prostate and, in association with the Garvan Institute of Medical Research and the St Vincent’s Prostate Cancer Centre, urological cancers. In 2009 a number of technical improvements took place with the installation of an online dosimetry system for the significant improvement in quality assurance in treatment delivery.
heart lung program
Cardiac Catheterisation Laboratories The Cardiac Catheterisation Laboratories provide a comprehensive program for the evaluation and management of patients with coronary and peripheral vascular, valve and other structural heart diseases. As the first Australian hospital to replace an aortic valve using a percutaneous transfemoral catheter based technique with the core valve system in 2008, the Hospital has since demonstrated great success in the growth of percutaneous valve replacements. In 2009 the innovation continued with St Vincent’s Hospital introducing a transapical approach – becoming the first hospital in NSW to perform Edwards percutaneous heart valve replacement.
procedure, heart surgery or any other cardiac condition. In addition, implantable cardiac defibrillator support groups are held quarterly. In 2009 1,704 patients attended phase one sessions and 212 new patients commenced phase two, an increase on the 180 new phase two patients in 2008. An increase in staffing facilitated improvements in patient referrals to local and rural programs and the Service now incorporates a formal assessment session for all new patients commencing the phase two program. Promoting positive health outcomes, the Service purchased a smokerlyser to assess and support patients attempting smoking cessation and staff engaged in online smoking cessation courses for health professionals. Identifying patient’s goals and perceived risk factors, the Service is participating in extensive research involving the collection of patient data.
Supported by the skills and expertise of St Vincent’s Hospital, other hospitals in NSW will soon join the program. To date a total of 42 percutaneous heart valve replacements have been performed, 21 core valves and 21 Edwards valves. Results are equal to world’s best practice and offer hope to seriously ill patients with end stage, life threatening aortic valve stenosis.
A live broadcast of a percutaneous aortic valve replacement procedure at St Vincent’s Hospital was conducted as part of the annual scientific meeting of the Cardiac Society of Australia and New Zealand.
The Cardiology Department offers a range of services, including non-invasive diagnostic services, cardiac catheterisation, angiography and a wide range of interventional cardiac, vascular and electrophysiological procedures.
Interventional cardiologists continue to provide outreach services to cardiac catheterisation laboratories in Tamworth and Wagga Wagga and an assessment clinic in Armidale. The appointment of three additional interventional cardiologists at St Vincent’s will provide closer ties with hospitals in Wollongong, Gosford and Coffs Harbour.
In 2009 St Vincent’s Hospital installed the Toshiba Aquilion One 320 slice Cardiac Computed Tomography scanner. This advanced scanner is the first of its kind to capture the total image of the heart and coronary arteries within a single heart beat. Its installation is a first for NSW Health and puts St Vincent’s Hospital at the forefront of technologically advanced, non-invasive coronary angiography. The acquisition was made possible through the generosity of the Curran Foundation and many of the Hospital’s donors.
Cardiac Rehabilitation The Cardiac Rehabilitation Service comprises a multidisciplinary team and offers a comprehensive service from admission to recovery. The program develops and manages individualised services for all patients who have had a heart attack, stent
The Heart Lung Program comprises Cardiology, Thoracic Medicine, Cardiothoracic Surgery, Heart Lung Transplantation and the outpatient Heart Lung Clinic. The Program provides the only heart and lung transplantation service in NSW. St Vincent’s Hospital is internationally renowned for its clinical excellence in the treatment of patients with heart and lung diseases. National and international patients attend the Hospital and the Program attracts many of Australia’s most complex cases.
St Vincent’s Hospital continues to develop a state-of-the-art cardiac magnetic resonance imaging (MRI) service with its 3T MRI machine. In conjunction with St Vincent’s Private Hospital, the Department leads the way in the widespread application of drug-coated stents within NSW. 47
The Unit provides adult cardiothoracic surgery for all patients being treated by the Cardiac Service; this includes the provision of services for the South Eastern Sydney and Illawarra Area Health Service and from other referral centres state wide. In 2009 the referral centres were extended to include the Central Coast and Northern NSW.
In 2009 the Electrophysiology Laboratory significantly expanded its complex ablation services and cardiac pacing therapies.
While the core activity remains coronary bypass surgery and all types of valve and aortic surgery, there is increasing demand for complex multiple cardiac procedures. The Unit conducted approximately 400 heart operations this year and continues to develop the robotic surgical service. Use of the mechanical assistance program left ventricular assist device (LVAD) has proven an important treatment for patients with severe left heart failure and provides the Unit’s patients with world’s best practice in cardiac treatment. Furthermore, introduction of a new total artificial heart program will cater for a group of patients who would previously have been unlikely to survive transplantation. The program oversees training of surgeons and the Unit aims to perform the Southern Hemisphere’s first implant in 2010. The Hospital provides the largest and most successful extracorporeal membrane oxygenation (ECMO) program in NSW. During 2009 ECMO program activity increased with the appointment of St Vincent’s Hospital and Royal Prince Alfred Hospital as lead sites for state wide ECMO retrievals. The onset of the winter months and the H1N1 epidemic saw the extensive and successful use of ECMO. In collaboration with the Cardiology Unit, the Cardiothoracic Surgery Unit embarked on a new trans-apical percutaneous aortic valve project, a pioneering effort between cardiology and surgery. The Unit continues to participate in basic and clinical research with an active large animal program under the directorship of Professor Peter Macdonald and Dr Paul Jansz. Incorporated into the new Victor Chang Cardiac Research Institute, the Unit aims to be the Southeast Asian training centre for the implantation of mechanical pumps. As the Unit moves into the future it continues to develop new pioneering techniques and provides an expanding range of services for patients requiring cardiac surgery.
The atrial fibrillation ablation program explored the role of new state-of-the-art technologies, including cryoablation of atrial fibrillation and robot guided catheter ablation. Use of computerised intracardiac mapping increases the accuracy of localisation. Cardiac resynchronisation therapy continues to provide life saving options for patients with cardiac failure and the Laboratory used new technologies and lead delivery systems to maximise patient response to the therapy. Leading the way, in 2009 the Electrophysiology Laboratory team implanted one of Australia’s first magnetic resonance imaging – safe pacemakers – the pacemaker incorporated a unique lead and generator configuration to enable what was once thought impossible. The cardiac electrophysiology program offers a structured training fellowship, with two cardiology fellows enrolled in 2009, and continues to collaborate with the Mark Cowley Lidwell Program in Electrophysiology and the molecular genetics program at the Victor Chang Cardiac Research Institute in the investigation of the relationship between genes and arrhythmia. The Electrophysiology Laboratory continues to provide vital outreach pacemaker and defibrillator clinics in Wagga Wagga, Griffith, Tamworth and Armidale.
Heart Lung Clinic The Heart Lung Clinic provides cardiopulmonary ambulatory care for transplant patients and those with heart and lung failure, tuberculosis and chronic obstructive pulmonary diseases. The Clinic’s activities include pacemaker checks, tuberculosis screening, pre and post lung transplant check ups, dressings and infusions. The Clinic is also responsible for patients on the transplant waiting list and those waiting to be listed. Transplant coordinators work with
Experiencing increased activity, 2009 saw a record number of patients seen in cardiopulmonary ambulatory care. In 2009 the Clinic celebrated 25 years of heart lung transplantation and was actively involved in two primetime television programs with the Nine Network, ‘The Gift,’ celebrating the gift of organ donation, and ‘Last Chance Surgery.’ As the Clinic moves towards 2010 it prepares for introduction of the total artificial heart program.
Heart and Lung Transplantation The Heart and Lung Transplant Unit provides all thoracic transplant services and mechanical heart assistance for NSW as well as thoracic transplant services for some patients from South Australia and Queensland. Continuing to attract world wide recognition, the Unit’s patient outcomes are significantly superior to international standards. Implementation of a new total artificial heart program will be of added benefit to the Unit and will provide a service to a group of patients who previously would have been unlikely to survive transplantation. St Vincent’s Hospital provides the largest extracorporeal membrane oxygenation (ECMO) program in NSW. In collaboration with Cardiothoracic Surgery and the Intensive Care Unit, the Unit has further developed the indications and utilisation of ECMO for severe respiratory failure refractory to conventional ventilation. To date, this has successfully bridged lung transplantation for four young women with cystic fibrosis. ECMO successfully provided post transplant patients with primary graft dysfunction, all five of whom have fully recovered. In response to NSW Health guidelines, the Unit developed a policy on lung transplantation and donation after cardiac death. Over the past two years introduction of the guidelines has resulted in 20 percent growth in the service delivery of lung transplantation with more than 40 lung transplants per annum.
In 2009 the Unit celebrated 25 years of heart lung transplantation. Joined by NSW Minister for Health, John Della Bosca MLC, and the longest living heart transplant recipient in the Southern Hemisphere, Fiona Coote, the occasion celebrated the success and growth of the Unit’s services. On 23 February 1984, a 39-year-old shearer from Armidale was the first Australian to successfully undergo heart transplantation at St Vincent’s Hospital. Fostering an environment of excellence, the Unit maintains an active research program. An increased ability to provide artificial heart and ECMO support will bring additional activity in 2010 to the Unit and will ensure best possible results.
Pulmonary Hypertension Clinical Trials Since 1999 the Heart Lung Program has engaged in trials to improve clinical outcomes for those with pulmonary arterial hypertension. Under the guidance of Professor Anne Keogh the research group participates in trials with double and triple therapy agents. To date hundreds of patients have benefited from participation in these trials and survival rates have been significantly improved – from 50 percent chance of two year survival to 85 percent. With some of the highest patient participation numbers St Vincent’s Hospital is a world leader in several clinical trials, including a Pfizer examination of sildenafil and a VITAL study of bosentan. Current therapies being trialled include macitentan, treprostinil, riociguat, selixipag and udenafil.
the Red Cross and a 24 hour telephone counselling and support service is available to transplant recipients from the past 25 years.
Sleep Unit The Unit provides a comprehensive sleep disorders diagnostic and treatment service for a range of respiratory related and non-respiratory sleep disorders including sleep disordered breathing, obstructive sleep apnoea, respiratory failure, narcolepsy, idiopathic hypersomnolence and sleep-wake cycle disorders. Each year the two-bed Unit conducts approximately 390 overnight sleep studies. In addition, portable unattended home diagnostic sleep studies are provided on a limited basis.
In collaboration with the Sleep Investigation Unit at St Vincent’s Private Hospital, and associated with the Heart Lung Program at St Vincent’s Hospital, the Unit provides pre-transplant work-up sleep studies and ongoing treatment and/or management of sleep disordered breathing in patients pre-transplant. Engaging in research the Unit is a reference site for sleep studies within multi-centre clinical trials and, in 2009, worked with the Hospital’s Heart Lung Transplant Unit in relation to sleep studies on patients with post-lung transplant obliterative bronchiolitis syndrome. In 2009 the Unit benefited from installation of the Alice 5 Diagnostic Sleep System; the software facilitates improved real time digital video monitoring. A new quality initiative resulted in the establishment of an inter-scorer data analysis concordance system. Introduction of a new portable sleep diagnostic service enabled the diagnosis and treatment of inpatients who are medically unsuitable for transfer to the Sleep Unit.
Thoracic Medicine The Thoracic Medicine Department specialises in acute and chronic airflow limitation such as asthma and emphysema; diffuse parenchymal lung diseases including interstitial pneumonia, sarcoidosis, dust diseases and pulmonary lymphangioleiomyomatosis; the multidisciplinary care of patients with lung cancer; lung transplantation; pulmonary hypertension; management of respiratory tract infections including acute and chronic bronchopulmonary sepsis, pneumonia and bronchiectasis; sleep and respiratory failure; tuberculosis and interventional bronchoscopy, including stenting, dilatation of strictures, laser therapy and endobronchial ultrasound.
St Vincent’s Hospital is the NSW referral base for interventional bronchoscopy and endobronchial ultrasound diagnostic services. In collaboration with cardiothoracic surgery, lung transplantation has increased by 20 percent over the past two years. With more than 40 lung transplants per annum, outpatient and bronchoscopy support services have been extended. Working with cardiothoracic surgery and the Intensive Care Unit, indications and utilisation of extracorporeal membrane oxygenation (ECMO) for severe respiratory failure refractory to conventional ventilation have been further developed. In 2009 ECMO bridged lung transplantation for four young women with cystic fibrosis and provided post transplant support for primary graft dysfunction in five patients, all of whom fully recovered. Furthermore with the onset of the winter months and the H1N1 epidemic, ECMO was used extensively with great success. The Department participated in the first global trial of a novel small inhibitory mRNA therapeutic for respiratory syncytial virus. The approach promises to revolutionise management of viral infections such as hepatitis C and conditions like Huntington’s disease and amyloidosis. Phase two results were presented at the World Conference on Antivirals in Beijing. The Department continues to engage in ongoing trials in alpha-1 antitrypsin deficiency replacement therapy, usual interstitial pneumonia, pulmonary hypertension due to interstitial lung disease, immunosuppression after lung transplantation, mesothelioma therapy, multidisciplinary lung cancer care, pulmonary lymphangioleiomyomatosis and the diagnostic utility of endobronchial ultrasound diagnostic services. The Department provides outreach services to Griffith Base and Royal Adelaide Hospitals.
population health program
Key to Population Health is quality of care and Program leaders endeavour to ensure all who access the Program’s services are treated in a timely manner, by the right person and in the correct place. The ultimate aim is to maintain the health of patients, whilst ensuring they spend as little time as possible in hospital.
Aged Care 2009 was a year of unprecedented growth and challenges for aged care. In partnership with the Transitional Aged Care Program (TACP) and the Aged Care Services Emergency Team (ASET) the Department of Geriatric Medicine supports the patient’s entire journey from admission through to discharge. Patients present to the Department with a range of geriatric syndromes including falls, delirium, dementia, mobility problems and/ or difficulty in coping at home. In 2009 the generosity of the Curran Foundation facilitated the purchase of a bladder scanner and donations to the St Vincent’s Mission Office funded the purchase of three recliner chairs.
Aged Care Medical Assessment Unit Established in 2008 the Medical Assessment Unit (MAU) facilities the rapid assessment and coordinated care of aged patients. Multidisciplinary, the service operates seven days a week.
In 2009 the Unit continued to go from strength to strength with ongoing improvements in performance leading to excellent care for all aged care patients. Unique, the Unit improves patient care through the minimisation of time spent by aged care patients in the Emergency Department; provides comprehensive multidisciplinary assessments within minutes of admission as well as twice daily consultant led ward rounds for the timely and safe discharge of aged patients. To date establishment of the Unit has improved links between inpatient and community services and the Aged Care Assessment Team. Thus, community care is prioritised for those most at risk of poor outcomes after discharge. Following the Unit’s establishment, which incorporated the opening of an additional 10 beds on Xavier Nine North, the Department of Geriatric Medicine has experienced 30 precent growth in overnight admissions and a two day reduction in the length of stay. In 2009 there was a total of 1,375 admissions with an average length of stay of 10.6 days. Establishment of the Unit has resulted in a shared model of care with the Hospital’s rehabilitation service and the opening of six geriatric rehabilitation beds at Sacred Heart. The Unit’s success is reflected in its ability to meet challenging performance indicators and benchmark figures as set by NSW Health.
Clinical Pharmacology and Toxicology The Department promotes the safe and effective use of medicines throughout the Hospital. Key services include the management and assessment of overdoses and poisonings presented through the Emergency Department, consultation of therapeutic problems, teaching and research. Staff play an important role in clinical supervision for SydPath’s NSW referral laboratory for therapeutic drug monitoring.
Community Health Service The Community Health Service provides health services to those at home in the local government areas of Waverley, Woollahra and the City of Sydney. Services include primary care, health promotion, community aged care as well as home, community and chronic care. In 2009 the Community Nursing Clinic commenced receiving referrals from staff at St Vincent’s Hospital; the new referral system removes the geographical cluster need for home assessment. Appointment of a community aged care manager enhanced links between the Hospital’s acute and community aged care services and increased funding was received from Home And Community Care (HACC) for podiatry services.
In 2009 the Population Health Program was restructured in line with changes across St Vincent’s Hospital. Population Health now brings together Aged Care, Clinical Pharmacology and Toxicology, Community Health, Dermatology, Endocrine and the Diabetes Centre, General Ambulatory Care, Homeless Health, Pain Service and Transport in a complementary fashion.
Throughout the year the Service was involved in detailed planning for the move to the new O’Brien Centre and will relocate in early 2010. 51
Endocrine and Diabetes Centre
The Dermatology Department continues to provide an inpatient consultation service to St Vincent’s Hospital as well as two weekly outpatient clinics and a weekly procedure/ biopsy clinic.
The Diabetes Centre offers a comprehensive, multidisciplinary service which incorporates education, management and support for those with diabetes, their carers and health professionals. Consolidating the Diabetes Centre and Endocrine Department, activities cover the management, teaching and research of hormone and metabolic disorders.
The Department’s five dermatology registrars are participating in an up skilling program with the College of Dermatologists. With a scabies prevalence rate of approximately 23 percent in Fiji, the Department is set to embark on a third study to assess the mass drug treatment of scabies on three Fijian islands. The Department’s activities with Fiji have been guided by Dr Margot Whitfeld’s interest in collaborative projects with the Ministry of Health in Fiji. Other research activities include assessment of Staphylococcus epidermidis in the pustules of the skin condition rosacea and a study into the contribution of venous disease and haematologic changes in the pathogenesis of cutaneous diseases. As the Department moves towards 2010 it plans to establish a multidisciplinary clinic, with general surgeons, plastic surgeons and radiotherapists, for the management of difficult skin cancers, as seen in many heart and lung transplant recipients due to the sustained immunosuppression required. The Department is also developing a specialist clinic for the biological agent treatment of severe psoriasis.
Core services are internationally recognised in the management of diabetes, osteoporosis and pituitary disease and are supported by active research programs at the Garvan Institute of Medical Research. The Centre continues to develop services for the multidisciplinary management of thyroid cancer and cares for patients from New Caledonia. The Bone Registrar, funded by the Osteoporosis and Bone Biology Program at the Garvan, assesses patients with fragility fractures who attend the Hospital’s orthopaedic clinics and who otherwise would not receive any assessment or treatment to reduce future fracture risk. A flexible intensive insulin program for people with type 1 diabetes was implemented and a transition service for children with childhood endocrine disease was provided. The multidisciplinary high risk foot clinic continues to support those in the community with diabetes and was bolstered through the generosity of private donations. Throughout 2009 a number of quality improvement projects were implemented to enhance the understanding of glucocorticoids in steroid dependent patients and glycaemic control in patients following admission for stroke and cardiac surgery.
The Centre’s policy fosters academic excellence and actively engages in undergraduate and postgraduate education, it also provides education support to allied health professionals and advocacy groups. With emphasis on education, the Centre continually engages in Hospital and community education in the areas of pituitary disease, diabetes and osteoporosis.
General Ambulatory Care As the Hospital’s core outpatient treatment and referral centre General Ambulatory Care houses a multi-purpose room for daily wounds and medication clinics and operates 35 medical/surgical specialty clinics, a plaster room and a room for minor procedures under local anaesthetic. Throughout 2009 General Ambulatory Care continued to be an area of increasing activity within the Hospital. In line with an increase in patients attending the Rheumatology Clinic and Movement Disorders Clinic the Unit’s services have expanded. Implementation of a fax referral system represented a significant change in patient care through improved access to clinics and better coordination with referring general practitioners. In addition, the new St Vincent’s Hospital website enhanced clinical and administrative processes through the provision of a directory service for all external referrals. In collaboration with the Community Health Service weekend clinics continue to provide outpatient services to those in need of medication administration and wound dressings.
Reinforcing the Hospital’s Mission, the Homeless Health Program addresses the health needs of the homeless community. Providing invaluable care and support, the Program is growing through invaluable internal and external partnerships.
The multidisciplinary Pain Service offers treatment for acute, chronic and cancer pain. Established in 1962 the Service is the oldest and one of the largest pain clinics in Australia. The Service operates a 10 week outpatient pain program that focuses on the management of pain through exercise and psychological techniques; pain rounds are undertaken six days a week for the treatment of post-operative and acute pain; a general chronic pain clinic for the development of a multidisciplinary treatment program takes place every Friday; cancer pain services are provided to palliative care patients and a special clinic for those with psychiatric issues and difficulty dealing with chronic pain takes place every Thursday. In addition, the Service operates a 24 hour on call service for patients at St Vincent’s Hospital with chronic and acute pain.
The Rheumatology Department cares for patients with acute and chronic musculoskeletal diseases and problems. It provides a consultative service to the Campus in musculoskeletal medicine, ambulatory management and supervision of biological therapies to patients with inflammatory arthritis.
Journeying with clients, the Community Outreach Medical Emergency Team (COMET) verifies the quality of homeless health services, whilst also highlighting areas for development. Bringing forth an exciting cultural change, in 2009 the Hospital sought to develop a strategic response to the needs of the homeless community. A collaborative and integrated approach to address health issues commonly experienced, essential to the development of this homeless health framework is the close collaboration of physical health, mental health and drug and alcohol services. The framework will result in the establishment of an integrated Hospital wide response to the health needs of this population. The Program looks to the future with plans to establish a primary care clinic within St Vincent’s Hospital. A direct result of the Garling Report and the Caring Together NSW Health Action Plan, the clinic will act as a ‘passage way’ between community and Hospital for non-emergency patients.
With an emphasis on research, the Service is assessing patient use of opiates following discharge. The Service is accredited by the Australian and New Zealand College of Anaesthetists’ Faculty of Pain Medicine to educate registrars and pain fellows. Collaborating with facilities across St Vincents & Mater Health Sydney, the Service also works closely with Sacred Heart, St Vincent’s Private Hospital and the Mater Hospital. As the Pain Service looks to the future, it is set to expand infrastructure to include a clinical nurse as well as further allied health support.
Teaching and training opportunities are offered to trainees in rehabilitation and addiction medicine as well as anaesthetics. This year research focused on conceptual issues in regional pain syndromes.
Transport The Department caters for the non-urgent transport of patients to and from St Vincent’s Hospital and operates a car fleet service for community health, mental health and St Vincents & Mater Health executives and staff. The Department’s services extend to private and public health facilities within South Eastern Sydney and Illawarra Area Health Service on a fee service structure. During 2009 six ambulances transported over 8,800 patients; a 10 percent increase on 2008. In addition, a wheelchair bus transported 4,500 patients to and from St Vincent’s Hospital for outpatient care and dialysis treatment and, in order to continue treatment closer to home, over 180 patients were transported to country hospitals after care at St Vincent’s Hospital.
Sometimes it’s all in the genes When it comes to healthcare Michele Marco, a 47-year-old breast cancer patient listens to the professionals, trusts and follows their advice. “Being knowledgeable is not a bad thing – it gives you more power to decide,” explains Michele. This belief may prove to be life saving not just for Michele, but also for her immediate and extended family. It is this confidence that led Michele to the Hereditary Cancer Clinic at St Vincent’s Hospital.
supervises the Hospital’s hereditary cancer service, testing resulted in the identification of a causative mutation in Michele’s BRCA2 gene – increasing Michele’s lifetime risk for breast cancer to 45 percent and ovarian cancer to 11-17 percent. However, this causative mutation was inherited from Michele’s paternal family – her father had recovered from prostate cancer and her great-aunt was diagnosed with breast cancer at a young age.
From an Ashkenazi Jewish family, a heritage with a comparatively high level of breast and ovarian cancer mutations, it was no coincidence that Michele’s mother, maternal grandmother, maternal greataunts and two of her mother’s cousins had all previously developed breast cancer.
“This information was then used to make decisions about managing this family’s cancer risk by tailoring management to each individual’s genetic profile. The finding of this mutation will allow for predictive testing of the rest of the family. Female family members that are identified as carriers will be offered options which range from implementing intense screening in the form of mammography, ultrasound and breast MRI to prophylactic removal of the breast, ovaries and fallopian tubes,” explains Professor Allan Spigelman, Director of Cancer Services, St Vincents & Mater Health Sydney.
With the discovery of specific inherited factors that can contribute to the development of some forms of cancer, genetic testing can positively influence treatment decisions and facilitate personalised care – tailoring treatment to a person’s genetic profile. The accumulation of breast cancer diagnoses in Michele’s family qualified her for full testing of both breast cancer genes, BRCA1 and BRCA2. Having met with Zara Richmond, a St Vincent’s Cancer Genetic Counsellor and Professor Allan Spigelman, who
“The entire family now has a choice – do they or do they not want to be genetically tested. Ultimately they need to decide if they want to know about their chances of developing cancer and if they are ready to deal with the outcomes,” says Michele.
“You will die, but it will not be until you’re about 80 and it won’t be from breast cancer.”
Stemming from the knowledge she has acquired of her increased risk of breast and ovarian cancer Michele has decided to undertake some key preventative measures – a double mastectomy, reconstruction and the removal of her ovaries all in one surgery scheduled for May 2010. As Michele reflects on her journey, which only commenced with her diagnosis of breast cancer in September 2009, she recalls a question she put to her breast surgeon, “Am I going to die?” His reply was “You will die, but it will not be until you’re about 80 and it won’t be from breast cancer.” For Michele these words are now reality. “The Hereditary Cancer Clinic at St Vincent’s Hospital has helped Michele’s family by providing them with forewarning and an opportunity to implement risk reducing strategies. Providing this family with crucial information has given them the power to optimise their future health,” concludes Professor Spigelman.
clinical governance Infection Control The Infection Control Department and Employee Counselling and Treatment Program provides infection control advice to staff, volunteers, patients and visitors as well as vaccination and exposure management for staff and volunteers. The Department undertakes surveillance activities to detect healthcare associated infections in areas including bloodstream infections, surgical sites and multi-resistant organisms. Ensuring patients are provided with a safe environment, the Department monitors the Hospital’s compliance with relevant infection control policies, standards and regulations. Key to the Department’s activities is the provision of advice and testing to all staff following an occupational exposure and the vaccination programs including the annual seasonal influenza vaccination program for all staff and volunteers. In 2009, and in association with Hand Hygiene Australia and the Clinical Excellence Commission, the Department established a new hand hygiene initiative. The initiative provides a framework for the Hospital to measure and report on hand hygiene compliance, results from the hand hygiene audits are displayed in the Hospital. As part of the initiative a number of alcohol based hand gels were trialled and, once selected, the new product will be placed in additional areas throughout the wards and units.
Patient Liaison and Representation Patient Liaison and Representation promotes the Mission and Values of the Sisters of Charity through advocacy work with patients and staff. Key activities include assisting with patient inquiries, facilitating meetings and acting as a liaison for country families coming to St Vincent’s Hospital for treatment. In addition, a trust fund is administered to support overseas patients and asylum seekers who are without health cover and are urgently admitted to St Vincent’s Hospital.
Quality and Risk Management The Unit plays a key role in the Hospital’s continuous quality improvement program and supports the governance responsibilities of the Patient Safety and Quality Committee. In conjunction with the revised organisational structure of St Vincent’s Hospital, the Unit was realigned with increased emphasis on patient safety and clinical quality improvements. In 2009 a new governance and reporting schedule was introduced to ensure the continual improvement of patient care and services. The revisions strengthened the responsibility and accountability of both management and clinicians. Participating in the NSW Health Patient Satisfaction Survey, St Vincent’s Hospital was rated highest amongst its state wide peer group – principle referral group A hospitals. With a score of 90.5 percent, the survey indicated a high level of patient satisfaction across eight domains of healthcare delivery.
Raising awareness of patient safety through the encouragement and acknowledgement of achievements, St Vincent’s Hospital’s annual quality awards were presented to J Ray, G Campbell and Dr A Richardson for Surveillance of Therapeutic Drug Monitoring Practice in Schizophrenic Clinic in the category of clinical excellence; T Sheridan, A Morgan, E Boxer, N Glenister and L Gregory for ICU Outreach and Early Recognition and Management of Deteriorating Patients After Hours – A Pilot Project in the category of patient safety; A Wheatley and Z Hill for Mental Health ‘Club Bright’ Aged Care Facilities Group Cognitive Behaviour Therapy Program in the category of innovation and A Henry, C Rudolph, P Penola for Goal Attainment Scaling (GAS) in Pulmonary Rehabilitation in the category of novice.
Radiation Safety The Radiation Safety Department safeguards staff, patients and the public from the harmful effects of radiation. Central to the Department’s activities is ensuring the Hospital’s compliance with benchmark radiation safety requirements. In 2009 the Department developed a radiation safety manual for the Hospital and key persons from across the Hospital completed training on the security of radioactive sources. As a result, radioactive sources used within the Hospital are protected from unauthorised use. The Department also commenced the recruitment process for a full-time radiation safety officer; an appointment will be made in January 2010.
Formed in 2009, Operations amalgamates clinically appropriate groups and brings together Allied Health, Diagnostics, Nursing and Emergency Response– its establishment acknowledges the multidisciplinary care offered across St Vincent’s Hospital.
Allied Health Audiology The Audiology Department provides hearing and balance testing for inpatients and outpatients and pre-operative and post-operative services for patients with cochlear and brain stem implants. The Department works closely with the Hearing and Balance Centre to provide a range of services and support groups. Medical Records The Department operates a seven day week service in the provision of medical records and health information services. Core to the Department is commitment to the continuum of patient care, patient safety, protection of patient privacy, quality health information as well as quality health record keeping and retrieval. Services include the processing of external requests for records and the collection of statistics to track the Hospital’s activity as well as the conditions and treatments of patients. In 2009 the Department provided over 1,500 records on a weekly basis for patient care and research purposes. In preparation for the opening of the O’Brien Centre, the Department successfully integrated the Hospital’s mental health service records with main patient files. Integration provides clinicians with easier access to all information pertaining to the patient’s health.
Nutrition Services The Nutrition Services Department provides dietetic services and nutritional counselling for inpatients and outpatients from a range of clinical areas.
Engaging in research the Department conducted A Very Early Rehabilitation Trial (AVERT) and commenced a stroke prevention study to reduce stroke reoccurrence through education.
In 2009 the Department introduced an innovative electronic system for the recording of inpatient and outpatient statistics as well as other activities such as professional development. To date, all dietitians have fully embraced use of this novel system.
At a state level, the Department facilitated a two day workshop on cardiac rehabilitation, sponsored by Greater Metropolitan Clinical Taskforce the workshop was attended by 30 therapists.
Advances in technology enabled the Department to successfully integrate an online inpatient referral system, the electronic system complements traditional referral methods. Valuing education, dietitians from the Department continued to lecture nutrition and dietetic students at universities in Canberra, Wollongong and Sydney. Occupational Therapy The Occupational Therapy Department works to aid functionality and recovery in a range of inpatient and outpatient services at St Vincent’s Hospital and Sacred Heart. In collaboration with the Medical Assessment Unit, the provision of a weekend service is improving both patient outcomes and patient flow. In 2009 the Department introduced constraint induced therapy principles for stroke care patients. A novel approach, this therapy facilitates reorganisation of the brain and, thus, improves function.
Pharmacy The Pharmacy Department provides St Vincent’s Hospital with a comprehensive pharmaceutical service and promotes high quality and cost effective use of medicines for all patients. Throughout 2009 the Department was a key player in the roll out of the Hospital’s Electronic Medication Management System (EMMS). Clinical information system pharmacists are innovative in using EMMS to electronically message NSW health policy directives and safety notices to clinicians at the point of care. Decision support tools are continually being developed to enhance and promote patient care and safety. The Department’s role in the Hospital’s community services strengthened in 2009. The role of the pharmacist in the Transitional Aged Care Program expanded and pharmacists are now instrumental in reducing medication related problems in patients being discharged into the community.
Service delivery was enhanced with the appointment of a dedicated pharmacy porter. To date, the time taken to transport discharge medications to wards has halved.
In a year of many achievements, Susan Welch was acknowledged for her work as a leader in clinical pharmacy practice and in practice based research. In recognition of her contributions, Susan was awarded the Australian Clinical Pharmacy Award from the Society of Hospital Pharmacists of Australia and the St Vincent’s Clinic Foundation 2009 Excellence Award for a Clinical Researcher-Allied Health.
patients in managing the significant impact of acute or chronic illness on their lives.
Physiotherapy The Department provides inpatient and outpatient physiotherapy services to patients and clients throughout the Hospital and the community setting.
Reinforcing the Hospital’s tradition of excellence, clinical psychologists in the Psychogeriatrics Service received a Positive Living in Aged Care Award from the Aged and Community Services Association, NSW Health and the Aged Care Association of Australia. The award acknowledges the innovative group therapy program which aims to improve the mental health and wellbeing of those in residential aged care facilities as well as promoting collaborative partnerships with specialist services.
Areas of service provision include all ward areas, the Emergency Department; Fracture Clinic; Sacred Heart Rehabilitation Service and Sacred Heart Palliative Care; musculoskeletal outpatients; rehabilitation outpatients; cardiothoracic outpatients; cardiopulmonary transplant outpatients; pulmonary rehabilitation; cardiac rehabilitation and immunology/ HIV outpatients. A productive year for the Department, a new barcoding statistics system was introduced. After successful implementation in the Physiotherapy Department, the system was rolled out across several of the Hospital’s clinical allied health departments. The Department established an exercise clinic to prescribe home based exercises for oncology and haematology patients, the first patients attended the clinic in December 2009. Tai Chi was introduced to cardiac rehabilitation, aged care, exercise and rehabilitation programs and, in line with the Garling Report, the Department benefited from the introduction of an official uniform, consisting of red shirts and navy pants. Reaching out to the community, the Department facilitated a healthy living workshop for the World Presidents’ Organisation. Psychology The Psychology Department consists of psychologists and clinical psychologists who work across the various specialties at St Vincent’s Hospital, including the mental health, drug and alcohol service, cancer program, rehabilitation service, bereavement service and the gambling treatment program. Throughout 2009 the Department continued to provide evidence based psychological treatments for a range of mental health problems and assisted
Psychologists at St Vincent’s Hospital continue to participate in clinical research. This year several clinical psychologists from Clinical Research Unit for Anxiety and Depression (CRUfAD) were involved in developing and evaluating internet based therapy programs in the virtual clinic.
Social Work The Social Work Department offers a comprehensive service to assist patients, their families and carers to work through the impact of illness or injury. Members of the Department work in multidisciplinary teams to promote safe and timely discharge and offer comprehensive services through the provision of professional counselling, information and links to appropriate resources. The Department assists patients and families in practical ways through the provision of accommodation for those from rural and regional areas and through the dispersal of trust funds to those in need. Throughout 2009 the Department enjoyed a number of highlights including integration of an Aboriginal liaison officer, an interdisciplinary learning program for allied health students and recognition of the Department’s role in the 25th anniversary of heart lung transplantation. Speech Pathology The Speech Pathology Department provides assessment and treatment services for acute and rehabilitation patients with communication and swallowing problems related to stroke; head and neck cancer; progressive neurological problems and other medical conditions. The Department offers a state wide service for patients with voice disorders including a combined Speech Pathology and Ear Nose Throat Voice and Swallowing Clinic, which works closely with the Botox Clinic in Neurophysiology. In conjunction with
Medical Imaging, a weekly Modified Barium Swallow Clinic offers detailed assessment of swallowing disorders. Specialist outpatient services are provided to patients with neurological communication, voice and swallowing disorders. Throughout 2009 a number of clinical improvements were implemented including the establishment of a specialist speech pathology position dedicated to aged care. The role has resulted in increased services for aged care inpatients with swallowing and communication disorders. The introduction of an oral health educator has provided education to Hospital staff and enhanced clinical services to patients. The Department is leading research into the use of Skype for follow up with patients from remote communities and the use of electronic chat rooms for those with aphasia. Switchboard The Department receives approximately 12,000 internal and external calls each week, calls range from inquiries about local traffic, directions to the Hospital to major emergencies, paging staff and contacting on call doctors and staff. In 2009 the Switchboard enhanced patient care with the introduction of colour codes for emergency procedures and introduced an overhead public address system for improved communication during emergencies. These improvements were supported by documented emergency and contingency plans should the paging system or switchboard fail. An uninterrupted power supply was installed to ensure power interruptions do not compromise telecommunication for the Hospital. Walter McGrath Library The Walter McGrath Library supports high quality patient care, research and education through the provision of information services and resources for staff and clinicians from across St Vincents & Mater Health. The Library maintains a collection to support specialty areas across the group and its services include document delivery, literature searches, training, electronic programs and resources. In 2009 the Library introduced a new library management system and catalogue. The open source system, Koha, provides a number of enhancements including online renewals and reservations, RSS feeds, indepth reporting as well as enhanced circulation and copy cataloguing features.
To support the provision of a library service for its students, the University of Tasmania funded the appointment of a part-time library technician for the first semester – the funding supports the position for a three year period. Promoting improved access to management literature the Library established an electronic table of contents service for allied health and executive managers. The system provides relevant managers with email alerts for selected leadership and management journals in healthcare and will assist in professional development. Throughout 2009 the use of EBSCO databases increased owing primarily to the changed interface and availability through the Clinical Information Access Program.
Diagnostics Medical Imaging The Department provides diagnostic medical imaging services including digital x-ray, multi-slice computed tomography (320, 64 and 16 slice), 3T magnetic resonance imaging (MRI), state-of-the-art ultrasound, orthopantomogram as well as
therapeutic and diagnostic interventional procedures. St Vincent’s Hospital is a lead site forthe ultrasound guided radio frequency treatment of varicose vein ablations; selective internal radiation therapy (SIRT) for extensive colorectal liver metastases; the insertion of ports for chemotherapy and offers a comprehensive range of angiography services including stenting and embolisations. In 2009 alone, the Department conducted approximately 90,000 examinations. Throughout the year several new diagnostic and therapeutic services were introduced including the Toshiba Aquillion One 320 slice Cardiac Computed Tomography. In collaboration with Cardiology, the advanced scanner is the first of its kind to capture the total image of the heart within a single heart beat and its installation is a first for NSW Health. Installation of a new radiology information system (RIS) has greatly improved the patient journey, whilst new services include computed tomography (CT) brain and body perfusions; and CT and MRI angiograms for coronary and cerebral care. The Department continues to engage in a number of medical trials including a haematology trial to assess the progress of lymphoma; a pharmacology trial for the treatment of osteoarthritis; a trial to assess the effectiveness of SIRT on extensive colorectal and liver metastases and functional MRI brain studies into cognitive performance, brain activity and visual awareness.
Nuclear Medicine The Department provides St Vincent’s Hospital with diagnostic and therapeutic nuclear medicine services including positron emission tomography and computed tomography (PET CT), these are particularly beneficial in the diagnosis, staging and monitoring of cancer and cancer treatment. The service specialises in the care of those with ovarian; head and neck; oesophageal or gastro-oesophageal junction; non-small cell lung and colorectal cancers as well as melanoma. Throughout the year the Department continued its research and teaching endeavours which included collaborative PET CT research in the areas of mesothelioma, lymphoma and the value of delayed imaging. The Department also supports the use of selective internal radiotherapy for treating hepatic metastases.
A new database, Health and Psychosocial Instruments (HaPI), was purchased in May 2009. A comprehensive bibliographic database, HaPI provides information on behavioural measurement instruments and includes questionnaires, interview schedules, vignettes/scenarios, coding schemes, rating and other scales.
SydPath provides pathology services to the Darlinghurst Campus as well as to a growing number of local medical practitioners and rural areas through its accredited laboratories and collection centres in Narrabri and Moree. Services are based on the most recent advances in scientific pathology and laboratory technology.
Fully accredited by the National Association of Testing Authorities and the Royal College of Pathologists of Australia, commercial activity includes the provision of specialised laboratory services to the pharmaceutical industry for clinical trials. In addition, SydPath pathologists and scientists are heavily involved in a wide range of research activities and teaching for the University of New South Wales.
has enabled the Division to efficiently achieve faster results with higher reliability.
SydPath is comprised of several divisions.
Within the Customer Service Division the central specimen reception area provides a wide range of pre and postanalytical services. In addition to lean processing strategies, introduced in 2008, the recent implementation of the modular pre-analytical system has further contributed to improved routine chemistry turnaround times and precision in sample preparation.
The Division of Anatomical Pathology provides core diagnostic services to the Darlinghurst Campus as well as onsite diagnostic cytopathologist services to breast clinics across Sydney and acts as a collection hub for the NSW Breast Cancer Tissue Bank. The Division continues its role as the Australian Reference Laboratory for HER-2 FISH testing and now provides HER-2 SISH testing. Pathologists are involved in numerous research collaborations with other St Vincent’s Campus colleagues. The Division of Clinical Pharmacology and Toxicology is the NSW State Reference Laboratory and is an Australian leader in the therapeutic drug monitoring of anti-HIV medicines and antifungal drugs as well as immunosuppressant medicines used in transplantation. The Division of Chemical Pathology is Australia’s first hospital based laboratory to incorporate linked analysers for routine chemistry and immunoassay, pre-analytical systems for automated centrifugation, aliquotting and sorting of serum samples. Installation and implementation of this Roche system required much collaboration between the automated chemistry laboratory and the specimen processing department. In full operation, the system
Throughout 2009 the Division maintained its profile in the clinical biochemistry field and was a major contributor to the professional and scientific activities of the Royal College of Pathologists of Australasia and the Australasian Association of Clinical Biochemists.
The Division of Haematology Laboratories provides a comprehensive service including blood transfusion, coagulation testing and general haematology. The Division offers a range of specialised tests including a cytogenetics and FISH laboratory and is home to the bone marrow transplant laboratory which supports the Hospital’s bone marrow transplant program. In 2009 research activities and quality improvement projects included the development of novel methods to assist in the diagnosis of platelet bleeding disorders; formulation of an algorithm, based on clinical and laboratory data, to diagnose heparin induced thrombocytopenia; a review and audit of prothrombinex usage at St Vincent’s Hospital and the consequent updating of the Hospital’s transfusion protocol.
The Division of Immunopathology provides diagnostic laboratory and contract services that span an extensive range of immunochemistry, autoimmune serology and flow cytometry. The FACS Canto II eight colour flow cytometer, introduced in 2008, has facilitated an increase in antibody panel availability and, with the BioPlex 200 system and Hamilton STARlet sample processor, is facilitating the introduction of exciting new luminex multiplex immunoassays. New and improved assays have been introduced for coeliac disease screening and in 2009 the laboratory opened a new service for the identification of myositis antibodies. The Division of Microbiology continues to provide a high quality clinical microbiology diagnostic laboratory service and plays a key role in the Infectious Diseases Clinical Service, the Infection Control Advisory Service and the stewardship of antibiotic use. A new Polymerase Chain Reaction (PCR) test for H1N1 influenza was introduced during the 2009 swine flu epidemic to cope with the large numbers of specimens. New, PCR tests for rapid identification of gram positive organisms in blood cultures and the identification of parasites are under evaluation. Research projects in parasitology are continuing with many papers published in the past 12 months.
Emergency Response Clinical Information Systems The Department leads planning, development and implementation of the Hospital’s electronic medication management system MedChart, electronic medical record system deLacy and the community health information system CHIME.
Together, we reflect.
medical record and new contingency plans were put in place to allow clinics and clinical staff to continue their work with clients in the absence of CHIME access. Throughout the year 412 clinicians attended training sessions for MedChart, 136 for CHIME and over 130 for deLacy, bringing the total number of staff trained by the Department to almost 700.
In 2009 use of the deLacy system was expanded. A web based clinical information system, deLacy supports multidisciplinary care through the provision of clinical communication, effective and efficient processes and risk identification and management. An infection control risk module was initiated and electronic allied health and aged care medical consult referrals were implemented. The referrals module enables receiving teams to change the status of referrals from pending to complete and provides feedback to referring clinicians.
Disaster Management St Vincent’s Hospital continues to place significant focus on disaster response and planning and has reached a level of preparedness for a timely and effective response should a disaster occur.
In addition, electrophysiology studies and cardiac catheter requests went electronic with the deLacy request automatically feeding into the online theatre bookings system. Throughout 2009 CHIME was enhanced with three major software upgrades, offering new functionality, updated data collections, bug fixes and additional assessment tools for preventative care, falls prevention and functional home assessment. CHIME records were integrated with paper based in medical records, providing inpatient clinicians with the knowledge that an electronic community file exists. Client registrations for Rankin Court, alcohol and drug services and stimulant treatment programs moved to the Customer Service Centre. A new service, Youth Mental Health, implemented CHIME as their primary
In 2009 work centred on the identification and training of staff for deployment to a disaster site, should an external emergency take place. Training was assisted by the NSW Health Counter Disaster Unit and the Ambulance Service of NSW. Preparedness for an external disaster has been assisted through collaboration with external stakeholders in disaster management. The ongoing building works around the St Vincent’s Campus resulted in the need to further identify disaster vulnerabilities and necessitated the development of policies and procedures to determine roles, responsibilities and planning activities. Emergency plan operations were activated at St Vincent’s Hospital during a complete loss of power to the Xavier building. Through the utilisation of a hospital incident command system and a specific incident response guide, senior managers quickly established control to manage the situation.
services, including the daily reporting to South East Illawarra Area Health Service and NSW Health. A new development within the emergency program, ongoing internal training was established. This commitment has been extended to assist Sydney Hospital and Sydney Eye Hospital with disaster preparedness training and the NSW Health Counter Disaster Unit with major incident medical management support training courses. St Vincent’s Hospital assisted in the appointment of a suitably qualified staff member for the NSW Health Services Disaster Coordination Centre. Several suitably qualified staff members from St Vincent’s Hospital volunteered for deployment to Samoa, following the tsunami in September 2009.
Volunteers One hundred and fifty members of the community actively engage in volunteering at both St Vincent’s Hospital and Sacred Heart. Volunteers extend and enhance the work of staff across the Campus. Volunteer roles are varied and include retail work in the Little Shop and Terrace Café and administrative support within various departments throughout the Campus. However, the majority of volunteers dedicate three hours a week to engage in positive supportive conversations with patients.
An active year, MedChart was implemented across an additional three wards. To date, 12 inpatient wards have replaced paper based prescribing with the electronic prescribing system. Following extensive testing, a new version of MedChart was established in June and brought significant enhancements to the system, including complex scheduling and calendar prescribing.
The H1N1 pandemic resulted in implementation of elements of the emergency operations plan to assist with increased demand on the Hospital’s 61
Unwrapping the gift of life
On Christmas Eve Jesse Hirst’s family prepared for the worst – the tiny window of opportunity was fast closing. At just 17 and on the transplantation waiting list for only nine days Jesse was in the Intensive Care Unit at St Vincent’s Hospital. No longer able to breathe by himself, Jesse was on a ventilator and his condition significantly deteriorated throughout the day. Born with the genetic condition cystic fibrosis, Jesse gave up high school to live with the severity of his condition and the demanding daily routine needed to keep him alive. In addition to hours of physiotherapy to clear his airways, Jesse had to do positive expiration pressure therapy to open smaller airways and vibrations to dislodge mucus in the chest.
Throughout 2009 it became clear that these measures were not enough. His oxygen saturation had deteriorated and Jesse was on oxygen day and night. He now needed support 24/7.
As Jesse’s Mum and Dad waited on Christmas Day the surgeons opened the lid of the ESKE containing the donor organs, to reveal Jesse’s gift of life. The perfect gift, the lungs were an ideal fit.
Barely conscious and hooked up to a ventilator, Jesse was transferred from John Hunter Hospital, Newcastle, to St Vincent’s Hospital by the Westpac Rescue Helicopter on 16 December 2009. Jesse’s body could simply no longer get enough oxygen to the blood.
Unable to talk, Jesse opened his eyes at 10 am on Christmas Day. He looked up to his Dad and once again gave him the thumbs up. With each breath he could already feel how easily his new lungs were working.
Accompanied by his mother, Jackie, as the chopper ascended Jesse gave his Dad the ‘thumbs up,’ the proverbial “I am fine, don’t worry about me.” Jesse was placed on the active list for a bi-lateral lung transplant and admitted to the St Vincent’s Intensive Care Unit. “We realised the next step was for Jesse to be placed on an extracorporeal membrane oxygenation (ECMO) machine to support his heart and lungs. After that, further deterioration meant it would be too late for Jesse to have a lung transplant,” recalls his Mum. Christmas looked grim – until 2 pm on Christmas Eve when Jesse and Jackie heard the magical words – “We might have a match.” “At this point my heart started to pound, there is risk involved. Looking at him, knowing what was about to happen was awesome – this is it. Our horrible Christmas was turning into excitement,” explains Jackie.
Jesse’s family celebrated the gift of giving – the gift of life. Two days post-transplant Jesse was out of the bed doing squats, four days posttransplant he completed a lap of the Intensive Care Unit and five days post-transplant he was transferred to the ward – just in time to bring in the New Year. Discharged within a week, Jesse started to enjoy everyday things like walking down the street and going to the cinema. Today Jesse is back on the road driving. He has finished restoring and has registered his green Morris Mini-Minor and has been tobogganing and rock climbing. In Jesse’s words “I am trying to fit as much in as possible.” For the Hirst family the Christmas celebrations were multiple and the tree remained up into 2010 – a reminder of their wonderful Christmas gift from the donor family.
Christmas looked grim – until 2 pm on Christmas Eve when Jesse and Jackie heard the magical words – “We might have a match.” 63
Together, we look forward.
Sacred Heart operates as part of St Vincents & Mater Health Sydney and is managed by St Vincent’s Hospital. An affiliated health organisation under the NSW Health Services Act 1997, the role and funding of Sacred Heart are defined by a Memorandum of Understanding between Sacred Heart, the South Eastern Illawarra Area Health Service and the NSW Minister for Health.
The Cunningham Centre for Palliative Care Established in late 2007 The Cunningham Centre for Palliative Care (CCPC) promotes excellence in palliative care research, education, clinical practice and quality care throughout NSW and beyond. A collaboration of Sacred Heart, the University of New South Wales (UNSW), the University of Notre Dame Australia (UNDA) and Calvary Health Care Sydney, the Centre is in part funded by the Cancer Institute NSW. Largely housed within Sacred Heart, the Centre maintains an office at Calvary Health Care, Kogarah. The Centre leads Sacred Heart in fostering palliative care research. Throughout 2009 a wide range of palliative care research and education projects took place including clinical trials to identify the impact of a number of different medications on symptom management; studies to explore the impact of videoconferencing and telemedicine interventions on education and clinical care in rural settings and the exploration of the psychological impact of cancer and poor prognosis on patients and carers. Studies are congruent with the Centre’s broad aim of improving care and support for people, and their families, with a life limiting illness.
One of Australia’s largest and leading palliative care and rehabilitation providers, Sacred Heart offers inpatient and outpatient services. Established by the Sisters of Charity in 1890 as a small cottage for the terminally ill, Sacred Heart has grown to a modern 73-bed facility. Integrating teaching and research in all aspects of care, Sacred Heart incorporates the Cunningham Centre for Palliative Care, an academic centre that offers palliative care professional development opportunities and research in medicine, nursing and allied health.
In 2009 the Centre established a research structure at Sacred Heart, designed to support both experienced and novice researchers to conduct palliative care research within this particularly frail and vulnerable population. Actively involved in education and the dissemination of information about evidence based practice in palliative care, the Centre engaged in the education of UNSW and UNDA medical students; assisted the well established palliative care education program at Sacred Heart and facilitated outreach education for the continuation of professional development for numerous groups of external health professionals, including nurses and general practitioners in both urban and rural settings throughout Australia.
Together, we care.
Palliative Care Services at Sacred Heart Sacred Heart provides interdisciplinary palliative care to patients with life limiting illnesses. As one of Australia’s largest and leading palliative care providers, holistic services include terminal care, pain control, symptom control, respite care and supportive care in the management of side effects from treatments such as chemotherapy and radiotherapy. The Service has two inpatient wards, 46-beds in total, and a 24 hour specialist community palliative care team that provides a consultative service and support to patients in their own homes and to those living in the area’s many residential aged care facilities. The community service incorporates a day activity centre for community patients and inpatients. A consultation service is provided to St Vincent’s Hospital and St Vincent’s Private Hospital. In addition palliative care is involved with Prince of Wales Hospital, Sydney Children’s Hospital and the Royal Hospital for Women. Outreach clinics to Bathurst, Orange, Parkes, Wagga Wagga and Albury continue to be provided by the Service. In 2009 the nursing team on Four North commenced the development of a daily nursing care assessment tool. The tool will reduce and improve the quality of bedside documentation and will result in the replacement of outdated forms. Frontline nursing staff will be provided with current patient information to facilitate excellent evidence based individualised care.
Sacred Heart Day Centre and Community Palliative Care Services Serving the northern sector of South Eastern Sydney and Illawarra Area Health Service, Sacred Heart Community Palliative Care Service is 24 hour a day; seven day a week consultative service that receives over 500 new referrals each year. The service supports people with a life limiting illness in their own home or aged care facility and at any time approximately 250 clients are registered with the service for regular and/or periodic visits from the multidisciplinary team. In addition to the community service Sacred Heart operates the Day Centre, open five days a week the Centre is utilised by palliative care inpatients and community outpatients. The Centre offers holistic care through the provision of a therapeutic environment and affords patients the opportunity to socialise and partake in a range of activities facilitated by a diversional therapist and nurse. Activities include music therapy, massage therapy, bbqs as well as arts and crafts. Acknowledging the individuality of each patient, the Centre launched an art exhibition in May 2009. Entitled ‘21 Grams,’ the exhibition featured more than 50 pieces of artwork. The works used thumbprints to creatively explore the personal leisure interests of community patients, inpatients and the Centre’s staff.
Sacred Heart Rehabilitation Service provides complete patient rehabilitation following an illness, injury or surgery with the aim of helping patients and their carers achieve their maximum potential through a multidisciplinary approach. The Unit offers seven day rehabilitation – the first public rehabilitation service in NSW to offer weekend therapy. Caring for a diverse and complex range of patients the Unit consists of a 27-bed inpatient unit and outpatient services. Patients are transferred to Sacred Heart from St Vincent’s Hospital, St Vincent’s Private Hospital, Sydney Hospital and other facilities for rehabilitation. In 2009 the Unit opened five new geriatric rehabilitation beds and commenced a spasticity service. The multidisciplinary team comprises medical, nursing, social work, occupational therapy, physiotherapy, speech pathology, pharmacy, pastoral care, dietetics, psychology, neuropsychology as well as administrative staff. In 2009 Sacred Heart Rehabilitation Service developed a streaming system, dividing patients into four clinical categories: neurological rehabilitation; geriatric rehabilitation; transplant and cardiothoracic rehabilitation and trauma/pain rehabilitation. Meanwhile, the Unit continues to provide rehabilitation to motor bike accident victims through the Motorcycle Accident Rehabilitation Initiative (MARI). Sacred Heart Rehabilitation Services’ Motor Accident Acute Rehabilitation Response Study (MAARRS) is awaiting publication in the Journal of Trauma, Injury and Infection and a study of orthopaedic injury from road trauma was published in Australian Health Review
The Unit attracted funding from the NSW Department of Health and the Council of Australian Governments (COAG). The COAG funding has improved rehabilitation intensity and enabled the Unit to increase staffing levels. Engaging a range of stakeholders, outreach services have been developed for Griffith, Bega and Pambula Hospitals as well as Moruya and Batemans Bay Hospital utilising Federal Government funding. Stroke rehabilitation advanced with the introduction of an innovative treatment program, involving electrical stimulation to improve post stroke foot weakness and hand function. In addition, a gait analysis walkway was created for video analysis of gait and arm function following neurological impairment. Purchase of a Nintendo Wii is benefiting patients’ upper limb strength following stroke and other neurological developments and the Unit is participating in a National Health and Medical Research Council funded study on the use of Nintendo Wii. Strengthening care through research the Unit successfully obtained a $380,000 grant from the Motor Accident Authority for the study of trauma rehabilitation in metropolitan Sydney and research funding for an upper limb study using botulinum toxin to improve hand care and function following stroke.
Sacred Heart Rehabilitation Service
Australia’s most experienced site for transplant rehabilitation, the Unit treated its one hundredth transplant rehabilitation case. Dr Malcolm Bowman presented the first 100 cases of transplant rehabilitation at the International Physical Medical and Rehabilitation Society’s World Congress in Istanbul, Turkey. To facilitate benchmarking, the Unit established a partnership with John Hopkins Medicine, Baltimore, USA. 67
It’s all in the steps
As Tereza Crvenkovic holds a yoga pose on Sydney’s Bondi Beach it is hard to believe that just six months ago she was unable to sit up by herself, let alone stand or walk. Today Tereza often recalls the happiness of a Saturday morning in late June 2009 when she walked unaided for the first time since her dense stroke some five weeks previous. With tears of joy Tereza’s few brief steps from the bathroom to her bedside locker, at Sacred Heart, were a sign of hope for the future. “At times I thought I would be unable to walk unaided, swim or do yoga. But with the help of the rehabilitation team I realised that all of these things would once again be possible. The entire team were so positive, optimistic and encouraging,” explains Tereza. Within a few days of the stroke the allied health team worked with Tereza, on the stroke unit at St Vincent’s Hospital, to re-establish movement in the left side of her body. Prioritising rehabilitation and the restoration of full functionality to the left side of Tereza’s body, Tereza was admitted as an inpatient to the Rehabilitation Service at Sacred Heart.
“The stroke resulted in many complications for Tereza, including weakness in her legs and arms, poor balance and an inability to do most tasks on her own. When she was admitted as an inpatient she was unable to remain sitting by herself let alone stand or walk. Tereza required two people to move at all times, had significant pain and fatigued very quickly. This was devastating for Tereza and her family as she was previously a very active and independent woman,” says Physiotherapist, Genevieve Woodbridge. In close collaboration the Physiotherapy and Occupational Therapy Departments worked with Tereza on a daily basis. “Throughout her inpatient stay Tereza put in a lot of effort, often spending two to three hours in the gymnasium each day. She remained focused and positive, even on the really hard days. To other patients on the ward she was an inspiration and source of encouragement, always ready to offer assistance to anyone in need,” furthers Genevieve.
Within two weeks of being an inpatient at Sacred Heart Tereza could already see the results. Tereza’s moment of realisation came as she made her first independent steps from the bathroom to her bedside locker. By the time Tereza returned home she could walk along the beach with the support of her husband. However, Tereza’s journey to recovery was just beginning. As an outpatient Tereza’s determination continued to prevail as she progressed her strength, balance, mobility and increased her overall independence. Today as Tereza holds her yoga pose on Bondi Beach she knows that the hard work has paid off. Since May 2009 Tereza has come full circle – returning to work, yoga, swimming and a life of independence.
As the days and weeks passed Tereza could walk aided in the gym, through the gardens at Sacred Heart, around the ward as well as up and down the stairs. “It was scary stuff to start with,” recalls Tereza.
Tereza’s determination continued to prevail as she progressed her strength, balance, mobility and increased her overall independence.
Together, we will be determined.
St Vincent’s Private Hospital
From humble beginnings 100 years ago, St Vincent’s Private Hospital is today internationally recognised as excelling in the provision of private healthcare services. St Vincent’s Private Hospital provides safe, quality, innovative medical and surgical services in an acute inpatient setting. A tertiary referring facility, the 250-bed Hospital enjoys an exceptionally high level of patient satisfaction and improved clinical outcomes and is a Hospital of choice for privately insured patients seeking excellence in healthcare services. St Vincent’s Private Hospital has an international reputation in the areas of cardiology, cardiac surgery, ear, nose and throat surgery, neurosurgery, orthopaedics and urology. The Hospital also provides treatment and care in oncology, colorectal surgery, dermatology, extracorporeal perfusion, gastroenterology, gastrointestinal surgery, gynaecology, head and neck surgery, immunology, medical imaging, ophthalmology, plastic and reconstructive surgery, rehabilitation medicine, thoracic medicine and vascular surgery. St Vincent’s Private offers an extensive day surgery service and has a Cardiac Catheter Centre.
The Hospital is renowned within Australia for having the most complex and acute patient profile. In 2009 St Vincent’s Private Hospital catered for an average case mix of 1.8 for all patients and 2.4 for overnight patients. The Hospital’s overnight occupancy was 86 percent and total occupancy 94 percent. In fostering a culture of excellence, the Hospital is a centre for education and research and is a teaching hospital for the University of New South Wales, University of Notre Dame Australia, University of Tasmania and the Australian Catholic University. Collocated with St Vincent’s Hospital and St Vincent’s Clinic, St Vincent’s Private offers a unique opportunity for clinicians to work across public, private and research sectors on the Darlinghurst Campus. An employer of choice for existing and prospective staff, the Hospital is fully accredited by the Australian Council on Healthcare Standards and is Australia’s first private hospital to commence the journey to Magnet designation.
Established by the Sisters of Charity in 1909 to support the public hospital and provide specialised private healthcare, St Vincent’s Private Hospital today continues the Sisters’ Mission and extends the healing ministry of Christ to those in need. Renovated extensively in 1997, the Hospital moved to its current location in 1976.
St Vincent’s Private Hospital looks toward the future with a vision to further develop a range of new and exciting patient centred services.
a year in review Celebrating its centenary, 2009 proved a monumental year in the history of St Vincent’s Private Hospital. The year commenced with the centenary opening ceremony in February, which highlighted the Hospital’s critical role in forging Australian private healthcare and the evolving journey of change and achievements in clinical care. The centenary festivities continued throughout the year, highlights included a community twilight fair; a centenary dinner in May highlighting ‘100 Years Serving the Nation’ at the NSW Art Gallery and was attended by friends of the Hospital, including former Prime Minister John Howard AC and Centenary Patron Mrs Roslyn Packer AO. His Eminence Cardinal George Pell AC celebrated a centenary mass at Sacred Heart Church, Darlinghurst, and events culminated with the opening of a healing garden in November. Set along the Hospital’s Victoria Street frontage, the commissioned garden is a lasting reminder of the achievements of the past 100 years. The centenary book ‘Compassionate Care – One Hundred Years of St Vincent’s Private Hospital,’ painstakingly researched, was launched in the garden. Doctors, staff and families marked the Centenary in November with a family picnic day in Centennial Park. An official centenary closing ceremony will take place in March 2010. Continuing the Mission and Values of the Sisters of Charity, St Vincent’s Private Hospital embarked on the Magnet recognition program in May 2009. Launched in conjunction with the centenary celebrations, the journey highlights the aspiration of St Vincent’s Private Hospital to become Australia’s first Magnet designated private hospital. The Magnet journey empowers staff to showcase improvements in care delivery. A completed narrative demonstrating excellence in nursing services at St Vincent’s Private Hospital will be submitted to the American Nurses Credentialing Centre. Magnet designation is viewed as a long term aspiration for the Hospital in the journey of continuous improvement.
Throughout 2009 major inroads were made in improvements to clinical care. These included a review of brachytherapy treatment and nursing care which resulted in the reduction of treatments from three to two, less patient anxiety, earlier mobilisation and nutrition as well as achieving a shorter patient length-of-stay. St Vincent’s Private Hospital established an Apomine™ Injection Program for patients with Parkinson’s disease. Initiation of the therapy sees patients admitted for first treatment and adjustment of therapeutic levels of the medication. The patient and family receive education about self administration and follow up post discharge. A Red Dot Mobility System was implemented throughout the Hospital to minimise the risk associated with patient mobility and patient falls. A Pressure Ulcer Point Relevance Audit was conducted showing St Vincent’s Private Hospital to have the lowest prevalence rate of pressure ulcers when compared to all other participating facilities. The Hospital participated in roll out of the National Institute of Clinical Studies venous thromboembolism prevention program. Obtaining significant external funding, St Vincent’s Private Hospital employed a project facilitator who worked with a multidisciplinary team to develop a range of evidence based interventions to improve clinician compliance with best practice. The program is already paving the way for significant improvements in compliance. A number of practice development projects were undertaken across the Hospital involving a wide range of clinicians and health disciplines improving, among others, bowel and fluid balance management, quality of discharge information and the management of patients with disturbed behaviour. With the launch of the St Vincents & Mater Health Sydney Australian Catholic University Nursing Research Institute in late 2009, St Vincent’s Private Hospital appointed its first Clinical Research Fellow.
The Benchmarked Injury Management Audit resulted in 89.5 percent and certification from the International Disability Management Standard Council for three years. St Vincent’s Private Hospital continued on from the success of the 2007 Australian Council on Healthcare Standards survey, a periodic review in November 2009 saw the Hospital maintaining the majority of extensive achievements and gaining an additional outstanding achievement. The periodic review confirmed improvement in risk assessment, informed financial consent and excellent outcomes of care reflected clinical indicators. In 2009 more than 70 percent of the Hospital’s patients were pre-admitted, 83 to 85 percent of patients were admitted on the day of surgery, in excess of 90 percent were comprehensively risk assessed with the Hospital gently growing its extended care program. Staff satisfaction through Best Practice Australia revealed that 75 percent of staff believe St Vincent’s Private Hospital to be ‘a truly great place to work.’ Staff were empowered with the introduction of a shared governance model and embraced evidence based practice. New uniforms were introduced throughout 2009 and the practice development framework was rolled out across the Hospital.
Doctor satisfaction through Press Ganey was at 92 percent, an increase from 86 percent in 2007. 2009 also witnessed an increase in demand from doctors seeking accreditation at St Vincent’s Private Hospital. Significant changes were seen in the Hospital’s fundraising structure. Following 34 years of solid commitment to St Vincent’s Private Hospital the Ladies Committee was dissolved in November 2009. Since its inception in 1975 the committee has raised millions of dollars for the purchase of state-of-the-art equipment and has significantly contributed to the quality of patient care. Dissolution of the Ladies Committee was followed by the establishment of ‘The Friends of St Vincent’s Private.’ Planning for the future, a master planning process for the new St Vincent’s Private Hospital commenced in April 2009. In parallel with site options, a clinical services plan is under development. International experts will be engaged in 2010 to further assist with the development of the clinical services plan. In the interim, the Hospital’s main foyer will be refurbished in February 2010. Honouring its commitment and responding to those in need, St Vincent’s Private Hospital is exploring the provision of private mental health services. An exciting time for St Vincent’s Private Hospital, the centenary year acknowledged the contribution of past and present generations of the Sisters of Charity, nurses, medical and support staff. As St Vincent’s Private Hospital moves into the future, the Hospital looks forward to the challenges and opportunities that lie ahead.
Another major positive outcome for the Hospital was the patient satisfaction rating which remained at 96 percent. As indicated through Press Ganey, St Vincent’s Private Hospital was ranked in the top four percent of peer group private hospitals. In July, St Vincent’s Private Hospital achieved 80 percent compliance with the Occupational Health Safety and Injury Management Profile.
The Hospital enjoyed few vacancies throughout the year with less than 3.5 percent vacancy levels and a lower turnover rate of 12 percent. In light of patient complexity, St Vincent’s Private provides a greater number of work hours per patient day than the average private hospital.
Allied Health Focusing on the patient’s quality of life Allied Health Services work towards the optimisation of patient function, mobility and involvement in activities that are most important to each individual patient. Services include occupational therapy, physiotherapy and speech pathology. Allied Health focuses on areas where normal function is not possible due to disease or surgical intervention and strategies are developed for independent, pain free mobility and self care. To ensure best clinical outcomes, the Department plans for discharge in collaboration with each patient, their family, nursing and medical staff. Inpatient Allied Health Services are coordinated by Therapy Services Physiotherapy and include occupational therapy, speech pathology, physiotherapy and massage therapy, including lymphoedema. Inpatient therapists are based at St Vincent’s Clinic and are collocated with colleagues who facilitate outpatient services and home visit physiotherapy and occupational therapy. In 2009 the Department expanded physiotherapy involvement with orthopaedic patients in the Hospital’s Day Surgery Unit. Home visit services were extended to directly facilitate inpatient discharges to home rather than to inpatient rehabilitation centres, the success of the service is accounted to the planned implementation and multidisciplinary approach. Throughout the year the Department developed a sleep and lifestyle solutions service. The outpatient service is provided by physiotherapists with a background in intensive care and
cardiothoracic physiotherapy, harnessing their specific expertise in the care of patients living with sleep disordered breathing. Management of patients with sleep disorders usually involves utilisation of nocturnal breathing support equipment, exercise and activity prescription. For many patients the results have been remarkable and have been reflected in improved quality of life.
Intensive Care Unit Providing timely, quality care to the critically ill, the Intensive Care Unit (ICU) at St Vincent’s Private Hospital offers cardiothoracic and general surgical intensive care services and serves as the cardiac arrest team for St Vincent’s Private Hospital and St Vincent’s Clinic. In 2009 the Unit provided 2,823 patient days and continued outreach services, offering patients a pre-operative visit, post-ICU follow up and total parenteral nutrition review. Major achievements include the remodelling of ICU patient care guides on the deLacy system, the Hospital’s web based clinical information system; introduction of a new oxygen delivery modem and new bowel management protocol; the first notation of new graduates and coordination of Darlinghurst Campus study days on dialysis and oxygen therapy.
Medical Imaging St Vincent’s Clinic Medical Imaging (SVCMI) provides services to St Vincent’s Private Hospital, St Vincent’s Clinic and external referrers. SVCMI is a joint venture between a partnership of
Following installation of a cardiac capable GE Lightspeed VCT XT, cardiac coronary computed tomography is now offered at SVCMI. High quality cardiac imaging is delivered in prospective and retrospective formats, with a comprehensive range of cardiac work ups including all functional studies. Most importantly, the prospective format enables extremely low dose, targeted cardiac review. St Vincent’s Clinic Medical Imaging has completed a breast Magnetic Resonance Imaging (MRI) trial and preliminary results indicate the utility of breast MRI in pre-operative assessment of patients with diagnosed breast cancer. Several contralateral tumours were identified and in several patients MRI has provided a more accurate diagnosis suggesting more extensive tumour than initially suspected based on other forms of imaging. St Vincent’s Clinic Medical Imaging has introduced Agfa Impax, a web based image and information management solution which provides referring doctors with access to their patient images and reports in their rooms, St Vincent’s Private Hospital wards, Intensive Care Unit and Recovery. Faster access to imaging substantially benefits clinical decisions and patient care. Three new Philips IU22 Ultrasound Machines with silicon transducer technology and 3D and 4D probes provide exceptional resolution and clarity, particularly for breast, musculoskeletal, obstetrics and gynaecology work.
The digital general room now possesses two Philips digital machines which utilise ‘image pasting’ providing much faster image acquisition than previous technologies and enhancing patient care through reduced waiting times. Darlinghurst X-ray (DXR) is a community based, multi-modality bulk billing practice, subsidised and operated by SVCMI to provide imaging services to the wider community. An extensive range of equipment upgrades have been implemented at DXR and include a GE 16 slice CT, two Siemens Antares 4D capable ultrasound machines, a Philips Duo Diagnostic general/screening room and a Siemens Sirona Dental unit. The new Agfa Computerised Radiography NX Platform is a significant shift from the traditional film screen method used previously and provides faster, more comprehensive image acquisition and improved turnaround times for patients.
Volunteers St Vincent’s Private Hospital engaged 86 volunteers in a range of services throughout 2009.
radiologists and St Vincent’s Private Hospital and operates at two centres – St Vincent’s Clinic and Darlinghurst X-ray.
Integral to the Hospital’s endeavours, volunteers participated in administrative tasks; supported patients in the Same Day Centre; welcomed patients; maintained fresh flowers on a daily basis; coordinated a daily shopping and library trolley with books and magazines donated by the volunteers; assisted main reception; actively worked in the Wintergarden, the Hospital’s coffee shop, and the pharmacy and acted as translators for CAFAT patients.
bernard Maintaining the vision
For Bernard Mahony the show must go on. A former member of vocal group ‘The Four Kinsmen,’ Bernard was diagnosed with Parkinson’s disease in 1993. However, it was not the symptoms of Parkinson’s – severe shaking, rigidity and slow movement – that posed one of Bernard’s greatest challenges, it was the unrelated clouding of his eyes. Now seeing double, Bernard could no longer watch sport, write poetry and he would be unable to see his first born grandchild. Considering the severity of Bernard’s condition, Dr John Kennedy, Ophthalmologist at St Vincent’s Private Hospital, knew something had to be done, he needed to fix it and fix it quickly. “Bernard had advanced bilateral cataracts causing deterioration of vision in both eyes almost to the point of legal blindness. Normally cataract surgery is done under local anaesthetic, operating on one eye at a time usually two to four weeks apart. “However, in this case local anaesthetic would not be possible as Bernard could not keep still long enough due to the Parkinson’s disease. The decision was made to operate under general anaesthesia and to operate on both eyes at the same time,” explains Dr Kennedy.
No stranger to St Vincent’s Private Hospital, Bernard had already been admitted some 18 times, since 2001, to the Hospital’s Level 10 and was comforted in knowing that he would see the familiar nursing staff across the ward. Utilising sophisticated technology, known as phaco-emulsification, Dr Kennedy operated to restore Bernard’s vision. The plastic shields covering Bernard’s eyes were later removed and he returned home with his wife only three days after being admitted. Returning home with his wife Jennifer, Bernard no longer blamed his glasses for the double vision. He could once again do the things he loved. Bernard’s famous curry nights were back on the menu and he was back online communicating with relatives in Victoria. But most importantly Bernard’s vision had been restored. He is ready to see his son walk down the aisle and is waiting for that first glimpse of his yet to be born grandchild. “The operation was successful and now Bernard has almost 6/6 vision in each eye,” concludes Dr Kennedy.
He is ready to see his son walk down the aisle and is waiting for that first glimpse of his yet to be born grandchild.
medical specialities Cardiac Catheter Centre
Relocated and expanded, the Cardiac Catheter Centre is benefiting from the lease of a cardiac catheter laboratory from St Vincent’s Hospital. These changes have facilitated additional cardiac catheter procedures and the introduction of complex endo-luminal vascular procedures. These new complex vascular techniques allow for the insertion of grafts into major vessels including the aorta.
The Department provides a comprehensive service for the diagnosis and management of hormonal disorders, with particular expertise in the areas of diabetes, obesity, pituitary disease and osteoporosis.
The Medical Oncology Department takes a holistic approach to cancer care. Offering the best available treatment and caring for the whole person, the well established multidisciplinary team supports patients and their families.
With the additional laboratory capacity the insertion of pacemakers and defibrillators have become routine procedures performed in the laboratories, providing a broader range of services to available patients. The expansion of the Cardiac Catheter Centre is also enhancing capacity to attract and retain quality nursing and medical staff, as it offers greater opportunities for staff to expand their knowledge and skill set.
Cardiology The Cardiology Department provides a comprehensive range of services including non-invasive diagnostic services, cardiac catheterisation, angiography and a wide range of interventional cardiac, vascular and electrophysiological procedures. In collaboration with St Vincent’s Hospital, the Department is a NSW leader in the application of drug-coated stents. Computerised intracardiac mapping increases accuracy of localisation, consequently ablation of heart arrhythmias has been extended to the curative treatment of atrial fibrillation.
Haematology and Bone Marrow Transplantation As one of the few adult centres in NSW accredited to perform complex adult transplantations, the Department of Haematology and Bone Marrow Transplantation provides comprehensive therapeutic services for the treatment of malignant and benign blood diseases and therapeutically focuses on bone marrow transplantation. 2009 was an exceptional year for the Service with a record number of bone marrow transplants taking place at the Darlinghurst Campus; two of these were performed at St Vincent’s Private Hospital. In 2009 the number of clinical trials available to haematology patients expanded significantly. Dr Sam Milliken was contracted to the NSW Institute of Medical Education and Training for a six month period to review medical oncology training across the state. In association with Dr Lesley Ashton of the Children’s Cancer Institute Australia, Associate Professor Anthony Dodds was awarded a National Health and Medical Research Council grant to study the rate and risk factors for second malignancy following bone marrow transplantation in Australia.
Neurology The Neurology Department promotes rapid assessment for diseases of the brain, spinal cord, nerves, muscles and other inflammatory disorders of the nervous system. Key to Department activities is the rapid, usually same day, service for truly urgent referrals or, minimally delayed clinical diagnostic consultations as well as access to most ancillary diagnostic investigations, including neurophysiological testing. Dr Ian Sutton has special expertise in multiple sclerosis (MS) and supervises the Tysabri program for suitable patients with MS. The recent appointment of Dr Susie Tomlinson confirms the Department’s commitment to the appointment of young neurologists with local and specialist overseas training. Dr Tomlinson brings particular expertise in Neurophysiology. A grant of $100,000 from the Curran Foundation for purchase of new neurophysiological equipment has enabled Dr Stephen Tisch to further advance the deep brain stimulation program for Parkinson’s disease and other movement disorders. Both Dr Tisch and Dr Paul Darveniza operate a specialised clinic
Promoting excellence in teaching and research, Dr Ray Garrick was recently appointed Associate Professor of the University of Notre Dame Australia and is head of the Clinical School of Notre Dame. Dr John O’Neill operates an outreach service in Wollongong.
Nuclear Medicine The Department provides St Vincent’s Private Hospital with diagnostic and therapeutic nuclear medicine services, including positron emission tomography and computed tomography (PET CT). PET CT is particularly beneficial in the diagnosis, staging and monitoring of cancer and cancer treatment. The service specialises in the care of those with ovarian, head and neck, oesophageal or gastro-oesophageal junction, non-small cell lung and colorectal cancers as well as melanoma. The Nuclear Medicine Department continues to engage in collaborative teaching and research efforts in the areas of mesothelioma, lymphoma study and the value of delayed imaging. St Vincent’s Private Hospital supports use of selective internal radiotherapy for treating hepatic metastases.
Palliative Care The Palliative Care Service at St Vincent’s Private Hospital provides both palliative care and pain management.
In 2009 the Service assisted over 200 inpatients with comfort, supportive and terminal care across a range of cancer and non-cancer conditions including heart, lung and renal failure. In addition, where requested supportive care was provided for patients undergoing radiotherapy. In conjunction with the Hospital’s pastoral care team, bereavement services are offered to family members. The Service collaborates with Sacred Heart and other palliative care services; this continuity benefits both patient and family.
Radiation Oncology Radiotherapy is provided for the full range of adult cancers, including 3D conformal, intensity modulated and image guided treatment options as well as Brachytherapy. An important year for the Radiation Oncology Associates, in 2009 an Intensity Modulated Radiation Therapy (IMRT) treatment program was established and the Image Guided Radiation Therapy (IGRT) program was further developed. The combined programs have enabled the provision of leading edge radiotherapy services.
Rheumatology The Department addresses the pain needs of patients with acute and chronic musculoskeletal diseases and problems and liaises closely with the neurosurgery, neurology, orthopaedics, clinical pharmacology and pain medicine departments. As well as providing clinical and consultative rheumatology services, the Department is involved in undergraduate, postgraduate and general practice education.
SydPath SydPath provides pathology services to the Darlinghurst Campus with collection centres located at both St Vincent’s Private Hospital and St Vincent’s Clinic. Specialised testing services are offered with particular emphasis on endocrinology, clinical pharmacology and immunopathology. SydPath also boasts specialised expertise in the fields of cytogenetics and molecular medicine. Services are based on the most recent advances in scientific pathology and laboratory technology.
Vascular Medicine The Department of Vascular Medicine manages patients with diseases involving the arteries, veins and lymphatic system. Throughout 2009 the Department was involved in collaborative work with numerous national and international vascular units and organisations. Members of the Department participated in local and global vascular meetings and presented on many topics including venous thromboembolism, popliteal entrapment and lower limb ulceration.
utilising botulinum toxin in the control of certain involuntary movement disorders, otherwise refractory to medical treatment.
The Department was successful in its application for research funding in the areas of venous thromboembolism and arterial disease.
The Hospital provides a broad range of surgical services undertaking every speciality, with the exception of psychiatry, paediatrics and obstetrics. In 2009 Surgical Services introduced a peri-operative surgical nurse assistant program, an advanced practice nursing role, the nurse functions as the first assistant to the surgeon. To date four nurses have commenced the postgraduate qualification. Surgical Services continues to provide educational sponsorship to all categories of staff. Offering quality of care, Surgical Services successfully underwent a Department of Health Audit and National Association of Testing Accreditation.
Cardiac Catheter Centre
Relocated and expanded, the Cardiac Catheter Centre is benefiting from the lease of an additional laboratory from St Vincent’s Hospital. These changes have facilitated additional cardiac catheter procedures and the introduction of complex endo luminal vascular procedures. These new complex vascular techniques allow for the insertion of grafts into major vessels including the aorta.
The Operating Theatres continue to increase workload, in particular in spinal and orthopaedic surgery. Da Vinci Surgical System remains a focus with 938 procedures undertaken since its inception in 2005. St Vincent’s Private Hospital remains the only hospital in NSW to provide robotic surgery, the surgery offers enormous benefits for patients when compared to traditional open surgical procedures.
Day Surgery Unit A major focus for Surgical Services has been the $1.6 million renovation of the Day Surgery Unit. The completed work has provided patients with an enhanced admission and discharge area. An additional state-of-the-art theatre was opened enabling installation of agronomic equipment and improved theatre layout. This has resulted in an overall increase in surgical procedures. Having taken a patient centred approach to the renovations, the unit now provides a more streamlined and comfortable patient experience.
Same Day Centre
As an acute surgical hospital, St Vincent’s Private enjoys an outstanding reputation in the healthcare sector for its commitment to compassionate care. Surgical Services encompass the Cardiac Catheter Centre, Day Surgery Unit, Operating Theatres, Same Day Centre and Sterilising Services.
A benchmark for Australian Catholic Health, the Same Day Centre admits approximately 80 to 85 percent of all surgical patients to St Vincent’s Private Hospital on the day of surgery, this has significantly improved the Hospital’s efficiencies as well as the patient experience.
Sterilising Services Sterilising Services continues to support all the needs of the Surgical Services. 81
surgical specialities St Vincent’s Private Hospital enjoys a strong reputation in the healthcare sector for its commitment to excellence. Most departments span the entire St Vincent’s Campus, with specialists providing services to both private and public patients.
The Department is internationally renowned for its leadership in heart and lung surgery. In collaboration with St Vincent’s Hospital, over 900 cardiothoracic surgical procedures were performed.
The Colorectal Surgical Unit at St Vincent’s Private Hospital performs operations for all aspects of bowel disease, in particular cancer, inflammatory bowel disease and ano-rectal disorders.
A range of gynaecology services are provided at St Vincent’s Private Hospital involving all benign and pre-invasive pelvic pathology including endometriosis and acute gynaecological emergencies.
The major developments included the refinement of mechanical heart assistance; long term cardiopulmonary support using extracorporeal membrane oxygenation and the introduction of robotic minimally invasive surgery, predominately for mitral valve repair. In collaboration with the cardiologists, catheter based aortic valve replacement has been introduced; this technique does not require cardio pulmonary bypass or sternal opening and is a major innovation for the elderly and infirm.
With evidence showing improved outcomes from laparoscopic surgery, selective patients are being offered keyhole surgery for major colectomies. In conjunction with Medical Oncology cancer patients are undergoing genetic evaluation, often aiding their care.
The Department focuses on endoscopic gynaecology and complicated major pelvic surgery and provides sub-specialist urogynaecology prolapse, urinary incontinence services. Its reputation in all these areas attracts nation wide tertiary referrals.
In recent years, the introduction of a specialist nursing team to care for patients recovering from colorectal surgery has been a major advance in overall patient care.
Robotic gynaecology surgery is offered using the da Vinci Surgical System.
A further innovation is the introduction of aortic valve replacement using catheter based techniques that are non-reliant on cardiopulmonary bypass or a mediastinal opening. The numerous innovations and refinements are credited to the collaborative efforts of the surgeons, cardiac anaesthetists and heart/lung perfusionists. 2009 was the 25th anniversary of heart transplantation at St Vincent’s Hospital and to support the further development of heart and lung replacement Dr Kumud Dhital joined the Department from a consultant position in United Kingdom.
Gastroenterology The Diagnostic Endoscopy Centre is devoted to the diagnosis and treatment of diseases and disorders of the gastrointestinal tract. In 2009 the Centre admitted an estimated 7,500 patients, with many undergoing more than one procedure during their admission. Excellent patient outcomes were achieved throughout the year owing to the dedicated and skilled team. The Centre’s optimal patient care resulted in four year accreditation from the Australian Council on Healthcare Standards.
The Gynaecology Department has a strong research output including many national and international publications and presentations.
Neurosurgery With seven consultants the St Vincent’s Private Hospital Department of Neurosurgery is the largest in NSW. Throughout 2009 the Department carried out in excess of 1,600 procedures across the Darlinghurst Campus. Caring for both inpatients and outpatients, the Department runs an Outpatient Clinic and boasts 45 neurosurgery beds, of which 25 are based at St Vincent’s Private Hospital.
Chairman of the Department, Dr Peter Bentivoglio, is set to establish a Professorial Chair in Neurosurgery. The academic position will increase the size of the Department. In addition to the seven consultants the Department includes a Research Fellow, SET1 and SET2 Accredited Registrars, one non-accredited Registrar and a Department Manager. The consultants and registrars are members of the Neurosurgical Society of Australasia and Fellows of the Royal Australasian College of Surgeons in the subspecialty of Neurosurgery. Fully accredited by the Royal College of Surgeons, the Department of Neurosurgery provides training for neurosurgical SET1 and SET2 doctors with Dr Richard Parkinson as Director of Training. Members of the Department have a strong interest in surgery of the skull base and work as neurosurgical members of the St Vincent’s Skull Base Unit. The Department is
committed to research, especially in the areas of pituitary tumours and minimally invasive brain surgery, with computer assistance.
The area of musculoskeletal oncology continues to grow. The Department recently welcomed Dr Warren Kuo and Dr Andrew Higgs.
Ophthalmology With a solid presence in ophthalmic care, the Department offers virtually all ophthalmic subspecialties including cornea, vitreo-retinal surgery, medical retina and oculoplastics. Caring for both inpatients and outpatients the Department facilitates a wide range of specialist clinics including oculoplastics, glaucoma and medical retina. In 2009 the Department unveiled a new phaco-emulsification machine for cataract surgery. The Department continues its focus on education and routinely teaches registrars in the area of phaco-emulsification surgery.
Orthopaedics Over 1,500 orthopaedic procedures are carried out each year across the St Vincent’s Campus, the majority at St Vincent’s Private Hospital. Further growth has continued in the areas of adult joint reconstruction and arthroplasty surgery, including hip and knee replacement and revision joint surgery as well as foot, ankle and shoulder surgery.
Otolaryngology, Head & Neck Surgery St Vincent’s Private Hospital is a leading Australian centre for otology, neuro-otology and skull base surgery. The Department of Otolaryngology also provides a full range of services for restoration of hearing with the use of a wide range of implantable hearing aids and cochlear implants. Each year the Department performs approximately 1,000 cases in all fields of otolaryngology, including head and neck tumour surgery, advanced nasal and sinus surgery as well as laryngeal and voice disorders. The Department continues to provide advanced training in otolaryngology and head and neck surgery for the Royal Australasian College of Surgeons as well as additional training for fellows in otology, neuro-otology and skull base surgery as well as rhinology.
Specialising in cerebral tumours, subarachnoid haemorrhage, degenerative and neoplastic processes of the spine, stereotactic procedures for tumour or deep brain stimulation for Parkinson’s disease and movement disorders, pituitary surgery, skull base surgery and endoscopic skull base surgery, the pre-operative and post-operative care of patients is undertaken by Department members based at St Vincent’s Clinic.
Continuing the Mission of the Sisters of Charity, the Department remains committed to an indigenous ear, nose and throat outreach clinic in Moree.
Plastic and Reconstructive Surgery At St Vincent’s Private Hospital a comprehensive range of plastic and reconstructive surgical services are provided including skin cancer surgery, major and minor reconstructive surgery after excisional procedures for head and neck cancer and limb tumours, maxillofacial reconstruction after trauma or congenital defects, breast reduction/augmentation reconstruction, other aesthetically related surgery of the face and trunk, with extensive microsurgery services and soft tissue hand surgery procedures. The Department continues to treat all patients formally admitted to St Vincent’s Hospital with acute hand injuries. In 2009 the Department welcomed Dr Stuart Myers, hand surgeon, to the newly opened Sports Medicine Clinic. The highly publicised Sydney shark attacks and the ensuing surgery at St Vincent’s Hospital provided new insight into optimum treatment pathways for such trauma. Continuing the Mission of the Sisters of Charity the lives of many patients with cleft lip and palate, burn contractures and
other debilitating conditions changed with Dr Kevin Ho’s outreach work with Interplast in the Philippines. The Department’s breast reconstruction and oncoplastic service, initiated by Dr Elias Moisidis, continues to expand, offering world class multidisciplinary treatment at one site. Purchase of a new vaser ultrasonic suction lipectomy machine has significantly improved the final result after breast reconstruction following mastectomy and certain microvascular flaps as well as some aesthetic procedures. Appointment of Dr Damian Marucci as Visiting Medical Officer has resulted in the commencement and expansion of fortnightly educational lectures at the St Vincent’s Campus as well as a monthly Journal Club for all NSW trainees, which is run at St Vincent’s Clinic. In 2009 Dr Russell Aldred pioneered innovative reconstructive techniques for difficult facial wounds after trauma or tumour removal, including the island inversion flap for nasal reconstruction.
Urology One of the largest and busiest prostate cancer treatment centres in Australia, St Vincent’s offers the full spectrum of available treatments for urological and prostate cancer, including open and robot assisted nerve sparing radical prostatectomy, high and low dose brachytherapy and high intensity focussed ultrasounds. A pioneer in the use of robotic technology, at the close of 2009 the Department had performed some 900 cases of robotic radical prostatectomy and is a leader in the areas of brachytherapy and lithotripsy. A new modality in the treatment of prostate cancer and less invasive, robotic radical prostatectomy has enhanced recovery time and improved outcomes. Excelling in research, the Department published numerous articles on the various forms of care available to those with prostate cancer. Findings were presented at the Urological Society of Australia and New Zealand’s national scientific meeting; international meetings of the American Urology Association and the European Association of Urology as well as the International Society of Urology’s congress in China.
With advanced facilities, the Department performs complex endovascular procedures on the aorta and peripheral arteries. These procedures significantly reduce admission into intensive care and hospital stay for patients with complex aneurysm and occlusive disease.
The Department continues to provide consultant services for Dubbo, Liverpool and Bowral.
Vascular Services Vascular Surgical Services provides St Vincent’s Private Hospital with a comprehensive vascular, renal transplant and dialysis service. Offering a full range of state-of-the-art vascular and endovascular services, the Department specialises in the treatment of complex aortic, cerebrovascular and lower limb arterial reconstruction. In conjunction with the Department of Renal Medicine, plans are underway for the introduction of a private renal transplant service at St Vincent’s Private Hospital. The opening of the new Cardiac Catheter Centre at St Vincent’s Private Hospital enabled the introduction of a number
of major treatment modalities, including treatment of complex thoracoabdominal and aortoiliac aneurysms. New technologies resulted in the successful management of a recurrent thoracoabdominal aneurysm with an endovascular technique involving a chimney type thoracoabdominal endograft. The second time such an operation was successfully performed in Australia, the patient fully recovered within a four week period.
Integrated into the Department is the St Vincent’s Clinic Vascular Laboratory. Conducting 10,000 studies each year, the Laboratory supports all of the Hospital’s vascular medicine and vascular surgical patients and operates the St Vincent’s Campus vascular ultrasound service. Approximately 20 percent of the Laboratory’s workload includes studies for venous thrombosis in pre and postoperative orthopaedic patients. The appointment of a Director of Education and Research in the laboratory is set to expand the future focus of the Laboratory’s research and education.
Throughout the year the Department grew in strength with the addition of two robotic fellows at St Vincent’s Private Hospital and one at the Garvan Institute of Medical Research conducting pre-clinical work.
Valuing education, the Department accepts medical students from the University of New South Wales St Vincent’s Clinical School. The Department plans to extend outreach services to Griffith and Wagga Wagga. 85
Two weeks post-surgery John had his life back.
The balance of life
In 2001 John was diagnosed with a “Text book case of Ménière’s disease,” according to his ear, nose and throat surgeon Dr Phillip Chang. The 62-year-old Newcastle man was treated with medication and conservative inner ear surgery. The vertigo came under control and the overnight results far exceeded all expectations – giving John nine trouble free years. However, Dr Chang had warned that with the Ménière’s disease now controlled but not cured the vertigo could viciously and unpredictably return. Sure enough it did. Out of the blue in 2009 John called out to his wife, “I am going, I am going.” His vertigo was back with a vengeance. The intensity was such that John was constantly vomiting. Life as he knew it stopped and his days were now consumed with 24 hour incapacitation – John was totally bed bound. Described by Dr Chang as “The most ruthless condition of the inner ear to affect hearing and balance,” it was no surprise that John was now unable to walk around his own home and had resorted to asking those near him to “Look at me so I can lip read.” John was robbed of the ability to do anything with his nine grandchildren, leaving him and his family devastated. “Over the years Ménière’s disease has slowly but surely destroyed all hearing in John’s left ear. With the sudden return of more aggressive vertigo, more delicate but invasive surgery was required immediately,” explains Dr Chang.
This would be in the form of a two hour operation known as a labyrinthectomy. The procedure would cure John’s Ménière’s disease but would not restore the hearing lost in his left ear, only a further operation down the line would do so. A disease that is complex to manage at the best of times, John’s case was particularly challenging to treat and was regarded as exceptionally severe. Furthermore, with John’s constellation of co-morbidities his case was not straight forward – his life has been punctuated by surgery having survived a serious truck accident which resulted in the amputation of his leg and with five back operations behind him John was naturally fearful of any further surgical procedures. Searching for the optimal outcome, Dr Chang discussed this understandable reluctance to undergo further surgery with John and his family. Together, Dr Chang and his patient agreed on a way forward. Should John undergo the surgery he knew he had to have, Dr Chang would cure the Ménière’s disease with the labyrinthectomy and, at the same time, restore hearing with an implantable hearing device – all in one operation, one anaesthetic and one hospital stay.
Nine years ago, the life of grandfather John Davies went into a sudden and unpredictable downward spin – literally. Without warning everything around him started to turn. Overcome by ferocious bouts of vertigo John instantly found himself housebound. The intense sensation of spinning had the ability to strike at any time – at any stage of any given day – making him violently ill.
Two weeks post-surgery John had his life back. Not only was John cured of his condition but he was also preparing to once again experience the sensation of sound. Today John is no longer bed bound – he is no longer confined by a hidden condition that is often underestimated in its power. John is back enjoying normal family life – with nine particularly chuffed grandchildren.
Together, we will grow.
The Mater Hospital is a leading private hospital renowned for its quality care and compassion. Among the various speciality units in the 200-bed hospital are Intensive Care, two 30-bed orthopaedic wards and a large Maternity Unit.
Core specialities include obstetrics, orthopaedics (including hip and knee joint replacements, bone and sports injuries), heart, lung and vascular medicine, cancer care and surgery, ear, nose and throat surgery, urology and renal haemodialysis. The Mater has a Day Surgery Unit for endoscopy and other day surgery cases, while elective and semi-urgent surgery is performed in the Operating Suites. Allied health services at the North Sydney Campus incorporate physiotherapy, pathology, radiology, pharmacy, nutritional services, medical imaging, including Magnetic Resonance Imaging, nuclear medicine and radiation oncology. Linking patient care, clinical research and medical teaching, the opening of the Mater Clinic heralded a phase of growth and development on the Mater Campus. The Hospital maintains close affiliations with the University of Sydney as well as several other tertiary institutions for medical, nursing and allied health education. It conducts a wide range of research projects, particularly in the area of cancer. In line with the Mission and Values of the Sisters of Mercy and the Sisters of Charity, the Mater is involved in several community programs to help the disadvantaged. Much of its work is made possible by the continued support of The Friends of the Mater Foundation, The Mater Lives Committee, the Mercy Foundation and other community groups and individuals.
Established by the Sisters of Mercy in North Sydney in 1906, the Mater Hospital merged with St Vincent’s Hospital, Sacred Heart and St Vincent’s Private Hospital in 2001 to form St Vincents & Mater Health Sydney (SV&MHS).
a year in review 2009 was a landmark year for the Mater Hospital, with the development and completion of several major projects to further enhance the delivery of healthcare services for patients.
The ongoing development of the Melanoma Institute Australia and its relationship with the Mater Hospital has resulted in the establishment of neurosurgery services at the Hospital.
The Mater has undergone a major capital works program, culminating in the opening of the long awaited Mater Clinic by the Governor of NSW, Her Excellency Professor Marie Bashir AC CVO, in August. The Mater Clinic, located on Gillies Street, includes orthopaedic, obstetric and cardiology consulting suites, three day surgical theatres, two research areas, pathology services and houses an additional 143 car parking spaces. Today more than fifty specialists consult in the Clinic.
Throughout 2009 significant departments within the Hospital were relocated to enable the establishment of a new ward. Following conversion of the former executive administration wing on the Hospitalâ€™s first floor, a 14-bed inpatient orthopaedic rehabilitation ward was created. Opened in July 2009, the ward is known as the JM Agnew Wing.
The establishment of the Poche Centre, aptly named to recognise the generosity of Mr Greg Poche, reinforces the St Vincents & Mater Health Sydney commitment to research. The Centre will incorporate the Melanoma Institute Australia, specialist consulting rooms, together with research and teaching facilities and 117 car parking spaces. The anticipated completion date is January 2010 with the official opening in March 2010. Melanoma is the most common form of cancer in individuals aged between 15 and 39 in Australia. Establishment of the Melanoma Institute Australia, within the Poche Centre, signals a new era in Australiaâ€™s ability to progress research, education and treatment of melanoma. In association with St Vincents & Mater Health Sydney, the Melanoma Institute Australia will minimise the devastating impact of melanoma on national and international communities.
In honour of Sr Josephine Mary Agnew RSM OAM, the naming of the wing acknowledges her lifelong service to the Mater, in particular her contribution and dedication to surgical nursing, palliative care and pastoral care. The Mater and Fresenius Medical Care, a major provider of renal dialysis services, developed a partnership for the provision of renal dialysis to Mater patients. As a result, the service expanded in February by increasing capacity by six chairs to 16. To accommodate this growth, the Renal Unit relocated to 272 Pacific Highway, Crows Nest. Mater Imaging doubled its overall area on the Hospitalâ€™s lower ground floor and expanded its services in readiness for increased demand generated by the Mater Clinic. The enhanced service boasts state-of-the-art diagnostic equipment, including digitalised reporting and a picture archiving and communications system. In addition, there are individual areas for both inpatients and outpatients.
Together, we lead the way.
In consultation with all clinical departments, the Mater undertook a major clinical governance review in 2009.
Set to continue the refurbishment of the entrance foyer and coffee shop areas, the Mater is creating an innovative garden concept, known as the ‘Healing Garden.’ The garden will maximise utilisation of the walkway located to the rear of the coffee shop and the large courtyard area adjacent to the car park. Designed by renowned garden designer Peter Fudge, the proposed area will encompass a prominent water feature, paved walkways, garden seating and extensive plants and shrubs. Anticipated completion date is March 2010.
In July partnership with the Northern Beaches Area Health Service provided registrar coverage to the Intensive Care Unit on a rotational basis. This has further enhanced consistency in the quality of care.
Facilitating an increased volume of traffic with the opening of the Mater Clinic, the Hospital widened the driveway at its entrance and upgraded signage. A fully automated parking system was installed with boom gates at the entrance to the upper deck of the car park. The increased number of parking spaces at the Mater Clinic, together with the automated parking has improved the flow of traffic entering and exiting the Hospital.
The Mater commenced planning for a comprehensive and integrated approach to Day of Surgery Admission (DOSA) including the establishment of a purpose designed area with appropriate staffing and equipment. The result will be an increase in DOSA and improved bed availability within the Hospital. Reconfiguration of the current day procedures centre is being investigated to accommodate this increase.
Following an organisational wide survey with the Australian Council on Healthcare Standards (ACHS) in June, the Hospital received full four year accreditation. The Mater received excellent feedback on the quality of services and identified a strong culture of safety and risk management. The surveyors were particularly impressed with the recently implemented clinical governance structure, which further supports the clinical risk management framework.
The Hospital’s main foyer underwent a major facelift, with the relocation of the reception desk, florist and coffee shop. To complement the new décor, stone flooring was laid and new ceiling lighting installed. An added feature, the original leaded glass window from the Mater General Hospital was restored and installed above the entrance to the Hospital’s chapel. For many decades the window was a prominent feature above the doors of the General Hospital’s main entrance. The project was made possible with the financial support of The Mater Lives Committee and the Mater Graduate Nurses Association.
Continuing the Mission of the Sisters of Mercy and Sisters of Charity, the Mater extends its hand to many families in remote rural areas of north-west NSW. A highly successful two day women’s health workshop was held in Lightning Ridge in June 2009.
From big hearts to big smiles
Before the sun rises two extraordinary men prepare for the day ahead. Showing a unique breed of dedication, John Chu and Denis Morris wake, while Sydney still sleeps, and make their way to the Mater. Without pay or fanfare the two veteran volunteers, John and Denis, set about their rounds of the Hospital, visiting each and every patient to deliver newspapers. Within three hours the ‘paper men’ call into 180 patients. In order to provide a seven day service they carefully plan and coordinate their roster days. Should either John or Denis be unavailable the other will cover, ensuring patients never miss out on the delivery of newspapers. “We are here for the people, the patients, and won’t let the Hospital down. If I am sick I ring John at 5 am and ask him to cover and if John can’t do it I will cover for him,” says Denis.
Integral to the Mater, John and Denis work together as a team clocking up around 30 hours a week. Both there out of the eagerness to support the patients, Denis explains simply “You say good morning, crack a joke and then you go. I want to leave the patient with a smile on their face.” The ex National Serviceman knows people from across NSW and finds the question “Where are you from?” as a great conversation starter. A veteran, volunteering at the Mater 13 years, John originally felt compelled to contribute to the Hospital in a meaningful way after being struck by the quality of care during his time as a Mater patient, “I wanted to go to the Mater because of what the staff had done for me.” As John spent more time volunteering he evolved into the role and started to learn more. These days though, John views his volunteering as more of a two
way street, as he feels an innate sense of healing when he’s there, even when he arrives feeling under the weather, “As soon as I walk into that place I am OK.” “John and Denis are just two of the inspirational band of volunteers who work across St Vincents & Mater Health Sydney (SV&MHS). Their big hearts, endless compassion and contribution to our community go a long way in supporting and extending the work of SV&MHS. Without the devotion of our volunteers, our facilities would simply not be what they are today,” states Mark Hales, Director of Mission and Corporate Relations, SV&MHS.
john & denis
“We are here for the people, the patients, and won’t let the Hospital down.”
Together, we journey.
Angiography The Angiography Suite provides cardiac and vascular diagnostic and interventional procedures as well as cardiac electrophysiology studies. As part of the cardiovascular emergency service and in conjunction with the Intensive Care Unit, the Suite provides 24 hour specialised care to patients with urgent cardiovascular problems. In 2009 the Angiography Suite underwent significant redevelopment, which included the installation of new equipment and sophisticated technology for the real time three dimensional imaging for complex electrophysiology. The first case in the new Suite will be undertaken in February 2010.
Day Surgery and Endoscopy The purpose built Department cares for patients undergoing elective day surgery and overnight procedures. 2009 witnessed an increase in the number of patients admitted on the day of surgery, with monthly day surgery admissions averaging at 422. In line with this increase the Department commenced planning for a comprehensive and integrated approach for day of surgery admissions. The concept includes a purpose designed area to facilitate an increase in day of surgery admissions and improve bed availability throughout the Hospital.
The number of endoscopy procedures performed by the Department increased by 16.5 percent in 2009, this increase is relative to the projected figures given for the implementation of the National Bowel Cancer Screening Program.
General Surgical/Medical Two Wards at the Mater Hospital provide services for all general surgical and medical patients. McAuley Ward collaborates with breast and palliative care nurses at the Patricia Ritchie Centre for Cancer Care and Research and, when the need arises, McQuion Ward cares for paediatric patients.
Intensive Care Unit The Intensive Care Unit continues to provide high quality and compassionate care for critically ill patients at the Mater Hospital. Supporting all specialties throughout the Hospital, the Unit recently commenced provision of post-operative care for neurosurgery patients having undergone craniotomy, a new service of the Mater Hospital. Throughout the year the Intensive Care Unit and its patients continued to benefit from installation of the Prisma Flex machine as generously supported by The Friends of the Mater Foundation. The machine enables the Unit to perform specialised renal replacement therapy for critically ill patients.
Working with all areas of the Hospital, the Unit operates an Acute Chest Pain Hotline for improved patient throughput and data collection.
Operating Suite The Nolan Operating Suite consists of nine operating theatres and is staffed by a multidisciplinary team of peri-operative registered and enrolled nurses with expertise in anaesthetic, scrub and recovery roles. In 2009 14,120 elective and emergency procedures were performed, representing a 3.4 percent increase on patient throughput in 2008. The Suite continues to specialise in orthopaedics with 1,759 procedures performed in 2009, an increase of 6.5 percent. The purchase of a Leica M720 OH5 surgical microscope, image guided surgical software for cranial and spinal procedures, an Ultrasonic Aspirator System and a variety of specialised instruments enabled the Suite to expand its services to neurosurgery, including complex spinal surgery. Since September 10 craniotomy surgical procedures were preformed.
Collaborating with the Mater, St Vincent’s Private and St Vincent’s Hospitals, the Suite engaged in a peri-operative ulcer prevention research program. Results will be published in 2010.
specialities Orthopaedics Operating one of the Southern Hemisphere’s busiest orthopaedic departments, the Mater performs over 1,600 joint replacement procedures each year. Main activities include hip, knee and shoulder joint replacements as well as spinal and ankle surgery.
Cancer Care The Patricia Ritchie Centre for Cancer Care and Research houses a busy clinical chemotherapy service, research office and multidisciplinary teams in breast, gynaecology as well as head and neck cancer. These services are closely linked to surgical, radiation oncology and diagnostic services within the Hospital and many Mater clinicians have academic appointments at the University of Sydney. The purchase of Claverton, an adjoining federation house on the Mater Campus, enhanced the Centre’s services with additional space for chemotherapy treatment and clinical trial programs. A generous donation from The Friends of the Mater made the acquisition of Claverton possible. In partnership with Northern Sydney and Central Coast Health, the Centre’s activities now encompass the Community Palliative Care Service at Greenwich Hospital. Serving the community through excellence, research is a key component of the Centre’s work. Throughout 2009 the Centre successfully attained numerous grants including a $153,000 grant from the Australian Health Research Institute to assess optimisation of recovery after breast cancer treatment. The Centre cared for 380 new breast cancer patients in 2009.
Heart, Lung and Vascular Services Hutchinson Ward provides the Mater with its core heart, lung and vascular services. In 2009 the Ward upgraded seven beds to level one intensive care beds for high dependency and cardiac care patients. The net result has been to significantly alleviate the demand for high care beds in the Intensive Care Unit.
Maternity Unit Offering a terrific start to life, the Mater’s Maternity Unit is renowned for quality of care. The Unit comprises six delivery suites, a 10-bed special care nursery and 38 antenatal/postnatal beds. Throughout 2009 the Unit continued to experience high demand with September 2009 presenting a record number of babies born since the Unit’s opening in 1991. 240 babies were born including three sets of twins. The high number of births necessitated extensive planning, registered nurses and enrolled nurses from orthopaedic and surgical wards engaged with the midwives to help accommodate this increase in demand. With an emphasis on education, parenting programs are conducted by a multidisciplinary team of midwives, mothercraft nurses, social workers, lactation experts and home visit midwives. The Mater offers classes in early pregnancy, labour and birth, parenting groups and pregnancy after loss support.
Building upon its excellent service and reputation throughout 2009, the Department consists of a pre-admission clinic, 61-bed acute surgical ward, 14-bed inpatient orthopaedic rehabilitation ward and an ambulatory day rehabilitation centre. The opening of a 14-bed inpatient orthopaedic rehabilitation ward in July 2009 now affords patients the opportunity to continue recovery from orthopaedic surgery as an inpatient. Called the JM Agnew Wing, the ward honours Sr Josephine Mary Agnew’s lifelong service to the Mater Hospital. The Mater Day Therapy Unit continues to increase outpatient rehabilitation treatments.
Mater Orthopaedic Day Surgery The Mater Orthopaedic Day Surgery (MODS) caters for sports injuries and minor orthopaedic procedures. Offering the best quality care and expertise, MODS upholds the core Values of St Vincents & Mater Health Sydney. Situated in the Mater Clinic and opened in July 2009, MODS consists of three state-of-the-art operating theatres with the latest in arthroscopic imaging equipment and incorporates a comprehensive pre-admission assessment, pre-operative review, efficient recovery and comfortable discharge areas as well as a post operative call and support service. Purpose built, patient flow from surgery to Hospital has been greatly enhanced with the close proximity of North Sydney Orthopaedics and Sports Medicine Centre and MODS.
Central Sterilising The Department is responsible for the sterilisation and reprocessing of reusable surgical instruments and trays in the operating theatres, wards and delivery suites. July 2009 saw a record with the Department sterilising some 1,470 kits, this compares to the monthly average of 540. This increase was significantly due to the opening of the Mater Orthopaedic Day Surgery theatres. A first in NSW, Central Sterilising purchased a STERRAD 100 Steriliser, with advanced technology the steriliser provides a faster turnaround time. In addition, the purchase of two new steam sterilisers doubled the Department’s capacity from eight instrument trays to 16 per load.
Mater Imaging 2009 was a monumental year for Mater Imaging, relocation and extensive renovations resulted in the provision of a comprehensive radiology service for the Mater Hospital, Mater Clinic and the Poche Centre. Mater Imaging now features two state-of-the-art digital x-ray rooms which reduce radiation dose and increase image quality, five ultrasound rooms along with computed tomography (CT), magnetic resonance (MR), fluoroscopy, orthopantogram (OPG) and osteodensitometry.
Designed to streamline inpatients and outpatients, the Department delivers images and reports electronically to referrers. The picture archiving and communication service is available throughout the Hospital. Thus, inpatient images are immediately available for clinician review. With international advances in breast MR imaging and MR guided breast biopsy; the Department will introduce computer aided diagnostic software to perform breast MRI procedures on MRI scanners in early 2010. This ground breaking technology will assist in the diagnosis of high risk patients and enable breast biopsy of suspected lesions that are traditionally not well visualised through other modalities.
Food and Nutrition Services Food Services support all the nutritional needs of patients, visitors and staff through the daily provision of approximately 500 meals. The Department is also responsible for nutrition education, advice and counselling for both patients and staff. Twice a year the Department undertakes audits to ensure maintenance of HACCP Australia Food Safety Accreditation.
LinkAGE LinkAGE is a community service program that provides trained volunteers to visit elderly, socially isolated residents in 50 aged
care homes across Sydney. Volunteers receive ongoing training and support from program coordinators based at the Mater Hospital. Celebrating its 10th anniversary, the LinkAGE program has gone from strength to strength. In 2009 25 new volunteers were recruited and trained, six new aged care homes joined the program and four volunteer support meetings were held with a record attendance of 43 at one. This year alone LinkAGE volunteers provided over 4,000 hours of caring companionship.
Volunteers Volunteers continue to provide the Mater with invaluable service and support. Throughout 2009 135 volunteers supported the Hospital and collectively worked an estimated 15,420 hours. Providing the Hospital with an important range of services, some of the many volunteer roles include reception desk activities, delivery of papers and magazines and patient escort duties. Appropriately trained volunteers assist Pastoral Services as Minsters of Communion. At the Renal Unit volunteers massage the hands and feet of patients and in the pharmacy volunteers assist staff in serving customers.
In the Maternity Unit volunteers deliver birth registration papers and ‘Marty Bear,’ a gift from the Hospital, to all new mothers. In 2009 assistance to the Unit increased to over 40 hours per week. 97
emily Mum gets
As Emily Barnier jumped up to contest the ball, her dreams came crushing down. Watching on the sidelines was Emily’s Dad who knew there and then that things were serious. At just 15 the elite netball player had torn a ligament in her left knee, her anterior cruciate ligament (ACL), an injury that coincidently her brother Nick sustained two years prior. With two treatment options; Emily knew that the non-surgical option would shatter her dream of one day representing Australia on the court, as she wouldn’t be able to regain the pivoting and twisting motion so critical to her promising netball career. Following the success of Nick’s recovery the decision was made for Emily to follow the same path. Emily’s ACL would be reconstructed by Dr Leo Pinczewski at the Mater Hospital and her mother, Lisa, would donate tendon for the procedure. Not unusual, the donation of tendon is often used for ACL reconstruction in younger patients, as their tendons are small. In addition, donation speeds up the recovery process.
Within a month Emily and Lisa made the journey from Woy Woy to the all new Mater Clinic and both mother and daughter were admitted for the day procedure. “Emily benefited in knowing that Nick had gone through it before,” explains Lisa. Under full anaesthetic Dr Pinczewski operated on both Emily and Lisa with mother and daughter returning home later that afternoon. Within a week Emily was back in school and, due to the physical nature of her occupation, Lisa returned to work within three weeks. Good timing, Emily’s six month recovery period did not impact on her love for netball – the injury was sustained at the end of the netball season. Six months post surgery Emily was back on the netball court training, just in time for the start of the season. For Emily her return to the netball court felt like a home coming.
mily’s six month recovery period did E not impact on her love for netball.
Together, we respect.
St Joseph’s Hospital Founded by the Sisters of Charity in 1886, St Joseph’s Hospital is today an 81-bed facility. The Hospital provides specialist services to support sick and aged residents in the Auburn area and the wider community of western Sydney. Offering services to both inpatients and outpatients, the Hospital’s core activities are rehabilitation, palliative care, aged care and aged care psychiatry.
a year in review Reaffirming its commitment to the delivery of quality healthcare, St Joseph’s Hospital scored 90.6 percent in the Occupational Health and Safety Injury Management Profile (OHS&IM Profile). A significant achievement, the revised and more complex OHS&IM Profile was carried out by three auditors over a two day period. A NSW Health mandate, the biannual Profile provided managers with a standardised audit tool for assessing performance in various essential aspects of occupational health and safety and injury management. A year of achievements, the Pets of Older People (POOPs) program received a NSW Seniors Week Achievement Award. The program attends to the healthcare of pets owned by seniors who are admitted to hospital. The award highlighted the program’s excellence in targeting older people with chronic illness, whilst also acknowledging the dedication of program coordinator Kath Gazzard.
Following the Clinical Excellence Commission’s survey of all health facilities in 2007 two sites were selected for the follow up verification within Sydney West Area Health Service. St Joseph’s Hospital was one of the two selected facilities for the Quality Systems Assessment. Quality Systems Assessment verification incorporated a review of the processes and documents quoted as evidence in the 2007/2008 activity statements as well as activity verification on infection control, hand hygiene, death review, morbidity and mortality, peer review meetings and correct patient/site/procedure. The overall findings were positive with a draft report suggesting various opportunities for improvement was supplied to the Hospital’s executive. Throughout the year staff completed a similar online survey which will be followed up by the Clinical Excellence Commission in 2010.
In 2009 St Joseph’s Hospital formed a partnership with The Order of Malta, a Catholic charitable organisation that provides medical, social care and humanitarian aid to those in need. Supporting St Vincent’s Health Australia palliative care services in Queensland and Victoria, the Order is set to extend its generosity to palliative care services at St Joseph’s Hospital.
St Joseph’s Hospital continues to support the undergraduate and postgraduate education of medical, nursing and allied health students and in partnership with the Australian Catholic University, Charles Sturt University, Macquarie University, the University of Newcastle, the University of New South Wales, the University of Sydney and University of Western Sydney provides clinical placements.
The 10th anniversary of the Auburn Carers’ Support Group was celebrated in August. Supporting carers the group was established by the Aged Care Assessment Team as a direct response to the withdrawal of local services. The celebratory lunch marked the importance of this support group and was attended by carers from the program and representatives from other support groups.
As 2009 came to a close, St Joseph’s Hospital looked towards the future and engaged with Sydney West Area Health Service to plan for service developments.
St Joseph’s Hospital was integrated into St Vincents & Mater Health Sydney in March 2005 and operates as part of the Sydney West Area Health Service. In line with the Mission and Values of the Sisters of Charity, St Joseph’s Hospital makes a significant contribution to the community through the provision of comprehensive services including outpatient clinics, aged care assessment services, support groups and outreach programs.
Aged Care Assessment and Rehabilitation Unit
The Unit continues to help patients achieve their maximum possible function and independence through rehabilitation. The average patient age is 83 and patients suffer from a range of disabilities resulting from conditions such as stroke, dementia, Parkinsonâ€™s disease, fractures, falls and hip and knee revisions.
The Department offers neuropsychological assessment for diagnosis and development of rehabilitation plans, behaviour management and the provision of feedback and education regarding dementia and acquired brain injury to patients and their families.
In 2009 acute episodes represented the largest patient category and reflected an increase in the complexity of patients treated by the Unit. This year initiatives included combined occupational therapy and physiotherapy exercise, an increased number of walk and lap belts and a falls management program which has resulted in reduced patient falls.
Aged Care Psychiatry and Neuroscience Unit Caring for both inpatients and outpatients, the Unit engages in the assessment and treatment of older peopleâ€™s mental health. The purpose built Catherine Mahoney Unit is a 19-bed ward that supports people in the community with a mental illness and/or dementia through home visits and an outpatient clinic. In 2009 the Unit participated in NSW benchmarking of mental health services for older people, received accreditation following EQUIP assessment and contributed to the clinical review of inpatient services. Installation of videoconferencing equipment has enabled the Unit to frequently participate in education sessions, teleconferences and Guardianship Tribunal hearings. Requiring maximum resources, the Unit continues to manage complex and difficult cases of behavioural and psychological symptoms of dementia.
In 2009 the Department purchased evidence based psychological instruments and strengthened alliances with the Sydney West Area Health Service Health Care Interpreter Service, a service that assists linguistically diverse demographics to access healthcare. The student neuropsychological clinical program underwent further development and a number of presentations were made to external agencies.
Medical Rehabilitation Unit The Medical Rehabilitation Unit (MRU) is a dedicated 20-bed medical rehabilitation ward. Caring for people aged 16 to 70 the Unit encompasses inpatient and outpatient models of care and provides two speciality services; the Motor Neurone Disease Multidisciplinary Service and the Spasticity Clinic. In 2009 the Unit reviewed the patient discharge and transfer process, set up a walking program to improve patient mobility and established a pilot patient leisure and activity group. The Unitâ€™s services continue to grow. Dr Shea Morrison was appointed Director of Rehabilitation Medicine and Dr Veena Raykar was welcomed as Rehabilitation Medicine Consultant.
Valuing education, the Unit continues to provide ongoing staff education and participates in the provision of clinical placements for medical, nursing and allied health students. The Unit also contributes to a data collection project with the Australian Motor Neurone Disease Registry.
Occupational Therapy and Diversional Therapy Service
Palliative Care Unit A core speciality at St Joseph’s Hospital, the Palliative Care Unit comprises a 22-bed inpatient unit, a day hospital, an outpatient clinic and an outreach medical service that caters for the palliative care needs of western Sydney. Patients are admitted to the Unit for symptom management, respite care or terminal care. The Unit adopts a multidisciplinary approach and aims to achieve the best possible quality of life for patients and their families.
The Department supports patients in rehabilitation, aged care assessment, palliative care, aged care psychiatry and the community through the provision therapeutic services to assist in recovery .
In 2009 the Unit collaborated with the Order of Malta to provide support and resources for palliative care patients and the Social Work Department collaborated with Calvary Hospital Kogarah in the study of younger patients requiring palliative care who are referred for nursing home placement.
Occupational Therapy (OT) services comprise assessment of disabilities and re-training in the areas of daily activity tasks and driving. The Department also provides education for OT students.
The Diversional Therapy Service promotes self-esteem and enhances participation in social and recreational activities through the provision of group activities for elderly former patients and those who have a mental illness or behavioural disorder.
Providing services to medical and aged care rehabilitation, palliative care and aged care psychiatry, the Department treats patients with a variety of conditions including neurological disorders, orthopaedic conditions and those who are de-conditioned. Services are offered to both inpatients and outpatients.
Throughout 2009 the Department developed evidence based practice guidelines and resources which resulted in the formulation of sensation training workshops for stroke patients, the management of shoulder pain and insight intervention and re-established the upper limb therapy group and upper limb resource development.
Throughout 2009 the Department focused on development of a ‘goal menu’ to assist patients in establishing physiotherapy goals. Evidence based practice in the areas of fall and stroke rehabilitation continue to be emphasised.
Together, we are compassionate.
therese A different voice
A nerve based disease, MND disables the muscles used for movement, breathing, speech and swallowing. In most cases MND does not affect cognition, memory or the senses and it follows no set pattern – symptoms and progression vary from person to person. In many cases such as Therese’s its cause is unknown and there is no cure. At just 26 Therese’s diagnoses was made on 24 June 2006. Life for the Aoun family was to change forever.
Introduced to the MND team at St Joseph’s Hospital, the multidisciplinary team were to become a big part of Therese’s life. Familiarising Therese with a range of equipment to assist in everyday living, including a computer system called SmartNav, the Speech Pathology and Occupational Therapy Departments at St Joseph’s Hospital set about giving Therese as much independence as possible. A lifeline, SmartNav efficiently provided Therese with a voice. Wheelchair bound and unable to speak SmartNav relies on head movement and enabled Therese to once again share her thoughts and opinions, her needs and her wants. Therese and her sisters, Zakhia and Raymonda, engaged in lengthy conversations, with Therese using SmartNav to type sentences on to the screen. Unable to answer the phone, Therese’s sister-in-law would ring, leave a voicemail and Therese would respond via SMS sent by SmartNav.
Along with her computer system, a laser head pointer attached to a hat enabled Therese to do what were some of the simplest tasks before life with MND. If she had an itch Therese would point the laser beam to ‘scratch’ on a special word board. A respite nurse would take Therese out shopping, giving her the freedom to choose her own purchases pointing the laser beam to her favourite item on the railing. Living at home with her mother and two sisters Therese’s condition has deteriorated. Therese can no longer use the laser head pointer or SmartNav system. However, today Therese uses a blink system, one blink means ‘yes’ and two half blinks ‘I love you.’ Between Therese’s smile and blinks you can see her positive spirit which has been simply inspirational to her family. Set to keep that spirit going, the team at St Joseph’s Hospital are confident of delivering a new system to once again give Therese a voice.
Therese Aoun described it as “the simultaneous end and the beginning of my life.”
It started with a tingling sensation in Therese’s left arm. The symptoms progressed, robbing Therese of her ability to walk, her ability to talk – her ability to do everyday tasks. Diagnosed with Motor Neurone Disease (MND), Therese Aoun described it as the “Simultaneous end and the beginning of my life.”
clinical support services Aged Care Assessment Team The Aged Care Assessment Team (ACAT) comprehensively assesses the overall care needs of the older population in the Auburn area and assists these individuals to gain access to the most appropriate services. ACAT’s primary focus is to enable older people – where appropriate – to remain independent for as long as possible in their own homes. The multidisciplinary team comprises medical, nursing, social work, occupational therapy, physiotherapy and administrative staff and in 2009 ACAT received 761 referrals. During the course of the year, an electronic aged care client record was introduced – a major inroad in care processing. Approvals for Commonwealth funded care and programs are now submitted electronically to Medicare, the necessary technology was supported by Commonwealth funding. ACAT has been involved in Sydney West Area Heath Service’s structural reform plan stemming from the Council of Australian Governments Long Stay Older Person Initiative.
Auburn Campus Mission Comprising Mission, pastoral and volunteer services, staff counselling and Hospital
Auxiliary, the Mission Directorate at the Auburn Campus caters for the needs of St Joseph’s Hospital and St Joseph’s Village. Throughout 2009 40 volunteers provided the campus with 9,750 hours of service and the vital role of volunteers was highlighted with the creation of a weekend volunteering project. The Campus welcomed Fr Isaac Koi msc as Pastoral Service and Catholic Chaplain and the pastoral services team were granted an educational scholarship with Dr Alex Nelson. Working with the wider community, a Christmas giving program was coordinated for the disadvantaged. St Joseph’s Hospital hosted St Vincent de Paul housing forums for refugees, with more than 100 people attending two sessions. A winter appeal for Sacred Heart Homeless Heart Community was established with an overwhelming response from staff.
Pharmacy The Department caters for the medication needs of every patient at St Joseph’s Hospital; this includes purchasing, dispensing and distribution of pharmaceuticals. A number of quality based activities were driven throughout 2009 including a new pharmacy refrigerator monitoring system and a review of ward resuscitation trays.
Social Work Social Work provides psychosocial assessments, counselling, practical assistance and home visits for inpatients, outpatients and the wider community. In 2009 the Department continued to facilitate placements for students from the Australian Catholic University. A new professional award enabled the appointment of a Deputy Senior Social Worker and the re-grading of some social workers.
Speech Pathology Comprehensive speech pathology services are provided to inpatients and outpatients referred through Medical and Aged Care Rehabilitation Services. Core activities focus on assessment and management of communication, swallowing disorders and education of patients, carers and other health professionals. The Department’s endeavours in supporting those with motor neurone disease continues to grow. The Department contributes to the clinical education of speech pathology students from the University of Sydney and Macquarie University.
administrative services Catering and Dietetics Catering and dietetics meets the nutritional needs of patients and staff through the daily provision of approximately 300 meals. The Department is also responsible for nutrition education and counselling for both patients and staff. In 2009 the Department implemented the NSW Food Authority’s food safety program, which includes regular audits and ongoing staff education. Ninety percent of catering staff are participating in a two year Certificate III in Hospitality Operation and will graduate in March 2010.
Health Information and Records Service The Department provides the Hospital with an efficient and effective health information and record management service. Core activities include the management, maintenance, secure storage and retrieval of healthcare records, clinical coding of patient episodes, data quality, maintenance of the patient administration system, statistics reporting and provision of information for medico-legal and research purposes.
In 2009 the Department contributed to Sydney West Area Health Service discussions relating to the implementation of electronic medical records.
Quality Management The Quality Management Department oversees patient safety and quality activities. The Department is responsible for maintaining the Australian Council of Healthcare Standards accreditation and Quality Systems Assessment (QSA) compliance. Continually striving for best practice in patient care, the Department monitors trends through the use of performance and clinical indicators. In 2009 a Hospital wide patient survey indicated a high degree of satisfaction with the care and services provided. The Hospital achieved 100 percent compliance in the annual QSA survey, as conducted by the Clinical Excellence Commission. In addition, a web based management program, ImproveIT, was launched in March 2009.
Risk Management and Occupational Health and Safety The Department oversees the Hospital’s risk management systems and occupational health and safety activities. Focussing on creating a culture of safety, the Department implements a range of strategies to meet requirements of the NSW Health Occupational Health Safety and Injury Management Profile, Australian Council of Healthcare Standards EQuIP accreditation as well as occupational health and safety legislation. 2009 was a year of outstanding achievements, the Hospital achieved 90.6 percent in the NSW Health Occupational Health Safety and Injury Management Profile and the NSW Health Security Continuous Improvement Program resulted in a 91.3 percent rating.
Together, we are united.
No ordinary home
The home of Fr. Isaac Koi McDonald is no ordinary home – it really is a community. With open doors the St Joseph’s Campus Chaplain’s house is, in fact, the Sacred Heart Community. Established by Fr. Isaac, the Sacred Heart Community brings humanity to life – it is a refuge for those who are broken due to homelessness and/or drug and alcohol dependency. Housing up to six men at any one time and sometimes feeding up to 20 people the community is dependant on the generosity of others – it was the St Joseph’s Campus winter appeal that sustained the Sacred Heart Community for much of the cold months of 2009. Established in 1996 and located in Hurstville, Fr. Isaac describes how the community “Provides a place where individuals are accepted and where humanity can heal itself.” Believing every heart is sacred he furthers “Simply being with people in this world makes us feel special. Simply being with them heals.”
A sacred place, the Community is unique. Indeed the Sacred Heart Community works with similar organisations to feed, cloth and shelter the many people in need of the service. With open doors, those in need of shelter are invited to stay for as long as they need. Permanent and transient, the residents become part of the Community and learn basic life skills – all doing their bit to help with household chores, washing, ironing and cooking. Located in a residential area, Fr. Isaac recalls how neighbours describe the diversity of the community as the “United Nations – we welcome all.” Mission Integration Manager at the St Joseph’s Campus, Marie Wetherall, explains “the winter appeal for the Sacred Heart Community is central to our Mission and highlights our commitment to works
of charity. The generosity of staff and volunteers from across the St Joseph’s Campus has made a huge difference to the community that Fr. Isaac cares for. Clothing, household linen, gloves and beanies were generously provided.” Restoring faith in life, it is the combined work of Fr. Isaac and the many supporters, such as the St Joseph’s campus, that keep the doors open. Fr. Isaac concludes, “Every month it just happens, through the generosity of others we can afford to keep our community going.”
“Every month it just happens, through the generosity of others we can afford to keep our community going.”
Together, we laugh.
St Joseph’s Village
a year in review Set to meet the challenges posed by an ageing population, 2009 saw the re-development of Carinya, the Village’s dementia specific unit. Now located to the rear of the Hostel, the number of dementia specific beds has expanded from 10 to 18. Anticipated completion date is March 2010. With the completion of the Carinya re-development, phase two renovations will commence. The second stage will see the transformation of a section of the Hostel into a 10-bed high care unit. Anticipated completion date is September 2010. The two stage re-development is a major objective for residents and their families. Subject to vacancies, residents may be transferred from their current apartment to the high care unit as their care needs become increasingly complex. In May 2009 St Joseph’s Village succeeded in receiving accreditation for a further three years from the Aged Care Standards and Accreditation Agency. The site audit indicated compliance across all 44 expected outcomes. The Village successfully underwent Fire Certification Inspection and also received an A rating in a food safety audit carried out by the NSW Food Authority. A new Deputy Director of Nursing was welcomed as overall Clinical Manager of the Hostel and self care residents, whilst an outside contractor was engaged to undertake policy development and quality reporting.
St Joseph’s Village offers a range of activities to entertain residents, engender a sense of belonging and create an environment of friendship and support. Residents enjoy daily exercises, games and quizzes as well as weekly sing-a-longs, happy hours, bowls and shuffleboard. Special days are celebrated and entertainers visit regularly.
Headed by the Deputy Director of Nursing, care staff assist residents with their personal care needs. With an emphasis on treating residents with dignity care staff take time to listen to residents, ensure their individual needs are met and offer constant reassurance.
Following feedback from residents weekend activities commenced in February 2009. This year an additional activity carer visited isolated residents for one-on-one support. The activity area was extended in February 2009 and a Nintendo Wii console was purchased, enabling residents unable to walk around a golf course to have a virtual golf experience. Also in the activity area, karaoke CDs designed for aged care, with slower and larger subtitles, were purchased to ensure residents continue to enjoy songs from their era.
Carinya Dementia Specific Unit A dedicated team of care staff support residents with dementia at Carinya, a dementia specific unit with a home like atmosphere. Specifically designed for Carinya residents, the Auburn Campus pastoral care program supports residents and nourishes their spiritual life through a range of strategies and resources, including memory box, prayer, music and spiritual reminiscence.
Finance Despite the introduction of the Aged Care Funding Instrument (ACFI) in March 2008, this year, St Joseph’s Village retained funding levels for current residents and brought new residents into a viable category of care for Village operations. A major achievement in 2009 was implementation of the people point system for the financial management of the resident debtors’ accounts. Compliant with ACFI changes in the Commonwealth funding system, the Village looks forward to implementing the care plan component of the software in 2010.
A residential aged care facility, St Joseph’s Village is collocated with St Joseph’s Hospital on the Auburn Campus. The Village comprises a 10-bed dementia specific unit known as Carinya, 27 self care apartments, 80 hostel beds for low care residents and 35 community aged care packages. The facility works collaboratively with St Joseph’s Hospital and is part of the residential aged care services provided by St Vincent’s Health Australia.
St Joseph’s Village Outreach provides 35 community aged care packages to the elderly living in the Auburn Local Government Area. These packages consist of outreach services, including personal care, social support, transport, domestic assistance, meal preparation and lawn mowing. Packages are also provided to the financially disadvantaged with a reduced fee or free package offered. Service hours are dependent on the recipient’s care needs. 111
caring for our people Excelling in patient care, teaching and research, the facilities of St Vincents & Mater Health Sydney (SV&MHS) are underpinned by the Mission and Values of the Sisters of Charity and Sisters of Mercy. SV&MHS prides itself on offering staff, volunteers and partner organisations experiences which foster advancement and mutual respect. As a not-for-profit organisation, significant importance is placed on the delivery of compassionate care within a positive working environment – an environment that encompasses both personal and professional development. Embracing transnational experiences, SV&MHS welcomes travellers and those who wish to experience Australian healthcare. St Vincents & Mater Health Sydney has partnerships with several national and international institutions, including universities in the United Kingdom and hospitals in Asia and Ireland. Operating numerous social accountability programs SV&MHS encourages staff to actively support its Mission. In the past 12 months staff participated in numerous Mission based programs including rural workshops to assist women in isolated areas, the delivery of hamper donations to the disadvantaged and Christmas giving trees in aid of local children who are less fortunate. In addition staff from across the Organisation frequently participate in awareness and fundraising events, including the ‘Dragons Abreast Dragon Boat Hospital Challenge,’ ‘City2Surf’ and the Sydney to Wollongong cycle – ‘Gong Bike.’ The human resources team continues to play a significant role in the development and delivery of several key initiatives across a number of areas.
Dignity in the Workplace
The human resources team delivers Dignity in the Workplace; Fundamentals for Staff and Managers. The six module program provides a broad range of staff with the knowledge and skills to fulfil core organisational and legislative responsibilities.
St Vincents & Mater Health Sydney is committed to the development of global networks. Fostering a relationship model these global networks enable healthcare discovery through the sharing and creation of opportunities within healthcare systems.
The Industrial Relations team promotes an increasingly harmonious workplace and provides coaching models for managers and staff to lead the way.
Reflecting on interactions in the workplace the workshops are designed to give participants greater insight into developing harmonious work environments.
Key to the SV&MHS global alliance program is the Bangkok nursing exchange. An opportunity to observe the delivery of healthcare in an international setting, the exchange reinforces the SV&MHS commitment to excellence in patient care, teaching, research and the development of relationships with international partners. Furthermore the Bangkok nursing exchange provides a number of staff with the opportunity to further their professional development.
Electronic Recruitment In November 2008 an integrated recruitment website and online job board was established. Customised to the specific needs of SV&MHS, the electronic recruitment system provides a more efficient and transparent recruitment process and creates opportunities to connect in a global environment. Since introduction of the online system and integrated employer brand strategy there has seen a significant increase in traffic to the site, www.careersatsvmhs.com.au, and to date more than 8,200 applications have been received.
In 2009 four senior nurses from across SV&MHS traveled to Bangkok as part of a three week program. The exchange facilitated the crossing of cultural boundaries, the collaborative sharing of knowledge and strengthened research practices. Ultimately the exchange enables the development of programs that make a real difference in the delivery of quality healthcare.
Throughout 2009 four separate enterprise agreements were successfully negotiated for nursing and support staff at St Vincent’s Private Hospital and the Mater Hospital. The agreements delivered a range of positive changes including salary increases and a re-vamped competency progression program at the Mater Hospital. Both Mater Hospital agreements were, for the first time, registered under the Federal Government’s Fair Work Act.
Safety Audit The NSW Health Occupational Health and Safety Injury Management Profile (OH&S IM Profile) measures the performance of healthcare organisations in the areas of occupational, health, safety and rehabilitation activities.
Together, we strive.
Human Resource Systems Throughout 2009 significant focus was placed on implementation of an integrated approach to payroll, human resource information systems and rostering. Set to go live in 2010, the system will result in greater operational and reporting capability in the roster management and payment of employees at St Vincent’s Hospital. At a group wide level the human resources team commenced development of an electronic performance management system. The system will incorporate internal policies, promote the development of best practice whilst also communicating generic, clinical, specialist and management competencies and key performance indicators.
Vocational Education Committed to the ongoing professional development of all staff across SV&MHS, more than 90 staff, from a range of support services, successfully completed Certificate III in Health Support Services. The certificate focuses on a range of core issues associated with healthcare including infection control, occupational health and safety and the development of positive workplace relationships.
Weight Watchers at Work In 2009 employees across the St Vincent’s Campus shed a combined weight of 657 kilograms which resulted in SV&MHS being awarded the title of Weight Watchers Healthy Life Workplace of the Year.
Weight Watchers at Work and other such programs benefit both SV&MHS and employees. Results to date indicate increased activity, a decline in absenteeism and improved job satisfaction for many.
WorkCover NSW SafeWork Awards Recognised for its commitment to safety, SV&MHS was a finalist in the WorkCover NSW SafeWork Awards, in the category of best workplace health and safety management system – public sector and not-for-profit.
In 2009 St Vincent’s Hospital and St Vincent’s Private Hospital achieved scores of 77 percent and 80 percent respectively, both rating well above the South Eastern Sydney and Illawarra Area Health Service average of 44 percent.
Staff dedication to Weight Watchers at Work resulted in some radically tailored solutions, including the relocation of meetings to theatres to enable clinicians to attend together in their theatre scrubs.
nursing at SV&MHS Nursing staff from across St Vincents & Mater Health Sydney (SV&MHS) continue the proud traditions of the Sisters of Charity and Sisters of Mercy in providing care and compassion to the sick and needy for over 150 years. Under the leadership of the Directors of Nursing, the individual facilities of SV&MHS provide a supportive environment in which nurses are able to make a genuine difference to the lives of patients while further developing their professional knowledge and skills. SV&MHS supports the ongoing professional development of nurses to enrich the quality of care whilst also significantly elevating staff satisfaction and enhancing recruitment and retention prospects. St Vincents & Mater Health Sydney employs registered nurses, enrolled nurses and assistants in nursing, all of whom make a significant contribution to clinical excellence in nursing and patient care, nursing research, undergraduate and postgraduate nurse education and professional development. In 2009 SV&MHS partnered with the Australian Catholic University (ACU) to officially launch SV&MHS ACU Nursing Research Institute. The joint venture empowers nurses to lead multidisciplinary research and marks the start of a bright and vibrant future for nurse led, clinically focused research centred on patient outcomes.
St Vincent’s Hospital The Division of Nursing at St Vincent’s Hospital continues to develop areas of education, research as well as quality and risk, whilst ensuring continuity of excellence in patient care. Fostering clinical development, the Division provided over 110,000 valuable hours of clinical placements to undergraduate nursing students throughout 2009. Incorporating many of the key outcomes and recommendations of the Garling Report and the Caring Together NSW Action Plan; the Essentials of Care (EOC) program was rolled out on Xavier Nine South with other wards set to follow in 2010. EOC provides a framework for health professionals to explore and enhance current clinical practice and practice environments. In addition, the Hospital’s Nursing Unit Managers attended ‘Take the Lead’ development programs, which complemented their tertiary qualifications. In line with recommendations from the Caring Together NSW Action Plan, the Hospital recruited Clinical Support Officers (CSOs), the role supports clinicians at the ward level and to date all CSOs are enrolled in Certificate III Health Administration. Led by the Nursing Workforce Unit, 2009 saw the roll out of the new St Vincent’s Hospital nurse, ward service assistant and ward person uniforms. Unique, the uniforms assist patients in identifying staff. In 2009 the Hospital’s nursing casual pool increased by approximately 45 percent with many members of the pool undertaking professional development opportunities. Implementation of the multidisciplinary project Patients with Acute Condition for Escalation (PACE) commenced in 2009 with the appointment of a PACE Project Clinical Nurse Consultant. Initial statistics indicate the program’s success with a decrease in cardiac arrests and unplanned Intensive Care Unit admissions resulting from cardiac arrests.
Throughout the year enrolled nurses were encouraged to participate in a course to develop skills for the early recognition of deteriorating patients. In addition a short term project, initiated primarily by the Nurse Learning Support Service, enhanced the clinical practice of staff and improved the early recognition and management of deteriorating patients on weekends and after hours. The overall result was improved patient outcomes and clinical care. Embracing new technologies, the position of an Electronic Project Officer was established in October 2009 and will see the development and implementation of strategies for live e-learning programs for nurses. Changes in the Trainee Enrolled Nurse program will see the course moving towards a pre-service model whereby students attend TAFE and gain clinical experience as a supernumerary. The end of an era, St Vincent’s Hospital will see the remaining six Trainee Enrolled Nurse students complete the program in February 2010. A year of outstanding achievements, the Hospital’s Clinical Nurse Consultant of Infection Control was awarded the Credentialed Infection Control Professional by the Australian Infection Control Association. Paul Smollen’s achievement brought the number of Credentialed Infection Control Professional awards for NSW to two.
St Vincent’s Private Hospital St Vincent’s Private Hospital prides itself on the recruitment and retention of nursing staff. The Hospital’s reward and recognition strategies continue to deliver excellent outcomes and throughout 2009 the Hospital enjoyed a minimal vacancy rate of less than 3.5 percent. Promoting a positive learning environment, the Nurse Education Training and Development Council was initiated in April 2009.
The Mater Hospital
Valuing education, numerous nursing staff are undertaking postgraduate studies with the College of Nursing, the Australian Catholic University and the University of Tasmania. Patient satisfaction at St Vincent’s Private Hospital remains high at 96 percent, whilst Best Practice Australia revealed that 75 percent of staff believe the Hospital to be a ‘truly great place to work.’
Additional services now provided at the Mater have enabled the Nursing Division to diversify and provide experience in rehabilitation nursing (orthopaedics), orthopaedic day surgery nursing and neurological nursing in both the operating theatres and on the wards. Under the guidance of the Professor of Nursing Research at SV&MHS, the focus on developing nursing research at the Mater continued throughout 2009. The Maternity Unit was successful in its application for a grant from SV&MHS to conduct research into the provision of maternity services in the future. The Mater continues to participate in undergraduate nursing clinical placements, training enrolled nurses and provides workplace experience for postgraduate general nursing students and postgraduate midwifery diploma students.
Investing in graduates, 2009 witnessed a focus on recruitment with St Vincent’s Private Hospital harnessing its reputation and increasing the number of first round preference selection for graduates applying through the Nursing and Midwives Office, applicants increased by 53 percent. Quality and safety are at the forefront of all endeavours and in 2009 the Hospital worked to progress numerous projects with a focus on medication safety, falls management and prevention as well as pressure ulcerations and skin tear. In addition, the infection surveillance program was strengthened. All of these nurse sensitive indicators faired extremely well when benchmarked within the healthcare industry. The Hospital’s commitment to increase its practice development and research profile materialised with the dissemination of a practice development and research framework throughout all clinical units and active participation and contribution to the SV&MHS ACU Nursing Research Institute. In pursuit of excellence, St Vincent’s Private Hospital commenced its journey towards Magnet designation in May 2009 which is an internationally recognised framework for the continuation of enhanced nursing and clinical practice. The Hospital aims to be Australia’s first Magnet designated private hospital. With four main components: transformational leadership; structural empowerment; exemplary professional practice and new knowledge, innovations and improvements, the Magnet recognition program is considered a gold standard in excellence in patient care services.
The Mater Hospital focuses on rewarding nursing careers.
St Joseph’s Hospital The nursing administration at St Joseph’s Hospital supports the professional development of nurses, especially in their chosen area of clinical nursing expertise.
The Council leads the way in nursing education, training and development initiatives and innovations to support and transform nursing practice and patient centred care.
In 2009 a number of nursing staff were supported to further both their education and careers. Five enrolled nurses commenced a Bachelor of Nursing and an additional three received medication endorsement from the Nurses and Midwives Board NSW. The Hospital launched the Nursing Achievement Awards, presented on International Nurses Day the awards enabled all nursing staff to nominate individuals and/or groups for their achievements and willingness to participate in the Hospital’s activities.
community support The work of St Vincents & Mater Health Sydney (SV&MHS) is made possible through donations and support from the broader Sydney community and beyond. This assistance not only provides modern clinical environments and state-of-the-art medical equipment, it also helps SV&MHS to attract and retain some of the country’s best healthcare professionals.
The philanthropic contributions of many individuals, organisations, corporations and staff make the SV&MHS vision a reality. In 2009 alone, community supporters raised in excess of $8 million for SV&MHS. This significant achievement is accounted to the tireless advocacy and fundraising efforts of volunteer groups, supporters and staff.
Without community support SV&MHS would be unable to provide the very best in healthcare. SV&MHS sincerely thanks those who make its vision a reality.
Some key areas that benefited from bequest giving in 2009 were blood diseases and cancer research, oncology research, orthopaedics, cardiac and urology research, the Coronary Care Unit, the Heart Lung Unit and St Joseph’s Hospital.
Direct Marketing Appeals The services of SV&MHS are continually strengthened through the generosity of individual supporters. In 2009 over 6,000 individual gifts were received from donors responding to direct marketing appeals, with each appeal focusing on an area of immediate need. The financial support provided made a significant difference to the lives of the many people treated across SV&MHS and will continue to do so in the future. Throughout the year a range of services benefited from the generosity of the many individual supporters and new initiatives were made possible, including: • The planned purchase of an oncology patient information system for Haematology and Oncology Ambulatory Care (HOAC) at St Vincent’s Hospital. The new system will enable the HOAC team to access a single integrated view of a patient’s situation. • Contributions to the pioneering of a mechanical assistance program at the internationally renowned Heart Lung Transplant Unit at St Vincent’s Hospital. The program will enable the implantation of a totally artificial heart – a first for the Southern Hemisphere. • Enhancement of non-stop patient access to essential services at the St Vincent’s Hospital Stroke Care Unit. • Implementation of the new ‘Humanity, Healing and Hope Fund’ to help patients who simply cannot afford to cover the costs of the treatment for urgent, yet out of the ordinary healthcare.
In 2009 in excess of $3.8 million was generated through bequests. The much needed funds enabled SV&MHS to purchase vital medical equipment, expand activities and ultimately improve both treatment and outcomes for patients.
St Vincents & Mater Health Sydney expresses its sincerest gratitude to the individuals, and their loved ones, who have left bequests. In particular, the following are acknowledged:
St Vincent’s Hospital and the Sacred Heart Estate Joyce Allegretto Estate John Eiler Andersen Estate Barbara Mary Andrew Estate Lynette Belcher Estate Esther Blashild Estate Carolyn Marjory Bligh Estate Paul John Brady Estate Janet Scott Brown Buchan Estate Morson A Clift Estate Leura M Crombie Estate Ena May Edwards Estate Violet Falls Estate Morris Zion Forbes Estate Malcolm Gordon Gleeson Estate Elizabeth Gorman Estate Alan Greenwood Estate Isobel Hancock Estate Wilhelmina Hughes Estate Joyce Prudence Kelly Estate Margaret Eleanor Kenny Estate Erica Anne Larish Estate Joseph R Lawrence
Estate Ella O’Neil Estate Bernard D. Rothbury Estate Mary Therese Rudman Estate Helga Ryan Estate June Somerville Estate Dorothy Peace Springett Estate Frederick Charles Vessey Estate Ralph G Winkler Estate Thomas Christopher Wright Estate Radiance Apsley Young St Vincent’s Private Hospital Estate Hans Lewin Estate Phyllis May Peardon Estate Reschs Family Trust Estate Margaret Judy Maitland Roy Estate Frank Maxwell Wootten The Mater Hospital Estate Joyce Allegretto Estate James Bonnar McBurney Estate Grace Mary Mitchell Estate Shirley Marguerita Rumble
St Vincents & Mater Health is indebted to the many individuals and community groups who support the organisation through fundraising initiatives. The generous spirit of giving and the commitment of many donors and community groups enable SV&MHS to realise its vision of excellence in clinical care, teaching and research through the acquisition of new technologies and the further education and training of medical staff. St Vincents & Mater Health Sydney is very grateful to its many supporters, including: Australian Federal Police Over the past five years, the 450 police officers at David Stewart’s command have hosted trivia nights in aid of a number of charities. As principal recipient, St Vincent’s Hospital has received $100,000 and Commander David Stewart describes the donations to Medical Oncology and the Renal Unit as testament to the value placed by his team on St Vincent’s Hospital. Mrs Angela Desiderio Passionate about helping people touched by cancer Angela worked tirelessly to raise money for cancer research. Angela sadly passed away in July 2009. Furthering Angela’s belief that research will one day lead to a cure for cancer, close friend, Mrs Josephine Minni, continues Angela’s work.
The Australian Wine Dinner, established by Judy in 1966, is a major event in the restaurant and catering industry’s calendar and will continue to be held in support of the Judy Hirst Memorial Foundation for cancer related palliative care at the Mater Hospital. David Hobbs Through ‘Kayak for a Cause’ David Hobbs supports palliative care nursing at the Patricia Ritchie Centre at the Mater Hospital. Malinda Jarry Fund Established in memory of Malinda Jarry, the nursing education trust fund within St Vincent’s Hospital Intensive Care Unit (ICU) has funded over 30 critical care scholarships and more than 60 nurses to attend ICU conferences. The Mater Lives Committee Formed in 1985 by a group of volunteer women, The Mater Lives Committee donated $365,000 to the Mater Hospital in 2009. Raised through fundraising events, the monies were generously contributed towards the refurbishment of the Hospital’s foyer and the ‘Healing Garden.’ The garden is a valuable addition to the Hospital and offers a place of quiet reflection for patients, family, friends and staff. In collaboration with The Friends of the Mater Foundation, the Committee raised in excess of $150,000 at the Mater Race Day for the purchase of a central foetal monitoring unit.
Since 2001 over $140,000 has been raised through donations, charity raffles and the ‘Love of Life’ charity dinner. The fundraising enables research activities within Medical Oncology at St Vincent’s Hospital.
The Order of Malta The Order of Malta has provided vital financial support for Gorman House since 2005. This support guarantees Gorman House’s service as a 24/7 operation.
Ian and Doris Grant In memory of their daughter Fiona Grant, Ian and Doris Grant regularly host jewellery market stalls at St Vincent’s Hospital. All proceeds go towards bowel and ovarian cancer research at St Vincent’s Hospital.
Gorman House offers ongoing, non-judgemental support and refuge for those with severe drug and alcohol dependency. Through Blake Dawson & Waldron the Order also coordinates free legal advice to residents and provides volunteers to accompany residents to legal proceedings.
Judy Hirst Memorial Foundation In November 2009 the Judy Hirst Memorial Foundation was relaunched in memory of Rob Hirst’s late wife Judy.
community support George and Effie Paliouris Assisted by Dimitra Gallos, George and Effie Paliouris organise raffles and fundraising dinners with proceeds going towards improved patient care and new equipment for the Heart Lung Unit at St Vincent’s Hospital. Championed by Ms Fiona Coote AM since its inception in 2004, the fundraising gala dinner has been strongly supported by the wider community. Barry and Carol Pryer Over the past 14 years Barry and Carol Pryer have supported the Oncology Department at St Vincent’s Hospital and have furthered cancer research through the donation of proceeds from the sale of the ‘Entertainment Book.’ St Vincent’s Private Hospital Ladies’ Committee and the Clinic Foundation Since 1999 St Vincent’s Private Hospital Ladies’ Committee and the Clinic Foundation have supported the Sr Mary Bernice Research Grant. In 2009 the $100,000 grant was awarded to Professor Richard Day for his work on factors affecting the blood concentrations of metformin, a drug widely prescribed for the treatment of type 2 diabetes. In addition, the grant recipient for 2010 was announced as Associate Professor Reginald V N Lord who will undertake a study on specific genetic testing and its clinical value in treating patients with oesophageal cancer. The generosity of the Ladies’ Committee and the Clinic Foundation also assisted in the purchase of state-of-the-art medical equipment for St Vincent’s Private Hospital. George and Charis Schwarz In 2007 St Vincent’s Hospital established a rehabilitation initiative for patients injured in motorcycle accidents. Following the successful sale of their photographic journal ‘Highlights of the Road,’ the Motorcycle Accident Rehabilitation Initiative (MARI) was made possible through the generousity of George and Charis Schwarz.
To date MARI has proven successful in identifying riders in need of follow up with the rehabilitation and social work teams at St Vincent’s Hospital and provides invaluable statistical data on safety issues. MARI continues to be strongly supported by the Motorcycle Council of NSW and the BMW Touring Club. SIRENS Group Since its launch in 2001, SIRENS has tirelessly supported the needs of the Emergency Department at St Vincent’s Hospital. To date fundraising initiatives have resulted in the donation of over $6 million for the enhancement of equipment and educational resources. The support from SIRENS has directly and positively impacted on patient care. In addition, SIRENS made possible the upgrade of facilities and equipment within the Physiotherapy Department and the purchase of St Vincent’s Hospital’s first magnetic resonance imaging 3 Tesla machine. As St Vincent’s Hospital looks towards 2010 SIRENS prepares to raise funds for the refurbishment of the Emergency Department’s triage and bereavement room and the development of infrastructure for disaster preparedness.
Trusts and Foundations St Vincents & Mater Health is also generously supported by many trusts, foundations and prescribed private funds. This assistance enables SV&MHS to invest in new technology, equipment and research; all of which directly and positively impact on patient care. The Curran Foundation The Paul and Elizabeth Curran Foundation is a major benefactor to the St Vincent’s Campus. Since its inception in 1984 the Foundation has provided close to $11 million in grants.
Other major gifts and grants from the Foundation’s capital earnings, totalling over $750,000, have supported stroke care and stroke research, clinical training facilities and priority ward items. The Foundation continues to uphold its commitment to the Curran Foundation Intensive Care Unit at St Vincent’s Hospital and provided over $200,000 in critical care equipment and continued support for intensive care research throughout 2009. The Friends of the Mater Foundation Since 2001 The Friends of the Mater Foundation has provided the Mater Hospital with almost $2.8 million in grants. The grants of $387,042 in the past year have enabled the Mater to: •C ommence phase two research into the survivorship care plan in breast cancer. • Acquire a system for the prevention of hair loss during chemotherapy. • Develop a patient information video. • Conduct research to compare two internationally established techniques used in breast cancer sentinel node mapping. • Engage in two orthopaedic research projects. • Conduct research into blood use in elective major joint arthroplasty. • Evaluate a psycho-educational program for patients with high risk melanoma. Mrs Patricia Ritchie AM and family donated $200,000 for cancer research and teaching at the Mater and have committed in excess of $2 million for the relocation of the Patricia Ritchie Centre for Cancer Care and Research to larger premises.
Mr Les Shirato AM generously donated over $130,000 for the acquisition of equipment for the Special Care Nursery and a hydrotherapy pool for the Day Therapy Unit. A total of $151,000 raised at the Hospital’s Race Day in August will enable the installation of a centralised foetal monitoring system in the Mater’s Delivery Suite. The Nelune Foundation Established in 2003 founders of the Nelune Foundation, Nelune Rajapaske OAM and Anna Guillan, are committed to helping patients to fight cancer with dignity. The Foundation funds one part-time and two full-time clinical psychologists, a breast care nurse and a neuro-oncology nurse at St Vincent’s Hospital and provides patient transport services and non-funded post-operative medical aids and entertainment items for patients undergoing cancer treatment at St Vincent’s Hospital. Justin O’Connor Foundation In memory of the late Justin O’Connor, a former patient of St Vincent’s Hospital, the Foundation was formed in 2000 to raise funds for use in cancer research. To date in excess of $750,000 has been generously donated to the Hospital’s Blood Diseases and Cancer Research Unit for groundbreaking research into treatments. St Vincents & Mater Health Sydney looks forward to continued assistance from existing supporters and encourages others who may wish to provide vital aid for SV&MHS to contact the Fundraising Department on 1800 800 595.
Throughout 2009 the Curran Foundation’s special project program generated $3 million for the acquisition of the Toshiba Aquillion One 320 slice Cardiac Computed Tomography – the most sophisticated technology currently available for the instant and non-invasive assessment of heart disease.
St Vincent’s Hospital, Sacred Heart Hospice, St Vincent’s Private Hospital, the Mater Hospital, St Joseph’s Hospital and St Joseph’s Village all have Australian Taxation Office deductible gift recipient status. All donations of $2 or more are tax deductible.
group services Working in collaboration with the individual facilities that comprise St Vincents & Mater Health Sydney a number of Departments and services work across the Organisation to provide seamless support and ensure consistency in approach.
The Corporate Governance and Planning Unit provides planning and project management support to the St Vincents & Mater Health Sydney Board and the Chief Executive Officer in realising the strategic objectives of the Organisation. Working in a partnership model, the Unit has provided support for a number of key initiatives since its formation in July 2009. St Vincent’s Research Precinct In partnership with its research and teaching partners, St Vincent’s Hospital is leading the development of the St Vincent’s Research Precinct. Through a major investment in research, the aim is to closely align the development of novel diagnostic, treatment and prevention strategies to improve the prevention and management of disease consistent with SV&MHS’ healthcare Mission. Stage 1 Lowy Packer Building The Lowy Packer Building houses the St Vincent’s Centre for Applied Medical Research and the Victor Chang Cardiac Research Institute. Completed in October 2008, the building is now fully operational. Stage 2 St Vincent’s Hospital will continue to work with its research and teaching partners to develop the Stage 2 site of the Precinct following on from advice that the University of New South Wales will develop the Institute of Virology on its Kensington Campus. Stage 3 Garvan St Vincent’s Cancer Centre St Vincent’s Hospital and the Garvan Institute of Medical Research have completed detailed plans and the design of the Cancer Centre which will be housed on
the Stage 3 site of the Precinct. Department of Planning approval has been received for the project application with construction scheduled to commence on the $110 million facility in early 2010. Griffith Private Hospital As part of the St Vincents & Mater Health Sydney (SV&MHS) commitment to rural health, and following on from the preparation of a financial feasibility study, the Organisation has been working closely with Griffith City Council and representatives of the local community to develop service and facility plans for a small 40-bed private hospital in Griffith. Under the proposal, SV&MHS will operate the hospital which will be owned by Council. The aim is to fund the capital cost of the hospital through community donation and Government grants. Wollongong Private Hospital St Vincents & Mater Health Sydney is working with the University of Wollongong and NSW Health to explore the feasibility of establishing an academic health complex in Wollongong. Under the proposal, SV&MHS will operate the private hospital and potentially the collocated medical suites and primary healthcare centre forming part of the clinical, teaching and research complex. The development is subject to the receipt of a major capital grant from the Commonwealth Government. Campus Master Planning St Vincents & Mater Health Sydney has commenced clinical and capital master planning processes on each of its three campuses to provide an overarching direction for service and capital investment in the future.
Hospital, St Vincent’s Private Hospital and Sacred Heart through the provision of laundry and cleaning services as well as waste management and recycling. In addition, cleaning services are provided for St Vincent’s Clinic and the Victor Chang Cardiac Research Institute. Throughout 2009 considerable emphasis was placed on sustainability with moves to reduce the carbon footprint of St Vincents & Mater Health Sydney, initiatives included the ongoing recycling of batteries, mercury and film. In collaboration with the Infection Control Committee a number of new initiatives were implemented at St Vincent’s Private Hospital including the monitoring of clinical waste with a bin barcode system, the result has been a 10 percent reduction in clinical waste; the replacement of laundry chemicals with a new more environmentally friendly range and the introduction of new lighter and warmer blankets which have increased patient satisfaction. A green cleaning audit highlighted the success of St Vincent’s Private Hospital in implementing environmental innovations and systems. At St Vincent’s Hospital cleaning services were extended to the weekends and, to enhance staff safety and space, a new cardboard compactor was installed. In collaboration with TAFE, Environmental Services developed a customer service DVD to enhance staff relations with patients and visitors. Furthermore, staff members are afforded the opportunity to advance their skills with Certificate III programs.
Financial Performance and Analysis
Environmental Services caters for the environmental needs of St Vincent’s
The Financial Performance and Analysis Centre provides management accounting
Corporate Governance and Planning Unit
support for St Vincent’s Private Hospital, the Mater Hospital and to the Chief Executive Offices of St Vincent’s Clinic and the Melanoma Institute Australia. Throughout 2009 the Centre provided financial support for a number of major strategic initiatives, incorporated a clinical costing process for departments at St Vincent’s Private Hospital and the Mater Hospital and introduced a tailored financial model for the establishment of the Mater Orthopaedic Day Surgery.
Group Purchasing and Supply
Catering for the nutritional needs of all inpatients at the Darlinghurst and North Sydney Campuses, the Department delivers a high quality meal service to improve nutritional status during hospital admission.
In 2009 the Department successfully integrated purchasing and supply functions into a Group Purchasing and Supply Department. Responsible for the storage, issue, delivery and receipt of items, the Department efficiently supports the operations of all facilities across St Vincents & Mater Health Sydney (SV&MHS).
Financial Services Centre
In 2009 a new computerised bedside service replaced the paper based menu system at St Vincent’s Private Hospital. Wireless, the computerised system delivers significant service and clinical benefits including face-to-face contact with nutritional staff and patients and the early identification and referral of patients at risk of malnutrition. Following success at St Vincent’s Private Hospital the computerised bedside service has since been established at St Vincent’s Hospital and Sacred Heart.
Providing financial services to St Vincents & Mater Health Sydney, the Centre incorporates accounts payable, accounts receivable, billing, credit control, financial accounting, revenue, tax and treasury activities.
A review of food distribution at Sacred Heart resulted in the development of a plan to alter the Centre’s meal distribution system. The revised system will improve the patient meal service, whilst also creating additional space for clinical development.
This year the Centre processed over 140,000 invoices and raised over 60,000 patient bills. The team prepared audited financial reports for over 14 separate entities, some on a pro bono basis.
The Terrace Café at Sacred Heart was renovated in 2009 and services were upgraded. Staff cafeterias and the Wintergarden, at St Vincent’s Clinic, continue to see improved customer satisfaction.
Recognising the value of education, the Centre mentored a number of students from the accounting body CPA Australia.
New auditors Ernst & Young were appointed during 2009 in an effort to consolidate auditors for St Vincent’s Health Australia with one national firm.
At the Mater Hospital a supper menu was established for patients on the Maternity Ward. All staff are afforded the ongoing opportunity to further their education with Certificate III TAFE programs.
Throughout the year the Department implemented a number of initiatives to cater for the individual needs of each unit across SV&MHS. These included the cataloguing of prothesis for the Peri-Operative Services at St Vincent’s Hospital and introduction of direct delivery of goods and services to the Mater Hospital’s Day Surgery and Endoscopy Unit.
Human Resources The Department of Human Resources (HR) adopts the term ‘business partner’ as a fundamental approach to all activities and their measurement. In a shift away from the traditional HR functions, the Department assists managers in delivering a stronger, more competitive business by helping them to make the best use of their people. It provides expert specialist knowledge of leading edge HR solutions at an operational level. HR professionals work closely with business leaders to influence strategy and steer its implementation.
Servicing St Vincents & Mater Health Sydney, the Information Technology Service Centre continues to develop and implement the deLacy clinical information system at St Vincent’s and St Vincent’s Private Hospitals. The system supports multidisciplinary care teams and quality patient care through the provision of clinical communication, effective and efficient processes and risk identification and management. Following successful commercialisation and being re-badged Emerging Health Solutions, the system will be implemented across all South Australian public hospitals in 2010. In 2009 St Vincent’s Hospital extended its implementation of the electronic medication management system, MedChart. MedChart replaced paper based prescribing with electronic prescribing and includes a clinical pharmacy review, medication administration recording, sophisticated real time decision making, configurable rules and alerts, safety and quality reporting and electronic transfer of prescriptions and charts. The Centre implemented a radio frequency identification tracking system across the Darlinghurst Campus. The system aids identification and location of crucial equipment. Other successful projects include installation of a radiology information and digital x-ray system at St Vincent’s and St Vincent’s Private Hospitals and the upgrade of numerous hospital websites.
Management Accounting Supporting both St Vincent’s Hospital and Sacred Heart, Management Accounting provides a range of services including the preparation of annual budgets, reporting on financial performance at both Hospital wide and program level, development of revenue initiatives and the provision of case mix costing information. Throughout 2009 the Department was heavily involved in the establishment of the new case mix funding model which rolled out across NSW; participated in a hospital wide assessment into the tracking and use of prosthesis, the process will result in more accurate costing at the patient level, whilst also reducing prosthesis costs and developed a key performance indicator report to enable the Hospital’s executive to access both financial and non financial information in an easy to read format.
Medici Graphics In 2009 Medici Graphics continued to support services across the Organisation. Working closely with Internal Communications, Medici Graphics was responsible for the introduction and production of a group wide staff magazine ‘Health Spirit.’ Benefiting all facilities the production of a full colour publication created a medium for cross campus communication.
Medici Graphics contributed significantly to the roll out of the St Vincent’s Private Hospital centenary celebrations. Developing material for all centenary events, Medici Graphics designed the centenary theme which was inspired by the angel etched onto the Hospital’s chapel doors; the centenary book, ‘compassionate Care 100 Years of St Vincent’s Private Hospital;’ and much more. Servicing all facilities, Medici Graphics is currently conducting a brand review. The review will identify use of the corporate brand across various mediums. Results will enable the development of a consistent and practical approach to branding, decrease complexity and reduce costs.
Security Services The Department operates a 24 hour, seven days per week service to proactively support staff and manage safety across the St Vincent’s Campus. Flexible and adaptable, the team provide rapid assistance to emergency and/or security incidents.
Information Technology Service Centre
Security Services assist clinical staff in the management of patient behaviour, maintain and test security systems, conduct 24 hour proactive security patrols and secure buildings after hours. Throughout 2009 many of the electronic security systems were aligned to provide users with uniform access across the St Vincent’s Campus.
St Vincents & Mater Health Sydney 406 Victoria Street, Darlinghurst NSW, 2010, Australia www.svmhs.com.au
St Vincent’s Hospital 390 Victoria Street, Darlinghurst NSW, 2010, Australia P + 61 2 8382 1111 F + 61 2 9332 4142 www.stvincents.com.au
St Vincents & Mater Health Sydney (SV&MHS) sincerely acknowledges all staff, patients and volunteers for their participation. The 2009 SV&MHS Annual Review was produced by the Public Affairs & Communications Department of SV&MHS.
170 Darlinghurst Road, Darlinghurst NSW, 2010, Australia P + 61 2 8382 9444 F + 61 2 8382 9518
Editor David Faktor
St Vincent’s Private Hospital
Design & Art Direction Graphic Surgery
406 Victoria Street, Darlinghurst NSW, 2010, Australia P + 61 2 8382 7111 F + 61 2 8382 7234 www.svph.com.au
Mater Hospital Rocklands Road, North Sydney NSW, 2060, Australia P + 61 2 9900 7300 F + 61 2 9959 4110 www.matersydney.com.au
St Joseph’s Hospital Normanby Road, Auburn NSW, 2144, Australia P + 61 2 9649 8941 F + 61 2 9649 7092
St Joseph’s Village 21 Alice Street, Auburn NSW, 2144, Australia P + 61 2 9649 6699 F + 61 2 9649 9614 www.stjosephsvillage.com.au
Writer and Production Coordinator Denise Coughlan
Photography Mediakoo For all inquiries contact: SV&MHS Public Affairs & Communications P +61 2 8382 2866 E firstname.lastname@example.org St Vincents & Mater Health Sydney Ltd ABN 36 054 594 375 © 2010 St Vincents & Mater Health Sydney. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, internet, or otherwise, without prior permission of the publishers.
Together, we are stronger.
Together, we are united.
St Joseph’s Village | St Joseph’s Hospital | Mater Hospital | St Vincent’s Private Hospital | Sacred Heart | St Vincent’s Hospital